Public Policy Update

Legislators and the American public are often skeptical when they hear the clamor for a new federal program. But now and then, there is a collective recognition that a problem needs fixing and a federal initiative could address a problem that is real, urgent and pressing.

The Garrett Lee Smith Memorial Act is an example of one such initiative. This law, passed in October 2004, provides federal support broadly for youth suicide-prevention activities through state entities and a technical assistance center.

In addition, within that new law, a program was created to provide matching grants to 22 college campuses that provide mental and behavioral health services. Modest as it is, the federal investment is changing the landscape of campus-based suicide-prevention initiatives.

In the United States today, suicide is the third leading cause of death for young people ages 15 to 24, surpassed only by accidents and homicide, according to the U.S. Centers for Disease Control and Prevention (CDC). Indeed, the program grew out of personal tragedy in the life of Sen. Gordon Smith (R-Ore.) and his family. The senator's 21-year-old son, Garrett, committed suicide in September 2003.

Here are examples of how a few of the programs, funded in fiscal year 2005, will focus on the mental and behavioral health needs of students on campus with a specific concentration on suicide prevention. These new programs are being administered by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Arizona State University

The need for a suicide-prevention program is especially critical at Arizona State University (ASU), given that it is one of the country's largest and fastest-growing higher-education institutions. ASU has more than 57,000 undergraduate, graduate and professional students. According to a 2005 CDC report, the suicide rate for students ages 20 to 24 in Maricopa County, most of whom attend ASU, is 24.1 per 100,000 students, significantly higher than the national average for students in the same age category (15.3). The program in place before the grant of $75,000 was "understaffed in relation to the demand for service," as well as devoid of widespread training and appropriate informational materials, according to the ASU grant application.

With its grant, ASU is targeting 818 freshman students who reside in Manzanita Hall. Since 86 percent of students from the hall frequent the student recreation complex, an important component of this plan is training recreation complex employees to identify students at risk of suicide and refer them for services at ASU's Counseling and Consultation Center. Years two and three of the ASU program will include a second residential area.

Another area of concern is the lack of in-depth, ongoing, extensive training in suicide prevention available to ASU faculty, staff and administrators as well as the lack of educational materials on the topic of suicide prevention. Comprehensive training, improved informational materials and an expansion of available services, including those offered by undergraduate peer advocates along with Counseling and Consultation graduates will address the areas of need in ASU suicide-prevention efforts.

University of Wisconsin-Oshkosh

While the number of suicides at the University of Wisconsin-Oshkosh (UWO) has remained relatively stable over the last several years, the UWO Counseling Center reports that suicidal ideation "has become an epidemic." The recent American College Health Association survey administered at UWO found that 1.3 percent of students actually attempted suicide, while 11.4 percent reported "seriously considering suicide in the past year." As a result, the need for an appropriate suicide-prevention plan, along with access to mental and behavioral health services, has become a top priority.

The stigma associated with seeking mental health services is of particular concern for UWO, where 60 percent of students are first-generation college students. These students are more likely to come from backgrounds in which their families have stigmatized the use of mental health services. This only heightens the importance of education campaigns aimed at raising awareness.

The underlying theme of the UWO $75,000 grant is to "educate and empower the campus community, student leaders and students themselves to identify, question, persuade and refer struggling students." One of the largest project undertakings is training faculty, resident-life advisers and students to identify and refer students who show risk for suicide. The program also seeks to break down barriers impeding the utilization of mental and behavioral health services through projects such as expanding the university's counseling center and adding information on depression, suicide and substance abuse to its outreach campaign. The university also aims to develop new materials and strategies to reach out to students and their families, with a focus on minority populations.

Blue Mountain Community College

Jump-started into action after two suicides during the 2003-2004 academic year, Blue Mountain Community College (BMCC), in Pendleton, Ore., conducted a comprehensive review of its institutional services, policies and procedures. After this tragic wake-up call, BMCC applied for and was awarded $73,000 during the first wave of the grant process.

The funding has been a boon to the college, says its director of grants, Susan Plass.

"As a rural community college covering an 18,000 square mile service area, we are starting the project with virtually no college services or expertise in mental and behavioral health or in suicide prevention," says Plass. "Our most rewarding experience to date has been SAMHSA's support-from the encouragement and advice of our program officer to the informative national conference in December to the extraordinary work being done nationally on cross-site evaluation procedures."

The college is using the money to strengthen both the widespread community networks and its internal infrastructure to better provide suicide-prevention services, according to Plass.

BMCC's plan seeks to establish connections with existing community services and create new programs and services on campus. One of those important connections is linking BMCC and the recently formed Umatilla-Morrow Emergency Response Crisis Management Coalition, which was established with a grant from the U.S. Department of Education. This partnership will allow the college to tap into the network of mental health providers along with other organizations and agencies.

Other outside resources providing BMCC with information on mental and behavioral health, research and funding opportunities are the Garrett Lee Smith Memorial Library at St. Anthony Hospital in Pendleton, the Northwest Chapter of the American Foundation for Suicide Prevention and the Oregon Health Department. There is considerable hope riding on the federal grant program, according to APA policy staff. This year, the federal investment in the program climbs to $5 million, supporting a number of new grants. That translates into a significant number of students whose lives will be potentially saved or improved as a result of being able to receive the sort of support necessary to address their mental and behavioral health needs-needs that would otherwise have remained unmet save for a small bite of the federal pie.

The application deadline for proposals for the FY 2006 cycle is May 16. The application can be accessed at www.samhsa.gov/news/newsreleases/060330_campus.htm. For more information about the Garrett Lee Smith Memorial Act, visit www.apa.org/ppo/education.

Matthew R. Whiting is an education public policy intern and Jennifer Beard Smulson is the senior legislative and federal affairs officer in APA's Education Public Policy Office.