Thursday, April 3, 2025
4/3/2025
Zero Suicide Initiative - Indian Health Council, Inc. (IHC) is submitting an application for a Zero Suicide Initiative (ZSI) Cooperative Agreement. IHC is a nonprofit Federally Qualified Health Center run by and serving nine Federally-recognized Tribes in Northern San Diego County (thus, it is a Tribal organization as defined by 25 U.S.C. 1603). In this application, IHC documents the strong need for this program and the focused plans to implement the Zero Suicide Initiative approach, both in clinic practice and in close coordination with the Tribal communities it serves. The Zero Suicide Model is designed to build an integrated system of care that is consistent with IHC’s long-term goal of serving as a patient-centered home for its clients. Specifically, IHC intends to leverage this grant to improve trauma-informed care throughout the clinic to strengthen the ability of all staff to identify individuals at elevated risk of suicide, and to offer them support, regardless of department or particular condition that brought them into the clinic. Need: In addition to the rise in suicide rates throughout the nation, American Indian/ Alaska Natives in particular experience suicide rates higher than those for any other racial/ethnic group, although incidence varies across ages, genders, Tribes and regions. In Northern San Diego County, despite the lack of precision (attributable to stigma and racial misclassification), statistics suggest that AI/AN suicide rates are high. Despite successful trainings such as QPR and Mental Health First Aid, the clinic and its communities lack comprehensive suicide prevention/post-vention policies before suicide clusters emerge, and a staff unevenly trained in suicide prevention and treatment. Plan: As structured by the application, we propose to follow the Seven Elements to bring IHC into alignment with the Zero Suicide Initiative framework, tracking progress through the ZSI Toolkit. 1. Lead: A designated coordinator will work with leadership to initiate the plan in all departments, tailoring it to each of the 9 consortium Tribes including Tribal Resolutions, policies and advisory boards for input and buy-in. 2. Train: Use new Relias system to track and deliver such that 100% of IHC employees will be trained in QPR and MHFA to build the collective confidence and competence to ask directly about suicidal ideation, plans and other difficult conversations. 3: Identify: The staff will screen all patients 10 and above for suicide risk using NextGen and waiting room surveys. 4. Engage. For every identified patient at risk, create a monitoring and prevention/treatment plan. To clarify, in the 5. Treat phase, staff capacity will be bolstered to assess and treat including dialectical behavioral therapy and cultural best practices that are regionally tailored. 6. Transition. Following the ZSI best practices, protocols to transitions with warm handoffs in the system for individuals at risk to safety plan and reduce lethal means access. Finally, 7. Improve encourages IHC to take advantage of IHS resources including technical assistance and regular check-ins with IHS ZSI staff for regular guidance and support. In sum, the IHC leadership has the proven ability to change systems (as it has in response to Covid among other external challenges including major fires) and also the infrastructure (e.g., the Relias training platform and i2i NextGen EHR screening and analytics platforms) for the required assessment and feedback loops, to ensure the continuity of care for patients at high risk for suicide. The proposed effort will build IHC’s robust suicide pre/postvention system.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).