Texas Department of State Health Services

The Zero Suicide in Texas (ZEST) initiative will provide suicide care services targeting youth at elevated risk of suicide. A comprehensive public health approach integrating best practices in prevention, assessment and intervention, modeled after the U.S. Air Force Suicide Prevention Program, will be developed in the public mental health system. This innovative best practice model will be implemented in Denton County initially and then expanded across Texas. The proposed initiative will target youth ages 10 to 24 in several high-risk categories. The suicide rate for this population in Texas is 7.52 (per 100,000), which represents 1 out of every 11.5 youth suicides in the U.S. The primary focus will be on enhancing screening, assessment and intervention services for youth with serious emotional disturbance (SED). Outreach will also target children of military families, young Veterans and lesbian, gay, bisexual and transgender (LGBT) youth through collaborations with organizations serving or coordinating support for this population and training of providers. The grant will provide enhanced suicide care services to 300 youth annually in Denton County, 900 in three years. These services will include 146 females, 35 Hispanic/Latino, 40 African American, and 10 LGBT each year. The goals of the ZEST initiative are to improve identification, treatment and support services for high risk youth by creating Suicide Safe Care Centers within the public mental health system; expanding and coordinating these best practice suicide prevention activities with other youth-serving organizations and community partners to create Suicide Safe Care Communities; and implementing research-informed training and communications efforts to create a Suicide Safe Care State. Measurable annual objectives are to (a) provide training to 250 members of the mental health workforce in Denton and at least 360 statewide, (b) develop policies and procedures to incorporate best practice screening, assessment, and clinical decision tools into care systems, (c) screen 700 youth and young adults annually and provide best practice suicide care to 300, (d) increase knowledge of the warning signs for suicide and skills for connecting to crisis care through gatekeeper training to 4,340 individuals annually, (e) provide effective communication campaigns with tools, products, and positive messages of hope for defined populations impacting 19,000 people, and (f) increase the coordination of suicide prevention efforts in communities through regional summits and a state conference with 500 participants.Public Health strategies to accomplish these objectives include changing policies within the public mental health system, building train-the-trainer infrastructure in core curricula, integrating best practice screening and assessment into business practices, developing implementation teams, creating a Zero Suicide Systems Toolkit, creating organizational endorsements, engaging partners in learning collaboratives, regional summits and state symposium, disseminating bilingual education materials in a variety of media, promoting prevention and postvention toolkits, and creating a website and social media messages promoting wellness and hope.