The vision for the Kansas Prevention Strategic Plan (KPSP) was that of Stephanie Rhinehart’s, Prevention Program Manager for Kansas Department for Aging and Disability Services (KDADS), to summarize and prioritize data-driven goals and objectives identified in various KDADS Prevention-supported behavioral health strategic plans and guidance documents.
The KPSP will be used by KDADS Behavioral Health Services (BHS) leadership and those subcontractors and grantees of KDADS BHS funds to keep the department’s focus on data-informed behavioral health priorities across Kansas. The KPSP focuses on preventing substance use, suicide, and problem gambling and promoting behavioral health. This plan will be used to guide program resources and as an anchor for prevention and promotion funding, and to include already existing prevention priorities and outcome goals, consolidating and unifying them under one plan for ease of summarizing KDADS BHS efforts across departments. The KPSP will clearly articulate the department’s prevention goals, needs assessment data indicators, and current strategies to facilitate desired change. The KPSP will also provide output and outcome data, which will be used for ongoing evaluation of the plan and KDADS programming.
The KPSP will be used by KDADS BHS for communicating to external partners and the public about the State prevention and promotion programs, goals, and outcomes of related strategies. The KPSP will highlight the priorities of the KDADS BHS Prevention program. The KPSP will demonstrate how Kansas uses data-informed strategic planning to prioritize behavioral health needs and respond with resources and programming made available to meet and reduce or eliminate these needs. Another purpose of the plan is to demonstrate the rationale for the investment of KDADS fiscal and personnel resources and funding opportunities made available to community organizations.
KDADS BHS Prevention program staff will review the KPSP goals and progress at least annually with subcontractors and grantees of KDADS BHS funds. As the most current data available for each of the identified goals and objectives, KDADS will review data and make decisions on mid-course corrections as needed for ongoing performance improvements and innovative adaptations and strategies to achieve stated goals
According to the Data Dashboard on the Kansas Department of Health and Environment’s website for the Division of Public Health:
The Kansas Department for Aging and Disability Services (KDADS) Behavioral Health Services Commission manages mental health services in Kansas, working with 26 community mental health centers across the state. In addition, it oversees addiction and prevention service programs for the State of Kansas, including targeted workforce development initiatives. In addition, the commission works in close collaboration with the Governor’s Behavioral Health Services Planning Council. The commission is also charged with overseeing the state’s two psychiatric hospitals. Supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), KDADS is responsible by statute and holds the authority and responsibility to coordinate and provide substance use and mental health services in Kansas. They promote effective public policy and develop and evaluate programs and resources for behavioral health prevention, treatment, and recovery services. With an intentional effort to move toward a more integrated and community-focused approach to substance use prevention, in 2016, KDADS started the Kansas Prevention Collaborative (KPC). The new system supports KDADS-funded community coalitions. The KPC is funded by the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS BG or SUBG). In June of 2015, four Kansas contractors were selected to provide state and local services and support as part of the Collaborative. Services provided by the Collaborative partners were designed to support capacity development, increase engagement and involvement, and expand opportunities, including fiscal and other resources to communities across the state. A description can be found in Table 1.
Oversight of the Kansas Prevention Collaborative is provided by KDADS Prevention Manager and Prevention Specialists. In addition to guiding the work of the KPC contractors and KDADS-funded KPCCI communities, the role of KDADS is grant administration, fiscal accountability, and monitoring. Funded community coalitions are responsible for developing and implementing a tailored strategic prevention plan for their communities, collecting data, and documenting their accomplishments. The flowchart in Figure 1 shows the infrastructure supporting the KPC.
Each year a KPCCI group or cohort of KPC community coalitions was funded by KDADS for a yearlong planning grant. This ensures time for training to apply the Strategic Prevention Framework (SPF) planning process, including comprehensive needs assessment, capacity development, and appropriate strategy selection. Successful KPCCI Planning grantees then have the opportunity for a three-year implementation grant to put their tailored strategic plan into action, including monitoring and annual evaluation of activities and outcomes.
In 2020, Kansas received a five-year SPF Rx grant from SAMHSA. The purpose of the Kansas SPF Rx program is to provide resources to help prevent and address prescription drug misuse within the State. The program is designed to raise awareness about the dangers of sharing medications and to educate about proper medication storage and disposal options. Another goal is to increase the use of the Kansas Prescription Drug Monitoring Program, K-TRACS, to help health professionals prioritize patient safety. The program focuses on reducing prescription drug misuse and ultimately, the number of prescription opioid-related overdose deaths and hospitalizations/emergency department visits. Data is tracked and incorporated into strategic planning and future programming.
The Kansas Garrett Lee Smith (GLS) State/Tribal Suicide Prevention and Early Intervention Program grant, which was recently awarded to KDADS for the first time, is a multi-component initiative that will utilize evidence-based trainings to reduce suicide deaths, behaviors, and ideation in youth and young adults aged 10-24. The program goals are tied to the Kansas Suicide Prevention Plan, revised in 2021 with a focus on addressing the four strategic directions identified by the National Strategy. The program goals and objectives are also aligned with recommendations created by the Kansas Governor’s Mental Health Task Force (2017) and the Special Committee on Mental Health Modernization and Reform (2021-2022).
KDADS (Kansas Department for Aging and Disability Services) has contracted with Wichita State University’s Community Engagement Institute (CEI) on a project for a national grant funded by the National Association of State Mental Health Program Directors’ (NASMHPD) Transformation Transfer Initiative (TTI). This TTI project is focused on improving crisis and suicide care in Kansas and is called Caring Across Cultures; Suicide Prevention Readiness Training (CACSPRT)
A purpose of the CACPRT project is to address the need for more inclusive suicide and crisis care in Kansas. KDADS’s goal is to improve our cultural humility and responsiveness to other cultures to facilitate effective collaboration, provide more equitable resources for populations experiencing marginalization, and address behavioral health disparities related to suicide. CACSPRT emphasizes culturally informed support-seeking and intentional consideration of diverse attitudes and beliefs within high-risk populations.
CACSPRT acknowledges the importance of learning from individuals within underserved communities. These communities include Black, Indigenous, People of Color, individuals with disabilities, service members, veterans, and their families, and others. It is our sincere intention to avoid harmful tokenization of anyone. CACSPRT is emphasizing with presenters and trainers that we understand the beliefs of people who share a certain cultural identity do not represent all views and opinions of others within their community or identities, and would like to reiterate that sentiment now.
However, KDADS and CEI want to provide an opportunity for others to have their voices heard in a respectful, open-learning environment.
These 12+ sessions will involve speakers from communities of people in Kansas who have often been marginalized, experience behavioral health disparities, are at higher risk for suicide, and/or have cultural identities shared with a community, and will discuss beliefs and perspectives on suicide and crisis services. Sessions will include panels and individual local and national experts sharing their passions, hopes, ideas, and culture to promote healing and improve behavioral health and behavioral healthcare for all. While each session will be focused on a specific cultural community, it is our intention to provide transferable skill-building, knowledge, and approaches that can benefit anyone seeking crisis care. KDADS and CEI hope participants remain open-minded, engage in self-reflection, and take away valuable information about the perspectives discussed.
With initial funding from the National Association of State Mental Health Program Directors (NASMHPD), this initiative will be sustained through KDADS with State General Funds that have been secured and are dedicated to suicide prevention efforts. WSU CEI and KDADS will also work with the Kansas Suicide Prevention Coalition (KPSC) to expand their membership to include representation by members of these communities.
With initial funding from the National Association of State Mental Health Program Directors (NASMHPD), this initiative will be sustained through KDADS with State General Funds that have been secured and are dedicated to suicide prevention efforts. WSU CEI and KDADS will also work with the Kansas Suicide Prevention Coalition (KPSC) to expand their membership to include representation by members of these communities.
About Suicide
Suicide is a preventable public health concern that can affect all ages. Suicide is a death resulting from an injury to oneself with the intent of ending one’s life. A suicide attempt occurs when one makes an effort to end one’s life but does not die. Suicidal thoughts occur when one experiences thoughts and feelings of no longer wanting to live. Suicide prevention requires a comprehensive, multifaceted, and public behavioral health approach. It must include both public and private partnerships and be inclusive of the voices from those with lived experience of suicidal thoughts, attempts, and loss. Understanding various perceptions, attitudes, and beliefs regarding suicide can help us be more effective in our work. It also assists us in combating the stigma associated with suicide. Because of this complexity, efforts must be adapted to consider the cultural differences of the individuals being served.
Community Roles
For suicide prevention within communities to be successful, it requires the collective work of individuals, organizations, and institutions. It is important for communities to implement prevention strategies and activities that aim to foster a supportive environment and create a sense of belonging. Building social connectedness and social support within communities can help protect vulnerable persons from suicide. To reduce suicide and suicide risk, address risk and protective factors related to suicide, raise awareness, and produce sustainable systems change for vulnerable populations, a level of understanding is required by those trying to effect change. Efforts must be appropriate to the community’s culture and fit the community’s needs.
About the Grant
The Kansas Community Suicide Prevention Grant is intended to address the ongoing crisis of suicide in Kansas through community-driven suicide prevention programs that seek to reduce and prevent suicidal behaviors through the implementation and sustainability of effective, culturally competent suicide prevention strategies and activities. The grant is intended to serve individuals across the lifespan. Funds come from the allocation of $1.5 million in State General funds for community efforts. The Kansas Community Suicide Prevention Grant awards are intended for populations that local communities have identified as most at risk. Applicants are asked to provide a community description, identify their population and areas of need, outline their plans for suicide prevention activities, and describe any challenges and/or barriers to achieving their goals. They must be able to speak to their organizational capacity, experience with strategic planning, and experience with grants. Grantees are chosen based on their ability to describe and carry out their proposal.
In 1987, Kansas launched the Kansas Lottery, which was followed by four tribal casinos opening in the late 1990s. In 2007, the Kansas Legislature was presented with the Kansas Expanded Lottery Act (KELA). This act allowed for the state of Kansas to own and operate a destination casino resort in four Kansas gaming zones, including the Northeast, Southeast, South Central, and Southwest Gaming Zones. Additionally, the Problem Gambling and Other Addictions Fund (PGAF) was established with casino revenue. PGAF funds a helpline with text messaging and chat capabilities, and funding for treatment, recovery, research, education, or prevention of pathological gambling (gambling addiction). In 2022, sports wagering was legalized and allowed at state-owned lottery gaming facilities, and over the internet through websites and mobile device applications. In 2023, historical horse racing machines were legalized, with one facility currently set to open in 2025 in the South Central Gaming Zone in Sedgwick County. Sports betting revenue is separate from casino revenue. However, a portion of the sports betting review is credited to the PGAF.
PGAF allows for the Kansas Department for Aging and Disability Services (KDADS) to award grant funding to four community task forces, one within each gaming zone. They are tasked with raising awareness about problem gambling and gaming, providing education about problem and responsible gambling and gaming, promoting the helpline services, and promoting the treatment resources available in Kansas. The Kansas Coalition on Problem Gambling (KCPG) was established in 1996 and has also been awarded grant funding. KCPG is a not-for-profit organization of statewide stakeholders whose mission is to reduce the onset and progression of problem gambling. Currently, there are four KDADS Gambling Specialists who work directly with the task forces, the communities they serve, and the KCPG. Their work includes building collaborative partnerships, consultation and technical assistance, training and education, community outreach about the impact of problem gambling, available services and resources, data interpretation, monitoring grant deliverables, and outcome evaluation.
The specialists serve on gambling initiatives at the local, state, and national levels. The federal government mandates that all states have a mental health services planning and advisory council. The Governor’s Behavioral Health Services Planning Council fulfills that mandate for Kansas. Problem Gambling is one of the Sub-Committees within the council. Its members may include task force members, KCPG members, prevention specialists, treatment providers, or citizen volunteers. The sub-committee helps to achieve the state’s goal of reducing gambling-related harms in Kansas and integrating mental health and addiction services by increasing the capacity of all Kansas Behavioral Health Services funded programs to address problem gambling and gaming through enhanced screening assessment, awareness, intervention, recovery, and health promotion strategies by advocating for problem gambling services throughout the state, identifying potential gaps in service, and presenting recommendations to the governor’s office regarding the need for funding to provide these services.
In 2012, the Kansas Department for Aging and Disability Services (KDADS) funded the Gambling Behaviors and Attitudes Among Adult Kansans survey. This survey found that 75% of survey respondents gambled in the past year, and 44% stated they had gambled in the past 30 days. Problem gambling screening questions were asked to 44% of respondents who had gambled in the past 30 days. Approximately 19% of this group responded “yes” to at least one of these questions. Although this study did not include a diagnostic instrument to assess problem gambling prevalence, the range of endorsements to problem gambling screening questions suggests that there may be persons considered at-risk for problem gambling. When respondents were asked directly if they thought they had a gambling problem, 1% said that “most of the time” they felt that they “have a problem with gambling,” and 6% said “sometimes,” suggesting some level of concern among thousands of Kansans if these results were to be extrapolated to the state population. The consequences of problem gambling can be emotional, physical, and financial. These consequences can extend to the friends, families, co-workers, and even the employers of those affected. About 26% of 2012 survey respondents said they had been personally affected by the gambling of others. As a follow-up to the 2012 survey, KDADS funded another prevalence study in 2017 to assess gambling prevalence, type, frequency, myths, perception, public opinion about gambling, and awareness of problem gambling treatment. To help expand the understanding of conditions associated with problem gambling, the 2017 Kansas Gambling Survey also asked broader behavioral health questions related to depression, suicide, and substance use. Participants of the 2017 survey engaged in gambling activities that they may not have considered gambling. For example, about 25% of participants who said “no” when asked if they gambled in the past 30 days, also said “yes” when asked if they played a state lottery or multi-state lottery.
Similarly, 6.4% of participants who reported not gambling reported paying for phone or computer credits or upgrades. Forty-eight percent (48%) of participants reported engaging in gambling activity in the 30 days prior to the survey. Nine problem gambling screening questions were used to categorize participants into three problem gambling risk categories (low, moderate, and high). Of those who reported any gambling in the past 30 days, just over six percent (6.1%) were in the high problem gambling risk category, 17.4% were at moderate risk, and 76.5% low risk. Almost thirteen percent (12.8%) of participants indicated they felt like they would like to stop gambling in the past year, but didn’t think they could. In 2017, 10% of participants reported being personally affected by the gambling behavior of a family member, 6% by a friend, and 3% by a co-worker. The percentages differ widely across risk categories. For example, 33.5% of participants in the high-risk category reported being personally affected by gambling behavior or a family member, compared to 8% in the low risk category When asked supplemental general health questions, 90.5% of participants reported their health was either ‘excellent,’ ‘very good,’ or ‘good,’ and 9.5% reported their health was ‘fair’ or ‘poor.’ When asked about mental health and depression, 48.8% of participants reported their mental health was not good on at least one day in the past 30 days. While 54% of participants in the high-risk for problem gambling category reported their general health was good, over 82% reported their mental health was not good on at least one day in the past 30 days, and 10% reported their mental health was not good on any day of the past 30 days. Almost 10 percent (9.6%) of all participants reported depression in the past year. The percentage of participants reporting depression increased as the risk of problem gambling increased, such that 7.9% in the low-risk category, 18.3% in the moderate risk category, and 32.5% in the high-risk category reported experiencing depression in the past year.
When asked about substance use, alcohol was reported as the substance most often used. Almost 58% (57.9%) of participants reported using alcohol in the past 30 days, 18.5% reported using cigarettes or electronic cigarettes, and 6.1% reported using marijuana. Cigarette smoking increased with risk category, with the lowest use found in the low-risk participants (12.5%), and the highest use found in the high-risk participants (41.1%). High-risk participants showed the highest rates of use of marijuana (21.1%) and the misuse of prescription drugs (23.2%). In comparison, only 5.6% of low-risk participants reported marijuana use, and only 2.5% reported prescription drug misuse. The Kansas Problem Gambling Helpline is 1-800-GAMBLER, which provides 24-hour assistance for information and referrals to treatment. Table 1 below provides historical data showing the total number of calls received by the helpline before the 2009 opening of Kansas’s first state-owned casino (2001-2008). Table 2 provides the total number of calls received by the Kansas Problem Gambling Helpline from 2009 to 2023, with notes indicating specific milestones in Kansas.c
The state of Kansas provides free training for a licensed counselor residing in Kansas to become a Kansas Certified Gambling Counselor (KCGC). This program was developed through KDADS’ Behavioral Health Services Commission’s Problem Gambling department. Currently, Kansas has 38 KCGCs.
Legalized forms of gambling, both in-person and through mobile apps, have expanded rapidly across the state. Consequently, Kansas has an increased duty of care to prevent and address gambling-related harm to individuals, families, and communities. Kansas promotes healthy communities, and problem gambling is a preventable and treatable public health issue that negatively impacts individuals, families, and communities. Providing education, prevention, and treatment for problem gambling is required to strengthen both general health and well-being, and mental health for all Kansans across the state.
The Kansas Prevention Collaborative operates using SAMHSA’s Strategic Prevention Framework (SPF). The SPF is a data-driven planning process that prevention practitioners use to understand and more effectively address the substance abuse and related mental health problems facing their communities. The SPF was designed to: prevent and reduce substance use and abuse, reduce problems in communities related to substance use, and enhance state and community prevention capacity and infrastructure. The framework includes five steps to ensure a comprehensive prevention plan. The first step in the development of a comprehensive strategic plan is to conduct a needs assessment and to prioritize areas of need based on data.
In Kansas, there were several statewide committees and subcommittees that developed their prevention plans based on their unique areas of focus. These committees include the Governor’s Behavioral Health Planning Council (GBHSPC) Prevention Subcommittee, the Kansas Suicide Prevention Coalition, and the Kansas Prescription Drug and Opioid Advisory Committee. Each committee had its own set of goals and objectives based on its respective focus and priorities. In addition, KDADS Behavioral Health Services leadership prepared a commission objective for prevention. The intent of the 2024-2027 Kansas Strategic Prevention Plan (KSPP) was to review the diverse goals and objectives of the other statewide prevention plans and align where possible to create a single document that could guide prevention planning and implementation across the state. The KPC formed a small subcommittee of members to complete a crosswalk of the various relevant goals and objectives to determine if there were similarities. The Crosswalk Subcommittee met to complete this task. To create efficiency, this group started the data review and initial prioritization process, which was then shared with all KPC contractors for final input and to set targeted milestones for objectives within each prioritized goal area.
With a directive to use data to inform decision-making, the Crosswalk Subcommittee used data gathered and reported in the Kansas Behavioral and Mental Health Profile ( https://kdads.ks.gov/kdads-commissions/behavioral-health/publications-and-reports), which combines data and information from multiple sources into a comprehensive document. Indicators were updated when newer data was available than what was published in the most recent Profile. Where possible, the Profile disaggregated data by gender, race, ethnicity, and age to help identify disparate populations. Data review included over 75 data indicators related to the prevalence, impact, and consequences of substance use, mental health, gambling, and treatment. The process of prioritizing significant areas of concern was based on the following criteria and considerations:
The Crosswalk Subcommittee members were provided with a Data Review Guidance document and a prepopulated worksheet that showed for each indicator: indicator definition/source, percentage or rate of prevalence, Kansas rate compared to national average (when available), and the five-year data trend. To review the potential differential impact of behavioral health on age, the data for each indicator were presented for youth (11-18), young adults (18-25), and adults (18+) separately. After reviewing each indicator, the Crosswalk Subcommittee discussed how much the indicator could be changed and how much effort was or would be needed to address the issue. Finally, the group made a list of current programs being implemented to address the issue.
The Subcommittee determined that current block grant priorities would automatically be included in the State’s prevention plan. While data for adults 18+ were reviewed, the Subcommittee also determined, based on the current funding structure, that the Kansas Prevention Plan would make priorities that focused on youth aged 11-18 and young adults aged 18-25.
Based on the data, the Subcommittee made recommendations for the State to prioritize the following substance use concerns for both youth and young adults: underage drinking, marijuana use, vaping, and increased awareness of fentanyl. See Section IV for resulting goals and objectives.
With substance use priorities decided, the Subcommittee identified the need to include mental health and problem gambling as part of a comprehensive prevention plan. A group of state experts met to review and pare down the mental health indicators to prioritize. A list of eight indicators was sent to the Crosswalk Subcommittee to rank order based on the criteria discussed earlier. Similarly, a list of problem gambling indicators was sent to the KDADS team and the Problem Gambling Coalition to identify goals.
The KPC Crosswalk Subcommittee presented the substance use goal areas to KPC partners at the March 2024 KPC Retreat. The KPC collaboratively set targets for each objective and actively discussed the mental health and problem gambling indicators. Final indicator selection for all priorities is outlined in Section IV.
The KPC prioritized the following goals and objectives for the Kansas Prevention Plan. These priorities will be monitored annually for improvement between 2024 and 2027.
Purpose of the Evaluation
The Kansas Department for Aging and Disability Services (KDADS) Behavioral Health Services Commission manages mental health services in Kansas and oversees addiction and prevention service programs for the State of Kansas. Supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), KDADS holds the authority and responsibility to coordinate and provide substance use and mental health services in Kansas. KDADS promotes effective public policy and develops and evaluates programs and resources for behavioral health prevention, treatment, and recovery services.
As a statewide system, KDADS supports efforts to mobilize communities using data to target high-risk areas for youth use of alcohol and drugs. It implements an integrated and community-focused approach to behavioral health through the Kansas Prevention Collaborative (KPC) and directly funds numerous community coalitions for the prevention of substance misuse.
KDADS has decades decades-long and effective history of implementing systematic prevention initiatives in Kansas. It has funded over 100 coalitions in the past 15 years in most of the 105 counties in Kansas.
Stakeholders are interested in how prevention efforts impact targeted goals and objectives of reducing substance use and promoting behavioral and mental health. The information from the evaluation plan will be used to monitor progress, promote adequate training and technical assistance, improve capacity for prevention work, and assess the impact on outcomes.
The following table outlines the goals and objectives identified by the Kansas Prevention Collaborative for the Kansas State Prevention Plan for the years 2024-2027. KDADS and the KPC Contractors will be responsible for the annual update of data and review of goals and objectives.
