AZ Discretionary Funding Fiscal Year 2023

The overarching goal of this project is to enhance Lifeline center staffing and infrastructure capacity to ensure that Lifeline centers can respond to 988 contacts (including calls, chats, and texts) originating in Arizona. The project approach includes developing and supporting state, regional, and local level collaborations, and service enhancements to develop and implement best practices to comprehensively address the full continuum of care related to 988 contacts. Arizona Health Care Cost Containment System (AHCCCS) intends to work with the lifeline centers to identify the actual staffing needed to meet the projected call volume as well as continue to monitor actual performance and call volume data to adjust the plan to maintain the target answer rates. AHCCCS will also continue to partner with the Lifeline centers as an entry hub for crisis services and ensure alignment with the AHCCCS crisis system. The goal will be for lifeline callers to be seamlessly connected to the full system of care when needed, including mobile crisis teams, and facility-based stabilization, such as crisis stabilization units, and behavioral health services that may be clinically appropriate.

Arizona Youth Partnership (AZYP) in collaboration with Interfaith Community Services (ICS) will train 725 individuals each year for a total of 3,625 over the course of the 5 year Pima, Mohave, Yavapai, Navajo, Gila, Pinal, and Santa Cruz counties most likely to interact with those who exhibit the signs and symptoms of mental illness in the evidence-based curriculum Mental Health First Aid and Youth Mental Health First Aid. The population of focus is youth, older adults, veterans, and those served through mental and behavioral health agencies across the entire county including outlying, rural areas. In 2018, AZYP was awarded a MHAT grant in Pima County. Over the past 3 years, we have received extensive interest for the training in nearby counties and propose to expand the project. The goals and objectives of the project are: • Goal 1: Increase the number of individuals trained in Pima, Mohave, Yavapai, Navajo, Gila, Pinal, and Santa Cruz Counties, Arizona to recognize the signs and symptoms of mental disorders including serious mental illness and serious emotional disturbance. • Objective 1.1: By September 29 each grant year, train 350 individuals in mental health agencies, faith communities, older adults, veterans, and community agencies in Mental Health First Aid as measured by sign-in sheets. • Objective 1.2:By September 29 each grant year, train 375 individuals who work with youth in schools & community-based settings in Youth Mental Health First Aid measured by sign-in sheets. • Goal 2: Increase linkages with schools and community-based organizations to educate about available resources and refer individuals to those resources. • Objective 2.1: By September 29 each grant year, 50% of workshop attendees will respond with the number of referrals made to a follow up survey at 2 weeks, 1 month and 3 months as measured by follow up surveys. • Objective 2.2: By September 29 each grant year, increase knowledge and awareness of workshop attendees of community resources for mental illness by 60% as measured by post survey. • Objective 2.3: By September 29 each grant year, distribute 8,000 Mental Health Services Pocket Guide in Pima, Mohave, Yavapai, Navajo, Gila, Pinal, and Santa Cruz Counties as measured by distribution logs.

Child & Family Resources, Inc. (CFR) will provide The Mental Health Awareness Training Program to adults working with youth, specifically educators and teen peers, to recognize signs and symptoms of mental illness in youth with a potential for Serious Emotional Disturbance (SED). Programming will be offered throughout Arizona, in high-risk communities in Pima County and the South East Arizona Counties of Cochise, Graham, Greenlee and Santa Cruz. CFR plans to increase mental health awareness with the goal of early detection, intervention and linking youth with support and treatment services thus providing youth with the opportunity to gain coping mechanisms, lead full and productive lives and develop a healthy emotional outlook on life. CFR will address service gaps by increasing public awareness among high-risk communities and directing mental health programming efforts to address early detection and intervention among youth ages 12-18. CFR's multifaceted approach to increase Mental Health awareness throughout Arizona will implement three evidence-based curricula Youth Mental Health First Aid (YMHFA), Mental Health First Aid (MHFA), and teen Mental Health First Aid (tMHFA) with specialty modules on cultural and environmental factors specific to communities to build capacity and reach youth with mental illness. Programming will increase public awareness, early detection and intervention by training participants to identify, understand and respond to signs and symptoms of mental health or substance use disorders and de-escalating techniques to defuse crises without compromising safety. Programming includes referring and linking participants with community resources for support and treatment services. Programming will reach a minimum of 100 adults and teens in the catchment areas, a minimum of 500 over the lifetime of the project. The MHAT program plans to increase mental health awareness and education among adults working with youth and teen peers in target communities by implementing evidence-based programming including recognizing the signs and symptoms/onset of mental illness among youth by training 500 adults and teen participants in YMHFA, MHFA and tMHFA with community specific specialty modules in Pima and rural counties. The MHAT program will reduce Mental Health related problems by training Law Enforcement working with youth in MHFA with public safety to recognize signs and symptoms of mental health and de-escalate without compromising safety. Additionally, the program will strengthen prevention capacity at the community level by training service providers in curricula to increase public awareness, early detection (recognizing signs and symptoms) and intervention within target communities by training participants and providing them with community resources.

The Santa Cruz County Mental Health Awareness Training Project will utilize a wide array of evidence-based strategies and approaches to meet the goals and community awareness an training objectives proposed by SAMHSA and NIH as well as targeted action items related to addressing the role of trauma in our community and enhancing trauma-informed and culturally sensitive approaches. In the first year of this project 2,400 individuals will be trained in mental health awareness and stigma reduction. Constructing Circles of Peace is proposing the Santa Cruz County Mental Health Awareness Training Project to fully implement the strategies and goals of the SAMHSA Mental Health Awareness Training Grant to veteran's, adults, parents, educators, and youth in Santa Cruz County, Arizona. Constructing Circles of Peace has a long -standing history of actively collaborating with other coalitions and community agencies across the county, state of Arizona and across the nation. Since 2004 Circles of Peace has been at the cutting edge of implementing holistic, trauma informed approaches and strategies to substance abuse prevention, treatment, support and recovery. Training and services will be delivered throughout Santa Cruz County, Arizona - a predominately Latino community in the southeastern corner of Arizona on the U. S. - Mexico border and home to Arizona's largest international border town of Nogales. Goals of this program will be to: Increase the capacity of individuals to recognize the signs and symptoms of mental disorders, particularly serious emotional disturbances (SED) among school-aged youth and serious mental illness (SMI) in veterans, victims of domestic violence and individuals with an SUD. Increase the capacity of local systems and individuals in those systems to utilize safe and developmentally appropriate responses when interacting with individuals displaying symptoms of mental illness. Decrease youth and adult untreated mental health and suicide rates by increasing awareness of community-based resources and improving cross-sector collaboration on school - and community-based referral processes. Decrease youth mental health and suicide rates by implementing evidence-based programs that improve resiliency and foresters supportive perspectives and responses among youth, parents/caregivers and systems that serve youth and families. Evidence based programs and frameworks to be utilized throughout this project will include Mental Health First Aid, Youth Mental Health First Aid, Kids at hope Model, ACES and Trauma, Screening, Brief Intervention, and Referral to Treatment (SBIRT), Strategic Prevention Framework (SPF), Trauma Informed Care Approach (TIC), Restorative Justice Circle Model (RJ), and Mindfulness Based Interventions. For the subsequent four years of the project, we intend to use our evaluation findings at the end of this cycle to inform the next iteration of the action plan, but will at minimum, continue to train 1,450 community members each year in mental health awareness and stigma reduction.

In partnership with key stakeholders in Pima County, including criminal justice agencies, emergency first responders, physical and behavioral health organizations and community organizations service the general public, Coyote TaskForce (CTF) will create a Mental Health Awareness and Training program in which partner organizations will identify staff to be certified as instructors in crisis de-escalation techniques, in particular the Mental Health First Aid (MHFA) curriculum, as well as a suicide prevention curriculum, at no cost to the partner organizations. In return, partner organizations will provide quarterly MHFA and suicide prevention trainings to the community at large. This "train the trainer" model will create an expansive network of MHFA instructors in Pima County and ensure that the greatest number possible of Pima County residents will be equipped with the skills and confidence to recognize the signs and symptoms of persons experiencing mental health disorders, and the resources available in the community for such individuals. Furthermore, the project will build seamless referral paths to a network of community-based mental health organizations committed to ensuring that those in need of mental health services are provided with timely, efficient and effective care. Through the CMHAT project, Pima County residents from all walks of life will have the tools they need to change the lives of fellow community members with mental disorders for the better.

The Navajo Nation (NN) is a federally recognized tribe and proposes to lead efforts to develop, implement and ensure Navajo/American Indians/Alaska Natives have access to a culturally responsive, trained 988 crisis center support to improve the health of the Navajo People. The goal is to increase the capacity of the Navajo Department of Health (NDOH) - Division of Behavioral and Mental Health Services (DBMHS) to coordinate the NN's 988 tribal response crisis center by strategically developing a holistic, comprehensive crisis continuum approach using Navajo culture practice-based evidence and evidence-based practices for mental and behavioral health crises prevention, intervention, treatment and recovery resources. Additionally, the establishment of a NN 988 Crisis Center will support data collection and surveillance for referrals, treatment, follow up, and mobile crisis outreach to maintain sustainability. According to the NN Division of Community Development database website, there are 331,813 enrolled NN members. The Navajo Area I.H.S. 2021 User Population was 238,951. The Navajo DBMHS is established under the NDOH within the Executive Branch of the NN government. The purpose of DBMHS is to provide substance use, mental health and behavioral health, and to ensure that a quality, cultural, and spiritual comprehensive approach is utilized for healing. The project estimates to reach at least half of the I.H.S. user population at 125,000. The Navajo DBMHS proposes the three (3) priority areas: 1. Develop and implement a NN 988 tribal response readiness needs assessment and strategic plan. 2. Increase effective 988 response, access, and NN Crisis Center with local, state, and national crisis centers for prevention, treatment, and recovery support. 3. Increase the capacity of DBMHS-NDOH to effectively sustain and establish data collection, and surveillance for mental, substance use and behavioral health crises support. The Navajo DBMHS-NDOH acknowledges and incorporates the Tribal Behavioral Health Agenda's American Indian and Alaska Natives Cultural Wisdom Declaration which calls attention to the importance of tribal identities, culture, spiritual beliefs, and practices for improving well-being. Navajo DBMHS proposes to use the Navajo Wellness Model (NWM) which is promising practice-based evidence and cultural-based practice that is a cycle interwoven practice of well-being of Nitsakahakees (Thinking), Nahata (Planning), Iina (Implementation) and Sihasin (Evaluation). The beauty of this approach is that it speaks to the specific life way of the Navajo people and community through the Navajo language and cultural practices.