DATE: September 10, 2019
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Adoption of Suicide Prevention Strategic Plan and Suicide Risk
Assessment Tool for Fresno County
RECOMMENDED ACTION(S):
TITLE
1. Adopt the Fresno County Community-Based Suicide Prevention Strategic Plan as the suicide prevention strategic plan for Fresno County; and
2. Adopt the Columbia-Suicide Severity Rating Scale as the recommended suicide risk assessment tool for Fresno County.
REPORT
Approval of the first recommended action will provide the County with a continued strategic framework to collaboratively approach, prevent, and respond to suicide. Approval of the second recommended action will provide a standardized tool for screening suicide risk in Fresno County. The recommended actions will help improve and enhance the continuity of care for those individuals who may be at risk of suicide or having suicidal ideation.
ALTERNATIVE ACTION(S):
Your Board may choose not to adopt the strategic plan and/or risk assessment tool, which may negatively impact county-wide suicide prevention efforts and services delivered to individuals who may be at risk of suicide.
FISCAL IMPACT:
There is no fiscal impact associated with the recommended action.
DISCUSSION:
On September 22, 2015, the Board approved Fresno County’s MHSA 3-Year Expenditure Plan which includes a Suicide Prevention/Stigma Reduction plan that was identified as a needed service through the MHSA community planning process. In January 2017, the Department of Behavioral Health contracted with three suicide prevention consultants through Purchasing Agreement P-17-223-T to develop a comprehensive, community-based, strategic suicide prevention and stigma reduction plan for Fresno County. On March 6, 2018, your Board approved an amendment to ensure the delivery of a completed suicide prevention plan for Fresno County. The strategic plan was finalized in September 2018 with the Columbia-Suicide Severity Rating Scale (C-SSRS) being one of various recommended universal strategies for implementation to ensure a comprehensive suicide prevention approach.
Although the plan was finalized and shared at the Board meeting on September 11, 2018, the plan was never formally brought before the BOS for adoption. With the adoption of the plan, Fresno County would have a uniform approach and framework to addressing and preventing suicide. Resources can be more accurately targeted and utilized in an efficient manner so individuals are connected to the level of care and support that would be most beneficial.
Adoption of the C-SSRS as the recommended tool for screening suicide risk utilized by all service providers in the system of care will enhance prevention efforts, care coordination and continuity of care, improve communication, and increase quality of care for those individuals who may be at risk of suicide or having suicidal ideation. The C-SSRS tool was recommended in the strategic plan, and stakeholders involved in the Suicide Prevention Collaborative has formally recommended adoption of C-SSRS as the screening to be used by organizations doing suicide risk screenings. This screening tool is available at no cost and is available in Spanish. The C-SSRS can be conducted by a wide array of persons. There are several versions of the C-SSRS for use in different settings, including screeners for first responders, schools and colleges, health care settings and facilities, military, correctional settings, as well as for parents and advocates. Additionally, the C-SSRS screening tool comes with a triage guide, which is vital in providing direction on next steps. Training of the tool will be supported by Department of Behavioral Health. Adoption and implementation of a standardized screening tool will assist in the prevention of suicide, and foster the goal of zero suicides in Fresno County.
In review of pending legislation, adoption of the plan is aligned with proposed Senate Bill 331, which will require all counties that do not already have a formal suicide prevention plan to have a suicide prevention plan in place by January 1, 2020. The bill has passed in the State Senate, and is in the Assembly’s Fiscal/Appropriations committee. The bill is expected to be approved by August 28, 2019. Thus, at all levels and in all committees, the bill has received unanimous bipartisan support. The bill is anticipated be to be passed and approved by the Governor in mid-September of this year. Fresno County’s plan is directly referenced as an example in the legislation and is used as a model plan for other counties. Fresno is one of just seven counties statewide that has developed such a plan. Should the two recommended items be approved, Fresno County would be one of the first counties to adopt a strategic plan and risk assessment tool.
REFERENCE MATERIAL:
BAI #4, September 11, 2018
BAI #31, March 6, 2018
BAI #5, September 22, 2015
ATTACHMENTS INCLUDED AND/OR ON FILE:
Fresno County Community-Based Suicide Prevention Strategic Plan
Example of Columbia Suicide Severity Rating Scale
CAO ANALYST:
Ronald Alexander