Project Abstract
The Eastern Shoshone 988 Tribal Response program will increase awareness and use of the 988 Lifeline on the Wind River Reservation located in central Wyoming. The program will train at least 20 individuals over the course of two years along with serving the Eastern Shoshone tribal members with an enrollment of 4,368 members.
Access to mental health services, substance use treatment and behavioral health therapies is limited on the WRR due to rural location, limited transportation, stigma, digital inequality, and long-wait times. Foundational guidance from needs assessments, quality improvement plans, and linkage to local, state, and national resources are needed. These gaps directly impact tribal members in crisis.
Data from the WRR Indian Health Service indicate that 246 individuals were treated at the clinic due to intentional self-harm diagnosis from 2016 - 2020. In 2021 there were 17 deaths by suicide in Fremont County, this was three times greater than the national average. A 2022 WRR community survey reported that the number one health concern was opioid use followed by unresolved trauma. This same survey reported that 22% do not have access to the internet and 19% are not aware of the telehealth services available (like 988), and 9% do not have access to a phone. Tribal members feel that most providers could benefit from cultural competency training.
The overall goal of the ESR 988 project is to save lives through the 988 Lifeline on the WRR. Though the implementation of six specific objectives, ESR will:
• Assist local 988 crisis centers with a quality improvement plan focusing on policies, first contact, assessment, referral, and access to local care to ensure there is a comprehensive and coordinated response to individuals at imminent risk for suicide.
• Establish collaborations with states, territories, and local crisis centers to improve effective 988 response and linkage to local resources, including cases of emergency intervention. This will result in 20 individuals referred to ESR for services from the 988 Lifeline.
• Provide training for two crisis call center staff per year that specifically addresses the needs of the WRR and tribes in Wyoming.
• Develop and implement a plan for sustainability which includes ongoing collaboration with the Wyoming DOH 988 Lifeline team.
• Partner with Lifeline 988 crisis centers to identify contacts and provide follow-up
• Train peer support specialists and community health workers on suicide prevention and crisis response
• Develop a culturally appropriate and culturally responsive curriculum for individuals in crisis
The ESR 988 project will continue to work with existing partners, current SAMHSA grants, and the Indian Health Services to offer evidence-based prevention, treatment, and recovery practices to the Eastern Shoshone community.