The University of North Dakota (UND), in partnership with NORC at the University of Chicago, is seeking federal funds to create a more robust suicide prevention and treatment system for three DAPs in Western North Dakota (ND): rural residents, veterans, and LGBTQ+ youth. A vastly frontier 21-county jurisdiction, the suicide rate in Western ND is significantly greater than the state average (26.2 vs. 18.1/100,000 in 2020) and at its peak. Our DAPs experience significant health disparities and higher rates of suicide morbidity and mortality within this region. Through data-driven interventions related to Healthcare, Opportunity, Prevention, and Education in Suicide prevention (HOPES), our project, ND HOPES, will address significant gaps in suicide prevention programming and ultimately reduce suicide morbidity and mortality among DAPs in Western ND by 10%.
The purpose of our project is to strengthen multisectoral partnerships, increase access to and utilization of timely surveillance data, create and maintain an inventory of suicide prevention programs in our jurisdiction, and to implement a set of strategies and approaches that will fill the gaps identified from our inventory and address the needs identified by our surveillance data. We will implement programs in all three tiers – community-based, healthcare-based, and upstream prevention strategies – including safe storage of firearms, conducting gatekeeper trainings, implementing Zero Suicide in primary and behavioral health care settings, utilizing tele-mental health, implementing Sources of Strength in schools and after school programs, and increasing access to and awareness of crisis services. We will aim to improve our suicide surveillance system by increasing uptake of the Suicide Consolidated Risk Assessment Profile data collection tool and Suicide Fatality Review committees and provide training for coroners and law enforcement to improve identification of veteran and LGBTQ+ status among suicide decedents. Last, we will communicate and disseminate data reports, emergent trends, project progress, success stories, and outcomes to partners, key stakeholders, and DAPs to increase awareness, acceptability, implementation, uptake, utilization, and coordination of effective approaches.
Our project includes multiple short-, intermediate-, and long-term outcomes. Short-term outcomes include: 1) increase engagement and coordination of partners, 2) increase awareness of DAPs, contributors, and emergent trends, 3) increase use of surveillance data to select DAPs, address contributors, and inform prevention strategies, 4) increase use of technical package strategies for DAPs, 5) increase partner awareness of progress, successes, and challenges, 6) increase awareness of emergent trends in suicide/self-harm, 7) increase DAP involvement in implementation of approaches, and 8) increase use of indicators and metrics for tracking impact of strategies in DAPs and for continuous quality improvement. Intermediate outcomes include: 1) increase engagement of multisectoral partners to support programmatic and surveillance activities, 2) increase partner use of surveillance data to inform suicide prevention and response, 3) increase coordinated and comprehensive suicide prevention among our team and partners in our jurisdiction, 4) increase protective factors and decrease risk factors among DAPs, 5) increase use of timely surveillance data to inform suicide prevention and response in our jurisdiction, and 6) increase capacity to sustain comprehensive suicide prevention in our jurisdiction. Long-term outcomes include: 1) decrease suicide morbidity and mortality by 10% among DAPs in our jurisdiction and 2) expand the implementation of effective suicide prevention strategies and approaches across ND. We will work with CDC as part of this cooperative agreement to refine and implement our partnership, surveillance, implementation, communications, dissemination, and evaluation plans to most efficiently