SAMHSA has partnered with the United States Department of Veterans Affairs (VA) to bring the Governor’s and Mayor’s Challenges to Prevent Suicide Among Service Members, Veterans, and their Families to states and communities across the nation. For the Governor’s Challenge, seven states are taking part in the challenge and are working to implement state-wide suicide prevention best practices for Service Members, Veterans, and their Families, using a public health approach. For the Mayor’s Challenge, 24 sites, 8 of which are within participating Governor’s Challenge states, have accepted the challenge. SAMHSA’s SMVF TA Center is providing technical assistance for these two initiatives. Challenge Objectives Convene a state (Governor’s Challenge) or city/community (Mayor’s Challenge) interagency military and civilian team of leaders to develop an implementation plan to prevent suicide among SMVF that will advance the VA’s National Strategy for Preventing Veteran Suicide (PDF | 2.9 MB) and incorporate evidence-based strategies from the CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices (PDF | 6.3 MB). Implement promising, best, and evidence-based practices to prevent and reduce suicide. Engage with city, county, and state stakeholders to enhance and align local and state-wide suicide prevention efforts. Understand the issues surrounding suicide prevention for SMVF. Increase knowledge about the challenges and lessons learned in implementing best policies and practices by using state-to-state and community-to-community sharing. Employ promising, best, and evidence-based practices to prevent and reduce suicide at the local level. Define and measure success, including defining assignments, deadlines, and measurable outcomes to be reported. Participating Governor’s Challenge States The following states are currently participating in the Governor’s Challenge: Governor’s Challenge Teams Arizona Colorado Kansas Montana New Hampshire Texas Virginia Participating Mayor’s Challenge Communities Some Mayor’s Challenge teams are city-based, some are county-based, and some are based in a local geographic region that crosses county lines. Mayor’s Challenge Teams Albuquerque, NM Atlanta, GA Austin, TX Billings, MT Columbus, OH Montgomery County, TN Detroit, MI Helena, MT Hillsborough County, FL Houston, TX Jacksonville, FL Kansas City, MO Las Vegas, NV Los Angeles, CA Manchester, NH Mecklenburg County, NC Oklahoma City, OK Phoenix, AZ Richmond, VA Suffolk County, NY Topeka, KS Truckee Meadows, NV Tulsa, OK Warwick, RI Team Composition Governors, Mayors, or County Commissioners appoint team leaders to serve as the point of contact and coordinator for the Challenge process. Team leaders then receive technical assistance to design a strategic interagency team composed of individuals with the ability and authority to advance and implement state-wide policy and practice changes. Teams are encouraged to include both military and civilian representatives as described below. Perhaps most critically, teams are encouraged to include suicide prevention coordinators representing the state public/behavioral health agency, VA, and National Guard. Senior-level representatives/policy makers from the following: Governor’s/Mayor’s/Commissioner’s Office representative Suicide prevention coordinators from state, VA, and National Guard Community Veterans Engagement Board (CVEB) Governor’s Challenge State agencies responsible for mental health, substance use, and Veterans Affairs The National Guard Reserve Affairs Medicaid and/or Social Security VA’s Veterans Integrated Service Network (VISN) serving the state Mayor’s Challenge State SMVF team leader A service member or Veteran and a family member of a service member or Veteran Teams are also asked to consider including other members, such as: SMVF peer support leaders Veterans service organizations Military and veteran caregivers State and/or local legislators State/local training leadership Leadership from federally recognized tribes Private-sector leadership from innovative programs serving the needs of SMVF, such as Community Mental Health Clinics, Community Service Boards, and Crisis Service Systems Individuals with expertise in labor/employment, criminal justice, housing/homelessness, primary care, substance use and mental health services (including suicide prevention), and child/family issues Individuals representing advocacy groups, social/public health organizations or coalitions, and the faith-based community This cross-section of military and civilian agencies allows the teams to effectively plan for increased coordination of efforts and integration of SMVF into their existing state/local suicide prevention plans. Creating a representative team is a critical phase of work. It builds collaborative working relationships across sectors that are often isolated. This process also allows for initiatives to be championed, coordinated, and disseminated across many sectors. Framework for Planning – Ensuring a Comprehensive Approach VA’s National Strategy for Preventing Veteran Suicide (National Strategy) (PDF | 2.9 MB) provides a framework for integrating and coordinating suicide prevention activities across multiple sectors. The Governor’s and Mayor’s Challenges advance the principles of the National Strategy by facilitating policy-to-practice implementation plans. These plans will serve as instruments of change, providing a best-practice public health model that demonstrates meaningful results in suicide prevention. The four interconnected strategic directions of the VA National Strategy are as follows: Healthy and Empowered Veterans, Families, and Communities; Clinical and Community Preventive Services; Treatment and Support Services; and Surveillance, Research, and Evaluation. In addition, CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices (Technical Package) (PDF | 6.3 MB) is used to help teams incorporate evidence-based strategies and best practices into their planning. SMVF Suicide Prevention Model Stone, D.M., Holland, K.M., Bartholow, B., Crosby, A.E., Davis, S., and Wilkins, N. (2017). Preventing Suicide: A Technical Package of Policies, Programs, and Practices. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. 1. US Department of Veterans Affairs. National Strategy for Preventing Veteran Suicide, 2018–2028. [Accessed November 6, 2018]. Published June 2018. Governor’s Challenge Process The Governor’s Challenge is an intensive year-long process that takes each state team through the stages of both a Policy Academy model and an Implementation Academy model. These models provide a proven process and foundation for bringing policy-to-practice change in state behavioral health care systems. TA is provided by SAMHSA’s SMVF TA Center throughout this process. Key Efforts and Accomplishments Key efforts and accomplishments for the Governor’s and Mayor’s Challenge teams include the following: Effort to reduce suicide among service members, veterans, and their families; Increasing access to services and support; Expanding state-wide capacity to engage SMVF in public and private services; Enhancing provider and SMVF peer practices; Implementing innovative best practices (e.g., Screening and Asking the Question – have you or a loved one ever served in the military?) See VA’s Community Provider Toolkit for additional information on screening Forming cross-system military and civilian consensus on priorities and plan for action; Identifying critical data elements to measure impact and quality of care; Strengthening the continuum of care; and Transferring knowledge on evidence-based practices, policies, and strategies that are effective across teams.