DC Discretionary Funding Fiscal Year 2018

The goal of the American Psychiatric Association (APA)/APAF Foundation Substance and Mental Health Services Administration (SAMHSA) Minority Fellowship Program (MFP) is to enhance the knowledge and capabilities of racial/ethnic and underrepresented minority psychiatry residents to provide culturally competent and evidence-based mental health services to minority and/or underserved populations. The APA/APAF MFP is also committed to investing in the future of psychiatry through Medical Student and Undergraduate Pipeline Programs that provides students with experiential learning, training, and professional development to become leaders in psychiatry. By meeting these goals, APA/APAF MFP helps to eliminate racial/ethnic disparities in mental health and substance use care. Since 1974, APA/APAF MFP has trained over 500 minority and underrepresented psychiatry residents to be leaders in psychiatry. Because of this program, patients of minority backgrounds have benefited from greater availability of minority mental health professionals who can offer culturally competent mental health and substance use care. However, the supply of minority and culturally competent psychiatrists still falls short of the need. This program aims to increase a workforce of diverse leaders in psychiatry who are committed to addressing the mental health needs of minority and underserved communities. During the 2018-19 academic year, APA/APAF MFP will provide support for up to 30 new psychiatry Fellows. Fellows will gain access to resources, APA/APAF leadership, and a lifetime network of mentors and peers. In addition to providing support to residents, APA/APAF will also provide support for up to 60 medical students and undergraduates to participate in one of eight programs designed to encourage them to pursue a career in psychiatry with a focus on serving ethnic/racial and underserved populations. APA/APAF MFP has successfully trained 538 psychiatrists to recognize the pivotal role that race, ethnicity, and culture play in providing quality care of all patients. The MFP seeks to further strengthen workforce diversity and build upon its previous success by promoting cultural competence; providing psychiatric education, training, and research experiences in minority mental health; recruiting medical students and undergraduates to the field of psychiatry; and, fostering lifelong mentoring networks.

The aim of the APA Minority Fellowship Program in Mental Health and Substance Abuse Services and Services for Transition Age Youth is to identify, select, and support the training of ethnic minority doctoral and master’s students and postdoctoral trainees who will significantly contribute to the behavioral health services needs of ethnic and racial minorities. This aim addresses the need to reduce health disparities among ethnic minorities in the U.S. specifically related to culturally competent and evidence-based mental health and substance abuse treatment. Thus, the APA-MFP has two target populations at the center of its efforts: ethnic and racial minorities in need of mental health services and ethnic minority doctoral and master’s students and postdoctoral trainees in psychology. To fulfill our aim, the APA-MFP will: (a) Increase the number of master’s and doctoral level psychology professionals providing behavioral health services to underserved populations by identifying and selecting at least 2 postdoctoral, 23 doctoral, and 30 master’s Fellows, designating at least one doctoral policy Fellow during each year of the project, and proposing expansion of master’s programs eligibility to the APA by year two of the project; (b) Provide quality training and support to increase Fellows’ knowledge, skills and abilities by hosting a professional development workshop to orient Fellows to MFP and SAMHSA, providing at least 8 training opportunities during the Psychology Summer Institute, hosting three training webinars, proving mentoring opportunities through the training advisory committee, and evaluating each training and mentoring experience in each year of the project; (c) Expand and maintain the infrastructure necessary to implement, sustain, and improve effective mental health and substance abuse services for the target population by implementing a social media campaign/strategy to increase program visibility and Fellow engagement, and conducting at least two recruiting presentations in regions with minimal MFP representation in each year of the project. By year three of the project, we will implement an upgraded online database for more efficient tracking of Fellows and by year five of the project, MFP will receive at least 100 master’s, 200 doctoral, and 20 postdoctoral applications for fellowships.

Community Connections (CC) proposes developing the Healing, Empowering, and Recovering Together (HEART) Project to serve children and families living with mental illness, addiction, and inter-generational trauma in the District of Columbia. HEART will reach and serve children 650 (plus an additional 300 in their mothers/primary caretakers) living in the poorest Wards of Washington, DC, including Ward 8. Services are for the whole family within one program utilizing Community Based Intervention (CBI) and Family Team Meetings at the core, with trauma-specific EBP offerings family members can choose amongst (TF-CBT for 1:1 child-specific recovery work, SFCR for multi-family group recovery work, and TREM for adult women's recovery work).

HEART's goals are: 1) outreach to improve access of children and families with multiple ACEs to integrated behavioral health and trauma recovery treatment; 2) screen, assess, and provide behavioral health services and EBPs to improve outcomes of children, caregivers, and the family unit; 3) collaborate with NCTSI and local partners for system alignment and transformation; and 4) develop data driven approach to evaluate and sustain system change.

Primary outcomes in children are: decreases in mental health symptoms, substance use, and days absent from school; improved health, social connectedness, and stability in housing; and in parents/families are: effective problem-solving, adaptive coping to threats and/or crisis, communication skills, clear family roles and routines, affective involvement and responsiveness with families.

CC will team with an experienced group of child health services researchers from the University of Maryland School of Medicine led by Laurel Kiser, Ph.D., to conduct process and outcome evaluations of the project.

The Washington DC Department of Behavioral Health will design and implement a transition age youth-focused system of care (SOC) in partnership with key city agencies, core service agencies, community-based organizations, health care providers, and family and youth networks. This SOC for 16 to 25 year olds, called the DC Transition Age Youth Initiative, will be delivered by Department of Behavioral Health's Core Service Agencies (CSAs). The CSAs will provide transition age youth-specific care planning, wraparound, evidence-based practices and recovery supports, and will employ Transition Specialists specifically trained to address the needs of transition age youth and provide customized, individual plans of care to successfully transition them to adulthood. This Initiative is designed to overcome the current fragmented and siloed system of care that complicates access to appropriate services for this age group, currently straddling the child and adult mental health systems, and replace it with a system where all services are transition age youth-focused. Youth and young adults will receive continuous, developmentally appropriate mental health treatment, guidance in moving towards self-sufficiency, and a full menu of recovery supports in the realms of education, employment and housing-the key domains represented in the transition to adulthood.

The DC Social Emotional and Early Development Project (DC SEED); a 4-year SAMHSA System of Care (SOC) Expansion and Sustainability Cooperative Agreement, will address the highly specific, largely unmet needs of young children (birth-6) residing in the District of Columbia who are at high imminent risk for or diagnosed with serious emotional disturbance (SED). DC SEED will serve children birth to 6 in all 8 wards of the District of Columbia and seek to identify and engage in DC SEED the approximately 29.4% who are at risk for social and behavioral problems and increase the number (currently 21% in DC, 29% nationally) who are receiving appropriate screenings and treatment. While all young children residing in the District are eligible for SOC services, DC SEED will prioritize the highest need Wards as identified by the District of Columbia Early Childhood Risk and Reach Assessment [DCRRA] which found that Wards 1, 4, 5, 7 and 8 were at highest risk and most underserved in terms of high quality early childhood and family support services. The vast majority of young children who will be served through the SOC are low-income African American and Black children, residing in one of these Wards.

Ethnic and racial minority groups in the U.S., especially those with serious mental illness (SMI) or co-occurring mental and substance use disorders (COD), continue to experience high rates of HIV and hepatitis infections. Building on the resources and expertise of Howard University's Mental Health Clinic (HU-MHC) and Center for Infectious Disease Management and Research (CIDMAR) and the Family Medical and Counseling Services, Inc. (FMCS), this project will create a mobile team of experts and provide evidence-based models of care - STIRR model (Screening, Testing, Immunication, Reducing risk, and Referring for treatment of HIV and hepatitis infection) and the IDDT model (Integrated Dual Disorders Treatment for people with co-occurring disorders) - to patients with SMI or COD living with or at risk for HIV or hepatitis who receive treatment at HU-MHC, CIDMAR, or FMCS. Howard University has a long and distinguished history of leadership and provision of humane services for ethno-racial minorities and other stigmatized groups for over 150 years; FMCS is a leading provider of primary care, HIV, and hepatitis treatment in Washington, D.C. Wards 7 and 8, medical and mental health resource shortage areas with a predominantly African American population that has the greatest SMI, COD, HIV, and hepatitis prevention and treatment needs. The Howard University Minority AIDS Network Effort (HUMANE) Project will address major gaps in services at HU-MHC -specifically, a lack of HIV and hepatitis prevention service, case management, or peer support services - and at CIDMAR and FMCS - specifically the lack of services to engage patients with SMI or COD in treatment for SMI or COD. The specific aims of the HUMANE Project are: Aim 1. Assemble a mobile team of experts plus a case manager and peer support specialist, all with expertise in the STIRR and IDDT models. Aim 2. Deliver STIRR and IDDT in HU-MHC and provide IDDT services in CIDMAR and FMCS by augmenting existing services with training, supervision, and direct service provision from the mobile team. Aim 3. Provide an independent evaluation of model fidelity, service outcomes, and implementation issues in HU-MHC, CIDMAR, and FMCS. Fidelity will be based on established measures. Outcomes will include specific targets for numbers of patients receiving STIRR and IDDT services and mixed methods evaluation of implementation issues to facilitate sustainability and dissemination.

Project Name: HUSSW Mental Health Awareness Training Program Population to Be Served: HU Residence Life (HU-RL) and HU Department of Public Safety (HU-DPS) personnel who have regular contact with over 10,000 students. Goals: Goal 1: To implement the evidenced based Mental Health First Aid awareness program. Objective 1.1: To increase the number of certified Mental Health First Aid trainers (Baseline 0) to increase 6. Objective 1.2: To train PhD students, project assistant, evaluator and the Project Director Goal 2: To implement the Mental Health First Aide training program for HU-DPS and HU-RL personnel. Objective 2.1: To train 50% (Baseline 120) HU-DPS personnel and to recognize the signs and symptoms of mental illness (including opioid and substance use disorders) and in de-escalating techniques. (Years 1, 2, 3) Objective 2.2: To train 50 % (Baseline 140) HU-RL personnel to recognize the signs and symptoms of mental illness (including opioid and substance use disorders) and in de-escalating techniques. (Years 1, 2, 3) and in de-escalating techniques. Objective 2.3: To conduct at least two initial Mental Health First Aid sessions per month with group size of no more than 20 participants beginning January 2019 or 4 months after grant funds are received. Objective 2.4: Design and pilot a culturally competent refresher short-course for years 2 and 3 Objective 2.5: To increase the capacity of HU-DPS and HU-RL to recognize the difference between noncompliance and a student in crisis by utilizing de-escalation techniques. Objective 2.6: To teach participants the five-step action plan, ALGEE, Goal 3: To develop a referral toolkit for use of HU-DPS and HU-RL Objective 3.1: To link students to mental health resources and services Objective 3.2: To refer students to appropriate resources based on level of crisis Goal 4: To develop and implement a mental health awareness training plan. Objective 4.1: To identify two Mental Health First Aid supplemental modules Objective 4.2: To develop and implement a referral tool to track the number of referrals made Summary: The Howard University School of Social Work Mental Health Awareness Program proposes to implement the evidenced based Mental Health First Aid Training Program for HU-PSD and HU-RL to ensure timely referrals for behavioral health interventions aimed at decreasing the severity of mental health episodes through early intervention and increasing the number of students who receive mental health services.

The District of Columbia's Project AWARE Program will leverage and build upon the District's Comprehensive School Mental Health Plan to build an integrated service-delivery reaching at least 11,000 youth, implement comprehensive training opportunities reaching at least 1500 educators and administrators, and engage the voices of youth and families in evidence-based, culturally-responsive, and developmentally-appropriate mental health infrastructure design and implementation. Key outcomes will include increased rates of screening and referral of students with concern for mental health need; development of integrated networks of school- and community-based mental health providers; increase in knowledge of mental health among students, families, and educators; and the implementation of state- and local-level policies, procedures, and systems.

The Wendt Center for Loss and Healing proposes to expand its Resilient Scholars Project (RSP) to increase the impact of, and access to, evidence-based mental health services for low-income minority youth and their families exposed to trauma in the District of Columbia. The Center's existing school-based RSP mental health program will be expanded to include a home-based component implementing Trauma Adapted Family Connections (TAFC). TAFC will be provided to a subset of youth ages 12-17 (75-96 students/year). This subset of students and their families (385 individuals/year) will receive evidence-based mental health services in a home-based setting in addition to school-based TF-CBT provided to all RSP students. Up to 1,740 individuals are served over the lifetime of the grant. Six hundred individuals will be trained over the lifetime of the grant. A critical policy piece is included, as is a research component comparing results of RSP students receiving with those not receiving home-based services.

The goal of this project is to significantly increase the impact and reach of mental health services for low-income, underserved minority youth and their families in the District of Columbia, including veterans and military, who are suffering the adverse consequences of exposure to trauma through a holistic, community-based program of evidence-based interventions delivered at home and in school. Measurable objectives include: 1) promoting stability and facilitating readiness to benefit from clinical services; 2) helping youth/families impacted by trauma overcome mental health barriers to healthy functioning and increasing resilience; 3) improving the ability of school staff/community members to understand, and more effectively respond to, the needs of children impacted by trauma; and 4) effecting systemic change (i.e., developing trauma-sensitive schools in DC) to improve educational outcomes for DC's children and youth.

St. Croix Peer-2-Peer SA, HIV, Viral Hepatitis Prevn Edu, Capacity Bldg, & Media