DE Discretionary Funding Fiscal Year 2023

Using a systems-change, quality improvement approach, DSAMH, partner organizations, and stakeholders will plan, implement, study, and refine approaches for training for community-based professionals and the identified populations of need; Hispanics, Caregivers, and Veterans, to ensure that Delaware's communities are Caring, Aware, Resilient, Empowering, and Safe-DelCARES. DelCARES will: - Increase mental health literacy across communities and improve community- based professionals' competence in reacting to acute crises and making appropriate referrals (Tier One). - Assess the existing referral protocol and expand communications to targeted community members and professionals across the state (Tier Two). - Facilitate ongoing professional learning community (PLC) for trained staff (Tier Three). DelCARES will provide MHFA, ASIST, and/or QPR training to at least 2,100 community members and professionals in five years and certify twenty-four (24) trainers in MHFA, ASIST, and QPR's evidence- based delivery- eight (8) in each program.

As the Single State Agency for substance abuse and mental health in the state, as well as the entity responsible for providing services to adults, DSAMH will oversee the implementation of the grant, in close partnership with the two Lifeline network call centers, ContactLifeline and Crisis Intervention Services (CIS). Using a systems-change, capacity building approach, DSAMH and Lifeline member centers will improve state response to 988 contacts by: -Maintaining a workforce to staff 988/Lifeline center to ensure calls originating from Delaware are answered in Delaware, meeting key performance indicators. -Unifying 988 response across all Lifeline centers. -Expanding the response structure needed for successful implementation of 988. With one existing Lifeline center (ContactLifeline) and one actively onboarding center (DSAMH-CIS), this Cooperative Agreement will support staffing capacity expansion for both, as well as supporting coordination and training across the two. The required activities will provide critical support for the transition from Phase 1 to Phase 2 by: (1) building new capacity within DSAMH CIS as a new Lifeline center and a future state-wide crisis response hub. (2) ensuring ContactLifeline have adequate staffing levels for maintaining an in-state answer rate above 80% and for adding text and chat service capacity.

The Delaware Certified Community Behavioral Health Clinic (CCBHC) Planning Grant project is a collaboration among the Department of Health and Social Services' Division of Substance Abuse and Mental Health (DSAMH) and Division of Medicaid and Medical Assistance (DMMA), and the Department of Services for Children, Youth and Families (DSCYF) to: (1) convene a cross-agency steering committee and engage stakeholders; (2) develop a CCBHC certification infrastructure and certify CCBHCs; (3) establish PPS; (4) conduct provider outreach/ education and engage stakeholders in implementation planning; (5) develop state and provider data collection and reporting capacity; and (6) prepare and submit a CCBHC Demonstration application. These activities will be continuously informed by consumer and constituent input through a dedicated Stakeholder Advisory Group. As one of the only four states in the country without this model, the CCBHC Planning Grant offers a critically needed organizational framework for Delaware to redesign and enhance its system of care statewide to improve service quality, accessibility, delivery, and outcomes for comprehensive behavioral health care services in an integrated, trauma-informed, person- centered manner across the lifespan. This initiative will address the needs of Delawareans with any mental illness and serious mental illness, children with serious emotional disturbance, and those with substance use disorder in all three counties, with additional focus on special populations, including pregnant and parenting people and justice-involved individuals. Delaware currently ranks 22nd out of 50 states in prevalence of mental health issues as compared to access to care, for both adult and youth measures. In Delaware, rates of depressive episodes in the past year for adults and youth are higher than the national averages. Delawareans also experience a significantly higher drug overdose death rate as compared to the national average per 100,000 populations. All three Delaware counties have drug overdose death rates higher than the national rate. Among youth aged 12-17 in Delaware, the annual average percentage of illicit drug use in the past month was above the national average. Delaware views CCBHCs as a system redesign effort that has the potential to positively impact 156,000 adults with mental health illness, and 10,000 youth ages 12-17 experiencing major depressive episode in the past year, through improved access to and quality of comprehensive behavioral health care services. Delaware views CCBHCs as a pathway to advance integrated and sustainably financed care coordination and delivery, thereby improving short and long-term outcomes for individuals while also improving the fiscal health of the behavioral health system. The proposed CCBHC planning process will effectively leverage and build upon major federal- and state -funded behavioral health system reform initiatives undertaken by Delaware, to enhance access to an integrated, coordinated, and person-centered behavioral health care system statewide. The Planning Grant will enable Delaware to launch a statewide CCBHC initiative, thereby expanding access to and availability of services in all three counties.

The current project is titled: Training Probation Officers in Mental Health First Aid: An Evidence-Based Approach to Improving Outcomes for Officers and Individuals under Supervision. As such, the primary goal is to improve services to individuals on probation by ensuring that probation officers have the requisite awareness, competency, and motivation to serve those with mental health (MH) and substance abuse (SA) needs. There is a sizable overrepresentation of MH and SA among individuals who are receiving community supervision. Furthermore, their supervising officers often do not have access to the knowledge and tools to support these individuals in their community reintegration efforts. This project is a collaboration between the University of Delaware’s (UD) Center for Training and Community Collaboration (C-TECC) and two jurisdictions of Corrections and Pretrial Services: the District of Delaware (DE) and the Eastern District of Pennsylvania (ED/PA). The project aims to train probation officers in identifying common MH and SA concerns and in evidence-based de-escalation strategies. The project will train approximately 75 officers and staff in Mental Health First Aid (MHFA). Additionally, C-TECC, DE, and ED/PA, will collaboratively examine and refine current referral processes with existing, contracted licensed mental health providers to ensure that individuals who need MH and SA services and supports, are connected to those services. The project also recognizes the importance of support for probation officers, as they often report high rates of burnout and corrections fatigue. Fatigue and burnout are major barriers to implementing compassionate care to those with MH and SA needs. Therefore, in addition to participating in MHFA training, the same 75 officers and staff will complete the From Corrections Fatigue to Fulfillment (CF2F) curriculum which raises awareness about corrections fatigue, its precursors and early warning signs, and strategies to promote wellbeing. To support learning and facilitate the maintenance of acquired knowledge and skills, officers will participate in refresher courses of these curricula and in a live role-play interaction with professional actors who will portray realistic scenarios of commonly occurring MH and SA concerns. This role-play interaction will be done in collaboration with UD’s Healthcare Theatre program, and will provide the opportunity for live feedback, group discussion, and honing of skills. It is anticipated that most training, implementation and evaluation efforts will be conducted in-person at DE and ED/PA offices. Overall, the project is designed to implement a sustainable program for increasing competent and compassionate services for individuals under community supervision who have MH and SA needs in these two districts.