The Indian Health Service (IHS), Office of Clinical and Preventive Service, Division of Behavioral Health (DBH), is accepting applications for cooperative agreements for Zero Suicide Initiative (ZSI)—to develop a comprehensive model of culturally informed suicide care within a system of care framework. This program was first established by the Consolidated Appropriations Act of 2017, Public Law 115-31, 131 Stat. 135 (2017). This program is authorized under the Snyder Act, 25 U.S.C. 13 and the Indian Health Care Improvement Act, Subchapter V-A (Behavioral Health Programs), 25 U.S.C. 1665 et seq.

For at least the past fifteen years deaths by suicide have been steadily increasing. On April 22, 2016, the Centers for Disease Control and Prevention's National Center for Health Statistics released a data report, Increase in Suicide in the United States, 1999-2014, which underscores this fact.

• From 1999 through 2014, the age-adjusted suicide rate in the United States increased 24%, from 10.5 to 13.0 per 100,000 population, with the pace of increase greater after 2006.
• Suicide rates increased from 1999 through 2014 for both males and females and for all ages 10-74.
• The percent increase in suicide rates for females was greatest for those aged 10-14, and for males, those aged 45-64.

The most frequent suicide method in 2014 for males involved the use of firearms (55.4%), while poisoning was the most frequent method for females (34.1%).

There is a sizable disparity when comparing the rate for the general U.S. population to the rate for American Indians and Alaska Natives (AI/AN). During 2007-2009, the suicide rate for AI/ANs was 1.6 times greater than the U.S. all-races rate for 2008 (18.5 vs. 11.6 per 100,000 population).[1]

The `Zero Suicide' initiative is a key concept of the National Strategy for Suicide Prevention (NSSP) and is a priority of the National Action Alliance for Suicide Prevention (Action Alliance). The `Zero Suicide' model focuses on developing a system-wide approach to improving care for individuals at risk of suicide who are currently utilizing health and behavioral health systems. This award will support implementation of the `Zero Suicide' model within federal, Tribal, and urban Indian health care facilities and systems that provide direct care services to AI/AN in order to raise awareness of suicide, establish integrated system of care, and improve outcomes for such individuals.