Seattle Indian Health Board (SIHB), an Urban Indian Organization and Federally Qualified Health Center, requests $400,000 per year for a three-year project titled “Suicide Prevention Infrastructure for Seattle’s Urban AI/AN.” The geographic catchment area for the project is King County, Washington, and the population of focus is urban American Indian/Alaska Native (AI/AN) people. The project’s goal is to build infrastructure and capacity for culturally attuned, evidence-based suicide prevention, education, and training across Indigenous organizations.
The project responds to the underinvestment in suicide prevention infrastructure for AI/ANs in Seattle/King County, which is a result of systems that are entrenched in colonialism and leave out urban AI/AN people. The project will build infrastructure and capacity through the four Actions of the National Strategy for Suicide Prevention (NSSP). To activate a broad-based public health response to suicide, SIHB will: (1) collaborate with the federally funded 988 initiative that is led by the Washington State Department of Health to create and market a local Indigenous 988 crisis line; and (2) support Indigenous organizational partners to integrate suicide prevention into structures, policies, and activities as well as provide the Indigenous Knowledge-Informed suicide prevention and education toolkit to Seattle-King County Public Health for them to share widely with their partners who work with urban AI/AN people. To address upstream factors that impact suicide, SIHB will: (1) train staff and community partners in a culturally adapted version of the evidence-based Question, Persuade, Refer (QPR) Gatekeeper model; and (2) work with partner Urban Native Education Alliance (UNEA) to carry out activities centering Indigenous values and positive cultural identity as a means to build protective factors that reduce suicide risk in young adults. To ensure lethal means safety, SIHB will implement gun safe distribution, gun return days, drug return days, and education on safe storage of guns and medicines. We will work with local gun ranges to promote SIHB’s gun safe distribution days and pay for firearm safety courses for AI/AN people. We will develop a culturally attuned version of Seattle’s firearm safe storage map and distribute this resource to AI/AN community members. Finally, to support adoption of evidence-based care for suicide risk, SIHB will train our health care providers in a cultural adaptation of Collaborative Assessment and Management of Suicidality (CAMS) and strengthen our protocols and procedures for rapid follow-up for Relatives who have attempted suicide or experienced a suicidal crisis.
SIHB’s project aims to achieve the following objectives: (1) By the end of Year 1 of the project, 80% of King County-based AI/AN-led organizational partners engaged in the project will adopt policies to integrate suicide prevention efforts into their structures, policies, and activities. (2) By the end of each year of the project, an average of 18 staff from King County-based AI/AN-led organizations and other agencies working with AI/AN clients will complete culturally specific QPR Gatekeeper training hosted by SIHB. (3) By the end of each year of the project, SIHB will equip six AI/AN-led organizational partners with culturally attuned lethal-means safety education and promotions to increase AI/AN community members’ participation in gun safety training, use of gun safes, gun-return events, and drug-return events. (4) By the end of Year 1 of the project, 40% of licensed mental health counselors working at seven AI/AN-led organizations will be trained in culturally specific CAMS, increasing to 60% by the end of Year 2 and 75% by the end of Year 3.