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Safe Schools Central Oregon

Potential strategies Technology

Phase 2: caring contacts under clinicians, and offer durable pieces to institutions

Proposed, for board reviewYear two

Phase 2: caring contacts under clinicians, and offer durable pieces to institutions

After six months of intake data, pilot clinician-sent caring contacts (brief, scheduled notes from a clinician after a crisis; letters first, texts only through a vendor eligible under the federal health privacy law, HIPAA) for Care Network clients with written consent, inside a partner that runs the Zero Suicide framework (a structured approach to follow-up and transitions in care), and offer each durable tool to an institution under a written agreement by the end of year two.

What has evidence in digital outreach is small and clinical, not an app. Caring contacts are brief, scheduled notes from a clinician after a crisis. In a randomized trial, brief caring letters sent to people who had declined care after a crisis lowered the suicide rate in the first two years. Trials that include adolescents have published protocols but no results yet, so the honest position is to run caring contacts only inside a partner with clinical oversight, with written consent, and to label the evidence as adult evidence while youth results are pending.

The group’s roster has no clinical director to own a protocol, so the pilot would live inside Deschutes County Behavioral Health, Mosaic Community Health or BestCare under that partner’s framework, and the group would pay for the letters and the evaluation. It would start with the low-cost version, a calendar and templates in the clinician’s own record, and move to texts only with a vendor eligible under the federal health privacy law (HIPAA), under a contract that binds the vendor to that law. Templates would be reviewed by young people, and the regional tribal health board would be consulted before any messages reach Native youth.

Year two is also when the group would keep its promise that nothing it built outlives it as an orphan. The verified lists would be offered to 211info and the county suicide prevention program, the Get Help Now content to the counties and districts, and the capacity board and log would stay with the host agency, each under a written agreement. The group would report at month 24 which tools an institution accepted and which were sunset, and would decline again any youth community platform.

Why we think it works

What we would do

  1. Run caring contacts only inside a partner with clinical oversight (Deschutes County Behavioral Health; Mosaic Community Health, the region's nonprofit community clinics; or BestCare, the community behavioral health provider in Madras and Prineville) under its Zero Suicide framework; the group would fund the letters, postage and a small evaluation; begin only after six months of intake data exist.
  2. Start with the calendar-and-template version in the clinician's own record; move to texts only with a vendor eligible under the health privacy law, under a business associate agreement (a contract that binds the vendor to that law); consult the Northwest Portland Area Indian Health Board (the regional tribal health board) and its THRIVE project before any message reaches Native youth.
  3. Obtain written consent from the parent and the young person as age requires; nothing runs through school channels; templates are reviewed by young people; report only counts, consent rate and messages delivered.
  4. Offer the verified lock and storage lists to 211info (the statewide help line and directory) and the Deschutes County Suicide Prevention Program, the Get Help Now content (the site's crisis contacts page) to the counties and districts, and the capacity board and log to the host agency, each under a written agreement, by month 24.
  5. Decline again any youth community platform; online peer spaces carry the risk that harmful behavior spreads between young people, along with moderation challenges.
  6. Report at month 24 which tools an institution accepted and which were sunset, and remove anything without a receiver.

How we would know it is working

  • Caring contacts delivered per enrolled client, and consent rate
  • Pilot evaluated with the partner and the result published, including a result that showed no change
  • Number of tools offered to a named institution by month 24, with each acceptance or decline reported
  • Zero tools without a receiver or a sunset date at month 24

What could get in the way

Youth evidence for caring contacts is pending, and a volunteer roster has no clinical director to own the protocol.
Clinician-supervised and consented inside a partner agency, with the adult evidence labeled as such and results published either way.
Caring contacts by text to minors referred by schools need parent and youth consent and a clinician of record; nothing can run through school channels.
Consent as age requires, letters first, a vendor eligible under the health privacy law for texts, and no school channel involvement.
Institutions need budget and staff to receive a tool, and a handoff that no one agreed to is an orphan.
Name the receiver before anything is built, offer content and process rather than software, and sunset what has no home.

Who we would work with: Deschutes County Behavioral Health, Mosaic Community Health or BestCare (clinical host), Zero Suicide Institute framework, Northwest Portland Area Indian Health Board (the regional tribal health board) THRIVE project, 211info (the statewide help line and directory) and Deschutes County Suicide Prevention Program (receivers), High Desert Education Service District (the regional agency that supports all six school districts) and the counties (receivers), Care Network clinician roster

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