The Tribal ROSE Initiative: Reducing Overdose and Suicide Events Across Tribal Nations - PUBLIC SUMMARY — First five lines (for Congressional reports, publications, and press releases): The Tribal ROSE Initiative: Reducing Overdose and Suicide Events Across Tribal Nations will strengthen youth suicide prevention, overdose-risk awareness, early intervention, safety planning, referral, postvention, and data-informed quality improvement for tribal youth and young adults up to age 24 through a partnership between Zero Overdose and the Manzanita Band of the Kumeyaay Nation. The initiative will build sustainable, culturally responsive prevention capacity within the Manzanita community in rural San Diego County, California—integrating evidence-based screening, safety planning, workforce training, lethal means safety, family support, and community-based prevention strategies into three youth-serving systems—to protect Manzanita youth and reduce the disproportionate burden of suicide and overdose risk in this federally recognized tribal community. FULL ABSTRACT: For many tribal communities, the rose is a symbol of life, vitality, and resilience. The Tribal ROSE Initiative draws on this meaning, aiming to be a source of healing and hope for Manzanita youth, families, and community members facing the disproportionate burden of suicide and overdose risk. According to CDC data, AI/AN youth experience the highest suicide mortality rate of any racial or ethnic group in the United States—22.9 per 100,000, more than double the national average. The East Region of San Diego County, where the Manzanita Reservation is located, was identified in the county’s 2025 annual suicide report as an area with elevated suicide death rates, with Native American residents named a priority population. Zero Overdose is a national 501(c)(3) nonprofit designated by the Manzanita Band of the Kumeyaay Nation to apply for this funding on the Tribe’s behalf. Zero Overdose will partner with the Manzanita Band in rural San Diego County to build local capacity for early identification, referral pathway development, training, postvention, lethal means safety, and data-informed system-level improvements. Suicide risk screenings and early intervention will be integrated into three required systems: (1) school systems and educational institutions, (2) mental health programs, and (3) pediatric health programs and public health systems. Trainings incorporate the PHQ-9, C-SSRS, Stanley-Brown Suicide Safety Plan, Now Matters Now safety planning resources, Integrated Overdose Safety Planning, lethal means safety, postvention practices, and the Zero Suicide framework—all adapted in partnership with Manzanita leadership. Over five years, the Tribal ROSE Initiative will: screen at least 250 youth; document at least 60 referrals; confirm service engagement for at least 45 referred youth; train at least 120 providers, community ambassadors, and natural helpers in suicide prevention; reach at least 300 family and community members; distribute at least 150 safe-storage or safety-planning supplies; and document at least 10 community-informed quality improvement recommendations. These objectives align with SAMHSA’s Strategic Priorities to expand crisis intervention care, address serious mental illness, improve access to evidence-based treatment, prevent substance misuse, and help individuals achieve long-term recovery. At the end of the project, the Manzanita Band of the Kumeyaay Nation will have increased local capacity—through trained community ambassadors, established referral pathways, documented safety planning protocols, a functioning data and quality improvement infrastructure, and sustained community-based prevention networks—to continue suicide risk identification, safety planning, postvention, referral, and early intervention strategies independently beyond the grant period.
