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The Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services (HHS), responds directly to the national mental health crisis brought on by the pandemic. Realizing that the effects of the pandemic on populations at risk needed to be addressed, SAMHSA offered the 2020 COVID-19 Emergency Response for Suicide Prevention (COVID-19 ERSP) grants. As a recipient of one of these grants, Tarzana Treatment Centers, Inc. (TTC) is ready to help stem the tide of hopelessness and despair by providing neededsuicide prevention services. As Clinical Director of TTC, Dr. Ken Bachrach is leading the team that has been implementing the grant’s objectives.

COVID-19 ERSP and Tarzana Treatment Centers

Dr. Bachrach describes the methodology of implementing those objectives within the TTC framework, saying, “Tarzana Treatment Center has always been dedicated to providing whole person, integrative care. Now, with the COVID-19 pandemic, many people are experiencing great stress. Such stress leads to increased thoughts, actions, and behaviors related to suicide. This grant is an opportunity for us to help these individuals and provide the necessary services that they need.”

The description of the Saving Lives Project relates directly to this implementation. As defined by HHS and “authorized by the CARES Act, SAMHSA is seeking to award $40 million for follow up with adults who have attempted suicide or experienced a suicidal crisis following discharge from psychiatric facilities or emergency rooms. These funds also are intended to facilitate patient follow up and train clinicians and community members, facilitate community planning and conduct screening.”

According to SAMHSA, there are over 57.8 million Americans living with mental and/or substance use disorders (National Survey on Drug Use and Health, 2018). Thus, the number of people at risk before the COVID-19 pandemic was high. Moreover, suicide is the tenth leading cause of death in the United States. Given the pressures brought on by the COVID-19 crisis, SAMHSA correctly postulated a surge in the number of Americans needing urgent care to address numerous mental health needs.

Suicide Risk and Mental Health Issues

Here is a partial list of mental health issues aggravated by the COVID-19 pandemic. Any of these issues can result in an increase in the suicide risk for an individual:

1. Depression
2. Anxiety
3. Trauma
4. Grief
5. Isolation
6. Loss of employment
7. Financial instability

Such challenges can increase the likelihood of suicidal thoughts and suicidal behaviors. Thus, the COVID-19 ERSP program will increase local efforts to prevent suicide and suicide behaviorsamong adults age 25 and older, particularly people already at risk. The goal of the program is to reduce the overall suicide rate and number of suicides in the United States during this stressful time when economic difficulties and fears are aggravating already dangerous conditions.

Mitigating Suicide Risk through Effective Implementation

Tarzana Treatment Centers (TTC)is helping to make that goal a viable reality in Southern California through identifying those at risk for suicide who enter TTC’s system of care or who are identified at local hospital emergency departments. When asked about the program funded by the grant, Dr. Salma Wahidi, Program Director and Clinical Supervisor of the Saving Lives Project describes the process of TTC’s implementation.

Dr. Wahidi explains, “So far the implementation has been going well. Although working in the context of the COVID-19 pandemic leads to a whole new set of challenges, we have been assessing and screening all the patients that come in through Tarzana Treatment Centers, including inpatient, residential and outpatient programs. We try to identify patients that are at risk for suicide. Once these patients have been identified, we follow-up with a more thorough risk assessment and safety planning. Although we plan to link patients to outside services, right now, we are directly providing mental health services and case management services.”

Memorandums of Understanding Between TTC & Local Hospitals

Moreover, to meet the objectives of the grant, TTC is going beyond their services by establishing collaborative working relationships with local areahospitals who may have a need to assess and refer eligible patients to the program. Dr. Bachrach illuminates this ongoing approach when he says, “We are not only looking within our system of care at people who contact us, but we also are looking to people who are presenting to hospitals, most often to the emergency departments. Once they are discharged, those people need ongoing follow-up services in the community.”

Given this need, Dr. Bachrachdescribes the role of TTC, saying,“We either provide those services directly to them or link them to services. We also provide six-months of case management. We know that the first thirty days after a person leaves a hospital, individuals are at greatest risk for engaging in suicidal behaviors. We want to do everything we can to mitigate those circumstances and prevent that from happening.”

Helping Domestic Violence Victims During COVID-19 and Beyond

Finally, there is a deeper understanding that suicidality is a challenge withmany facets. Beyond mental health and substance use disorder issues, the grant also is designed to help victims of domestic violence and human trafficking.“In addition to screening all the patients for suicide risk, we also screen everyone for domestic violence and for human trafficking,” explains Dr. Wahidi. “If a patient screens positive, then we are able to link them internally with TTC’s domestic violence services. Moving forward, we work together to provide whatever services these patients require.”

Dr. Wahidi values the extent of the help that the grant has provided to underserviced populations. As she details, “Through this grant, we also have been able to provide services to people whoare undocumented, have no insurance whatsoever, and may be homeless. The feedback from these patients has been particularly valuable because they are happy,and they feel that finally, their needs are being addressed. Many of them are suffering from mental health and substance use disorder related issues, and they truly need this help. Being able to receive services because of a grant like this one has been extremely important and often a lifesaving experience.”