MA Discretionary Funding Fiscal Year 2016

Alliance for Inclusion and Prevention, Inc. (AIP) proposes to launch the Center for Trauma Care in Schools (CTCS), a hub for training and school-based delivery of evidence- based practices to treat traumatic stress in children in Boston's public schools. The Center's goals are to improve quality and increase access to evidence-based practices for trauma and help schools become more trauma sensitive environments for children. The Center intends to achieve these goals by providing a significant new workforce development infrastructure for training school-based clinicians and clinical interns.

The Center will train 530 professionals who provide clinical services in the Boston Public Schools (BPS) in the use of evidence-based screening tools and treatments for trauma. Over the grant period they will screen17, 000 Boston students for trauma (average of 3,500/year). This represents the first opportunity the school district will have had to undertake a broad trauma screening program. A parallel increase in the number of school-based clinicians to deliver EBPs for trauma will dramatically increase access for these needed services.

The Center's trauma focus will align closely with the school district's initiatives to address trauma and promote social-emotional wellness. The Center will help the Boston Public Schools better serve the impact of high levels of violence and other forms of trauma among its 53,530 students, the majority of whom are classified as "High Needs," a reflection of majority low-income students from distressed and under-resourced neighborhoods.

Partners in Care: Community-Based Implementation of Evidence-Based Treatment for
Childhood Trauma's (Partners in Care) overarching goal is to improve access to and quality of evidence-based trauma-informed care for children and families who experience trauma throughout Massachusetts. Partners in Care will: 1) Disseminate the In-Home Therapy (IHT) application of Trauma-Focused Cognitive-Behavior Therapy (TF-CBT) on a statewide scale; 2) Implement a program of training in trauma-informed mental health care for paraprofessionals working in a variety of community-based mental health settings;3) Strengthen cultural competence of the clinical workforce for trauma-informed treatment within special populations. Partners in Care proposes to serve families with children ages 5 to 18 who have experienced trauma regardless of gender, race, or sexual orientation. Partners in Care will serve a total 630 families through TF-CBT throughout the project.

Partners in Care will train 210 IHT therapists and 170 IHT paraprofessionals within 5 years of the grant. It is anticipated that University based trainings will be conducted 2 times per year, 250 paraprofessionals will be trained throughout the life of the grant, 63 of whom will have lived experiences, and 25 will work in integrated care practices. Increased training throughout the state in culturally-competent trauma-informed care will create a cadre of skilled clinicians and para-professionals that will increase access to and improve delivery and quality of evidence-based trauma-informed treatment.

Title: Refugee Trauma and Resilience Center at Boston Children's Hospital: A Treatment and Service Adaptation Center for Refugee Children and Families. The purpose of the project: Refugee Trauma and Resilience Center at Boston Children's Hospital.

The Massachusetts Multi-City Young Children's Mental Health System of Care (SOC) Project brings together the state's three largest cities (Boston, Worcester and Springfield) and several state agencies to implement the strategic plan developed through our SAMHSA-funded SOC Planning Project. The lead agency is the Boston Public Health Commission, the city's health department. The project has a two-fold purpose. (a) In the three cities, to expand and strengthen the system of care to better engage the primarily local institutions which already serve young children, ensure early detection and appropriate intervention for children up to age 6, better serve the families of young children with serious emotional disturbances and provide a detailed roadmap for integrating efforts across the multiple sectors that engage young children and families. (b) Statewide, to demonstrate a replicable and sustainable model for local mental health service delivery that is integrated with the existing state system, and use lessons learned from the project to influence major statewide improvements in the system of care for young children with serious emotional disturbances and their families.

The Enhancing Systems of Care: Supporting Families and Improving Youth Outcomes (ESOC) project, is intended to disrupt patterns of MH disparities in treatment access and outcomes, particularly among children of color or where English is not spoken at home, through an integrated system-of-care for families with children who receive primary care at Cambridge Health Alliance (CHA) and have, or are at-risk for, SED. Massachusetts had the highest rate of child abuse and neglect in the US during FY14 (DHHS, 2016). E-SOC will create integrated services for its primary care "safety-net" population of 25,000 children (0-18 years), living in CHA's five surrounding cities, with a special focus on identification of child trauma, autism spectrum disorder, youth/caregiver substance use and early psychosis. E-SOC partners include CHA's Departments of Pediatrics and Psychiatry, the state Departments of Mental Health (DMH) and Child Welfare (DCF), as well as MassHealth (MA Medicaid), the institute for Health and Recovery (IHR), and the Cambridge Schools Special Education Dept. E-SOC aligns with CHA's MassHealth-Accountable Care Organization RFA, offering MA the opportunity to model a sustainable system-of-care for its most vulnerable children. CHA has active training programs in social work, psychology, pediatrics and child psychiatry, as well as a nationally recognized program for medical students in community settings, providing opportunities to build workforce capacity for integrated systems of care.

The purpose of the Primary and Behavioral Health Care Integration (PBHCI) Program of Franklin County is to establish coordinated and integrated services through the co-location of primary and behavioral health care medical services in the Center for Human Development's community-based mental health site in rural Franklin County, Massachusetts. The Center for Human Development will partner with a Federally Qualified Health Center, the Community Health Center of Franklin County, in providing integrated primary care. The goal is to improve the physical health status of adults with serious mental illnesses (SMI) who have or are at risk for co-occurring primary care conditions and chronic diseases, with the objective of supporting the triple aim of improving the health of those with SMI; enhancing the consumer's experience of care (including quality, access, and reliability); and reducing/controlling the per capita cost of care. The PBHCI Program of Franklin County will focus on providing primary care and chronic disease management services to those consumers who live with/or are at-risk for obesity, diabetes, pre-metabolic syndrome, hypertension, and dyslipidemia, all of which are risk factors for coronary heart disease.

Clinical and Support Options (CSO) will use Attachment, Self-Regulation, and Competency (ARC) as its primary evidence-based practice in the proposed Trauma Treatment and Training Institute of Western Massachusetts. CSO seeks maximum impact for both trauma treatment and trauma training by reaching out to populations with the highest level of disparities to reduce stigma and foster acceptance and understanding. ARC-trained clinical staff will treat 240 children and families annually, totaling 1,200 for the 5-year period. The Institute will train 160 people in ARC annually including 60 clinicians to be ARC-certified, totaling 775 people over the 5-year period.

Goal 1: CSO will provide and oversee effective service approaches by offering high quality training and technical assistance in ARC, an evidence-based practice. Objective 1.a. CSO will provide free trauma training and technical assistance to institutional workforces; Objective 1.b. Training participants will understand and be able to operationalize the core principles of a trauma-informed approach to care. Objective 1.c. CSO will integrate trauma training with its current community training offerings.

Goal 2: CSO will increase access to high quality trauma treatment services for children and their families. Objective 2.a. CSO will create an ongoing system of outreach and engagement to at-risk children and families. Objective 2.b. CSO will provide screening for trauma to 100% of youth and children referred to CSO for trauma treatment. Objective 2.c. CSO and its partners will provide direct trauma treatment using ARC to 240 children and their families a year.

Goal 3: To create awareness of the importance of recognizing and treating trauma. Objective 3.a. CSO will reduce stigma of trauma induced mental illness/emotional disturbance by general trauma education across communities and agencies. Objective 3.b. CSO will use communication and social marketing tools to engage communities in primary prevention.

Clinical and Support Options, of Western Massachusetts (Hampshire, Franklin and northwestern Worcester (North Quabbin) Counties), plan to offer Mental Health First Aid, both youth and adult, to those in our communities who are in a position to make a difference: public school and college/university faculty and staff, primary care providers, community-based agency staff, first responders/law enforcement and juvenile court personnel. There are 33,534 youth 10-19 in the tri-county service area. YMHFA training will be provided at three of five outpatient centers and in community venues in the counties' population centers: Greenfield in Franklin County, Athol in the North Quabbin area and Northampton in Hampshire County. Through partnering with Communities that Care and the Collaborative for Educational Services, widespread marketing and community outreach in general mental health awareness as well as to publicize free YMHFA training for any resident will be achieved. CSO will coordinate an information and referral process in which all participants will be trained. Instructors will also be certified in three specialties: Rural Audiences, Higher Education and Public Safety. The project's goals will be achieved through the following objectives: to teach community members how to support the individual and to help seek appropriate treatment for them by training 650 people in YMHFA; to reduce the stigma of mental illness in our communities; and foster an understanding of mental illness in trainees and in the community at large through increasing public awareness in every segment of the community through a process of community outreach and marketing. Six Instructors will be certified in YMHFA, who will train 650 community residents over three years.

This project will serve transition age youth (TAY) and the adults that work most closely with them at 12 colleges and universities in 11 distinct census tracts in Worcester County, Massachusetts. Working closely with the identified colleges and universities, Community Healthlink will train over 1,100 adults on campus to become Mental Health First Aid "First Aiders" that will be know how to recognize TAY with emergent mental health issues and will refer them to area behavioral health service providers for assessment and treatment. Project success will be measured by: a decrease in the percentage of TAY who report depression or anxiety; an increase in the percentage of adults who are trained as MHFA First Aiders; and an increase in the percentage of TAY referred to behavioral health service screening, assessment, or treatment.

Bristol County, Massachusetts will expand the Behavioral Health Treatment court located in New Bedford, MA. The New Bedford Drug Court will collaborate with multiple community treatment and recovery providers to address the behavioral health needs of adults who are involved in the criminal justice system. The project will allow eligible individuals to receive treatment and recovery support services as part of the court collaborative. The program will focus on connecting with individuals early in their involvement with the criminal justice system; provide them with treatment, rehabilitative services as well as to provide recovery support services in an effort to improve the Greater New Bedford area's public health and safety.