Initial Needs Assessment

PURPOSE AND GOALS OF

THE NEEDS ASSESSMENT

This initial needs assessment provides guidance to the GFOL staff to ensure that all planning, decision-making, and action align with the overall goals of the Program. This assessment identifies the current needs in the community for developing services geared toward the target population specifically focused on higher education institutions. The information in this assessment was gathered through research using archival data and information provided to the Evaluator by the University of Guam and Guam Community College.

TARGET POPULATION AND STAKEHOLDERS

The Program is designed to build infrastructure and capacity for suicide prevention in Guam for youth ages 10-24, their natural supports, youth-serving organizations, and entities providing behavioral health services to youth. According to the 2010 Census, there were a total of 41,829 youth between the ages of 10-24 (ages 10-14: 15,046; ages 15-19: 14,408; ages 20-24: 12,375). This makes up 26% of Guam’s total population. From 2010-2020, the target population was expected to decrease to 41,001 which is 24% of the total population (2018 Guam Statistical Yearbook).

Updated data from the time that the GFOL Program application was submitted show that in 2019, there were 31 suicide deaths in Guam. This is a decrease in the crude suicide rate to 18.6 compared to the previous four years (2015: 21.6, 2016: 30.7, 2017: 22, 2018: 26.6). This, however, is still significantly higher than rates in the United States. Compared to the U.S. where the highest numbers of suicides are among adults aged 45-54, Guam’s highest suicide rates occur in youth and young adults.

The Guam Behavioral Health and Wellness Center is the primary government entity that provides behavioral services to youth. Services are also available at each public education agency (Guam Department of Education, University of Guam and Guam Community College), the Department of Youth Affairs (DYA), and the Judiciary of Guam. Additionally, there are an estimated 30 non-profit organizations that serve the youth including Mañe’lu, Sancturay, Inc., and Youth for Youth Live Guam!.

The data

According to the 2018 Guam Statistical Yearbook, suicide ranked 6 in the top ten causes of death in Guam. In 2018, the total number of suicides in Guam was 44. This is significant given that in 2013 and 2014, suicide was not listed in the top ten causes of death. In 2018, 1 suicide death is reported from the age group 10-19 years and 22 were reported between the ages of 20-29 years which represented the highest number of the total reported. The largest group by ethnicity and sex is Chamorro males at 18 suicides followed by Chuukese males at 12 suicides.

In 2018-2019, 3,744 students were enrolled at the University of Guam (UOG). 2,916 student or 78% of the total enrolled were part of the target population. In that same year, 2,078 students were enrolled at the Guam Community College (GCC). 1,280 students or 62% of the total enrolled were part of the target population.

EXISTING SERVICES

Guam received the GLS suicide prevention grant in 2009-2015 to build capacity for suicide prevention, intervention and postvention. Funds were used to build community awareness about suicide through multimedia campaigns, conversations and training as well as increase capacity for youth-serving organizations and direct service providers to respond to youth identified with suicide ideation and behaviors. Service providers were able to build skills to identify persons thinking of suicide and to increase their safety through referral to treatment services. During this grant period, over 4,000 gatekeepers were trained in intervention skills. At risk youth were referred to community-based mental health care.

UNIVERSITY OF GUAM

The University of Guam has a Suicide Prevention and Response Protocol that was adapted from Columbia College Chicago’s Suicide Prevention Response Protocol in Fall 2008. In 2018, UOG established a Mental Health and Suicide Prevention Advisory Council with the goal of educating the UOG community on protocols regarding suicide incidents, advising on programmatic initiatives and policy regarding suicide prevention and mental health, and promoting awareness of available services.

UOG provides students with services through their Enrollment Management Services (EMSS). These counseling services includes individual and group counseling, academic counseling, mental health counseling, marriage and family counseling, and expressive arts therapy. Counseling services are also available through Isa Psychological Services Center and I Pinangon Campus Suicide Prevention Program. Services available at Isa Psychological Services Center include individual psychotherapy for adults, adolescents, and children; family and couples therapy; group therapy; clinical assessment; crisis intervention and postvention; consultation; outreach programs; and personal growth retreats. I Pinangon provides suicide prevention services including suicide prevention presentations, training workshops, educational seminars, psychotherapy for suicidal individuals, and community outreach services for UOG students, staff, faculty, and members of their families.

GUAM COMMUNITY COLLEGE

The Guam Community College Counseling Services provide a wide range of services to students in the areas of academic, career and personal goals. These services include advisement to undeclared postsecondary students, high school students in GCC’s CTE programs, and adult students in high school diploma programs. Limited counseling services are available for personal counseling. Counselors provide initial counseling-related assessments, make referrals to students needing psychological support, assist with intervention in emergencies or immediate situations requiring counseling. For suicide or suicide-related behaviors, counselors perform intake and referral services.

GCC has three postsecondary counselors, one adult education counselor, one Adult Basic Education counselor for at-risk students, and four career counselors who work with GCC’s Career and Technical Education students in GDOE high schools. Although primarily academic counselors, all are trained in suicide intervention. GCC does not currently provide internship or practicum opportunities for students.

RECOMMENDATIONS

1. Update the Guam State Prevention Enhancement Comprehensive Strategic Plan to outline the goals for the next five years including the agency’s strategies for achieving excellence in providing patient safety and safer suicide care.

2. Identify key individuals in the community including those from higher education institutions like counselors or instructors. Consider making the town hall meetings small-scale to foster a safe environment for training natural helpers.

3. Ensure that all programs, plans, and resources are place based. This can be achieved by utilizing the research from the Fellowship Program to inform and develop best practices. Place-based programs should also be driven by current data on suicide and based on the unique characteristics of the local community.

4. Expand data collection to include more detailed profiles of students seeking services.

5. Expand the service reach of the University of Guam to include additional programs and services through EMSS and increase staff hiring to expand services at ISA and I Pinangon.

6. Develop a policy and protocol for suicide prevention, intervention and postvention at the Guam Community College. Build the capacity to provide training and in-house counseling services to students and employees.

7. Develop a centralized database and/or directory of all available wrap-around services through government entities and private and non-profit organizations that can be shared with the community.

8. Include the collection of data that assesses effectiveness of trainings and workshops to measure the capacity built by the Program to include follow up surveys with individuals trained and referred for services.

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