Choctaw Nation Health Service Authority

Tomorrow's Hope
Garrett Lee Smith Tribal

The Choctaw Nation of Oklahoma, a Promise Zone as designated by President Obama, proposes to implement Tomorrow’s Hope. Tomorrow’s Hope follows the Choctaw way of Achchukmali Imabachi Sa Banna, a language concept which denotes a special caring and protection to make life better, teaching to make better. This traditional concept will guide us as we build a system wide embrace around our youth at risk for suicide, their families, the providers who serve them, law enforcement, and the community. For American Indians/ Alaska Native youth, age 15-34, suicide is the second leading cause of death. In fact, loss to suicide is 2.5 times higher for Natives than the national average for that age group. Of special concern to the Choctaw Nation is that, according to the Oklahoma state plan for suicide prevention, in the 10 county area served by the Choctaws, two of our counties report suicide deaths at 50%+ above the overall state rate, three counties report deaths at 25 – 49% above the state average, and four report deaths at 1 – 24% above the state rate. These losses are of great concern and as a result, the Choctaw Nation of Oklahoma proposes to implement Tomorrow’s Hope, a project that will better integrate the following services: medical, behavioral health, prevention, substance abuse treatment, Jones Academy (residential educational facility), domestic violence, Eastern Oklahoma State College, and law enforcement in an effort to firmly establish new linkages and strengthen a system wide response to suicide prevention /intervention. Tomorrow’s Hope proposes to annually: a) train 1,100 youth, service providers and community members in 40 QPR (Question, Persuade, Refer) trainings; b) train 100 medical providers in Emergency Department Means Restriction Education (NREPP Registry, 2014); c) train eighty Choctaw Nation Youth Advisory Board members and Jones Academy students (80) in Coping and Support Training (CAST, age 13 to 24); and d) refer/engage 240 youth and 120 family members per year in 3 to 4 month long outpatient treatment for substance use, mental health or both; offer law enforcement officers and campus police training opportunities related to suicide intervention and QPR. This means that this project will impact, minimally, 8,000 youth, health providers, college students, Jones Academy students, law enforcement and family members during it’s five year duration and hopefully, throughout their lives. Services proposed will be based out of the three counties (McCurtain, Pittsburg, and Latimer) that evidence the highest suicide rates. However, because Tomorrow’s Hope will build a system wide approach, all 10 counties served by the Choctaw will benefit since all counties utilize clinic and hospital services. Tomorrow’s Hope, will enhance already existing linkages, build new ones, strengthen the net of protection through education, introduce and expand evidence based interventions, utilize EHR to establish a Community Alert (a function within the EHR system to notify both medical and behavioral health to a patients risk for suicide), and reduce access to means of firearms, the leading method of suicide in the 10 county area of the CNO.