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Sustainability Key Area 3 | Implementing Policy and Practice Change
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A final strategy for increasing sustainability is to incorporate suicide prevention approaches through policy and practice changes that reflect the best available evidence. Policies and practice guidelines exist at the national, state, and local levels and directly influence the day-to-day functioning of organizations and the wider community.
Policies refer to the formal adoption of specific types of action. They can be created through state or community legislation but also through organizational leadership. Examples might include state policies that require community mental health centers to train staff on the use of suicide prevention screenings or a school district’s formally adopted protocols that say how and when referrals from schools to mental health providers occur.
Practices are less formal than policies. They refer to actions that individuals are expected to do within the local culture. For example, it might be common practice for a local community news outlet to compare drafted news article content on suicide against the Recommendations for Reporting on Suicide, but there may not be any policies requiring this action. Policies often guide and help strengthen implementation of sound practices. But practices can also be developed more informally when cultural norms call for certain actions to occur.
As you consider implementing policies and practices in community suicide prevention, note that both need significant support, action, and advocacy from community members who will be affected by them. But once policies and practices are in place, they will significantly contribute to sustainability.
Before developing suicide prevention policies and practices, ask your national, state, and local partners for information on what policies and practices already exist in community settings. Sometimes, there are state legislation or agency policies that require local-level suicide prevention activities. Two common examples of these are:
As a coalition, talk with your state suicide prevention lead to learn about any relevant state legislation or policies that can inform local efforts (visit www.sprc.org/states). Also learn about any already existing policies guiding suicide prevention efforts in your coalition members’ organizations.
As you consider what policies can be helpful, look at national and state guidance on policy content. National suicide prevention and mental health organizations often create model policies and guidelines for organizations to adapt to local needs. States also often have priority populations, settings, or areas for which they create model policies and best practice guidance. Using these as a starting point can strengthen the local policies your group develops and implements.
National sources of model suicide prevention policies include the following:
To find information on your state’s policy guidance, visit https://sprc.org/states and reach out to your state contact.
As you implement your community’s suicide prevention strategic plan, you will find that some approaches can be formalized through policies and practice. For example, you may find that local schools are experiencing great success in training school educators on how to recognize the warning signs of suicide. If your state does not already have a law requiring this, your school district might formalize these trainings by adding a policy that requires these trainings to be offered as part of educators’ annual in-service days.
On the other hand, you may note as you implement your strategic plan that some approaches will not work without policies, protocols, and practices supporting them. For example, you might note that teachers trained in recognizing warning signs of suicide are demonstrating great gains in knowledge, but these trainings are not leading to increased support given to students. In this case, you may need to develop a school-specific protocol that explains how school staff should refer students to community mental health services. This school protocol can strengthen the existing suicide prevention approach.
When you engage in regular strategic plan monitoring and evaluation of prevention approaches, you will be better able to identify which approaches should be formalized and why. Be sure to consider which policies and practices will be most effective in strengthening suicide prevention approaches in different community settings and groups. What works well in one setting may be a poor fit for another. Refer to your previously identified policy guidance (in Key Step 1 above). It may provide model language or practices that you can incorporate into local policies.
Find champions to create and advocate for policy and practice changes. They should include the following:
As you identify champions, form a work group (or connect the champions with an existing work group) that can focus on the development of relevant policies. This work group can provide a structure for champions to discuss policies, strategize about their creation, and monitor their implementation.
Advocacy is usually needed to make changes in policy and practice. Advocacy includes any actions to support a cause. Examples include writing petitions, sharing stories of impact, and raising awareness of the need for sustainable suicide prevention efforts. However, it is important to read through any restrictions on advocacy when receiving state or federal funding because state and federal governments do not allow advocacy.
Advocacy efforts will be most successful when your work group creates an advocacy plan. This plan should describe the advocacy methods that will be used, which partners will be responsible for carrying out different activities, and when key steps will be taken. Examples of methods include interviews with the news media, dissemination of a petition, or presentations for relevant organizational leadership.
As you develop your plan, it is important to consider key community dates that can impact your advocacy efforts. For example, if you are calling for your local school district to create a formal suicide prevention policy, consider how the school year impacts this policy rollout. Or if you are advocating for your county commissioners to set aside funds for suicide prevention trainings in agencies, note when the annual budget is approved each year.
For additional guidance on creating action plans, visit the Planning element. For additional guidance on advocacy planning, visit the Community Tool Box: Developing a Plan for Advocacy.
You will need to develop messaging on why the policy and practice changes called for in the advocacy plan are needed. Following are key messaging points to include:
You can create position statements, one-page handouts, and talking points that members of your work group can use to guide their conversations with organizational and community leaders.
For additional guidance on developing advocacy messaging, visit Developing Messages for Advocacy from EvalPartners.
Monitor progress as you advocate for policy and practice changes. You may find that some advocacy efforts are not gaining much traction, while others are gathering leader or community interest. Just as with strategic planning, be sure to assess and adjust your efforts as needed.
Continue to expand your group of advocacy champions. You can do this by putting out periodic calls for advocates, hosting meetings with members of the community impacted by promoted policy or practices, and providing different types of advocacy involvement. Examples of the latter include participating in an advocacy day, developing key messages, telling stories, or helping with behind-the-scenes tasks. The more voices supporting a change, the greater the community reach and influence.
Once a policy has been implemented in an organization, members of the organization need to receive training on it. If a community ordinance is passed, advocates need to help provide information on it to the community. In both cases, implementation needs to be monitored, and changes made as necessary.
Advocates should be aware of the risk for policies and practices to be forgotten, poorly followed, or removed. Advocacy work groups, organizational leaders, and community decision-makers should all work together to keep policies and practices current and ensure they are achieving their intended purposes. If you identify portions of a policy or practice that are not being followed, talk with community members to find out why. Sometimes, this may arise due to policies or practices failing to be practical in everyday life. Other times, it is because there is a lack of awareness or training.
When you engage in ongoing monitoring of your policy or practice implementation, you can note shortcomings and work with people impacted by the policy or program to identify how to (a) adjust it or (b) increase community ability to follow it. You will need to track and monitor the impact of the policy or practice just as you monitor the impact of your larger strategic plan.
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