1. Zero Suicide in Texas (ZEST) Zero Suicide in Texas (ZEST) Collaborative Call: July 2015 DSHS: DSHS: Jenna Heise TIEMH: TIEMH: Molly Lopez Erica Shapiro

2.  Six slots for audiotape submissions on the 15 th of each month, beginning this month, to ensure adequate time for review and feedback  Sign up for a slot using Google Docs. Please let me know if you need it re- sent.  Select whether an audiotape of an actual (or mock) session will be submitted  If a mock session is selected, have your “client” contact Erica Shapiro by email (erica.shapiro@austin.utexas.edu) to be assigned a vignetteerica.shapiro@austin.utexas.edu REMINDER: SIGN UP FOR SAFETY PLANNING INTERVENTION TAPE SUBMISSION

3. UPCOMING TRAININGS  Zero Suicide Academy: August 18, 2015  State Suicide Prevention Symposium: August 19, 2015  ASK: August 27-Austin; August 31-Houston; and September 17-Fort Worth

4. SUCCESSES & CHALLENGES…  CAMS Implementation  What has been the feedback from staff taking the training?  How have you planned roll-out within your organization?  Have staff implemented the model and how are they doing?  How has the agency been supporting staff while learning this new practice?  How are you evaluating the impact?

5. SUCCESSES & CHALLENGES…  Suicide Risk Pathways  How has your team thought about implementation of the pathways?  Have you begun steps towards measuring or implementing the pathways?  Where do you see the biggest challenge to implementation?  How can you evaluating the impact?

6. POSTVENTION PLANNING Goal: Agencies will develop a suicide postvention plan that addresses individuals who may be affected by the suicide death of an individual in care or an agency employee.

7. RATIONALE An average of 4.5 to 7.5 immediate family members and around 15 to 20 extended family members, friends, and colleagues can be considered “intimately and directly affected” by suicide. Many others may also be affected, even if they did not have a relationship with the deceased. Exposure to suicide behaviors or death increases the risk of those exposed for suicide. Suicide Postvention is Prevention

8. Although most work focuses on “Suicide Survivors,” more recent models argue for examining a broader population of focus Although most work focuses on “Suicide Survivors,” more recent models argue for examining a broader population of focus Cerel et al.’s model (2014) Cerel et al.’s model (2014) Exposed to suicide Exposed to suicide Affected by suicide Affected by suicide Bereaved with short term impact Bereaved with short term impact Bereaved with long term impact Bereaved with long term impact MODELS OF IMPACT

9. DEFINING POSTVENTION Survivors of Suicide Loss Task Force (2015) define postvention as: Survivors of Suicide Loss Task Force (2015) define postvention as: “An organized response in the aftermath of a suicide to accomplish any one or more of the following: (a) to facilitate the healing of individuals from the grief and distress of suicide loss; (b) to mitigate other negative effects of exposure to suicide; and (c) to prevent suicide among people who are at high risk after exposure to suicide.”

10. POSTVENTION PLANNING Organizational plan should address the possible death of a consumer or former consumer a staff member Organizational plan should identify steps related to communication with Family members Consumers who may be impacted Staff members Check out the sample plan from Centerstone!

11. STAGES OF POSTVENTION Immediate Minimize trauma impact Provide psychological first aid to those exposed Short Term Promote healthy grieving Provide additional support/services to those most affected Long-Term Reflects the shift from postvention to prevention Offer multiple strategies for identifying/engaging individuals at risk of suicide Consider impact of anniversaries or other events

12. Model of active suicide postvention where trained suicide loss survivors are dispatched to the scene of a suicide to provide information about community resources and begin to instill hope for the future. LOSS TEAMS

13. PSYCHOEDUCATION AND SUPPORT GROUPS Psychoeducation Suicide Awareness Voices of Education (SAVE) Suicide Survivor Support Groups Survivors of Suicide Survivors after Suicide Additional Resources AFSP Facilitator Training program Towards Good Practice: Standards and Guidelines for Suicide Bereavement Support Groups SAVE and AFSP maintain lists of support groups

14. Research is limited, but would suggest that evidence-based trauma and grief interventions would be most beneficial Some suggestions: Trauma-Focused CBT for Traumatic Grief Complicated Grief Therapy Prolonged Exposure Therapy Cognitive Processing Therapy TREATMENT OF TRAUMA/COMPLICATED BEREAVEMENT

15. MOVING BEYOND-COMMUNITY EXPANSION Postvention response teams Postvention responses within the community (schools, first responders, health care staff, clergy, funeral directors) Consultation to partner organizations on developing best practice postvention plans Raise awareness of local media on safe messaging guidelines

16. ZEST GROUPS & MEETING DATES Wednesdays, 2pm CST Fridays, 9am CST Border RegionTropical Coastal PlainsHarris Hill CountryBluebonnet ATCICSpindletop TarrantTri County *Denton Month Wednesdays, 2pm CST Fridays, 9am CST October (2014)ALL GROUPS: Weds 2pm, Oct 29 th NovemberNov 19 th Nov 21 st DecemberDec 17 th Dec 19 th January (2015)Jan 28 th Jan 30 th February Safety Planning Training MarchMar 25 th Mar 27 th AprilApr 22 nd Apr 24 th MayMay 27 th May 29 th JuneJun 24 th Jun 26 th JulyJul 29 th Jul 31 st AugustZero Suicide Summit SeptemberSep 23 rd Sep 25 th