Expanding Continuity of Care to Prevent Suicide in Pennsylvania will implement a two-tiered approach that includes 1) sustaining and expanding prior statewide youth suicide prevention efforts in schools, colleges, and primary care into adult-serving service systems (Tier 1); and 2) enhancing continuity of care in five regions through training and screening within behavioral health systems to improve care transitions for high-risk individuals (Tier 2). This project extends current SAMHSA-funded youth suicide prevention efforts in PA while capitalizing on the groundbreaking initiatives of a newly developed Governor’s Suicide Prevention Task Force and Executive Order targeting a reduction in suicide firearm deaths.
Suicide deaths of those age 25 and older in PA (19.59 per 100,000) exceed the national rate (18.59; CDC, 2020). Five regions were selected for this project due to increased suicide rates and/or high volumes of suicides. While these counties only represent 26% of adults in PA, they accounted for 38% of suicide deaths in 2017. Several counties have rates significantly higher than the national average in multiple age groups (25-44 years, 45-64 years, 65+ years). Of particular attention will be the National Guard, where the suicide rate is the highest among military components (Department of Defense, 2019) and Pennsylvania has the second largest contingent of National Guard in the country. We will also focus on local jails, where 33.1% of all deaths are suicides. As a whole, Pennsylvania is 75.9% Caucasian, 10.6% African American, 3.5% Asian American, 2.1% biracial, and less than 1% all other races. About 7.6% identify as Latino. Approximately 3.6% of all PA residents identify as LGB and 0.4% as transgender.
The project has four primary goals, with associated objectives and key implementation strategies. Goal 1 is to promote early identification and referral of adults at risk of suicide within adult-serving systems, including primary care, emergency departments, and community settings through evidence-based training and screening (Tiers 1 and 2). Goal 2 will increase capacity-building among behavioral health providers to screen, assess, manage, and treat those at risk of suicide (Tiers 1 and 2). Goal 3 will expand partnerships to support care transitions, reentry, and follow-up for those admitted into and discharged from hospitals and treatment centers (Tier 2). We will increase the number of service systems that have established protocols to facilitate care transitions and increase communication between crisis and other systems. Goal 4 is to develop a comprehensive and sustainable model for continuity of care for suicidal adults based on lessons learned from county-level efforts through engaging broad stakeholders, including those with lived experience, to develop a toolkit that can be implemented statewide (Tier 2).
Based on extensive data from previous GLS projects, as well as projected similarities in terms of scope and approach, we project to serve approximately 15,000 through training, 12,000 through screening, and 200,000 through awareness activities, for a total of 227,000 served.