This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network |
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This Web site is a component of the SAMHSA Health Information Network. |
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DIVISION OF PROGRAM DEVELOPMENT, SPECIAL POPULATIONS, AND PROJECTSSuicide Prevention National Suicide Prevention Strategy CMHS is taking the lead for SAMHSA in addressing suicide and suicide prevention as a public health issue. CMHS sponsored a 2-day workshop to consult with experts in suicide prevention and related fields on the development of a National Suicide Prevention Strategy (NSPS). The goals of the meeting were to: achieve consensus on a set of goals and objectives for the NSPS; provide recommendations on an outline for the first NSPS document; and provide recommendations for next steps, including the identification of key partners. The idea for developing a national strategy to prevent suicide originated at the first formal National Suicide Prevention Conference, held in October 1998, in Reno, Nevada. The NSPS is the first-ever national strategy to reduce the burden of self-directed violence, injury, and death in the United States. When completed, it will suggest activities for Federal, State, tribal, and local governments, based on the best available science. The strategy will also provide guidance for organizations and individuals who seek to be involved in suicide prevention. CMHS is providing leadership in the development of the NSPS. The strategy's draft Goals and Objectives document is organized into 11 broad goals and an additional 59 measurable objectives, blending both scientific and policy elements. The document is organized in this way to initiate and direct activities that contribute to the goal of suicide prevention across the spectrum of the national community. The Goals and Objectives will form the heart of the NSPS. The final version will establish a conceptual framework for understanding suicide and suicide prevention and will suggest how government agencies, private organizations, and individuals can effectively help to achieve the Goals and Objectives. The draft Goals and Objectives document is posted for public comment on the U.S. Surgeon General's web site at www.sg.gov. CMHS is helping to support a limited number of regional public hearings to solicit public comment on the draft Goals and Objectives. The primary goal of the hearings is to build grassroots support for the NSPS. Cooperative Agreements CMHS is funding local pilot suicide prevention initiatives for school-age children. The 2-year cooperative agreements are designed for community organizations to promote prevention of youth violence and suicide and to enhance healthy youth development. They are part of SAMHSA's larger youth violence prevention initiative, which includes the "Safe Schools/Healthy Students" program. National Suicide Prevention Consensus Conferences CMHS is supporting a 5-year series of coordinated annual national suicide prevention conferences and workshops being organized and conducted by the University of Rochester School of Medicine's Center for the Study and Prevention of Suicide. Institute of Medicine Report on Suicide Prevention CMHS is a sponsor of the National Academy of Sciences Institute of Medicine report on suicide prevention, titled Pathophysiology and Prevention of Adolescent and Adult Suicide. The Institute of Medicine committee charged with preparing the report will: (1) assess the science base of suicide etiology, including cognitive, affective, behavioral, sociological, epidemiological, genetic, epigenetic, and neurobiological components and examine the vulnerability of specific populations and age groups; (2) evaluate the current status of primary and secondary prevention, including risk and protective factors and consider what does and does not work in national and international efforts; (3) evaluate and design strategies for studies on suicide, including consideration of the ethics of incorporating suicidal persons into drug trials, reevaluation of the current classification of suicides, and design of scales to evaluate suicide risks and outcomes; and (4) provide conclusions concerning gaps in knowledge, research opportunities, and strategies for prevention of suicide. High School Screening and Suicide Intervention Program CMHS is supporting the operations and analysis of information gathered from a high school screening and suicide intervention program. The High School Outreach Program 2000 embraces the U.S. Surgeon General's Call to Action to Prevent Suicide and is a first-ever program of depression education, screening, and suicide intervention targeted at high schools. The program's non-Federal sponsor is Screening for Mental Health, Inc., the organization founded to institutionalize and promote National Depression Screening Day. The High School Outreach Program 2000 is designed to expand awareness of depression through educational materials for the classroom and to provide the opportunity for self-administered depression screening under the supervision of a school health professional. Students will be encouraged to seek further evaluation, if necessary, through existing school and community resources. Anti-Stigma Efforts and Suicide Prevention CMHS commissioned review of the literature and recommendations on the role of mental health anti-stigma information campaigns in suicide prevention. Given that anti-stigma efforts are considered by many to be a valuable intervention in any overall national strategy to reduce suicide and suicidal behaviors, the scientific basis for advocating the expenditure of resources in this area merits exploration. Community Mental Health Centers (CMHC) Between 1965 and 1975, the National Institute of Mental Health awarded $275 million in construction grant funds to 575 grantees to build community mental health service facilities. In exchange for construction funds, grantees assumed a 20-year obligation to provide five essential mental health services, continuity of care, and a reasonable amount of free or reduced-cost care. Forty-two grantees have remaining service obligations in this fiscal year and beyond. CMHS continues to monitor active grantees through site visits and annual surveys to determine whether CMHC facilities are being retained and/or used as required by legislation. Based on site visit reports and annual surveys, more than 90 percent of the grantees are in full compliance with program requirements. Emergency Services and Disaster Relief Branch (ESDRB) The ESDRB works in partnership with the Federal Emergency Management Agency (FEMA) and the Office for Victims of Crime (OVC) of the U.S. Department of Justice (DOJ) in overseeing national efforts to provide emergency mental health services to disaster survivors and victims of criminal violence, respectively. These efforts are implemented through two independent interagency agreements between CMHS and FEMA and OVC. The Branch also works with state mental health directors and other local agencies in implementing mental health activities after major disasters through the provision of Crisis Counseling Program Grants. Crisis Counseling Grants Grant Awards Since May 2000, the Branch consulted with FEMA to award nearly $1 million to Missouri, Texas, and New Mexico to implement Crisis Counseling programs in response to Presidentially declared disasters. In addition, 18 Crisis Counseling programs were carried over from FY 1999. Six of these 18 grants have ended, and Branch staff are reviewing program and fiscal documentation necessary to close them out. Nine site visits have been made to these grantees to provide technical assistance and evaluate program activities. Guidelines for Evaluation As part of a new initiative, guidelines will be drafted for States on building an evaluation component into their grant applications and carrying out an evaluation. Branch staff hosted a 2-day conference with selected States and research experts to brainstorm issues and methodologies. Standardization of Data Collection and Reporting Practices Efforts are also under way to standardize data collection and reporting practices for Crisis Counseling program grantees. This would improve the ability of CMHS and FEMA to accurately report the services levels of the Crisis Counseling program to Congress and other oversight agencies. Collection and reporting of accurate data is also critical to new program evaluation initiatives. Training As part of its interagency agreement with FEMA, the Branch designs course curricula and facilitates necessary training on preparing for and responding to disasters. The Crisis Counseling Program: Basic Training workshop took place September 25 to 29, 2000. Occasionally, the Branch is asked to provide special training or to present information about disaster mental health and the Crisis Counseling program to specific groups or communities. This fiscal year, staff conducted special training for the District of Columbia, the State of California, and the State of New Hampshire. Publications The Branch is also developing a publication that addresses the unique issues of working with children in disaster situations. It will be available by the end of the year. Another important effort is under way directed toward achieving cultural competency in Crisis Counseling grant programs. Guidelines are being drafted to ensure that all populations have access to appropriate disaster mental health services provided in a culturally appropriate manner. To further this goal, plans are being implemented to translate existing crisis counseling publications and program materials into Spanish. Materials will be translated into other languages as needed. Victims of Crime Activities The Branch is working closely with OVC to provide consultation on appropriate mental health technical assistance and training for the victims of crime. CMHS signed an interagency agreement with OVC in 1999 for a 2-year project to advise their staff and other Federal, State, and local entities on appropriate mental health activities for victims of Federal crimes, particularly terrorist events and mass violence. Branch staff participated in several focus groups with victim advocacy representatives and mental health providers who serve crime victims. Focus groups were also held with representatives from law enforcement agencies and public and private researchers. The focus groups were charged with the task of determining the appropriate Federal role in helping communities plan for and respond to incidents of mass criminal victimization. Efforts have been initiated to: develop appropriate training modules; examine current state-of-the-art program practices in victim counseling; provide guidance concerning the appropriate Federal responsibility in responding to the emotional impact of mass criminal incidents; and critique current mental health practices serving crime victims. A new position has been funded by OVC, housed within ESDRB, to develop additional program initiatives. Additionally, the ESDRB Branch Chief gave a presentation at the National Criminal Justice Association Forum 2000. National Crisis Response Technical Assistance Center The Branch negotiated a new interagency agreement with the National Center for Post Traumatic Stress Disorder, Department of Veterans Affairs, to examine the efficacy of a variety of trauma interventions and to develop field guidance for mental health providers working with disaster, trauma, and crime victims. To support this project, contracts have been issued to examine governmental roles, prepare planning documents, and develop training modules. Project outcomes will form the basis for the National Technical Assistance Center on Crisis Mental Health Response. Special Programs Development Branch In the past few months, the Special Programs Development Branch has continued its efforts to prevent school violence through grant programs, cooperative agreements, and communication dissemination projects. The Branch has also initiated the development of a series of activities to support the science base and has undertaken several new outreach activities. School Violence Prevention Initiative "Safe Schools/Healthy Students" A central component of the School Violence Prevention Initiative is the "Safe Schools/Healthy Students" Grant Program. "Safe Schools/Healthy Students" is a collaborative effort of the Federal Departments of Education, Justice, and Health and Human Services. In September 1999, individual grants of $1 to $3 million were awarded to 54 local education authorities that have formal partnerships with local mental health and law enforcement agencies. Through these partnerships, comprehensive plans were developed and are being implemented to promote healthy development, foster resilience in the face of adversity, and prevent violence. The plans cover six primary areas: (1) school safety, (2) alcohol and other drug and violence prevention and early intervention programs, (3) school and community mental health prevention and treatment services, (4) early childhood psychosocial and emotional development programs, (5) education reform, and (6) safe school policies. A total of $41 million from FY 2000 was used to fund 23 new grants, announced on April 15, 2000. In addition to the grant program, this initiative includes an evaluation component to assess process and program effectiveness. In FY 2000, CMHS continued the activities of the School and Community Action Grant Program, and developed Cooperative Agreements for Comprehensive Community Actions to Promote Youth Violence Prevention, Suicide Prevention, and Resilience Enhancement. These cooperative agreements require applicants to address youth violence/suicide prevention in two phases. During the initial phase, grantees are to undertake community-based consensus- and collaboration-building in order to be able to establish and sustain a specified, evidence-based youth violence prevention program. The second phase is devoted to community-based implementation of the youth violence/suicide prevention program based on community needs assessment. CMHS expects to award grants averaging between $100,000 and $150,000 annually for 2 years to 30 to 40 school or community organizations. Coalition Building Coalitions for Prevention Grants CMHS has also developed a new grant program to States and political subdivisions to promote partnerships between these governmental entities and community service delivery systems. The grants will be used to promote a community-wide understanding of youth problem behaviors and approaches to violence prevention, assist communities in assessing youth behavioral problems, identify risk and protective factors for behavioral problems, and evaluate gaps in services. CMHS expects to award grants of $150,000 to $350,000 annually, over a 2 to 3-year period, to 25 applicants. Family Strengthening Initiative CMHS, in collaboration with the Center for Substance Abuse Prevention (CSAP), will jointly fund a cooperative agreement to support the CSAP Family Strengthening Initiative. The initiative is designed to: (1) increase the capacity of local communities to deliver best practices for effective parenting and family programs to prevent or reduce substance abuse and violence; (2) document the decision-making process for the selection and testing of effective interventions in community settings; and (3) determine the impact of interventions on target families in the study. CMHS and CSAP expect to award grants of $80,000 to $100,000 annually, over a 2-year period, to 20 to 30 applicants. To support a variety of parenting initiatives, CMHS, in collaboration with the White House Council on Youth Violence, awarded a contract for the design of a series of pamphlets for parents that offer activities, resources, and guidance for fostering the healthy development of adolescents and reducing school violence. The pamphlets will provide parents with teenagers with information on child development, mental health, ways to promote healthy and resilient children, anger management and conflict resolution, and problem-solving skills for teens. Communication Dissemination Projects In order to convey the violence prevention message, CMHS has embarked on a number of communication dissemination strategies. These are detailed below. School Violence Prevention Message/Campaign Development CMHS has developed a partnership with a Washington, D.C. television station, WJLA-TV, to research, develop, and air program messages about school violence prevention. In order to create appropriate messages for the target audience, WJLA-TV has collected information about public perceptions on school violence. Based on this research, WJLA-TV will develop and test relevant messages with target audiences, such as parents and teachers. These messages will be made available to CMHS as PSAs for distribution to the grantee network and the interested public. Television Prime Time Special on School Violence Prevention A prime-time television special on school violence prevention will also be developed as part of the school violence communications campaign. The program will focus on issues related to school violence prevention, the development of resilience in school-aged children, the promotion of science-based violence prevention interventions, and activities for parents to engage their children. Educational Television Program on Resilience In 1998, CMHS launched the Resilience Project to complement its Youth Violence Prevention Initiative. An example of one activity is work with public television WHYY to produce an educational television program, titled "Enhancing Resilience", which will portray persons who have demonstrated resilience and feature researchers in the field. The educational program will be broadcast by WHYY and distributed to other interested public television stations. It will also be made available to "Safe Schools/Healthy Students" grantee sites for training and motivational purposes. Interactive Software Coordination Project CMHS continues its work to develop computer learning software for children, parents, and teachers. The web-based programs use interactive technology to engage students in knowledge transfer activities, improve decision-making skills, and change attitudes and behaviors about violence. CMHS is also developing accompanying text on school-based violence for teacher/parent guides to assist elementary, middle, and high school students, and their teachers and parents, to develop positive attitudes, adequate knowledge, and effective skills in preventing school-based violence. Materials will be presented in developmentally appropriate frameworks which address the needs and learning styles of children, adolescents, parents, and teachers who are at risk for violence either as aggressors, victims, or witnesses in urban, rural, suburban, and tribal populations. Bibliography on the Effects of Video Games CMHS is working with Mediascope, a social science research and education organization, to develop an annotated bibliography of research regarding the social effects of electronic interactive technology (video games) on the perceptions of young people on violence and behavior. Many mental health professionals have expressed concern that video games with violent and sexist themes may encourage identification with the aggressor, increase the incidence of imitating violent behavior, and desensitize young people to real violence. The bibliography will be based on research from 1995 to 2000 that explores and documents: cognitive development and game performance; education use and academic performance; game user habituation and skills; gender issues; health issues; personality and motivation; and violence and aggression. The final product will be available to mental health professionals, teachers, parents, and the public. Focus Groups To further refine message development, nationwide discussion groups of ethnically diverse young people will be conveyed to elicit information about ways to increase and enhance parent and child communication, with the ultimate goal of reducing incidences of violence. Information from these discussion groups will be used to create practical promotional and educational products that feature a "how-to" approach for parents and caregivers to communicate with children. Supporting the Science Base White Papers To further the science base in the prevention and health promotion arenas, CMHS is producing a number of white papers. Three separate white papers will examine the status of research and research-based programs to promote mental health (including fostering resilience) and prevent mental and behavioral disorders in the following populations:
These three white papers will describe and critique evidence-based programs, offer recommendations for improving programs and interventions. They will also offer specific policy recommendations for strategies to promote mental health, foster resilience in the face of adversity, and prevent mental and behavioral disorders among these populations. Other white paper topics include:
Replication Projects Activities to further the science base include efforts to enhance replicability of successful strategies. An example of such a project is CMHS' work with the Judge Baker Children's Center. Research has revealed that families with significant parent psychopathology are difficult to engage in family treatment in which parent training is provided, because of the familial stress family members experience as a result of the parent's mental illness. Dr. William Beardlee developed a brief family-focused intervention for families with significant parent psychopathology, which has been proven to be effective in changing attitudes, behaviors and interactions in these families, as well as reducing the long-term risk of mental health problems among their children. CMHS' work with the Baker Center supports a set of activities to enhance the applicability and replicability of this program. These activities will include the: 1) development of a concept paper on the major issues and barriers involved in the applicability of the intervention program to diverse social and clinical target populations; 2) revision and expansion of an existing intervention manual; 3) development of training materials to support implementation of the program; and 4) determination of assessment procedures necessary for program implementation. Outreach to Special Populations The Branch is continuing its outreach efforts to a number of special populations through a variety of different mechanisms. Rural Community Outreach Workers CMHS is collaborating with the National Association for Rural Mental Health to develop a report that: 1) explores the roles of rural outreach workers in the community; 2) reviews and summarizes findings about existing mental health outreach and consumer and family involvement in rural communities; 3) matches the role of workers with the needs of rural communities; and 4) provides information and recommendations to identify appropriate roles for outreach workers in specific rural service areas. The project will result in a technical assistance document to assist States and counties in employing rural outreach workers to improve consumer access to and use of services. Culturally Competent Performance Measures for Mental Health Programs CMHS has printed a new report, Cultural Competence Performance Measures for Managed Behavioral Healthcare Programs, to identify culturally competent performance measures for mental health services. The report was produced to assist policy makers and program planners in developing and implementing appropriate culturally relevant mental health and substance abuse services for African Americans, Asian Americans and Pacific Islanders, Hispanics/Latinos, and Native Americans. Asian Americans and Pacific Islanders (AAPI) CMHS has awarded a contract to the Child and Adolescent Services Asian Pacific Development Center to develop a strategic plan to address the mental health needs of Asian Americans and Pacific Islanders. The plan will engage experts from the Asian American and Pacific Islander communities to develop a strategy that helps to build and sustain culturally competent services for these populations. In another effort to improve the availability of culturally competent and appropriate services for Asian Americans and Pacific Islanders, CMHS has funded a contract with the Families and Schools Together (FAST) program to implement and adapt the FAST program to fit the cultural needs of Among American families. The FAST program is a research-based, outreach and multi-family group process that has been widely replicated. Under the CMHS contract, FAST program staff will research and document the impact of the adapted FAST program on the psychosocial functioning of Among children and their families. The project is intended to enhance relationship building and prevention programming and to address stress and social isolation issues that Among children and their families experience, with the ultimate goal of reducing family, school, and community violence among this population. Go To Report Page One: Year-end Report Page Two: Legislative Update Page Three: Program Activities and Initiatives Page Four: Division of Knowledge Development and Systems Change Page Five: Division of Program Development, Special Populations, and Projects Page Six: Division of State and Community Systems Develpment Page Seven: CMHS Staff Notes |
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