Idaho Lives Project SAMHSA State / Tribal Youth Suicide Prevention Grant (GLSMA) grant awarded to Idaho on 10/7/ year award totaling $1,295, of seven grantees nationwide

Organizational Structure State Department of Education Sources of Strength Shield of Care Local / National Expert Mentors Trainers / Facilitators SPAN Idaho BSU Ctr for Health Policy Grant Administration Program Implementation Program Evaluation School / Community Impact Strategies

Suicide Statistics US 2010 ID 2010 ID 2011 ID 2012 Total Deaths 38, Deaths/week Suicide Rate

Where Does Idaho Rank? US Suicide Death Rate Rankings (CDC 2010) WyomingIdaho U.S. New York

Youth Suicide Facts Idaho high school students, 2013 YRBS shows 1 in 13 have attempted suicide 1 in 8 actually have a suicide plan 1 in 7 have considered suicide

Youth Prevention Survey Administered in Spring, 2014 Sample size: 12,650 (grades 6, 8, 10 & 12)

School Changes

Suicide Ideation by County

Protective Factors

School-Age Children Idaho has lost 83 school-aged children to suicide in the last 5 years. 16 of those children were age 14 or younger

What are you seeing? Indicators of ideation ATOD issues Dating relationship violence Bullying / harassment Self-harm Toxic family / community influences GLBTQI discrimination Others???

Interpersonal-Psychological Theory of Suicide Thomas Joiner, PhD Perceived Burdensomeness Thwarted Belongingness Those Who Are Capable of Suicide Fearlessness about Pain, Injury & Death Acquired Ability or Self-Harm Serious Attempt or Death by Suicide Those Who Desire Suicide Derived from Sketch of a Theory Power Point presentation, 2013 Thomas Joiner, PhD DistalFactorsDistalFactors Why People Die by Suicide

Idaho Lives Project Goals Model Goal 7: Data Collection, Evaluation & Reporting Goal 3: Suicide Assessment Training for BH & PC Professionals Goal 2: School & Community Gatekeeper Training Goal 1: Sources of Strength in Schools Goal 4: College & University Involvement Goal 5: Connectedness & Capability Strategies for All Schools Goal 6: Shield of Care for Juvenile Justice Facilities

Goal 1 1. Sources of Strength conducted A. 8 pilot schools trained in year 1 Provided by Sources professionals B.10 – 14 schools trained in year 2 Provided by Sources professionals and Idaho trainees C.15 – 21 schools trained in year 3 Provided by Idaho Sources trainers D.12 – 14 Idaho Sources trainees trained and certified over two-year period E.After training, adult advisors and peer leader teams carry out Sources activities in the school TM

Goal 2 2.Gatekeeper training – “QPR Plus”* (Question, Persuade & Refer) A.Training for personnel of all Sources schools B.Training for communities around Sources schools and Shield of Care facilities C.Targeted outreach to special populations for training * “QPR Plus” adds to QPR: The Interpersonal-Psychological Theory of Suicidal Behavior State/Regional/Local statistics Sources of Strength overview Suicide survivor issues Information specific to the audience

Goal 3 3.Training for Behavioral Health and Primary Care providers A.Suicide assessment training for BH and PC providers in Sources school communities B.Training provided by recognized national expert on suicide assessment C.BH and PC providers will be available and trained to meet the needs of identified youth

Goal 4 4.Universities and Colleges involvement A.Reach out to Colleges in Sources school communities to participate in gatekeeper training B.College interns recruited to be involved with Sources trainings C.Interns distribute materials D.Outreach to year-olds with materials E.Targeted outreach and coordination with U of I (SAMHSA college grant recipient)

Goal 5 5.Promoting connectedness and capability in Idaho schools A.Strategies for increasing connectedness, belonging and capability among students and staff are made available to all Idaho schools B.Feeder schools to Sources schools are targeted for distribution of materials C.National expertise on strategies provided at Annual Prevention Conference D.Formal recognition for individual and organizations demonstrating effective or innovative strategies

Goal 6 6. Shield of Care for juvenile justice facilities A.Juvenile justice facility mental health contacts trained to train Shield of Care B.Trained mental health contacts train facility staff in Shield of care C.SPAN Idaho provides support

Goal 7 7.Data collection, evaluation and reporting A.Data is collected and evaluated for all activities B.Boise State University College of Health Sciences provide project evaluation. C.ILP Advisory Committee is created and assists in reviewing project evaluations and developing data-driven improvement plan D.Reports on evaluation findings and improvement plan

ILP Programs

Goal 1 Status: School Community Selection 8 school communities for cohort 1 and 7 school communities for cohort 2 were selected based upon : – Demonstrated need – Readiness to Benefit – Level of interest/commitment – Needs of special populations

Cohort 1: Schools Selected & Trained 1. Priest River Lamanna HS, Priest River 2. Lapwai MS-HS, Lapwai 3. Parma HS, Parma 4. Parma MS, Parma 5. Nampa HS, Nampa 6. Silver Creek Alternative HS, Hailey 7. Salmon MS-HS, Salmon 8. Teton HS, Driggs Trained March 3-14, 2014

Cohort 2: Schools Selected 1. Emmett HS, Emmett 2. Homedale HS, Homedale 3. Frank Church HS, Boise 4. Rimrock Jr/Sr HS, Bruneau 5. Pocatello HS, Pocatello 6. Preston Jr HS, Preston 7. Preston HS, Preston

Goal 2 Status: Community & School Staff Training Community Gatekeeper Training February 13 th - Priest River February 18 th – Parma February 19 th – Nampa February 27 th – Lapwai March 3 rd – Driggs March 5 th – Salmon March 6 th – Hailey, Staff Gatekeeper Training January 20 th – Parma February 14 th - Priest River February 19 th – Nampa February 24 th – Hailey February 28 th – Lapwai March 3 rd – Driggs March 5 th – Salmon

Goal 3 Status: Suicide Assessment Training Schedule Round 1 February 24 th – Caldwell February 25 th – Hailey February 25 th – Twin Falls February 26 th – Idaho Falls March 24 th – Coeur d’Alene March 25 th – Lewiston Round 2 Three locations and video teleconference to rural areas, early 2015 M. David Rudd, PhD

Goal 4 Status: University Involvement & Young Adults Training – June 5 th – BSU TRiO Upward Bound Residential Mentor staff – August 20 th or 21 st – CSI staff Interns – One identified for cohort 2 from NNU Young Adult Outreach – Young adult-serving entities identified – Man Therapy contract secured

Goal 5 Status: Belongingness & Capability Research completed Strategies developed Belongingness session at SDE’s Prevention Conference Prepared to provide strategies/activities to elementary and middle feeder schools fall 2014

Goal 6 Status: Juvenile Justice February 4 th - Shield of Care Train the Trainer May 2014 – Scheduling individual facility training for entire staff – June – Shoshone-Bannock Juvenile Justice Center – September – Snake River Juvenile Detention Center

Goal 7 Status: Data MEASUREMENT TOOL & CODES TOOL TYPE AUDIENCE ADMINISTERED BY DATA COLLECTED & RESULTS COMPILED BY RESULTS EVALUATED BY PL-Consent = Sources Peer Leader Consent FormConsent FormParentsSchool PL-Pre = Sources Peer Leader Pre-SurveySurveyPeer LeadersSchoolILPBSU PL-Post = Sources Peer Leader Post-SurveySurveyPeer LeadersSchoolILPBSU SS-Pre = Sources School Staff Pre-SurveySurveySchool StaffSchoolILPBSU SS-Post = Sources School Staff Post-SurveySurveySchool StaffSchoolILPBSU GK-Pre = School Staff Gatekeeper Pre-TestTestSchool StaffSchoolILPBSU GK-Post = School Staff Gatekeeper Post-TestTestSchool StaffILP StaffILPBSU QPR+ = Question, Persuade, Refer EvaluationEvaluationStaff & Cmty.ILP StaffILPBSU TUPS = Training Utilization Survey- AdultConsent FormStaff & Cmty.ILP StaffILP & SDESAMHSA TUPS-A = Training Utilization Survey- AdolescentConsent FormParentsSchoolILP & SDESAMHSA Rudd = David Rudd Clinician Survey/EvaluationSurvey & Eval.CliniciansILP StaffILPBSU TASP = Training Activity Summary PageReport FormILPSDE StaffSDESAMHSA EIRF= Early Identification, Referral, Follow-upSurveyClinician/StaffSDE StaffSDESAMHSA SST-Self-Eval = School Sources Team Self-EvaluationEvaluationAdult AdvisorsSchoolILPBSU SST-Status = School Sources Team Status ReportReport FormPL & Ad. Adv.SchoolILPBSU SMH-Ref = School Mental Health Referral FormReport FormSchool Couns.ILP StaffILPBSU COS = Community Outreach Survey?? TBDSurveyGen. Pop.ILP StaffILPBSU

Important Notes about Warning Signs The more signs, the greater the risk. Warning signs are especially important if the person has attempted suicide in the past. One sign alone may not indicate suicidality but all signs are reason for concern and several signs may indicate suicidality, and any one of three signs alone is cause for immediate action RISKRISK

Warning Signs Previous suicide attempts Talking about, making a plan or threatening to complete suicide Isolation, withdrawal from friends, family or society Agitation, especially when combined with sleeplessness Nightmares

Warning Signs Changed eating habits or sleeping patterns Giving away prized possessions, making final arrangements, putting affairs in order Themes of death or depression in conversation, writing, reading or art Recent loss of a friend or family member through death, suicide or divorce Sudden dramatic decline or improvement

Warning Signs Feeling hopeless or trapped Use or increased use of drugs and/or alcohol Chronic headaches and stomach aches, fatigue Major mood swings or abrupt personality changes Neglect of personal appearance Taking unnecessary risks or acting reckless No longer interested in favorite activities or hobbies

Signs of Immediate Risk = Take Immediate Action Talking about wanting to die or to kill oneself Looking for a way to kill oneself Talking about feeling hopeless or having no reason to live

How to Ask Direct: Are you thinking of suicide/killing yourself? Less Direct: You seem to be ________. Sometimes when people are ________, they think about suicide. Are you thinking of suicide?

How to Listen Listen well Non-judgmentally Non-condescendingly Matter-of-fact yet caring approach Reflective listening Not problem solving

Helping & Getting Help Ensure the person is not left alone Get a commitment to accept help Make arrangements/help the person contact mental health help Get others involved; a family member, friend, clergy, someone whom the person trusts. Ensure that the trusted person will get the person in crisis to help

Getting Help TALK (8255) Call police if person is in possession of a weapon Follow up Self care

Remember Watch for signs/clues Get help Instill hope Listen well Have the courage to ask

Your Assistance Educate Schools about the Project – Cohort 1 – 18 school applications – Cohort 2 – 11 school applications (3 repeats) Share community and clinical training announcements Implement upstream approaches at your school

Resources Idaho Lives Project Dedicated SDFS $$$ ($2.2 million) Postvention protocol Surveillance data (YPS / YRBS) Idaho hotline TALK (8255)

Likely keynotes: Dr. James Garbarino Keith Orchard RFP for workshops coming soon Currently searching for counselor scholarships

For More Information Matt McCarter, Director Student Engagement & Postsecondary Readiness Division State Department of Education Project Director, Idaho Lives Project (208) Jeni Griffin, Executive Director, SPAN Idaho Project Administrator, Idaho Lives Project (208) Kim Kane Program Director Idaho Lives Project (208)