Section B: Proposed Approach
1. Goals and Objectives. The overall purpose of the project is to reduce the burden of
suicide in Wisconsin by:
 Promoting the development of community based suicide prevention networks
in 10 communities that are culturally sensitive and consumer inclusive that
work towards formally establishing a system by which agencies,
organizations, and communities will identify and intervene reducing the
burden of youth suicidal behavior and suicides within their communities;
 Disseminating lessons learned through regional sharing sessions, a toolkit, a
listserve, and a statewide conference.
To accomplish this undertaking, the following goals and objectives will be accomplished.
These goals and objectives are directly linked with those outlined in the WSPS.
Table 4a: Goals for 10 Pilot Projects
Goal 1 – Promote Awareness that Suicide is a Public Health Problem
Obj. 1. By 3/06 and annually thereafter, pilot projects will implement a suicide infrastructure survey to
assess knowledge of suicide, suicide prevention resources, and agencies and organizations working to
prevent suicide or intervene with youth at-risk for suicide.
Obj. 2. By 9/06, community stakeholders will increase their knowledge about the burden of suicide and
suicide risk and protective factors.
Goal 2 – Develop Broad-Based Support for Suicide Prevention
Obj. 1. By 9/06, pilot projects will have representation in their suicide prevention activities from the
following groups: law enforcement, juvenile justice, school systems, mental health programs, foster care
programs, substance abuse programs, public health, EMS, parents, business community, faith groups,
primary care, media, and representatives of high-risk groups including survivors and consumers.
Obj. 2. By 9/06, pilot projects will have developed a community-level suicide prevention strategic plan.
Goal 3 – Increase Community Linkages With and Access to Mental Health and Substance Abuse Services
Obj. 1. By 9/06, pilot projects will have a formal network of stakeholder agencies, organizations, and
advocates who work together to identify and intervene among youth at-risk for suicide.
Obj. 2. By 9/07, pilot projects will integrate current ongoing suicide prevention education into newly
developed suicide prevention programs and services.
Goal 4 – Develop and Implement Suicide Prevention Programs
Obj. 1. By 9/07, pilot projects will implement at least one evidence-based suicide prevention and early
intervention program.
Obj. 2. By 9/07, culturally appropriate suicide prevention and early intervention educational materials will
be made available to the deaf and hard of hearing community.
Obj. 3. By 9/07, 75% of high school youth in pilot communities will receive some information about
suicide prevention, risk factors, and available early intervention services in the community.
Obj. 4. By 9/07, 75% of the high schools in the pilot communities will adopt a formalized local crisis
response system to refer suicidal youth.
Obj. 5. By 9/07, local crisis response teams will report an increase in the number of referrals and variety of
referral sources.
Goal 5 – Reduce burden of suicide in 10 Wisconsin communities
Obj. 1. By 9/08, in the pilot projects, reduce to at least 25% the number of youth who report feeling so sad
and hopeless almost every day for two weeks or more during to previous 12 months (state prevalence is
currently 31%).
Obj. 2. By 9/08, in the pilot projects, reduce to at least 15% the number of students who report seriously
considering suicide during the past 12 months (state prevalence is 19%)
Obj. 3. By 9/08, in the pilot projects, reduce to 5% the number of youth who report actually attempting
suicide in the previous 12 months (state prevalence is currently 11%).
Obj. 4. By 9/08, in the pilot projects, reduce to 1% the number of youth who report a suicide attempt that
resulted in treatment by a doctor or nurse (state prevalence is currently 3%).
Obj. 5. By 9/09, in the pilot projects, reduce by 20% the rate of emergency department visits from selfinflicted injuries (current state unadjusted rate is 69/100,000).
Obj. 6. By 9/09, in the pilot projects, reduce by 20% the rate of hospitalizations from self-inflicted injuries
(current state unadjusted rate is 91/100,000)
Obj. 7. By 9/09, in the pilot projects, reduce by 10% the rate of deaths from suicide.
Table 4b: Goals for Disseminating Lessons Learned
Goal 1. By 3/06, create a listserv for youth suicide prevention related information and resources for state
and local groups across Wisconsin.
Goal 2. By 9/07, hold a meeting will all pilot sites to begin development of a suicide prevention toolkit
through a National Mental Health Association facilitated process.
Goal 3. By 10/07 hold two regional sharing meetings to discuss lessons learned, challenges, opportunities,
and successes.
Goal 4. By 6/08 hold two additional regional sharing meetings to discuss lessons learned, challenges,
opportunities, and successes.
Goal 5. By 9/08, hold statewide suicide prevention and early intervention conference.
Concurrent with the grant activities, the SPI will also be undertaking a number of efforts
to strengthen state and regional level infrastructure for promoting youth suicide
prevention. These will include completing a survey of all county suicide prevention
efforts, developing a plan to promote awareness of suicide as a public health problem,
disseminating information about training and effective clinical practices, and developing
a plan to obtain additional funding to support suicide prevention efforts.
The goals of the project are further identified in the logic model on the following page.
The proposed project will address all of the purposes described in Sec. I-2.1 of the RFA.
Specifically it will:
 Support development and implementation of youth suicide prevention efforts
in the various systems described (the emphasis in each site will be driven by
the local assessment).
 The entities directly involved in this project are those public and private
entities that were instrumental in development of the WSPS and
implementation of the WSPS to date.



The Injury Research Center at the Medical College of Wisconsin will be a
subcontractor to act as our local evaluator and serve on our oversight
committee.
The data analysis for the project will advance research, technical assistance
and policy development and will support our longer term funding efforts by
providing data that the State and local communities can use in seeking funding
from other sources.
The long-term goal of reducing youth suicide will allow the state to move
towards its targets under Title V of the Social Security Act. As noted in Sec.
A, 1. our 2002 youth suicide rate for 15-19 y/o was 10.5 and our target is 9.
The project is also clearly consistent with the WSPS in that it is locally driven but utilizes
mentors and expert consultants to ensure that development of local plans are based on
evidence-based and best practices. The selection process for sites will ensure that projects
are targeted to geographical areas at greatest risk and mentors will assist local entities to
focus on sub-populations at greatest risk. Mentors will also educate project sites on the
need to address access to lethal means. Therefore this approach addresses the needs
identified in Section A. Because the WSPS follows the goals and objectives of the NSSP
(see Appendix 4) it is clearly supported by the NSSP.
2. Grant Activities. The grant activities can be thought of as falling into two distinct, but
related, parts. First, we will support the development of 10 local youth suicide prevention
efforts through the provision of grants, mentoring and expert consultation. The
competitive application process described in Sec. A, 4. will ensure that sites are selected
by October 1, 2005. Second, a variety of methods will be utilized to disseminate
information about youth suicide prevention and the lessons learned from the project sites
to promote sustainability.
a. Local youth suicide prevention projects. The project utilizes a mentoring and expert
consultation approach to achieve the goals of the project. The approach is especially well
suited to Wisconsin’s system of local control as it maximizes local initiative while, at the
same time, ensuring that local sites benefit from what is currently known about best
practices. This approach has been utilized in a variety of human services and educationrelated initiatives in Wisconsin.
Each site will be assigned a mentor who has broad experience and knowledge related to
suicide and excellent facilitation skills. This mentor will:
 Meet with the local coalitions established through this project to assess the local
needs and resources.
 Assist local coalitions to identify where issues of age, race, ethnicity, culture,
language, sexual orientation, disability, literacy and gender are significant issues
for the target population.
 Educate the local coalitions on identified evidence-based or best practices.
 Assist local coalitions to develop and implement a workplan.
 Assist the local coalitions to identify training and expert consultation needs.
The MHA will make available expert consultants in a variety of areas; including experts
in working with various cultural groups, suicide prevention programs (e.g., TeenScreen)
and systems (e.g. law enforcement). A partial list of such consultants is identified in
Table 5. Funds will be allocated equitably across sites in years 1 and 2 of the grant.
Where it makes sense, multi-site training and education sessions will be utilized.
Mentors will meet on-site with members of the coalition 9-12 times per year during the
first two years of the project. Site visits will be reduced when project staff determines that
the coalitions have developed the ability to manage their local activities. Monthly
teleconferences including the local coordinators, the mentors, the project coordinator,
MCW and key state partners will be utilized to monitor progress across sites, identify and
address barriers to project implementation, discuss issues of concern to all sites (such as
evaluation-related issues) and provide an opportunity for feedback from the local sites.
Members of the state-level Suicide Prevention Initiative (SPI) steering committee will be
invited to participate in these meetings to provide two-way feedback between the SPI and
the project sites. Table __ is a workplan for the project sites other than WSD.
Name/
Expertise
Tassy Parker,
PhD., R.N.;
Native American
Gary Hollander,
Phd. GLBT
Jeff Lewis,
Crisis Services
and 1-800Suicide
Nancy Pierce*
MH and Law
Enforcement;
CISD
John Humphries;
*school suicide
prevention
Marian Sheridan,
RN, BSN; Teen
Screen
implementation
Table 5: Expert Consultants
Qualifications
Assistant Professor of Psychiatry and Behavioral Medicine, Medical College of Wisconsin;
Member of Seneca Nation, Health Disparities Fellow, National Center on Minority Health
and Health Disparities, NIH; Organized grassroots initiative to identify mental health issues
of adjudicated Native youth and to develop a network of adult Natives to mentor
incarcerated Native youth and deliver culture-specific programs for the youth while they are
incarcerated.
Executive Director, Diverse and Resilient, a capacity-building organization committed to
the healthy development of LGBT people in Wisconsin. Clinical faculty member of the
University of Wisconsin - Milwaukee and the University of Wisconsin School of Medicine.
Teaches in the Lesbian, Gay, Bisexual, and Transgendered Studies Program at the
University of Wisconsin - Milwaukee.
Mr. Lewis is the Crisis Services Coordinator at North Central Health Care Facilities and a
consultant to the Bureau of Mental Health and Substance Abuse Services on crisis services
and supports the development of crisis services across Wisconsin. He is part of the
statewide Crisis Network and has also been instrumental in implementation of 1-800SUICIDE lines in Wisconsin.
MASW, U. of Chicago. Advanced Clinical Practitioner in the Emergency Services Unit at
the Mental Health Center of Dane County. Trainer/consultant for schools, mental
health/human services, law enforcement on mental health crisis response, suicide/violence
risk assessments and crisis safety plans.
Master’s Degree in Education and is a Nationally Certified School Psychologist. School
Psychology Program Consultant at the Wisconsin Department of Public Instruction.
Provides suicide prevention training modules to school district personnel across Wisconsin.
Coordinator of School Health and Safety Program, Fond du Lac School District.
Responsible for the ongoing promotion, delivery, follow-up and maintenance of the
Columbia TeenScreen Program. Member of the Fond du Lac Board of Health. Graduate
Certificate in Public Health
Chris Hanna*;
rural issues
Capri-Mara
Fillmore*; preand post-partum
depression.
Linda Russell,
D/HOH
Vanessa Key
AmericanAfrican
Masters in Public Health, University of Northern Colorado. National Children’s Center for
Rural and Agricultural Health and Safety at the Marshfield Clinic. Receives support from
the Children’s Safety Network and the Suicide Prevention Resource Center to provide
technical assistance and training on violence-related injuries to children in rural areas.
MD from Vanderbilt Medical School, MPH at Johns Hopkins School of Public Health.
Associate Medical Director of the City of Milwaukee Health Department. Designed,
developed, initiated and evaluated a middle and high school depression screening program.
Focus on pregnant teens. Director of maternal and child health programs.
Gallaudet University 71-75; Mental Health Specialist for D/HH, Bureau of Mental Health &
Substance Abuse Services; National Association of the Deaf Mental Health Committee;
Wisconsin Association of the Deaf Board of Directors; prior experience as case manager for
deaf persons with mental illness.
Associate Director, New Concepts Self Development Center; Establishing Mental Health
Training Institute; outpatient clinic; collaborating with hospitals, MCW; 30 years
experience working with the African –American community; youth prevention
programming
*Presented at SPRC Regions 3 and 5 Conference, Pittsburgh, May 18-20, 2005
TABLE 6: Workplan for Project Sites (other than WSD)
Timeline
Activities/Tasks
Responsible
Coalition Development and Community Assessment: October 2005-June 2006
10/05-12/05 Initial meetings of core team.
Mentors
Outreach and engagement of other
MHA
community partners.
Community
Initial education of coalition members on
coalition (CC)
suicide prevention.
MCW
Begin work with local coalitions on data
SPI
collection needs and methods.
1/06-3/06
Assess current community resources, and Mentors
needs through infrastructure survey and
MHA
other means identified by the coalition.
CC
Identify community education needs.
MCW
Begin identification of desired program
SPI
efforts based on WSPS 11 core
components.
Begin identification of expert
consultation needs.
Begin to address future funding needs.
4/06-6/06
Complete community infrastructure
Mentors
assessment.
MHA
Finalize local workplan.
MCW
Identify expert consultation needs.
SPI
Begin program development.
10/05-6/06
Work with cross-site evaluator to develop MCW
evaluation materials and forms.
DPI
Educate local coordinators about
MHA
evaluation plan and requirements for
CC
tracking outcomes.
Work with schools to implement local
version of Youth Risk Behavior Survey.
Community Youth Suicide Prevention Activities: July 2006-September 2008
7/06-9/07
Implementation of program efforts per
Mentors
workplans and oversight by mentors and
MHA
cross-site teleconferences.
CC
Identify additional training and program
SPI
Objectives
Formation of community
coalition that can oversee and
sustain the initiative.
Education of coalition members
on suicide risk and prevention.
Preparation for community
assessment and data collection.
Identify community needs and
resources.
Begin development of workplan.
Begin to address sustainability
issues for local site.
Workplan is finalized and
implementation begins.
All evaluation procedures are in
place prior to implementation of
program efforts. Complete “pretest” of YRBS.
Suicide prevention efforts are
implemented according to local
workplan and future
sustainability is addressed.
7/06-9/07
7/06-9/07
6/07-8/07
9/07ongoing
1/08-5/08
needs.
Pursue alternative future funding.
Coordinate expert consultation on
program and cultural competency as
identified by local sites.
Collect data on implementation of
program initiatives as identified in grant
and as required for cross-site evaluation
Evaluation of first year efforts.
Make decision about modifying workplan
for year two.
Continued efforts as determined by
community coalition.
Access alternative funding.
Complete second local version of YRBS.
MHA
SPI
Mentors/CC
Mentors
MCW
MHA
CC
Mentors/CC
MHA/SPI
MCW
CC/Mentor
MHA
SPI
Grantees.
DPI/MCW
Local projects are implemented
according to evidence-based and
best practices.
All sites are routinely submitting
necessary data for evaluation to
MCW and cross-site evaluator.
Suicide prevention efforts are
implemented as planned with
modifications as necessary.
Program efforts are sustained.
“Post-test” of YRBS is
completed.
WSD’s workplan is unique for a number of reasons:
 MHA is currently working with WSD as part of our mini-grant project.
 WSD serves students from across Wisconsin so has a different “community” to
address.
 WSD is currently communicating with Columbia TeenScreen about creating an
American Sign Language (ASL) version of TeenScreen for use with their
students. If TeenScreen agrees to this, this project will be funded under the
MHA’s mini-grant to WSD.
 WSD must work to develop cultural competence among area professionals so
they better understand Deaf culture, know how to work with interpreters and thus
can better respond to the mental health needs of the students.
Finally, the workplan includes development of an ASL version of the S.O.S. video that
can potentially be a resource to deaf youth throughout the country. S.O.S. is an evidencebased program listed on SAMHSA’s National Registry of Effective Programs and
Policies. Screening for Mental Health has committed to collaborate with us on this to
ensure that the video accurately incorporates the A.C.T. model (Acknowledge, Care,
Tell) they promote and Raymond Rodgers, a professional deaf producer, has also agreed
to work with us on this. Their letters of commitment can be found in Sec. G. Table
7identifies anticipated activities that will be funded through this proposal:
TABLE 7: Workplan for WSD
Timeline
10/05-3/06
10/05-6/06
Activities/Tasks
Arrange and implement videoconferencing at 4-5 sites across
Wisconsin for parents to receive
education about youth suicide.
Build collaboration with local human
service departments, mental health
professionals, law enforcement and
hospitals through in-service presentations
that educate agencies about Deaf culture,
Responsible
WSD staff
Mentor
Linda Russell
WSD staff
Mentor
Office of Deaf
and Hard of
Hearing
Objectives
Parents will have increased
knowledge about mental health
and suicide and will learn how to
better support their children.
Area professionals will increase
their cultural competency
regarding the deaf students they
serve. Professionals will more
appropriately respond to the
communication issues and mental health
issues affecting deaf youth.
Provide in-service training to staff at
WSD using Eliminating Barriers to
Learning modules.
Linda Russell
needs of deaf youth.
WSD staff
MHA
Linda Russell
3/06-10/06
Begin development of ASL version of
SOS video for use with deaf students.
10/06-3/07
Begin implementation of TeenScreen if
materials are completed.
R. Rodgers
WSD staff
Linda Russell
MHA
SOS Staff
WSD staff
Staff will have improved
understanding of mental health
needs of students and how to
recognize and respond to signs
of suicide.
Initial development of scenarios
appropriate to deaf youth.
Initial development of agreed
upon ASL to use with video.
10/06-3/07
Complete development of SOS video
3/07-6/07
Begin use of SOS video
1/06-6/06
R. Rodgers
WSD Staff
Linda Russell
SOS staff
WSD staff
Targeted students will be
screened and appropriate
referrals will be made.
Production will be completed
and video will be ready for use.
WSD students will understand
how to identify and respond to
signs of suicide in others.
b. Information Dissemination. Information dissemination activities are identified in Table
__.
Table 8: Evaluation and Dissemination of Program Outcomes:
3/06
Develop listserve for youth suicide
prevention
MHA
6/07
Cross-site evaluation meeting.
9/07-6/08
Offer regional sharing sessions that bring
together representatives from grantee
sites and others interested in developing
youth suicide prevention efforts in their
communities.
Publish and disseminate “lessons learned”
from project.
Develop implementation toolkit for
communities interested in replicating
these efforts. *
Hold a statewide conference on youth
suicide prevention to further educate
stakeholders and to promote key learnings
from the project.
Complete evaluation activities
NMHA/MHA
Mentors/CC
MCW
SPI
Mentors
MHA/SPI
CC Reps
Other interested
sites.
Mentors
MHA/NMHA
DPI
DHFS
MCW
HOPES
MHA
DPI
DHFS
MCW
5/08-9/08
6/08-9/08
5/08-9/08
Listserve including project sites,
SPI and others interested in
youth suicide will be developed.
Gather input on lessons learned,
items to be included in toolkit,
planning for information
dissemination.
Learning from grantees will
stimulate efforts in other
communities.
Support future youth-based
suicide prevention efforts.
Provide material that all partners
can use for future training.
Promote and elevate the
dissemination of information on
youth suicide.
Evaluation completed and
disseminated.
The National Mental Health Association (NMHA) will provide support and expertise to
the information dissemination efforts (see letter of commitment in Sec. G). NMHA will
assist in developing and facilitating an all-site meeting that will be used to kick-off the
development of the toolkit. The meeting will facilitate input from stakeholder groups
around lessons learned and to identify priorities and values that are the root of community
change. NMHA will facilitate discussion and planning among stakeholders to specify
actions other communities could take to achieve desired change, set timelines for such
action steps and identify additional technical assistance needs. The NMHA will also
assist in development of the toolkit.
The toolkit will be a compendium of information on youth suicide prevention, which will
be based on the activities of the grant. While the final shape of the toolkit will be
dependent upon the outcomes of the projects, it is expected that the toolkit will include
the following: a detailed description on developing community coalitions, including
examples of workplans; models for assessing community capacity, resources and needs
including the community infrastructure survey; model school policies; information about
gatekeeper training programs; information on screening programs, examples of media
efforts to educate on suicide and address stigma; model policies on suicide prevention for
mental health and alcohol and drug abuse treatment professionals; model policies for
child welfare, juvenile justice and law enforcement based on Wisconsin legal
requirements and national best practices; examples of suicide prevention efforts from
project sites; an annotated bibliography of research support for suicide prevention efforts,
including the evaluation for this project, that communities can use in applying for local
grant funds to support projects; information about sources of financial support for youth
suicide prevention.
While specific program activities will be determined locally and in accordance with the
WSPS, the MHA and the mentors will ensure that all program requirements as specified
in Sec. I-2.2 of the RFA will be addressed.
As noted in Sec. A, 1 we will continue to utilize the SPI as our oversight group and
expand its membership as needed to better incorporate the critical stakeholders.
The MHA and other project partners will work collaboratively with the national technical
assistance center for suicide prevention on State/tribal-sponsored youth suicide early
intervention and prevention strategies. We will collaborate with NIMH-and CDC-funded
suicide prevention efforts as requested.
3. Evidence-Based Practices. The project’s mentoring and expert consultation approach is
well suited to ensuring that services implemented by local coalitions represent the best
evidence-based and promising strategies. Indeed, the MHA has already utilized many of
the resources identified in the RFA in its mini-grant program:

For its 2005 mini-grants the MHA required grantees to implement either S.O.S.,
which is on SAMHSA’s National Registration of Effective Programs and Practices
(NREPP), or Columbia TeenScreen, which was identified as a model program in the
President’s New Freedom Commission Report on Mental Health.




The WSPS will be utilized as a resource by our mentors. TheWSPS incorporates the
practices identified in the NSSP. The WSPS represents the current best practices for
suicide prevention. Kalafat found that a comprehensive approach such as that
contained in the WSPS, which addresses multiple levels of school and community
contexts, could reduce youth suicide rates.i
Our mentors will also be able to utilize a review of evidence-based programs
conducted for the DPI by Dr. Leona Eggert: Best Practices for School-Based Youth
Suicide Preventionii. Dr. Eggert is a national expert in school-based youth suicide
prevention.
Sue Opheim is a certified trainer for QPR, a well-researched gatekeeper training
program for recognizing and responding to persons exhibiting signs of suicide. Sue
will be able to train trainers and provide direct training as part of her mentoring
activities.
The MHA has been part of the development of Eliminating Barriers to Learning
(EBL). EBL is a curriculum designed to educate teachers about mental disorders and
how to create a mentally healthy classroom. EBL is part of a SAMHSA-sponsored
anti-stigma initiative, the Eliminating Barriers Initiative (EBI). As a member of
Wisconsin’s EBI team, the MHA also has access to other EBI products that can be
provided to project sites should they wish to undertake anti-stigma initiatives as part
of their workplan.
Wisconsin will utilize the Suicide Prevention Resource Center (SPRC) to keep abreast of
development of best practices. Project mentors will be expected to attend the AAS
conference annually as another means of remaining up to date on current practices.
4. Emergency and Cross-System Care. Through its mini-grant program the MHA has
learned that before any suicide prevention activities are directed towards youth there must
first be work done to educate the various systems connected to youth so they can respond
appropriately if youth identify as at-risk for suicide. That is why one of our first activities
will be the infrastructure survey. Mentors will work with sites to make sure that during
the first year, prior to implementation of activities directed toward youth, the local
coalitions develop policies for working together across systems and ensuring the key
individuals within each system are trained around suicide prevention. Among these will
be policies and practices to respond to youth identified as at immediate risk for suicide or
suicide attempts. We will use the State’s Crisis Network, a workgroup representing crisis
programs in over half of Wisconsin’s counties, as a vehicle for identifying and
disseminating best practices in suicide response.
5. Parental Consent. Parents are one of the key stakeholders who must be part of the local
coalitions. The local coalitions will determine the most appropriate means for educating
parents about any suicide prevention efforts being undertaken in the community. This
may include utilizing existing parent teacher organizations, forming specific parent
advisory committees for this project, and/or media stories about youth suicide generally
and specific activities implemented through this grant. Mentors will educate local
coalitions about the need to obtain active, written consent from parents or legal guardians
as required by the Garrett Lee Smith Act. Sample consent forms from the Fond du Lac
TeenScreen program are provided in Appendix 3. These will be modified for specific
types of programs, as needed, and will conform will all requirements of the Garrett Lee
Smith Act as communicated by SAMHSA.
The key entities participating as partners, their roles and responsibilities are identified in
Table 2 in Sec. A, 3. Key in-kind contributions include $10,000 from DPI for John
Humprhies’ training activities, $10,000 in-kind support of the DHFS staff for the project
and the identified in-kind support, valued at $35,000 from the NMHA.
6. Potential Barriers and Responses. Through its experience to date with its mini-grant
program the MHA has learned some important lessons about implementing local suicide
prevention initiatives. Because of this we have in fact been able to incorporate elements
into this proposal to address the potential barriers we have identified to date.
1. A broad community coalition is essential. No one system (schools, mental health, law
enforcement) can implement a successful initiative on its own. The unwillingness of
key systems to be involved could undermine the success of the project
Response: The MHA will require, as part of the competitive application, that
local entities document the willingness of key systems to participate in their
coalition.
2. Because the WSPS, and Wisconsin’s approach to human and social services, is built
on local control and decision-making, it will be impossible to show that one particular
program done in each site was successful in reducing youth suicide.
Response: Success can be demonstrated by a number of different evidence-based
practices, when properly implemented, and as part of a comprehensive, crosssystem effort.
3. While many potential practices exist for addressing youth suicide, they vary in terms
of exactly what they are addressing and what they will impact. For instance,
TeenScreen does a good job of identifying youth with mental disorders but, unlike
S.O.S. does not educate students about responding to immediate signs of suicide.
Response: The use of mentors will help to ensure that sites pick programmatic
approaches that are matched to the specific needs they identify as well as being
comprehensive.
4. The simple logistics and pragmatics of many of the youth suicide prevention efforts
can result in significant delays in implementation or potentially overwhelm local
staff, undermining the effectiveness of the interventions.
Response: Again, the use of mentors and the availability of expert consultants
should minimize the “surprise” factor as communities implement programs.
5. The data presented in Sec. A, 1. made it clear that Wisconsin youth use firearms for
suicide well above the national average. This would suggest that securing of lethal
means is a critical issue. However, Wisconsin has a strong culture of hunting that will
present challenges to efforts to restrict access.
Response: Mentors will focus attention on this issue, especially in rural areas
where hunting is more predominant. Work with primary care providers to educate
individuals about this issue from a health care perspective and with law
enforcement will be encouraged as critical elements of local plans.
7. Sustainability. Sustainability is built into the project at three levels. At the local level
the formation of committed community coalitions will provide the basis for
sustainability. These coalitions, by design, will be required and supported in their efforts
to obtain future funding from other sources (e.g., local foundations or businesses). The
evaluation efforts that are part of this project will facilitate this by providing outcome
data that sites can use in their funding requests. Local systems will have achieved
changes in their infrastructure and capacity through training, policy development and
implementation of new procedures designed to improve collaborative responses to youth
suicide risk.
The second level of sustainability is within the project partners. The DPI, DHFS, HOPES
and MHA will have enhanced their knowledge and skills in this area and be better able to
provide training and technical assistance to other communities interested in replicating
these efforts. The lessons learned from the project will inform this process and the toolkit
will support it. DPI and DHFS have funded the MHA’s youth suicide prevention efforts
to date, and depending upon the availability of their funding, could continue to be
supportive when the grant ends. MHA will have developed improved web resources and
a listserve that can continue to inform schools and communities in these efforts.
Identification and knowledge of expert consultants in various areas will facilitate the
ability to provide training when requested. It is also expected that policy and procedure
changes that will facilitate local collaborative efforts may be made at the State-level as a
result of things learned through this project. Regional consortia promoted by the SPI will
also strengthen state infrastructure. Therefore we anticipate both the capacity and
infrastructure at the state level will be significantly enhanced through this project.
The third level of sustainability is the foundation this project will provide for securing
additional funds for statewide replication. As noted in the letter of support from the
Kubly Foundation, a current funder of the MHA’s youth suicide prevention initiative, the
availability of positive outcome data will support our ability to seek funds from private
foundations such as theirs to sustain our efforts. The MHA will also seek funds from
Wisconsin’s two medical schools, which are managing an endowment from Blue
Cross/Blue Shield. This endowment is funding public health prevention efforts in
Wisconsin. Because these efforts must be consistent with Wisconsin’s public health plan,
Healthiest Wisconsin 2010, and because mental disorders are a priority health condition
under the plan, the MHA believes that these youth suicide prevention efforts are
fundable. Because the Medical College of Wisconsin is one of these two medical schools,
our relationship through this grant could provide the foundation for a successful
application for these funds. The final source of potential support is the government.
Given the extremely tight budget situation that applies in Wisconsin, as elsewhere,
obtaining State funding is a great challenge. But as witnessed by the letters of support
from Sen. Mark Miller (D) and Rep. Al Ott (R), the mental health community in
Wisconsin does have bipartisan support for our efforts. Again, the outcome data from this
project could be a significant factor in solidifying such support.
i
Kalafat, J., School Approaches to Youth Suicide Prevention, American Behavioral
Scientist, V. 46, N.9, May 2003.
ii
Randell, Brooke P., Eggert, Wallace V., and Eggert, Leona L., Best Practices for
School-Based Youth Suicide Prevention, June 2002