Since the PMO began operating on July 1, 2012, we have played a pivotal role in unprecedented success across the state and in individual communities in the prevention of substance abuse and suicide.
WHSAA Collaboration. For the past two fiscal years, the PMO has partnered with the Wyoming High School Activities Association (WHSAA) to bring substance abuse prevention messaging to parents and others attending high school sporting events. This messaging was promoted by the PMO’s on-site presence at these events to distribute educational materials such as booklets developed as part of the First Lady’s Talk Early and Often campaign (http://www.talkearlyandoften.org/) and to engage attendees in conversations about how to prevent underage drinking, drug use, and suicide. In 2016, this partnership was supported by a major social media campaign featuring Facebook posts that included recorded educational videos from prominent local figures. The first two culminating events of the WHSAA campaign, the Wyoming state football championships held in Laramie from October 27-November 12, 2016 and the state volleyball tournaments held at the Casper Events Center on November 3-5, 2016, produced 52,319 total Facebook impressions across all videos used, with approximately 20-25% being organic reach (or earned media). This campaign also included a Snapchat Filter that produced 1,653 impressions and 73 filter uses upon its initial launch. The WHSAA campaign included a prevention app developed by the PMO for both Google and Apple, which was made first made available for download at the November 2016 sporting events.
Episcopal Diocese Suicide Prevention Partnership. The faith community can be a powerful partner in prevention. In 2014, the PMO partnered with Episcopal Diocese of Wyoming to help widen the community safety net when it comes to suicide prevention. According to Rev. Dr. Bernadine Craft, chair of the Episcopal Suicide Prevention Coalition: “As a community of faith, I pray that our partnership with Prevention Management Organization will empower those who serve to end this epidemic, and comfort those who suffer.” See http://stjohnsjackson.diowy.org/dfc/newsdetail_2/3167378. Bishop Smylie of the Episcopal Diocese of Wyoming further stated, “We are excited to be joining with the Prevention Management Organization of Wyoming as the faith partner in suicide awareness and prevention.” Since cementing this partnership, the PMO and Episcopal Diocese have facilitated the training of clergy, lay ministers and congregation members across Wyoming. This partnership also has raised awareness about the problem of prevention and elevated the conversation around the need to reach out to those at risk.
Statewide Policymaker Forums. The PMO has partnered with the Wyoming Association of Sheriffs and Chiefs of Police (WASCOP), Wyoming Department of Transportation (WYDOT), Governor’s Council on Impaired Driving (GCID), local police departments, and county sheriff’s offices to conduct a series of community forums held to discuss the impact of substance abuse on crime in Wyoming and locally. An important focus of each forum is the role of community leaders in helping address emergent substance abuse issues in their county. These events are co-hosted by the PMO and Ernie Johnson, a consultant for WASCOP and the GCID. Mr. Johnson provides an analysis of state and local arrest data and offers suggestions for how the policymakers in attendance can work with their local prevention coalition to make a difference. To date, Mr. Johnson has partnered with the PMO on thirteen policymaker forums, with three more scheduled in 2017.
Tobacco-Free School Policy Initiative. In 2016, we worked with the Wyoming Survey and Analysis Center (WYSAC) to complete a statewide survey to determine the number of school districts and schools that have adopted 100% tobacco-free policies (covers all tobacco products, at all times, by all people, in all places). The results of this survey will be used to inform our community prevention staff and their coalitions about those communities in need of technical assistance to strengthen their local schools’ tobacco-free policies, utilizing the model policy developed by the PMO. The survey and model policy are set forth in Appendix C. Our community prevention staff will work with their coalitions and local schools to adopt the model policy.
Building System-Level Suicide Prevention Capacity through Zero Suicide and Clinical Training. The PMO is a strong proponent of Zero Suicide (ZS), an evidence-based framework that facilitates and guides healthcare organizations to examine their capacity to provide suicide-safer care for at-risk patients. Participating organizations learn how to develop internal policies and procedures to improve capacity to safely treat suicidal clients. The National Action Alliance for Suicide Prevention has identified Zero Suicide as one of our program priorities. In determining threshold capacity for implementation of ZS, the PMO identified the need for physicians to have additional training in recognizing and treating suicide risk factors. Accordingly, the PMO promoted two online training programs to meet the preliminary awareness needs of Wyoming physicians: At Risk in Primary Care and At Risk in the ED. More than five hundred (500) medical care providers across Wyoming completed one of these courses.
An initiative by the PMO to deepen the reach of suicide prevention in the healthcare environment was the 10 Hospitals in 10 Weeks campaign launched in 2016. This campaign focused on recruiting ten hospitals within ten weeks to commit to training 100% of their staff in suicide prevention within a year, thereby earning recognition as a “Champion in Medicine and Suicide Prevention.” Of the ten hospitals who accepted the challenge, Ivinson Memorial Hospital was the first hospital to complete the challenge, joining West Park Hospital and the Wyoming State Hospital, which who had already trained all their staff and committed to continuing to do so on an annual basis. Governor Mead recognized these three hospitals for their leadership in suicide prevention at the 2016 Governor’s Symposium on Suicide Prevention.
Building on the momentum of the 10 Hospitals in 10 Weeks campaign, in October 2016 the PMO, in partnership with Wyoming Medical Center and Wyoming Behavioral Institute, hosted an Introduction to Zero Suicide workshop to raise awareness of the evidence-based ZS framework and to encourage healthcare organizations to pursue our adoption. Representatives from Fremont Counseling, West Park Hospital, Wyoming Medical Center, Summit Medical Center, Wyoming Behavioral Institute, Northern Wyoming Mental Health Center, Wyoming Girls School, Johnson County Healthcare, Fremont County Suicide Prevention Task Force and the Wyoming Hospital Association attended the introductory workshop. The PMO will offer a Zero Suicide Academy in May 2017, to assist these healthcare organizations (and others who were unable to attend the workshop) in developing action plans tailored to their organization to reach and maintain the Zero Suicide effort. During the intervening months, the PMO is working with healthcare organizations across the state to conduct organizational self-studies and to identify preliminary areas that can be addressed in the near term.
To further outcomes of the Zero Suicide initiative, the PMO offers “Train the Trainer” programs for doctors and mental health clinicians. In November 2016, the PMO partnered with Peak Wellness to provide an Assessing and Managing Suicide Risk (AMSR) training to provide behavioral healthcare providers with the core competencies and best practices in suicide risk assessment, management, and documentation. Eight individuals – from Peak Wellness, Wyoming Penitentiary, Cheyenne Regional Medical Center, Central Wyoming Counseling Center, and the PMO – completed the course to become new AMSR trainers and have committed to travel across Wyoming as needed to meet the needs of other behavioral healthcare organizations. The PMO also has the capacity to provide the evidence-based Recognizing and Responding to Suicide Risk: Essentials for Primary Care training to primary care physicians, which provides knowledge, tools, and resources to effectively screen, triage, refer, and treat those who are at risk for suicide in the primary care setting. These two “T4T” courses create the capacity and sustainability within Wyoming to begin to ensure that healthcare providers have training in the most recent evidence-based strategies in early identification and management of suicidal patients.
Muley Fanatics Partnership. Middle-aged and older males account for the most suicide deaths in Wyoming each year. In fall 2016, the PMO established a partnership with the Muley Fanatics Foundation (MFF), a hunting and wildlife conservation group, to educate its members on the dangers of tobacco and suicide. This outreach will occur through the promotion of suicide prevention education and tobacco cessation information through MFF’s social media platforms that reach more than 23,000 followers, as well as through its mailing list of 37,000 subscribers. This partnership will allow the PMO to get key messaging to an otherwise difficult to reach target population at significantly higher risk for suicide and tobacco use.
Crisis Text Line. In 2016, the PMO partnered with the Grace For 2 Brothers Foundation (GF2B) to bring to Wyoming a Crisis Text Line (CTL) that provides residents in crisis and at risk of suicide with anonymous, continuous crisis support. Anyone with a mobile phone with SMS capability has access to this free support by texting WYO to 741-741. The CTL employs specialists with training in crisis intervention to provide emotional support to anyone in crisis, as well as safety planning and referrals. With support from the Wyoming Department of Health and GF2B, the PMO is in the midst of a major roll out of the CTL that includes distributing 700 posters and 50,000 business cards to every high school and middle school in the state. On December 15, 2016, the PMO used our state and community Facebook pages to conduct a social marketing campaign to raise awareness about the CTL. The response was phenomenal– within the first ten days we had more than 46,000 impressions, 1,675 engagements, and 827 shares.
Crisis Intervention Team Capacity Building. The PMO has facilitated the expansion across Wyoming of Crisis Intervention Team (CIT) training—a 40-hour course that teaches law enforcement officers and first responders how to recognize individuals with mental health problems and to de-escalate situations that involve those individuals. This intensive training has gained increased recognition and support, as officers have experienced the positive benefits of early intervention with someone in crisis and the ability to immediately transfer the individual to mental health services for further care. Seven Wyoming communities have established CIT programs (Cheyenne, Laramie, Casper, Cody, Powell, Torrington, Gillette), two more are actively planning their CIT training program, and five locales have expressed high interest in starting a program. To support this growth, the PMO has developed a CIT Quickstart Toolkit, which includes tools and sample documents from CIT programs and tools to assist communities in establishing their own CIT program without needing to reinvent forms, strategies, and protocols.
Systems-Wide Suicide Prevention Training. The PMO has made evidence-based suicide prevention and intervention-level training an organizational priority. Indeed, the PMO’s strong infrastructure development and capacity-building efforts in suicide prevention have led to widespread system change across the state. In 2014, the State of Wyoming Suicide Prevention Plan set a benchmark of training ten percent (10%) of the adult population in Wyoming in suicide prevention by the year 2019–a goal that seemed more visionary than practical at the time. The PMO took on the challenge, and to date has conducted 1584 gatekeeper-level and intervention-level training, with more than 28,000 people trained in PMO-sponsored training workshops, and another 16,000 people trained through community partner initiatives for which we helped build capacity. As of the date of this submission, 44,630 Wyoming residents have been trained in suicide prevention, reflecting 8.9% of the state’s adult population. We believe this accomplishment is unequaled in any other state in the country.
Follow-Up Survey to Demonstrate Training Outcomes. Unsatisfied with being able to report only on the number of persons trained in suicide prevention, the PMO completed in 2016 a post-training follow-up survey to determine whether our training is effective in producing real results. There were 615 total responses to this survey, resulting in 550 completed surveys (an overall completed response rate of 89.4%). Of those who completed the survey, 239 participants (43.5 %) reported using the suicide prevention skills they learned an average of roughly three times, with a total of 680 interventions provided to individuals showing warning signs of suicide. Participants further reported that immediate emergency interventions (e.g., doctor, counselor, hospital) were provided to 175 individuals in crisis as a direct result of suicide prevention training provided or fostered by the PMO. In addition to crisis intervention, informal support was provided in 310 cases, safety plans were developed in 251 cases, and 289 individuals were referred to a professional caregiver. These are unprecedented outcomes that directly impact those at risk for suicide by connecting them with professional help. These survey results provide strong evidence that our commitment to universal suicide prevention training is producing life-saving outcomes and sparing families and individuals across Wyoming the heartbreak of losing a loved one to suicide.
Carbon County RSBT Ordinance. In the town of Rawlins, data from the community’s comprehensive needs assessment indicated the over-service of alcohol to adults was a significant problem that could be addressed by passing a local ordinance requiring retailers to have all staff complete a Responsible Beverage Server Training (RSBT). Our local CPS met with every liquor retailer to; (1) ensure they were educated on how a potential ordinance would affect their business, (2) gain retailer buy-in for RSBT; and (3) solicit retailers to personally appear before the city council to express their approval. In collaboration with the Rawlins Police Department, the City of Rawlins, the Responsible Community Task Force coalition, area residents, local alcohol establishments, the county attorney, and local judges, the PMO was successful in passing an ordinance that states: all persons who sell, distribute, or serve alcoholic or malt beverages in the licensed premises successfully complete the Alcohol Server Training Program promulgated by the State of Wyoming, within four months from the date the person begins to provide such services.”
Natrona County Demerit Point System. To address the problem of binge drinking in Natrona County, in 2013 our local CPSs began meeting with law enforcement to discuss the feasibility of adopting a Demerit Point System (DPS) – an administrative penalty levied on local retailers that are intended to act as a deterrent to prevent service to intoxicated individuals and minors. Over the course of several months, PMO staff met with local law enforcement officials, bar owners, and staff from local municipalities to determine the scope of work needed to revise existing ordinance language, and to solicit local support for the implementation of a DPS. By the end of 2013, there was a DPS in place in Casper, Midwest, Edgerton, Mills, and Bar Nunn. Enforcement of the ordinance is ongoing. Retired Casper Police Captain Steve Freel commends the partnership created with the PMO as a result of this endeavor, stating: “As a result of this work, I was able to recommend that the Natrona County PMO office be honored as the Casper Police Department’s Community Partner of the Year for 2 years in a row. Their staff did all of the behind the scenes work that made my job much easier.”
Sublette County Comprehensive Impaired Driving Reduction Program. On November 18, 2015, the Sublette County Prevention Coalition brought Ernie Johnson from the GCID to speak to policymakers and stakeholders about crime and alcohol. During the meeting, the group discussed the fact that 82.5% of Sublette County residents felt their community had a significant problem with impaired driving. Following the meeting, the PMO helped foster collaboration with the Wyoming Highway Patrol, Sublette County Sheriff’s Office, Circuit Court Judge Haws, the County Attorney, Sublette County Defense Attorney, and other stakeholders to develop and implement a driving under the influence (DUI) reduction campaign. An early accomplishment of the campaign was to get buy-in from local stakeholders for the universal imposition of a $750.00 fine for first-time DUI offenders, as opposed to the suspended sentence historically imposed in Sublette County.
To support Sublette County efforts to reduce impaired driving, we developed the “DUIs Blow” digital marketing campaign to inform and warn local residents of the dangers surrounding impaired driving. This campaign will run for twelve months and consists of three major media pieces including social media, newspaper, and radio. Social media will include Facebook, Instagram, Twitter, Snapchat and specific app development. Pulling from information generated by focus groups conducted by the PMO, we constructed a hyper-visual media campaign with locally-driven content aimed to reach our targeted demographic. The goals of the campaign are two-fold: (1) to educate local residents on the legal consequences of impaired driving and the $750 fine; and (2) to change the behavior of the highest-offending demographic (males aged 21-35). To date, the campaign has generated 12,799 total impressions, which translates into 127% of the Sublette county population. These impressions produced 887 post clicks and 379 interactions, which in turn have persuaded a number of community members with varying opinions to get behind the cause. Throughout the campaign, Sublette County PMO will provide increased TIPS training to local retailers.
Park County Marijuana Summit. On June 6, 2016, the PMO hosted a pioneering Marijuana Summit in Cody. The keynote speaker was Wilson Compton, M.D., Deputy Director of the National Institute on Drug Abuse of the National Institute of Health, who spoke on the importance of applying science to a public health approach to marijuana use. This event had more than 130 participants from across Wyoming, including law enforcement, primary care and mental health providers, educators, members of the faith community, and representatives of various business, social, and civic organizations. Following the Summit, Dr. Compton stated: “I was impressed by the dedication and interest of the coalition in Wyoming. … It was clear to me that learning from established science will be key to any policy and practice implementation in Wyoming.”
Teton County Gunlock Project. In any given year, two-thirds or more suicides in Wyoming and Teton County are by firearm. Given this alarming statistic, the PMO’s Teton County team identified reducing firearm suicides as a priority. Since May 2015, PMO Teton has distributed 3400 free gun locks locally through seventeen community partners, including social service organizations, healthcare and mental health providers, churches, law enforcement agencies, and community organizations such as the recreation center and library. In the process of giving away gun locks, local CPSs have been able to educate the public about the risk of firearms as it relates to suicide. According to a local Sheriff’s Deputy, one of our gun locks recently was used successfully to prevent harm in a high-risk situation with a potential for domestic violence and/or suicide. This initiative has rapidly spread from Teton County to communities across the state, and to date, the PMO has facilitated the distribution of 11,400 gun locks in the counties we serve.