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GU Discretionary Funding Fiscal Year 2021
The U.S. territory of Guam is requesting funding from CMHC to support Guam Behavioral Health and Wellness Center (GBHWC) efforts to establish a cohesive system between GBHWC and correctional facilities; Department of Corrections (DOC) and Department of Youth Affairs (DYA) to ensure individuals who are experiencing SED, SMI and COD are provided initial assessments, appropriate referrals, engagement in treatment while incarcerated and continuum of care as the individual transitions back into the community within a two-year period. Within the grant period, the number of unduplicated individuals to be served are minimum of 300 each year. GBHWC will provide on-site services to DOC and DYA to include telepsychiatry to maximize immediate access to mental health services instead of waiting on the correctional facilities to transport individuals to GBHWC facility. GBHWC, as a CARF (Commission on Accreditation of Rehabilitation Facilities) accredited facility will utilize standards as well as the National Commission on Correctional Health Care standards to guide practice and treatment in serving the DOC and DYA consumers. GBHWC is an active partner with the judicial system and involved in the implementation of the second chance reentry program. GBHWC’s involvement in onset of treatment will strengthen the identification and referral of consumers to the reentry program. According to the 2020 GBHWC individual data report, GBHWC served more than 3,000 individuals with 15.5% ages 17 and below, while 84.6% were adults ages 18 and older living with an SED, SMI, or COD. With GBHWC as Guam’s only community provider for mental health services, we expect the number of individuals to increase, most especially once the new school year begins in August of 2021, when students return to in class learning. According to the 2019 Department of Corrections monthly statistical report, showed 700 referrals to their Forensic Unit with 68 of those referrals needing immediate psychiatric services at GBHWC. While the remaining population are still awaiting assessments due to shortage of mental health providers within the correctional facility. According to the 2019 Citizen Centric Report, Department of Youth Affairs had 328 admissions with recidivism rate of 67.07%. 60 of those individuals were referred to GBHWC for assessment and psychiatric services. Target populations will be reached by increase delivery of clinical services to individuals with SED, SMI and COD who are at DOC and DYA and in need of services; through timely access to mental health screenings, telepsychiatry, availability and access to medications, and coordination of outreach efforts with partnered agencies in the community to assist target populations with supports and services for reintegration back into the community.
The U.S. territory of Guam requests funding for Project Ågang (aw-gang), which means “call” in Chamorro – Guam’s indigenous language. The project aims to establish reliable 24-hour Emergency Services for individuals experiencing a mental health or substance abuse crisis. The project proposes to serve children ages 5 and older with SEDs and individuals ages 18 and older with SMI, including those with Substance Use Disorders or Co-Occurring Disorders. In 2018, one individual on Guam died by suicide every 8 days. From 2014-2018, over 1,300 calls were made from Guam to the National Suicide Prevention Lifeline (NSPL) and 0% were able to receive help because 0 crisis centers on island are members. Additionally, in 2019, GBHWC’s inpatient units saw 465 admissions; and of the total, 42 were children and 423 were adults, with an average length of stay at 7.3 days. A 2019 Client Data Report showed GBHWC served over 3,300 clients, with 16% of them being children ages 5-18 and 84% being adults ages 18 and older. In addition, almost half of all clients served consisted of individuals experiencing the 3 most frequently reported diagnoses which are Mood Disorders (Major Depression and Bipolar), ADHD, and Schizophrenia. Additionally, 24% of GBHWC’s clientele were diagnosed with an SUD with almost 15% of them living with a Co-Occurring Disorder. According to the Agency for Healthcare Research and Quality (2019), mood disorders are the most common cause of hospitalization for all people in the U.S. under age 45. Project Ågang seeks to decrease the number of suicides and hospitalization on Guam through 24-hour Emergency Crisis Services by establishing a Lifeline Crisis Center (LCC) and Mobile Response Stabilization Service (MRSS). There is an alarming need for a LCC on Guam that links with the NSPL. Lifeline centers are reported to significantly reduce emotional distress and suicidality in callers. Additionally, people in crisis can easily use lifelines to access help when other mental health, substance abuse, and social services are inaccessible during late-night hours and can also be utilized to provide monitoring or tracking of patients after hospitalization for a suicide attempt (NASMHPD, 2018). In addition to serving over 3,000 individuals from our focus population, Project Ågang seeks to serve no less than another 200 individuals (unduplicated) per year through its Emergency Crisis Services. The project’s three primary goals are: 1) Increase access to treatment and support services for the target population through a 24-hour Emergency Crisis Intervention Service (LCC and MRSS); 2) Increase identification of individuals ages 5 and older with SEDs, SMI, SUD, and/or COD, in need of services; and 3) Develop a Continuous Quality Improvement & Sustainability Plan.
Project LINC (Linking Individuals in Nurturing Communities) - Treatment for Individuals with Serious Emotional Disturbances or Co-Occurring Disorders experiencing homelessness
Project Tulaika: Healthy Transition Services for Youth and Young Adults age 16-25 with Serious Emotional Disturbance and Serious Mental Illness
WestCare Pacific Islands’ (WPI) proposed “Ma’lak na Ha’åni” (CHamoru for Bright Futures) program will provide culturally responsive treatment for trauma-related mental health issues for male and female youth ages 11-17 living on the U.S. territory of Guam, specifically focusing on the island’s CHamoru, Filipino, Asian, and other Pacific Island subpopulations. The current availability of mental health treatment on Guam comes nowhere near to meeting the need for services. According to the 2019 Youth Risk Behavior Survey for all high school youth in Guam’s public school system, 46.9% of respondents reported feeling prolonged sadness and hopelessness; 11.3% reported experiencing sexual violence; and 11.1% reported feeling unsafe at or on their way to and from school. More alarming are the respondents’ reports on suicide with 23.8% having seriously considered attempting suicide; 24.4% made a plan about how they would attempt suicide; 16.5% had attempted suicide; and 3.7% made a suicide attempt that resulted in the need for medical intervention. These statistics illustrate a dire need to address the effects of traumatic stress for Guam’s youth. WestCare Pacific Islands (WPI), in collaboration with cross-sector community partners, proposes to step into this unmet need and provide critical, culturally relevant mental health support and treatment services for children and families impacted by trauma. WPI proposes to provide evidence-based, developmentally appropriate, trauma-informed mental health services and coordinated linkages to other needed supported services in the community. The project will also deliver a series of community events and trainings to increase awareness and understanding of trauma-related mental health issues among parents, community members, youth-serving agencies, and others who interact with children, deepening and expanding community relationships to better serve the children and families of Guam. WPI’s Ma’lak na Ha’åni program proposes to serve 75 unduplicated participants per year for a total of 375 unduplicated participants served over the five-year grant term. The program’s proposed goals, each with measurable objectives, are to 1) Increase the screening, diagnosis, treatment and referral of mental health issues for male and female youth ages 11-17 years and their families on the pacific island of Guam in order to improve the well-being of youth who have experienced trauma; and 2) Increase the awareness and capacity on the pacific island of Guam to provide trauma-informed mental health clinical services to male and female youth ages 11-17 years, parents/guardians, and community members to better detect and respond to mental health issues. In pursuing these goals, WPI will apply evidence-based practices including Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Seeking Safety, and Motivational Interviewing (MI).
PEACE Partnerships for Success (PFS)
Project STEER (Stop Transmission through Education, Empowerment, and Resources), proposed by WestCare Pacific Islands, Inc., is a constellation of substance misuse and HIV prevention and treatment services for youth and young people ages 13-24 on the island of Guam, specifically focusing on racial and ethnic minorities of indigenous CHamoru (33.7%), Filipino (26.3%), Chuukese and Caucasian (7% each), and other Asian and Pacific Island ancestry. Guam, the largest and southernmost island in Micronesia, is a diverse, multicultural and multilingual nation English spoken in nearly half of households (43.6%) followed by Filipino (21.2%), CHamoru (17.8%), and other Pacific Island and Asian languages. Nearly half of Guam’s population (44%) is under 25 years old: about one-quarter of the population is aged newborn to 14 and 17% are 15-24. The services of education, testing, and substance use treatment are especially critical on an island where 85% of families with children under 18 live in poverty. More than half of high school students have experienced alcohol and 17% had their first drink before the age of 13, and nearly half have tried marijuana with more than a quarter currently using it. About one-third of high school students report having had sexual activity and one-quarter are currently active. However, the overwhelming majority of students did not use a condom during their last encounter and nearly 80% have never been tested for HIV. On this island, more than half of the diagnosed AIDS cases are in Stage 3. With its partners in the public health system, the two public universities, and the LGBTQI and straight allies organization, STEER will provide crucial counseling, testing, and linkages to services. STEER’s goals, each with measurable objectives, are: 1) Expand capacity of Guam to provide substance misuse and prevention services to the population of focus; 250 minority youth and young people over five years will be counseled and tested for HIV and hepatitis and linked to services; 2) Improve the ability of Guam minority youth to function socially without alcohol and other drugs; 3) Reduce problems related to substance misuse including HIV transmission; and 4) Enhance the capacity of youth to reduce substance misuse and HIV/AIDS transmission through messaging and digital outreach. The evidence-based PRIME for Life intervention will be used to help 500 youth and young adults increase positive decision-making including substance use reduction, and nontraditional site testing for HIV and hepatitis will be supported by Counseling, Testing, and Linkage (CTL) and intensive service coordination to ensure that clients who test positive are supported in care, stay in care, and ultimately achieve viral suppression. STEER aims to create an environment free of stigma or fear and serve as a hub of advocacy and support in the promotion of happiness and health in the lives of youth and young adults on Guam.
Building Prevention and Intervention Strategies on Guam through Maolek Na Lina’La (“Life is Good”)
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