Public Health Program Planning & Implementation

 

 

Introduction

Overview

Suicide is common in Sevier County Utah, and it was the number one cause of death for community members ages 10-24, and the suicide rate in central Utah was 32 per 100,000 in 2019 (Utah Department of Health, 2020(UDOH), 2020). Some of the root causes are other family members and friends have committed suicide, Utah has a large number of guns in households. Religious beliefs, of the Latter-Day Saints, and other religions shame people for having a sexual orientation other than heterosexual. Drug and Alcohol abuse is commonly associated with suicide, and this is due to poor mental health treatments.

With these high rates, it leaves people to wonder about the happenings but according to research, it shows there are several reasons, such as mental health, attitudes, and religion. The methods of suicide include the use of firearms, hanging, and poisoning. The goal is to reduce suicide and attempted suicides, which will help the overall health of the entire population in Utah. Suicide is a vicious circle that leaves many healthy people dead, and the people who care for and love the victim of suicide pick up the pieces of their shattered lives due to the mental health problems that plague our communities.

Once the program is implemented it will increase the knowledge of the facility and staff about risk factors associated with suicide, how to respond to students about suicide, and identify students who may be at risk for suicide. Most importantly is to ingrain in children to seek help before suicide becomes an issue, and be able to ask for help learning to self-regulate their feelings and share their feelings. Middle schools currently have suicide prevention programs, so this is not new, only the introduction to elementary school new. Utah has money for $ 500 in grant money that will be allocated to each elementary school for suicide prevention (Utah State Legislature, 2021)

Interviewing Stakeholders and Key Informants for Planning and Implementation

Programs such as Yellow Ribbon ask 4-help use a method that makes it easy for the targeted youths to seek help. Therefore, there is a need to engage various stakeholders through interviews intended to assess if the program is making the impact and possible changes that would lead to more acceptance in the society. Further, the planning should be based on feedback and suggestions collected during the interview. Therefore, there should be progressive engagements through interviews to ensure proper planning and implementation.

When engaging stakeholders, it will be significant to consider people who are against having guns. Many people think the way to gun control is to get rid of guns, limit access to guns, or put tight restrictions on guns. Their voice should be heard because many of the people, who oppose having guns are victims of gun violence. They would be considered stakeholders because they are members of the community or public and taxpayers. Yet, I appear in agreeance with you on guns. Guns are not going anywhere but up; more and more people are purchasing firearms, and it is better to be aware and educated on the usage of firearms. Plus, furthermore and it has been shown that half of the people who commit violent gun crimes do not meet any prohibiting conditions (Webster, & Wintemute, 2015) and most deaths from firearms are from suicide and not homicides in the past 30 years and that homicides have decreased and suicides for increased (Wintemute, 2015).

Barriers to Service

Some of the barriers are people have become accepting of suicide as a means of death, committing suicide has become a cultural norm and an acceptable way to deal with life. Having ready access to guns is over 50 percent of the cause of death by suicide. Utah has an open carry for handguns, and many people use guns for hunting, becoming culturally acceptable to leave guns not locked or guns are left loaded and ready for action. Mental Health treatment is not diverse, in small communities, everyone knows everyone, and church and the school have no separation, making people less likely to seek help when needed.

Problem Statement of the Study

 Suicide runs in families, yet many people keep silent on the facts that lead to suicide. When young people commit suicide, it takes away from the communities to see needed changes to make a life where everyone can feel loved and accepted. Poor gun handling and corrupt licensing have led to the presence of illegal firearms in the hands of children. As a result, there is an increasing trend of unintentional shooting. Lack of training and knowledge in firearms handling has eased incidences of suicide using guns.

Methodology

Theoretical Orientations to Types of Program Designs.

Proposed solutions to prevent suicide, is to ensure that children feel loved, and are taught to deal with stress positively. Raise awareness about suicide, starting at a young age, teach children to share their feelings, and let them know it all right to be different. Enforce gun safety, implement policies that prohibit loaded guns, teach gun safety, because if teachers can have guns in schoolchildren need to be aware of the capabilities and proper ways to handle guns. Implement mental health programs and screening for suicide ideology, would help get to the root causes of suicide before it becomes a reality.

Project Goals and Impact Objectives

The first goal and in reducing suicides and attempted suicides is by helping our elementary children deal with mental health issues and learn to self-regulate and share their feelings. Studies show that such programs like the "Yellow Ribbon ask 4-help" have reduced and helped children and parents deal with suicide (Ross, 2019; Hoover & Mayworm, 2017). The idea is to reach children in their adolescence to seek help before suicide becomes the issue (Schmidt, et.al 2015). Prevention is better than cure and taking caution at early stages will save many lives.

 Through these services, the mental health educator will train teachers, how to present classes, and teach Yellow Ribbon to ask 4-help curriculum in schools. The initial training program will focus on a designated teacher and caregiver who will undergo 3 hours of training and is given yearly. The two will be trained and become trainers of the other teachers and children on how to deal with their feelings, fears, and emotions. Building a strong sense of self-worth, and how to identify people they can trust with their feelings, and knowing when to ask for help for themselves or others.

The objective of formulating and implementation of the Yellow Ribbon ask 4-help program before the end of the 2020/2021 academic year will be to target elementary schools in Sevier County Utah. It is projected that the program will have a positive impact on children. The targeted results will be to reduce fear and suicide mentality by 75 percent among children. Therefore, the objective will be to change the children’s fear and build self-confidence and be outspoken when they need help. It will increase the rate of reporting and helping their friends in reporting incidents instead of keeping to themselves and fuel suicidal thoughts. As a result, the intensity of the suicide intervention program will be significant.

The second goal is gun control because people use guns to commit suicide more than any other method, this can be done through gun safety training that includes parents, this can be implemented through and become part of the yearly hunter safety program, to include children that don't hunt, yet will receive a certificate of completion. Research shows that gun ownership, increases 26.9 percent in the youth suicide rate, (Boston University School of Medicine, 2019). Safety training among children will play a significant role in reducing unintentional gun accidents. Guns will not be in the wrong hands or held carelessly when children are involved.   

The objective would be to ensure that all children and parents who own guns, attend a gun safety course, and become certified to hunt safely as required by hunting regulations. The program would be implemented by hunting season, which starts in August and runs through November. This will include an updated gun safety program, including all people who will want to attend, and it will be like a sporting event like golf or bowling. Reducing the rate of gun death by suicide by 50 percent in the first year.

The third goal is to offer free telehealth programs in rural Sevier County Utah that can be accessed through libraries or home computers. This will help and protect individuals, who feel they need help but do not have local mental health care providers they can trust, and who are not biased. The statistic shows that 80–90% of people who attempted or committed suicide had depression (Shahtahmasebi, 2013). With telehealth, people will be able to remain anonymous to their family and peers and be able to pick a counselor that is more appealing to their needs, such as lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) issues without bias.

 The objective is to have a computer with access to telehealth providers in libraries and ensure that people know how to access home computers or cell phones to make the connection for counseling, this can be done within 6 months, inform the community about the available access, which will be free. Such plans will help to cut down the suicide rates by at least 25 percent within the first year of access.

Methods and Timelines Chart Activity

Activity	Participants	References	Implementer	Qualifications	Timeline	Fully Functional
Yellow Ribbon Program	Elementary age children	Schmidt, (2015) Brooks, (2009)	Mental Health counselors, Train teachers and parents, who teach the children.	Master’s degree in behavioral/social science field. Yearly training for teachers and parents and an ongoing curriculum for children	3 months to begin the program. 1 year before results	1 year
Gun Safety Program	Teenagers and parents who own guns.	UDOH, (2020) Krisber, (2017) UDWR, (2021)	Local Hunter safety trainers expand training to include suicide awareness.	Expert in firearms, with knowledge of suicide prevention.	1-month training of instructor, Safety program 12 hours in length and is usually given over several weeknights and/or weekends.	6 months
Telehealth Access	Everyone in the community	Lu, (2014)	Ensuring access to computers and advertising services available.	Licensed Mental Health Professionals and people trained in helping others access computer programs.	Access availability is 24 hours a day.	1 year

 

                                        Evaluation

A proposal on suicide prevention has been submitted, and will be reviewed for funding and because part of the funder's concerns will be if my proposal meets ethical responsibilities because information gained through my plan will be used for research purposes to show that it is working at reducing suicide. Therefore, when following up on the proposal will include sending an email addressing how the health plan will meet ethical and federal guidelines that meet informed consent from participants in my planned proposal by the institutional review boards (IRBs).

There will be also an executive summary of the plan proposal and a graph or a chart that is easy to understand the program; because it can influence and gain more attention when making the final decisions on if they will adopt the plan (Issel, 2013).  The second important thing is to keep the funder informed about the program. There will be quarterly newsletters on the outcomes, of the program to include items that are directly affected by the program even if they do not precisely in preventing suicide, such as how getting children in touch with their feelings, and the ability to ask hard questions also prevents bullying in the schools.

In addition, the program will also include how training programs for teachers and others who attend the training feel about the training by documenting the results on questioners to be shared with the funders. Keep in constant touch with the funders and letting them know how the program provides benefits, not just suicide alone will help keep the funders interested and want to donate more in the following years.  Another thing would be to compare your program to other programs and point out the differences and what is the same, always looking for improvement and fill in the gaps that are missing through guided research.

To evaluate the program all participants will complete pre and post-tests for knowledge and awareness of identifying risk factors, and training students about how to share their feelings, not only about suicide but also about other mental health issues. Furthermore, all volunteers in the program must pass the free suicide training offered monthly by the National Alliance of Mental in Utah.

In the Yellow Ribbon, ask 4-help program data shows that help-seeking from a crisis hotline, which increased from 2.1% to 6.9%, (Brooks et.al, 2009) in high school students, other reports were insignificant, yet awareness about suicide is hard to collect data, and any education that gives hope to less suicide is beneficial. Data used from using the helpline that is included in the curriculum, as part of the program will give information on how many people in the area use the hotline to prevent suicide, through area codes used in the area.

Budget

Through grants and the Utah State Education funds paying the wage of the Social Worker, leaves the amount of 19,153.00. The remaining amount of money can be raised through individual or corporate donations. Suicide touches the lives of everyone, and in rural communities, where everyone knows everyone else finding contributions should not be a problem. The study will use a Private Researcher to collect and send all data for suicide prevention.

 

EXPENSES	TOTAL BUDGET	IN-KIND CONTRIBUTIONS & INCOME
Item:		Source:
Salaries & Wages		Government Grants & Contracts
Community Organizer and Social worker wage Bonus Private Researcher for Suicide data-part time 1 workday a month this person will be 1099	59,659.00 120.00 3,000	State of Utah Grant 500.00 X 3 Select Health Awards 3000.00	1500.00 3000.00
Social security 401K Disability Healthcare Pension Time off Total Compensation	4,573.00 2,929.00 956.00 6,371.00 2,511.00 7,588 84,709	Foundations (specify) ASFP Research Grant	15,000.00
Fringe Benefits & Payroll Taxes
(estimated at 20 percent)	1695.80	Corporations
10x Computers for training	10,000.00

 

Car for Community Organizer	24,000.00	Religious Institutions, LDS Church 6 at a 1000.00	6,000.00
100 miles 1 day a week for 52 weeks each facility Gas and maintained for travel @.54 a mile	2808.00
Membership for Yellow Ribbon Yellow Ribbon email	750.00   120.00	Individual Contributions
Supplies
10 X Ask 4 Help Cards (Pkt 100cds/$12)	120.00	Fundraising Events Collection jars in stores X 20 at approximately 100 a month	24,000.00
200 x Yellow Ribbon Brochures 2.25 each	450.00
300 x Yellow Ribbon Wristband 3.00 each	900.00
1 x Yellow Ribbon Sticker (3" Round) Roll of 1,000	79.95
20 x Yellow Ribbon Decal (Vinyl) 7.00	140.00
2 day virtual workshops Adults $395, x30 Youth/Students/60+/ Military $295, x 30 Re- certify $150.	11850.00 8850.00	Membership Income
60 Lunches for workshops	600
Telephone & Fax 1 dedicated for program 50.00 a month for 12 months	600	In-Kind Support

 

Rent & Utilities
4 x Large Conference Room 2nd Floor 28' X 34' 952 Sq Ft - 55 Person Occupancy $100 per day Clean Deposit of $150 (Refundable upon acceptable checkout) In three community centers	1200	Other –The state of Utah pays wages for Community Organizer/Social Worker	84709.00
Other
Social Media/Web design	500.00
Projector	1000.00
TOTAL EXPENSES:	153,362.	TOTAL INCOME:	134,209
		BALANCE (requested funds):	19,153

 

 

 

 

References

American Foundation for Suicide Prevention (AFSP), (2021) Research Grant Information, Pilot           Innovation Grants. Retrieved at https://afsp.org/research-grant-information#grant-cycle-    2020---2021

Boston University School of Medicine. (2019, January 17). U.S. youth suicides more prevalent    in states with higher gun ownership, study finds: On average, three youths between 10-       and 19-years old die by firearm-related suicide every day. ScienceDaily. Retrieved February 2, 2021, from www.sciencedaily.com/releases/2019/01/190117090446.htm

Brooks, D., Wright, C. Emme, D., (2009) Yellow Ribbon Suicide Prevention Program, Office of Suicide Prevention at the Colorado Department of Public Health and Environment. Grant # 09000050, retrieved at https://www.YellowRbn_Tlbk_Elem_Preview.pdf

Hoover, S. A., & Mayworm, A. M. (2017). The benefits of school mental health. In Handbook of             rural school mental health (pp. 3-16). Springer, Cham.

Issel, L. M. (2013). Health program planning and evaluation: A practical, systematic     approach for community health (3rd ed.). Retrieved from             https://www.vitalsource.com

Krisberg, K. (2017). Few gun owners get safety training. The Nation’s Health, 8, 21.       

Lu, M. W., Woodside, K. I., Chisholm, T. L., & Ward, M. F. (2014). Making connections:           Suicide prevention and the use of technology with rural veterans. Journal of Rural             Mental Health, 38(2), 98–108. https://doi-org.proxy-      library.ashford.edu/10.1037/rmh0000021 

Ross, M. (2019). Suicide prevention methods within a modern-day society: focusing on mental    health in our school prevention programs.

Schmidt, R. C., Iachini, A. L., George, M., Koller, J., & Weist, M. (2015). Integrating a Suicide   Prevention Program into a School Mental Health System: A Case Example from a Rural         School District. Children & Schools, 37(1), 18–26.

Shahtahmasebi, S. (2013). Examining the Claim that 80-90% of Suicide Cases Had Depression.   Frontiers in public health, 1, 62. https://doi.org/10.3389/fpubh.2013.00062  

Utah Department of Health (UDOH), (2020) Public Health Indicator-Based Information System,             Report of Suicide, retrieved at             https://ibis.health.utah.gov/ibisphview/indicator/view/SuicDth.LHD.html

Utah State Legislature, (2021) 53F-5-206. Grant awards for elementary suicide prevention          programs. Retrieved at https://le.utah.gov/xcode/Title53F/Chapter5/53F-5-    S206.html?v=C53F- 5-S206_2018032220180322

Yellow Ribbon Suicide Prevention Program, (2021) Training Programs, and custom printing,     retrieved at https://yellowribbon.org/what-we-do/training-programs/adult-gatekeeper-            training.html