Garrett Lee Smith Tribal – Page 7 – Suicide Prevention Resource Center

Wichita and Affiliated Tribes

The Wichita and Affiliated Tribes, located in Anadarko, Oklahoma, will provide youth suicide prevention programming to Wichita Tribal members and American Indian youth in Caddo County. The service area will also include neighboring counties of Blaine, Canadian, Custer, Grady, and Washita although the area of focus will be Caddo County. The purpose of the Wichita and Affiliated Tribes (Wichita) Tribal Youth Suicide Prevention & Surveillance Project is to identify American Indian/Alaskan Native youth with risk factors for suicide, and engage these youth in comprehensive, culturally relevant services to prevent suicide attempts and completions. This project will achieve its purpose through a collective community-based surveillance effort, which includes components of community outreach and awareness, coalition development, system-wide training, screening, assessment, care coordination, comprehensive follow-up services, data collection, and ongoing quality improvement.

The Wichita and Affiliated Tribes will utilize current programs that heavily serve youth and existing relationships with service providers to accomplish the goals set forth below:

Goal 1: Increase awareness and understanding of suicide while concurrently reducing stigma associated with suicide through advisory board development and public education.
Goal 2: Engage the tribal community and partnering entities while developing support for the Wichita Tribal Youth Suicide Prevention and Surveillance program through coalition development, training, and outreach.
Goal 3: Develop the workforce to ensure the effective assessment and treatment of youth at-risk of suicide through expert training.
Goal 4: Implement community-based surveillance programming to identify at-risk youth and connect youth with Wichita Tribal Youth Suicide Prevention and Surveillance project.
Goal 5: Ensure effective treatment and coordination of care through comprehensive case management and follow up services.
Goal 6: Conduct surveillance and quality improvement on suicide attempts and completions

The Wichita Tribal Youth Suicide Prevention and Surveillance Program will identify, refer, follow-up and serve American Indian youth ages 10-24 with the intent to promote protective factors and reduce the risk of suicide in the community.

Washoe Nation

The Washoe Nation (WN) Health Clinic Healing Center’s youth suicide prevention and early intervention project will improve/expand upon strategies in behavioral health programs, educational Institutions, juvenile justice systems, and other child- youth-serving organizations for ages 10-24 struggling with trauma, depression, and/or suicidal ideation living in WN’s four reservation communities( Carson, Dresslerville, Stewart, and Woodfords) and surrounding areas. Services target Washoe and American Indian/ Alaskan Native youth and their family members in the community sitting. Prevention (improve response to suicide) includes informing participants, partners, professionals, and the public in effort to prevent, delay, reduce or eliminate suicide and promote wellness in the communities. It will include universal, selective and indicated prevention types. Strategies will include information dissemination (public awareness campaign), education, alternatives, early identification/referrals, capacity building, and environment (tribal codes). Quarterly community presentations, submission to the Health Centers newsletter, and community wide activities will take place in the communities. Early Intervention (screening and referral will increase our community’s ability to identify and refer youth at risk for suicide in multiple departments throughout the WN including, but now limited to, education , health, juvenile probation, recreation and social services ( including Tribal Temporary Assistance for Needy Families). Gatekeeper and Crisis Intervention training for 50 community providers, partners, and public takes place eight times per year (400 total). Early Intervention (assessment and services) will naturally result after a positive screen and referral. A school-based Mental Health Therapist will provide crisis intervention , assessment and treatment (including post-suicide intervention) onsite within the school system for an estimated 30 youth per year. Continuing Care Services (including post suicide intervention) will assist youth in transition (step down) from more intensive to less intensive services as they reconnect with their community. Behavioral Intervention Specialist (intensive services for very high risk) will provide behavioral modification with youth in community, school, office and home settings for approximately 20 youth total per year. Medical Social Worker will coordinate wraparound services with community providers to include, at minimum, screening, crisis intervention, care coordination, and family support for an estimated 75 youth and their family members at community- and office-based settings. Data collection and sharing will inform community members, leaders, partners, and professionals.

Wabanaki Health and Wellness

Wabanaki Health and Wellness (WHW), in partnership with Wabanaki Public Health (WPH) recognizes that there is an ongoing need to increase infrastructure support and capacity to adequately serve Native American youth from the five tribal communities in Maine (Aroostook Band of Micmac; Houlton Band of Maliseet Indians; Passamaquoddy – Pleasant Point; Passamaquoddy – Indian Township; and Penobscot Nation, are known as the Wabanaki, the People of the First Light). Additionally, it is necessary to improve the system of care for behavioral health treatment, suicide prevention, and recovery for community members. Equally important, is the level of ongoing supports and services offered to parents, guardian’s, and caregivers; many of whom lead single-parent households, living in rural areas who need assistance with the complexities of raising a family. WHW and WPH seeks funding to improve and increase suicide prevention programming with the ultimate goal of decreasing youth suicide attempts and completions. To do this, we are proposing a project that will substantially increase the capacity of the behavioral health system, improve the suicide data surveillance system, and improve and enhance the system of behavioral health care. This will be accomplished by (1) leveraging and expanding youth prevention strategies using evidence-based strategies to increase community engagement, (2) expanding current case management and peer programs (3) increase connections between Tribal providers (i.e. health clinic, juvenile justice, foster care, etc.) for screening and referral to services providing opportunities for early identification and intervention (4) conducting community, parent, and provider trainings to raise awareness and support, (5) building crisis intervention teams to provide support for attempted and completed suicides, (6) collaborating with a higher education partner, University of Nebraska Medical School to develop a youth mental health and suicide surveillance system, and (7) ensuring all activities are grounded in culture.

University of Montana/Fort Peck

The Sister Nations Empowerment Project (SNEP) will support the youth of the Fort Peck Assiniboine and Sioux Tribes and the agencies that serve them in their journey toward a suicide-safer community. A collaboration of the Tribes and the National Native Children’s Trauma Center (NNCTC), SNEP is a reservation-wide, multi-intervention program rooted in local wisdom, cultural practices, and evidence-based practices.

The project will build upon work successfully completed during SNEP’s initial GLS funding period of 2011-14 as well as during a no-cost extension year of grant work in 2015. The five-year grant proposed will target American Indian youth aged 10-24, including those identifying as LGBTQ or two-spirit, those with lived experience of suicide, and survivors. SNEP will be guided by four primary goals: 1) to increase the number of youth, school staff, juvenile-justice workers, elders, tribal leaders, and community members trained to identify youth at risk of suicide, refer them to clinicians, mitigate risk factors associated with youth suicide, and promote protective factors; 2) to increase the capacity of the reservation’s health-care system to provide evidence-based screening, treatment, and follow-up services for youth at risk of suicide, including those who receive treatment for substance-use and mental-health disorders; 3) to promote cross-system collaboration among the reservation’s youth-serving stakeholders, ensure community input and buy-in, and enhance ongoing cross-system data-collection efforts; and 4) to enhance public awareness of suicidal risk and behaviors and make suicide prevention a core priority of the reservation’s youth-serving system.

Funding will enable SNEP to accomplish the following objectives: placement of a clinician and wraparound transportation resources in the Tribes’ Health Promotion/Disease Prevention program; support for two clinicians in the private Northeast Montana Health Services hospital system; training of clinicians in contact, follow-up, and safety-planning protocols to ensure long-term safety of patients; implementation of screening and safety planning procedures for suicidal patients admitted to local emergency departments; the sustaining of a local elders’ mentoring group and of a youth advisory council to foster the incorporation of youth voice and leadership; the provision of traditional healing ceremonies; stakeholder and community trainings in suicide prevention and in addressing risk factors including mental illness, substance abuse, trauma, and bullying; the implementation of annual Community Readiness Assessments to enlist community ownership of the project; and the facilitation of cross-system collaboration and data collection. All Indirect Cost (IDC) charges are donated. An estimated 1,062 community members will be served per year, for a five-year total of 5,310.

Two Feathers Native American Families Services

The Two Feathers Native American Family Services of Northwest California, Chekws: Hope for Tomorrow (C-HFT) Project, serves American Indian (AI) youth ages 10-18 and their families in Humboldt County. The system-wide goal for C-HFT is to build an effective, collaborative and sustainable AI-focused mental health and substance use program within two school districts to prevent suicide and improve overall well-being for AI youth and their families. The C-HFT system will operate in partnership with Klamath Trinity Joint Unified School District (KTJUSD) and Northern Humboldt School District (NH), including 24 schools and over 1,200 AI students. C-HFT will also work closely with Humboldt County Department of Mental Health and Stanford Psychiatry, Stanford Center for Youth Mental Health and Well-Being to offer trainings on suicide assessment, prevention, and intervention, as well as telemedicine psychiatric services for acute cases in the schools. C-HFT will utilize evidence-based practice (EBP) interventions and treatment approaches, as well as locally defined, culturally infused practice based programs to increase the safety net of suicide prevention and interventions for AI’s living in Humboldt County. The C-HFT plans to serve 1000 youth through the following goals and objectives: Goal 1: Increase the number of culturally competent professionals able to identify and work with youth at risk for suicide. Two Feathers staff in collaboration with Humboldt County Department of Health and Human Services will provide culturally appropriate Mental Health First Aid Training to 80% of school personnel in both school districts. Goal 2: Improve prevention and early intervention for AI youth in the schools. Conduct screening with 200 AI youth annually, 1000 over the course of the 5-year project. Refer 20 parents of at risk youth per year to parent support groups. Refer 30 youth per year to local cultural groups, and 15 youth per school district annually to a trauma informed skills development group. Goal 3: Increase the engagement of youth and their families with accessible, culturally appropriate clinical service providers who can assess, manage and treat AI youth at risk for suicide. Conduct assessments with youth identified as needing a higher level of care based on screening outcomes or referrals form outside providers. Provide intensive therapeutic services to 75 youth per year. Goal 4: Increase culturally appropriate, post-suicide services for AI youth and their families. Provide direct crisis stabilization for all AI youth in the C-HFT school districts who have attempted suicide and their families through “”Family Intervention for Suicide Prevention”” services.

Tule River Indian Health Center

The Tule River Indian Health Center, Inc. (TRIHC) will implement the Tribal Youth Suicide Prevention (TYSP) Project. The TYSP Project will provide much-needed suicide prevention, assessment, and early intervention services for Native American youth (ages 10 – 24), who reside on the Tule River Indian Reservation in Tulare County (California), as well as other Native American youth (ages 10 – 24) from throughout Tulare County. The target population reports high levels of depression related feelings — 23.7%% in past month — and high levels of suicidal ideation — 17.1% in past month. The project will use three (3) evidence-based practices, including: Cognitive Behavioral Therapy (CBT); Interpersonal Psycho-therapy (IPT); and Eye Movement Desensitization and Reprocessing (EMDR). The project will also use culturally appropriate activities, including: sweat and healing lodges; smudging; teaching traditional ways; singing, dancing, and drumming; storytelling; traditional crafts; and traditional games. The goals of the project are to increase the number of educators, health care providers, emergency services personnel, and government agency personnel working with tribal youth in Tulare County who are aware of, and can identify the risk factors associated with, Native American youth suicides and provide early interventions and/or referrals as needed, as well as to increase the number of Native American who are provided with evidence-based suicide prevention, assessment, and early intervention services. At the conclusion of the five-year project period, at least 35% of educational and medical associations active in Tulare County will have incorporated suicide prevention screenings and training into their regular personnel training and patient assessments. Further, at the conclusion of the five-year project period, at least 250 youth will have completed treatment with at least 75% reporting positive long-term effects of the treatment and at least 75% of at-risk youth referred to the TYSP Project following an inpatient stay due to mental health issues will report their experience through the project as productive with a decrease in feelings of depression and ideas of self-harm.

Tanana Chiefs Conference

This project builds the capacity of four TCC subregions, located in the Interior region of Alaska, to prevent suicide and promote mental health among youth and young adults age 10-24 through extensive outreach, engagement, community involvement, and training in evidence-based strategies. Population to be Served: The Zhiiniidzelt’aey project, will serve four TCC subregions: Upper Tanana Subregion, Yukon Flats Subregion, Yukon Tanana Subregion, and the Yukon Koyukuk Subregion, which together include 29 tribal communities. The total population of the geographic catchment area is 6,222 and the population of youth and young adults age 10-24 in the geographic catchment area is 1,275. The population of focus is individuals age 10-24. This project will directly serve approximately 75% of the individuals between the age 10-24 (956 individuals) and will train and support 300 adults over the entire five-year project period. Strategies/Interventions: The Zhiiniidzelt’aey project will establish and support subregional Crisis and Wellness Response Teams to respond to and assist youth at risk of suicide; develop culturally-based uniform procedures to identify and assist youth at risk of suicide, respond to crises, provide postvention, reduce access to means, and increase resources for communities to address suicide; develop and implement trainings and assist youth at risk of suicide, respond to crises, and provide postvention; hold subregional healing ceremonies to promote a sense of belonging and foster supportive relationships; develop and implement youth prevention activities to identify and assist youth at risk of suicide; provide activities at subregional wellness camps for youth and adults; and to development and implement a case management program to ensure that at-risk youth access behavioral health services and families receive support. Project Goals and Measurable Objectives: The overarching goal of this project is to increase the number of youth and young adults at risk of suicide who are referred and admitted to behavioral health services. To meet this goal, this project will focus on two goals: 1) To increase the capacity of tribal communities to identify, prevent, and respond to youth suicide and 2) To increase access of youth ages 10 to 24 to behavioral health services. Our objectives include training four subregional Crisis and Wellness Response Teams to implement culturally-based uniform procedures; training tribal leaders in the geographic catchment area (tribal council members, tribal employees, school personnel, and behavioral health and primary care providers; approximately 300 individuals) to identify and respond to suicide warning signs among youth ages 10 to 24; to engage youth (approximately 956 individuals) ages 10 to 24 in suicide prevention and intervention activities; to engage youth (approximately 200 individuals) referred for suicide ideation or risky behaviors will have received case management services to improve their access to and use of behavioral health services; and to engage youth (approximately 956 individuals) in early intervention and assessment services.

Southcentral Foundation

Southcentral Foundation (SCF) will continue to work with other youth serving organizations throughout southcentral Alaska to encourage suicide prevention as a top priority. This project proposes to serve the estimated 9,400 Alaska Native/American Indian (AN/AI) Youth in the targeted age group. The goal for the next five years is to enhance direct suicide postvention and prevention services for youth ages 10-24, promote organizational change, increase suicide prevention capacity, and improve continuity of youth integrated health care throughout the region. The population of focus are AN/AI youth ages 10 to 24 living in Anchorage and in several remote rural southcentral Alaska villages. With SAMHSA support for the past five years, SCF’s Preserving the Future Program has made positive impacts with Anchorage with the National Strategy and Zero Suicide prevention strategies by increasing the number of youth identified at risk of suicide and referred to services, increasing training opportunities for youth-serving organization and initiating organizational system change as well as further promoting the National Suicide Prevention Lifeline. The approach will be to: 1) build awareness and network by attending twenty outreach events and sharing resources with 10,000 youth, their families, and other community members each project year and by providing a major public awareness campaign during the project period; 2) provide culturally appropriate suicide prevention, interventions, and postvention trainings to 480 or more staff from at least ten youth-serving organization each project year; 3) provide four life skills development sessions each month to a total of 200 youth each project year using SAMHSA approved curriculum that develops social, emotional, and positive thinking skills; 4) help 400 youth each project year to build healthy habits and lifestyles that includes physical and mental health care by providing eight culturally resonant wellness trainings each month; 5) support 400 youth each project year to build resiliency by using ten cultural activities to share approaches to dealing with trauma and stress; 6) provide 200 youth with early suicide intervention and assessment services such as screening, referral, follow-up, mental health and substance abuse counseling, and case management services each project year; and, 7) collect and analyze data and evaluate the project to assess need for system changes, improve practices that include evidence-based suicide care and culturally appropriate treatment services, and add to the National Outcomes Evaluation each project year.

Saint Regis Mohawk Tribe

Saint Regis Mohawk Tribe Mental Health Services will partner with 4 youth serving programs to expand the mental health screening, referrals and treatment for youth ages ten to twenty four who are at risk for suicide in Akwesasne. We will work with the local school district where we already have 2 school based satellite mental health clinics, Akwesasne Girls and Boys club, division of Community and Family Service and the Alcohol and Chemical Dependency Programs to expand our screening and treatment capacity. Youth and parents/guardians who consent to completing a screening tool will be given results of their screening and offered services. We provide training in youth mental health issues, suicide prevention, intervention and postvention to the school staff, agency personnel, youth and their families using trainings such as Question, Persuade, Refer, Connect and Youth Mental Health First Aid. Expansion of behavioral health staff will also be a priority. We will hire an additional therapist, youth care coordinator, traditional support worker and increase psychiatric prescribing ability. Training of behavioral health staff in effective screening and treatment of youth who are at risk of suicide will increase our expertise and capacity to save lives and reduce the trauma that occurs in our small community when there is an unexpected youth suicide in Akwesasne.

Sacramento Native American Health Center, Inc.

The purpose of the Sacramento Suicide Prevention & Early Intervention Initiative is to strengthen protective factors to decrease Native youth suicide in the Sacramento, California region. Sacramento Native American Health Center (SNAHC) serves Sacramento’s American Indian and Alaska Native (AI/AN) people as well as members of the local community. SNAHC will serve 250 youth AI/AN ages 10-24, their families, community members, partners and gatekeepers each year and 800 unduplicated individuals over the life of the grant. Programming will be based in SNAHC’s Behavioral Health Initiatives and Services Department, which integrates AI/AN youth prevention programming, early intervention services, and behavioral health treatment, and will build off existing work to expand suicide prevention, screening, assessment, early intervention and postvention services for AI/AN youth 10-24 and their families in Sacramento County. The project goals include: 1) advancing community readiness to address suicide among AI/AN youth 10-24 and their families in Sacramento County; 2) strengthening suicide preventative factors among AI/AN youth 10-24 and their families; and 3) strengthening SNAHC’s clinical and system response to suicide risk, attempts, and postvention. SNAHC will build new partnerships to address suicide prevention and early intervention needs through the formation of the Community Suicide Prevention Coalition. SNAHC will also engage existing partners: the Multi-Agency Partners consisting of county-wide stakeholders; the youth, parent, and evaluation Advisory Groups; and the Intersegmental Group, representing local educational systems that serve AI/AN. Strategies and interventions to be used will include both Evidence-Based and Community-Defined Practices to best address suicide risk among urban AI/AN youth. Practices already underway include PHQ-9 Screening for depression, Question, Persuade, Refer (QPR), Applied Suicide Intervention Skills Training (ASIST), Youth Mental Health First Aid, and Mental Health First Aid. The direct therapeutic service practice will be Healing the Circle – Mending the Child, a culturally adapted Trauma-Focused Cognitive Behavioral Therapy for AI/AN. Prevention work will use the Gathering of Native Americans curriculum and trainings from Native Wellness Institute Curriculum, We R Native, Native Stand and the Native Youth Sexuality Network. Social marketing approaches will be engaged on a peer-to-peer model to promote positive social messages. Objectives include: training 250 providers, Gatekeepers, and community members; developing a youth peer mentorship program serving 9 youth per year; providing suicide prevention screenings at out-reaching community events; providing early intervention services to 50 youth per year; providing postvention services; providing a Youth Safe Space to 80 youth per year; providing a Family Gathering of Native Americans to 80 AI/AN community members; providing regular talking circles for teens; creating peer-based social marketing materials; providing life skills training to 15 transition-aged youth per year; and building on our Tribal Youth Suicide Prevention work to strengthen clinical referral processes and postvention services.