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EMPACT-Suicide Prevention Center’s Arizona Covid-19 Suicide Prevention Project will reduce the rate of suicide and suicide attempts in Maricopa and Pima Counties, during the Covid-19 pandemic, through a) Increased awareness and identification of suicide risk, b) Rapid connectivity and follow-up, and c) Connecting “at-risks” individuals to ongoing evidence-based treatments. EMPACT-SPC will collaborate with Banner Health Hospitals and local domestic violence providers to serve adults, 25 years of age and older, who are at risk or have attempted suicide due to risk factors exacerbated by the Covid-19 crisis. The Project will provide an additional emphasis on those individuals experiencing domestic violence. The Arizona Covid-19 Suicide Prevention Project provides a holistic method to reduce suicide through a three-prong approach involving 1) Suicide Prevention/Awareness Training for community members and clinical staff 2) Rapid community-based connectivity and coordination of care and 3) Implementation of seamless access to Evidenced Based Practice Treatments to increase opportunities for recovery. In addition, the Project is committed to ensuring that those experiencing domestic violence are provided additional support and services, including safe-places to stay while addressing the unique needs and challenges frequently associated domestic violence. Individuals will be identified, screened and referred for services through EMPACT-SPC’s National Suicide Prevention Lifeline, Banner Health Hospital Emergency Departments, and EMPACT-SPC’s Domestic Violence Hotline. The project will provide rapid screening and assessments and direct coordination with individuals transitioning from Hospitals, including care transition and reintegration into the community. Peer “Navigators” will assist individuals, providing emotional support, while helping members access services and encourage maintaining participation in ongoing treatment services. Project therapists will be able to provide a variety of Evidence Based Treatments for addressing suicide risk, such as Trauma Focused Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, EMDR and others as clinically indicated. During the 16-month program period, the Project will: • Train 250 Community and Clinical Staff in ASIST and/or Mental Health First Aid • Screen 1000 Individuals for risk for suicidal thoughts and behavior o This includes a minimum of 250 Domestic Violence Victims • 280 Individuals will receive Post-Crisis Navigation and Recovery Services • 225 Individuals will successfully participate in evidence-based behavioral health treatment. • 75% of clients enrolled in treatment will report improved “quality of life” (entry vs exit)

Guam Behavioral Health and Wellness Center (GBHWC), the island’s only state agency for mental health and substance use, is seeking emergency funding in response to the growth in urgent mental health care caused by COVID-19. While Guam is only 30 miles long and 4-12 miles wide, Guam’s suicide mortality rate remains significantly higher than the U.S., with our age-adjusted rates being over twice that of the nation. Guam’s Bureau of Statistics & Plans (BSP) reported in 2018 that suicide was the sixth-leading cause of death among residents, with one occurring every eight days. Three days after the first confirmed positive COVID-19 case on island, GBHWC staffed the 24-hour Crisis Hotline that saw a dramatic increase of calls from an average of 25 per month to over 20 per day, with calls varying from general COVID-19 anxieties about health and employment, suicide ideations as a result of home quarantine with a violent spouse, to active suicide attempts stemming from hopelessness and despair. The proposed population of focus is individuals 25 years of age and older, who are at-risk for suicide during the COVID-19 pandemic, including victims of domestic violence. As reported by NASMHPD, between 2014 – 2018, over 1,300 calls were made from Guam to the National Suicide Prevention Lifeline’s 1-800 number and 0% of them were able to receive help nearby because there are no crisis centers on island. In 2019, GBHWC serviced over 70 clients who disclosed being victims of domestic violence. These numbers are expected to drastically increase as the island remains under stay-at-home orders. Additionally, Guam’s Department of Labor has already received information from employers that more than 18,000 workers have been directly affected by the COVID-19 pandemic, and they project about 20,000 more are going to file for unemployment benefits in the coming weeks. As these numbers continue to increase, the community persistently is faced with heightened stress, fear, and anxiety, while adjusting to the severity of acute shifts in lifestyles such as mandatory home isolation, travel quarantines, and job loss. Guam has already seen an increase in suicide attempts and suicidal crises with more and more people being transported to GBHWC from all three Emergency Departments (EDs). Guam’s COVID-19 Emergency Response for Suicide Prevention funds will help expand GBHWC’s capacity to support the community through the expansion of telehealth services, a 24/7 crisis hotline, and the establishment of formal transition and discharge protocols with EDs promote a comprehensive approach to suicide including those affected by domestic violence. During the project period, GBHWC aims to serve 200 individuals on top of the average 3,300 consumers annually.

The COVID-19 pandemic disaster is different from any other that Missouri or our country has ever experienced. In response to COVID-19, Missouri's Suicide Response for COVID-19 Project (MSRCP), Department of Mental Health (DMH) will collaborate with two mental health providers: Compass Health Network and Behavioral Health Response (BHR) to serve adults age 25 and older at-risk for suicide, including those at-risk for domestic violence. Currently, suicide is the 10th overall leading cause of death both national and in Missouri. In Missouri, it is also the leading cause of death for individuals between 10-44 years of age. The COVID-19 pandemic has the potential to exacerbate these numbers and contribute to an alarming number of Missourians needing urgent care to address their mental health needs, including suicidality. MSCRP will work to mitigate these results and reduce the overall number of suicides through the integration of suicide prevention in healthcare systems in counties devastated by COVID-19. This project will utilize effective practices for suicide outreach, assessment, intervention, and treatment to provide rapid follow-up for adults accessing emergency departments and inpatient hospitals due to a suicidal crisis and/or domestic violence. MSRCP will provide rapid response services across twelve high-risk counties due to suicide rates, COVID-19 cases, and domestic violence. These counties include six urban and six rural counties. the selected urban counties have the highest number of COVID-19 cases and deaths, the highest number of suicides, the more rural counties have lower COVID-19, but tend to have higher suicide rates than the urban areas and higher rates of domestic violence. MSRCP will provide services to a mix of both urban and rural areas to cover those most at-risk. Over the 16 month project period, MSRCP will serve over 2,000 at-risk adults, with over 500 of those being victims of domestic violence. MSRCP will align community-based efforts through working in partnership with the Missouri Suicide Prevention Network to establish a statewide communications approach for suicide awareness, a rapid response plan and obtaining real-time data to guide continuous efforts. Statewide training will be provided on evidence-based practices and recommendations including 1)Best practices in care transitions for individuals with suicide risk: Inpatient care to outpatient care and the Recommended Standard Care for People with Suicide Risk: Making Health Care Suicide Safe, 2) Collaborative Assessment and management of Suicidality, 3) Counseling on Access to Lethal Means, 4) Trauma-informed care and domestic violence best practices, and 5) Stanley Brown safety planning training. Trainings will primarily be virtual to safely reach as many service providers as possible. Through the multi-pronged approach of utilizing 1) intensive, emergency suicide response for adults and domestic violence victims, 2) coordination with Missouri Suicide Prevention Network to address statewide community recovery supports, and 3) utilization of evidence-based trainings; MSRCP will significantly reduce the suicide rate and number of suicides in Missouri. MSRCP is directly in line with SAMHSA's initiative to reduce the number of suicides nationally and mitigate the behavioral health impacts of COVID-19.

Massachusetts Department of Mental Health (DMH) will implement comprehensive suicide prevention practices that bridge health and behavioral health systems wit community services and recovery supports to address risk for suicide and suicide attempts in Hampden County, MA, a region hit hard by COVID-19. This work will be accomplished in partnership with Behavioral Health Network, Inc., the primary medical center serving the region, with particular attention to the needs of domestic violence victims under stat-at-home and quarantine orders. Adults discharged from emergency departments and inpatient psychiatric units following a suicidal crisis will receive rapid follow-up and care transition support provided by BHN's ESP team of crisis clinicians and community recovery navigators. MA-ERSP will also support state-wide service enhancements for victims of domestic violence responsive to the COVID-19 emergency environment and the associated increase in suicide risk. Hampden County has among the highest suicide rates in MA with a 32% increase in suicide among adults over 25 between 2015-2017. In 2017 intimate partner problems were reported in 23% of suicides in the region. Hampden County consistently ranks last out of all MA counties for health outcomes and has a rate of psychiatric hospitalizations double the state's rate. With COVID-19, nearly 38% of the regions' workforce have applied for unemployment benefits and local police departments report an 11% increases in domestic violence calls. Most notably, Hampden Country has the highest rates of death due to COVID-19 in MA and similar to national trends, COVID-19 hotspots fall in areas with mostly low-income residents of color. The goals of MA-ERSP are to 1) Strengthen the collective capacity of the Hampden County health care system to provide safer suicide care by establishing pathways for rapid follow-up and safe care transitions, increasing providers' competencies to implement evidence-based suicide prevention, and enhancing services for domestic violence victims and their dependents; 2) Expand access to community recovery supports for adults at-risk for suicide, and their impacted friend sand family; and 3) Adopt a systematic approach to comprehensive suicide prevention across MA state agencies to ensure evidence-based practices and policies for suicide prevention are incorporated into health and human service initiatives in a coordinated effort statewide. Measurable impacts include an increase in screening, referral, and treatment of adults at risk for suicide. The number of people served over the 16-month grant is projected to be: 12,976 ED screening for suicidality/domestic violence; 3,244 referrals to RAPID; and 348 IPU and PH referrals to RAPID for a total of 16,568 persons served.

Project Title: Georgia COVID-19 Emergency Response for Suicide Prevention Project Population(s): Adults age 25 and older, including older adults, who are at high risk (including victims of domestic violence (DV) and unemployed workers) for or have attempted suicide and live in seven of the state’s counties that have the greatest number of confirmed COVID-19 cases, hospitalizations, and total deaths. The seven counties are Clayton, Cobb, DeKalb, Dougherty, Fulton, Gwinnett, and Hall. Strategies/Interventions: The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) will contract with the following Comprehensive Community Providers (CCPs) to provide suicide prevention services for adults age 25 and older who are at high risk for or have had a suicide attempt and live in one of the seven target counties: Aspire Behavioral Health (Dougherty County); Avita Community Partners (Hall County); Clayton Center CSB (Clayton County); Cobb CSB (Cobb County); and ViewPoint Health (DeKalb, Gwinnett and Fulton Counties). In addition to expanded services provided by the participating CCPs, DBHDD and partners will provide suicide prevention gatekeeper training for state agency staff at the Department of Labor (DOL) and Department of Family and Children’s Services (DFCS), and implement two certified peer and/or support partner pilots and a suicide survivor support group in partnership with Grady Hospital ED and the Division of Aging Services (DAS). DBHDD will collaborate with Partnership Against Domestic Violence (PADV) to provide a Suicide Prevention curriculum to residents of two community-based shelters in Fulton and Gwinnett Counties. PADV will also provide DV awareness training and information to CCPs in the identified target counties. Training packets and resource toolkits will be developed for DV victims who may be a high risk for suicide. And with the launch of the new 2020-2025 Georgia Suicide Prevention Strategic Plan, the Georgia Suicide Prevention Task Force is being formed to oversee plan implementation. The task force will be composed of high-level suicide prevention stakeholders, decision-makers, advocates, and survivors representing diverse sectors, agencies, organizations, and community groups. A task force work group will be established to address COVID19 and DV specific issues and to develop recommendations specifically for emergency departments, inpatient psychiatric facilities, other behavioral health settings, and other sites as determined by the workgroup. As part of the new State Strategic Plan Launch Project, which will provide training and promotion on the plan across agencies, the task force workgroup COVID-19 and DV recommendations will be posted online and will be available in hardcopy version. Pamphlet versions will also be developed and information on the guidance will be included in social media advertising of the state plan.

The Emergency Expansion of Multisystemic Suicide Prevention and Treatment across Colorado in Response to COVID-19 Project is designed to significantly increase the availability of mental and behavioral health services to treat suicidality in Colorado. This will be accomplished by increasing capacity to treat at the Psychological Services Center and partner providers around the state. The project aims to increase the use of evidence-based practices to treat both clients and frontline workers, with a focus on adults 25 or older who are under and uninsured, domestic violence victims, and/or individuals with substance use disorders. Our catchment area is the State of Colorado, which is composed of approximately 5.8 million people living in urban, suburban, rural, and agricultural communities. Before the COVID-19 pandemic, Colorado ranked as 7th highest in number of deaths by suicide, with an average suicide rate almost 1.5 times that of the national average. Additionally, suicide was the 7th leading cause of death in the Colorado in 2018, and data show a disproportionate rate of suicide by geographic location, with age-adjusted rates of suicide in rural and agricultural regions of Colorado significantly higher than rates in urban areas. The goals of this proposal are to decrease suicidality in Colorado by implementing evidence-based practices and training partnered providers in the use of evidence-based practices; increase the Psychological Services Center's capacity and the capacity of partnered providers to provide direct services to prevent and treat suicidality in the state of Colorado; and to decrease suicidality among frontline workers responding to COVID-19 through education, training, and treatment. The objectives to be accomplished during the grant period are: the project direct will hire and the clinical trainer will train 5 new clinical staff, the clinical staff will start providing services by the 3rd month; the clinical trainer will provide suicide risk assessment and intervention training to at least 5 partner providers by the 5th month; the communications director and rural outreach director will develop a minimum of 6 additional partnerships with service providers around Colorado by the 6th month; the community outreach director and consultant will modify the RCHC by the 3rd month and the communications outreach director will deliver a minimum of 16 mRCHC groups serving approximately 120 frontline providers; the Integrated Suicide Treatment Team will increase the current caseload of the Psychological Services Center by at least 50%, providing services to at least 60 new clients, 25 of whom are victims of domestic violence; the Social Work Assistant will connect with at least 75 clients, at least 25 of whom are victims of domestic violence, with social services and COVID19 related relief services over the project period. The Assessment Director will be responsible for all data reporting. The Assessment Director will submit required clinical data, performance assessments, updates on accomplishments and barriers, and a detailed summary of our progress reports using SAMHSA's Performance and Accountability Reporting System at the required times.

For the Bergen County Suicide Prevention and Response Program, Care Plus NJ (CPNJ) and Bergen New Bridge Medical Center (BNBMC) will work collaboratively to advance efforts to prevent suicide and suicide attempts. This will be accomplished through comprehensive, intensive follow up and support services for individuals age 25 and older at risk of suicide who reside in Bergen County, NJ. There will be a particular focus on serving Domestic Violence (DV) victims and essential personnel as defined during the COVID-19 crisis. It is expected that the number of individuals seeking mental health services will rise exponentially due to COVID-19. As a result of the social restrictions aimed to stop the spread of the coronavirus, support systems have been severed, creating a great amount of stress, anxiety, conflict, violence, and sense of isolation leaving many in a state of crisis. According to the World Health Organization, these are all risk factors for suicidal behavior, with many suicides happening in moments of crisis. A population particularly prone to suicidal behaviors are DV victims, with data showing that Intimate Partner Violence played a role in 2,031 male and 439 female suicides across all age groups (FBI, 2018). CPNJ also proposes targeting essential personnel who are dealing with grueling workloads, unprecedented stress, PPE shortages, and steep death counts. Adding to these factors is the personal fear of contracting the virus and possibly bringing it home to their families. In particular, a study released last month reports that 50% of healthcare workers showed signs of depression, 45% reported anxiety and 72% felt some form of psychological distress (Liu and Hu, 2020). The trauma experienced by frontline workers and healthcare professionals can lead to chronic mental health challenges including PTSD, anxiety, depression, substance abuse, and suicidal ideation if not properly addressed. CPNJ and BNBMC will join forces to develop plans for rapid follow up of adults who have attempted suicide or experienced a suicidal crisis who are presenting to emergency departments and/or admitted to inpatient psychiatric facilities. The SPR program will outline care transition protocols to ensure patient safety, including enhanced services for DV victims. The program will provide, or assure provision of, suicide prevention training to community and clinical service providers and systems serving adults at risk. In addition, the program will work across state and/or community departments and systems in order to implement comprehensive suicide prevention. Suicide screening and assessment, transition to appropriate clinical treatment services will be facilitated, as well as recovery supports to assist individuals who have attempted or are at risk of attempting suicide and impacted household members. CPNJ and BNBMC will employ the Zero Suicide model to reduce the number of preventable deaths by suicide.

In response to the impact of COVID-19, Denton County MHMR Center proposes three goals to reduce the prevalence of suicide, domestic violence, and substance use in Denton County: strengthen the Mobile Crisis Outreach Team’s virtual presence in the community, hire additional staff to accommodate the needs of individuals discharging from local psychiatric hospitals, and implement educational courses such as Applied Suicide Intervention Skills Training (ASIST) and Mental Health First Aid (MHFA) for direct service provider organizations to promote suicide awareness and teach crisis intervention skills. This grant will address the needs of adults age 25 and older with suicidal ideation, serious mental illness, substance use disorder, dual diagnosis, or who are victims of domestic violence. Increasing behavioral health and substance use service gaps are evident from the impact of COVID-19 while clinical characteristics show approximately half of individuals receiving mental health treatment from the Center in 2019 were comorbid with substance use. The Center will utilize evidence-based practice strategies including but not limited to Collaborative Assessment and Management of Suicidality (CAMS), Dialectical Behavior Therapy (DBT), and Safety Planning Intervention (SPI) to address problems of suicide in Denton County and domestic violence reports that increased in the city of Denton and surrounding areas during COVID-19 restrictions. The Center’s objectives are to: obtain nine iPads for virtual screenings and assessments within the community, provide ASIST and MHFA training to least 10 different community agencies, train remaining Center staff in ASIST, utilize 100% of allocated funds towards the population of focus’ basic necessities, engage 75% of the individuals served in Employment Specialist services, provide a resource to 100% of referrals, ensure 50% of individuals served connect to that resource, explore 100% of barriers within individuals who did not connect to a resource, and lastly increase the number of face-to-face contact with individuals discharging from inpatient treatment to 90%. The number of individuals to be served with this grant is approximately 2,450 throughout the lifetime of the proposed project.

The population of focus is adults over 25 years of age with mental illness (75%) and victims of domestic violence (25%). Services will be delivered in the Southern Suburbs of Cook County (Congressional District 2), which has a population of 694,459.[1] Many of the communities in the target area have demographics that reflect high minority, crime, unemployment, poverty, and food insecurity rates and these risk factors contribute to mental illness, anxiety and domestic violence. Community and clinical providers serving these populations are also targeted to receive suicide prevention training to ensure continuity of care and appropriate referrals to service providers. The project will serve 900 people across all activities. Sertoma Centre, Inc. recognizes the need to quickly shift and adapt services to have the largest impact on people in our communities at any given time. During the recent shelter in place executive order Sertoma’s mental health services quickly adapted by providing individual and group services virtually and continue to shift staff positions toward services and activities most appropriate during this time. In addition, many staff continue to have face to face contact with people who are most at risk as addressing mental health is critical and “essential.” As part of this shift, Sertoma intends to develop and implement a comprehensive suicide prevention program as an emergency response to the COVID-19 pandemic. The comprehensive program includes 1) crisis stabilization for those recently attempting suicide, 2) active mental health treatment and case management for individuals who are considered at risk for suicide completion, 3) ongoing screenings for suicidal ideation and depression 3) community outreach and professional education on suicide prevention strategies and intervention, 4) crisis support for those with active suicidal ideations, and 4) community recovery supports for people who have attempted suicide and their families. Sertoma has the established infrastructure and services to begin implementing the emergency response suicide prevention program immediately. The focus is to increase access to existing services, improve existing services, add additional supports, improve partnerships to focus on suicide prevention, and develop metrics for assessing changes in mental health and suicidal ideation. Sertoma recognizes that the risk of suicide is especially high for those who experience domestic violence during shelter in place orders. Special focus will be given to this group through several of our efforts outlined in this initiative. In addition, all other efforts are available to those who experience domestic violence this group will be identified separately in our data tracking.

The Pima County Suicide Prevention program identifies and prevents suicides and domestic violence among those uninsured and underinsured individuals age 25 and older who live in Pima County, Arizona. These individuals will be outreached by behavioral health technicians in emergency room and psychiatric hospital environments, where they will be screened using the Columbia suicide screening tool. Individuals in need will then be referred to behavioral health and, or domestic violence services. We will provide an estimated 300 to 400 individuals with emergency housing and an additional 1500 with crisis hotline services during the 16 month grant period. Evidence based practices to be used include The National Action Alliance for Suicide Prevention Care Transitions Advisory Group authored Best Practices in Care Transitions for Individuals with Suicide Risk, Inpatient Care to Outpatient Care, safeTalk, ASIST, the Columbia suicide severity rating scale, and Motivational Interviewing. Through this work, we will increase referrals of at risk individuals, engage the county hospitals, and increase knowledge of suicide prevention through community based trainings. We will be measuring the number of unique individuals referred into care, individuals provided emergency housing, and individuals who complete suicide prevention training. We will work alongside partners at Pima County Health Department to track suicide rates. This application for funding is in partnership with Arizona Complete Health, the regional behavioral health authority in Pima County, and Emerge, the domestic violence provider for the county.

Volunteers of American Western Washington (VOAWW) proposes a COVID-19 Emergency Response for Suicide Prevention (ERSP) project to expand follow-up, care coordination, and aftercare support services for an adult population who are aged 25 and older experiencing emotional issues identified through the 24/7 Care Crisis Response Services (CCRS) and links with the National Suicide Prevention Lifeline (NSPL). Within the population are adults at risk of domestic violence (DV), in crisis and present in emergency departments (ED), and whose mental health (MH) has been adversely affected by the COVID-19 pandemic. The project will focus on service delivery for an eight counties Snohomish, Skagit, Whatcom, Island, San Juan, Clallam, Jefferson, and Kitsap in the western region of Washington state. Two hospitals in the catchment area have received an increase of ED visits related to suicidal ideation, depression, domestic violence, overdose, and alcoholism during the pandemic. Criminal justice reports indicate a reduction of domestic violence call volume and the calls they do receive are from concerned neighbors and family. DV advocates suggest sheltering-in-place has minimize the ability of victims to call for help and statistics do not reflect what is transpiring in homes. VOAWW’s COVID-19 ERSP project goal is to reduce the number of repeat visits to ED from individuals with suicidality and risks of domestic violence through follow-up, care coordination, and aftercare. Crisis Line Specialists will forward consent from crisis line callers to a team of Behavioral Health Navigators (BHNs) who will contact the client by phone or telehealth platforms. BHNs will (1) conduct a client needs assessment, (2) develop a client service plan (CSP) with the client’s input, documenting a safety plan and specific support services, (3) coordinate linkage between the client and service provider, (4) provide an aftercare plan designed with graduated follow-up to maintain client contact, ensure ongoing safety, reconnect them with resources if circumstances change, and preserve the client-BHN relationship for an authentic six-month follow-up interview. Client contact during aftercare will include the use of telehealth, text, chat, and visual communication. Five BHNs will serve 672 clients over the grant period; two BHNs will provide specialized case management to DV clients. Specifically, BHNs will offer hotel vouchers to provide safety for DV victims who need safe, emergency shelter until the BHN can link the client with DV services. ED contacts will request follow-up through the crisis line for individuals who present in the ED with suicidality, substance abuse, or other emotional distress prior to discharge and following a medical clearance and consent. VOAWW’s certified Living Works safeTalk trainers will deliver no cost suicide prevention training along with trauma informed care training for 150 clinical service providers to increase their confidence and competency when working with at-risk adults. To contribute to the prevention of suicide and suicide attempts, VOAWW respectfully requests $800,000 to implement the proposed COVID-19 ERSP project.

The Newport County (RI) System of Care (NCSOC) COVID-19 Emergency Suicide Prevention Program will be led by Newport County Community Mental Health Center (NCCMHC), in collaboration with Newport Hospital, East Bay Community Action Program, CODAC Behavioral Health, and the Women’s Resource Center. These collaborators currently work together in a local System of Care that utilizes a No Wrong Door approach for individuals and families with complex needs. The proposed program seeks to implement a Zero Suicide program that will be embedded within the NCSOC. The population of focus for this grant includes all adults aged 25 and older who are at risk for suicide in Newport County, RI, which has a population of 83,204. The racial makeup of the county is 92% White, 5.5% Black, 1.2% Native American/Alaska Native, and 2.5% Asian. 5.6% is Hispanic or Latino of any race. The median household income is $75,463. 9.0% of the population is below the poverty line. The mental health effects of the coronavirus disease 2019 (COVID-19) pandemic are profound and suicide has become a major concern as the pandemic spreads and has longer-term effects on the general population, the economy, and vulnerable groups. Specific sub-populations at increased risk include frontline healthcare workers, first responders, those who develop the illness, those with mental health issues, those who become unemployed, and victims of domestic violence. The program will provide many entry points into care for patients at imminent risk for suicide. Staff at the collaborating agencies will receive evidence-based training and practices to enhance their skill sets and change the culture to empower them to better address the behavioral health needs of the county’s population. Under the proposed program, all individuals who seek care at one of the partner sites will be screened for mental health and suicide issues using the Columbia Suicide Severity Rating Scale (C-SSR). Anyone identified at risk for suicide will receive immediate treatment or referral, a Suicide Care management Plan, and follow-up care. Specialized interventions to be utilized will include Cognitive Behavioral Therapy for Suicidal Prevention (CBT-SP), Dialectical Behavior Therapy (DBT), and Collaborative Assessment and Management of Suicidality (CAMS). Project goals include: 1) Reduce the incidence of deaths by suicide in Newport County. 2) Create a leadership-driven, safety oriented culture committed to reducing suicide among people under care. 3) Train and develop a competent, confident, and caring workforce. 4) Identify and assess suicide risk among people receiving care. 5) Engage individuals in ensuring that they have a pathway to care that is timely, adequately meets their needs, and includes a collaborative safety plan and means restriction. 6) Treat those assessed to be at risk of suicide with evidence-based treatments, and 7) Provide patients to continuous contact and support, especially after acute care. The project will seek to achieve a 40% reduction in suicides in the county and will serve 10,000 individuals by the end of the 16-month project.

The Implementation of COVID-19 Suicide Prevention across UT Physicians Program will provide comprehensive screening and systematic stepwise treatment plans for all adult patients presenting with suicidal thoughts and behaviors and victims of intimate partner violence at UT physician primary and multispecialty community-based clinics in the greater Houston area. The program is a collaborative effort between the UT Physicians the practice plan of the UT Health McGovern Medical School, and the Faillace, MD, Department of Psychiatry and Behavioral Sciences at the University of Texas Health Science Center at Houston (UTHealth). The desired outcomes of the COVID-19 Emergency Response for Suicide Prevention across UT Physicians are to increase screening, provide access to treatment, and reduce the risk of suicide to all patients that attend UT Physicians community-based clinics. The proposed program will address a critical gap by 1) universally screen all individuals for suicide, 2) train primary care and behavioral health providers to better identify and assess adult patients at risk of suicide, 3) create a care management plan for patients at risk of suicide and victims of domestic abuse and provide evidence-based treatment, and 4) coordinate care and transition stable patients back into a primary or integrated behavioral care setting. We estimate that the suicide prevention program at UT Physicians will serve approximately 30,000 patients over the 15 months funding period. Expected outcomes of the COVID-19 emergency response program include increased access to, and engagement in suicidal behavior interventions, reduced suicidal attempts and domestic violence, and improved the health and functioning of all program participants. Another key outcome will be the development of well-trained and confident clinicians and staff in the management of suicide risk. Additionally, it is expected that there will be a decrease in stigmatizing attitudes among clinic staff due to an increased understanding of suicidal behavior.

Wichita and Affiliated Tribes Emergency Response for Suicide Prevention (WAT-ERSP) The Wichita and Affiliated Tribes (WAT), working with its Tribal Partners and a Licensed state mental health therapist, will provide Telehealth counseling and other services to over 20,000 Tribal members in two counties in SW Oklahoma through the WAT ERSP program. We are focused on care coordination, early screening and safety planning to expand our reach through partnerships with first responders, law enforcement, child welfare and medical experts. We are joined in this effort by the Kiowa, Caddo, Apache and Fort Sill Apache who will partner in all grant activities. COVID 19 prevention, which has become a matter of life or death, requires social distancing that isolates Tribal members while at the same time requiring individuals caught in relationships fraught with interpersonal violence to remain in close quarters with violent individuals. Studies conducted in the Southwest United States and throughout the nation demonstrate that interpersonal violence is very high among Native communities and, that it is also very under-reported. These studies conclude that routine screening is a needed first step. Our use of Telehealth to conduct such screenings reduces barriers related to lack of transportation, stigma, and fear of retribution by being conducted in a private and protected setting such as a phone conversation with a Telehealth provider. Natives in violent situations will be given a Safety Assessment and Plan to help distance women and children from harm. Our work will be modeled upon a current WAT program that currently serves 38 families the Domestic Family Violence Program. Suicide information (which is often under-reported as well) shows that Natives in Oklahoma have much higher rates of suicide (over 19.7/100,000) than any other races. Our project will provide early screening for suicide as well as supportive care that is culturally appropriate (White Bison Wellbriety and Telehealth Counseling) for Native people. The WAT is experienced in Care Coordination and Benefits Coordination and we will use our Tribal expertise in these areas to connect Natives at risk of suicide with supportive resources. WAT ERSP will identify and serve Natives with severe mental illness and substance abuse disorder. With the availability of Telehealth, we hope to greatly increase the number of these individuals served and improve our services to them. Aggregated information (to protect confidentiality) gathered from Telehealth screenings will be used to create an adult Suicide Surveillance Database modeled after the White Mountain Apache and John Hopkins University successful suicide interventions in Arizona. No such database currently exists in Oklahoma. Native people respond best to culturally appropriate care and our WAT ERSP people is delivered and trained by local Native experts. Our project will have a PhD level evaluator experienced in suicide evaluation who will visit the project every each week and will produce an evaluation report about for suicide as well as for domestic violence interventions. We will serve a minimum of 350 Natives over the 16 month period and reach approximately 2,000 through other media information distribution.

The proposed project, entitled the BestSelf Enhanced Response for Suicide Prevention Project will serve individuals aged 25 and up who may be at-risk of suicidal ideation and behavior as well as victims of domestic violence in Erie County. BestSelf Behavioral Health, Inc. will enhance services and support for individuals at-risk of suicide ideation and behavior as well as victims of domestic violence. Both of the target populations may be at increased risk as a result of the COVID-19 pandemic. The proposed project will provide enhanced care coordination, linkage, and follow-up including safety planning. The project’s goals and objectives are as follows: Goal 1: Enhance support and services for individuals at an increased risk of suicidal ideation and behavior in Erie County. Objective 1a: By October 29, 2021, 400 unique clients will receive rapid follow-up care transition, linkage, and support after discharge from an inpatient setting Objective 1b: By October 29, 2021, 400 clients enrolled in rapid follow-up will be screened and assessed using the C-SSRS Objective 1c: By October 29, 2021, 40% of individuals enrolled in rapid follow-up will be referred to Dialectical Behavior Services (DBT) at BestSelf Objective 1d: By October 29, 2021, 10% of individuals enrolled in rapid follow-up will be referred to Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) at BestSelf Goal 2: Provide group support for individuals who have survived a suicide attempt. Objective 2a: By October 29, 2021, 30 individuals who have survived a suicide attempt will participate in a support group for survivors based on the Didi Hirsch Survivors of Suicide Attempts Support Group model Goal 3: Provide suicide prevention training to community and clinical service providers and systems serving adults at risk. Objective 3a: By October 29, 2021, 200 community members including those serving adults at risk will receive Question, Persuade, and Refer Training (QPR) Objective 3b: By October 29, 2021, 200 community members including those serving adults at risk will receive Mental Health First Aid Training Objective 3c: By October 29, 2021, 400 community members including those serving adults at risk will receive instructions on how to access the myStrength online platform Goal 4: Provide enhanced case management and coordination services for victims of domestic violence and their dependents Objective 4a: By October 29, 2021, 200 victims of domestic violence will receive comprehensive care management and support including linkage to existing services in Erie County

The proposed COVID Suicide Prevention Project will focus on adults age 25 and older, who are transitioning back into their community and families after making a suicide attempt. Most individuals will be discharging from the hospital but they may be coming from other crisis services (e.g., emergency department [ED]). Within this population we will have a specific focus on individuals who are current or past victims of domestic violence. With suicide rates following immediately following psychiatric hospitalization discharge over 50 times greater than the national average (Chung et al., 2017) and rates for outpatient behavioral healthcare continuing to remain under 50% for those with a diagnosed psychiatric illness (SAMHSA, 2019). These data speak to the value of continuity of care, highlighted in Knesper’s (2011) seminal review. The current COVID-19 pandemic has led to noticeable stressors related to finances, food insecurity, and social isolation – all leading to an increase in psychiatric hospitalization. The project is designed after other successful statewide efforts and includes a two-tiered approach. Tier 1 includes broad efforts that support training clinical and community staff across Pennsylvania, thus providing a forum for promoting evidence-based practices to all statewide providers. Tier 2 engages 13 counties within the catchment area of the lead agency, Center for Community Resources (CCR), and brings together a comprehensive aftercare protocol for individuals following psychiatric discharge and discharge from emergency departments and medical units following suicide attempts. We have developed an intervention that includes rapid follow-up, ongoing assessment, group support for suicide attempters, family-based intervention, connection to follow-up outpatient care, crisis support, and additional evidence-based interventions, such as safety planning and caring contacts. These individuals will be offered individual group support (in-person or telehealth) and family support via telehealth. Additionally, they will be offered a web-based screening tool, the Behavioral Health Screen (BHS; Diamond et al., 2010), that assesses and monitors for risk, automatically sends follow-up assessments, provides embedded safety planning, and initiates caring contacts. Thomas Jefferson University and Drexel University will offer follow-up clinical support and evaluate outcomes. Our model exceeds national standards, providing multiple touch points to engage suicidal adults, stabilize family support, and provide follow-up assessment and crisis supports, as needed. CCR receives nearly 25,000 crisis contacts annually, with 656 annual contacts involving imminent or high risk for suicide and another 1,066 calls for domestic violence, providing a viable performance site for this project. Considering our intervention not only addresses these individual but also family members who may be at increased risk, we expect a minimum of 7,191 individuals to be served by this project (assuming an average of 2.14 family members per high risk adult [U.S. Census Bureau, 2019] and a 16-month intervention phase). By training providers statewide in Tier 1, this estimate will significantly increase.

Through the Utah Responds Suicide Prevention Project, the Utah Division of Substance Abuse and Mental Health (DSAMH) will implement rapid follow-up with adults with adults at risk of suicide, training of clinical and community providers, expansion of nontraditional referral pathways and telehealth services, and enhanced services to survivors of domestic violence and their children. DSAMH will contract with Weber Human Services and Southwest Behavioral Health to implement rapid follow-up/care transition services to recently discharged adults ages 25+ at risk of suicide at two Emergency Departments, one each in northern and southern Utah, serving approximately 1,050 adults over the life of the project. The target areas, Weber County and Washington County, are in the top 5 most populated counties in Utah. Follow-up/care transition services will include the following evidence-based suicide prevention interventions: caring contacts, resource linking, appointments with rapid follow-up clinics, counseling on access to lethal means, safety planning, suicide screening, and clinical risk assessment (as needed). DSAMH will also increase access to quality services, including through non-traditional pathways, by implementing evidence-based suicide prevention training to community and clinical service providers for adults at risk for suicide. Approximately 250 clinicians will receive training in evidence-based suicide assessment and suicide-specific treatment interventions over the life of the project. Approximately 1000 community partners and paraprofessionals serving adults at risk of suicide will receive evidence based suicide prevention gatekeeper and means counseling, over the life of the grant. Additionally, DSAMH will partner with Utah Department of Health to provide phone crisis counseling services to approximately 420 individuals referred through the COVID 19 Active Monitoring program, over the life of the grant. Finally, DSAMH will contract with the Utah Domestic Violence Coalition, using the Home Safe program, to increase safety and stability for victims of domestic violence and their dependents including a safe place to stay in the event that individuals are unable to remain safely in the home setting; serving approximately 98 families over the life of the project. Utah Responds Suicide Prevention Project will allow DSAMH to plan and act now to mitigate the negative mental health impacts of COVID 19 and prevent unnecessary suffering and death.

Hegira Health, Inc.’s Pathways for Suicide Prevention (PSP) program will address the gaps in service delivery for adults who have attempted suicide or experienced a suicidal crisis by strengthening care transitions, enhancing treatment processes using evidence-based practices, and developing a suicide prevention campaign that includes education and training opportunities for staff and the community. The key priorities of PSP include: 1) increasing access during care transitions by offering expanded rapid, comprehensive treatment available through mobile crisis services, 2) increasing suicide prevention competency through training and public service campaigns 3) improving care outcomes through enhanced risk and treatment standards, 4) enhancing treatment for victims of domestic violence and sexual assault through training staff on screening, assessment and treatment for patient population, and 5) increase postvention supports for attempt survivors. Following the Zero Suicide framework PSP will provide immediate access to Mobile Crisis Stabilization teams upon discharge from inpatient hospitalization, emergency departments, or through a referral process with First Step, a domestic violence organization and shelter. PSP will expand screening, assessment and treatment capability for suicidality and domestic violence issues including use of the Danger Assessment and Columbia Suicide Severity Rating Scale (C-SSRS), and expanding capacity for utilization of EBP’s including Question, Persuade, Refer (QPR), Motivational Interviewing, and Collaborative Assessment and Management of Suicidality (CAMS). Staff will receive dedicated training on domestic violence and sexual assault and consultation from First Step experts. PSP will impact community awareness and prevention of suicide by obtaining QPR Master Trainer status, which will allow us to train community partners as QPR Trainers, and they can then train their staff and community partners as suicide prevention gatekeepers. In addition, HHI will launch a digital media campaign providing education and awareness of suicide prevention and suicide and domestic violence to help break down stigma and increase knowledge of community resources available. HHI’s intended catchment area for PSP funding is Wayne County, Michigan (population 1,761,382) which includes the City of Detroit (population 659,135). U.S. Census data for 2019 reports 22.7% of Wayne County residents live below the federal poverty level (FPL) as compared to Michigan (14.2% FPL) and the nation (13.4% FPL). The Michigan League for Public Policy’s (MLPP, 2018) annual report identifies the racial profile of the County as 53.1% Caucasian, 39.1% African American, 5.7% Hispanic or Latino, and 2.0% “other” including Asian and Native American populations. Over 49% of families are single-parent and 30% have a High School diploma or less. Unemployment also remains higher with 5.2% for Wayne County, 4.2% for Michigan, and 3.7% nationally. PSP will 1) provide rapid response clinical services to 450 individuals during the grant period, 2) reach 3,500 individuals through community training, suicide prevention conference and digital media campaign.

Liberty Resources Inc. (LRI), NCQA PCMH certified and current SAMHSA PBHCI and CCBHC grantee, proposes establishing a comprehensive crisis intervention system in a three county region in Central New York (CNY), to include Onondaga, Oswego and Madison Counties. Approximately 800 will be served in the mental health crisis intervention system of mobile crisis and crisis respite. Of those, it is anticipated that approximately 75 of those will be high risk for suicide. The CNY Region is among the neediest in comparison to the state. Onondaga County’s suicide mortality rate exceeds that of New York State (NYS) of 10 vs. 8 per 100,000. In the city of Syracuse, 15.4% of adults report experiencing poor MH for 14 or more days in the last month; higher than NYS excluding NYC (11.2%). Depression is the leading cause for ED visits in Oswego County, with 8 of the top 10 conditions for ED visits in the region being BH related. Oswego County has a suicide mortality of 17.3 per 100,000 people, far exceeding the national average, twice that of NYS and the highest in CNY. Compared to NYS, Oswego County has a higher rate of binge drinking (consuming 5+ drinks in a row) at 22.5% compared to 19.6%, and a higher rate of alcohol consumption at 23.90% compared to 15.70%. Madison County also experiences a higher rate of suicide mortality than the NYS average at 14.1 per 100,000 and a Non-Suicidal Self Injury Hospitalizations at 117.4 per 100,000 persons in Madison County compared to 65.0 in NYS; in addition 11.7% of adults report poor mental health for at least 14 days of the last month, including stress and depression. Madison County is also higher than the NYS average for binge drinking at 25%. LRI proposes to expand on the continuum of behavioral health services with a focus on interventions for rapid care for adults who have attempted suicide or experienced a suicidal crisis. LRI promotes a model for Central New York (CNY) that aligns with the SAMHSA National Guidelines for Behavioral Health Crisis Care Best Practices. LRI’s existing services and key community partnerships promote a framework for this model. The system includes a Regional Crisis Call Center, LRIs Mobile Crisis team, three Residential Crisis Respite facilities, outpatient mental health and substance use disorder (SUD/OUD) services, comprehensive care coordination and care transition planning. Regional Prevention Coalition DCOs in each county will provide extensive suicide prevention training in safeTALK, Mental Health First Aid, and ASIST Training. In addition, coalitions will provide comprehensive community prevention education. All clients will be referred to LRIs outpatient services or community based recovery supports. A population of focus will be given priority access to LRIs Help Restore Hope domestic violence hotline, advocacy and shelter dwelling facilities. Suicide focused Evidenced based practices will be employed in clinical treatment. Also, telehealth services will be utilized during the pandemic situation. IT setup for Electronic Health Records will be prioritized to ensure the appropriate data collection and analysis of outcomes can be reported.

The WA COVID 19 ERSP will implement best practice care transitions for individuals with suicide risk from emergency departments and inpatient psychiatric facilities to outpatient care. Community and service providers and systems serving adults at risk, including domestic violence providers, will receive suicide training in assessment of risk and protective factors, best practice interventions and treatment (including lethal means), and follow up care. The Project's target population is adults 25 years of age or older, high risk individuals in health and behavioral health care settings, victims of domestic violence and their dependents, and who have also attempted suicide or experienced a suicidal crisis after discharge from an emergency department or inpatient psychiatric facility. The WA COVID 19 ERSP is a statewide collaboration between the Washington State Health Care Authority, Harborview Medical Center's Behavioral Health Institute (BHI), New Beginnings' domestic violence program, and emergency departments and inpatient psychiatric facilities located in the greater Seattle area and NE Washington to implement evidence based digital strategies for caring for individuals with a history of suicide risk during the critical transition from inpatient to outpatient care. In the month after patients leave inpatient psychiatric care, their suicide death rate is 300 times higher in the first week and 200 times higher in the first month than the general population's (Chunt et al., 2019). Hospital emergency departments and inpatient psychiatric facilities are the front lines. We will use this grant opportunity to advance findings from the Washington State Bree Collaborative Suicide Care Report and Recommendations, which includes risk assessment and screening, clinical protocols for timely and adequate care, lethal means reduction, collaborative safety planning interventions, and evidence based treatment and follow up care. Through consultation and training with our states leading experts in suicide prevention we will implement Caring Contacts (CC), an intervention that involves sending patients who are suicidal brief, non demanding expressions of care and concern following discharge. Our goals and objectives include: 1) serve 202 patients in year 1 and 300 by the end of the Project), 2) train 4,640 professionals in year 1 and 6,500 by the end of the Project, 3) reduce suicide related deaths through use of evidenced based practices, 4) serve patients in a culturally competent, patient centered care manner, and 5) seek sustainable program financing.

Burrell Behavioral Health (Burrell) is requesting $800,000 to implement the Missouri ASAP (Agencies for Suicide Assessment and Prevention) project; an emergency community suicide prevention plan in response to COVID-19 to flatten the mental health curve and prevent the second wave of potential increased mental health concerns, including suicidality. AS Missouri's second largest Certified Community Behavioral Health Organization (CCBHO), Burrell serves two distinct service areas (SA) encompassing 17 counties in southwest and central Missouri. The project SA population exceeds 892,000; nearly one in five Missourians. 100% of the counties are designated Medically Underserved Areas and Communities. Grant dollars will support advancing community efforts to prevent suicide and suicide attempts among adults age 25 and older as the current COVID-19 crisis continues to contribute to the growth in the number of Americans needing urgent care to address mental health needs, including suicidality. Targeted communities of focus include; 1) domestic violence victims and their families; 2) individuals with serious mental illness (SMI); 3) individuals with substance use disorder (SUD); and 4) individuals with co-occurring behavioral health disorders (CODs). At the time of submission COVID-19 has impacted Burrell's service area with 669 known cases, this accounts for 17% of Missouri's 11,340 known cases. With Missouri counties all experiencing different paths to reopening, it is unclear when the COVID curve will flatten as cases have increased in Missouri by more than 50% since April 2020, when there were 5,111 cases detected. SAMHSA has referenced the increases in depression, anxiety, trauma, grief, isolation, loss of employment, financial instability and other challenges that will impact people's mental health; creating a crisis. Burrell's CEO, CJ Davis refers to this as the "second curve". While hospitals are concerned about being overwhelmed with COVID-19 cases, mental health systems have concerns about the increase in demand for services as well. Missouri ASAP will provide funding and resources to implement a comprehensive community effort to reduce incidence and impact of suicide events and promote hope and healing in our geographic areas. ASAP's plan will reduce risk factors, increase protective factors and take a strategic approach to the design and implementation of the SAMHSA required activities. Burrell will work with community partners to create, implement and follow a comprehensive community suicide prevention plan that provides appropriate services to those in need and those affected by suicide. There will be significant planning with community partners to strengthen or improve current suicide prevention steps that are already in place and operating in the community, as well as add to the current suicide prevention plan based on the collective knowledge of the community partners. CARF accredited with over 1,600 staff, 26,000 persons served and $125 million in annual revenue, Burrell has over 42 years of experience as a stated designated CMHC. It is a current SAMHSA funding recipient (CCBHC-E, PBHCI, PATH, TREE, SOC) and is a SAMHSA Science and Service Award winner.

Project Name: Seasons COVID 19-ERSP Project Applicant: Northwest Iowa Mental Health Center dba Seasons Center for Behavioral Health Project Summary: To increase access to behavioral health services for individuals, families and communities during the COVID-19 pandemic and enhance efforts to prevent suicide and suicide attempts within nine counties in rural northwest Iowa. Target Population to be Served: The target population for the proposed project is adults age 25 and older struggling with behavioral health challenges as a result of the recent COVID-19 crisis. The project will target three unique subpopulations: victims of domestic violence, farmers and ag-related workers, and immigrants and refugees. Demographic and Clinical Characteristics of Target Population: The geographic service area for the project encompasses 9 counties in rural northwest Iowa: Buena Vista, Clay, Dickinson, Emmet, Lyon, O’Brien, Osceola, Palo Alto, and Sioux. The service area has a population of 137,943 residents (Census 2018 Estimates). Seasons provided behavioral health services to 4,382 individuals in 2019, including 2,827 adults, from the nine county service area. Evidence-Based Strategies and Interventions: Adult Mental Health First Aid (MHFA), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Motivational Interviewing (MI), Seeking Safety (SS), Matrix Model, Assertive Community Treatment (ACT). Project Goals and Measurable Objectives: Goal I: To create the organizational capacity to implement grant activities, ensuring the required elements of the grant are delivered on time and as intended, specifically the sub-population of victims of domestic violence. Goal II: To equip mental health professionals with skills, knowledge, and resources to provide high quality, evidence-based, trauma-informed, and culturally responsive services, targeting identified sub-populations. Goal III: To ensure individuals and families are able to easily obtain behavioral health services, resources, and supports along a continuum of prevention, early intervention, and treatment, including suicide prevention. Goal IV: To enhance collaboration with other service systems, community agencies, and local businesses to raise awareness on mental health, suicide, and domestic violence during the COVID-19 pandemic and beyond. Number to be Served Throughout Lifetime of Project: The targeted total number of individuals to be served by the project over the 16 month project period is 1,820. A breakout of the number served includes: Direct Services-150, Training in Mental Health Practice-16, and Training in Mental Health Prevention or Promotion-1,820.

Zepf Center, in partnership with ProMedica Flower Hospital, Mercy Health St. Charles Hospital, Northwest Ohio Psychiatric Hospital, Bethany House, the YWCA of Northwest Ohio, OhioMeansJobs Lucas County, and the Lucas County Family and Children First Council proposes the Emergency Response for Suicide Prevention Program (ERSP) in Northwest Ohio. We anticipate serving 75 unduplicated individuals over the course of the 16 months, with an anticipated start date of June 30, 2020. This project works directly with two domestic violence shelters (Bethany House and YWCA), three hospital systems, employment services, and family services to create a cross-system approach to addressing suicide due to COVID-19.

The Louisiana Department of Health, Office of Behavioral Health (OBH) will implement the COVID-19 Emergency Response for Suicide Prevention (COVID-19 ERSP) Project in southeast Louisiana. This area of the state has been chosen due to the high COVID-19 rates of infection and deaths, and rates of domestic violence incidents. Socially and financially disadvantaged families are more vulnerable to stresses and traumas, and the risk for mental health problems and domestic violence increases after families face extreme adversity, such as those related to COVID-19 disruptions and trauma. The overarching goal of this project is to decrease rates of suicides and suicide attempts in adults ages 25 and older, with attention directed to those affected by COVID-19 discharged from hospitals and psychiatric settings. To achieve this goal, OBH will partner with the Mental Health Association for Greater Baton Rouge (MHA) and other statewide and regional agencies to implement comprehensive suicide follow-up, screening, assessment, prevention, treatment, postvention, and recovery support services. MHA will employ a Case Management intervention model utilizing Peer Support Specialists as the case managers. MHA will coordinate the services of an array of partners to include the National Suicidology Training Center and the American Foundation for Suicide Prevention to provide evidence-based suicide prevention training for first-responders, providers and the general public offered on a state-wide basis. Given the enhanced threat of domestic violence during recent stay-at-home and quarantine orders, Southeastern Louisiana University, Discovery/Renew Family Resource Projects will establish an advocative role for domestic violence victims and establish a relationship with shelters and other domestic violence coalitions and resources to address trauma in the 14 parish geographic area of focus. Support groups and empowerment counseling will be provided by the Discovery/Renew Project, as well as case management and access to resources. MHA and its partners will ensure referral to appropriate crisis and treatment services offered by the network of clinical professionals at Local Governing Entities (LGEs) in the identified regionals. This multilayered effort has the ultimate goal of preventing a spike in suicides in the state of Louisiana as a result of the COVID-19 crisis and the resulting economic impact.

The proposed project will be implemented by AtlantiCare Behavioral Health, which is the behavioral health department of AtlantiCare Health System. The geographic catchment area will be southern New Jersey, including Atlantic, Cape May, Ocean, Burlington, and Camden counties. Data indicates that the suicide mortality rate in our primary service area is rising faster than the national average. We plan to screen 290,000 unduplicated individuals over the five years of this grant. AtlantiCare’s leadership has adopted the components of the Zero Suicide model with the goal of reducing the number of suicides and suicide attempts in the communities we serve. The proposed project will address disparities in access, service use and outcomes by developing a system-wide approach to suicide prevention and treatment. AtlantiCare provides a wide spectrum of services at multiple locations throughout southern New Jersey. These multiple points of contact are accessible to diverse populations in the county. Using an evidenced-based tool, we plan to screen all individuals seen at AtlantiCare clinical sites for suicide risk. Individuals screened as at-risk will be immediately referred for a full assessment of their risk level with an evidence-based assessment tool. Using a standardized algorithm, individuals will be referred to an appropriate level of care based on their risk level and assessment of their risk/protective factors. All individuals assessed as at-risk will complete a Safety Plan and receive counseling on access to lethal means. Individuals assessed as immediate risks will be transported to the nearest county screening center for further assessment on the need for inpatient psychiatric hospitalization. Individuals assessed as a high risk will also be offered the opportunity to link with a Suicide Prevention Coordinator. The Coordinator will be able to provide participants with daily checks on risk status, immediate access to outpatient care, and assistance with safety planning. AtlantiCare has also adopted an evidence-based therapy model to specifically address suicidal ideation and behaviors. AtlantiCare proposes to hire a dedicated Suicide Prevention Team of a Project Director, Project Evaluator and two Suicide Prevention Coordinators. The task of this team will be to move forward and expand the nearly seven years of groundwork in the use of the Zero Suicide Model. This team will allow AtlantiCare to centralize and coordinate work across the many and varying areas of the system. Having a dedicated team that can demonstrate this leadership is essential to the expansion of the work that has already begun. The intention is to set specific measurable objectives to guide the project toward the ultimate goal of reducing the number of suicides and suicide attempts for the individuals we serve. AtlantiCare will implement a data-drive quality improvement process. This process will include the establishment of a Team Scorecard with defined objectives and targeted results to be reported out on a quarterly basis. The goal of this process is to measure and track improvement of the full line of Zero Suicide elements with a focus on improved outcomes and better care for individuals at risk of suicide.