9. Performance Requirements

Priority Population:
The priority population for this project is youth aged 10-24 who are one or more of the following:
a) youth in the community involved with or at risk of becoming involved with the foster care or juvenile justice systems;
b) sexual minority youth, including those who are gay, lesbian, bisexual, and/or transgender, or questioning;
c) youth who are or have been victims of dating violence, sexual abuse, bullying, violence in the community or other types of victimization;
d) Native American youth;
e) youth with disabilities;
f) youth with substance abuse issues or mental illness; and
g) other priority populations as identified in the area assessments completed as part of this project.

All award recipients will be required to complete the following activities within the three year grant period:

1. Conduct Assessment and Planning: (Year 1) Through an assessment and planning process each of the three CHNAs accepted, with the support of MDPH, will:
(a) Identify and describe priority populations at highest risk for suicide, and resources and strategies for reaching them. Though each CHNA will develop and carry out its own area-specific process, we expect that the basic components will include:
Identifying and inviting people to be part of the planning process.
Working with the local health departments, other community resources and MDPH to determine which youth populations are dying or making suicide attempts, and by what means. Special attention must be paid to the priority populations identified in this application, but local data may also lead the partnership to identify additional priority populations.
Identifying existing resources for prevention, assessment, crisis intervention and treatment. Also identifying obstacles to engaging the resources.
Creating a plan that considers universal, selective and indicated prevention strategies. (See 3b below for definitions)
Choosing a process to measure prevention strategies to determine effectiveness.
Identifying additional sources of financial or in-kind support that might be needed to implement and sustain prevention strategies.
MDPH will provide assistance with the assessment by engaging an evaluator who will develop an assessment tool and provide training in how to use it.
(b) Develop a strategic suicide prevention plan and timeline for targeted prevention and postvention activities with the priority populations over the next two years of the project. The plan will include a person or agency designated with responsibility for the activity, budget and timeline. Since project resources are limited, each CHNA will prioritize its strategies to ensure that the most promising strategies are implemented first. The plans will include components that address:
training and other capacity-building needs,
intervention strategies, and
the development of a timely, routine notification and response system.
MDPH and an evaluator will provide assistance in the development of the plan.
(c) Engage the local and regional partners necessary to reach the target population and carry out the prevention plan. While each CHNA's response to the RFR will include a description of its members, MDPH expects that additional members will be added to strengthen the CHNA and help it engage its priority populations. For example, if a region’s intervention plan includes a focus on GLBTQ youth, the CHNA may utilize the expertise of its membership and/or find new members who can help it engage and intervene with this population. Or if a key component is an indicated prevention program that helps to connect individual at-risk youth to mental health and substance abuse services, the CHNA will need to ensure that local providers of those services are fully engaged in the CHNA. The Department of Children and Families (DCF, formerly DSS), the Department of Youth Services (DYS), the Department of Mental Health (DMH), or agencies contracted by those Departments, should also be involved in this process.
Each CHNA must engage at least one university or community college to participate in the project assessment, planning and intervention activities. If applicable, the CHNA may partner with one of the schools of social work that has been conducting suicide prevention education under our current SAMHSA-funded suicide prevent project. The participating schools of social work are at Salem State College, Boston University, Simmons College and Springfield College.

2. Increase Capacity-building: (Year 1, 2 & 3) Through training and technical assistance for the awardees and their member agencies, in cooperation with MDPH and the project evaluator, a further goal will be to increase capacity among at least 90 agencies and 3,000 agency staff, gatekeepers and other stakeholders within the three CHNAs to plan and implement effective suicide prevention interventions.
3. Implement Prevention and Postvention: (Year 2 & 3) Following the assessment and planning phase the CHNAs will develop and implement interventions which:

(a) Raise awareness among community members and key stakeholders about suicide prevention and
postvention needs and resources. Area awareness strategies could include: collaborating with media outlets to cover topics related to suicide as a public health issue and to help educate the public about suicide prevention; promoting awareness of suicide as a public health issue through community-based organizations; and educating policy makers and the general population about suicide as a public health issue using forums and awareness events.

(b) Reach at least 9,000 youth and families within the three CHNAs with early intervention activities. The types of strategies could include:

(i) Universal suicide prevention programs, which target and benefit everyone in the
community irrespective of their suicide risk. Some examples include educational materials, workshops, building resiliency, and mental health services.
(ii) Selective prevention programs benefit priority groups whose members have a
significantly higher risk of developing suicidal behaviors, e.g. youth who are in foster care, youth involved with the juvenile justice system, and GLBT youth.
(iii) Indicated prevention programs, which target and benefit identified high-risk individuals
or those who already exhibit suicidal behavior, such as a recent suicide attempt or suicidal ideation.

(c) Offer postvention support to survivor families and peers in twenty-five incidents of youth suicide
within the three CHNAs. Postvention can take many forms depending on the situation in which the suicide takes place. Schools and colleges may include postvention strategies in overall crisis plans. Individual and support groups may be offered for people affected by the suicide of an individual.

Postvention includes measures to prevent suicide attempts by friends, loved ones, and others in the aftermath of a suicide. These may include activities to:
(i) alleviate the distress of suicidally bereaved individuals;
(ii) reduce the risk of imitative suicidal behavior and;
(iii) promote the healthy recovery of the affected community.

(d) Support the development of regional suicide prevention coalitions. During this project, the
Massachusetts Coalition for Suicide Prevention (MCSP) and MDPH will work with the three selected CHNAs to develop regional suicide prevention coalitions in the three participating areas. The CHNAs will be expected to support the growth and development of the regional coalitions. In tern, these regional suicide prevention coalitions will serve to sustain the efforts of the CHNAs beyond the life of the funded project.
4. Develop a timely, routine notification and response system: MDPH will work with the CHNAs to ensure that the majority of suspected youth suicides are reported to MDPH within 48 hours of occurrence and to coordinate postvention services for the appropriate community systems (schools, workplaces, and others), to support survivors and manage the risk of suicide contagion.
5. Provide monthly reports to MDPH on project activities and periodic budget reports and comply with evaluation requirements. MDPH will provide a service delivery report form to be completed by the awardees monthly. Periodic spending reports will be required. The awardees must comply with all SAMHSA evaluation requirements. An evaluator will be hired to assist the awardees with these requirements.