AZ Discretionary Funding Fiscal Year 2023

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.

Summary: Chinle Unified School District Project AWARE will serve Native American PreK-12 students by implementing a school-based, recovery-oriented, tiered system of school- and community-based mental and behavioral health interventions. The project will provide counseling, cultural mentorship, suicide awareness and prevention, and related trainings to students, school staff, families, and members of the community. Project Name: Chinle Unified School District Project AWARE Population Served: Universal prevention services for Native American PreK-12 students, with tiered interventions for students experiencing trauma and related mental/behavioral health needs. Strategies & Interventions: This project will equip students with the prevention, intervention, and postvention to promote recovery and reduce the prevalence and impact of trauma-induced mental and behavioral health challenges, substance use, and suicidality. This will be accomplished through school-based mental health counseling, behavioral health counseling; screening, third-party service referrals, and cultural mentorship; teacher and school staff training; and family and community member training. We will use evidence-based programming to promote positive behaviors among students, especially with curriculums and programs designed for use with Native American students. This includes the WhyTry program, QPR, and Connections to Medicine, among other approaches. All students will receive universal prevention services, and students screened and determined for higher tiers of service will receive individualized counseling plans and the support of a wraparound support specialist to provide coordinated care and community connections. Project Goals & Objectives: Goals include (1) increasing student access to trauma-informed, culturally-informed behavioral/mental health interventions by integrating services into their school environment, (2) increasing knowledge of students, staff, families, and community members to identify, refer, and support students demonstrating behavioral/mental health consequences of trauma to promote positive youth development, and (3) increase student social and emotional competencies and decrease emotional challenges and negative behaviors among students by implementing school-based, trauma-informed, multi-tiered mental health and social emotional services. Goal-aligned objectives include (1a) implementation of individual and small group counseling, (1b) development of a formal crisis response procedure, (1c) collection of informed consent, (2a) training for staff members at Chinle Unified School District, (2b) training for parents and families of students, (2c) provision of universal prevention services for students, (3a) decreasing the need for referral to the highest level of services, and (3b) reducing the incidence of negative behavioral occurrences within the school environment. Number of Individuals Served: This project will serve 5,435 unduplicated individuals throughout the five year project period (2,659 in year 1, 1,681 in year 2, and 365 each year in years 3, 4, and 5) including children, youth, school staff members, and members of the community. Throughout the entire project, including retrainings (duplicated services on a year-over-year basis), the project will serve 19,875 total individuals.

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.

COPE Community Services, Inc. (COPE) proposes to implement the comprehensive CCBHC model through the COPE All-Access Team (CAAT) in Pima County, AZ, to provide high quality mental health and SUD services informed by a local needs assessment. With a 24/7 point of entry into behavioral health care, the CAAT will provide crucial treatment expansion, agency-wide improvements, and will aim to reduce substance use and improve mental health symptoms. The CAAT will serve populations with or at risk for mental illness and/or substance use disorders in Pima County, AZ. The extent of the problem in Pima County is aptly characterized by the four health priority areas identified by Pima County Health Department (PCHD): behavioral and mental health, substance use disorder (SUD), access to care, and social determinants of health (CHNA, 2022). The interacting priorities emphasize the critical need for comprehensive, coordinated behavioral health care. Access to timely, culturally, and linguistically appropriate mental health and SUD care is an urgent service gap in Pima County. Compounding this, the COVID19 pandemic caused both MH symptoms and SUD rates to skyrocket in Pima County. Overdose deaths in Pima County have doubled from 176 in 2017 to 335 in 2022. Non-fatal overdoses have also doubled; there were 297 in 2017 compared to 607 in 2022 (AZDHS, 2023). Additionally, areas with high social vulnerability (based on the CDC Social Vulnerability Index) experience disproportionate overdose deaths, emphasizing the disparities between under-resources communities and the general population. The CAAT will serve as an efficient physical and digital 24/7 entry point for COPE's treatment programs and will implement several strategies to achieve its objectives. The team will consist of a Project Director, Program Manager, Behavioral Health Medical Professional (BHMP), and six Behavioral Health Technicians Specialists (BHTS) staff, all comprehensively trained to provide targeted case management and behavioral health treatment services. COPE will also make agency-wide infrastructure improvements to enable full implementation of the CCBHC model. The goals of the CAAT are 1) To provide comprehensive and coordinated behavioral health services by planning and implementing the CCBHC model system-wide within COPE Community Services Inc; 2) To provide comprehensive outreach, screening, assessment, treatment, care coordination, and recovery support services to individuals in need of behavioral health care; and 3) To increase timely access to behavioral health care, supporting recovery and improving outcomes among individuals served by the CCBHC. These goals are reinforced by specific and measurable objectives designed to measure progress in program implementation and the outcomes of interest: increased access to care, improved mental health systems, and decreased substance use. The CAAT will serve 300 clients per year (1050 total, 150 in year one). The CAAT will provide crucial treatment expansion and essential agency-wide improvements, increasing timely access to coordinated behavioral health care in Pima County, AZ. COPE currently offers most of the core CCBHS services, and the proposed program will supplement those services and nearly eliminate the delay between first contact and full intake through immediate same-day provision of services, regardless of benefit enrollment status or ability to pay. Rapid initiation of services will allow staff to intervene quickly to address the needs of the whole person: medial, mental health, substance use, and social determinants of health.

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 purpose of the Health, Home, Hope (H3) Project is to end the cycle of homelessness for households currently experiencing long term unsheltered homelessness in Tucson and Pima County through the expansion, integration, and coordination of local community BH, physical health and housing support systems. We will provide BH and other recovery-oriented services to those experiencing long-term unsheltered homelessness through (1) intensive street outreach, (2) navigation designed to rapidly connect individuals with substance use disorder and or COD to mainstream treatment and recovery services including MAT, and (3) coordinate housing and services that support sustained recovery and wellness within permanent housing. Our goal is to move 150 of the most vulnerable unsheltered homeless individuals into permanent supportive housing, while increasing their wellness, to include their ability to manage their addictions, mental health symptoms, and acute and chronic physical conditions. This will be accomplished through a continuation of the existing El Rio/OPCS outreach teams, an integrated multidisciplinary community team, including a FNP, Medical Assistant, Care Coordinator, Navigator, and Peer Guide; making bidirectional referrals between OPCS and the El Rio Specialty BH team (MD/Psychiatrist, BH Professionals, and BH CMs); and coordinating the provision of mainstream services through collaboration with emergency shelter providers. This team will initiate approximately 200 contacts with unsheltered homeless individuals each year, offering non-emergency medical assistance, screening for the presence of addiction and mental health concerns, SA/COD treatment and medication monitoring/ MAT, and immediate enrollment into mainstream benefits, such as Medicaid, TANF, and SNAP. This initial interaction will be facilitated by a certified peer guide who was recently homeless from this same geographical area. All staff will be guided by Motivational Interviewing and trauma informed practices. Additionally, we will provide intensive navigation assistance to a minimum of 50 individuals per year, to include same-day transportation to benefits offices, enrollment/intake offices of mental health providers, non-emergency medical and BH appointments, and appointments with potential landlords. This navigation assistance will include assistance with completion of documentation and applications needed to gain housing, benefits, and treatment for mental health, addiction, and physical health conditions. This will result in 30 individuals entering permanent housing per year, or a total of 150 persons over the five-year period. A minimum of 50 patients per year will be seen for medical and MH services for a total of 250 over 5 years. As a result, at follow-up, we expect 45% of participants to experience a reduction in days using drugs or alcohol, 50% a reduction in criminal activity, 75% increase in social connectedness, 50% reduction in emergency room usage, and a 50% increase in income from all sources, which is based on our previous 4+ years of similar work. The project will be led programmatically by the Project Director (PD) with assistance from leadership at both El Rio and OPCS, and our Evaluator, the UA SIROW. The integrated project team will meet quarterly to review progress toward our housing goals, engagement in addiction, mental health, and physical wellness supports, as well as our general impact on unsheltered homelessness in Tucson and Pima County, and to review all the data collected from participants.