Garrett Lee Smith Tribal – Page 10 – Suicide Prevention Resource Center

New Hampshire

Leveraging the innovative Integrated Delivery Networks (IDNs) created through New Hampshire’s 1115 Waiver Project and the corresponding Regional Public Health Networks (RPHNs), NAMI New Hampshire and its project partners have designed New Hampshire Nexus Project 2.0 (NHNP2), a cross-systems, collaborative approach to reduce suicide incidents among youth by improving pathways to care and offering comprehensive training to provide youth-serving organizations with the resources to identify, screen, refer, and treat at-risk youth. Population to be served: Based upon the most recent NH youth suicide data, NHNP2 will focus on youth/young adults ages 10-24 in IDN 2 (Capital) and IDN 7 (North Country/Carroll County). IDN 2 reported 14.5 youth suicides per 100,000, while IDN 7 reported 12.3 per 100,000. Both regions are higher than the US rate of 10.57 per 100,000. These 2017 rates indicate a 67% increase in Region 2, and a 50% increase in Region 7 since 2016. Strategies: 1. Leverage the infrastructure of NH’s IDNs to enhance functional inter-agency care systems and improve care coordination, continuity of care, and provider communication. 2. Enhance the ability of child and youth-serving organizations to recognize and engage youth at risk of suicide; establish referral pathways and cohesive procedures that connect high risk youth with appropriate services; and increase the capacity of communities to respond to suicide risk in a timely manner. 3. Build upon existing public/private partnerships to enhance the statewide capacity to recognize and respond rapidly and appropriately to suicide risk among youth/young adults. Goal: Reduce suicide incidents among youth/young adults by strengthening cross-systems collaboration, improving pathways to care, and offering comprehensive training opportunities that provide youth-serving organizations with the resources to identify, assess, refer, and treat at-risk youth. Measurable objectives: 1. Develop a Care Liaison role in each region to facilitate pathways to care for high-risk youth/young adults. 2. Leverage technology to advance screening and assessment and improve care coordination and cross-systems communication. 3. Convene and train regional implementation teams comprised of providers serving high-risk youth in suicide prevention/intervention/postvention. 4. Engage regional teams in planning to build infrastructure around best practices for suicide prevention/postvention. 5. Develop youth/young adult leadership in regional youth suicide prevention efforts. 6. Engage statewide organizations that interface with at-risk youth/young adults in suicide prevention/postvention training and planning. 7. Promote safe messaging in accordance with the NAASP framework. 8. Enhance and expand NSPL Lifeline follow up calls. Number to be served: The project will train an estimated 10,456 stakeholders and providers working in child and youth-serving organizations in suicide prevention, intervention, and postvention. The Care Liaison will work with approximately 60 high-risk youth/young adults annually. Approximately 10,756 individuals will be served over 5 years (Yr. 1 = 2,106; Yr. 2 = 2,302; Yr. 3 = 2,159; Yr. 4 = 2,038; Yr. 5 = 2,151).

Nebraska

The purpose of Nebraska’s proposed project is to reduce the number of suicides and attempts for youth ages 10-24 with a focus on outreach to15-24 year olds because their suicide rate is increasing in Nebraska, exceeding the US rate. Prevention activities are concentrated in southeast Nebraska because the youth suicide rate for this area is over the state and US rate. We reach the entire state by including suicide prevention in coordinated school health plans for K-12 schools and workforce development for clinicians serving youth in crisis. Nebraska will promote the zero suicide approach for health and behavioral health organizations along with evidence based strategies and practices to prevent youth suicide. The project has four goals. 1) Decrease the youth suicide rate 80% in Region 5 by 2024. 2) 100% of Nebraska public school districts will have policies and protocols in place for suicide prevention, post-suicide intervention, and transition back to school after a suicide crisis by 2024. 3) Twenty (20) Nebraska providers or healthcare systems will implement the zero suicide approach by 2024. 4) 100% of Nebraska’s child serving systems will adopt evidence-based practices to follow-up with youth after a suicide attempt or hospitalization by 2024. During the course of the grant we will reach 70,000 15to 24-year-olds in Region 5, and embed suicide prevention practices in 244 school districts reaching 187,000 public school students in grades 5-12 statewide. We will train at least 200 clinicians by introducing 30 organizations to the zero-suicide initiative, embed suicide screening with school psychologist services in 17 educational service units and 12 treatment organizations, We will implement evidence based follow-up after youth experience a suicide crisis in five child serving systems and two healthcare systems, and implement evidence based post-suicide intervention practices on five post-secondary campuses impacting lives of 40,000 college age students.

Native American Health Center, Inc.

The Native American Health Center’s Zero Suicide project will use a culturally competent, holistic care coordination model to reduce suicidal behaviors for AIAN and other underserved community members ages 25 and older living in the San Francisco Bay Area. Programing will strengthen organizational ability to effectively identity and treat community members at-risk for suicide by expanding suicide prevention, intervention, and behavioral health programing. Project activities will include the implementation of the Zero Suicide Model within NAHC’s suicide prevention framework. Project goals and measurable objectives are as follows:

Goal 1. Strengthen NAHC suicide prevention and treatment programming framework. Objectives include: 1. Provide 2 multi-departmental trainings in QPR and crisis intervention annually; 2. Engage suicide prevention projects across target populations thorough quarterly collaboration meetings; 3. Review and revise (if necessary) agency suicide prevention plan and disseminate findings using Zero Suicide Organizational Self Study annually; and 4. Enhance suicide assessment and treatment systems capability within NAHC’s E.H.R system in Year 1.

Goal 2. Strengthen NAHC’s treatment response to suicidal ideation and/or attempts for the target population by providing outpatient clinical behavioral health services. Objectives include: 1. Conduct screening, assessments, reassessments, and follow-ups to 1200 members annually; 2. Provide evidence based individual counseling and case management to 200 members annually; 3. Develop suicide care management plans for 200 members annually; 4. Provide internal referrals to substance abuse counseling and/ or mental health counseling services, prevention groups and recovery support services to 300 members annually; and 5. Provide rapid-follow-ups to 25 members annually.

Goal 3. Strengthen NAHC’s prevention response to suicidal ideation and/ or attempts for the target population by providing community based prevention services. Objectives include: 1. Provide community based suicide prevention outreach, support, at AIAN cultural events and activities to 500 members annually; 2. Provide intergenerational suicide prevention and recovery support group for 25 members annually; and 3. Engage 1-2 community volunteers to serve as program advisors. This project will use a variety of interventions including the NAHC developed Holistic System of Care for Native Americans in an Urban Environment; Question, Persuade, Refer Gatekeeper Training; Cognitive Behavioral Therapy, Dialectic Behavioral Therapy, and Eye Movement Desensitization and Reprocessing to 200 members annually and 1,000 members over the life of the project.

Native American Development Corporation

Billings Urban Indian Health and Wellness Center (BUIHWC) under the nonprofit status of Native American Development Corporation (NADC) will be submitting a SAMHSA Garrett Lee Smith State/Tribal Youth Suicide Prevention & Early Intervention Grant application. The purpose of this project will be to implement youth suicide prevention and early intervention strategies. The purpose of this project, submitted by the Native American Development Corporation (NADC) and the Billings Urban Indian Health and Wellness Center (BUIHWC) is to achieve measurable reductions in suicides among American Indian (AI) youth, ages 10-24 years of age, through implementation of the Zero Suicide model and culturally appropriate programming in five Montana (MT) cities served by Urban Indian Health Centers (UIHC). BUIHCW will lead and launch the project, Standing Buffalo Strong, in Billings, MT, which has the largest AI total and youth population. Billings is the largest community in MT—located nearby the Crow and Northern Cheyenne Reservations—has three major health care providers, a Veterans Administration clinic and is the largest medical/health community in the state. It is also a regional commercial center, attracting large numbers of AI families and children seeking diverse services. The following chart provides population data for Billings and the 4 other communities served by UIHC. Major Goal: To implement a culturally appropriate suicide prevention care model at the 5 Montana Urban Indian Health Centers (MUIHC) to ensure all AI youth, ages 10-24 years and their families receive immediate, safe and personalized suicidal care. To accomplish this, NADC/BUIHWC will lead and implement the Zero Suicide model and culturally appropriate treatment/services to achieve (or facilitate) a cultural shift away from fragmented suicide prevention and care toward a comprehensive approach. Working with the other 4 UIHC, along with developing a network and commitment from health care providers, community organizations and educational institutions in Billings, Helena, Missoula, Great Falls and Butte. With these partners, BIUHWC will be able to introduce AI youth suicide prevention efforts that include traditional and cultural treatments/services. This was identified by the MNYSRSP as a gap in suicide treatment. BUIHWC, as it takes on the leadership role in working on the youth, i.e. 10-24 year population, will coordinate with both the State of Montana, DPHHS Zero Suicide grant/program funded by SAMSHA (targeting AI over 25 years) and the ongoing MNYSRSP efforts. BUIHWC work will be complimentary, focusing on off-reservation youth and their families.

National-Louis University

National-Louis University, a broad-access institution in Chicago, proposes NLU-SPI, a suicide prevention approach in which a network of internal and external partners will develop a university-wide process for responding to students’ mental health needs; oversee training for staff and students; implement social media and other outreach to increase awareness of services; and increase knowledge of how to understand and respond to the impact of adverse childhood experiences (ACES). The project will focus on three vulnerable populations: an undergraduate program designed specifically for first-generation, predominately low-income students; veterans and military-connected family members; and young adults with intellectual and multiple emotional disabilities. Over 1,500 primarily African-American and Hispanic students will be served annually, for a total of 4,500 students over the three years of the project. The six project goals are:

Goal 1: Create a comprehensive infrastructure and collaborative network of internal and external partners that will establish a proactive and cohesive plan to monitor and respond to student mental health needs;
Goal 2: Implement a comprehensive training program to increase student, faculty and staff capacity to recognize and effectively respond to warning signs of self-harm, suicidality, and substance abuse in others;
Goal 3: Increase student knowledge of mental and substance use disorder services by developing a student outreach plan focusing on the three target populations;
Goal 4: Increase student access to voluntary mental and substance use disorder screenings and assessments;
Goal 5:Increase student knowledge of the National Suicide Prevention Lifeline (TALK) as well as others other relevant lifelines;
Goal 6: Create a Trauma Informed culture that starts with an understanding of the life-long impact of Adverse Childhood Experiences (ACEs). The impact objectives focus on increasing faculty, staff and student knowledge and changing responses to mental health needs:
By Y3/Q4 faculty, staff and students will show a 20% increase over Y1 baseline in knowledge about how to recognize and effectively respond to warning signs of self-harm, suicidality, and substance abuse in others;
By the end of Y3/Q4 there will be a 20% increase over Y1 baseline in faculty and staff reporting on student mental health needs;
By the end of Y3/Q4 students will show a 20% increase over Y1 baseline in knowledge about mental and substance use disorder services as measured by SPEAKS survey, designed for GLS campuses.
By Y2/Q4, students will show a 25% increase over Y1 baseline data in participating in voluntary mental and substance use disorder screenings and assessments

National University

National University Wellness Program National University (NU) is proposing to implement the

NU Wellness Program, including the creation of NU’s first cross functional Campus Assessment Response and Evaluation (CARE) team with Wellness resources, such as individual case management, assessment, online treatment opportunities, and referral services for the targeted community. The target population of the program includes all current students attending NU either onsite or online, both undergraduate and graduate. A total of approximately 29,000 students. NU is a Hispanic serving institution with a Latino population of 25%. Ten percent of the population is African American; 58% are female, and 21% are Veterans/Active Duty Military. The Program will augment its current infrastructure to improve effective identification, intervention, and prevention services for all students, including those at risk for the development of suicidal behavior, serious mental illness, and/or substance-related overuse or injury.

Activity #1: Create a network infrastructure to link the institution of higher education with appropriately trained behavioral healthcare providers and community stakeholders.

Activity #2: Train college students, faculty, and staff to respond effectively to college students with mental and substance use disorders.

Activity #3: Administer voluntary mental/ substance use disorder screenings and assessments.

Activity #4: Provide outreach services to inform and notify college students about available mental and substance use disorder services.

The goal of the proposed program is: The NU Wellness Program will augment its current infrastructure to improve effective identification, intervention, and prevention services for all college students, including those at risk for the development of suicidal behavior, serious mental illness, and/or substance-related overuse or injury.

Objective #1 – By month three, develop and implement a centralized reporting system and awareness trainings.

Objective #2 – By month four, utilize the newly-developed centralized reporting system to collect and analyze data

Objective #3 – Beginning in month six, develop and provide online and onsite trainings for students, faculty, and staff.

Objective #4 – In month three, develop case management processes and procedures, and by month four, roll out these policies and procedures to key stakeholders including faculty and staff to begin managing student cases.

Objective #5 – Beginning in month six, offer and expand resources and information for mental health treatment to all students at the University.

Number of people to be served annually: 1,000 and over the 3-year life of the project: 5,000

Muscogee Creek Nation

MCNDH wishes to continue to utilize funding provided through GLS to build on previous success and to create a network throughout the entire health system to identify potential suicidal patients, to treat patients who have attempted suicide, and to continue successful community outreach and education events to build resilient and mindful communities. MCNDH will successfully create a comprehensive network within our by implementing electronic patient assessments in outpatient and inpatient facilities, expanding clinical support specific for at risk patients, and creating care coordination for discharged patients

Montclair State University

Project Suicide Awareness Violence Education and Response (Project SAVER) aims to build and support sustainable infrastructure for suicide and violence prevention at Montclair State University (MSU) and throughout campuses across New Jersey (NJ) by establishing The University and College Alliance for Prevention of Suicide (UCAPS). This statewide collaborative will inform and support all institutions of higher education in NJ as well as MSU, a diverse public institution of higher education located in Montclair, NJ, 14 miles from New York City. MSU is listed as one of Campus Pride’s top 25 LGBTQ-Friendly Colleges and Universities and designated as a Hispanic Serving Institution. The University’s nine colleges and schools serve more than 20,000 undergraduate and graduate students with more than 300 doctoral, master’s and baccalaureate level programs.

In addition to establishing UCAPS, Project SAVER endeavors to:

(1) launch a statewide database of referral resources that MSU students and other universities can access,
(2) implement gatekeeper training for all MSU staff and faculty,
(3) bolster MSU counseling center clinicians’ skills in assessing and treating suicidal ideation and other high risk mental health problems,
(4) augment current outreach via social media and other technology based formats, linking students to crisis supports (National Suicide Prevention Lifeline and Crisis Text Line),
(5) implement online psychoeducation and training that assists students in battling stress, anxiety and depression, and
(6) shift campus attitudes toward help seeking and decreasing stigma related to mental illness through public messaging campaigns.

These initiatives aim to provide universal prevention to reach all MSU students through one or more facets of Project SAVER, engage all MSU staff and faculty in gatekeeper training by the end of grant funding, and extend the reach of this project to students and staff at universities and colleges across New Jersey through the UCAPS consortium.

Goals and objectives of this project will be evaluated using both quantitative data (data from electronic medical records, surveys, questionnaires, and analytics provided by social media and other web based programs) and qualitative data (Suicide Prevention Committee/UCAPS feedback as well as interviews with and reports from students, faculty/staff, and JED Campus experts). While the majority of Project SAVER programs are intended to reach and impact all MSU students, it is estimated that at least 25% of MSU students (~5,000) will be directly served by one or more components of the proposed project.

Mississippi State University

The MSU It Takes a Community initiative is a new multidisciplinary program at Mississippi State University – Starkville designed to make suicide attempts and death by suicide a never event. Informed by the 2012 National Strategy for Suicide Prevention and based off the SPRC’s comprehensive suicide prevention program, this new initiative aims to reduce suicides by 1. Increasing student connectedness and fostering belongingness; 2. broadening our mental health network by providing gatekeeper training to student leaders, faculty, and staff; and 3. creating new health and wellness initiatives aimed to help reduce suicidal ideation and encourage help-seeking behaviors. MSU is the largest university in the state of Mississippi with an enrollment of 21,883 students and growing. Although a majority of our students are from the state of Mississippi, 65 percent, we have a large number of out-of-state, 32 percent and international students from 80 countries around the world, 4 percent. Our campus is extremely diverse with 18.6 percent of students being African American and 28.3 percent affiliating with an ethnic minority group. The MSU Initiative has nine primary objectives based upon the SPRC evidence-based model. The project aims to 1. increase our ability to identify and assist students in distress, 2. increase student help-seeking behaviors, 3. provide evidence-based, effective care, 4. improve links between providers to ensure seamless transitions, 5. increasing connectedness, 6. teach new life skills and increase resilience, 7. reduce access to suicide means, 8. implement a postvention plan, and 9. utilize an evidence-based crisis response plan. The focus of the project will be building the infrastructure for a sustainable, evidence-based comprehensive suicide prevention program. Through this funding we aim to train at least 1,000 students, faculty, staff, and community members. We will also build a strong infrastructure through further development and validation of our gatekeeper training, developing a first year student course designed to teach life-skills and improve resilience, improving the mental health services offered on campus, and implementing service-learning opportunities designed to increase connectedness and reduce burdensomeness. Although the grant funding will last only three years, the focus of our initiative is to create a permanent and sustainable suicide prevention network at MSU aimed at making suicide a never event. The project is based upon the recommendations in the 2012 National Strategy for Suicide Prevention, inspired by Zero Suicide, and takes advantage the SPRC’s evidence-based model for comprehensive suicide prevention.

Mississippi Band of Choctaw Indians

Youth suicide risk among American Indian/Alaska Native (AI/AN) populations has increased since 2003 and remains highly concentrated among AI/AN youth. The proposed program, the Mississippi Choctaw Youth Resilience Initiative (CYRI-MS), will augment and extend previous suicide prevention efforts implemented by the Mississippi Band of Choctaw Indians (MBCI). The MBCI is a self-governing vibrant Native American tribe of 11,000, but has historically faced the compounded disadvantages of cultural marginalization in one of the nation’s most impoverished, racially segregated states. Many tribal members live in rural areas of Mississippi beset by significant health disparities and other challenges that accompany residing in rural underserved areas. Current data indicate that young MBCI are especially at risk of suicide. CYRI-MS will (1) increase the number of youth-serving organizations able to identify and work with youth at risk of suicide; (2) increase the capacity of clinical service providers to assess, manage, and treat youth at risk of suicide; and (3) improve the continuity of care and follow-up of youth identified to be at risk for suicide, including those discharged from emergency department and inpatient psychiatric units. The key population of focus will be MBCI citizens 10-24 years old, with the goal of2500 youth served (500 per year of project implementation). Fidelity and impact will be determined through a rigorous evaluation predicated on continuous quality improvement. Strict adherence to cultural competence standards will ensure that all services are delivered in an appropriate manner, and efforts will focus on generating a series of improvements that will provide sustainable gains in the face of this significant problem. The following nine activities are required as part of the project and will be delivered after the brief four-month preparation period: (1) Provide early intervention and assessment services for MBCI youth; (2) provide timely mental health care referrals and follow-up for MBCI youth at risk; (3) collect and analyze data on tribal youth suicide, intervention, and prevention strategies; (4) provide post-suicide intervention services, care, and information; (5) ensure that educators, childcare workers, etc. are trained in suicide risk identification; (6) ensure that child-serving professionals are trained in early intervention and prevention; (7) use SAMHSA resources including ATTCs to deliver prevention-related training and technology; (8) ensure that informed consent is obtained from parents/guardians prior to intervention; and (9) secure input from individuals with lived experience, including survivors, in all efforts. A combination of evidence based programs and practices (EBPs) will be used, with cultural adaptations undertaken as directed by tribal leaders: (1) QPR, (2) ASIST and AIM-SP, (3) Hazelden Lifelines, (4) EIRF, and (5) other infrastructure enhancements (e.g., policy, data, evaluation), including the design and administration of a Choctaw Youth Risk & Resilience Surveillance Survey (CYRuS). This project will improve the MBCI tribal prevention infrastructure while expanding AI/AN EBPs.

The Suicide Prevention Resource Center at the University of Oklahoma Health Sciences Center is supported by a grant from the U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), under Grant No. 1H79SM083028-03

The views, opinions, and content expressed in this product do not necessarily reflect the views, opinions, or policies of CMHS, SAMHSA, or HHS.