2022 COMBAT Funding: $160,534.00

In ReDiscover's Own Words

The Zero Suicide program was initially implemented in 2018 to reduce youth suicide through an integrated systems-level approach. The program leverages existing resources by improving coordination, building linkages and filling gaps in service delivery.

Nearly 400 Children & Youth Served

COMBAT funds provide services to 350-400 children and youth, ages 10-19, and their families in Jackson County. Youth served are female (71%), male (22%), unknown (3.5%) and transgender (3.5%). Racial/ethnic demographics served include 71% Caucasian, 12% African American, 15% Other/Mixed/Biracial and 2% Hispanic/Latino. 

Of the youth served, 25% identify as lesbian, gay, bi-sexual, transgender, and questioning (LGBTQ+). 

Program participants are Medicaid and CHIP beneficiaries (23%), have private insurance (26%) or are uninsured (24%). 

Healthcare coverage often does not fully cover services offered by Zero Suicide, creating service gaps for underinsured individuals.

Those Zero Suicide primarily helps are some of the most traditionally underserved: predominately females (74%) and LGBTQ+ (31%). The average age of children enrolled in Zero Suicide was 15 years in 2019, with children as young as seven receiving services.

Services/Activities Provided

Services include screening, crisis intervention, intensive case management and follow-up procedures. Zero Suicide differentiates itself from typical suicide programming in that it emphasizes engagement, retention and delivery of high-quality, trauma-informed and meaningful treatment. 

The program provides comprehensive and individualized services in an extensive geographic area of multicultural communities, establishes partnerships, collaborations, and strategic alliances to enhance services, and provides trauma-informed education and support to individuals, families and the community. COMBAT-funded staff conduct suicide prevention activities and awareness using a trauma-informed approach. Once a client is identified, engaged and stabilized (typically 90 days), staff provide ongoing and follow-up services within the existing behavioral health delivery system (typically according to service area).

Program Activities

Program activities involve four stages:

• Stage 1 - hospital and/or school contacts ReDiscover to screen/assess and provide short-term stabilization for at-risk youth; 

• Stage 2 - intensive case management and assertive outreach activities take place; 

• Stage 3 - behavioral health services based upon participant’s residence are given; and

• Stage 4 - support services are coordinated.

At-Risk Identified By Hospitals & Schools

Zero Suicide screens at-risk youth identified by hospitals and schools. In hospital settings, they complete on-site evaluations, next-day transfers and link to outpatient services upon discharge. Practitioners arrange services and deliver short- and long-term interventions and collect and enter youth information into ReDiscover’s electronic medical record (EMR). 

In school settings, practitioners screen at-risk youth, as identified by school personnel or other organizations (foster care, court systems, drop-in centers, etc.). They provide assertive outreach, engagement and linkage to youth after discharge. Finally, they collect and enter data into the EMR.

Missouri Suicide Surveillance System

The project utilizes Missouri Suicide Surveillance System (MOSSS), which contains information from youth obtained during their follow-up care management. During a first encounter with a Zero Suicide practitioner, youth complete a brief intake form and two screenings: the Columbia Suicide Severity Rating Scale (C-SSRS) and Patient Health Questionnaire (PHQ-9). 

Results are entered into MOSSS. The program manager facilitates weekly team meetings to discuss cases, weekly supervision with practitioners, monthly brainstorming with Tri-County Mental Health Services and others community agencies, and monthly fiscal discussions with the finance director and clinical director.

Trying To Main A Low Staff-Client Raito

The current staff-client ratio is 1:35 and COMBAT funds will ensure this low ratio continues. For active clients, those needing one or more weekly meetings, the ratio is approximately 1:18; an additional twelve maintenance-level clients are seen bi-weekly or monthly. Length of stay is typically 90 days, with a range of 30 to 180 days. Staff provide services in hospitals, schools, homes, and within the community. 

COMBAT funds support the program manager position, who coordinates suicide prevention and education activities and training using a trauma-informed approach for faculty and staff across Jackson County. Major milestones include:

• the delivery of Zero Suicide services to existing and newly-identified schools and hospitals

• the delivery of suicide prevention and health education to students, faculty, hospital personnel, and general public, including suicide prevention education and outreach for the Mayor’s Challenge for Suicide Prevention (ReDiscover is lead)

• development of policies and protocols (schools, hospitals, clinics, etc.)

• implementation and sustainability of Missouri Suicide Prevention Network

• and improved health outcomes and reduced suicide attempts and costs

Program Goals and Expected Outcomes

1) improve the system of care for suicidal youth who use hospital emergency departments, in-patient psychiatric facilities, and/or crisis hotlines; 

2) improve capacity of the school systems to identify, respond, and refer youth at risk; 

3) strengthen overall prevention efforts for at-risk youth populations in other settings. ReDiscover will leverage COMBAT funds with government funding (Substance Abuse and Mental Health Services Agency, SAMHSA) funding to build trauma-informed schools and communities to reach more youth and mitigate the effects of trauma and prevent suicide. 

In 2019, ReDiscover accomplished the following:

• 2,778 individuals attended one of 58 Zero Suicide trainings - 74% were specifically geared towards youth, 79% were in-person (21% online), and 21% included behavioral rehearsal/role-playing.

• ReDiscover received 279 total referrals; 91.4% (255) were enrolled in the Zero Suicide program.

• 60% of children were referred to Zero Suicide by schools, the rest from hospitals or internal or other referral sources.

• At enrollment in Zero Suicide, 92.2% youth reported having suicidal ideation, with 48.2% reporting self-injury.

• At the three-month assessment mark, the percentage of youth who reported suicidal behavior decreased by 63.7%. 

• Youth mood and behavior changed dramatically for the better after the three-month assessment:

– Percent of youth who felt depressed or sad most days decreased by 44.8%. 

– Percent of youth who reported deliberately hurting themselves decreased by 45.8%.

– Percent of youth with at least one suicide attempt decreased by 65.1%.

– Percent of youth who reported having access to firearms decreased by 2.7% after the three-month assessment.

– There was an increase of 20.3% of youth enrolled in a long-term behavioral health treatment program in the community by the three-month assessment mark.

ReDiscover has served over 10,000 children within the four years of Zero Suicide’s inception, and this number continues to grow exponentially each year. Since the 2018 implementation of ReDiscover’s Zero Suicide program in various schools throughout Jackson County, the suicide rate has gone down 5.8%.