NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by a contract between the National Academy of Sciences and the Department of Veterans Affairs (#36C24524C0125). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-99520-7
Digital Object Identifier: https://doi.org/10.17226/29215

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242; https://nap.nationalacademies.org.

The manufacturer’s authorized representative in the European Union for product safety is Authorised Rep Compliance Ltd., Ground Floor, 71 Lower Baggot Street, Dublin D02 P593 Ireland; www.arccompliance.com.

Copyright 2025 by the National Academy of Sciences. National Academies of Sciences, Engineering, and Medicine and National Academies Press and the graphical logos for each are all trademarks of the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2025. Development, Implementation, and Evaluation of Community-Based Suicide Prevention Grants Programs: Proceedings of a Workshop. Washington, DC: National Academies Press. https://doi.org/10.17226/29215.

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. Tsu-Jae Liu is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

Rapid Expert Consultations published by the National Academies of Sciences, Engineering, and Medicine are authored by subject-matter experts on narrowly focused topics that can be supported by a body of evidence. The discussions contained in rapid expert consultations are considered those of the authors and do not contain policy recommendations. Rapid expert consultations are reviewed by the institution before release.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

WORKSHOP ON BEST PRACTICES FOR IMPLEMENTATION AND EVALUATION OF A NON-CLINICAL COMMUNITY-BASED SUICIDE PREVENTION GRANTS PROGRAM PLANNING COMMITTEE

CARL A. CASTRO (Chair), University of Southern California

DIANA E. CLARKE, American Psychiatric Association

DANIEL J. FRIEND, Mathematica

BERNICE A. PESCOSOLIDO, Indiana University Bloomington

ELLYSON R. STOUT, EDC

COLIN G. WALSH, Vanderbilt University

Staff

TINA M. WINTERS, Project Director

SHARON BRITT, Program Coordinator

DANIEL J. WEISS, Director, Board on Behavioral, Cognitive, and Sensory Sciences

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

LISA BRENNER, University of Colorado Anschutz Medical Campus

GILLY CANTOR, D’Aniello Institute for Veterans and Military Families at Syracuse University

COLLEEN CARR, National Action Alliance for Suicide Prevention

KATRINA MESSER, U.S. VETS

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by NADINE KASLOW, Emory University School of Medicine. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

Acknowledgments

The Board on Behavioral, Cognitive, and Sensory Sciences expresses its sincere gratitude to the members of the workshop planning committee for their leadership in developing an agenda that supported informative presentations and rich discussions. The Board also thanks the invited speakers, whose expertise and thoughtful engagement made the workshop a success. We are deeply grateful for the generous support of the U.S. Department of Veterans Affairs (VA), and to VA Office of Suicide Prevention staff members Bruce Crow, Sandra Foley, Melissa Hall, and Michelle Kuntz for their collaboration and guidance throughout the planning process.

The Board also wishes to thank Sharon Britt for her invaluable contributions to the coordination and execution of this project; Bea Porter for her careful edit of the proceedings, as well as her contributions to Chapter 5 and the publication process; Kirsten Sampson Snyder for her oversight and guidance during the review and publication process; and Anthony Janifer for his support during the review process.

Contents

Acronyms and Abbreviations

1 Introduction

WORKSHOP GOALS AND INTRODUCTORY PERSPECTIVES

ORGANIZATION OF THIS PROCEEDINGS

REFERENCES

2 Setting the Stage: Examples of Non-Clinical Community-Based Suicide Prevention Programs

USAA FACE THE FIGHT INITIATIVE

Face the Fight Structure and Collaborative Model

Face the Fight Impact and Data-Driven Strategy

Examples of Funded Activities

VIRGINIA DEPARTMENT OF VETERANS SERVICES SUICIDE PREVENTION AND OPIOID ADDICTION SERVICES PROGRAM

Program Launch and Growth

Grantee Diversity and Impact

WHITE MOUNTAIN APACHE CELEBRATING LIFE SUICIDE PREVENTION PROGRAM

Tribal Context and Early Response to Suicide

The Celebrating Life Surveillance and Case Management System

Celebrating Life Program Impact

GARRETT LEE SMITH AND NATIVE CONNECTIONS SUICIDE PREVENTION PROGRAMS

Origin and Structure of the GLS Program

Evaluation Findings, Impact, and Program Reach

Native Connections Program

REFERENCES

3 Considerations for Program Development and Oversight and Grantee-Level Implementation and Performance Metrics

FOUNDATIONAL PRESENTATIONS

Theory of Change, Theory of Action, and Performance Metrics

The Public Health Approach and Comprehensive Suicide Prevention

Models for Effective Community Suicide Prevention

Developing Logic Models for Community-Based Suicide Prevention

Comprehensive Technical Assistance to Support Program Outcomes

Design of Actionable Dashboards for Supporting Program Implementation and Oversight

PANEL DISCUSSIONS AND AUDIENCE Q&A

Lessons Learned from Examples of Non-Clinical Community-Based Suicide Prevention Efforts

Expert Insights on Program Development and Oversight and Grantee-Level Implementation and Performance Metrics

Audience Q&A

REFERENCES

4 Considerations for Program Evaluation

LESSONS LEARNED AND EXAMPLES FROM THE FIELD

From Program Evaluation to Comprehensive, Community-Based Suicide Prevention Evaluation: Lessons Learned from the Field

Multi-Site Community-Based Suicide Prevention Program Evaluation: An Example from the Field

PANEL DISCUSSION AND AUDIENCE Q&A

Evolution of Program Design and Administration Based on Evaluation Findings

Best Practices for Balancing Evaluation Across Multiple Levels

Using Intermediate Indicators to Track Progress Toward Suicide Prevention Goals

Grantee Involvement in Evaluation and Building and Sustaining Capacity Over Time

Audience Q&A

5 Communicating Program Results

STRATEGIC COMMUNICATION AND DATA STORYTELLING

Best Processes for Strategic Communication of Program Results

Data Storytelling: Best Practices for Communicating Impact

PANEL DISCUSSION AND AUDIENCE Q&A

Tailoring Communication to Different Audiences

Evaluating Communication Strategies

Sharing Academic Literature Effectively

Audience Q&A

REFERENCES

6 Reflections on Workshop Themes

PROGRAM DESIGN

PROGRAM IMPLEMENTATION

PROGRAM EVALUATION

DEFINING AND COMMUNICATING SUCCESS

CONCLUSION

Appendix A Workshop Agenda

Appendix B Biosketches

Box, Figures, and Tables

BOX

1-1 Statement of Task

FIGURES

2-1 Visualizing Face the Fight’s impact

2-2 Centers for Disease Control and Prevention (CDC) evidence-informed strategies and dynamic data modeling

2-3 Virginia Department of Veterans Services Suicide Prevention and Opioid Addiction Services (SOS) Community Grant first year outcomes

2-4 Screening tools used by Virginia Department of Veteran Services Suicide Prevention and Opioid Addiction Services (SOS) grantees

2-5 Suicide attempts and deaths among the White Mountain Apache Tribe

2-6 Suicide death rates for U.S. youth ages 10–24, by race

2-7 Impact of Garrett Lee Smith (GLS) programming by duration of exposure

2-8 Map of Garrett Lee Smith (GLS) state and tribal grantees, FY 2021

3-1 Psychoeducational resilience-building workshop as an illustrative example of a cohesive theory of change

3-2 Why do performance measurement?

3-3 Public health approach to suicide prevention

3-4 Suicide rates by age group and sex, 1999 versus 2023

3-5 Suicide rates by race and ethnicity and sex, 1999 versus 2023

3-6 Veteran and non-veteran suicide rates, 2001 to 2022

3-7 Scope of suicide-related thoughts and behaviors among U.S. adults, 2021

3-8 Illustrative model for suicide prevention across the continuum of risk

3-9 What to implement for effective community suicide prevention: Suicide Prevention Resource Center (SPRC) comprehensive approach

3-10 How to do effective community suicide prevention: Suicide Prevention Resource Center (SPRC) strategic planning approach

3-11 Logic model layout and terminology

3-12 Logic model development and example

3-13 Comprehensive technical assistance example

3-14 Data dashboard actionability

3-15 Actionability as a design process

4-1 Nested evaluation model for suicide prevention

4-2 Principles of participatory evaluation in community-based suicide prevention

5-1 The COM-B model of planning behavioral interventions and a “typical” logic model of the policy process

5-2 Think about the desired outcome and work backward to develop communication strategies

5-3 Crafting a narrative: Mapping data storytelling to a classic story arc using context, characters, climb, consequence, and conclusion

5-4 Types of visualization: Examples of tools to communicate quantitative and qualitative data

5-5 Quantitative “before and after,”

5-6 Qualitative “before and after,”

TABLES

2-1 Comparison of the Grant-Making Components of the Garrett Lee Smith (GLS) Program

3-1 Comprehensive Suicide Prevention Strategies and Approaches

Acronyms and Abbreviations