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AK Discretionary Funding Fiscal Year 2021
Project Summary: Our project responds to the needs of individuals with SMI and SUD who are also impacted by the mental health stresses caused by the Covid-19 pandemic. We will develop a comprehensive plan of evidence based mental and substance use disorder treatments for individuals with SMI and SUD impacted by the COVID-19 pandemic. Project Name: St. Paul Island Emergency COVID-19 Population(s) to be served: The Pribilof Islands Aleut Community of St. Paul Island (ACSPI) is a federally recognized tribe. Out of a population of 425 (Census 2014-2018) 410 (85.6%) are all/ part Alaska Native. We estimate that there are 50 individuals with SMI, 50 individuals with SUD, 20 individuals with both SMI and SUD, 20 individuals with mental disorders that are less severe than serious mental illness, including 5 in the healthcare profession and first responders. Strategies/interventions: The program services for St. Paul Island community members meets three critical needs: (1) A need to expand outpatient treatment capacity as a result of COVID-19; (2) A need to implement an evidenced-based treatment model and (3) A need to implement the Global Appraisal of Individual Needs -1. Project Goals and Measurable Objectives: Project Goal: Develop and implement a comprehensive plan of evidence-based mental and/or substance use disorder treatment services for individuals impacted by the COVID-19 pandemic. Objective 1: Screen and assess customers for the presence of mental and substance use disorders and/or co-occurring disorders, and use the information obtained from the screening and assessment to develop appropriate treatment approaches Objective 2: Provide evidence-based and population appropriate treatment services. Objective 3: Provide recovery support services Objective 4: Develop and implement Crisis mental health services Number of people to be served annually and throughout the lifetime of the project: Target population: 50 individuals with SMI, 50 Individuals with SUD, 20 individuals, with both. In addition, the total population of 425 will benefit from some of our activities.
Through technology, Aleutian Pribilof Islands Association aims foster connectivity with adults 25 years and older by developing accessible resources in effort to prevent suicides and domestic violence. APIA’s mission is to promote self-sufficiency and independence of the people by advocacy, training, technical assistance and economic enhancement; to assist in meeting the health, safety, and well-being needs of each Unangax community; to promote, strengthen and ensure the unity of the Unangax?; and, to strengthen and preserve the Unangax cultural heritage. The Substance Abuse and Mental Health Services Administration award COVID-19 Emergency Response for Suicide Prevention Grant (COVID-19 ERSP) aligns with APIA’s mission to meet the health, safety, and well-being needs of Unangax communities. The Unangax region is comprised of sparsely populated archipelago islands. The rugged beauty and rich history are in stark contrast to the ruthless weather (fog, wind, rain, repeat). Residents are a hardy group. They have had to rely on each other to survive, which the task of daily living can take a toll. The rate of suicide among all Alaskans in 2017, 26.9 per 100,000, was nearly 2 times higher than the national rate. For Alaska Native people in 2017, the rate was more than 3 times higher than the national rate, 51.9 per 100,000 (U.S. Centers for Disease Control and Prevention (CDC). Suicide mortality by state: 2016). More than 4 in 5 American Indian and Alaska Native (AI/AN) women (84.3 percent) have experienced violence in their lifetime (Rosay, 2016). The COVID-19 pandemic impacts this at-risk population disproportionally (https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-…). There is a high potential for an increase in suicides and domestic violence in both the region and in the urban center, within a state that already faces such high numbers in these areas, it is a public health concern. The goal of this project is to increase the capacity of APIA’s Behavioral Health Services Program and the Healthy Relationships Program in order to increase support and communication with at-risk adults age 25 years or older who are at greater risk of domestic violence and suicide due to COVID-19. The following objectives will be implemented to reach our goal: Objective 1: By November 15, 2020, APIA Healthy Relationships Program will have three public services announcements focused on domestic violence prevention and resources completed and ready for release in Atka, Nikolski, St. George, and Unalaska via public radio and VHF (in communities without radio). We will also post the PSAs on Facebook for a wider audience to raise awareness and promote services during times of social isolation due to COVID-19. Objective 2: By January 30, 2021, APIA will have an app and patient portal with 24-hour access. This will increase resources available to adults who may be isolated due to COVID-19. The app and patient portal will have evidenced based resources such as video clips (e.g., mindfulness exercises), worksheets (CBT and DBT activity sheets), and culturally relevant content (e.g., APIA’s Unangam Tunuu word of the day). National suicide and domestic violence numbers will be on the app and portal along with the state wide AA call in number.
Tlingit and Haida COVID-19 Mental Health and Substance Abuse Response Initiative Abstract The Tlingit & Haida COVID-19 Mental Health and Substance Abuse Response Initiative will provide crisis intervention services, mental and substance use disorder treatment, and other related recovery supports for Native families impacted by the COVID-19 pandemic. The Project will target more than 200 Native families in Southeast Alaska who have been identified as impacted by, or at risk for, serious emotional disturbance and/or substance abuse disorder, exacerbated by the COVID-19 crisis. The project catchment area will include the Juneau urban area, and the following southeast Alaska Native villages and communities: Craig, Klawock and Kasaan. Native families in Southeast Alaska are already at extreme risk for mental health problems and related substance abuse problems. Many families in the urban areas have relocated from village settings in an effort to escape extreme poverty and gain employment. When the impacts of the COVID-19 pandemic are added to other at risk factors, these families find themselves faced with overwhelming mental health and substance abuse challenges due to the isolation and economic disruption caused by the COVID-19 pandemic. The stresses and pressures on already overburdened Native families has been drastically increased as a result of the COVID-19 crisis. Families that have been experiencing domestic violence or child endangerment issues are forced together in a 24 hour lockdown situation, which acts as an absolute powder keg for further violence and abuse. This is especially true for smaller rural Native villages where there is simply no place to run and hide. COVID-19 lockdown produces nothing less than a living nightmare for vulnerable Native women and children. OBJECTIVE 1/YEAR 1 (MONTHS 1-4): Community Readiness/Strategic Planning: By the end of Month Four, the Tlingit and Haida TFYS Department, in consultation with project partners, will complete a planning, consultation, and service model development effort in preparation for delivery of comprehensive mental health and substance abuse services. Initial assessment of need and severity of conditions will be a simultaneous focus. OBJECTIVE 2/YEAR 1 (MONTHS 4-12): By the end of Year One, the TFYS Department, in consultation with project partners, will complete pilot implementation efforts for delivery of comprehensive mental health and substance abuse treatment services under the Tlingit and Haida Covid-19 Mental Health and Substance Abuse Response Initiative; delivery of comprehensive, culturally appropriate care to a minimum of 50 Native families will occur. OBJECTIVE 3/(MONTHS 12-16): By the end of the 16th month, the TFYS Department, in consultation with project partners, will achieve full program implementation of delivery of comprehensive mental health and substance abuse treatment services to a minimum 100 targeted Native families most in need of care due to the pandemic, and will develop a sustainability model for the future, drawing on federal, state, tribal and private funding streams.
Through the proposed COVID-19 Emergency Response for Suicide Prevention (ERSP) project, Cook Inlet Tribal Council, Inc. (CITC) will provide behavioral health services and direct assistance, and advance comprehensive community efforts such as training and cross-referral, to address heightened risk for suicide related to impacts of the COVID-19 pandemic. The population to be served include Alaskan adults (age 25 and up) of all genders and ethnicities assessed as at risk for self harm or possible suicide attempts, particularly those who are victims of domestic violence. CITC is a mature, tribally-operated social services agency with an extensive history providing recovery and other behavioral health services to individuals at heightened risk for suicide throughout Alaska’s Cook Inlet region. There is a profound need for the proposed project. Even prior to the appearance of COVID-19, the demand for behavioral services in Alaska far outweighs provider availability and the virus is clarifying – as well as exacerbating – the entrenched disparities in socioeconomic, physical, and behavioral health conditions that influence experiences of suicidality in Alaska. Few people in our communities have escaped the personal impact of self-harm or suicide. State data released in 2019 tells us that Alaska’s suicide rate has been the first or second highest in the nation since 2012. It is the leading cause of death among Alaskans ages 10–64 years, and the sixth leading cause of death overall – compared with tenth in the U.S. as a whole. In 2017, Alaska’s age-adjusted suicide mortality rate was nearly twice the national rate. The rate among AN/AI Alaskans was nearly three times the nation’s, up 19% since 2008. In alignment with SAMHSA’s funding opportunity, CITC will conduct and report on all required activities, including developing or updating rapid follow-up plans and care transition protocols, facilitating suicide prevention trainings for community members and providers, collaborating with regional partners for comprehensive suicide prevention efforts, providing screening, assessment, and treatment referrals, telehealth, and community-based recovery supports, and by offering victims of domestic violence enhanced services and direct assistance with emergent housing, transportation, and other safety needs.
This project is titled Copper River Native Association expansion of telemedicine in response to COVID-19. The project goals are to expand our existing telehealth services to serve a population the geographic size of Ohio through Zoom, telephonic and Social Media to provide substance abuse treatment, recovery support services that directly address the substance abuse crisis that is currently in our region. With COVID-19 we are seeing a rise in substance use that is leading to an increase in domestic violence, child abuse and neglect.
Fairbanks Native Association (FNA) is applying for SAMHSA COVID-19 ERSP funding. Our proposed project will expand our existing Alaska Native Pandemic Project (ANPP). The focus of ANPP-2 is to provide prevention training, case management, and Recovery Support services for American Indians and Alaska Natives (AI/AN) adults (25+) who have attempted or are at-risk of suicide and/or domestic violence from the effects of the COVID-19 crisis. AI/AN suicide and domestic violence rates far exceed the national average. AI/AN face disproportionately high financial, health, and behavioral health challenges, all of which are exacerbated by the pandemic. Stay-at-home orders increase the risk of domestic violence, substance misuse, poverty, and disconnection from social and cultural supports. ANPP-2 will serve 120 unduplicated clients over the 16 month period. Existing FNA Behavioral Health (BH) ANPP-1 services include 1) a comprehensive community-wide plan of evidence-based substance use disorder and co-occurring SUD and mental health disorder treatment services for individuals impacted by the pandemic; 2) Recovery Support services for all for residential and outpatient individuals with Chronic Mental Illness or Serious Mental Illness, or mental health and/or alcohol disorders; 3) Crisis Mental Health Services (including a 24 hour on-call crisis team and Crisis Intervention, Stabilization, and Therapy); and 4) a plan for rapid follow-up and protocols following crisis. New services to enhance and expand the ANPP include the addition of 1) suicide and domestic violence prevention training for community members at large, community coalition members, and clinical providers; 2) a social media campaign to raise community awareness of new services and recruitment mechanism, 3) case management for Recovery Support services for individuals who have attempted or are at-risk for suicide and are exiting the emergency room or treatment and victims of domestic violence. The existing 17 member community coalition, the Interagency Transition Council (ITC) will play a key role in the project. During its six year tenure it has provided leadership, planning, and rapid access to behavioral health service and Recovery Support providers to FNA projects for the past six years. The ITC is the BH System of Care for this service area. It includes representatives in the following service domains and individuals: Mental Health, Substance Abuse, Juvenile and Criminal Justice, Education & Employment, Spiritual/Cultural, Housing, Health and Emergency Care, Child Welfare, a suicide victim survivor, a veteran, youth, an AI/AN Elder, and members of the community-at-large. Formal agreements are in place for most of the ITC providers, with the remainder to be updated or formalized within three months of project funding. The ITC is responsible for the social media campaign, identification and recruitment of clients, rapid access to care, and assisting in the identification of suicide and domestic violence curriculum.
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