In FFY 2023, Title V will continue to implement strategies to improve adolescent mental health and reduce child injury. Improving systems and upstream factors will be crucial in executing the State Action Plan strategies associated with these priorities. To that end, Louisiana Title V will also implement strategies that align with the following Systems Priorities:
Louisiana Title V selected the following Adolescent Health National Performance Measure for the FFY 2021-2025 cycle:
- NPM 7: Injury Hospitalizations: The 2020 Needs Assessment displayed increasing trends in suicide, self-harm thoughts and behaviors, and mental health disorders among adolescents. These findings highlighted a significant and urgent need for mental and behavioral health services for adolescents across the state. The assessment also demonstrated a need to address the toxic stressors and adverse childhood experiences of Louisiana’s adolescents that can precipitate mental health issues, including those linked to various forms of violence and injury. To reduce injury hospitalizations, Title V will partner with initiatives leading statewide efforts to improve adolescent mental health outcomes with an emphasis on shared risk and protective factors related to injury and violence prevention, especially self-harm.
Population Priority Needs: Improve Adolescent Mental Health and Reduce Child Injury and Violence
Investigate and effectively communicate trends and factors related to injury hospitalizations and deaths: In FFY 2023, Louisiana Title V will continue to fund and support state and local Child Death Review (CDR) panels to review unexpected deaths of children under age 15, identify risk factors, and disseminate prevention recommendations. Title V will also continue to collaborate with the National Violent Death Reporting System (NVDRS), which will monitor trends in violent deaths among adolescents of all ages and investigate contributing factors for these fatalities.
In FFY 2023, the BFH Communications team will continue to play an active role in the Bureau's injury prevention work, particularly in relation to the CDC-funded Emergency Department Surveillance of Nonfatal Suicide-Related Outcomes (ED-SNSRO) project. The OPH Infectious Disease Epidemiology (ID Epi) program is working with the BFH Communications team to share new emergency department data with suicide prevention partners across Louisiana. The team has interviewed key audience members (e.g., behavioral health providers, suicidologists, legislators, etc.) to discuss which numbers and what formats would be most helpful for local suicide prevention. In FFY 2022, the team began developing three things to empower prevention partners with previously unavailable data: an email-based rapid alert system for suicidal activity at the parish level; a suite of interactive data dashboards showing statewide suicide trends over time; and an annual report on injury and violence in Louisiana, which will include policy recommendations for a legislative audience. The overarching goal is to make recent suicide data easier to access, thereby equipping partners with the best available evidence to plan their prevention projects.
Although NVDRS and ED-SNSRO do not receive Title V funds directly, both efforts will enhance overall Title V assessment capacity and are supported by Title V infrastructure.
Support implementation of Be SMART Louisiana: In FFY 2023, BFH will support the ongoing implementation of the Be SMART Louisiana campaign to promote responsible gun ownership to reduce child gun deaths and injuries. In FFY 2022, the State CDR launched the Be SMART campaign, and MCH Coordinators and other partners began distributing materials across the state to target audiences including gun rangers, gun shops, pediatricians offices, and coroners. BFH will continue to support the distribution of physical materials, such as palm cards, posters, and pamphlets, as well as the social media graphics for digital use.
Support implementation of Comprehensive Suicide Prevention program: In FFY 2023, Title V will support the implementation of CDC-funded Comprehensive Suicide Prevention program. In FFY 2022, BFH began the collaborative process to create a Comprehensive Suicide Prevention Plan, which will be updated annually, that leverages current public health and behavioral health approaches and partnerships and elevates best practice prevention work to fill gaps. BFH will also serve as the lead implementing and evaluating the Comprehensive Suicide Prevention Plan. BFH’s State and local Child and Maternal Mortality Review Panels and Community Advisory and Action Teams and suicide prevention coalitions will play an essential role in furthering the goals of this Comprehensive Suicide Prevention plan.
BFH will address several risk and protective factors through the implementation of evidence-based strategies chosen from the CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices. Building off of the partnership developed through the CSLC cohort activities described in the FFY 2021 report narrative, BFH will work with The Family Tree to enhance their suicide prevention training by funding an additional Suicide Prevention Coordinator. The Family Tree’s Jacob Crouch Suicide Prevention Services consist of suicide awareness and prevention programs for schools in the Region 4 area, and the additional BFH-funded Suicide Prevention Coordinator will enable the organization to expand evidence-based gatekeeper training for school personnel and peers beyond Region 4. The additional trainings will initially be conducted in the Region 6 area and will then expand to a statewide focus. These programs provide students with the tools necessary to help themselves or others showing signs of at-risk behavior.
Support implementation of Injury Prevention Strategic Action Plan: As described in the report narrative, in late FFY 2021, BFH learned that it was not awarded the CDC grant that BFH applied for to fund the activities outlined in the State Injury Strategic Action Plan. Around the same time, BFH also received a surprise notice that it would be funded for a CDC Comprehensive Suicide Prevention grant that BFH applied for but was initially denied. For most of FFY 2022, the BFH Injury Team focused efforts on rapidly executing the first year of the new grant’s deliverables and adjusting the team’s structure, so implementation of the Injury Prevention Strategic Action Plan was temporarily put on hold. In FFY 2023, Title V staff and infrastructure resources will support the BFH Injury team with updating the implementation plan for the Injury Prevention Strategic Action Plan to ensure advancement of shared strategies and better align with newly-funded related initiatives, such as the Comprehensive Suicide Prevention program.
Build community awareness around ACEs, trauma, and resilience science: The ACE Educator Program seeks to build community awareness around ACEs, trauma, and resilience science via a robust network of trained educators. This work is part of a larger effort to develop policies and practices informed by an understanding of the lifelong impact of childhood adversity and trauma. Abuse, neglect, and other ACEs are not only a cause of child injury, but are also linked to heightened risk for many other problems, including adolescent suicide2. Through training in ACEs, adults who work with children and adolescents are more adept at identifying and addressing ACEs, both to prevent harm and to buffer lasting negative effects. This work provides a foundation for the creation of safe, stable, nurturing relationships and environments for all youth.
In FFY 2023, the ACE Educator Program will begin to offer school-specific ACE cohorts in collaboration with the Louisiana Department of Education (LDOE). Following these trainings, the ACE Educator Program will continue to support LDOE ACE Educators by reviewing end-of-course evaluation forms and revising materials accordingly. Several schools have already submitted applications to participate in this cohort. In addition to the school-specific trainings, the ACE Educator Program has planned a cohort in Region 5, based on population density and a lack of ACE educators in the region.
Develop a statewide plan to address ACEs: The ACE Educator Program is working closely with the Office of the First Lady to develop a trauma-informed statewide plan to reduce ACEs. In FFY 2023, BFH will convene a state plan steering committee that will meet monthly to review recommendations, guide and plan community listening sessions, and draft the trauma-informed state plan. Following this committee meeting, BFH will host two community listening sessions to solicit input from Louisiana community members on the state plan.
System Priority Need: Ensure Title V strategies are outcomes-focused and rooted in essential public health services
Support quality improvement in School Based Health Centers (SBHCs): In FFY 2023, Title V-funded staff will continue to manage contracts for 57 state-designated SBHCs through the Adolescent School Health Program (ASHP). Building off of the QI education offered to the SBHC champions in FFY 2021, programs can choose between two QI initiatives to implement in FFY 2023: risk assessments/screenings, or increasing service utilization. Enrollment rates (i.e. signed consent forms) are generally high at Louisiana SBHCs, but service utilization rates hover around 40%. ASHP will continue to support this QI implementation work throughout FFY 2023.
Pilot validated risk screening tool: In alignment with the priority needs, ASHP is working to develop and implement strategies to meet adolescent mental and behavioral service needs through SBHCs. In FFY 2022, behavioral health specialists from five SBHCs participated in a pilot program to test the implementation, utilization, data analytics and reporting capabilities of the Rapid Assessment for Adolescent Preventive Services (RAAPS) online tool. The RAAPS tool is a standardized validated risk screening tool that supports professionals in addressing the risk behaviors impacting health, well-being, and academic success in youth. In FFY 2023, ASHP will analyze the data collected from this pilot group to identify top risk factors among adolescents in Louisiana. Louisiana Clinical Services (LCS) will continue to provide funding to support the implementation of RAAPS. Moving forward, ASHP will document intervention services offered by SBHCs that target the identified risk factors. SBHC providers will be encouraged to work with school administrators to address these risk factors.
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