Can an Infusion of Federal Funds Result in Sustainable Projects? An Evaluation of Suicide Prevention Programs.

Our study evaluated the sustainability of programs in early cohorts of the Garrett Lee Smith (GLS) Memorial Act suicide prevention initiative, a major source of federal funding for youth suicide prevention among states, tribes, and institutions of higher education. We sought to: (1) determine whether suicide prevention activities initiated with federal support continued after funding ended, and (2) identify factors associated with sustainment. Thirty-three sites between 1 and 4 years beyond the end of their GLS grant participated in a retrospective online survey assessing their level of suicide prevention activity 1 year before, during (during-GLS), and 1 year after funding (after-GLS). We found that, on average, sites experienced a 6% decrease in their overall level of activity from during- to after-GLS. Twenty-two (67% of responding sites) exhibited either an increase in activity level or no more than a 10% decline from during- to after-GLS periods. After-GLS scores for the 11 remaining sites declined between 11 and 30% from their during-GLS levels. We conducted semi-structured follow-up interviews with 13 sites that successfully continued their activities to explore factors associated with sustainability. Our findings indicate that program actions in the during-GLS period associated with sustainability included: maintaining a sustainability mindset, developing and nurturing partnerships and relationships, embedding services in parent organizations, pursuing new and diversified funding, and implementing cost-reduction efficiencies. Actions in the after-GLS period associated with sustainability included: obtaining funding from other sources, reconfiguring, and maintaining continuous leadership.