Through partnerships, Local Health Departments (LHDs) can enhance their capacity and increase their impact in addressing the intersection of Adverse Childhood Experiences (ACEs), suicide, and overdose prevention. Partnerships contribute to diverse perspectives and align efforts to the community’s culture, create community buy-in from a broader range of groups, extend resources and reach, allow complex challenges to be addressed across multiple sectors, and improve efficiency in addressing shared risk and protective factors.
Look at the results of Q8-10 in your completed SPACECAT to identify opportunities to strengthen networked partnerships.
Communities already have assets that can reduce the shared risk factors of suicide, overdose, and ACEs and increase resilience. Map out what stakeholders in the community are already doing in these areas and who they reach. Current coalitions related to suicide, overdose, or ACEs prevention may offer a good starting place to identify stakeholders.
- Physical Health: Health systems, hospitals, Federally Qualified Health Centers, primary care providers, pharmacists
- Behavioral health: Mental health providers, inpatient and outpatient substance use treatment services, harm reduction organizations
- Education: Primary and secondary schools, institutions of higher education
- Public safety: Law enforcement, emergency medical services, fire
- Criminal justice: Adult and juvenile justice systems, drug courts, diversion programs
- Family and youth services: Family support organizations, parenting education and support, tutoring, mentoring, family violence and intimate partner violence support services
- Employment services: Labor and unemployment offices, economic development or job training programs
- Housing service: Local housing authority, homeless services, community development offices, housing programs for seniors
- Food assistance: Food banks and pantries
- Media: Newspapers, television, radio, online media
- Faith-based organizations: Congregations, national denominations and their affiliate networks (e.g. Catholic Charities, the Salvation Army, YMCA), and independent faith-based nonprofits
Partners occur at the local, state, or national level and include governmental, for-profit, or non-profit agencies and organizations. Partners should also cross sectors.
When assessing current partnerships, remember to consider what partnerships you already have and who is missing from the table that could help you reach additional, critical audiences and facilitate linkages to care. Ask yourself:
- What organizations/agencies will help increase impact in the intersection of suicide, overdose, and ACEs prevention?
- Who has influence that can open doors in the community?
- How does the work of the partner connect to this intersection work?
- What would be the partner’s driving motivator in working together on the prevention of suicide, overdose, and ACEs?
Depending on the community context and need, specific populations may also be at higher risk of suicide, overdose, or ACEs (see the Health Disparities section to learn more), and have dedicated community-based organizations or services, such as those serving veterans, individuals identifying as LGBTQ, or refugee and immigrant populations.
Partnerships exist along a continuum, ranging from informal networking partners that raise awareness of programs and services to integrated strategic partners with shared planning and decision-making. It’s important to remember that the level of engagement will vary by partner, and that not all partners need to involve close collaboration and common work plans. Trust and buy-in with partners takes time. Commitment will be critical to strengthening and maintaining partnerships, no matter the level of engagement. When considering your current partnerships:
- Define your current partnerships along the Levels of Partnership continuum.
- Identify strengths and limitations of the partnership in its current state.
- Consider what would be needed to maintain their current level of engagement. Use the Tips for Overcoming Challenges to Increase Partner Engagement sheet to assist you with brainstorming ideas.
- Determine whether an increased level of engagement is needed to move the intersection work forward.
- Identify barriers (yours and theirs) to increased support, participation, and partnership and what would be needed to increase engagement. Competing priorities, political constraints, limited influence, different philosophies/approaches, and limited resources are common barriers to successful partnerships.
The Current Partner Analysis tool can also assist you in considering your current partnerships.
 Taylor-Robinson DC, Lloyd-Williams F, Orton L, Moonan M, O'Flaherty M, Capewell S. Barriers to partnership working in public health: a qualitative study. PLoS One. 2012;7(1):e29536. doi: 10.1371/journal.pone.0029536. Epub 2012 Jan 4. PMID: 22238619; PMCID: PMC3251584.
In addition to better understanding and considering your current partnerships, you may realize that important stakeholders are missing and need to be engaged. Brainstorm a list of potential partnerships within your community. Consider the following and/or use the Potential Partner Analysis tool:
- What missing piece would this partnership assist with?
- Has this partner expressed interest in working with us? If so, what is their motivation to engage in and support the work? If not, what do we see their role as?
- What is the partner’s biggest concern, if any, over working with us? What is our biggest concern, if any, over working with them?
- What do we need to do to gain their support?
Once you have identified a new partner to engage, determine who the individual(s) responsible for building the relationship will be. This may be someone who already has a connection with someone in the organization or someone who is passionate and knowledgeable about the intersection work. When reaching out, consider the best ways to present the importance of the work and/or potential partnership.
- Demonstrate the need for a community approach using data
- Highlight successes of work you are already doing in the intersection of suicide, overdose, and ACEs
- Personalize the work through a recent community event or story. Discuss ways a partnership could enhance the work the potential partner is already doing, particularly opportunities and/or activities that would align with its mission.
Remember to adapt your messages to the information that will be most meaningful to the partner!
Whenever possible, seek formal agreements with your partners to clarify commitments and expectations. This can come in the form of:
- Letter of Commitment: A legally binding statement from both parties stating both partners are fully capable of participating in the agreed upon set of activities to deliver agreed upon outputs. These letters should highlight the specific roles and responsibilities for the activities and any financial obligations for the work to be successfully completed.
- Memorandum of Understanding (MOU): A written agreement between two partners establishing ground rules for partnership activities. MOUs should outline what each party agrees to contribute to the partnership, a timeframe for delivering the desired outcomes, details of how the partners will collaborate (e.g., regular in-person meetings, conference calls, written approval of all activities by both parties), and any financial obligations for delivering outcomes.
- Financial support via grants/contracts: LHDs may serve as a funding source to support community resources via grants or contracts. In this situation, the agreement associated with the funding can serve as a means of formalizing the partnership and the work to be done
A worksheet to analyze the relationship, motivation and needs of current and potential partnerships.
- Collaboration Between Local Health Departments and Community Health Centers (NACCHO and the Center for Sharing Public Health Services)- A report that provides detailed information on established collaborations between local health departments and community health centers, collected via survey.
- Cross-Sector Innovation Initiative: Community and Partner Engagement (Center for Sharing Public Health Services)- A report that describes grantee work in community and partner engagement as a part of the Cross-sector Innovation Initiative (CSII).
- Establishing Powerful Program Partnerships (Centers for Disease Control and Prevention)- A CDC Recipe for Public Health compiled using findings from a CDC- conducted evaluation that lays out “ingredients” for establishing powerful program partnerships.
- Comprehensive Assistance for Shared Services (COMPASS) (COMPASS)- A resource repository that provides information and tools to assist in the implementation of cross-jurisdictional sharing.
- Partnership Assessment Tool for Health (Partnership for Healthy Outcome)- A tool that gives community-based organizations insight on the effectiveness of their partnerships by identifying successes and areas for improvement.
- Developing Effective Coalitions: An Eight-Step Guide (Prevention Institute)- A guide outlining the process for coalition development.
- Rural Health Networks and Coalitions Toolkit (Rural Health Information Hub)- A toolkit that provides guidance on the development and expansion of health networks and coalitions in rural communities.
- Roadmap to Develop Shared Services Arrangements Between Local Health Departments and Health Centers (NACCHO and the Center for Sharing Public Health Services)- A "roadmap" that provides a framework for sharing agreements between local health departments and health centers.
- Guide for Developing Legal Documents Governing Shared Services Arrangements Between Local Health Departments and Health Centers (NACCHO and the Center for Sharing Public Health Services)- A toolkit that provides guidance for the development of legal documents governing shared services between local health departments and health centers.
- Factors that Contribute to Successful Shared Services Arrangements Between Local Health Departments and Health Centers (NACCHO and the Center for Sharing Public Health Services)- A toolkit that provides an overview of the factors that result in shared service arrangements between local health departments and health centers.
- Local Health Department- Community Health Center Collaboration Toolkit (NACCHO and Altarum Institute)- A toolkit that provides tools designed and collected to support collaborations/partnerships between local health departments and community health centers.
- Collaboration Trust Scale for Shared Services Arrangements Between Local Health Departments and Health Centers (NACCHO and Center for Sharing Public Health Services)- A toolkit that provides information on how to evaluate trust levels and resource sharing between local health departments and health centers considering or already involved in shared service agreements.
- Cross- Sector Innovation Initiative: Aligning Partnerships Across Sectors (Public Health National Center & Center for Sharing Public Health Services)- A report that describes grantee work to align partnerships across sectors to achieve future sustainability.
- Violence Prevention in Practice: Partnerships (Veto Violence, Centers for Disease Control and Prevention)- Resource guide and toolkit for implementing CDC’s technical packages for violence prevention. This toolkit includes information on creating and sustaining partnerships.
- Collective Impact Forum (Collective Impact Forum)- A webpage about what collective impact entails and how collective impact achieves social change.
- Roadmap for Advancing Community IVP Partnerships (Safe States)- A collection of recommendations and associated resources to provide concrete guidance and tools to support public-private partnerships.
- Partnerships and Collaboration (Suicide Prevention Resource Center)- A resource repository from the Suicide Prevention Resource Center that contains various templates and worksheets designed to help the development and implementation of partnerships in suicide prevention programs.
- Building Hope and Resiliency: A Collaborative Approach to Suicide Prevention in Riverside County (Riverside University Health System)- A report that outlines Riverside County's strategic plan for suicide prevention.
- Suicide Prevention Toolkit for Primary Care Practices: Developing Mental Health Partnerships (Suicide Prevention Resource Center)- A suicide prevention toolkit for primary care practices that contains tools, information, and resources to implement suicide prevention practices. This includes modules about creating and sustaining partnerships with mental health professional stakeholders.
- National Strategy for Suicide Prevention Implementation Assessment Report (Substance Abuse and Mental Health Services Administration)- A report that discusses the national strategy for suicide prevention, including information for how to integrate and coordinate suicide prevention activities across different sectors.
- Suicide Prevention: Toolkit for Engaging Communities (World Health Organization)- A toolkit with a guide for how to initiate suicide prevention activities within communities, including creating community action plans.
- Strategies for Community and School Settings for Youth Suicide Prevention (American Academy of Pediatrics)- A blueprint for implementing youth suicide prevention activities within the community, including a module about building community partnerships.
- Public Health and Safety Team (PHAST) Toolkit (CDC Foundation)- A toolkit that provides guidance to local agencies on how to develop and sustain partnerships across sectors to reduce opioid overdose deaths.
- Partnership Mapping Tool (National Overdose Prevention Network)- A tool that helps to organize and visualize community partners in overdose prevention.
- Templates for LHD Opioid Prevention & Response: A How-To Guide (NACCHO)- A reference document that supports local health departments as they plan for, implement, and evaluate their efforts, including information on planning partnerships.
- Build State, Local, and Tribal Capacity to Respond to Opioid Overdoses: Strategies and Partnerships (Centers for Disease Control and Prevention)- A webpage that provides information about building partnerships with programs working to build capacity in state, local communities, and tribes to prevent opioid overdoses
- Building Community Resilience: Coalition Building and Communications Guide (Milken Institute School of Public Health, George Washington University)- A guide that provides a framework for coalition building and communications.
- Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities (Centers for Disease Control and Prevention)- A technical package from the Centers for Disease Control and Prevention that provides evidence-based strategies to prevent child abuse and neglect, including information and guidance on multi-sector involvement.
- Collaboration Toolkit (FRIENDS National Resource Center for Community-Based Child Abuse Prevention)- A toolkit that provides tools and resources, categorized across ten elements.
- Child Abuse Prevention and Child Welfare: Collaborating for Creative Solutions (FRIENDS National Resource Center for Community-Based Child Abuse Prevention)- A framework that provides guidance on developing collaborations.