High School

The Suicide Prevention in Schools and Colleges initiative will implement suicide prevention and early intervention strategies for youth ages 10-25 across Pennsylvania. The grant will provide gatekeeper training, suicide risk management training, standardized screening, and training in empirically supported treatments. The project will raise awareness, increase identification of at risk youth, facilitate referrals to treatment, and improve treatment outcomes.

The problem addressed by our proposal is that suicide risk is being under identified in Pennsylvania’s schools, community colleges, and universities. There is no systematic training for professionals or standardized screening procedures to identify youth at risk. Therefore, too many young people are not identified and too many of those who are high risk are not being adequately screened, and not receiving treatment and support.

There are 500 school districts and 181 community colleges and universities in Pennsylvania. In the general state population, there are 2,570,000 individuals age 10-15 representing a wide range of cultures and demographic diversity. The majority are white, but there are also Black, Hispanic, Asian and American Indian students. We will focus on racial and ethnic, rural and urban cultural differences as well as the needs of the Veteran and the LGBT populations.

Building on the Student Assistance Program in Pennsylvania schools, we will provide gatekeeper training and state of the art screening tools to appropriate school personnel and the behavioral health systems that serve these schools. Building on the work of past Campus Grants, we will organize a coalition of community college and university representatives to develop model suicide prevention plans and processes for higher education throughout the Commonwealth.

Project goals and measurable objectives include: a) increasing the number of persons in schools, colleges, and universities, trained to identify and refer youth at risk for suicide, b) increasing the number of clinical service providers (including those working in schools, mental health, and substance abuse) trained to assess, manage, and treat youth at risk for suicide, c) increasing awareness about youth suicide prevention, specifically including the promotion and utilization of the National Suicide Prevention Lifeline, d) comprehensively implementing applicable sections of the 2012 National Strategy for Suicide Prevention to reduce rates of suicidal ideation, suicide attempts, and suicide deaths in their communities, and e) promoting state systems-level change to advance suicide prevention efforts in our public schools.

With gatekeeper training and awareness campaigns, we plan to reach 186,000 youth over five years. With screening in schools, colleges, and primary care practices, we plan to reach approximately 26,000 indicated youth over five years. Thus, our total impact will be felt by nearly 212,000 youth across Pennsylvania.

The State of Oklahoma proposes to utilize funding available from this State-Sponsored Youth Sucide Prevention and Early Intervention opportunity to continue the Oklahoma Youth Suicide Prevention and Early Intervention Initiative.  Specfically, funds will be used to implement evidence-based youth suicide prevention strategies in selected high-need
communities and implemenation of the state’s suicide prevention plan. As a Cohort I, IV, and VI grantee of SAMSHA’s Garrett Lee Smith initiative, the State of Oklahoma has taken important steps toward the development of a public health infrastructure to promote the prevention of suicide. Universal and targeted projects have been initiated in communities, universities, schools, tribal governments, hospitals, faith communities, armed forces, mental health and substance abuse treatment facilities, and other youth-serving agencies.

Project goals are to:
1. Increase suicide prevention capacity and implementation within priority counties.
2. Increase suicide prevention capacity and implementation at the state level.
3. Increase the number of youth at risk of suicide who are identified and receive mental health services.
4. Increase the number of effective and evidence-based clinical suicide prevention practices implemented.
5. Improve and expand suicide surveillance systems.

The proposed service area is the state of Oklahoma and six high-risk communities. Contracted subrecipients will provide gatekeeper training, and establish an emergency department sucide attempt database with follow up consent protocol. The project will reach nearly 50,000 individuals with suicide prevention training/education (including 900 clinicians and up to 25 colleges/universities). Approximately 40 communities statewide will receive suicide postvention/prevention consultation and training. Funding will also be utilized to continue statewide suicide prevention efforts initiated with Cohort I, IV, and VI strategies. The state will develop four Regional Suicide Prevention Chapters of the State Suicide Prevention Council, gatekeeper and clincial suicide prevention training statewide, and crisis response protocol in public school systems to specifically address student death by suicide. The project is expected to reduce the rate of non-fatal suicide attempts and deaths in youth aged 10-24.

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 [QPR’s 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 It’s 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 Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) proposes Tennessee Lives Count-Connect (Connect) to reduce suicidal ideation, suicide attempts, and deaths among youth and young adults ages 10-24 by developing and implementing statewide suicide prevention and early intervention strategies, risk screening/assessment, and enhanced follow-up for 6,250 unduplicated (Year 1: 1,000; Years 2-5: 1,250/year).

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/behaviors among youth/young adults. Tennessee’s suicide rate for the focus population (8.83) exceeds the national rate (7.57) and 111 young Tennesseans died by suicide in 2010. Among the focus population, 20% experience serious psychological distress; 8% of adolescents ages 12-17 and 11% of 18-25 year olds have had a major depressive episode; and 7% of adolescents, 4% of 18-20 year olds, and 16% of 21-25 year olds have been admitted for substance abuse treatment – all risk factors closely associated with youth suicide. Risk factors are exacerbated among subpopulations (children in state custody, juvenile justice involvement, veterans, and LGBTQ2S youth), with 50% having mental health and/or substance use disorders. Locally, suicide prevention, intervention, and follow-up resources are sparse and disjointed, and accessibility creates key service gaps for youth/young adults and their families.

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 evidence-based Applied Suicide Intervention Skills Training (ASIST) and Columbia Suicide Severity Rating Scale (C-SSRS) models. Connect 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%. A Youth Advisory Council comprising stakeholders and focus population members will support Connect’s goals/objectives: (1) increasing the number of people in youth-serving organizations trained to identify/refer youth at risk of suicide, (2) increasing the number of clinical services providers/first responders trained to assess, manage, and treat risk for suicide, (3) improving continuity of care and follow-up for youth discharged from emergency/ psychiatric units, (4) increasing risk identification, referral, and behavioral health services utilization, and (5) increasing the promotion and utilization of the National Suicide Prevention Lifeline. Evaluation will report as required on participant outcomes and on progress and performance regarding infrastructure development.