ME Discretionary Funding Fiscal Year 2018

Amistad, Inc. will continue to recruit and develop an active Statewide Consumer Network in Maine, made up especially of people working in Peer Services. Although Peers are being hired more than ever before, there are currently wide gaps and disparities in the roles they are playing in their jobs, the amount of money they make, and the type of supervision and guidance they are receiving. Some Peers are paid a living wage and are doing real, professional-level Peer Support work, with all the rich sharing of experience, and the positive outcomes that suggests. Some Peers are working as greeters and drivers for low-wages. Peer Services are a rapidly growing field in Maine. Behavioral Health Homes, community mental health organizations for individuals who receive MaineCare (the state Medicaid program) are mandated to hire at least one Peer per agency. Also, the new contract terms for the twelve (12) Peer Support and Recovery Centers and five (5) Substance Abuse Peer Support and Recovery Centers mandate that all staff working with consumers have their CIPS. As a result, there are now more than 125 Peer Services workers in the state, and soon there will be more than 200. Our project will advocate not only for the continued expansion and integration of Peer Services into current health reform efforts but will also advocate for standardization of Peer Services across service delivery settings, and widespread recognition of the value, effectiveness, and professional nature of Peer Services. We intend to coordinate and partner with state government to implement this project, as well as with numerous provider and advocacy groups. Collaborators include the Certification program for Intentional Peer Support Specialist (CIPSS) training, The Maine Association of Peer Support and Recovery Centers and The Consumer Council System of Maine. We believe that Peer Services should have an important place in the health care service mix, and the strongest advocates for Peer Services are people who are already demonstrating the effectiveness of the model on a daily basis. As part of this project, we plan to continue to organize and grow the Statewide Consumer Network; offer trainings and information to traditional providers who now must hire Peers; negotiate to insert governing language into state contracts that is consistent with best practices in Peer Services, and advocate for consumer concerns regarding healthcare as well as Medicaid billing codes for Peer Service. We believe that our efforts will ensure that Peer Services in Maine will achieve the standards of professionalism, the cost savings and the positive outcomes for which these services are known.

Aroostook Band of Micmacs (ABM), located in Maine's northern most county (Aroostook County), will provide youth with substance abuse and suicide prevention programming, in collaboration with the Penobscot Boys & Girls Club - Presque Isle Unit (PBGC), Pi'gunji'jg/Little Feather's Head Start and myriad of community partners that addresses the need of community Native Youth through the Aroostook Band of Micmacs Native Connections program. ABM will focus on youth aged 3-18 because these youth are most in need of additional programming in our community. Services will be provided to 260 Native youth annually including youth attending the Pi'gunji'jg/Little Feather's Head Start and PBGC with additional youth added throughout the lifetime of the project. The overarching goal of the Aroostook Band of Micmacs is to reduce the impact of mental and substance use disorders, foster culturally responsive models that reduce and respond to the impact of trauma in our Native community and allow our community to facilitate collaboration among agencies to support youth as they transition into adulthood. The primary goal is broken down into smaller, specific goals: Goal one- Reduce the impact of mental and substance use disorders in our community through increased participation of at-risk youths aged 3-18 in prevention programs. Goal two - Facilitate collaboration among community agencies to support at risk Native youth.

CANDO (Creating A Network of Diverse Opportunities)

Maine-AWARE implements a multi-tiered system of interventions that integrates school positive behavior supports, social emotional learning, and mental health literacy and intervention strategies in order to maximize school/community capacity to identify and serve school aged children with mental health needs. The three LEAs selected to pilot and build a statewide comprehensive approach to school mental health are representative of the challenges by Maine's typically small, rural school districts - notably reliance on community mental health partners who do not have the ability to participate in broader school prevention/intervention activities and shortages of qualified mental health professionals. Maine-AWARE supports the co-training of community and school based clinicians and nonclinical staff in compatible evidence based practices, supports multiple opportunities for collaborative problem solving, and addresses policy/funding stream issues create barriers to interagency collaboration and funding flexibility. The project culminates in the development of a statewide comprehensive school mental health framework that can be sustainably implemented and supported within the local control environment that characterizes Maine education.

The 2012 National Strategy for Suicide Prevention (NSSP) identifies the need to promote suicide prevention as an essential element of health care services, and the importance of implementing effective practices for assessing and treating individuals at risk of suicide. In support of national efforts to reduce suicide deaths among adults, the Maine Center for Disease Control and Prevention Maine Suicide Prevention Program (MSPP) will implement the Communities of Care (CoC) Project, with the goals of increasing access to suicide-safer care for individuals served by primary care and behavioral health services; implementing comprehensive systems change to support suicide screening, assessment, treatment, and follow-up within major community mental health agencies; and developing shared discharge protocols between hospitals, emergency rooms, and regional crisis service providers to ensure rapid follow-up and transition of care for individuals after a suicide attempt or suicidal crisis. Specifically, the MSPP CoC Project will focus efforts in three areas: ? Goal 1: Increase the number of providers within Maine?s Behavioral Health Homes who use evidence-based practices to assess, treat, and manage suicide risk among patients and clients. ? Goal 2: Increase the number of behavioral health systems that implement evidence-based protocols and clinical pathways, using the Zero Suicide framework (Zero Suicide Practice Transformation), for suicide risk screening, intervention, treatment, and follow-up. ? Goal 3: Increase the number of hospitals, emergency rooms, and inpatient behavioral health programs that have developed shared protocols with regional crisis service providers that include procedures for rapid follow-up and care connections for individuals following a suicide attempt or suicidal crisis (Strengthening Supports). To increase health and behavioral health providers? skills in evidence-based suicide screening and treatment, MSPP CoC Project staff will partner with the Sweetser Training Institute to create a web-based training portal that provides access to best-practice educational resources in suicide prevention. The MSPP will expand upon these trainings by partnering with two additional major community mental health providers to implement the Zero Suicide model, a quality improvement process that focuses on creating organizational systems and policies to support screening, intervention, treatment, and ongoing follow-up for all clients at risk of suicide. The CoC Project will increase community supports for individuals at high risk by engaging hospitals, emergency rooms, and local crisis service programs to ensure rapid follow-up and supported care transitions for individuals following a suicide attempt or suicidal crisis. The Maine Suicide Prevention Program has a long history of engaging with community partners to provide innovative suicide-prevention interventions across many sectors. The MSPP takes a data-driven approach to implementing high-quality services. As part of the Communities of Care Project, the MSPP will train over 650 health and behavioral health providers in evidence-based suicide prevention practices, and support high-quality suicide-safer care and community follow-up for over 3500 Maine adults. The MSPP believes that these efforts will have a positive impact on the well-being of our communities by reducing Maine?s rate of suicide deaths and suicide attempts.

Mid Coast Hospital, Brunswick, Maine, has been awarded a Substance Abuse and Mental Health Services Administration training grant to implement “Mid Coast Youth Mental Health Awareness Project”. Mid Coast Hospital will be partnering with NAMI Maine and other community partners to offer free training to youth serving agencies, families, caregivers and peer leaders in Sagadahoc County, Brunswick and Harpswell. Mid Coast Hospital’s goal is to increase community ability to recognize early signs of mental illness in youth, appropriately respond to prevent and de-escalate crisis situations, connect youth to local resources, and increase overall community mental health awareness. A community advisory and oversight team will be coordinated by Midcoast Community Alliance. Project Goals and Objectives Train 1,340 unique individuals; 430 in year one, 455 each in years two and three. Increase community capacity to appropriately respond to youth and young adults, ages 12-24, with signs of mental illness. By September 30, 2021: • 50 young adults will complete Moral Reconation Therapy. • 18 Youth Mental Health First Aid trainings will be held to increase the number of adults who recognize the signs of, and local resources for, mental illness in youth and young adults. • 30 interagency advisory team meetings will be held to increase community linkages • 6 Crisis Intervention trainings will be completed to increase the number of enforcement and emergency service personnel who are trained in crisis de-escalation techniques. • 3 Applied Suicide Intervention Skills Trainings will be held to increase the number of adults who can identify and respond to youth and young adults expressing signs of suicide risk. • 3 school districts will be trained in the Sources of Strength curriculum to increase the help seeking behaviors of youth and promote connections between peers and caring adults. • 3 mental health resource campaigns will be completed to increase awareness of support. Increase resiliency skills in youth to reduce the effects of significant adversity on mental health. By September 30, 2021: • 9 Mindfulness-Based Stress Reduction trainings will be held to increase use of evidence based skills by youth to manage daily stress and anxiety. • 18 six-week Progression courses will be held to increase coping skills of youth who have experienced a first episode of psychosis or received a mental health diagnosis. • 10 youth serving agencies and schools will implement at least 1 Midcoast Community Alliance led resiliency awareness event.

The Spurwink Refugee Mental Health Project which will utilize Trauma Systems Therapy for Refugees (TST-R) is a multi-tiered mental health promotion model used to improve access to trauma-informed mental health services for refugee children and adolescents in Maine. The project is a partnership with the Refugee Trauma and Resiliency Center at Boston Children's Hospital (BCH), United Somali Women of Maine, schools, providers, and grassroots organizations. The project will serve an average of 415 individuals per year-a total of 2,070 over five years- in Biddeford, Lewiston/Auburn, and Greater Portland, Maine.

TST-R takes a social ecological approach to working with these children and youth, building systems of care that respond to their multi-dimensional needs. The initiative includes broad-based prevention and community resilience building, community-based skill-building groups for youth, and intensive home-based family therapy for those with significant mental health needs. All services are delivered by mental health clinicians and cultural brokers who assist the team and community in creating cross-cultural understanding and change.

The Spurwink Refugee Mental Health Project will increase access to effective trauma-focused services for participants by improving community awareness of the trauma-related needs of refugee youth and increasing acceptance of mental health services among refugee families. Participants in skill-based groups will develop improved sense of belonging, emotional regulation and school behavior. Participants in home based TST-R will experience improved mental health and reduced stressors in their social environment and will avoid juvenile justice involvement.

The project will provide training and technical assistance services to the substance abuse prevention workforce in the six New England states. This will include in person trainings as well as webinars, self-paced on-line courses, and other distance learning opportunities. The project will also engage prevention scientists to work with prevention practitioners to develop tools to facilitate the effective delivery of science-based prevention programs in New England communities. By the end of the 5 year project (September, 2023), the project will have provided training and technical assistance services to a minimum of 19,500 prevention professionals and stakeholders in New England. Upon successful application, this project will seek to engage state substance abuse prevention and public health officials in each of the New England states. Services provided by the New England Prevention Technology Transfer Center will assist the State and funded prevention contractors, with the trainings and tools to maximize the impact of state and federal prevention dollars.

The Coalition will prevent and reduce youth substance use by implementing the following strategies: provide information through social marketing and social norm campaigns aimed at changing youth and adult perceptions related to underage drinking, marijuana, prescription drug misuse, bath salt, and methamphetamine abuse; reduce youth access to alcohol through retail alcohol outlets by providing resources to retail outlets to support them in their efforts to enforce underage drinking laws; reduce access to prescription drugs for illegitimate purposes by sponsoring health care provider training and promoting the use of Maine's Diversion Alert Program by health care providers; advocate for changes to relevant policies that impact alcohol, marijuana and prescription drug abuse; provide information, support and resources to local schools and communities to address youth bullying; and provide information, support and resources to local schools and communities to foster stronger relationships between parents and children.

The City of Bangor's Health & Community Services Department is applying for a Drug Free Communities grant on behalf of the Bangor Region Public Health Advisory Boards Substance Abuse Prev Task Force