Although concerns about Nevada's high rate of suicide have been well know for many years, specific targeted state actions to address this concern have been underway only since 2002. Dealing with suicide as a major public health problem requires strong cooperation and support from all individuals and agencies who deal directly with those at risk for this problem.

Much of the suicide prevention activities we see now in Nevada began with the Governor's Commission on Mental Health and Developmental Services establishing the Suicide Resources Coordination Task Force (SRCTF) in August of 2002. Representatives were invited from various public and private facilities and agencies that provide care and services for individuals at risk for suicide and their families. This Task Force recognized an urgent need for a greater degree of coordination of suicide related resources in the state. The task force developed a series of formal recommendations (Study of Suicide Prevention, Bulletin 03-11, Nevada Legislative Counsel Bureau, 2003) .

Some key suicide prevention activities, which MHDS has been a major part of, include:

• In late 2002, MHDS worked with the SRCTF to develop Nevada's first ever-statewide Suicide Resource Directory. Now in its second edition (2007), it lists all available resources in suicide prevention. The Directory's Quick Reference Index lists resources by region (South and North/Rural) in Nevada with corresponding page numbers for each facility or agency. Each profile includes information that will facilitate easy referral and access to suicide prevention, intervention, and postvention.
• Nevada funds a statewide Crisis Call Hotline (1-877-885-HOPE or 1-877-885-4673), which is operated out of Reno, Nevada but provides statewide coverage for suicide calls and referrals.
• MHDS provides comprehensive clinician training in suicide and risk assessments. Suicide assessment is one of the cornerstones of daily clinical practice for both mental health professionals and primary care clinicians. A practical interviewing strategy for efficiently eliciting valid suicidal ideation has been provided to MHDS staff. Staff training efforts have been enhanced so that MHDS clinicians are fully versed in completing suicide assessments which are now required for each admission.
• MHDS drafted and enacted legislation which required the development of a Nevada State Suicide Prevention Plan and established a Statewide Suicide Prevention Program within the Director's Office of Nevada's Department of Health and Human Services (DHHS). The purpose of the state plan/program is to reduce the number of attempted and completed suicides in Nevada. The state plan addresses the risk factors related to suicide and identifies populations most at risk. The plan will be made available to the public in February, 2007.

The State Suicide Prevention Plan is modeled after existing state plans in Georgia and several other states, which incorporate goals from the United States Surgeon General's 2001 report, National Strategy for Suicide Prevention: Goals and Objectives for Action. Nevada's state plan focuses on the Surgeon General's goals relating to public awareness, building community networks, and implementing suicide prevention training programs for law enforcement, health care professionals, school employees, and others who are the first contacts with individuals at risk of suicide.

The Statewide Suicide Prevention Program includes the establishment and funding of two positions to develop and implement suicide prevention programs in Nevada. Misty Allen, MA, was hired in December, 2005 as the Statewide Suicide Prevention Coordinator based in the Director's Office of DHHS in Carson City. She is tasked with the development, implementation and evaluation of the Nevada Suicide Prevention Plan. Linda Flatt was hired in February, 2006 as the Suicide Prevention Trainer & Networking Facilitator based in the DHHS Office of Suicide Prevention. Together, the Coordinator and the Trainer/Facilitator will assist in developing a network of community-based suicide prevention programs throughout Nevada, including the establishment of one or more local suicide prevention advisory groups in the urban areas. Additionally, The Garrett Lee Smith Memorial Act Grant was secured by the Nevada Department of Child and Family Services in late 2005. In April 2006, Jodi Tyson was hired as the Youth Suicide Prevention Program Coordinator to manage this grant.