Kansas State Plan Review Reports

Methods

The Resource Development subcommittee met monthly over Zoom to discuss the process and logistics of review, document any progress made and recommendations for the next update, and to finalize this report. 

To track and monitor progress on the goals and action steps, the Resource Development State Plan Review spreadsheet (See Table 1) was developed. This spreadsheet tracked the Strategic Direction with the relevant goals and action steps. Over the course of the review, the subcommittee met to discuss one to two goals each meeting, and we allowed time for questions for the Executive Board or KSPHQ and open discussion. 

Within each Strategic Direction, there are subpoints that the Resource Development Subcommittee translated into Objectives and subsequently Action Steps. These areas drove the subcommittee conversations and timeline. Comments were added to allow for further ideas and recommendations to be documented. 

Progress 

Progress has been made primary towards Goal 1: “Integrate and Coordinate Suicide Prevention Activities Across Multiple Sectors and Settings,” and it’s action steps; specifically, in regards to the effort towards the establishment of a statewide suicide prevention coalition, establishing representative cohorts, creating a resource repository, meeting in person or online at least once annually, and creating an avenue for feedback. 

The KSPC meets monthly via Zoom, and also conducted an in-person Annual Meeting event in May. These meetings have had consistent participation by at least 50 individuals, and focus on providing educational opportunities, as well as foster new community connections. Four subcommittees have also been established to support representation of various aspects of identified work, and these subcommittees meet monthly and report out at each KSPC meeting. 

In an effort to create and share a survey analyzing the landscape of suicide prevention activities in Kansas, the KSPC partnered with KSPHQ and Greenbush Education Services Center; the tool includes various filters to support accessing specific interventions based on target groups, needs, region, etc.. 

The Coalition has worked with local web developers to build a website that will host this resource tool, as well as a dedicated space to share feedback with the KSPC. This feedback tool is meant to provide a space to all, but specifically those with lived experience, to express needs or concerns directly to the KSPC in a way that is safe and easily accessible.

Recommended Updates

The Resource Development Subcommittee, who reviewed this Strategic Direction, recommends that future iterations of the State Plan break action steps down into more specific steps and connect them intentionally with specific entities to work and accomplish the associated goals with the action step. 

Additionally, it is recommended that updates identify key stakeholders and better touch points/contacts for collaboration with other stakeholders; it is key to communicate to each identified stakeholder the recommendations as a whole and how their entity plays a role. 

Finally, consider if there are Memorandums of Understanding that are necessary to ensure proper communication and expectations and maintenance of work on actions steps. 

Next Steps

In order to address Goal 2: “Strengthen and Broaden Public Communication Efforts about Risk and Protective Factors for Sucide,” and the action steps specifying the need for consistent messaging and engaging media partners, the KSPC will work towards developing and launching a public awareness campaign. This work will include initial drafts of what the messaging will include, developing a comprehensive campaign rooted in data from the landscape analysis, utilization of tool kits developed by community partners, the development of a media calendar, and a media tool kit that can be shared with members to support their own media engagement with consistent messaging. 

There will also be a collaborative effort between the Resource Development and Community Engagement subcommittees to develop strategies to engage diverse communities and grow membership among these populations. 

Sector representation within KSPC membership will continue to be tracked in order to notice areas of strength and needed growth.

Methods

On December 13th and January 9th, the Community Engagement Subcommittee convened to engage in insightful discussions centered around Strategic Direction 2 Goal 2. These meetings encompassed an initial phase of introductions, followed by a comprehensive analysis of the guiding focus points pertaining to Strategic Direction 2 Goal 2. The subcommittee produced thoughtful conversation regarding the stakeholders listed in 2.2.1. and 2.2.2., while also providing due consideration to the potential incorporation of additional stakeholders. Furthermore, the subcommittee explored the methodologies employed to establish effective channels of communication and engagement with the identified stakeholders at the local level. 

Key Findings

2.2.1. Key Findings

The Community Engagement Subcommittee’s analysis of Goal 2, Subgoal 2.2.1. revealed several pertinent insights. The subcommittee identified the additional stakeholders beyond the existing list that could broaden representation and engagement within the suicide prevention plan. Several noteworthy suggestions were put forth. These recommendations included the involvement of law enforcement personnel, local gun club and shooting range owners, individuals from the community who possess relevant experiences and expertise outlined in the actions and activities described in 2.2.1. Moreover, it was proposed to engage stakeholders such as range management personnel, gun shop owners, organizations that provide free gun locks and informational resources, gun show attendees and/or hosts, shooting sports leaders, rotary organizations, and rural organizations.

The subcommittee also underscored the importance of maintaining consistency in messaging. Recognizing the potential divergent viewpoints and perspectives associated with firearms-related issues, the subcommittee felt it was crucial to ensure that the coalition promotes consensus-based recommendations and messaging. This approach necessitates actively incorporating input from local-level stakeholders while adhering to the coalition’s values and mission.

Finally, given that Strategic Direction #2, Goal 2 aims to support localized efforts, the subcommittee emphasized the significance of considering the diverse array of groups and perspectives across the state. By actively engaging with communities and incorporating their input, the coalition can foster a sense of inclusivity, thereby aligning recommendations and messaging with the values, goals, and mission of the broader coalition. 

2.2.2 Key Findings

Upon conducting an analysis of Goal 2, Subgoal 2.2.2., the Community Engagement Subcommittee noted several key findings. The subcommittee identified potential stakeholders that could be included in addition to the existing list, thus fostering a more comprehensive and inclusive approach within the suicide prevention plan. Based on insights and recommendations by the subcommittee members, the following stakeholders were proposed for consideration: healthcare students, prescribers and other healthcare professionals, owners and employees of medication drop-off locations, the SPFRx group, the Poison Center, and the KDHE Palliative Care and Substance Use Disorder/Overdose Prevention Program.

With the involvement of healthcare students, the coalition could tap into the unique perspectives and fresh insights they bring to the realm of suicide prevention. Similarly, including prescribers could provide invaluable expertise regarding medication management and appropriate prescribing practices. Similarly, including prescribers could provide invaluable expertise regarding medication management and appropriate prescribing practices. Engaging owners and employees of drop-off locations could contribute to the creation of effective disposal programs for medications and other potentially harmful substances. The involvement of the SPFRx group, Poison Center, and the KDHE Palliative Care and Substance Use Disorder/Overdose Prevention Program would help ensure a holistic approach to substance abuse prevention and intervention, as well as facilitate the sharing of critical information and resources.

By expanding the stakeholder network to encompass these suggested entities, the subcommittee seeks to enhance collaboration, knowledge-sharing, and collective efforts in addressing the multifaceted challenges related to suicide prevention within the state.

Emerging Themes & Recommendations

Throughout the process of the Strategic Direction 2 Goal 2 review, the Community Engagement Subcommittee identified several emerging themes and formulated corresponding recommendations. These insights and recommendations are crucial in guiding future efforts and enhancing the effectiveness of suicide prevention initiatives at both the state and local levels. 

Emerging Themes

Stakeholder Inclusion: The subcommittee recognized the need to expand the stakeholders beyond that of the current list for both 2.2.1. and 2.2.2.

Community-Centric Approach: The subcommittee highlighted the significance of adopting a community-centric approach to better address local-level needs and challenges.

Consistent Messaging and Inclusive Collaboration: Consistency in messaging and fostering inclusive collaboration emerged as critical themes. Recognizing the diverse viewpoints and stances on issues related to firearms, the subcommittee emphasized the importance of consensus-based recommendations that incorporate input from local-level stakeholders. 

Recommendations

Based on the identified themes, the Community Engagement Subcommittee would like to put forth the following recommendations:

Expand Stakeholder Engagement: Actively engage additional stakeholders. Further valuable perspectives, expertise, and resources serve to enhance the effectiveness of suicide prevention efforts.

Refine Stakeholder Definitions: Continuously refine the definitions of “community” and “local” to ensure clarity, consistency, and optimized impact across statewide suicide prevention initiatives. Ongoing consideration will facilitate the most accurate measurement of progress, effective coordination of efforts, and comprehensive engagement of diverse communities. 

Promote Consensus-Based Messaging: Foster inclusive collaboration and open dialogue to promote consensus-based recommendations and messaging. Actively incorporate input from local-level stakeholders to ensure that suicide prevention efforts reflect the needs, values, and perspectives of the communities they aim to serve. 

Facilitate Information Sharing: Establish channels for information sharing among stakeholders to encourage dissemination of critical resources, best practices, and educational materials to empower communities in preventing suicide.

The coalition can further strengthen its suicide prevention strategy and foster a collaborative environment that embraces diverse perspectives through the implementation of these recommendations. These efforts will enhance the progress of Strategic Direction 2 Goal 2, promote community resilience, and contribute to the reduction of access to lethal means across Kansas. 

Methods

Participants – Subcommittee members representing a spectrum of professions participated in the review process including health services, clinical psychology, analytics, public policy, and domestic and sexual violence advocacy.

Procedures – We utilized a template of three questions for structured review: 1) Do the actions/activities match the goal? 2) Are the timelines doable? and 3) Are there stakeholders we need to add/remove? We used inspiration from a wider set of questions in reflection, but we tried to have an answer for each of these three under every goal. Discussion and feedback were collected and translated into the notes reflected in this report.

Emerging Themes & Recommendations

Need for specific implementation steps and action items

As a statewide agenda, it was expected that the State Plan wouldn’t have the most detailed and locally adapted implementation steps. However, without identified groups responsible for implementation and no breakdown of steps and assigned roles, there were times the Subcommittee found it difficult to identify where progress has been made. The Subcommittee recommends clarification of responsible parties, timelines, and action steps in revisions to the State Plan.

Actions/Activities

In general, Strategic Direction #3 is often lacking clear, measurable, action steps under the Actions/Activities. For example, Activity 3.3.2.b says “Create a guidance document to improve continuity of care.” The plan doesn’t mention how to accomplish this task, breakdown what it should entail, or name who is responsible for its completion. To really envision what this “guidance document” would look like, this activity should include action steps such as 1) Identify organizations 2) Facilitate conversations around what supports they need and 3) Develop ways to meet those needs, etc.

Stakeholders

The plan identifies stakeholders, but without clearly defining what it means by the term, it could be overly broad and apply to anyone doing the work within systems of care. Revisions to the plan should specifically identify the stakeholder responsible for the action. In general, specificity around the stakeholder entity would be helpful. For example, KDADS is often listed as a stakeholder, but the department is massive, is there a specific bureau or program that should be named?

Timelines

In general, the timelines in the plan feel realistic. “Short term” is consistent with activities like training and short interval projects. For bigger system change activities, “ongoing” is appropriate.

Reflect and build on the work happening across the state

The Subcommittee identified the following projects to highlight ongoing work around the state. We know that there is more happening than what is captured here, but these were projects that frequently came to mind as we thought about objectives laid out in the State Plan. The Subcommittee recommends reflecting and building on these strides of progress when revising the State Plan.

Zero Suicide Framework

Subcommittee members highlighted ongoing work of embedding suicide care via the Zero Suicide framework under Goal 3.1.3. Erica Molde has also revamped trainings to speak to trauma and marginalized communities. 

988 Suicide & Crisis Lifeline

The State Plan includes actions/activities related to expansion and promotion of the National Suicide Prevention Lifeline written before the national launch of 988. The Subcommittee identified that 988 feels like a particular area of strength. Through 988 implementation, most actions/activities under Goal 3.2.1 are complete or ongoing. 

Resource Directory

Early on, the Subcommittee identified the need for a list of Kansas based resources that stakeholders could utilize. Independently, KSPC had already entered into collaboration with Greenbush to launch a survey and build a Resource Directory. The Subcommittee helped forward the survey link out to networks to increase participation. 

A Friend AsKS

The statewide app mentioned in Goal 3.2.2, “A Friend AsKS“, has launched and is available to download. The Subcommittee wondered whether the app’s launch means the goal is actually complete and how the Subcommittee can assist with and support its rollout. The Coalition should discuss how the app fits into the overall statewide purpose of connecting people with information and local resources. Then the Subcommittee can help with a dissemination plan.

Grief & Financial Support for Suicide Loss Survivors 

The Subcommittee identified that Lemon Aid could shine in this area – monetary assistance is a practical and substantial resource that makes a radical difference in the lives of suicide loss survivors. Grief support is also available through peer wellness programs at CMHCs. Subcommittee members also noted that suicide prevention and awareness community events such as walks/runs are also a source of solidarity for grieving folks who seek support in other ways.

Mobile Response Teams (MRTs)

Mobile crisis response and co-responder programs are in development. The Subcommittee identified this as a major area of growth in the state. New collaboration and partnerships with law enforcement and emergency departments have evolved through implementing 988 and mobile response.

Crisis Response Plans in the Workplace

The Subcommittee wondered whether suicide prevention groups are modeling the things we encourage our partner organizations to do, such as having a crisis response plan for staff. It was noted that Zero Suicide may have some resources on this. Mental health first aid training is also an option. 

Need strategic plans for outreach

Publicity of 988 and Other Programs

KSPHQ has placed more emphasis on 988 calls while it works toward 24/7 coverage for chat. Currently chat is available 8am-midnight and the goal is to be 24/7 by the end of May. After that, KSPHQ plans to push publicity for the new resource. The Subcommittee plans to work on breaking that publicity down into action items and a strategic plan for reaching further communities. KSPHQ already has handouts that could be streamlined as well as, “what to expect ” palm cards. Publicity of programs came up in discussion of other resources across the state as well.

Advertising and Amplifying Training Opportunities

Training outreach has expanded to more kinds of communities and workforce professions such as church groups, employers, jails, and parole. These groups are receiving training on evidence-based practices they may not have been previously exposed to through mental health first aid, ability to recognize signs and symptoms, and the Zero Suicide Academy. There’s still an identified need for training on self-determination – but first must identify organizations that should receive training and consumer led organizations that provide this training. 

Identifying Needs from Consumers

The Subcommittee considered a variety of ways we gather input from consumers on their needs. Eventually, the website will also include a way to provide feedback. It’s impossible to fully untangle demystifying the system and changing the system, it’s a bit of both. We know that the current system does not work for many consumers, but we also acknowledge that it is the system we have and must help consumers navigate now. We want to demystify the system while making it overall easier to navigate and meet consumer needs. 

Understanding Allocation of Resources in the Community

The Subcommittee discussed the allocation of resources, impacts of legislation, and importance of advocacy. In general, the coalition should monitor how resources directed toward youth needs change over time. It can also monitor legislation’s impact on workforce development opportunities such as BSRB training and requirements, and changes to clinical supervision material. In future discussion, the Subcommittee would like to consider what it could look like to expand our advocacy efforts and present KSPC as a united front. KSPC has the opportunity to provide a platform for consumer voices and create more avenues for consumers and families to participate in system change.

Methods

The SRE subcommittee met monthly over Teams to discuss the process and logistics of review, document any progress made and recommendations for the next update, and to finalize this report. Prior to our work reviewing the plan, we wanted to outline a timeline for review (see Table 2) and some questions to keep in mind while we review the Plan (see Table 3).

Once the timeline and questions were outlined initially, a Google Sheets spreadsheet was created where each goal had its own page and each subsection was an individual line so reviewers could comment and provide recommendations on a line-level basis. Over the course of the review, the subcommittee met to discuss one to two goals each meeting, and we allowed time for questions for the Executive Board or KSPHQ and open discussion. 

Overall Recommendations

Throughout Strategic Direction 4, and the Plan as a whole, there are references to “State Suicide Prevention Plan Workgroup,” we recommed updating this language to the subcommittees of the coalition if future reviews of the plan will be completed by these subcommittees. We also recommend updating “County Health Departments” to “Local Health Departments.” Across Kansas, there are multi-county and city-county health departments, thus “Local Health Departments” is a more inclusive term for the varying types of health departments. The final overall recommendation from this subcommittee is to assign lead agencies/entities to the actions and activities outlined under the goals and objectives. We believe this will help move the work forward by ensuring a stakeholder is responsible and accountable for a specific action and it would also help future reviews by knowing who is leading the specific work and collecting the necessary data.

Goal 1

Progress 

The first goal of Strategic Direction 4 of the Plan is “Improve data collection related to suicide morbidity and mortality.” Some progress has been made towards this goal. In particular, when it comes to regular data reporting and sharing efforts. The Kansas Prevention Collaborative has a Behavioral Health Indicator Dashboard that includes county-level rates for suicide. Through funding from SAMHSA for the Kansas Zero Suicide Program, KDHE has been able to hire a full-time epidemiologist dedicated to suicide and self-directed violence data analysis and dissemination. Additionally, the Kansas Health Institute has published multiple reports on suicide disparities in Kansas over the last several year. The Kansas State Epidemiological Outcomes Workgroup (SEOW) is a group of “data experts and prevention stakeholders” that has a focus on behavioral health data.   

There have also been efforts identified for Objective 4.1.2. The Kansas Syndromic Surveillance Program is working on collecting near real-time inpatient hospitalization data and mortality data into their Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) data system.

Recommended Updates

On page 17, under the first bullet for Goal 1, we recommend updating “Violent Death Reporting System” to say “National Violent Death Reporting System” to be consistent with language from CDC and also to add “… and the Youth Risk Behavior Survey” after “Kansas Communities that Care Survey.”

Under Objective 4.1.1 , there is discussion around making suicide a reportable condition. There is still much work to be done on this objective and its associated actions and activities. In order to make more progress in this area, the subcommittee recommends extending the timeline on the actions and activities. Additionally, we recommend adding coroners to the stakeholders list and including them in discussions surrounding making suicide a reportable condition or other data collection policy discussions.

Objective 4.1.2 is to “Support efforts to gather timely mortality statistics.” We would recommend adding “morbidity” to the title of this objective.

Next Steps

For Objective 4.1.1, we identified a few next steps as a subcommittee we could take to move work forward. First, we would like to research policies from other states who were successful at making suicide or suicide attempts reportable to learn from others how this could potentially look in Kansas. We would also like to understand if other states or national organizations have developed guidance on standard definitions to share with data collectors. We also identified that we need to know where we’re at now, so cataloging current practices, policies, and definitions for data collection is an important next step.  

Some next steps for Objective 4.1.2 include identifying current practices in-state and by other states for creating statewide standardized death reporting protocols and to include law enforcement and coroners in all of these discussions.

Goal 2

Progress

Goal 2 of Strategic Direction 4 is “Annually review and report on State Suicide Prevention Plan.” Overall, we have made progress on this goal as review of the Plan is currently ongoing. Objective 4.2.1 states “Request assistance from SEOW to review available data annually and more frequently.” There are two active members of the SRE subcommittee that are also members of the State Epidemiological Outcomes Workgroup (SEOW), thus there is a strong relationship between the SEOW and SRE subcommittee to make sure the work on this objective is complete. Under Objective 4.2.1, Action/Activity 1 recommends the SEOW annually review and update the Kansas Behavioral and Mental Health Profile. This was completed in 2022, and is located here.

Objective 4.2.3 is to “Report on progress, revisions, and roadblocks to plan efforts in annual reports,” which is currently being done as the subcommittees are reviewing Strategic Directions related to their committee’s work.

Recommended Updates

A few updates to the plan are recommended for Goal 2. The first is to add some clarifying language for Activity 2 under Obj. 4.2.1. This Activity recommends that the SEOW report progress on suicide data indicators, but does not mention to whom the SEOW should be reporting. Additionally, the SEOW was not mentioned as a stakeholder on Obj. 4.2.1 despite being a major partner for this objective. Currently, there is not an Objective numbered 4.2.2, so the final recommended update is to renumber Objective 4.2.3 to 4.2.2.

Next Steps

Three items were discussed as being next steps for Goal 3. The first is to have the suicide prevention epidemiologist with KDHE present yearly to the SEOW on suicide-related indicators so there is timely data being shared with partners. Another next step is to make some headway on Action/Activity 1 of Objective 4.2.3 which states “Researchers and State agencies will collaborate on suicide prevention research and evaluation.” We would like to begin identifying researchers and contacts in academia in Kansas who can assist with this objective. Finally, there was mention of an evaluation plan, but this has not yet been started to our knowledge so we recommend beginning the discussion around creating an evaluation plan. 

Goal 3

Progress

The final goal of Strategic Direction 4 is “Evaluate the impact and effectiveness of suicide prevention interventions and systems and synthesize and disseminate findings.” To-date, not much work has been done towards the overall goal because the evaluation plan hasn’t been created. Once the evaluation plan is in place, we will be able to effectively evaluate the impact and effectiveness of items outlined in the Plan, as well as other indicators of suicide prevention efforts. 

Certain Actions/Activities have been started. For instance, the Coalition has collected some membership and involvement data, which falls under Objective 4.3.1 Action/Activity 2 “Track involvement of identified stakeholders and document participation.” And the Coalition has also created a survey to track suicide prevention resources across the state, which is part of Actions/Acitivities 3 thru 5 (“Document any known milestones in suicide prevention efforts in Kansas,” “Document the names of new evidence-based strategies implemented in Kansas communities,” and “ Document the population demographics being served in implemented Kansas Suicide prevention strategies,” respectively). 

Recommended Updates

Two updates are recommended for Goal 3. The first is to consider adding a discussion that suicide does not exist in a bubble as it shares intersects with adverse childhood experiences, overdose and other forms of violence. And the second is to add some clarifying language to Action/Activity 5 of Obj 4.3.1. Currently, it states “Document the population demographics being served in implemented Kansas Suicide prevention strategies,” and it would be helpful to know if these “suicide prevention strategies” are only the ones identified in the Plan or if this extends to other strategies occurring across the state.

Next Steps

As mentioned in the previous goal, this subcommittee would like to begin work on an evaluation plan for the state Plan. The Coalition and KSPHQ have begun some work on collecting data that can be used to evaluate the work identified in the plan, and we should be sure to include the current evaluation processes in the evaluation plan as it’s being created.