Addressing the Intersection of ACEs, Suicide, Overdose, and Mental Health Concerns
Adverse childhood experiences (ACEs), suicide, overdose, and mental health-related concerns are not isolated challenges. They are linked across the life course and often reinforce one another, with early adversity increasing the risk of later suicidal behavior, substance use, overdose, and mental health conditions.
As conveners, strategists, and coordinators across sectors, health agencies play a critical role in addressing the intersection of these important public health issues. ASTHO — with CDC funding — has developed this suite of resources to support them in this critical work. It draws upon strategies from multiple CDC Prevention Resources for Action and other related research on preventing ACEs, suicide, overdose, and mental health concerns, emphasizing those related to economic and foundational supports, the built environment, and trauma response efforts. These strategies enable agencies to:
- Align policy, funding, workforce, data, and partnerships across various programs (e.g., behavioral health, injury prevention, maternal and child health, and chronic disease prevention).
- Support cohesive, agency‑wide prevention strategies rather than fragmented programs.
- Maximize existing resources and reduce duplication of effort.
Intersections Suite Overview
Learn more about the resources and how health agencies can use them to strengthen prevention efforts in this brief video.
Transcript
Adverse childhood experiences- also known as ACEs, suicide, overdose, and mental health-related concerns are not isolated challenges. They are linked across the life course and often reinforce one another, with early adversity increasing the risk of later suicidal behavior, substance use, overdose, and mental health conditions.
Recognizing these connections creates an opportunity for more coordinated and effective prevention efforts. To support state, territorial, and freely associated state health agencies, ASTHO, with CDC funding, has developed a suite of resources to address these issues simultaneously. These resources are grounded in evidence-informed prevention strategies, emphasizing those related to economic and foundational supports, the built environment, and trauma response efforts.
Health agencies play a critical role as conveners, strategists, and coordinators across sectors. By addressing ACEs, suicide, overdose, and mental health concerns together, agencies can:
- Align policy, funding, workforce, data, and partnerships across programs.
- Support cohesive, agency-wide prevention strategies rather than fragmented efforts.
- And maximize existing resources while reducing duplication of effort.
ASTHO has created several resources detailing practical guidance and real- world examples addressing these challenges, including:
- The roadmap offers a starting point for understanding the overall approach of the action guide and offers a high-level overview of the strategies.
- The action guide expands on the roadmap, providing detailed practical guidance and resources to support implementation.
- The Voices from the Field success stories shows how jurisdictions are putting these approaches into practice.
- The SPACECAT webpage features resources that can be revisited at any time for ongoing capacity building, tracking progress, identifying gaps, and strengthening coordinated prevention efforts over time.
Together, these resources help health agencies strengthen prevention efforts and advance a more coordinated approach to improving health and well-being.
To learn more about the project or these resources, contact ASTHO's Social and Behavioral Health Team at sbh@astho.org.
Action Guide
Together, these resources serve as an action guide for health agencies, delving into approaches for implementing key intersection strategies. Treat them as flexible references: Rather than reading the resources end-to-end, revisit them as your team’s priorities and questions shift.
Action Guide Overview
View a short demonstration of how to use the action guide.
Transcript
ASTHO, with CDC funding, developed this Action Guide to help state, territorial, and freely associated state health agencies address adverse childhood experiences—also known as ACEs—suicide, overdose, and mental health-related concerns simultaneously.
The action guide provides detailed implementation strategies and approaches drawn from CDC Prevention Resources for Action and other evidence-informed research, along with relevant resources and examples to help health agencies de-silo their work across these interconnected areas.
This action guide is designed for health agency staff working on ACEs, suicide, overdose, and/or mental health concerns. The guide is not intended to be read end-to-end; instead, it is a flexible reference you can revisit as your team's priorities and questions shift.
To help identify the action guide strategies most relevant to your agency's current efforts and priorities, start with the roadmap, which also highlights the role that health agencies play in this work.
The Action Guide is grounded in the idea that no single strategy can prevent ACEs, suicide, overdose, or mental health concerns on its own. Instead, multiple evidence-informed approaches are layered together.
Much like the Swiss Cheese Model, each strategy addresses different risks and gaps. When combined, they create stronger protection for individuals, families, and communities.
The Roadmap offers a starting point for understanding the overall approach and a high-level view of the strategies.
The strategies include:
Strengthening Economic Supports for Families by:
- Bolstering household financial security.
- Enhancing work-related family supports.
- Building employment opportunities.
- Supporting stable and affordable housing.
Strengthening Community and Home Environments by:
- Promoting modifications to community environments.
- Promoting safe home environments.
Ensuring Strong Foundational Supports for Children and Families by:
- Enhancing early childhood supports.
- Enhancing programs and supports for school-aged children.
- Providing skill development training.
Strengthening Supports to Lessen the Impact of and Prevent Future Traumatic Experiences by:
- Supporting behavioral health integration into primary care.
- Enhancing access to behavioral health treatment and services.
- Improving civil protections.
- Enhancing responses to traumatic events.
For each strategy, you will learn its impact on the intersection, the role of the health agency, and the needed steps for implementation.
As you work through the action guide, consider how the core competencies, including data, policy, partnerships, workforce, and funding, inform your jurisdiction's efforts and connect across the strategies.
For questions regarding the action guide or to learn more about addressing ACEs, suicide, overdose, and mental health concerns simultaneously, reach out to ASTHO's Social and Behavioral Health Team at sbh@astho.org.
Roadmap
Start here for a high-level view of the intersection strategies. After better understanding how these work together to address multiple health concerns, use this resource to identify the strategies most relevant to current efforts and priorities.
Key Strategies
Strengthening Economic Supports for Families
Learn how to help stabilize families by improving financial and housing security.
Ensuring Strong Foundational Supports for Children and Families
Explore how to shape lifelong health through early childhood supports, school-based programs, and more.
Strengthening Community and Home Environments
Dive into approaches that support safe, nurturing households and neighborhoods.
Lessening the Impact of and Preventing Traumatic Experiences
Learn how to aid effective interventions when trauma occurs and reduce the likelihood of future occurrences.
Featured
Voices from the Field
Read a collection of stories demonstrating how jurisdictions are tackling prevention work.
Suicide, Overdose, and Adverse Childhood Experiences Prevention Capacity Assessment Tool
Use these resources for ongoing capacity building, tracking progress, identifying gaps, and strengthening coordinated prevention efforts over time.
Supplemental Resources
As you engage with the strategies in the action guide that are most relevant to your organization’s goals, use these ASTHO resources to build core competencies.
Data
A strong data infrastructure enables health agencies to pinpoint where their efforts will be most effective, better understand and demonstrate the impact of their work, and communicate information to the public more clearly. Here are some resources you can leverage to improve your data systems.
- How to Modernize Data Infrastructure: A Toolkit for Public Health Leaders
This toolkit guides health agencies on their journey to improve their public health data infrastructure, providing a structured approach to prioritizing and implementing essential data modernization strategies. - Data Modernization Primer and Tactical Guides
This primer provides a high-level overview of the objectives and significance of data modernization, as well as the roles it plays in a successful initiative. The five tactical guides detail key strategies and tactics for implementing and maintaining data modernization initiatives within public health agencies. - Sustaining DMI: Leveraging Medicaid to Advance Public Health Data and Surveillance
This primer describes how to leverage Medicaid to design and execute a sustainable data modernization initiative. It provides guidance, resources, and practical tools for effective management, strategic planning, and skill development to strengthen sustainability planning. - Successful Informatics Alignment: Policy Approaches for State and Local Data Sharing
A collection of resources written for health agency staff navigating policy considerations for advancing state and local data sharing. - Policy Approaches to Improve State and Local Data Sharing
A policy guide to improving data sharing between state and local health departments. - Overcoming Common Barriers to Data Linkage
A brief that outlines lessons learned in data linkage for public health, focusing on partnerships, data matching, and sustainability. - Accelerating Data Exchange in Public Health
This report presents an overview of several Fast Healthcare Interoperability Resources (FHIR) pilot projects, examining approaches to unidirectional and bidirectional exchange. It also identifies key successes, challenges, and lessons to inform continued FHIR adoption across state/local public health agencies and their health care partners. - How Massachusetts is Advancing Public Health Data Standards
An example of how one state public health agency has used Public Health Infrastructure Grant funding to accelerate their data standards. - Data-Sharing Strategies to Support Access to Care Interventions
Examples of how three state public health agency Primary Care Offices have implemented policy changes to improve access to reliable, accurate data.
Cross-Sector Collaboration
Cross-sector collaboration enables health agencies to reduce duplication, streamline services, and maximize impact. Partnering with other program areas improves service delivery, while engaging trusted community partners builds public trust and increases uptake of interventions. Coordination with other government agencies further enhances service design and delivery. The following resources support effective cross-sector collaboration.
- Cross-Sector Partnerships to Prevent Adverse Childhood Experiences
A collection of resources from ASTHO on fostering cross-sector relationships through activities focused on assessing, building, and sustaining partnerships. - Adverse Childhood Experiences Stakeholder Mapping Roadmap Course
This interactive course on stakeholder mapping is designed for health agencies to use with their departments and partners. Before conducting the stakeholder mapping process with others, it is essential to understand the process and how partners play a role in your work. - Leveraging Healthy People 2030 to Build Non-Traditional Multisector Partnerships
A toolkit aimed at helping build non-traditional, non-public health sector partnerships to improve health outcomes. This toolkit is implementation-focused, providing partnership-building and sustaining skills that are rooted in Healthy People 2030. - Creating Successful Collaboration Structures in Public Health Initiatives
A resource that provides practical tools and guidance to help health agencies design, strengthen, and sustain effective collaboration structures.
Workforce
A skilled and supported workforce is central to implementing and sustaining intersectional prevention initiatives. Workforce capacity includes training, recruitment, and retention. Use the following resources to develop and support your workforce.
- Actions to Build Capacity for ACEs Prevention
A tool designed to help health agency staff describe how they address ACEs in their jurisdiction and identify opportunities to maximize resources and impact. Designed for health agency leadership and staff focused on child maltreatment prevention and/or addressing risk and protective factors for ACEs. - Workforce Planning Guide: Guidance, Tools, and Resources to Assist Public Health Agencies in Workforce Planning
This guide provides guidance, tools, and resources to assist public health agencies in workforce planning, including how to create a three- to five-year workforce plan, and is designed for all stages of plan preparation. - Strategic Planning Guide for Promoting Sustainable Systems Change (log-in required)
This guide assists groups in developing strategic plans. Groups will follow proven methodologies to create a strategic plan that fosters long-term change. This guide can be used by units, organizations, or community coalitions/boards. It can also be adapted for strategic planning within partnerships involving multiple organizations. - Strategic Planning Module (log-in required)
A compilation of resources to help guide strategic planning at health agencies. - From Plan to Action: Tools to Support Public Health Implementation
A suite of resources designed to help public health teams bridge the gap between plans and implementation and turn strategies into action. - How Public Health Can Support Modern Administrative Readiness in a Dynamic World
A guide to the key strategies needed for administrative readiness at public health agencies. Key strategies highlighted in this guide include proactive planning, risk assessment, leveraging information technology, building resilience, and continuous improvement. - Strengthening the Public Health and Health Care Workforce
This policy brief examines legislative trends in public health career pathways, recruitment, retention, and funding.
Policy
Policy levers create environments that can enable or hinder a health agency’s work. Public health agencies have a range of options for building policy capacity, from helping develop laws and regulations to developing internal policies. The following resources offer strategies to help agencies identify and enact policies related to their public health priorities.
- Policy Academy On Demand (log-in required)
A self-paced learning opportunity designed to assist in building capacity for, advancing, and supporting the development of health policy-bolstering programmatic work for health agency employees at all levels. This course will deepen understanding of how to strengthen relationships and to better identify, assess, design, enact, implement, and evaluate policies related to key public health priorities. - Adverse Childhood Experiences Prevention Policy Toolkit
A toolkit to assist health agencies in implementing policies that reduce the risk factors and/or promote protective factors that can decrease the overall prevalence of ACEs in a community. - Strengthening Public Health Agencies for Safe and Healthy Communities
2023 legislative prospectus brief on public health legal authorities, workforce capacity, and workforce funding. - Public Health Legal Mapping Center
This legal mapping work plots the legal landscape for public health priorities. These interactive maps and tables aim to explore trends, track shifts in the law over time, and assist in understanding intricate public health law and policy questions.
Funding
Flexible funding, braiding and layering, and grants management are among the strategies that health agencies can leverage to support intersectional priorities. The following resources can help agencies build capacity across silos and improve efficiency.
- Braiding & Layering Funding to Sustain Cross-Cutting Efforts that Benefit Multiple Programs and Funding Streams (log-in required)
This four-part module explores key components of braiding and layering, including leadership and visioning, prioritization and communications, implementation and management, and continuous quality improvement and evaluation. También disponible en español. - What Territorial Health Officials Need to Know about Grants Management (log-in required)
This introductory presentation provides territorial health officials and their leadership teams with an overview of grants management to help them better utilize current and future grant funding. - Driving Impact with Flexible Funding
This report explores how health agencies are leveraging flexible funding strategies to advance initiatives that address non-medical factors influencing health, with a particular focus on nutrition. - Braiding and Layering Funding to Address the Social Determinants of Health
Strategies for braiding and layering funding to address complex public health issues. These white papers highlight case examples and provide best practices for sustainably funding initiatives. - Braiding and Layering Funding for Adverse Childhood Experiences Prevention
This report aims to help health agency staff understand the process of braiding and layering funds across multiple program areas and identify opportunities to maximize ACEs prevention resources and impact.