Zero Suicide Academy Application
The Indiana Zero Suicide Academy is sponsored by Community Health Network (CHNw) and the Indiana Division of Mental Health and Addiction (DMHA).
Sponsoring Organization Email
Funding for this training was made possible by the CHNw Zero Suicides for Indiana Youth grant number SM-061768 from the Substance Abuse and Mental Health Services Administration (SAMHSA). The intent of this funding is for the state-wide dissemination of Zero Suicide initiatives
Zero Suicide Academy materials are provided at no charge to organizations selected to participate. All other costs, such as travel, food, and lodging, are the responsibility of the participating organizations.
Selection Criteria: The review committee will rate applications based on their merit in responding to and providing a complete application. The review committee reserves the right to select participants who are representative of geographical and organizational diversity.
Applications will be rated using the following criteria:
- Commitment: Letter of commitment; identification of appropriate Implementation Team members to attend the Academy; and pre-approved funding for travel, lodging and per diem. (25 points)
- Readiness: Demonstrated success of integrating collaborative models within your health system/organization; completion of organizational self-study. (30 points)
- Implementation and Sustainability Plan: Understanding of what it will take to adopt and implement a Zero Suicide initiative, including anticipating challenges. (25 points)
- Goals: Articulated realistic and feasible goals for attending the Academy participation at the Academy will clearly launch the initiative. (20 points)
Organizations will demonstrate these criteria through their applications. The web form linked below consists of the following parts:
- About the Organization. Short demographic information about organization's type, practice transformation initiatives, and size.
- Attendees to the Academy. Name and contact information of Team Lead and up to three other attendees.
- Narrative. A 2-4 page description of organization's implementation goals and strategy for Zero Suicide initiative. Upload via PDF or Word.
- Letter of Commitment. A letter of commitment written by organization's CEO or Director endorsing strategy. Upload via PDF or Word.
- Organizational Self-Study. Organizations are encouraged but not required to complete the Organizational Self-Study prior to applying.
Register for a free login to read more about the requirements for each part.
Click "Fill Out Form" below to be automatically redirected to the registration and login page.
May 25, 2018
All application materials must be submitted via the website. Applicants may save their progress as they go until they are ready to submit. If, during the course of the application, an organization decides not to submit it is fine to leave the application as is. Incomplete applications will be deleted after the Academy is held.
Notification of application decisions and status will be provided via email by June 1, 2018.
- Application release date: April 17, 2018
- Application Q&A: April 30, 2018 4-5pm EST
- 317-621-9329 Local Indianapolis
- Meeting Number 591 596 942
- 317-621-9329 Local Indianapolis
- Application Due: May 25, 2018
- Notification of application: June 8, 2018
- Zero Suicide Academy: July 25 and 26, 2018
Contact Jasmine Atkinson, EDC, at JAtkinson@edc.org.