Centerstone COVID-19 Emergency Response for Suicide Prevention in Indiana (IN-ERSP) will advance efforts during the COVID-19 pandemic to prevent suicide and suicide attempts among adults age 25 and older, including victims of domestic violence, in the geographic area comprising 26 Southern Indiana counties. IN-ERSP anticipates serving, at minimum, an unduplicated total of 125 adults in the 16-month project period, based on considerations including area/population need, staff caseload/capacity, and timeframe for meeting client care needs.
IN-ERSP’s focus population demographics are expected to mirror those of the catchment area, with 50% male, 50% female, 92% white, 3% African American, 3% Hispanic/Latino individuals ages 25+. IN-ERSP will place special emphasis on supporting victims of domestic violence who face suicide risk factors (e.g., stress, anxiety, trauma) exacerbated by current conditions (e.g., stay-at-home orders). Prior to the pandemic, suicide rates among the focus population far exceeded the nation (16.5/100,000 vs. 14.5); rates are expected to rise as a result of the COVID-19 crisis. For example, local Indiana service providers have seen a 48% increase in suicide calls and a 116% increase in crisis text contacts, many regarding domestic abuse.
In response to the COVID-19 pandemic and related behavioral health needs, IN-ERSP will provide rapid follow-up, including care transition/coordination services, among clients who have attempted suicide or experienced a suicidal crisis after discharge from emergency departments (EDs) and inpatient psychiatric units (IPUs), and help clients secure a mental health appointment within a week of discharge. Care transition/coordination will also be provided for clients of the Stride Center, Centerstone’s crisis diversion facility. IN-ERSP will assess clients’ risk level and develop a crisis management plan comprising of safety planning, reduced access to lethal means crisis intervention, continuous contact/monitoring, and rapid follow-up. Victims of domestic violence and their dependents will be provided enhanced services, including a safe place to stay if they are unable to remain safe in their home. IN-ERSP suicide-specific evidence-based practices include RELATE; the Interpersonal Theory of Suicide (ITS); Cognitive Behavioral Therapy-Suicide Prevention (CBT-SP); Suicide-Prevention Focused Narrative Exposure Therapy (S-NET); Dialectical Behavioral Therapy-Skills Treatment (DBT-ST); Attempted Suicide Short Intervention Program (ASSIP); and Counseling on Access to Lethal Means (CALM).
IN-ERSP will accomplish the following goals: 1) Develop/implement a plan for rapid follow-up after discharge from EDs/IPUs; 2) Provide follow-up and care transition/coordination services; 3) Enhance/expand community and clinical service provider training; 4) Develop/expand collaborations with relevant state/community organizations/departments/systems to implement comprehensive suicide prevention; 5) Enhance/expand community recovery supports for clients and household members; and 6) Conduct a comprehensive evaluation. IN-ERSP objectives will measure the number of screenings/assessments and rapid follow-up conducted; services (including telehealth services), care transition, and care coordination delivered; and community/clinical trainings conducted, as well as outcomes related to substance use, employment status, housing stability, suicidality, and social connectedness among participants. IN-ERSP has secured commitments from partners, including domestic violence organizations, who are dedicated to the project’s success and who will serve as linkage/referral sources; provide recovery support services; and take part in project trainings, Advisory Council, and Evaluation activities.