Idaho State Department of Education

The Idaho Lives Project is a collaboration among the Idaho State Department of Education (SDE), Suicide Prevention Action Network of Idaho (SPAN Idaho) and their partners to reduce suicide in Idaho (ranked 6th) by targeting youth, ages 10-24, with a comprehensive approach including Sources of Strength, Shield of Care, community gatekeeper training and updated assessment and treatment training for health, mental health, and substance abuse professionals. Entire school communities, including all sub-groups of the population, will be included. The project seeks to ensure that suicidal youth are identified and referred to expertly-trained mental health providers. The Idaho Suicide Prevention Hotline welcomes calls for crisis or referral of suicidal people. In Grant Year (GY) 1, an estimated 5,200 Idahoan’s will be served; GY2:10,330; GY3: 15,423; the total for all GYs, 31,000 people. Evaluations will be conducted for trainings and all other services with regular assessment of data collection to produce reports to the project advisory committee for continuous project improvement corresponding to Project Goal 7. Current national research suggests that involving youth in mental health and suicide prevention activities may be the only way to decrease suicide. As 27% of Idaho population is under age 18 (2011), Goal 1 provides Sources of Strength to 42 high schools over three years. This program teaches students to reach out to adults when peers exhibit suicidal tendencies. 20-25% of these students self-identify as depressed in the Idaho Youth Risk Behavior Survey; 1 in 14 has made a suicide attempt. Goal 2 provides for comprehensive suicide awareness and prevention training to the communities surrounding the high schools. Goal 4 implements Shield of Care at juvenile justice centers teaching staff to identify and refer youth who exhibit warning signs of suicide as incarcerated adolescents are four times more likely to die by suicide sometime in their lifetime than their non-justice-involved peers. Universities will provide interns to assist high school students and to take prevention information back to campuses aligning with Goal 5. As Idaho Lives Project connects schools, community, health and mental health, Goal 6 provides strategies for belongingness, connectedness and capability to elementary and middle schools. Idaho is a diverse state with very rural and frontier areas, small towns and large cities. Its people generally espouse the rugged individualism and self-reliant attitudes promulgated by their Western ancestors; many of whom access only their primary care physicians for mental health. Research shows that health and mental health providers need current information related to best practice assessment and treatment to address this population. Goal 3 provides for David Rudd,PhD, an expert in this area, to train these professionals. In addition, three Idaho suicide prevention experts will provide support and mentoring for local behavioral health providers related to suicide assessment. All goals align with the goals of the Idaho Suicide Prevention Plan (ISPP) and the National Strategy for Suicide Prevention (NSSP).

Georgia Department of Behavioral Health and Developmental Disabilities

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) Comprehensive Local Awareness and Suicide Prevention (CLASP) project blends local coalition development and support, protocol development, community awareness, gatekeeper training, school/university-based peer leadership, and advanced training for direct service providers in nine counties and two separate community programs serving Latino and LGBTQ youth. Building on the success of the current GLS Youth Suicide Prevention Project, DBHDD and its partners will expand youth suicide prevention capacity according to the goals and objectives in the State Suicide Prevention and the Georgia Youth Suicide Prevention (in development) plans.

The CLASP project will work with youth aged 10-24 in nine counties. Three of these counties are entering their third year of programming and will be creating linkages and sustainability plans. Two of the counties are in the early stages of development in the current GLS YSP Project and the four new counties have suicide death rates and/or hospital discharges for suicide attempts and/or self reported ideation above the state average, diverse populations and existing youth suicide prevention support. The project is projected to impact 10,000 new students and 500 adult staff per year as the number of participating schools increases to 40. In addition to working directly with six school systems to coordinate the CLASP project locally, DBHDD will expand to work with two community mental health and substance abuse services provider agencies to coordinate activities in the multiple counties they serve.

In the proposed counties, the project will support local suicide prevention coalition development and enhance linkages among mental health, substance abuse, youth-serving agencies, schools, institutions of higher education, and military and veteran programs. It will support a school-based suicide prevention program that combines protocol review with two evidence based practices; Question, Persuade, Refer (QPR) training for adult school staff and the Sources of Strength program that develops a diverse group of peer leaders who work school-wide to improve peer coping and help-seeking behaviors and build relationships with trusted adults, mentors and caregivers.

In order to train professionals to use evidence-based practices, the project will offer a comprehensive training package to include: QPR gatekeeper training; Annual Professional Seminar Series on Critical Issues Facing At-Risk Children; Assessing and Managing Suicide Risk; Counseling on Access to Lethal Means; Working with Those Bereaved by Suicide in the Professional Setting: Postvention Strategies; Mental Health First Aid; and suicide prevention toolkits for primary care physicians. Training will be proximal to the selected counties, and be open to over a 1000 professionals annually in communities throughout the state.

Connecticut Department of Mental Health and Addiction Services

The CT Department of Mental Health and Addiction Services in partnership with state agencies, the CT VA, universities and behavioral health providers will collaborate to bring sustainable evidence-based, suicide prevention and mental health promotion policies, practices and programs to scale at institutions of higher education statewide for students up to age 24. A total of 8,715 students will receive screening, brief interventions and mental health services over three years. The CT Campus Suicide Prevention Initiative (CCSPI) will build campus infrastructure to enhance suicide prevention efforts and linkages to existing systems of care including CTs Military Support Program and behavioral health providers to address recommendations identified in the National Strategy for Suicide Prevention, CT Comprehensive Suicide Prevention Plan, and the CT Youth Suicide Advisory Board (YSAB) recommendations for this population. The CCSPI will also build on the work of the YSAB and the infrastructure developed through DMHAS’s previous cohort 2 Garrett Lee Smith Grant. The YSAB will serve as advisory to the CCSPI, providing feedback and guidance to staff and partners, ensuring that the initiative addresses the needs of the students and satisfies the requirements of the federal grant. The project will enhance the breadth and scope of behavioral health services provided through CT’s Statewide Healthy Campus Initiative (CSHCI). The CSHCI is comprised of over 30 institutions of higher education, state government officials, and community organizations whose mission is to serve as a catalyst for creating and sustaining healthy campus and community environments.

The CCSPI, will use SAMHSA’s Strategic Prevention Framework (SPF) and the national Suicide Prevention Resource Center (SPRC)/JED Foundation’s Comprehensive Approach to Suicide Prevention and Mental Health Promotion to enhance the number of colleges statewide with infrastructure and evidenced-based services for students at risk. Through training and technical assistance, campuses will develop and expand a continuum of suicide prevention services and increase the number of students who are referred to and receive mental health services. Students served will include, but not be limited to, those with mental health needs veterans, active duty military personnel and members of their family, students of lesbian, gay, bisexual, and transgender (LGBT) orientation, Latina, and those who are survivors of suicide attempts and bereaved by suicide. Funded campuses will work with DMHAS and the SPRC to assess gaps in services and identify evidence-based strategies appropriate for their unique campus needs. Campus personnel, peer educators and student organizations and cultural centers, will be engaged to participate in related health and wellness strategies. The UCHC will conduct a process and outcome evaluation of the proposed initiative through documenting and assessing statewide and campus level infrastructure and suicide prevention interventions, and will work with staff to ensure that all national cross-site evaluation requirements are met.

Connecticut College

Suicide is a major public health problem and has become an important topic on college campuses today. The purpose of the Connecticut College Campus Suicide Prevention grant proposal is to enhance services for students with mental and behavioral health problems by providing a comprehensive array of services within the campus community, using a public health approach, to enhance the ability to identify and assess students at risk and to raise the skill level of the various campus helpers to make appropriate referrals of students whose behavior indicates they are at risk for mental and behavioral health problems, including suicide. This will be achieved by developing training programs for students and campus personnel, by enhancing the existing campus networking infrastructure, by creating campus-wide policies and procedures to address campus crises including suicide, by providing psychosocial education in the form of seminars, by distributing materials to the college community and to families, and by creating links to community resources and suicide hotlines. Much of the focus will be on identification and referral of students with mental and behavioral health issues, including affective disorders, substance abuse disorders, and suicide.

Thus, the proposed Connecticut College suicide prevention project will utilize handing to implement an education/public health approach to suicide prevention by promoting enhanced knowledge and awareness of suicide prevention throughout the campus and by enhancing and expanding existing networking infrastructure of campus support services for students.

Confederated Salish and Kootenai Tribes

Target Population: American Indian youth, ages 10-24, who reside on the Flathead Indian Reservation in Montana. Strategies/Interventions: After school programming will be conducted in one of the most remote locations. With partners, they will identify a quarterly theme for the survivor activity, as a way for them to connect, heal, and be part of the prevention movement. Programming that supports interactions with elders and inclusion of cultural elements will be set up each year. Promote ongoing engagement; provide support groups and therapy to youth impacted by suicide. Support tribal/nontribal agencies in development of intervention and prevention activities. Goals: Decrease the occurrence of suicide on the Flathead Reservation by implementing evidence based trainings and providing information to expand community capacity for responding and referring at-risk youth; Raise tribal youth resiliency on the Flathead Reservation by offering culturally informed, evidence based activities that connect them to peers, elders, and the community; increase capacity on the Flathead Reservation for responding to youth at-risk for direct suicide with improved collaboration, system changes, and better use of technology and evidence based screenings; improve the emotional well-being of Flathead Reservation tribal youth with direct services by Mental Health Specialists and Case managers; cultivate better health outcomes for families and friends who have experienced a loss by delivering a battery of post suicide interventions. Numbers served annually/throughout the project: 27,235 Yr 1 3,845, Yr 2 4,750 Yr 3 6,210 Yr 4 6m,230 Yr 5 6,300.

Cherokee Nation

The Cherokee Nation seeks to fashion a wide-ranging and integrated suicide prevention system to detect, prevent, and provide early intervention services to 735 American Indian youth who reside within the rural 14-county area of northeastern Oklahoma served by the tribe. The Cherokee Nation Seeking Hope project shall define the need for treatment services, the gaps between needed and available services, barriers to services, and other problems related to the need to implement suicide prevention and early intervention activities for American Indian youth at risk of or currently experiencing issues that may lead to suicide.Further, the Cherokee Nation shall enlist in area communities, area child-serving agencies, Cherokee Nation health facilities, and schools in the planning, assessment, implementation, and evaluation phases.

The key outcomes of the project include: Rapidly increase the number of AI youth identified as at risk for suicide; increase the number of youth referred for services; increase the number of youth who receive services; increase the number of youth-serving individuals trained to identify, refer, assess, manage, and treat at risk youth; and further promote the National Suicide Prevention Lifeline.

The cultural appropriateness of the project, often lacking in main-stream approaches, shall be assured through the active participation of community members, consumers, schools, tribal leaders, tribal members, and highly qualified and experienced native staff who bring their own traditional beliefs and values to the planning, implementation, and evaluation processes.
The project will serve 735 American Indian Youth over the course of the project.The target population is rural American Indians who are at great risk for suicide or suicide behaviors.

Goal 1: To expand the capacity, effectiveness, and efficiency of suicide prevention services for American Indian youth and their families who reside within the area served by the Cherokee Nation
Goal 2: To reduce the prevalence suicide and suicidal behaviors among the Cherokee Nation at risk youth populations

Alabama Department of Public Health

The purpose of the Youth Suicide Prevention and Awareness Program is to implement a comprehensive suicide prevention, education, and awareness campaign, increase access to services, and increase suicide related surveillance across Alabama’s resident and transient populations, via utilization of Crisis Centers, Universities, nonprofit organizations, and local and state resources. Alabama the Alabama Suicide Prevention and Resource Coalition (ASPARC), the Alabama Department of Public Health (ADPH), the University of Alabama at Birmingham, and three crisis centers located in north, central, and south Alabama will be engaged in this initiative, allowing for a dissemination range from the State level, to local and community level. This multifaceted approach will allow for a larger degree of community engagement and local buy in as well as a multiple exposure methods to Alabama’s populations, which suffered from 14.2 suicides per 100,000 populations in 2009, and have seen higher rates than the U.S. average since 1989.

An awareness and educational campaign, QPR training to increase the knowledge and self efficacy of individuals in recognizing and making referrals, educational sessions conducted in communities, schools, and universities, increased access to call line services, referrals, and counseling, and media exposure, will all work to increase the education of suicide prevention, and reduce the number of suicides in Alabama. These initiatives will include conducting a minimum of 72 educational sessions in schools, communities, universities and juvenile justice systems and veteran’s organizations, training a minimum of 1,500 QPR Gatekeepers, increasing crisis call line availability, and lowering the number of students self-reporting suicidal ideation on surveys from 30% to 20%. The educational and awareness campaign will consist of message development, ten audio podcasts and a cell phone application. In addition, efforts to utilize social media, social networking, and local publications will be undertaken.

This project expects to form alliances with different agencies, groups, or organizations measured through MOUs, letter of supports, or contracts. Qualitative measures of knowledge and educational efforts will be measured through pre and post surveys. The creation of a web-based data collection mechanism that will be added to the existing infrastructure will assist with data collection for surveillance and follow-up from helpline calls and referrals. We expect the number of individuals reached and the number of organizations involved to increase each year of the grant. All objectives will be monitored for the entirety of the project for assessment and evaluation.

Yakama Nation (Confederated Tribes and Bands)

The Confederated Tribes & Bands of the Yakama Nation is a federally recognized tribe in southwestern Washington. Our tribe experiences high rates of suicide, substance use and other health disparities amongst our youth ages 10 – 24. We plan to address the issue of suicide through culturally proactive interventions and strengthening our service provider collaboration to preserve our culture and future generations.

Demographics/Clinical Characteristics. The Yakama Nation reservation is 130,000 acres in southwestern Washington. It is located within the Yakima County and part of Klickitat County. There are four rural communities located within the reservation boundaries: Toppenish, Wapato, White Swan, and Harrah. There is high rates of suicide across the reservation amongst AIAN adolescents and young adults. We also experience high rates of alcohol and drug abuse.

Strategies/Interventions. YNBH will make proactive efforts to do community outreach through training, selected evidence based programs and prosocial activities. While hosting events, coalition/service provider meetings, we will emphasize the importance of data collection, service collaboration and evaluation.

Goals/Measurable Objectives. The purpose of the proposed project is to develop and implement tribal youth suicide policies and evidence-based prevention programs that enhances awareness, identification, referral and treatment strategies.

Number of People Served Annually of Project Lifetime. YNBH provides services to all Native American and/or Native American descendants. Services are not limited to Native American and/or Native American descendants residing on the Yakama Nation reservation. According to the Yakama Nation Indian Health Services, there were a total of 12,914 patients in FY 2013. This number includes 7,245 patients identified as Yakama Nation enrolled members, 2980 patients were identified as Yakama Nation descendants, and 2689 identified as Native American and/or Native American descendants from different federally recognized tribes. Indian Health Services estimated that 8,839 of the patient population reside on the Yakama Reservation and 4,075 reside outside the reservation boundaries.

Winnebago Tribe of Nebraska

The Winnebago Tribe of Nebraska requests $2,261,099 from the U.S. Department of Health and Human Services, SAMHSA Garrett Lee Smith State/Tribal Youth Suicide Prevention Early Intervention Grant Program over a five-year period with $376,732 of the funds requested in the first year to maximize resources and enhance the overall continuum of care by implementing culturally adapted evidence based practices to reduce risky behaviors and suicide ideations among Winnebago youth and young adults 10 to 24 years of age. Winnebago is a small Indian Reservation located in northeast Nebraska approximately 20 miles south of the Sioux City, IA metropolitan area and 90 miles north of the Omaha, Nebraska metropolitan area. According to the 2010 U.S. Census the Winnebago Reservation population is 2,694 residents.

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.