The steering committee of Project Safety Net — with some 20 member organizations — last week approved a carefully worded "theory of change" document drafted over the past six months.
The group has sliced the number of its anti-suicide "strategies" from 22 to nine and the number of its committees from seven to three.
Addressing tensions over whether Project Safety Net's primary purpose is suicide prevention or general "youth well-being," the document reflects a dual mission for the future.
"The Palo Alto community struggles with the pain and loss of youth to suicide," the group said in its core statement. "There is urgency for on-going, coordinated community action to promote youth well-being and prevent suicide."
Becky Beacom, health education manager at the Palo Alto Medical Foundation and a member of Project Safety Net's steering committee, said the reorganization has helped member groups to prioritize "more concrete goals instead of abstract ones.
"When we first started this group we were in a reactive mode, with a lot of anxiety, stress and tension," Beacom said at an Aug. 22 meeting, three days after the steering committee approved the new format.
"This process has given us the ability to respond as opposed to reacting.
"We're gaining tools and skills and learning how to be in a situation that's unimaginable — beyond what anyone wants to believe has happened — but our reality is it has happened and it's likely to happen again.
"We now have some tools and guidelines."
In the future, members said, the group will be more explicit in its discussion of suicide and its goal of reducing the stigma surrounding use of mental health services.
At the same time, it will focus on the "upstream" goal of promoting youth well-being and resilience, with the hope that such education will protect many teens from developing problems later.
When Project Safety Net began meeting in the fall of 2009, Palo Alto had been rocked by three high school student suicides in a period of four months — and additional deaths were to come.
Multiple organizations and individuals stepped forward to try to help. Staff members from the city and the Palo Alto Unified School District informally organized the group, which produced a June 2011 document outlining a complicated organizational structure.
Run by a 15-member steering committee, Project Safety Net settled into monthly public meetings during the school year — typically drawing about 30 people — at which representatives of member groups shared ideas and information on projects relating to teen mental health and suicide prevention.
Those projects varied, depending on the organization, but have included the training of more than 1,000 school staff members and students in the suicide-prevention method known as QPR (Question, Persuade and Refer) under the auspices of Stanford School of Medicine adolescent psychiatrist Shashank Joshi, and teen art shows, with narratives, organized by the Palo Alto Youth Collaborative.
The need to re-evaluate the mission of Project Safety Net came after Palo Alto officials committed to the organization $2 million of the nearly $40 million the city is receiving in mitigation funds for the Stanford University Medical Center expansion.
Compass Point, a consulting firm hired to help allocate the funds, recommended that Project Safety Net first refine its focus, hence the re-evaluation process.
The new structure, said steering committee member Terry Godfrey, gives prospective funders, including the city, greater confidence that Project Safety Net has a clear strategy.
The new committees will focus on educating the community about the so-called Developmental Assets — a framework describing 41 attributes that youth need to thrive. Committee work also will focus on reducing the stigma of seeking help, reducing access to means of lethal harm and ensuring "robust" access to mental health services.
Members also are considering changing the Thursday lunch meeting times in hopes of attracting more student members.
Paly senior Jessica Feinberg, the only student who attended the Aug. 22 meeting, said many teens have never heard of Project Safety Net.
"It's hard for students to feel like they could get involved because they don't really know how it's shaped or how it works," said Feinberg, who hopes to start a peer support group at Paly.
"Suicide isn't a problem that's going to go away just because we haven't had deaths. The lack of deaths — it's great and really important and obviously that's a success — but it's kind of like having a yearly flooding problem and putting up a dam, but not to address that there's too much water in the first place."
Staffing for Project Safety Net has been provided by the school district and the City of Palo Alto and is undergoing a shift.
Social worker Christina Llerena, who worked for the city for the past 16 months, recently resigned to take a position with West Valley Community College. The city plans to hire a replacement for Llerena as well as to add administrative help for the position, said Rob DeGeus, assistant director of Palo Alto's Community Services Department.
Llerena said she'll stay on for 10 hours a week until she can train her replacement.
"To be honest, I'm still processing everything for myself in terms of what kind of impact I've made, but it's a challenge to move change, especially around issues of mental health and suicide prevention," Llerena said.
Project Safety Net, she said, is a "classic grass-roots coalition where you organize around a crisis and then you have to make it sustainable.
"It's really common, depending on what stage a collaborative is in, to have some sort of growing pains or learning curve around structure and revisiting mission, vision and accountability," she said.
"When you're dealing with these stigmatized issues like mental health services and suicide it's even more important to have a clear charge of how you organized the work and structure it."
The 22 groups currently listed on Project Safety Net's website are Adolescent Counseling Services, Caltrain, Children's Health Council, City of Palo Alto City Manager's Office, City of Palo Alto Community Services Department, Palo Alto Council of PTAs, Community Center for Health and Wellness, local psychologists, Lucile Packard Children's Hospital, parent representatives, the Palo Alto Parks and Recreation Commission, the Palo Alto Fire Department, the Palo Alto Police Department, Palo Alto University, Palo Alto Medical Foundation, Palo Alto Unified School District, Palo Alto Family YMCA, Project Cornerstone, Santa Clara County Mental Health Department, suicide parent survivors, youth and teen representatives and Youth Community Service.