Governor’s and Mayor’s Challenges to Prevent Suicide Among Service Members, Veterans, and their Families

SAMHSA partners 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, all 50 states and 5 territories are engaged in the challenge and are doing ongoing work to expand and implement state-wide suicide prevention best practices for SMVF, using a public health approach. For the Mayor’s Challenge, 24 communities were originally engaged as part of the challenge. Currently, 14 of those teams are still actively participating. SAMHSA’s SMVF TA Center continues to provide ongoing technical assistance for these initiatives.

A color-coded map of the United States and U.S. Territories indicating which year a team joined the Mayor's or Governor's Challenge.

Governor’s Challenge teams are indicated in blue with the lightest shade of blue identifying the oldest teams and the shade of blue getting darker for each subsequent year of engagement.

2023 Governor’s Challenge Teams: Commonwealth of the Northern Mariana Islands; Idaho; Oregon; and South Dakota

2022 Governor’s Challenge Teams: Alaska; American Samoa; California; Connecticut; Delaware; Guam; Hawaii; Indiana; Iowa; Maine; Nebraska; New Mexico; North Dakota; Puerto Rico; Vermont; and U.S. Virgin Islands

2021 Governor’s Challenge Teams: Arkansas; Louisiana; Massachusetts; Mississippi; Missouri; New Jersey; Utah; and Wyoming

2020 Governor’s Challenge Teams: Alabama; Florida; Georgia; Illinois; Kentucky; Maryland; Michigan; Minnesota; Nevada; New York; North Carolina; Ohio; Oklahoma; Pennsylvania; Rhode Island; South; Carolina; Tennessee; Washington; West Virginia; and Wisconsin

2019 Governor’s Challenge Teams: Arizona; Colorado; Kansas; Montana New Hampshire, Texas; and Virginia

Mayor’s Challenge Teams are indicated with dots.

Green dots indicate 2018 Mayor’s Challenge Cities and Communities: Phoenix, AZ; Los Angeles, CA; Hillsborough County, FL; Jacksonville, FL; Billings, MT; Helena, MT; Las Vegas, NV; Albuquerque, NM; Austin, TX; Houston, TX; Richmond, VA; Atlanta, GA; Detroit, MI; Manchester, NH; Providence, RI; and Topeka, KS.

Orange dots indicate 2019 Mayor’s Challenge Cities and Communities: Kansas City, MO; Truckee Meadows, NV; Suffolk County, NY; Mecklenburg County, NC ; Oklahoma City, OK; Tulsa, OK; and Montgomery County, TN

*Not included in the Map is a 2021 Mayor’s Challenge Team in Lawton, OK

Challenge Objectives

• 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 | 2.8 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.

Team Composition

Upon acceptance of the Governor’s or Mayor’s Challenge invitation, a team leader (or co-leaders) was appointed by the Governor or Mayor to lead the effort. Each state/territory or city/county then selected 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 teams are comprised largely of military and civilian individuals with the ability and authority to impact and implement state/territory or city/county-level policy and program changes. Team members include representatives from state/territory agencies responsible for mental health and substance use, state departments for veteran affairs, National Guard, veteran service organizations, community behavioral health providers, peer support and faith-based organizations, local universities, state and local legislators and more. Team membership evolves over time, including leadership transitions and the introduction of new members as needed to support implementation of the strategic plan.

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:

1. Healthy and Empowered Veterans, Families, and Communities;
2. Clinical and Community Preventive Services;
3. Treatment and Support Services; and
4. Surveillance, Research, and Evaluation.

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.

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.

Ongoing TA and Support

Governor’s and Mayor’s Challenge teams continue to receive ongoing support from the SMVF TA Center to maintain momentum and advance their suicide prevention strategies. Technical Assistance activities include:

• Monthly Team Leader Calls – supporting leadership efforts and providing opportunities for knowledge exchange
• Monthly Community of Practice sessions – convening team members to share information on suicide prevention best practices, including lessons learned through planning and implementation
• Subject Matter Expert Consultations – providing access to expertise from the field to consult on specific goals or strategies
• Direct TA via Virtual or In-person Site Visits – responding to identified needs or direct requests for TA, including customized agendas, expert facilitation, consensus building, action planning and subject matter expertise

In this phase, ongoing TA for Governor’s and Mayor’s Challenge teams primarily targets sustainability for both the team and its collective priorities and identified suicide prevention strategies.

Sustainability efforts are usually focused on embedding practices into state, territory, and community systems through diversified funding, formalized partnerships, and succession planning. This ongoing technical assistance ensures that teams are equipped to adapt to changing needs, preserve continuity, and sustain long-term impact beyond the initial planning and implementation phases of the process.

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 Health Care Provider Resources and Tools for additional information on screening and suicide prevention.
• 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.