Adolescent Health: Annual Report

Priorities:

• Suicide Prevention/Mental Health
• Healthy Relationships

NPM 7.2: Rate of hospitalization for non-fatal injury per 100,000 adolescents, ages 10 through 19

ESM 7.2.1: Number of students trained in teen Mental Health First Aid

Data Statement:

South Dakota met the target of 282 with a non-fatal injury hospitalization rate of 281.9 per 100,000 adolescents, ages 10 through 19, in 2019. The target was reset at a 10% decrease and the new 2025 target is 253.8 per 100,000 adolescents. The 2018 rate was 318.8 hospitalizations for non-fatal injuries among adolescents, ages 10 through 19. South Dakota ranked 47th in the nation with a significantly higher rate than the U.S. rate of 204.2 per 100,000 adolescents.  

 

State Objective 1:

Decrease the adolescent suicide rate among 15 through 19-year-olds from 34.4 per 100,000 (2018-2020) to 26.3 per 100,000 in 2025 (NVSS). 

State Objective 1 Data Statement:

South Dakota did not meet the 2020 target rate of 32.5 with an adolescent suicide rate of 34.4 among 15 through 19-year-olds. This is an increase from 33.10 in 2018. South Dakota ranked 48th in the nation with a significantly higher rate than the U.S. rate of 10.8. The change from the base year (2014-2016) is not significant. 

 

State Objective 2:

Decrease the percentage of 9th-12th graders who attempted suicide in the past 12 months from 12.3% in 2019 to 9.0% in 2025 (YRBS).

State Objective 2 Data Statement:

The objective was aligned to the South Dakota suicide workgroup’s target of 9.0% in 2025. The percentage was based on an average rate of 9.4 from 2011-2019. South Dakota does not have any updated data for this objective, but the 2020 target was 12.0%. 

Strategy 7.2.1. Promote evidence-based programs and practices that increase protection from suicide risk

• Activity: Provide Youth Mental Health First Aid Training
• Activity: Provide Question Persuade Refer (QPR) trainings for high school staff
• Activity: Provide teen Mental Health First Aid Training

Title V continued to partner with Helpline Center to provide suicide prevention trainings across the state. A new training offered during this reporting period was teen Mental Health First Aid (tMHFA). Teen Mental Health First Aid is a training program for youth by the National Council for Mental Wellbeing in partnership with Born This Way Foundation. Youth are be provided the skills they need to have supportive conversations with their friends and learn how to get help from responsible and trusted adults. TMHFA focuses on youth in grades 10th to 12th or ages 15 to 18 years old. During this reporting period the Helpline Center, Suicide Prevention Director attended a virtual instructor training and provided one teen Mental Health First Aid training to 38 - 10th grade students at Flandreau High School (ESM for NPM 7.2.1).

Additional Suicide Prevention Trainings provided with this partnership: 

• Youth Mental Health First Aid Training – 1 training (7 attendees)
• Question Persuade Refer trainings for high school staff – 3 trainings (67 attendees)

 

• Activity: Provide and promote Text4Hope - Teen Crisis Texting Support

Text4Hope: Title V partially funds the Text4Hope program. The program provides crisis texting support for all high school students in the state of South Dakota. Students will typically text in to talk about a variety of issues such as suicidal thoughts, anxiety, depression, stress, concerns about a friend, relationship issues and family issues.

• Number of Text: 141
• Text4Hope Presentations: 19

 

To understand our current reach with Text4Hope, Title V and the University of South Dakota (USD) developed a short survey for South Dakota high school counselors regarding their school’s usage and promotion of Text4Hope. Received 29 responses.

 

Here are some of the results:

 

• Is the Text4Hope program a resource that you provide/promote to students at your High School? Yes 48.3%, NO 51.7%

 

• If you answered yes to the question above, where do you display/share the Text4Hope resources:

 

• Would you like to request additional materials for use in your school? Yes 79.3%, No 20.7%

 

With the Text4Hope survey results the Helpline Center was able to send 22 South Dakota schools more information about Text4Hope and set up 10 school presentations. Survey results also highlighted the need for continued promotion.  

 

Additional Text4Hope *NEW* promotions during this reporting period:

• Lutheran Social Services (LSS) added the Text4Hope to their resource card which is passed out at every Healthy Relationship class.
• Miss South Dakota promoted at speaking engagements and on social media
• Developed COR Health + Wellbeing Social Media posts to promote Text4Hope
• Helpline Center promoted Text4Hope on Snapchat
  • Text4Hope Snapchat Ad
    • Duration: 11/11/20 - 12/11/20
    • Impressions: 909,823 (# of times ad was viewed)
    • Swipe Ups: 11,705
    • Swipe Up Rate: 1.29%

 

7.2.2. Create opportunities for Positive Youth Development (PYD) among diverse youth with a health equity lens

• Activity: Develop and promote PYD training for organizations working with diverse youth on suicide prevention/mental health.

 

Positive Youth Development Conference: Title V partnered with LSS to provide the Positive Youth Development Conference. The conference was started to provide an opportunity for those that work with youth and young adults to come together and discuss the latest issues affecting them today. The PYD conference was held online (April 2021) due to safety concern from the pandemic.

Topics discussed were:

 

• Search Institute: 40 Developmental Assets
• Intentional Relationships
• Lakota Culture
• Bullying
• Human Trafficking

 

• Activity: Collaborate with Youth Advisory Council that focuses on adolescent priorities and provide activities that emphasize health equity and integrating youth voice

 

Youth Advisory Council: Title V worked with an MPH Student to develop a youth advisory council plan after receiving additional funding (see the General Department SRAE paragraph below). Title V partnered with LSS of South Dakota to develop a youth advisory council. The first council meeting was December 2020. The council will look at both MCH adolescent priorities - Healthy Relationships and Suicide Prevention/Mental Health. Due to staff turnover and COVID-19, in person meetings were limited.

 

 

7.2.3. Develop and disseminate equitable and accessible suicide prevention education materials, resources, and messaging.

• Activity: Promote suicide prevention and mental health messaging for Cor Health + wellbeing social media

Title V continued to work with Hot Pink marketing agency to develop suicide prevention, mental health posts for Facebook and Instagram.

www.facebook.com/corhealthsd

www.instagram.com/corhealthsd

 

Since Cor’s launch in December 2019, the primary goal has been to provide resources to South Dakota parents and youth (10 to 24 years old). To accomplish this, we’ve been utilizing Facebook and Instagram carousels to distribute Cor messages on a variety of different subjects such as mental health, suicide prevention, stress management and injury prevention.

During this reporting period the impact of COVID on youth mental health was emerging and experts were warning the toll it was taking. Title V worked with the Hot Pink marketing agency to develop additional messaging focused on mental health related to the COVID-19 pandemic and resources available. 

• Activity: Develop and promote Suicide Prevention training for parents of young people 10 to 19 years old, including vulnerable/underserved youth.

 

Title V partnered with USD Center for Disabilities to develop a 4-part Suicide Prevention Video Series. Series focuses on Suicide Prevention, ACEs, Protective Factors, and Mental Health Resources. The video series was developed for parents or those that are working with youth between the ages of 10 to 24 years old. Each part is 5 to 6 minutes long and can be found on the SD DOH website under the youth and young adult section: https://doh.sd.gov/family/Youth/Suicide.aspx. Since the video series was finalized at the end of this reporting period, it will be promoted and disseminated during FY2022 reporting period.

 

• Part 1: Suicide Prevention
• Part 2: ACES Awareness
• Part 3: Protective Factors
• Part 4: Resources

 

 

• Activity: Utilize communication platforms to disseminate trainings and materials accessible to diverse parents and organizations working with young people 10 to 19 including vulnerable/underserved youth.

 

Adolescent Health Coordinator attended the Suicide Prevention in Rural Primary Care two-part webinar series. One take away was that people who die by suicide are likely to have been seen by a Primary Care Provider in the previous month before their death. This is especially true in rural areas where behavioral health resources are fewer and stigma around mental health is greater. The training walked through strategies for primary care providers and provided a step by step Suicide Prevention Toolkit.  One activity mentioned was putting materials in office waiting rooms to create an environment that the patient feels comfortable sharing concerns and to share what types of services are available in the community. Title V team began brainstorming ways it could coordinate efforts in the 74 Community Health Clinic/WIC offices across the state.  At this same time, the NPM 1 Well Women workgroup was beginning to look at how to initiate depression screening in Community Health offices. The NPM 1 and NPM 7.2 coordinators collaborated to develop two mental health/suicide prevention resources:

1. Suicide Prevention and Mental Health rack card-provides South Dakota resources and mental health/suicide prevention apps.
2. Mental Health poster that could be posted in waiting rooms or exam rooms. (see below)

 

7.2.4. Develop partnerships with diverse, multi-sector local and state agencies to address youth mental health and suicide prevention among all South Dakota youth

Title V continued to partner with organizations that were involved with the Title V Needs Assessment and build rapport with new organizations working with diverse youth in mental health and suicide prevention.

The MCH NPM #7.2 workgroup includes the following diverse partners:

• Suicide Prevention Director, Helpline Center
• Suicide Prevention Director, Department of Social Services
• Injury Prevention Coordinator, Department of Health
• Director of REACH, Lutheran Social Services
• Pediatric Clinical Nurse Specialist, Sanford Children’s Hospital
• Pediatrician/DOH Medical Consultant, Dr. Poppinga
• USD Center for Disabilities, Training Specialist/Adjunct Graduate Faculty  

SPM 1: Improve young peoples’ (10-24 years) relationships by increasing the percentage of 10–19-year-olds who would talk to a trusted adult if someone they were dating or going out with makes them uncomfortable, hurts them, or pressures them to do things they don’t want to do from 50.9% in 2021 to 55.2% by 2025.

 

Data Statement:

In 2021, South Dakota exceeded the target of 50.2% with 50.9% of 10-19-year-olds reporting they would talk to a trusted adult if someone they were dating or going out with makes them uncomfortable, hurts them, or pressures them to do things they don’t want to do. A new 2025 target has been set at a 10% increase from the previous target. The new 2025 target is 55.2%.

State Objective 1:

Decrease the proportion of females aged 15 to 24 years with Chlamydia trachomatis infections attending family planning clinics from 12.5% in 2021 to 11.52% by 2025 (EHR NetSmart).

State Objective 1 Data Statement:

South Dakota met the 2030 target of 12.8% with 12.5% of females aged 15 to 24 years with Chlamydia trachomatis infections attending family planning clinics in 2021. A new 2025 target has been set at a 10% decrease from the previous target. The new 2025 target is 11.52%.

State Objective 2:

Decrease the South Dakota teen birth rate, ages 15 through 19, from 18.7/1000 in 2020 to 18.4/1000 in 2025 (NVSS).

State Objective 2 Data Statement:

South Dakota met the 2020 target of 19.1/1000 with a teen birth rate of 18.7/1000 in 2020. The annual target for 2021 is 18.67/1000. South Dakota ranked 38th in the nation and has a rate that is significantly higher than the U.S. rate of 15.4/1000. The change from the base year (2015) to the current year is significant.

 

Strategies:

1.         Promote evidence-based programs and practices that increase healthy relationship skills, STI prevention and pregnancy prevention

 

• Activity: Provide and promote STI guidelines training to providers serving young people 10 to 24-years-old, including vulnerable/underserved youth.

• Family Planning conducted a CQI on STD Screening for their clinics, as part of that study a STI training was set up for providers and nurses.

 

• Activity: Collaborate with South Dakota Family Planning Program, Rape Prevention Education, Title V Sexual Risk Avoidance Education, General Department Sexual Risk Avoidance and Personal Responsibility Program Grants serving diverse populations.

General Department SRAE grant: During this reporting period, SD DOH received a new grant, General Department SRAE (Sexual Risk Avoidance Education). This grant will expand the reach of teen pregnancy prevention education to rural areas with high teen birth rates and high STD rates. SRAE funding provides youth with skills on how to voluntarily refrain from non-martial sexual activity. The target population for this programming focuses on Native American youth and vulnerable youth between the ages of 10 to 13 years old living in rural South Dakota.

•                  *NEW* Activity: Develop a youth evaluation plan for MCH programs and partners working on healthy relationship grants and activities.

 

A new activity was added for the Healthy Relationship priority to develop an evaluation plan for MCH programs and other healthy relationship grants and activities. The Healthy Relationship Evaluation was designed to review program strategies, objectives and indicators; to align youth programming and resource: to improve each individual program and to measure impact on youth and collective effectiveness. Title V will work with the evaluation center, SDSU Population Health to review the MCH healthy relationship priority and five other healthy relationship grants. The five healthy relationship grants are:
 

• Personal Responsibility Education Program (PREP)
• Title V Sexual Risk Avoidance Education (SRAE)
• General Departmental Sexual Rick Avoidance Education (GDSRAE)
• Rape Prevention Education (RPE)
• Title X Family Planning Program

 

2.         Create opportunities for Positive Youth Development (PYD) among diverse youth with a health equity lens

• Activity: Develop and promote PYD trainings for those working with diverse youth on healthy relationships
• Activity: Collaborate with Youth Advisory Council that focuses on adolescent priorities and provide activities that emphasize health equity and integrating youth voice throughout.

 

See Positive Youth Development Conference and Youth Advisory Council sections above.

 

• *NEW* Activity: Develop an assessment tool for Positive Youth Development activities.

With the development of youth advisory council and the positive youth development conference – a new activity was developed to evaluate youth-focused programming and will measure youth engagement in programming and communities. Development of this tool will help guide Title V and LSS on their youth programming activities and to see the impact of PYD activities in South Dakota.  

 

3.         Develop and disseminate equitable and accessible healthy relationship, STI prevention and pregnancy prevention materials, resources and messaging.

 

Title V worked with Hot Pink marketing agency to develop 6 carousels for the parent-teen communication campaign. The purpose of the parent-teen communication campaign was to raise awareness among South Dakota parents as to what they can do to promote healthy relationship with their teens, and where to find programs and tools to support ongoing healthy communication. Some key messaging included: 3 ways to ease the tension with your teen; 3 tips to talking with teens’ Parent Power!;  What you say to your teen matters; 4 ways to ease the tension with your teen, and practice being positive. It Works!

 

 

Title V collaborated with Federal Youth Services Bureau Personal Responsibility Education Program (PREP) and Lutheran Social Services to develop a social media post to promote the Families Talking Together class. Families Talking Together is a class for parents to reduce adolescent sexual risk behaviors and focuses on parent-adolescent communication; monitoring and supervision; and relationship building activities. Here is the example of the Families Talking Together carousel:

• Activity: Develop youth-friendly services materials for agencies and clinics servicing young people 10 to 24 years old.

During this report period the STI National Strategic Plan: 2021-2025 was released, the SPM 1 workgroup began looking at this framework to develop new activities to focus on.

There were 3 sections that stood out to the workgroup:

“Awareness education and training are particularly relevant for providers seeing preteen and teen patients. Research suggests that not enough teens get private and confidential time with their providers”

“Among providers caring for preteen and adolescents, strengthening privacy and confidentiality while implementing practices that encourage sexual health assessments and increase risk-avoidance behaviors can further reduce STIs and STI-related stigma and shame.”

“…engagement includes providing a welcoming environment.”

Through these ideas a new activity was implanted to ‘develop youth-friendly services materials for agencies and clinics servicing young people 10 to 24 years old.’

 

4.         Develop partnerships with diverse, multi-sector local and state agencies to address youth healthy relationships, STI prevention and pregnancy prevention among all SD youth

 Title V continues to partner with organizations that were involved with the Title V Needs Assessment and build rapport with new organizations working with diverse youth in mental health and suicide prevention.

 

The MCH SPM #1 workgroup includes the following partners:

• Director of REACH, Lutheran Social Services
• Pediatrician/Department of Health Medical Consultant, Dr. Poppinga
• Department of Health, Family Planning Manager
• Boys & Girls Club of Watertown, Prevention Specialist
• Department of Health, Sexual Violence Prevention Coordinator

Other Adolescent Health activities during this reporting period:

South Dakota Suicide Prevention State Interagency Workgroup: Adolescent Health Coordinator continued to participate in South Dakota Suicide Prevention State Interagency Workgroup that developed the 2020 to 2025 State Suicide Prevention Plan. Workgroup meets monthly to look at understanding local data, develop strategies to address suicide prevention and coordinate efforts and resources in suicide prevention.

OCFS Community Health Office: Adolescent Health Coordinator continued to collaborate with 74 OCFS Community Health clinics located in 61 of SD’s 66 counties that provide public health services to the adolescent population such as contracting with local schools for Community Health Nurses to provide preventive health screening and student health education. Education includes growth and development, injury prevention and suicide prevention for middle and high school students.  

Miss America South Dakota: Miss South Dakota Kaitlin O’Neill reached out to Title V to see what resources were available for mental health. Miss SD’s social impact initiative was Mental Health and her goal as Miss SD 2021 was to help all individuals no matter the age how to find a healthy balance mentally, physically, and emotionally. She developed a program called BLOOM to help youth and young adults find strategies they can incorporate into their lives and grow towards that balance. Miss SD promoted a variety of different suicide prevention and mental health resources including BeThe1SD and Text4Hope on her social media platforms and at her speaking engagements.