The proposed program – Toiyabe Suicide Prevention, Intervention, and Postvention Program (TSPIPP) – is designed to raise community-wide awareness about the prevalence of suicide risk in Toiyabe communities, provide extensive culturally-honoring prevention education and services, increase the identification of at-risk patients, provide services/referrals, and enhance intervention/postvention care coordination. The proposed program will strengthen care coordination within Toiyabe and with care provision partners. The proposed program has the support of all seven tribes, because the program will increase services to each of the communities served. Toiyabe is eager to improve care coordination across Toiyabe staff, Tribes, and community partners through mental health training and the formation of a Suicide Response Team through new and existing staff, who will collaborate with key community partners to improve response to youth and adults-at-risk of suicide. The primary goals of TSPIPP are: 1) to improve care coordination through training and the formation of a Suicide Response Team; 2) to expand available behavioral health care treatment services; and 3) develop or expand activities for the Generation Indigenous Initiative. As a result of the implementation of TSPIPP: 1) a minimum of 500 individuals will be provided education about suicide prevention, intervention resources, and postvention services (e.g., warning signs, how to help someone at risk) each year; 2) a minimum of 3,000 Toiyabe patients a year will be screened for suicide (e.g., depression and other mood disorders, suicidal ideation, etc.) and those identified as high-risk will be referred to the TSPIPP Integrated Therapist for further assessment; 3) all (100%) of Toiyabe patients flagged as at-risk for suicide will be educated about treatment options and offered services; 4) a minimum of 80% of DBT group members will demonstrate a reduction in signs of depression as measured by PHQ9 s
core from the start of the group as compared to after three months of treatment, and at six-month follow-up; 5) a minimum of 10 Hope Squad peer mentors (age 14-24) will be selected by their peers to engage with at-risk students through education, discussion, and strengths-based cultural activities; 6) a minimum of 200 youth (typically age 12-24) will participate in the TSPIPP GONA each year; 7) a minimum of 50 youth (age 14-24) will participate in the TSPIPP Trade Walk each year; 8) at least 80% of TSPIPP participants who participate in Hope Squad, GONA, or Trade Walk will report that they were very satisfied with the service/event; and 9) at least 80% of participants in postvention services (e.g., therapy, support group, school-based support services) as a result of a suicide-related event or a person close to them experiencing a suicide-related event (e.g., threaten, attempt, or complete a suicide) will report that they were very satisfied with the services provided. Continuity and comprehensiveness of care will be maximized through long-standing collaborative relationships with both local and statewide networks of healthcare services providers, which include Northern Inyo Hospital, Inyo and Mono Behavioral Health Departments, which receive referrals from Toiyabe. Toiyabe will work with the Owens Valley Career Development Center and the Bishop Indian Educational Center to implement and help fund budget items for the GONA that are typically ineligible for grant funding (e.g., food, raffle prizes, other incentives). Toiyabe will partner with the California TEC to gather data, the external evaluator, a contracted Media Coordinator, and mobile app developer, ChopDawg to provide planned activities and services.