Native American Rehabilitation Association of the Northwest, Inc.

Abstract: NARA (Native American Rehabilitation Association of the Northwest), an integrated primary and behavioral healthcare organization, located in Portland, Oregon, will launch a system transformation initiative by implementing the Zero Suicide model. The proposed project will implement suicide prevention and intervention programs at all NARA sites that serve adults 25 years of age or older. These sites include primary health and dental care, substance abuse treatment and mental health services. The proposed project will impact the NARA health system by consistently and systematically raising awareness of suicide, establishing effective screening, assessment, and referral processes, and improving overall care and outcomes for NARA patients who are 25 years and older. and at risk for suicide. The emphasis on adults, 25 years and older is important because it bridges the gap between existing NARA youth suicide prevention services whose focus has been youth and young adults 24 years of age and younger. The bridging of this gap is crucial for the health system because it allows for a more efficient, integrated and systematized perspective for suicide prevention and intervention. For the greater Portland area community, the proposed project brings much needed access to behavioral health services, a crucial gain for a city and state that rank very low for available behavioral health resources. The project will partner with Unity Behavioral Health Center, Portland’s only Psychiatric Emergency Room and Inpatient hospital for transitional care The Zero Suicide NARA project will provide prevention and intervention services to 750 Individuals each year of the project for a total of 3,750 participants over the five years. The project proposes to train 150 staff annually. Key interventions and strategies are: (1) create a leadership hub committed to reducing suicide among those in care at NARA; (2) development of a data-driven quality improvement approach to suicide care; (3) systematically identify, assess and monitor suicidality in the entire patient population; (4) systematic monitoring along a patient’s entire treatment pathway, for purposes of triage and indication for appropriate levels of acuity and intensity of care; (5) provide responsive family and community support to those at risk, those who have attempted and those who have survived. By adopting the Zero Suicide model, NARA seeks to reduce rates of suicidal ideation, suicide attempts and suicide deaths. Through system transformation, NARA commits to goals focused on increased suicide awareness activities and education; access to prevention, treatment; data reporting capacity; increased access to quality through continuous improvement; provision of targeted, evidence-based clinical interventions; and improved accessibility, follow-up and family/caregiver engagement.