Grantee Categories: Garrett Lee Smith Tribal

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.

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.

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.