Grantee Types: Garrett Lee Smith State

The Florida Linking Individuals Needing Care (Florida LINC) Project is a partnership between the Florida Office of Suicide Prevention (SOSP), the Florida Council for Community Mental Health and the University of South Florida (USF) to innovatively enhance services to reach at-risk priority populations and ensure that young people receive needed services. The Inter-Agency Dissemination and Collaborative Network, the state suicide prevention infrastructure, will partner with up to three competitively selected applicant behavioral health regional coordinating service entities and utilize a sustainable mentorship model to continue to enhance, expand, and implement culturally sensitive, evidence-based (EBP) suicide prevention and early intervention strategies. Partnering entities will be selected based on need; prior suicide prevention experience; organizational capacity; established interagency partnerships and referral networks; community and stakeholder buy-in; and commitment to evaluation.

The goals/measurable objectives are to (a) continue to enhance the SOSP by cultivating sustainable partnerships; (b) expand the number of culturally competent trainers; (c) increase the quantity/quality of adult prevention gatekeepers; (d) utilize innovative training to increase: (i) the number of community and school personnel trained to manage crises associated with suicide, (ii) the number of youths/family members taught coping and support skills to prevent the development of suicide risk, and (iii) the quantity/quality of care coordinators able to link and track at-risk youths to cross-system, wrap around services; (e) increase distribution of prevention materials; (f) increase family involvement; (g) increase the number of at-risk youth identified by gatekeeper activities; (h) improve the quantity/quality of professional assessments of at-risk youth especially in high risk settings; and, (i) increase the number of referrals and successful, sustainable treatment, recovery, and support linkages for at-risk youth. Over 5 years, the project will prevent suicide morbidity and mortality by (1) conducting EBP training of adults [Question, Persuade, Refer, with 6,000 adults trained]; (2) training 300 mental health professionals [QPRs Suicide Risk Assessment and Management training] and 465 care coordinators [Linking Individuals Needing Care] with EBP/evidence-informed (EIP) programs; (3) providing skills training to 220 students [Penn Resiliency Program] and 720 family members [It?s Time to Talk about It Family Training] with EBP/EIP programs; (4) disseminating suicide prevention materials [16,000 National Lifeline materials and Its Time to Talk about it Family Guides distributed]; and (5) training 450 school/community personnel with an EIP program [Pillars of Postvention for Suicide Events].

Prevention efforts will target specific service sectors and at-risk youth (10-24): young adults not in school, youths involved with juvenile justice and foster care, military families, survivors of suicide attempts and loss, LGBTQ youth, AI/AN and Latino youths, and substance abuse, mental health, primary care, emergency department, and inpatient psychiatric settings. Independent quality assurance and evaluation efforts will be conducted by USF.

The Florida Youth Suicide Prevention (FLYSP) Project was a collaborative partnership between the Florida Statewide Office of Suicide Prevention (SOSP), the American Foundation for Suicide Prevention (AFSP), the Florida Council for Community Mental Health (FCCMH) and the University of South Florida (USF) to build upon the state’s prior Garrett Lee Smith implementation of the state’s comprehensive suicide prevention plan. Through the creation of an Inter-Agency Dissemination and Collaborative Network (IDCN), the FLYSP Project expanded, disseminated and implemented the state’s pilot-tested, culturally sensitive, evidence-based suicide prevention strategies into three Florida regions (Northeast Florida, West Central Florida, and South Florida including greater Miami).

The goals/measurable objectives of the FLYSP were to:

1. Enhance the SOSP website in cultivating sustainable partnerships;
2. Expand the number of culturally competent prevention trainers;
3. Increase the quantity and quality of adult and youth prevention gatekeepers;
4. Increase distribution of suicide prevention materials;
5. Increase family involvement in suicide prevention;
6. Increase the number of at-risk youths identified by screening and gatekeeper activities;
7. Improve the quantity and quality of professional assessments of at-risk youth; and
8. Increase the number of referrals and successful, sustainable treatment linkages for at-risk youth.

To achieve these goals, the FLYSP Project strategically engaged, educated and empowered individuals, families, schools, and communities to prevent suicide morbidity and mortality in selected counties by:

1. Developing a sustainable mechanism through the IDCN to foster collaborations and create viable networks that disseminated and supported implementation of suicide prevention efforts
2. Expanding family and community outreach efforts (via the It’s Time to Talk About It Family Guide: 18,223 distributed)
3. Conducting evidence-based training of adults [QPR, Question, Persuade, Refer, with 6,833 adults trained], mental health professionals [QPR-T, Question, Persuade, Refer – Treatment, with 203 mental health professionals trained], training/screening of students [SOS, Signs of Suicide, with 559 students trained/screened], development/pilot implementation of postvention training for schools [PPSE, Pillars of Postvention for Suicide Events, with 43 school officials trained].
4. Promoting, enhancing, and supporting existing crisis support services [National Lifeline promotion (36,961 materials distributed), Assessing and Managing Suicide Risk, postvention materials and resources, cross-system referral linkage, and tracking (434 youth tracked)].

Ultimately, these activities were intended to lead to a reduction in youth suicide attempts and deaths. Prevention efforts targeted specific service sectors providing direct services to the following at-risk populations: lesbian, gay, bisexual, or transgender youth, foster children, American Indian and Latino youths, college students, veterans and military families, survivors of suicide attempts and loss, youth substance users, and bullied and victimized youths. Three applicant regions were competitively selected for dissemination of these activities based on need for suicide prevention programming; previous suicide prevention experience; organizational capacity; established public and private interagency partnerships and referral networks; community and stakeholder buy-in; and commitment to evaluation research. Independent quality assurance and evaluation efforts were conducted by USF.

Washington, D.C. proposes to address youth suicide through its suicide prevention initiative, Capitol CARES: Comprehensive Approach to Reducing Risk for and Eliminating Suicide. The program involves three distinct activities to extend existing successful suicide prevention efforts in the District of Columbia: 1) Gatekeeper training of special populations including schools, police, clergy and primary care providers; 2) Screening through collaborative efforts with both public and private partners; and 3) Social Marketing to educate the community about suicide prevention and potential warning signs.

The vast majority of youth ages 10-24 in D.C. are of ethnic minority descent, with approximately 82% African American and 11% Latino. Although the numbers of completed suicides for youth in D.C. is low, youth are almost twice as likely as the national sample to attempt suicide. Healthy lifestyles for thousands of D.C. children are hindered by environmental and social factors such as poverty, community violence, drugs, gangs, and child abuse. Given the risk factors and the small geographical size of the District, all youth in D.C. will be exposed to this suicide prevention program, though we will be targeting schools for screening primarily in the City’s poorest neighborhoods.

We plan to saturate D.C. with QPR Gatekeeper Training to “natural gatekeepers” in schools, juvenile justice, foster care services, residential treatment centers, churches, and primary care settings such as pediatrician’s offices and emergency rooms to increase awareness and response to youth distress. Mini-grants will be offered to local organizations who work with youth to help raise awareness about the relationship of suicide to related risk factors specific to urban youth such as violence exposure, trauma, substance abuse, and early and unprotected sex. A social marketing plan will be developed for the purpose of reducing stigma associated with mental health services and raising awareness about suicide behaviors and related risk factors as a public health problem in D.C.

The unique goals and objectives of this grant are to: (1) Create city-wide infrastructure of linked supports for suicide prevention; (2) Increase awareness of the extent of the problem, signs and symptoms, and appropriate response for suicide risk, including related risk factors for suicide (e.g., violence exposure, gang involvement, unprotected sex, HIV/AIDS exposure, substance abuse); (3) Identify and link youth at risk for suicide to services; (4) Build capacity for referrals and ensure availability of care for youth at risk for and during a suicidal crisis; (5) Reduce suicide attempts by D.C. youth; and (6) Suicide reporting and data collection for DC will be accurate, comprehensive, and up to date. We hope to reach at least 1000 youth annually through mini-grant activities. We also hope to provide QPR to at least 1000 people annually. By 2015, all residents of D.C. will have been exposed to some suicide prevention materials.

Project SAFETY (Suicide Assessment Follow-up Education Texting for Youth and Youth Adults) targets youth and young adults ages 10-24 across the state with the goal of reaching this broad population through implementation of screening in a variety of settings including middle and high schools, university health centers, hospital emergency department, primary care offices (prioritizing Kent and Sussex counties), juvenile detention centers and in the state’s 24-7 mobile crisis service. Screening in primary care is a priority for Project SAFETY because data indicates that suicidal individuals often have contact with their primary care physician within a month of attempting suicide. In addition, implementing screening within primary care offices will reach a broad demographic (e.g. race and ethnicity, sexual orientation, etc.) and increase the likelihood of earlier identification of not only suicide risk but substance use and behavioral health problems as well. To broaden its outreach to youth/young adults, Project SAFETY will introduce a Suicide Texting Service which is expected to be user-friendly and is the chosen preferred way of communicating by youth and young adults. Between broad screening and increased outreach more youth in need of assessment and/or treatment will be identified especially in Kent and Sussex Counties. Project SAFETY also will include expanding the staffing of the state’s 24-7 crisis service (for children) in Kent and Sussex counties to meet the anticipated increased demand once screening is initiated. Finally, Project SAFETY will provide the SPRC developed Assessing and Managing Suicide Risk (AMSR) training for behavioral health professionals across the state to enhance the assessment and treatment services for suicidal youth. The goals of Project SAFETY align with Delaware’s Suicide Prevention Plan (2013-2018) and support recommendations made by the Center for Disease Control and Prevention (CDC) in its report on the 2012 suicide cluster.

The specific goals and objectives are:

1. Increase number of youth/young adults screened for suicide and associated risk factors.
2. Strengthen suicide competencies in professionals assessing – managing suicidal youth/young adults.
3. Enhance access to suicide assessment/intervention and linkage to follow-up treatment for youth in Kent and Sussex Counties.
4. Increase community supports and reduce stigma.

With this statewide project, Delaware will expand its capacity for crisis intervention and response, increase knowledge and awareness of suicide and prevention among secondary school teachers, administrators and students and their parents and train adults who work with youth in the community about suicide risk and about how to help when they learn about a potential youth suicide. Delaware will rigorously evaluate project strategies and sustain key project activities.

This federally-funded-funded project will allow Delaware to address a critical service gap across our state. Since data shows middle schools have virtually no suicide prevention education but middle school students are at high risk, the primary population of focus for this project is our state middle school student population. Suicide prevention will be provided to at least 6,250 students across the states middle schools (about 2,000 per year). Research shows the middle school population is a critical audience for suicide prevention education. The middle schools population reflects the Delaware population demographics of our families and community.

The project strategy is to increase the state systems capacity for crisis response, then directly reach middle school students across the state, using an Lifelines, an evidence-based intervention, to provide essential information about suicide risk, prevention and what to do if the student learns of a potential suicide plan. Lifelines will be used for educators and parents in the schools. In addition, outreach to adults who work with youth in Delaware communities statewide will be provided through the Mental Health Association of Delaware and Family Voices, educating adults (including parents, medical practice and community juvenile justice staff) in suicide prevention using the Lifelines or safeTALK curriculum to strengthen our state capacity to respond across our entire community. Finally, a communications campaign supported by all project partners and publicized through Family Voices, Delaware only family-run organization and provider of the states Family-to-Family Health Information Center, will help us increase awareness of families statewide about suicide prevention, with particular outreach and attention to military families.

Delaware is ready for rapid implementation to achieve these Goals and Objectives:

1. Increase the crisis response capacity of Delaware’s child behavioral healthcare system
2. Increase knowledge and awareness of suicide prevention statewide via communications campaign, with suicide prevention education primarily for middle school students, parents and educators, using Lifelines and SafeTalk
3. Train adults who work with youth in delaware in youth suicide prevention
4. Rigorously evaluate, with partner University of Delaware, the effectiveness of these strategies to inform data-driven decision-making at the state policy and operations levels
5. Sustain core project activities after the expiration of the federal grant

The LGBTQ Youth Suicide Prevention Project will build a system of suicide prevention in high schools in five counties.  The project will promote acceptance of culturally diverse students, particularly LGBTQ youth; increase the capacity of peer and adult gatekeepers to recognize warning signs and risk factors of suicide; and increase knowledge and use of LGBTQ-specific and other suicide prevention resources.  It will also increase the number of mental health professionals in California trained to recognize and manage suicide risk among clients.  Counties selected through an RFP process will demonstrate a youth suicide or suicide attempt rate higher than the national average and commitment to LGBTQ youth suicide prevention.

Goals

• High schools in five counties have policies, procedures, and plans in place that promote school preparedness and safety for all students.
• School personnel are better equipped to recognize and respond to suicide risk among LGBTQ other students.
• Students better understand the impact of language and behavior on peers, and hot to recognize and effectively respond to warning signs of suicide among peers.
• A community-based volunteer infrastructure serves as an ongoing source of community engagement and sustainability.
• Providers are trained to provide effective suicide prevention and treatment services.

Objectives

• Complete an RFP process to identify five counties with youth suicide or suicide attempt rates higher than the national average and recruit education Consultants to provide outreach and education activities.
• Review and enhance school policies, procedures, and plans related to suicide prevention and school safety for all students.
• Provide professional development and training for teachers and school personnel to better understand LGBTQ youth health issues, how to recognize and respond to suicide risk among students (1,250 school personnel will be reached).
• Provide Lifeguard Workshops for students to promote understanding of the impact of language and actions on LGBTQ peers and how to recognize and respond to suicide risk among peers, and where to seek help (5,000 students will be reached).
• Recruit and train volunteers to become Lifeguard Workshop facilitators and community LGBTQ champions after the life of the grant (150 volunteers trained).
• Support Assessing and Managing Suicide Risk (AMSR) training in the five selected counties and build a corps of AMSR trainers statewide (1,925 mental health professionals trained).

The Arkansas Department of Health’s (ADH) Injury and Violence Prevention Section proposes to launch this population-focused Arkansas Youth Suicide Prevention Project to be funded through the Garrett Lee Smith Memorial Suicide Prevention RFA 2014. Our public health approach will effectively embed youth suicide prevention practices statewide through regional dissemination of evidence-based and culturally competent programs.

Arkansas is the only state in the nation that has never been awarded this funding. The purpose of this proposed project is to save the lives of at-risk youth in Arkansas. Within the total population of youth ages 10-24, several groups face heightened risk, including those age 18-24 who have the highest rates of suicide, as well as those identified as high risk by the National Action Alliance for Suicide Prevention including, but not limited to: Latina youth; lesbian, gay, bisexual, transgender, or questioning (LGBTQ); American Indian and Alaska Natives; military family members; and veterans. Other high-risk groups include individuals with disabilities, survivors of suicide attempts and of suicide loss, and young working-aged men and women. From these groups we form our population of focus. Following the goals of the National Strategy for Youth Suicide Prevention, the overarching goals of this project are as follows: 1) build youth suicide prevention capacity across service sectors; 2) provide early identification training for caregivers and professional gatekeepers; 3) improve suicide risk assessments, management, and treatment through use of evidence-based practices; 4) provide resiliency training for adolescents; 5) increase public awareness, promotion, and use of the National Suicide Prevention Lifeline; 6) improve continuity of care and follow-up of youth identified at risk for suicide; and, 7) promote state systems-level change. Cultural competence on ethnicity, sexual orientation, and military culture issues are built into proposed interventions.

Many actions and foci populate the Arkansas Strategy for Suicide Prevention. Because suicide risk is significantly elevated for youth, we know that our efforts must involve public/private collaboration among youth-serving institutions and agencies including schools, educational institutions, the juvenile justice system, foster care systems, substance abuse and mental health programs, families and youth, and other child and youth supporting organizations.

We propose the following interventions: the Emergency Department Means Restriction Education; the Kognito Family of Heroes for military families; LifelinesTM Curriculum; Making Educators Partners in Suicide Prevention; Assessing and Managing Suicide Risk (AMSR): Core Competencies for Mental Health Professionals; Columbia-Suicide Severity Rating Scale (CSSRS); Growing On After Loss (GOAL) support group for survivors and, a follow-up program that includes Suicide Safety Plan Intervention for youth identified at risk for suicide. Through execution of these complementary youth suicide prevention interventions, we will save lives of at-risk youth and improve the overall health of Arkansans.

The purpose of Arizona’s Suicide Prevention Project is to reduce the rate of completed suicide among Arizona youth, ages 15-24. The project involves developing the capacity of Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) organizations to incorporate evidence based strategies and best practices into their programs. Simultaneously, the project will provide training in gatekeeping and climate improvement for education, behavioral health and juvenile corrections.

The Arizona Suicide Prevention Project is a partnership among three organizations: the Arizona Department of Health Services, Division of Behavioral Health Services (ADHS/DBHS), Arizona State University (ASU), and the Arizona Suicide Prevention Coalition (AzSPC) and involves implementation of key components of Arizona’s strategic plan for suicide prevention.

Universal components of the project involve establishment of a gatekeeper training network, provision of gatekeeper training, and ongoing training for educators, behavioral health providers, and juvenile corrections professional in suicide prevention and in how to develop a safe and supportive climate for LGBTQ youth. Mini grants will be extended to organizations that serve LGBTQ youths for selected interventions, including gatekeeper training, social marketing, parent education, youth leadership training, and other approaches to suicide prevention.

An indicated component of the project involves pilot testing an emergency room intervention with a hospital in Maricopa County. In addition, the project will work to develop referral networks to increase access to needed health services for at risk youth, as well as to expand availability of support services for survivors of suicide.