Pueblo of San Felipe

Abstract: The purpose of the San Felipe Zero Suicide (SFZS) is to implement the Zero Suicide prevention and intervention program throughout the health care system in the Pueblo of San Felipe. The target population is San Felipe tribal members 25 years of age or older who are risk for suicide. The aim will be to raise awareness of suicide, establish screening, referral, and treatment processes, and improve care and outcomes for individuals who are at risk for suicide. By addressing all elements of ZS, health care providers in San Felipe will transform the health system to one that is ready to identify, treat, refer, and ensure continuity of care for individuals at risk for suicide and suicidal behaviors. The goals of SFZS are to:

(1) Create a leadership-driven, safety-oriented culture committed to dramatically reducing suicide among people under care;

(2) Develop a competent, confident, and caring workforce;

(3) Increase access to care;

(4) Engage survivors of suicide attempts and loss in leadership and planning; and

(5) Utilize an ongoing Continuous Quality Improvement framework to provide feedback aimed at improving the system.

Services provided will be universal screenings of all patients accessing health services, assessment, safety planning and referral to treatment for all those who screen positive for suicide, and treatment using evidence-based practices such as Cognitive Behavioral Therapy Suicide Prevention (CBT-SP) and Counseling on Access to Means (CALM). The unduplicated count of individuals served is broken up into 3 categories: training, screening and intervention. TRAINING. It is anticipated that 27 staff will participate in SFZS via training, including 19 clinical and non-clinical medical staff of the IHS Health Clinic (4 primary care physicians, 4 registered nurses, 1 patient registration staff, 1medical records/front desk staff, 1 nutritionist, and 1 diabetes educator in the medical clinic; 1 pharmacist, 3 pharmacy techs, and 2 contracted pharmacists in the pharmacy; and 2 dentists, 2 dental hygienists, 2 dental assistants, and 1 front desk staff in the dental clinic). In addition, 6 licensed behavioral health providers and 2 unlicensed behavioral health providers from the Behavioral Health Program will participate via training (4 independently licensed behavioral health providers, 2 substance abuse providers, 1 psychology doctoral level intern, and 1 psychiatrist). SCREENING. Based on the annual numbers served, it is anticipated that 2,000 patients will be screened annually at the primary care IHS Health Clinic. INTERVENTION. Based on national statistics that indicate that of 1.8% of patients screened in primary care settings are at high risk for suicide and 4.5% are at moderate risk, we anticipate a minimum of 25 patients participating in CBT-SP annually. We gradually increased this number over time as we believe we will have a higher rate of recruitment into SFZS over the years, as services become better known in the community. Thus, we anticipate 175 individuals participating in CBT-SP over the life of the grant.