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March 1, 2022
Note: This issue highlights Oregon’s work, progress and data related to youth suicide prevention.
In this issue ...
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I am starting to see new plants sprouting every day in my yard and even the first crocus has popped out to say hello. It is time to take that deep breath and start over, moving forward with new projects and new hope. An essential part of our unit’s focus on the health and mental wellbeing of all young people is suicide prevention.
The Oregon Health Authority (OHA) Suicide Prevention Intervention Postvention team spans our unit, the adult team and Public Health. This team is a great example of how collaboration with internal partners and community organizations creates new growth and synergy.
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I am proud to be a part of such a vibrant and active team that shines a bright light on the need, and offers tangible ways, for Oregonians to help take care of one another.
As the 2022 legislative session prepares to close, we are looking strategically at the needs of our youth and families that will need the attention of legislators in 2023. Our efforts are informed by engagement with and feedback from our communities. The themes from this are incorporated into the Child and Family Behavioral Health Work Plan. Many of you have participated in this process and our gratitude goes to all of you.
Thank you to all who have read our newsletters. In response to feedback, we now have an easy sign up link for any new readers. We are open to suggestions, comments and feedback for future editions. Please send them to kids.team@dhsoha.state.or.us.
Chelsea Holcomb
This year the Suicide Prevention Team has been focused on the theme of “Growing Roots.” In 2019, the legislature invested dedicated funding for youth suicide prevention programs.
The Big River program, available in English and Spanish, is a statewide initiative sponsored by OHA to increase access to suicide prevention and intervention trainings.
- These programs are each led by a statewide coordinator, underpinned by Train the Trainer events. They work to equip youth-serving professionals and community members with knowledge and skills to help prevent suicide.
- This allows for locally delivered suicide prevention programs, with robust human and financial support from the state. That synergy strives to give Oregon’s youth more protection against suicide.
Jill Baker, youth suicide prevention policy coordinator, describes her work as “like the phenomenon of crown shyness that some species of trees practice. These trees grow tall and beautiful branches. When they get within a certain distance of other trees, they give space.
"This allows for the tree itself to remain healthy while still allowing the life around and below its own canopy to access the sun. That is what the Oregon Suicide Prevention team is hoping to accomplish. Strong, robust programming that works together in a community-delivered way.”
Training and programming are only part of Oregon’s suicide prevention strategy. The team of suicide prevention coordinators at OHA work closely with our evaluation team at University of Oregon and Oregon Alliance to Prevent Suicide advocates to develop a framework for suicide prevention. This framework, the Youth Suicide Intervention and Prevention Plan (YSIPP), provides a five-year plan for Oregon to nurture and grow the seeds that have been planted. This includes:
- Centering equity and the voices of those with lived experience,
- Rooting in good policy, informed by rich data and evaluation, and
- Delivering care in a trauma-informed and culturally responsive way.
A note about 2021 preliminary data
The YSIPP annual report is due for release in March. Its preliminary data on youth suicide fatalities in 2021 indicate, when compared to 2020:
- A decrease for youth ages 17 and younger.
- A similar number for youth ages 18-24.
- An overall decrease for youth ages 24 and younger.
This represents the third consecutive year of a decrease for youth ages 17 and younger in Oregon. This is the first time since 2001 that Oregon has had a three-year decrease (ages 24 and younger).
While this is positive news, it is important to note that there are counties in Oregon that did not experience an overall decrease in 2021. Oregon remains above the national average for youth suicide rates. This good news is also wrapped in the context of significant challenges for so many in Oregon. There is much more work to be done to create safety for our children and young people. The suicide prevention team at OHA and our partners across the state remain earnestly focused on this work.
2021 Big River Programs by the numbers
Local communities equipped:
33 of Oregon’s 36 counties have active trainers in one or more of the Big River programs.
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1,257 trainers in Oregon:
There are currently 1,257 trainers across the eight Big River programs that have Train the Trainer structures. In 2021, the Big River programs collectively added 391 new trainers to this total.
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Mental health providers:
The Big River programs added Advanced Skills training options for mental health providers focused on treating suicidal ideation within their practice. In 2021 alone, 544 providers in Oregon received training across the five training options supported by OHA.
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Community-centered and culturally responsive adaptations: Seven of the eight Big River programs have community-centered or culturally responsive elements intentionally embedded. Two of the eight are available in Spanish and two more will launch Spanish options in 2022. Work continues to improve creating access to trainings that resonate with diverse communities.
Tribal Nations: Each of the nine Oregon Tribal Nations and NARA NW receive funding and support for suicide prevention directed by each Tribe.
Mobile Response and Stabilization Services (MRSS) Community Conversations
Work on MRSS is underway. Join an informational conversation to understand and contribute to the vision of creating a customized statewide mobile response model for children, youth, young adults and their families. These conversations provide the same information and attendance is open to all.
Dates and times:
- March 2, from 2 to 3 p.m.
- March 14, from 10 to 11 a.m.
- March 29, from 2 to 3 p.m.
How to join:
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) trainings in 2022
TF-CBT is a highly rated, evidence-based therapy designed to treat children ages 3 through 17. TF-CBT treats children who have experienced trauma, including children with multiple and complex traumas in their lives. This is a virtual course designed for Oregon master’s level mental health professionals who directly work with children who have experienced trauma. It is an intermediate-level course.
This training is sponsored by OHA, is free for participants and includes up to 20 hours of virtual training and up to a year of consultation. Up to 13 Continuing Education Credits will be received for participating. Participants are responsible for pre-training expenses of approximately $75 and post-training certification expenses.
- March 17 and 18, 2022 (2 days): 8 a.m. to 4 p.m.
- May 12 and 13, 2022 (2 days): 8 a.m. to 4 p.m.
Sources of Strength
 Elementary Coaches training: April 13 and 14
Sources of Strength is hiring a statewide trainer. Position open until March 11. See posting here.
Question Persuade Refer (QPR)
 QPR Training for Trainers
Virtual training:
- Thursday, March 17 with priority seats for Eastern Oregon Counties including Wasco, Wheeler, Sherman Gillam, Morrow, Umatilla, Union, Wallowa, Grant, Baker, Harney and Malheur.
- Wednesday, April 20
QPR in Spanish
QPR is available for Spanish speakers. Reach out to Crystal Larson at Lines for Life to be connected to a Spanish-speaking trainer to find training dates.
There is also a need for more trainers who speak Spanish. If you are interested in becoming a trainer in QPR and speak Spanish, please contact QPR@linesforlife.org or 503-575-3759.
Youth Mental Health First Aid
 Youth Mental Health First Aid Training for Trainers: June 7 through 9. Email Maria Gdontakis Pos at mpos@aocmhp.org to indicate your interest and to learn more.
Applied Suicide Intervention Skills Training
 Applied Suicide Intervention Skills Training for Trainers: May 9 through 13
Email Tim Glascock at tglascock@aocmhp.org to indicate your interest and learn more.
YouthSave
 YouthSAVE Training for Primary Care Providers
Three upcoming training dates:
- March 14 and 15
- April 20 and 21
- May 12 and 13
System of Care Learning Collaborative
Each second Tuesday of the month from 3 to 4:30 p.m., the Oregon Family Support Network, Youth ERA and OHA facilitate a conversation for people involved with System of Care work.
Come with questions and a desire to learn and unlearn. Topics include how to develop skills that center youth and families, how to be culturally and linguistically responsive and how to ensure services and supports are community-based.
Contact Nat Jacobs at nat.jacobs@dhsoha.state.or.us for more details.
A Time for Families
A Time for Families is a weekly drop-in discussion hour for parents and family members hosted by Chelsea Holcomb and OHA’s Family Partnership Specialist, Frances Purdy.
Please note that the Zoom link changed for 2022. Click here to join the meeting (conference ID 676907).
Warmline
Reach Out Oregon, funded by OHA is a part of the Oregon Family Support Network, has a warm line at 833-732-2467, a website, a chat room for any family member needing support and a weekly virtual support group.
Children’s System Advisory Council – help needed
The Children’s System Advisory Council (CSAC) serves as an advisory group for the Child and Family Behavioral Health (CFBH) Unit to support system planning, coordination, policy and fiscal development and the evaluation of service delivery and function.
CSAC is looking for new members who fall into the following categories to join the council:
- Child and adolescent psychiatry, preferably a member of the Oregon Council of Child and Adolescent Psychiatry
- Primary care
- Rural coordinated care
- Early childhood system
- Community-based prevention or early intervention program
- Youth who have received behavioral health services (four people wanted)
- Oregon Department of Human Services, preferably from a Child Welfare field office
- Juvenile justice system or Oregon Youth Authority
Please contact Nat Jacobs to apply, or with any questions: nat.jacobs@dhsoha.state.or.us.
Why We Build – Suicide Prevention in Lane County
The Suicide Prevention Coalition of Lane County, in cooperation with Lane County Public Health and with funding from OHA, announces the upcoming launch of “Why We Build” – a multimedia project told in the first person by people who have survived suicide attempts in Lane County.
- During the past 18 months, 16 project participants have worked with artists to document their lives through photographs and recordings of their own most personal stories.
- The goals of sharing this project are to raise awareness about suicide prevention and encourage people to seek support and support others.
The “Why We Build” project will be on display in four galleries in Lane County and online with a grand opening at the Broadway Commerce Center in Eugene on March 4 from 5:30 to 8 p.m.
Contact Roger Brubaker, suicide prevention coordinator with Lane County Public Health with any questions: roger.brubaker@lanecountyor.gov
Mental health services satisfaction surveys:
OHA’s Mental Health Statistics Improvement Program (MHSIP) collects data about children and families who received Medicaid-funded mental health services in outpatient, psychiatric residential or day treatment settings using two surveys:
- The Youth Services Survey (YSS) for youth ages 14 to 17, and
- The Youth Services Survey for Families (YSS-F) for caregivers of children and youth younger than the age of 18.
The 2021 Survey Report for youth is available and you can also review reports by coordinated care organization (CCO). As you will find, the report includes rich information and useful feedback from youth and caregivers. We encourage you to read the full report.
Youth Services Survey Domain Satisfaction:
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Access: 71.5% satisfied
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Cultural sensitivity: 91.4% satisfied
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General satisfaction: 71.9% satisfied
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Participation: 76.4% satisfied
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Treatment outcomes: 56.4% satisfied
A few notable takeaways:
Youth were most satisfied in the cultural sensitivity domain (91.4%) and least satisfied with treatment outcomes (56.4%). In the last five years, there has been a significant upward trend in both the access and cultural sensitivity domains.
Telehealth
While only 9.9% of youth were dissatisfied with virtual sessions, 67.6% said they preferred to see their provider in person and nearly half (47.3%) found it harder to focus when using telehealth.
More details can be found on the MHSIP web page.
Emergency department usage:
There is ongoing concern about the overuse of emergency departments (EDs) as the pathway to inpatient psychiatric services and the number of young people who wait for long periods in EDs for these beds. The CFBH Unit tracks data trends on young people who stay more than 24 hours in an ED, known as ED boarding. The latest data for July 2020 through June 2021 will be available in April.
Restraint and seclusion:
The use of restraint and seclusion in mental health intensive treatment facilities is an important metric for the children’s system. OHA’s Children’s Seclusion and Restraint Report 2018 – 2020 documents these data, with the 2021 report being issued soon. These numbers are compiled as rates per 1,000 patient days, allowing for cross-facility comparison.
If you have specific questions about these data, please email shannon.karsten@dhsoha.state.or.us.
State law also requires Oregon Department of Human Services to submit to the Oregon Legislature quarterly reports regarding abuse, use of restraints and involuntary seclusion in licensed child-caring agencies. Beginning February 2022, the quarterly reports generated by Children’s Care Licensing Program can be found on the Child-Caring Agency (CAA) Licensing Reports page.
Capacity in the children’s psychiatric and substance use disorder residential system:
The CFBH Unit has been closely monitoring capacity at all Oregon Health Plan child behavioral health facilities since spring of 2021. The goal is to develop a centralized access process so we know how many children and families need services and we can increase capacity to get children the right service at the right time.
Goal capacity:
- Acute psychiatric and psychiatric residential: 286 beds
Operational capacity:
As of Jan. 31, 2022:
- Acute psychiatric and psychiatric residential: 143 beds (57% of operational capacity, 50% of goal capacity)
- Substance use disorder residential: 25 beds (33% operational capacity, goal capacity undetermined)
Pre-pandemic operational capacity:
- Acute psychiatric and psychiatric residential: 251 beds (88% of goal capacity)
- Substance use disorder residential: 75 beds (goal capacity undetermined)
Projected operational capacity:
- Acute psychiatric and psychiatric residential (by Dec. 2022): 263 beds (92% of goal capacity)
- Substance use disorder residential (by July 2023): 275 beds (96% of goal capacity)
What should you ask about? What can you do? How do you advocate for your family’s needs? If you need information about what might happen at the hospital and how you can prepare for and after the visit, check out this advocate’s guide.
- This was developed by families who have lived experience with trips to a hospital emergency room with a child having “big emotions” or displaying actions that might hurt someone or themselves.
- In a practical and easily understandable way, the guide explains about the “suicide or overdose” safety plan, behavioral health services in Oregon, and how to talk to family members or school after a visit.
- It’s now available on the OHA website in 13 languages, including Spanish, Arabic, Korean and Vietnamese.
After you use or read this guide, if you have feedback, questions or want to make suggestions for changes, please contact our Family Partnership Specialist at frances.s.purdy@dhsoha.state.or.us or 503-957-9863.
Mobile Response and Stabilization Services $6.5 million
Mobile Response and Stabilization Services (MRSS) will be a statewide model for Oregon’s crisis response system focused on providing 24/7 connection for youth and their families.
- The MRSS model includes immediate face-to-face response and up to eight weeks of stabilization services.
- Two-person teams will respond to the community and may provide screening and assessment, stabilization and de-escalation, coordination and referrals, and warm hand-offs to other community-based services and natural supports.
In anticipation of 988 rolling out in July, the CFBH team is working closely with interested parties and county leadership throughout the state to ensure that county mobile response teams receive specialized training and best practices for assessment and intervention strategies when responding to children, youth, young adults and their families in the community.
For more information on 988 or MRSS please contact Beth.Holliman@dhsoha.state.or.us or brian.m.pitkin@dhsoha.state.or.us.
Psychiatric Residential Treatment Services $7.525 million
Requests for Grant Proposals are in development with funding opportunities centering health equity, and with the enhancement and expansion of this much needed service in Oregon. Due to the ongoing focus on emergency COVID-19 response and staffing needs for our Psychiatric Residential Treatment Services providers, the current anticipated release is April 2022.
Young Adult Residential Treatment Homes $9.2 million
The Request for Proposal (RFP) developed in collaboration with Intensive Services, Housing & Social Determinants of Health Unit with health equity as a core component is planned for release by early March. You can access the RFP once it is posted on Oregon Buys.
Interdisciplinary Assessment Teams $5.7 million
A broad-based workgroup is forming to determine and review options that meet current statewide needs for interdisciplinary assessment of youth and young people with complex and high needs, in the most effective way.
SB 1 (2019) established priorities for this work. Because the population of focus, assessment needs and the service array have changed in the past three years, in part due to COVID-19, the workgroup will develop a revised implementation plan for this work in partnership with the System of Care Advisory Council.
Young Adult Services Coordinator: This position coordinates and develops statewide services for transition-aged young adults and works closely with young people to develop programs that meet their needs.
Early Childhood Program and Policy Development Specialist: This position serves as a resource and expert on early childhood programs across Oregon, including evidence-based models to meet the needs of children and families from infancy to school-age, such as PCIT and Generation PMTO.
For feedback and suggestions for our newsletter and information: kids.team@dhsoha.state.or.us
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