OPHI Program Outcomes. Presented April 2, 2014 Oregon’s State Garrett Lee Smith Youth Suicide Prevention Grant: Creating System Change through Community Coalitions and Prevention Trainings Oct 2014-Sept 2019 Presented at the Oregon Youth Suicide Prevention Conference, Clackamas OR, March 13, 2018 Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

OPHI Program Outcomes. Presented April 2, 2014 Agenda Introductions GLS Grant Goals & Overview Strategies from 3 GLS Counties: Jackson, Umatilla, and Washington Developing a Community Coalition Promoting Continuity of Care Questions/Comments? If time: Grant accomplishments to date Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

OPHI Program Outcomes. Presented April 2, 2014 Presenters: GLS Grant Evaluator: Karen Cellarius, MPA Portland State University   County GLS Suicide Prevention Coordinators: Kristin Parrish, MS Jackson County Mental Health Amanda Walsborn, MLS Umatilla County Public Health Deb Darmata, MS Washington County Public Health Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

Garrett Lee Smith Memorial Act (GLSMA) (2004 ) OPHI Program Outcomes. Presented April 2, 2014 Garrett Lee Smith Memorial Act (GLSMA) (2004 ) In memory of OR Senator Gordon Smith’s son Funds State, Tribal & Campus Youth Suicide Prevention Programs Youth aged 10–24 Established Suicide Prevention Resource Center (SPRC) Funding Agency: Substance Abuse Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS ) Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

GLS Priority populations: OPHI Program Outcomes. Presented April 2, 2014 GLS Priority populations: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youths American Indians and Alaska Native (AI/AN) residents Youths in contact with juvenile justice systems Military family members Veterans Survivors of suicide attempts Those who have experienced suicide Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

Types of Suicide Prevention Strategies Implemented by GLS Grantees

OPHI Program Outcomes. Presented April 2, 2014 GLS Grants in Oregon Campus: -Western Oregon University -OSU Cascades (ended 2016) Tribal: -Native American Rehabilitation Association of NW (NARA) -NW Portland Area Indian Health Board -Yellow hawk (Umatilla) State: -Oregon Caring Connections Initiative Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

Oregon Caring Connections Initiative: OPHI Program Outcomes. Presented April 2, 2014 Oregon Caring Connections Initiative: SAMHSA Garrett Lee Smith (GLS) State/Tribal Youth Suicide Prevention Grant Awarded to: Oregon Public Health Division Focus: Systems Change Grant Period: Oct 2014–Sept 2019 Cohort 9: 26 sites funded in U.S. Counties with Suicide Prevention Coordinators: Deschutes Jackson Josephine Umatilla Washington Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

Oregon Caring Connections Components: OPHI Program Outcomes. Presented April 2, 2014 Oregon Caring Connections Components: Gatekeeper Trainings: Community members, schools and veterans organizations (QPR, Safetalk) Clinical Trainings: Behavioral Health Clinicians (ASIST, AMSR, CALM, Implementation of guidelines for continuity of care: Youth discharged from E.D.s/inpatient psychiatric units. Improvements to county crisis response plans. Promotion of the National Suicide Prevention Lifeline (NSPL) Implementation of Zero Suicide: Washington County Evaluation: PSU Regional Research Institute for Human Services Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

OCCI GLS Prevention Activities Gatekeeper Training through ASIST, QPR, and Kognito Clinical Trainings in Assessing and Managing Suicide Risk (AMSR) Improving county crisis response plans and the Continuity of Care. Implementing Zero Suicide Promoting the National Suicide Prevention Lifeline (NSPL)

GLS Goal #4: Improving county crisis response plans and the Continuity of Care Community Coalitions

Promoting Continuity of Care through Community Coalitions Jackson County Suicide Prevention Coalition Medford, Oregon   Umatilla County Suicide Prevention Coalition Pendleton, OR (Meets by teleconference) Washington County Suicide Prevention Coalition Hillsboro, Oregon Josephine County Suicide Prevention Taskforce Grants Pass, Oregon Central Oregon Suicide Prevention Alliance (COSPA) Rotates meeting locations.

Non-GLS Suicide Prevention Coalitions Mid-Valley Suicide Prevention Coalition Oregon Alliance to Prevent Suicide Others?

Jackson County Suicide Prevention Coalition, Medford, Oregon History Development  Planning Programs represented at the coalition Topics discussed during meetings

Central Oregon Suicide Prevention Alliance (COSPA) Meets quarterly. Leadership team meets at least quarterly and sometimes more frequently Sub-committees meet more regularly as needed Outreach Primary care Veterans  https://www.deschutes.org/health/page/central-oregon- suicide-prevention-alliance-cospa Wednesday, March 14th, 10:30-Noon in Room 2119: Firearm Safety in Rural Primary Care. Presenters: Susan Keys and COSPA member Laura Pennavaria (CEO of St. Charles Medical Group)

Umatilla County Suicide Prevention Coalition, Pendleton, OR How long has the Coalition been meeting? How did the Coalition come together? How often do you meet and where? Who attends? What are you currently working on? Major accomplishments?

Washington County Suicide Prevention Coalition, Hillsboro, OR How long has the Coalition been meeting? How did the Coalition come together? How often do you meet and where? Who attends? What are you currently working on? Major accomplishments?

Developing a local suicide prevention coalition (Panel Discussion): What works? What doesn’t work? Who needs to be at the table Local factors to be aware of: Rural/Urban Local communities Existing Response system Other tips?

Promoting Continuity of Care around Suicide Prevention and Response

State Continuity of Care Model OPHI Program Outcomes. Presented April 2, 2014 Continuity of Care State Continuity of Care Model Presented by Karen Cellarius, PSU Regional Research Institute, cellark@pdx.edu

Continuity of Care Partnerships Advisory Team Systems of care Crisis Response Follow-up care MOUs EDs, BH, Primary Care, Schools, School-based Health Centers, First Responders, Crisis Teams & Crisis Lines, etc. Supporting Foundational Documents

Promoting continuity of care around suicide prevention and response (Discussion): Local factors to be aware of: Rural/Urban Local communities Existing Response system In which setting(s) or systems is there the greatest need and/or opportunity? Emergency department discharge Referrals from school to mental health Other? Where might you have the greatest success? At the local level, the regional level? What partnerships need to be in place? Who is already at the table? Who needs to be added? What are your expected challenges and how will you overcome them?

Questions? Comments?

Oregon Caring Connections Initiative Year 3 Accomplishments Oct 2016-Sept 2017 Presented at the OCCI Annual Meeting, Bend, Oregon PSU Regional Research Institute for Human Services November 29-Dec 1, 2017 Updated Dec 21, 2017

OCCI GLS Prevention Activities: What have we done so far? Gatekeeper Training through ASIST, QPR, and Kognito Clinical Trainings in Assessing and Managing Suicide Risk (AMSR) Improving county crisis response plans and the Continuity of Care. Implementing Zero Suicide Promoting the National Suicide Prevention Lifeline (NSPL)

OCCI Prevention Activity 1: Gatekeeper Trainings (ASIST, QPR and Kognito)

Completed QPR, ASIST Trainings in Year 3 (Objective: One training per County per Quarter) (Data source: TASP forms ) County ASIST QPR Total Deschutes 2 (86) 8 (193) 10 (279) Jackson 7 (172) 34 (943) 41 (1,115) Umatilla 1 (15) 5 (67) 6 (82) Josephine 3 (40) 19 (555) 22 (595) State Total* 13 trainings (313 people) 66 trainings (1,758 people) 79 trainings (2,071 people) *Washington County trainings do not use GLS funds

Total QPR, ASIST and safeTALK Trainings (Objective: One training per County per Quarter) (4 Quarters x 5 Counties=20 trainings/year) (Data source: TASP forms ) Year ASIST QPR SafeTALK Annual Total 1 21 trainings (567 people) 10 trainings (274 people) - 31 trainings (841 people) 2 (492 people) 42 trainings (1,300 people) 1 training (17 people) 64 trainings (1,809 people) 3 13 trainings (313 people) 66 trainings (1,758 people) 79 trainings (2,071 people) State Total 55 trainings (1,372 ppl) 118 trainings (3,332 ppl) (17 ppl) 174 trainings (4,721 ppl)

Location Where Training Occurred Kognito: At Risk for High School Educators (Data source: Automated Kognito reports) (Objective=100 schools & 20,000 educators and staff by Jan 15, 2018) Location Where Training Occurred Schools Users Completed Jackson 2 4 Washington 17 Deschutes 1 Non-GLS counties* 11 129 Non-Schools+ N/A 22 Year 3 Total 16 173 Year 2 Total 234 Year 1 Total 3 10 Total to date 35 417

Kognito: At-Risk in Primary Care in Year 3 (Objective to complete by Sept 30, 2019: Train staff at all 103 School-Based Health Centers in state and to pediatricians in three counties) Organization Location Users Completed Bend LaPine School Nurses Deschutes 5 Bend High School 1 Ensworth Elementary School Pendleton High School Umatilla 2 Sunridge Middle School Merlo Station High School Washington Tigard High School Rogue Community Health Center Jackson 3 Non-GLS Counties Multiple 11 Other+ Unknown Year 3 Total (includes 8 SBHCs & 2 PCPs) 16+ 29 +Participants grouped into the “Other category” could not be identified, so the exact number of locations is unknown.

Kognito: At-Risk in Primary Care (Promoted in Years 2 & 3 only) (Objective to complete by Sept 30, 2019: Train staff at all 103 School-Based Health Centers in state and to pediatricians in three counties) Locations Users Completed Year 2 Total (includes 1 PCP and 1 SBHC) 2+ 17 Year 3 Total (includes 8 SBHCs & 2 PCPs) 16+ 29 Total to Date (includes 3 PCPs and 9 SBHCs) 18+ 46 +Participants grouped into the “Other category” could not be identified, so the exact number of locations is unknown.

Kognito: At Risk in the ED (Promoted in Years 2 & 3 only) (Data source: Automated Kognito reports) (Current Objective=Emergency Department staff in all Oregon counties) (Original Objective: ED staff in all four Portland metro health systems that treat more than 300,000 patients annually) Institution Name Location Users Completed Providence - Milwaukie Hospital Clackamas 2 Providence - St. Vincent Medical Center Washington 1 Tuality - Tuality Community Hospital Year 2 Total 3 4 Providence Medford Medical Center Jackson Randall Children's Hospital at Legacy Emanuel Multnomah St. Charles Health System - Redmond Deschutes Other+ Unknown 7 Year 3 Total 3+ 10 Total To Date* 6+ 14

OCCI Prevention Activity 2: Trainings for Clinicians (AMSR)

Total remaining to train AMSR Trainings: (Objective=11 Trainings & 550 participants by Dec 29, 2019) Training Date Training Location Clinicians Trained 2/27/2015 Washington 49 10/30/2015 Jackson 42 03/30/2016 Josephine 41 07/12/2016 Deschutes 08/05/2016 Malheur 47 09/16/2016 Lane/Douglas 51 09/22/2016 Multnomah 46 09/01/2017 Umatilla 17 09/22/2017 20 Total to date 9 362 Total remaining to train 2 188

OCCI Prevention Activity 3: Improve continuity of care and follow-up of youth identified at risk for suicide discharged from EDs and inpatient psychiatric units

Youth identified as at-risk for suicide and subsequent referrals to mental health or related services following a GLS gatekeeper training or other GLS system effort (Years 1-3) Source: Early Identification and Referral Forms/Organizational Data (EIRF s) County Data Source GLS Connection Responses to crisis calls involving youth Youth ID’d as needing referral Percent referred Percent seen within 3 months Washington Hillsboro School District Schools trained in Kognito 18 11 (61.1%) 7 (63.6%) Not tracked Jackson Jackson County Mental Health GLS Prevention Coordinator housed here & coordinates continuity of care. Responds to all youth crisis calls in county. 289 (100%) 283 (97.9%) 237 (83.7%) Josephine Options for Southern Oregon 232 185 (79.7%) 184 (99.5%) 167 (90.8%) Total (Y1 – Y3 Combined) 539 485 (90.0%) 474 (97.7%) 405 (85.4%) -Crisis response data were received for 742 calls from three counties, however data on the result of those calls were not available for 203 of those cases. -Crisis response data for Umatilla and Deschutes County were not available at the time of this report.

OCCI Prevention Activity 4: Implementing Zero Suicide

Oregon Zero Suicide Timeline Original GLS OCCI proposal Promote Zero Suicide in one urban county Years 1&2 Zero Suicide promoted in Washington County & adopted by major mental health provider (Lifeworks NW) Year 3 Zero Suicide adopted as goal for all counties State Zero Suicide Coordinator position created Zero Suicide Trainings during monthly coordinator calls Year 4 Statewide Zero Suicide Academy in September

OCCI Prevention Activity 5: Promoting the National Suicide Prevention Lifeline (NSPL)

Callers thinking of suicide on day of call Crisis Calls Made in GLS Grant Counties from October 2016 thru September 2017 Total calls based zip code or other information provided by caller. (Data source: Lines for Life, statewide NSPL responder)* County Number of Calls Callers thinking of suicide on day of call Deschutes 625 211 Jackson 958 246 Josephine 465 87 Umatilla 346 86 Washington 2,117 548 Total 4,511 1,178 -Includes calls to the NSPL Helpline, the Lifeline, the Portland Lifeline, the VA Crisis Line and the Oregon Youthline. -Additional contacts were made via the Youthline’s text line, chat line and email address -Does not include calls that rolled over to overflow responders if Lines for Life lines were all occupied.

Suicide-related Crisis Calls from GLS Grant Counties – Years 1-3 Caller responded Yes to the question: “Are you thinking about suicide today?” (Data source: Lines for Life, statewide NSPL responder) County Year 1 Year 2 Year 3 Deschutes 62 161 211 Jackson 82 171 246 Josephine 21 81 87 Umatilla N/A 86 Washington 125 335 548 Total 290 748 1,178 -Includes calls to the NSPL Helpline, the Lifeline, the Portland Lifeline, the VA Crisis Line and the Oregon Youthline. -Additional contacts were made via the Youthline’s text line, chat line and email address -Does not include calls that rolled over to overflow responders if Lines for Life lines were all occupied.

Recap: OCCI Prevention Activities Gatekeeper Training through ASIST, QPR, and Kognito Clinical Trainings in Assessing and Managing Suicide Risk (AMSR) Improving county crisis response plans and the Continuity of Care. Implementing Zero Suicide Promoting the National Suicide Prevention Lifeline (NSPL)