Grantee Types: Garrett Lee Smith State

Alaska Department of Health and Social Services

Alaska is consistently among the states with the highest suicide rate in the nation. The Division of Behavioral Health (DBH) approach to the Alaska Youth Suicide Prevention Project is to build on the work and success accomplished through our existing Garrett Lee Smith program as well as our Prevention and Early Intervention Services community grant programs; to integrate the National Strategy for Suicide Prevention, planning and evaluation process at both the state and community level; and to establish a strong partnership between the state and Alaska communities dealing with the ravages of alcohol and drug use, abuse and dependency, which have been shown to have strong linkages to suicide in Alaska.

  1. The Divisions main proposal strategy is to implement suicide prevention trainings statewide. Previous training efforts have not had the level of output and effectiveness as identified in program evaluation findings of the Alaska Suicide Prevention Gatekeeper Training. Therefore, renewed efforts to expand and enhance suicide prevention trainings will be able to demonstrate and meet the goals of the project: Alaskans will have an increase in knowledge that youth suicide is preventable;
  2. Alaskan communities will have an increase of healthy social & emotional skills in their youth;
  3. Alaskan communities will have increased access & availability to effective behavioral health services targeting youth with high risk for suicide;
  4. Alaska will continue and increase suicide prevention & early intervention research and evaluation methods for prevention of youth suicide.

The training models that will be implemented include, 1) The Alaska Gatekeeper Suicide Prevention Training, 2) ASIST, 3) At-Risk for High School Educators 4) Other trainings based on need including Mental Health First Aid, and Critical Incident Stress Management. In order to accomplish these goals and training strategies, the Division proposes to provide leadership, technical assistance and support, and ongoing monitoring to ensure that participating communities are successful in developing locally designed and culturally appropriate suicide prevention strategies and incorporating the goals of the Alaska Suicide Prevention Plan.

Critical to the success of the Alaska Youth Suicide Prevention Project is the commitment to developing a quality data-driven and outcome-focused system to promote accountable, effective and results oriented evaluation at the state, community and program level. Through collaboration with key partners including the University of Alaska Anchorage, the Alaska Statewide Suicide Prevention Council, and other critical partnerships will be enhanced (where they have existed) and developed (where they have not existed). Through these partnerships Alaska will continue to improve and strengthen its prevention capacity and statewide infrastructure towards the reduction in suicide in the years ahead.

Alaska Department of Health and Social Services

The Alaska Youth Suicide Prevention Project will enhance and expand suicide prevention programs and services to specific regions and youth populations where suicide rates are exceedingly high. The goals and outcomes of the Alaska Youth Suicide Prevention Project include

  1. Increase Alaska’s understanding that youth suicide is preventable.
  2. Increase promotion of healthy social and emotional growth and youth development.
  3. Increased access and availability of behavioral health services.
  4. Increase use of suicide prevention research and evaluation methods.
  5. Decrease suicide and suicidal behavior among Alaska’s youth.

Regional Suicide Prevention Teams (RSPTs) will be developed statewide in early 2009 and will implement the community-based planning model, Strategic Prevention Framework (SPF), developing strategic regional plans to support project outcomes. Plans will incorporate a culturally responsive and sustainable approach to include early prevention, intervention and postvention strategies targeting youth. RSPTs will include representation from school districts, community youth organizations, mental health providers, churches, parent groups, juvenile justice, children’s protective services and other youth-related groups. Special emphasis will be on high risk youth populations in Alaska, including Alaska Native male teens, military youth Veterans 18-24, early teen females who have high rates of depression onset, gay, lesbian, bisexual and transgender (GLBT) youth, and youth in residential/institutional settings such as youth detention or foster care. The University of Alaska Anchorage, Behavioral Health Research Services (BHRS) will be conducting the project’s program evaluation including an ethnographic analysis for each region, conducting key informant interviews, assist in program evaluations for regional teams, and participating in a cross site evaluation. BHRS will also pilot a university campus program at UAA. Another GLSMA recipient, Maniilaq’s Project Life in Kotzebue region is entering into its third year of their project and Kawerak Inc. in Nome has also recently been awarded.

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.

West Virginia Bureau for Behavioral Health

West Virginia will implement this grant statewide through the West Virginia Bureau for Behavioral Health’s six regions, in partnership with Prevent Suicide WV and the Regional Youth Service Centers, to serve youths aged 10-24 at risk of suicide through suicide prevention and early intervention strategies in schools, higher education institutions, juvenile justice and foster care systems, substance use prevention and treatment programs, mental health programs, and other youth-serving organizations. This grant will build upon the state’s prior GLS grants, which made great strides in suicide prevention education and policy in schools and higher education institutions, to crystallize systemic integration of suicide risk screening, assessment, referral safety planning, and follow-up in other youth-serving settings, including primary care, emergency department, and psychiatric settings. The overarching goal is to reduce youth suicides through a seamless, sustainable, accessible continuum of care for youths at risk of suicide in the state.

Virginia Department of Health

The Virginia Youth Suicide Prevention Program, coordinated by the Virginia Department of Health (VDH), will employ a public health approach focusing on policy and systems change to implement statewide strategies targeting youth ages 10-18 attending Virginia public schools and youth ages 18-24 attending Virginia colleges and universities reaching 1,290,970 youth annually. Multiple efforts supporting a comprehensive suicide prevention approach will be engaged at the local level to enhance screening and treatment services provided to high risk children receiving services funded by the Comprehensive Services Act for At-Risk Youth and Families (CSA) and twelve colleges/universities.   There are three primary goals associated with this project.

Youth at-risk of suicide attending Virginia public schools will be identified and receive appropriate treatment.  To reach this first goal 75% of middle and high school educators statewide will receive evidence-based gatekeeper training to identify, approach and refer students who are exhibiting signs of psychological distress; 75% of local CSA systems will include suicide prevention strategies, means restriction and/or treatment services as part of the service plans for youth who are at-risk of suicide as identified through the Child and Adolescent Needs and Strengths assessment tool; and 100% of Virginia Community Service Boards will demonstrate improvement in screening, identification and treatment of youth at-risk of suicide as compared to levels identified in the needs assessment.

The second goal is that youth at-risk of suicide attending Virginia colleges and universities will be identified and receive appropriate treatment.  This will be met as 100% of public and private colleges and universities will receive outreach and resources to support campus-based suicide prevention efforts on a regular basis; 100% of target colleges and universities will demonstrate the establishment of policies and procedures in alignment with a comprehensive approach to suicide prevention; and 75% of target colleges and universities will demonstrate community-clinical partnerships through the regional suicide prevention councils supporting the provision of mental health services.

Finally, Virginia will have a comprehensive, coordinated statewide youth suicide prevention system.  To meet this goal, the Virginia Suicide Prevention Interagency Committee will demonstrably support this type of system and the Virginia Department of Behavioral Health and Developmental Services will align with the efforts of this proposal in southwest Virginia.

Utah

The Utah Youth Hope Project is committed to reducing the rate of fatal and non-fatal suicides for youth and young adults in Utah. Key partners will work together to implement a comprehensive approach to youth suicide prevention and early intervention both statewide and in targeted areas. The following goals is to increase the number of adults who interact with youth who are prepared to respond to youth at risk for suicide, increase access to and quality of behavioral health care for youth at risk for suicide, to improve rapid follow up and care transitions for youth and young adults at risk suicide , to increase implementation evidence based early intervention and screening assessment strategies, and increase state and local capacity to implement evidence based post suicide intervention strategies.

The Commonwealth of the Northern Mariana Islands

The Commonwealth of the Northern Mariana Islands, Commonwealth Healthcare Corporation Youth Suicide Prevention Program will utilize a system-wide, multi-strategy approach to reduce the incidence of suicide and increase access to appropriate suicide prevention and intervention services for youth and young adults in the CNMI between the ages of 10-24 years old.

The Youth Suicide Prevention goals include the following:

1) Promote awareness that suicidal and self-destructive behavior is a public mental health problem in order to reduce the stigma associated with being a consumer of suicide prevention or intervention services;
2) Increase system-wide capacity to deliver effective suicide prevention and intervention services;
3) Develop collaborations and networks that support common goals in suicide prevention;
4) Improve the usefulness of data surveillance systems to effectively inform suicide prevention and intervention efforts.

The Youth Suicide Prevention Program proposes to implement a multi-strategy approach to address youth suicide in the CNMI. The program will promote behavioral and mental health and wellness; provide suicide prevention education and outreach; provide intervention and treatment services for those at risk of suicide; and provide support for those in recovery from suicide behaviors.

The program’s measurable objectives include the following:

1) Increase community-wide support for the prevention of suicide and self-destructive behavior by promoting public awareness that these acts are a serious public health problem and that many of these acts are preventable;
2) Implement a state-wide campaign that promotes accurate and responsible reporting and portrayals of suicidal behavior and self-destructive behavior;
3) Implement a social marketing plan that promotes behavioral and mental wellness and reduces the stigma associated with accessing suicide prevention and intervention services;
4) Provide training for youth-serving agencies and key stakeholders (including educational institutions, foster care systems, juvenile justice systems, etc.) in recognizing the signs of persons at-risk for suicide and in accessing resources for prevention and treatment programs;
5) Provide training to increase the ability of healthcare professionals and staff to screen for at-risk indicators, identify protective factors, promote resiliency, and refer for appropriate services;
6) Provide training for clergy and community members in recognizing the signs of persons at-risk for suicide and in accessing resources for prevention and treatment programs;
7) Promote and support the presence of protective factors by improving clinical skills;
8) Provide comprehensive direct treatment to at-risk individuals including wrap-around and recovery support services;
9) Improve and expand comprehensive education programs and support services for survivors of suicide;
10) Implement a system of care linking youth-serving agencies, government and non-government partners, community members, peers and other appropriate stakeholders;
11) Increase collaboration with public and private nonprofit organizations;
12) Increase the number community-based support groups;
13) Develop and implement a comprehensive uniform system of data collection;
14) Develop a database that links and analyzes information on suicide and self-destructive behavior derived from separate data systems;
15) Measure the effectiveness of the implementation of the goals and objectives;
16) Utilize program evaluation data and analysis to develop a program sustainability plan.

The program goals and objectives will guide a data-driven process which will inform decision-making at all levels.

Texas

Resilient Youth – Safer Environments (RYSE) will create comprehensive Suicide Safer Early Intervention and Prevention (SSIP) systems to support youth-serving organizations, including Texas (TX) schools, mental health (MH) programs, educational institutions, juvenile justice systems, substance abuse programs, and foster care systems. The target population, youth ages 10 to 24 years at elevated risk of suicide and suicide attempts, will receive enhanced services through best practice trainings, improved suicide care in clinical early intervention, treatments services as well as effective programs. TX will expand upon its previous success in the last GLS grant, Zero Suicide in Texas (ZEST) initiative which improved services for youth at risk of suicide through the development of Suicide Safer Care Centers (SSCCs) in the public MH system. With increased capacity to serve and recognize youth at risk, and enhanced infrastructure for strategy implementation, these SSIP systems will produce robust clinical and community services with collaborative networks to promote youth resiliency, recovery, and safety. In 2017, 3,488 individuals died by suicide in TX with 657 in the target population. Galveston County (GC) has been above the national average rate of suicide for the target population over the last 15 years, with a crude rate of 16.8 compared to the national rate of 9.6. Additionally, GC residents experienced the devastation of Hurricane Harvey in August 2017 and the Santa Fe (SF) school shooting in May 2018. The trauma associated with exposure to disasters and critical incidents can contribute to increased risks for depression, anxiety and suicidal ideation (SAMHSA, 2017; Usher, et al, 2016). Therefore, activities will begin with youth, ages 10 to 24, living in GC, and specifically in SF, attending schools in SF Independent School District. The goals of the grant are to: (1) improve SSIP systems with development of a Suicide Prevention Community Collaborative (SPCC) to support community planning, workforce development and oversight; (2) increase early identification and referral of youth ages 10 to 24 years at risk of suicide; (3) provide evidence-based interventions to enhance protective factors, promote mental health and reduce suicide risk; (4) enhance postvention strategies to reduce risk following exposure to suicide attempts or deaths in the community; and (5) continuously measure RYSE activities to improve quality and document lessons for expansion. There are numerous objectives for each of these goals; for example, Obj. 1.1: By January 2020, establish SPCC inclusive of community health agencies, BH agencies, schools, non-profits, juvenile justice, foster care, faith-based organizations, and individuals with lived experience, and Obj. 3.1: In year two, begin the Hope Squad youth peer model in a high school as a universal prevention strategy. There will be services and programs implemented to include the following strategies and interventions: screening and referrals, care transition services, suicide early intervention evidence-based practices (EBPs) trainings, and postvention services employed in all years of the grant. Services will be provided to the following numbers of individuals: year one (2,105), year two (3,000), year three (3,780), year four (4,375), and year five (5,200) with a total of 18,460 individuals served through the lifetime of the grant.

Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS)

The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) proposes “Tennessee Lives Count Connect2” to reduce suicidal ideation, suicide attempts, and suicide deaths among youth and young adults ages 10-24 by building on existing grant-funded suicide prevention and early intervention strategies to enhance and expand capacity statewide, including enhanced follow-up in 30 focus counties for 5,000 unduplicated individuals (Year 1: 750; Years 2-5: 1,063 annually). The focus area is the State of Tennessee, comprising urban and rural populations with multiple socioeconomic disparities (e.g., high poverty, unemployment) that contribute to high risk for suicidal ideation and behaviors among youth/young adults. Tennessee’s suicide rate for the state (16.8) exceeds the national rate (14.0), and 1,163 Tennesseans died by suicide in 2017. Among the focus population, 35% are enrolled in Supplemental Nutrition Assistance Program (SNAP) and 65% are enrolled in the state’s Medicaid program. Focus county schools serve over 6,200 students with an identified severe emotional disturbance/mental illness, with 31.5% of state high school youth reporting they felt so sad they stopped usual activities, 17% seriously considered suicide, and 14% made a suicide plan. Of the 128,000+ calls to the Statewide Crisis Line, 16% were made by youth under 17. TDMHSAS will partner with Tennessee Suicide Prevention Network and Centerstone of Tennessee to provide suicide prevention and postvention trainings for gatekeepers (schools, law enforcement, foster care, etc.) and training for primary/behavioral health professionals, screening/assessment, early intervention, follow-up, outreach/education, and linkages to treatment services, using the RELATE curriculum, based on evidence-based theory and incorporating evidence-based approaches, and the Columbia Suicide Severity Rating Scale (C-SSRS). Connect2 will also strengthen public/private collaborations and support higher learning institutions to train students in recognizing early signs of suicide and referring individuals needing help. Outcomes will include reduction in suicidal ideation and suicide attempts by 30% and suicide deaths by 10%. An existing Youth Advisory Leadership Council comprising stakeholders and focus population members will support Connect2’s goals/objectives: (1) increasing gatekeeper/stakeholder capacity to identify/refer youth at risk of suicide; (2) increasing stakeholder capacity to assess, manage, and treat youth/young adults at risk for suicide; (3) expanding provision of enhanced follow-up for youth experiencing suicidal ideation and/or a suicide attempt; (4) increasing risk identification, referral, and behavioral health services utilization; (5) increasing the promotion and utilization of crisis response services; (6) implementing key elements of the National Strategy for Suicide Prevention to reduce rates of suicidal ideation, attempts, and deaths for youths/young adults ages 10-24 in Tennessee; and (7) conducting a comprehensive evaluation and developing/disseminating a thoroughly documented service model for replication/adoption across the state and nation. Evaluation will report as required on participant outcomes and on progress and performance regarding infrastructure development.

South Carolina Department of Mental Health

The SC Department of Mental Health (SCDMH) will implement the Young Lives Matter Project to reduce deaths by suicide and nonfatal suicide attempts among SC youth and young adults age 10-24. The project will focus on increasing access to screening and mental health services, raising awareness through social media marketing, increasing protective factors through training across community domains, supporting clinicians and educators in implementing evidence-based interventions, utilizing safety plans in emergency departments, and strengthening statewide infrastructure. Within the overall focus population, SCDMH will focus on the subpopulations of those with Serious Mental Illness (SMI), justice system involved, and LGBT. Strategies and interventions include a marketing/outreach campaign as well as suicide prevention programming conducted in 80 school districts and on 5 college campuses; implementing the evidence-based Interactive Screening Program; provision of screening, assessment, and therapeutic services (utilizing the evidence-based Attachment-Based Family Therapy); improving state infrastructure through training, re-creation of the SC Suicide Prevention Coalition, improving discharge protocols in emergency departments, and development of a universal response protocol to respond when it is suspected that a YYA is suicidal.

Goals of Your Life Matters are:

  • To strengthen statewide infrastructure that will support improved behavioral health services delivery to potentially suicidal YYAs, including formation of a statewide Suicide Prevention Coalition and regional youth suicide prevention task forces.
  • To raise awareness and knowledge of YYAs and those who care about them (e.g., teachers, parents, counselors) regarding how to get help for depression and other mental health issues that may lead to suicidal ideation and suicide attempts.
  • To educate parents, teachers, and other caring adults on the risk and resiliency factors that impact YYA mental health, suicidal ideation, and attempted suicide; on how to respond when they believe YYAs to be suicidal; and on how to access services.
  • To increase screening of YYAs for suicide risk and their access to services.
  • To implement evidence-based practices and successful intervention strategies to reduce suicide attempts and deaths by suicide.
  • To develop an interagency response protocol to use in the event that a youth or young adult is determined to be at risk of suicide.

Primary project objectives (not an inclusive list) are:

  • 300,000 individuals will be exposed to mental health awareness social media marketing and will be contacted through program outreach efforts
  • 10,000 individuals will receive training in prevention or mental health promotion
  • 30,000 individuals will be screened for mental health or related interventions
  • 20,000 individuals will be referred to mental health or related services
  • 25 organizations/communities will demonstrate improved readiness to change their systems
  • All 46 SC counties will improve connection via a shared information technology system
  • 90 contacts (at key agencies/institutions) will be made through program outreach efforts
  • 131 programs/organizations will implement mental health-related practices/activities

It is estimated that at least 300,000 youth and young adults (60,000 annually) will be reached with social media marketing over the lifetime of the project and 30,000 (6,000 annually) youth and young adults will be screened for suicide risk and mental health needs.