PREVENTS Executive Order
On March 5, 2019, President Donald J. Trump signed Executive Order (EO) 13861: The President's Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS), with a call to action to amplify and accelerate the progress in addressing Veteran suicide in the United States. Answering this call to action requires an aspirational, innovative, all-hands-on-deck approach to public health — not government as usual. EO 13861 is a Cabinet-level, interagency effort to develop the first Federally coordinated national public health strategy to address Veteran suicide. Building on previous work, PREVENTS elevates and amplifies existing suicide prevention efforts and addresses identified gaps observed within the existing environment of suicide prevention.
The vision of PREVENTS is to prevent suicide, which requires culture change, seamless access to care, a connected research ecosystem, and robust community engagement. To achieve these ambitious goals, an integrated action plan is needed to develop, implement, and evaluate programs, research, policies, and a communication campaign. Ten recommendations have been created to guide the direction of the action plan. Over 150 subject matter experts from more than 15 Federal agencies have (1) identified the most critical problems for existing suicide prevention efforts, (2) carefully studied existing background information to understand the current state, (3) conducted detailed analysis of potential solutions, and (4) recommended next steps for solving each problem.
To ensure effective execution and coordination among and between Federal agencies, each of the Roadmap recommendations falls into four priority focus areas: programs, research, policies, and communication strategies.
2020 Priority Focus Areas
PREVENTS will prevent suicide within the Veteran community — and lead the way in preventing suicide for all Americans — by employing a public health approach to empowering every individual through a nationally driven, community-implemented four-part integrated strategy.
Communications Campaign: Develop and drive a national public health campaign.
What success looks like:
- Strong awareness of risk factors for suicide and the adoption of help-seeking behaviors among all communities and Veterans in particular
- Culture of openness, support, and belonging surrounding the topic of suicide and mental health more broadly.
Research: Prioritize precision suicide intervention and enhance the federal research ecosystem.
What success looks like:
- Prevention and intervention methods tailored to each Veteran's unique suicide risk profile
- Enhanced federal research ecosystem — promote team-based research approaches, public-private partnerships, shared resources, and frequent engagement with government funders and regulators
Programs: Scale data-backed programs at the community, local, state levels.
What success looks like:
- Streamlined access to comprehensive end-to-end mental health and suicide prevention care for all communities and with a specific focus on Veterans
- Active suicide prevention initiatives and conversations by workplaces, schools, faith-based communities, and other stakeholder organizations
Policies: Develop and support policies to improve prevention.
What success looks like:
- Legislative proposal that drives grant funding to communities, enabling them to increase collaboration and integration of services to Veterans
- Universally driven and adopted policies that allow for more coordinated, action-oriented research and the implementation of evidence-based suicide prevention programs
- Create and implement a national public health campaign focused on suicide prevention for Veterans and all Americans.
- Identify and prioritize suicide surveillance and research that focuses on a Veteran's unique combination of individual, relationship, community, and societal factors to deliver the most effective intervention(s) tailored to meet their needs and circumstances.
- Promote foundational changes to the way research is conducted — including improving the speed and accuracy with which research is translated into practice, improving efficiency through data sharing and data curation practices, and using innovative funding techniques to drive team science and reproducibility.
- Develop effective partnerships across government agencies and nongovernment entities and organizations to increase capacity and impact of programs and research to empower Veterans and prevent suicide.
- Encourage employers and academic institutions to provide and integrate comprehensive mental health and wellness practices and policies into their culture and systems.
- Provide and promote comprehensive suicide prevention trainings across professions.
- Identify, evaluate, and promote community-based models that are effectively implementing evidence-informed mental health and suicide prevention programs across the country. In doing so, they should leverage relationships with community-based efforts, non-profit organizations, faith-based communities, VSOs, and MSOs focused on saving the lives of Veterans.
- Increase implementation of programs focused on lethal means safety (e.g., voluntary reduction of access to lethal means by individuals in crisis, free/inexpensive and easy/safe storage options).
- Develop a coordinated, interagency Federal funding mechanism to support, provide resources for, and facilitate the implementation of successful evidence-informed mental health and suicide prevention programs focused on Veterans and their communities at the State and local levels.
- Streamline access to innovative suicide prevention programs and interventions by expanding the network of qualified healthcare providers.
PREVENTS 2020 Priorities
The PREVENTS Office deemed the following opportunities, including a national public health campaign, enhanced research environment, and Suicide Prevention Grand Challenge Competition among others, to be high impact initiatives, and therefore high priority for the success of the national Roadmap. The PREVENTS Office has begun to leverage its resources and partnerships to make critical progress advancing these 2020 Priorities.
Priority 1: National public health campaign
Research, test, refine, and launch a national public health campaign across the United States, partnering with every agency in the Task Force, as well as with non-governmental organizations, corporations, faith-based leaders, and sub-populations to provide targeted messaging that empowers the public to recognize risks and protective factors through high visibility channels.
- Began concept testing and market research
- Tracking lessons learned in terms of process and outcomes from the #MoreThanEverBefore campaign to inform the REACH campaign
Priority 2: Enhance research
Accelerate scientific discovery through structural changes, policy, and incentives, which includes prioritizing suicide prevention research that promotes interventions that factor in a person's unique combination of individual, social, and environmental risk factors.
- Convened a Research Implementation kick-off to determine the structure and nature of interagency coordination with PREVENTS and the Office of Science and Technology Policy
- Developed a comprehensive list of available data sets across government agencies, including, purpose, study sample, data collection, variables, and products
- Developed agency specific strategies to formulate roles and responsibilities for each agency based on the data sets related to PREVENTS and ongoing agency efforts
- Published a Request for Information in the Federal Register on July 3, 2019 to solicit broad input on the seven elements described by the Executive Order
- Received 608 individual and 114 organization responses which provided details regarding promising suicide prevention actions and programs
Priority 3: State, local, and community grant program(s)
Leverage existing federal agency funding priorities to support PREVENTS state, local, and community grants, and prepare for grant implementation.
- Reviewed all PREVENTS Roadmap recommendations against feasibility and impact criteria to develop an overarching implementation process that promotes sustainability and lasting positive effects
- Developed a state-local data implementation plan to ensure that states and communities have timely access to relevant information that will support data driven implementation and evaluation of strategies appropriate for the communities depending on their unique needs
- Identified existing funded grant by agency, state in which the grant recipient resides, program type, and amount for PREVENTS related projects
- Created a database to track all ongoing grant opportunities focused on Veterans, mental health, suicide prevention, and community outreach in an effort to begin coordinating with Task Force agencies and amend programs to focus on empowering Veterans
Priority 4: State, local, and community integration, activation, and collaboration empowerment campaign
Increase capacity at all levels to begin or enhance existing implementation (prior to grant administration in initiative three above) of PREVENTS recommendations to prevent suicide; promote a stronger sense of belonging and purpose among community members, including Veterans; and build collaboration through convening stakeholder groups, including faith-based communities, universities, non-profits, entertainment industry, insurance providers, and philanthropies.
- Visited five states (Texas, Arizona, Tennessee, Florida, and California)
- Developed implementation plans for recommendations and began initiating outreach with states and communities
- Developed a system to engage with interested parties, sharing PREVENTS updates, beneficial resources, and opportunities for state, local, community, and tribal community engagement
- In partnership with the Veterans Experience Office, Office of Mental Health and Suicide Prevention, Defense Suicide Prevention Office and VA Chaplaincy, PREVENTS coordinated and developed a PREVENTS suicide prevention survey which is in its final stages of gaining OMB Clearance
- Worked with VA's Office of Mental Health and Suicide Prevention (OMHSP) and SAMHSA to incorporate PREVENTS into all Governors Challenge Policy Academies in FY 20
- Worked with OMHSP and SAMHSA to present and provide information to all current Governors and Mayors Challenge State Team Leaders
Priority 5: State proclamations
Engage all 50 states, territories, and tribal communities to participate in the PREVENTS effort by signing a PREVENTS Proclamation outlining agreed-upon practices and steps. State proclamations will also allow states that are not already engaged with the Governor's Challenge to become involved with this initiative or a similarly coordinated effort.
- Worked with PREVENTS working groups to draft a State Proclamation Template which will be delivered to State Governors Offices formally requesting their support
- Received approval on State Proclamations Pledge and submitting formal requests for State Governors to sign State Proclamation Pledge on or before September 10, 2020
- Working with the VSO/MSO community, the National Association of State Directors of Veterans Affairs, Ambassadors and other PREVENTS partners to identify champions in each state to assist in obtaining each Governor's Office concurrence and pledge of support
Priority 6: PREVENTS Ambassadors' program
Identify, confirm, and train at least 50 high-profile individuals to champion PREVENTS messaging at events and through other relevant opportunities to raise awareness and empower the public to prevent suicide; PREVENTS will also identify and develop a community of national and state level Ambassadors.
- Confirmed 18 key Ambassadors to amplify PREVENTS messaging, including Karen Pence, Second Lady of the United States and Vice Admiral Jerome Adams, MD, MPH, U.S. Surgeon General of the United States
Priority 7: PREVENTS employer pledge and toolkit
Engage employers representing at least 25% of the national workforce to commit to prioritizing mental health and well-being in the workplace.
- On November 13, 2019, the U.S. Chamber of Commerce Foundation's Hiring Our Heroes hosted a signing ceremony for companies committing to prioritizing the mental health and wellness of employees. Organizations representing more than 6 million employees have signed the PREVENTS employer pledge
Priority 8: Suicide Prevention Technology Challenge
Launch an interagency challenge to promote innovation in the field of suicide prevention, including innovation in the approach to access and delivery of suicide prevention efforts.
- Signed a Memorandum of Agreement with VA's Innovation Center to formalize the intra-agency partnership in supporting the Suicide Prevention Grand Challenge Competition. The Suicide Prevention Grand Challenge Competition presents an opportunity to bring together evidence-based solutions — including resources, tools, programs, and services — in an effective, user-focused marketplace-platform to advance mental health education, assessment, and treatment. This Challenge will revolutionize mental health care and suicide prevention through a technology-based marketplace that connects individuals to resources in a meaningful, efficient, evidence-based way.
- Developed PREVENTS Suicide Prevention Grand Challenge Competition Statement
- Developing an outreach plan to promote the PREVENTS Suicide Prevention Grand Challenge Competition in collaboration with VA's Innovation Center
Priority 9: Professional credentialing and certification
Work with partner organizations inside and outside of government so that partners can develop and share best practice examples of core curriculum to include mental health and well-being, social connectedness, and suicide prevention, intervention, and postvention by profession across all states.
- Establishing partnerships with professional bodies and credentialing agencies. Formal MOUs and MOAs have been established with:
- American Medical Association
- American Psychological Association
- National Association of Social Workers
Since July 22, 2019, when Dr. Barbara Van Dahlen was appointed as Executive Director of the PREVENTS Office, the Office has marked a number of critical milestones. To date, the Office has:
- Established committed working groups of more than 150 stakeholders across more than 11 federal agencies to create the PREVENTS Roadmap
- Held state visits, including townhall events and meetings with state and local government officials, local community collaboratives, state and VA Suicide Prevention Coordinators, first responders, and Veteran Centers in Texas, Arizona, Tennessee, Florida, and California to elevate and amplify PREVENTS work, and garner buy-in for the initiative
- Completed the PREVENTS Roadmap, as well as Supplemental Materials for the Roadmap, outlining a comprehensive, national strategy for changing how the United States treats mental health and understands suicide prevention. The Office adjudicated over 2,374 comments from 11 federal agencies who reviewed and provided input on the Roadmap
- Established PREVENTS Facebook and Twitter accounts, which have garnered 106,635 impressions on Facebook (with an average of 792 impressions per post) and 1,118,685 impressions on Twitter (with an average of 5,850 per tweet) since their inception
- Created and launched the PREVENTS website: www.va.gov/prevents/
- Launched the More Than Ever Before (MTEB) public awareness campaign to support the mental health of Veterans and all Americans during COVID-19
- Begun to identify, engage, and leverage a community of influential PREVENTS Ambassadors to bring awareness to suicide prevention. So far, the Office has secured 18 Ambassadors, including the Second Lady and the U.S. Surgeon General
Upon the release of the Roadmap, the PREVENTS Office will kick off a formal Launch Week, which will include the launch of the PREVENTS National Public Health Campaign as well as cross-sector engagement through events with faith leaders, corporations, survivors of suicide, and more.
In the coming months, the PREVENTS Office will also take the following action to advance PREVENTS 2020 Priorities:
- Convene interagency action teams to advance PREVENTS 2020 priorities
- Launch a suicide prevention survey to provide insight related to Veterans' experiences accessing services and resources
- Build a resource map that will pinpoint suicide prevention resources offered at the state, local, and national levels
- Work with state governors to encourage states to formally declare their full support for the implementation of the PREVENTS Roadmap
- Expand the national and state cohort of PREVENTS Ambassadors championing PREVENTS messaging at events and through other relevant opportunities
- Kick off the joint PREVENTS Office and VA Innovation Center Prevention Grand Challenge Competition aimed at developing a technology-based platform that will serve as a resource of evidence-based mental health and suicide prevention solutions
- Work with partners to assess existing professional credentialing and certification requirements related to suicide prevention and mental health, and develop a plan to meet any gaps