Meet People “Where They Are”
Under the PMO, CPPs who had previously supported either substance use or suicide prevention efforts were now expected to support both. “We were asking people to work outside their comfort zones,” says Erica Mathews, Substance Abuse and Suicide Prevention Program Manager for the Wyoming Department of Health. “It was especially scary for staff members who had never before addressed suicide prevention.”
To prepare staff for their new roles, the PMO implemented an extensive “onboarding” process designed to build staff knowledge and skills, clarify job responsibilities, and ease anxiety. The PMO also established “cross-discipline” mentor relationships that enabled practitioners to draw on their peers for information and advice. According to Feliciana Turner, Director of Statewide Prevention and Wellness for the PMO, these efforts were extremely helpful in moving practitioners along a “continuum of readiness” and in strengthening connections between practitioners.
Develop a Shared Prevention Framework
A primary goal of the onboarding process was to help CPPs understand and appreciate that they were all partners working together to address a common problem. For example, since alcohol and other substance use disorders are risk factors for suicide, both fields share an interest in preventing alcohol and drug use and misuse. The CPPs needed to understand that their goals were the same, and develop a shared language to describe their work moving forward. SAMHSA’s Strategic Prevention Framework (SPF) provided the foundation for this shared understanding—initially among the CPPs themselves, and later among the communities with which they worked. Regardless of their prevention focus, CPPs learned to consistently return to the model to guide their prevention efforts. According to Turner, “The SPF was the ‘glue” that held these areas of prevention together.”
To further underscore the relationship between substance use and suicide, the PMO also added an “S”—for suicide—to the commonly used acronym ATOD—alcohol, tobacco and other drugs. The new acronym, ATODS, formally reflected the state’s commitment to addressing both issues equally. “When we first launched the PMO, suicide prevention efforts were much more visible than substance abuse prevention efforts,” says Turner. “Creating the new acronym helped us move beyond division and competition, and publicly declare that both areas of prevention are equally valued.”
Provide Communities with Adequate Support
Before the PMO era, most communities supported separate coalitions that worked independently to prevent substance use or suicide. With the launch of the PMO, communities were required to address ATODS through coordinated coalition efforts. The role of CPPs facilitates the shared framework being used across ATODS coalition/s. “This integrated approach was new to many communities,” says Mathews. “It took a lot of TA [technical assistance] to bring communities together, to look at a community as a whole and to work on making it “well” as a whole.” During the first year of PMO operations, much of this TA focused on helping communities assess their prevention needs—which, for the first time, required coalitions to look not only at their substance use data, or their suicide data, but at both together.
Keep the Communication Flowing
Effective communication has been key to the success of the PMO. Staff members are quick to pick up the phone to share experiences and stories, and are provided regular opportunities to talk about their work and trouble-shoot problems collectively. PMO leadership also relies on communication with CPPs to know what is happening at the local level. “Communication is key,” says Mathews. “You can’t rely solely on written reports. You need to communicate regularly, be involved, and get to know everything.”
Regular communication with the public has also been an important factor in building an understanding and acceptance of the PMO model, and correcting misperceptions. “People were afraid that the PMO meant a loss of funding to their communities,” says Mathews. “We needed to explain that funds would still get to their communities—just through a different mechanism.” Whenever possible, the PMO delivered these messages face- to-face, with the help of the CPPs.