GU Discretionary Funding Fiscal Year 2023

Guam is an unincorporated territory of United States, a small island with a diverse multiple ethnic and cultural population of 159,381 people. Guam Behavioral Health and Wellness Center is accredited by the Commission on Accreditation of Rehabilitative Facilities and the only State mental health facility in the Western Pacific providing mental health services for Guam, Commonwealth of Northern Marianas Island and active duty military, retirees, veterans and families. There are glaring gaps, barriers, lack of training and resources in Guam's current service structures and programs. Guam has no mobile crisis response unit for the targeted population, forcing many families to access mental health services via Guam Police Department. Guam Police Fire Department directors have requested trainings to guide first responders to resolve mental health crisis in constructive, safe, and humane manner. On Guam, individuals with SMI and SED may be transported to the emergency departments or GBHWC but more likely, they would be arrested, detained and released without services. Due to mental health stigma and language barriers, parents and family members of individuals with SMI and SED are unable to recognize warning signs and symptoms of mental illness and access services too late. Under the leadership of GBHWC, Project Tiningo will provide evidenced based mental health awareness trainings for school personnel, law enforcement, emergency personnel, medical, behavioral providers, military, veterans and parents families of individuals with SED and SMI.

The U.S. territory of Guam requests funding for Project Guam 988 Lifeline Center to build local 988 capacity. The funding will be utilized to increase current Lifeline center capacity through increasing Lifeline workforce capacity and the implementation of chat/text crisis services. Guam presently has only one Lifeline Call Center, operated by the Guam Behavioral Health and Wellness Center (GBHWC), the island's only state mental health agency. Thus, the GBHWC Lifeline Center will serve the entire diverse population of 153,836 people (U.S. Census, 2020) including 10,026 veterans (U.S. Department of Veteran Affairs, 2017). In the past, the GBHWC's Hotline was staffed with Inpatient nurses and volunteers during the holiday season. However, during the COVID pandemic the need grew, and the pandemic forced the issue of having a stable, consistent 24/7 crisis hotline. In response, GBHWC established a 24/7 crisis hotline with dedicated staff that were trained in crisis intervention. The COVID pandemic has had a major impact on call volumes. Prior to the pandemic, the GBHWC Crisis Hotline, received an average of 25 calls/month. In 2020, with the advent and persistence of the COVID pandemic, call volumes rose to an average of 748 calls/month, of which approximately 15.8% were "crisis" calls, thus raising the average monthly call volume for crisis-related issues from 25 calls/month to 118 calls/month (GBHWC Crisis Hotline Data). Using the current average of 118 calls/month, we project the number of chats/texts at the initiation of Guam's 988 Lifeline to be at approximately 50%, with a progressive increase once the population becomes familiar with this mode of interaction. Data shows the increased need for 988 services, thus the major goals and objectives of this grant will be to 1) increase the capacity of the Lifeline Center to handle current and projected 988 volumes for calls, texts/chats, and follow-up services and 2) increase the capacity of the Lifeline Center to successfully launch 988 by executing the Guam 988 Implementation Plan. Project Guam 988 Lifeline Center will serve 6,000 over the life of the 2-year grant.