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 (SMVF) to states, territories, and communities across the Nation. For the Governor’s Challenge, 54 states and territories are currently taking part in the challenge and are working to develop and implement state-wide suicide prevention best practices for SMVF, using a public health approach. For the Mayor’s Challenge, 22 communities were originally engaged as part of the challenge. Currently, 19 of those teams are still actively participating. SAMHSA’s SMVF TA Center is providing technical assistance for these initiatives.
- Convene a state/territory (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 Suicide Prevention Resource for Action (PDF | 25.4 MB).
- Engage with city, county, territory 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/territory-to-state/territory and community-to-community sharing.
- Implement 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
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
Each state/territory or city/county will select team members with a long-term commitment to developing and implementing a strategic plan to enhance access to SMVF suicide prevention services and best practices. The interagency team should be comprised largely of military and civilian individuals with the ability and authority to impact and implement state/territory or city/county-level policy changes. Technical assistance is provided primarily through site visit meetings and academies; all team members are encouraged to attend.
- A Team Leader, appointed by the Governor, who serves as the point of contact throughout the Policy Academy process, and throughout the process of implementing the action plan. A team may also elect to have a co-leader if desired.
- Mayor’s Challenge Team Leader(s), if applicable
- Senior level suicide prevention and behavioral health representatives from:
- State/territory agencies responsible for mental health, substance abuse (e.g., Single State Authority), and State Veterans Affairs
- National Guard (i.e., The Adjutant General or his/her representative)
- Medicaid and/or Social Security
- Department of Veterans Affairs Veterans Integrated Service Network (VISN) serving your state/territory (Chief Mental Health Officer and/or VISN Suicide Prevention lead)
- Leadership from SMVF Caregiver Organizations
- Private sector provider and peer support leadership from programs serving the health and behavioral health needs of Service members, Veterans, and their families
- Data and evaluation lead
Teams are encouraged to consider the needs of SMVF in selecting other members of the team. Examples include leadership from:
- Federally recognized tribes
- Reserve Affairs
- Community Veterans Engagement Board (CVEB)
- VA Community Engagement and Partnership program (Community Engagement and Partnership Program Manager [CEP-PM] or Community Engagement and Partnership Coordinator [CEPC])
- Crisis response system lead
- Law enforcement
- The public and private sectors in labor/employment, criminal justice, housing/homelessness, primary care, substance abuse and mental health services (including suicide prevention), and child/family issues
- Academic partners: colleges and universities
- SMVF advocacy groups and social/public health organizations or coalitions
- The faith-based community
- Public school systems
- State and/or local legislators
- Outreach or public information/public affairs
- State/territory Medical Boards and/or licensing authorities (Social Work, Nursing, Mental Health Professions, etc.)
- Members from diverse populations including historically underrepresented groups (Women, ethnic minority advocacy organizations, LBGTQ+ organizations, etc.)
- Military spouse organizations, caregiver support organizations, etc.
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/territory/local suicide prevention plans. Creating a representative team is a critical phase of work. It builds collaborative working relationships across sectors that are too 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 (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.
From the VA’s National Strategy, Suicide Prevention (SP) 2.0 Community-Based Interventions for Suicide Prevention (CBI-SP) (PDF | 380 KB) was developed. The CBI-SP model aims to reach Veterans through multiple touchpoints. CBI-SP initiatives include the Governor’s Challenge, Together with Veterans and Community Engagement and Partnership for Suicide Prevention. Community Engagement and Partnership for Suicide Prevention involves a comprehensive strategy to hire and train qualified Community Engagement and Partnerships Coordinators (CEPC) and Community-Based Interventions Program Managers (PM), who collaborate at the community, regional and state levels, to support community coalition building for evidence-informed suicide prevention interventions specific to each locality’s Veteran population. This model strengthens VA’s focus on high-risk individuals in health care settings while embracing cross-agency collaborations and community partnerships to meet Veterans where they live, work, and thrive.
In addition, CDC’s Suicide Prevention Resource for Action (PDF | 25.4 MB) is used to help teams incorporate evidence-based strategies and best practices into their planning.
Governor’s Challenge: Focused Priority Areas
Governor’s Challenge Process
The Governor’s Challenge is an intensive process that takes each state/territory team through the stages of both a Policy Academy model and an Implementation Academy model. These models offer a proven process and foundation for bringing policy-to-practice change in state/territory systems. Technical assistance (TA) is provided by SAMHSA’s SMVF TA Center throughout this process.
The process descriptions are included below. Note: The graphics and descriptions below are intended only as guidelines to be considered throughout the process. The actual sequencing of events may be modified as a result of situational and funding factors.
Year One - Planning Stages Step by Step Technical Assistance Events
The purpose of the Policy Academy model is to provide an introduction to the Governor’s Challenge process, support states and territories in selecting and inviting their team members and begin the planning process. This includes conducting environmental scans of current efforts, analyzing strengths, weaknesses, and opportunities, and developing logic models and action plans that can be implemented in subsequent stages of the process. These efforts are provided through state-specific site visits with SMVF TA Center facilitators, a session introducing RAND’s Getting To Outcomes® framework, and a multi-state Policy Academy that provides an opportunity for state-to-state sharing and support from subject matter experts and national leaders.
Year Two – Implementation Stages Step by Step Technical Assistance Events
The next stage moves forward to the Implementation Academy model with the purpose of supporting the established teams in planning for the implementation of pilot projects or efforts within their suicide prevention action plans. To this end, teams work to define and measure success, create milestones with assignments and timelines, and measurable outcomes that can be reported to key stakeholders. These efforts will also include state and territory-specific site visits with SMVF TA Center facilitators, a second session with RAND on specific implementation of the Getting to Outcomes framework, and another multi-state and territory Implementation Academy that will help teams initiate the implementation process.
RAND Prep Session
The RAND Prep Session serves to introduce RAND’s Getting To Outcomes® framework for comprehensive planning, implementation guidance, and evaluation of programs and community initiatives. The virtual session is lead by a subject matter expert from the RAND Corporation, specifically discussing best practices in the implementation of prevention practices and providing examples and guidance on how to build an evaluation plan for each strategic priority area.
Key Efforts and Accomplishments
Key accomplishments for the Governor’s and Mayor’s Challenge teams include the following:
- Reducing suicide among service members, veterans, and their families;
- Increasing access to services and support;
- Expanding state and territory-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.