AK Discretionary Funding Fiscal Year 2023

Over the next five years, the CRNA Creating Conditions for Community Healing Project will support the training of over 300 community members in various positions, both professional and community-based, who reside in the Copper River Region of Alaska. The Copper River Native Association, using evidence based practices, will implement programming to train service professionals, first responders, education professionals and community members to recognize and support individuals in the community with serious mental health challenges. The project will support Ahtna people who are affiliated with the Copper River Native Association. The project will train between 50-100 individuals annually. The goal of the project is: by the end of the five-year MHAT grant program, the CRNA Creating Conditions for Community Healing Project will substantially increase the capacity of service providers and community members in the Copper River Region to respond effectively to our tribal community members who struggle with serious mental illness. The project will accomplish this through consistent training of service providers using evidence based methods, through resource development and referral services, and through promoting community mental health awareness.

The Alaska Child Trauma Center at Alaska Behavioral Health is proposing a Rural Child Trauma Center to raise the standard of care and improve access to evidence-based treatments for rural children impacted by child trauma. The Center will provide training in rural communities to improve identification of child trauma and training to mental health professionals to improve the quality and accessibility of child trauma treatment in rural areas. The Rural Child Trauma Center will use four strategies; (1) rural community training on child trauma to improve local awareness, identification and responsiveness to child trauma (2) training and ongoing professional consultation on evidence-based treatments to mental health professionals serving rural areas (3) training on the provision of child trauma treatments using telehealth, to extend services to areas with mental health professional shortages (4) rural child trauma-focused Learning Communities to improve professional and organizational rural-service competency (5) an annual Rural Child Trauma Institute to disseminate best practices in rural child trauma treatment nationwide. The Rural Child Trauma Center will provide training to over 10,000 persons living in, or serving, rural areas over the project period. The sought outcomes of the Center are increased identification of child trauma in rural areas, improvement in the availability of evidence-based trauma treatments in rural areas and improvement in access to those services for children and families in rural communities.

The Alaska Mental Health Awareness Training Program (AKMHAT) will provide statewide training to Alaskans in key systems such as education, public safety, first responders, services for veterans and service members and family members of persons experiencing mental illness or crisis. The goals of this training initiative will be to improve awareness of mental health, improve responsiveness of key systems to mental illness or crisis and to facilitate the referral of persons to mental health services as needed. We will use three evidence-based training curricula, the Alaska Trauma 101, Mental Health First Aid and QPR Suicide Prevention training. Training will be targeted to those working in key systems who are responding to members of the public who experience severe mental illness (SMI) children who experience severe emotional disturbance (SED) and both adults and children with substance use disorders (SUD) and co-occurring disorders (COD). The project will train 900 persons in the first year and 1000 persons each in years 3-5 for a total of 4900 persons trained. We will use a hybrid, rural training delivery model to provide in-person training in rural hub communities and live webinars to reach communities statewide. This initiative will be supported by a targeted mental health awareness campaign and development of streamlined referral processes and referral process trainings to support the successful referral of Alaskans experiencing mental illness or crisis to appropriate mental health services.

Alaska serves as the 49th state, gaining statehood in 1959, and is larger than the three next largest states combined. The geographical makeup of this state includes many isolated, largely roadless, and rural areas that make accessing needed services a difficult goal to achieve. The Anchorage Municipality serves as the “urban hub” for Alaska with the Anchorage School District (ASD) gaining the title of Alaska’s largest, most urban district, educating 44,325 students over 2,000 square miles with minority students comprising more than 50% of our student population. While Anchorage serves as the “urban hub” for many services in Alaska, residents are often faced with wait times to access services exceeding six months. Specifically, 62.9% of Alaskan youth who had depression in 2021 did not receive behavioral health services. Additionally, Alaska ranks 43rd on the Overall Child Well Being Scale and has the second highest rate of suicide in the country. To address these gaps in services, ASD has partnered with the Alaska Department of Education, Alaska Division of Behavioral Health, Providence, Volunteers of Alaska, Azevedo Consulting, and Alaska Behavioral Health to build a district wide evidence-based comprehensive school mental health system to improve school climate, increase mental health awareness, and reduce violence and suicide rates in our schools. ASD’s Comprehensive School Mental Health Systems Project will serve students in Elementary, Middle, High School, and Alternative settings with an average of 10,778 students served per year of the grant and a total of 44,527 students served over the lifetime of the grant. The first goal of the project is to build system infrastructure and capacity through interagency collaboration to increase quality and sustainability of mental health services for students. ASD will utilize the evidence-based Interconnected Systems Framework (ISF) to develop a comprehensive implementation plan, advisory board, and community needs assessment to achieve this goal. The second goal of this project is to increase the capacity of schools to directly respond to mental health needs of students. ASD will implement universal behavioral health screening using SAEBRS (Social, Academic, Emotional Behavior Risk Screener), embed school-based mental health clinicians who will utilize evidence-based interventions including CBITS and Bounce Back and implement the evidence based Positive Behavior Interventions & Supports (PBIS) across all project schools to achieve this goal. The third goal of this project is to promote wellness and resiliency among students and staff by fostering healthy environments and providing comprehensive prevention (Tier I), early intervention (Tier II) and intensive individualized services (Tier III). ASD will facilitate district wide training for 100% of ASD project staff on PBIS, Youth Mental Health, and ISF to reach this goal. The fourth goal of this project is to ensure effectiveness of program activities through program monitoring and reporting. ASD will accomplish this goal through the universal implementation of Tiered Fidelity Inventory at all project schools.

Chugachmiut is seeking funding through the U.S. Department of Health and Human Services/Substance Abuse and Mental Health Services Administration (SAMHSA) in order to support the national 988 Crisis Line manned here in Alaska and overseen by the Alaska 988 Coalition and to support the local Chugachmiut Crisis Line as a culturally sensitive partner for the 988 number. Chugachmiut is the primary organization for health and social services serving Alaska Natives (approximate enrollment of 2200 members) within the seven communities of the Chugach Region including Chenega, Cordova, Nanwalek, Port Graham, Seward, Tatitlek, and Valdez. Chugachmiut’s seven communities range in size between 68 and 3,927 people, including many non-Native residents. Of those seeking any services (Health, Behavioral Health, Crisis Line, etc.) from Chugachmiut within the past three years from our five core communities (Chenega, Nanwalek, Port Graham, Seward, and Tatitlek), 83% have been Alaska Native, 98% have been non-Hispanic, and 24% are designated as Alaska Native Elders, meaning that they are age 55 years or older. Of our service population, 26 individuals are listed as “gravely disabled” in that they require additional assistance to continue living in our remote rural communities. According to the Centers of Disease Control and Prevention (CDC), National Center for Injury Prevention and Control , Non-Hispanic American Indian/Alaska Native people are at the highest risk of all ethnic populations to commit suicide and are at a rate of 23.9 per 100K. This is our population within the Chugach Region that we seek to help through the current funding opportunity. During this past year, we have logged 97 crisis calls on our 24/7 toll-free Crisis Line from our region (roughly two per week), and two Native Alaskan residents from our communities completed suicides. The goals of the grant are: “(1) ensure American Indians/Alaska Natives have access to culturally competent, trained 988 crisis center support; (2) improve integration and support of 988 crisis centers, tribes, and tribal organizations to ensure there is navigation and follow-up care; and (3) facilitate collaborations with tribal, state and territory health providers, law enforcement, and other first responders in a manner which respects tribal sovereignty.” In response to this, our goals are stated as: Goal #1- Powerful, intuitive, and responsive suicide prevention and intervention services will be available to all people at all times. Goal #2- Chugachmiut will reach every individual in every community that we serve with suicide prevention education and knowledge as to how to access suicide prevention, intervention, and follow-up (postvention) services. Goal #3- Chugachmiut will weave a larger network of support for people suffering from depression and those at highest risk for self-harm through local resources. If our grant application is selected for an award, the funding would support the expansion of Chugachmiut’s 24/7 toll-free Crisis Line through linkages to the National 9-8-8 Program. Clients from our region will be able to call the national number and request a transfer of the call to a local counselor from Chugachmiut. Within this partnership, we believe we will be better able to save lives.

Students in the Ketchikan Gateway Borough School District (KGBSD) experience trauma at extremely high rates due to region specific social, economic, and cultural conditions. Child sexual abuse, child abuse and neglect, exposure to domestic violence, intergenerational trauma, and bullying are all concerns within the KGBSD. A dedicated focus on trauma-informed capacity building district wide is needed to assure the successful support of students in the school system and build capacity to prevent trauma and promote healing in the community. The proposed project would allow the school district to collaborate with partner Women In Safe Homes (WISH): 1. Increase the accessibility of trauma-informed mental health services and student support; 2. Expand the capacity of the KGBSD to fully integrate trauma-informed policies and practices through staff training; 3. Operationalize the use of a common framework for trauma-engaged schools; and 4. Increase administrative oversight to assure compliance with best practices for trauma-informed and culturally responsive school systems. The KGBSD and WISH have historically partnered to provide trauma-informed and culturally responsive services for students and training to educator. KGBSD and WISH currently partner to provide mental health support services available to students who have experienced domestic violence. The proposed program would greatly expand the number of students able to access mental health services, and expand the capacity of the district to provide social work services, educator training, and fully-realize being a trauma-engaged school district. Goals for the program are to 1. Expand the Ketchikan Gateway Borough School District’s relationship with organizational partner WISH and other local mental health service providers and service agencies better identify, refer, and provide services to students impacted by trauma and their families; 2. Increase the capacity of the school district to identify students impacted by trauma and mental health struggles and provide them with access to comprehensive, low barrier supports and services to improve their social, emotional, and academic outcomes over the lifespan; 3. Operationalize a district wide administrative plan based on the Alaska Department of Education and Early Development’s Transforming Schools: A Framework for Trauma-Engaged Practice in Alaska, and 4. Implement a comprehensive training and oversight plan. The program will utilize Transforming Schools: A Framework for Trauma-Engaged Practice in Alaska (TSF), developed by the Alaska Department of Education and Early Development in 2019. The evidence-based framework is a roadmap for effectively integrating components to fully-realize becoming a trauma-informed school system through improvements in the domains of: 1. Deconstructing trauma; 2. Relationship building; 3. Policy considerations; 4. Planning and coordination of schoolwide efforts; 5. Planning and coordination of schoolwide efforts; 6. Professional learning; 7. Schoolwide practices and climate; 7. Skills instruction; 8. Support services; 9. Cultural integration and community co-creation; 10. Family partnership; and 11. Self-care for staff. The proposed project includes specific activities at the direct service, administrative, and school-policy levels to assure full realization of a trauma-engaged school, as described in the implementation plan. The result of implementing TSF is a school-district that builds on existing efforts to fully integrate trauma-informed and culturally responsive practices in all aspects of operations. The program will hire a Program Director, Evaluator, Three School Social Workers and Three School-Based Mental Health Counselors to carry out program services including student support services, school staff training and development, enhance community partnerships, and engage KGBSD families in activities that support student health, wellness, and achievement.