MS Discretionary Funding Fiscal Year 2020

The North Mississippi Commission on MI/MR (d.b.a. Communicare/Region 2 Mental Health), an established, accredited political subdivision with 50 years of experience, robust infrastructure and proven track record serving the population of focus in SAMHSA grants, will implement, evaluate and sustain the proposed COVID-19 ERSP program to prevent suicide and suicide attempts. Project Name: COVID-19 ERSP. Population(s) served: Adults age 25 and older, including victims of domestic violence. Strategies: 1) develop strategies to eliminate disparities and improve social determinants of health reducing substance abuse, criminal justice involvement, homelessness, suicide fatalities and limited family and social connectedness; 2) develop, implement and sustain community-based mental health treatment with oversight from an COVID-19 ERSP Coalition; 3) promote flexible, 24/7 on-call, community-based, multi-disciplinary team and mental health services resources; and 4) implement cross-sector workforce training. Evidence-based: Trauma-informed, culturally competent and linguistically appropriate ASIST; SafeTALK; MI; QPR peer/family supports and community/provider trainings. Goal: Implement culturally competent, trauma-informed, multi-disciplinary community-based outpatient mental health treatment team services with a flexible, continuous quality improvement approach utilizing person-centered case management and evidence-based practices/programs. Objectives: Over 16 months, 1.1) Work collectively with mental health, substance abuse, and other COVID-19 ERSP stakeholders as part of a COVID-19 ERSP Coalition to establish follow-up and care transition protocols to help ensure patient safety, especially among high risk adults in health/behavioral health care settings who have attempted suicide or experienced a suicidal crisis, including those with SMI and/or substance use disorder(s) with 80% or more stakeholders actively attending Coalition meetings; 1.2) Develop and implement a plan for rapid follow-up after discharge from EDs and inpatient psych facilities to ensure care transition and care coordination resulting in 100% of COVID-19 ERSP participants with accurate diagnosis for trauma, SUD/COD, and suicide risks via screening/assessments and enrollment in outpatient/IOP; 1.3) Provide suicide prevention training to community and clinical service providers serving the population of focus (20 certified trainers will be trained on ASIST & SafeTALK who will train an additional 100 community/clinical service providers) with 100% demonstrating changes in competence/confidence; 2.1) 100 COVID-19 ERSP participants will receive suicide screening/assessment/treatment with telehealth options; 2.2) Provide community recovery supports for 100 COVID-19 ERSP participants who attempted or are at risk for suicide, including supports for impacted household members; and (2.3) 100% of participants who are victims of domestic violence and their dependents in need of housing will improve housing stability, including a safe place to stay when unable to remain safely at home. # to be served. 100 participants; 100 providers trained.

SEEDS (Strategies for Emergency Empowerment for the Delta) utilizes a three-prong approach to maximizing project reach while ensuring efficient use of funds: Treatment, Prevention, and Recovery. SEEDS will decrease risk factors for developing trauma-related mental health issues and/or substance misuse and strengthen protective factors among students who experienced disaster in Holmes County, Mississippi during April 2019 when 17 tornadoes struck the state. One death, 18 injuries and 230 damaged homes leaving tens of thousands without power. In Holmes, first responders rescued a stalled motorist engulfed in rising water. Rapidly falling timber blocked dozens of roads trapping a school bus between two trees. Due to these storms, Gov. Haley Reeves Barbour declared disaster in 22 counties including Holmes. The difference between Holmes and the other 21: Holmes was fighting for survival before the storms. SAMHSA research shows that following a natural disaster, children are vulnerable to: • Severe stress reactions: post-traumatic stress disorder, functional impairments, traumatic stress & other disorders. • Children who have lost property or loved ones may go through lengthy periods of grief, pain and depression. • Youth are at greater risk than adults of developing psychiatric and substance abuse disorders Holmes County Population = 17,999 • Pop by race: Black= 82.5%; White= 16.2% Three out of 10 families survive on less than $10,000 per year. Moreover, Holmes County ranks DEAD LAST in health outcomes. Holmes is 100% rural AND designated 100% Health Professional Shortage Area in all 3 categories: primary, dental, and mental health care. Yet, the ratio of residents to mental health providers is 3,550:1. Holmes County Consolidated School District (HCCSD) is rated “Grade F” and struggling with academics – let alone disaster-trauma care with a student/counselor ratio of 1-to-336 – the standard is 250-to-1. Student Behavior Data Indicator: HCCSD State U.S. Out of School Suspension 13.9% 8.9% 4.7% Acts of Violence Per 1,000 74 32 13 Youth Who Report … Holmes State Youth Who Report Holmes State Alcohol use past 30 days 35.7% 18% Not viewing alcohol/drug use as dangerous 87.5% 43% Illicit Rx Use (ever) 35.1 % 2.7% Binge drinking alcohol (ever) 25.7% 9.9% Contributing Factors Holmes State US Contributing Factors Holmes State US Uninsured 16% 14% 6% Free/Reduced Lunch 100% 75% 32% Teen Pregnancy 86 61 20 Child Mortality 135.0 92.2 41.4 Single-parent households 78% 44% 20% Severe housing cost burden 17% 14% 7% SAMHSA says effective prevention saves $18 per $1 invested. Thus, with this $1M investment in treatment, prevention, and recovery - SEEDS will save an estimated $18m. Further, it allows us to plant SEEDS of health and wellness that will bloom in an otherwise desolate landscape.

The Mississippi Band of Choctaw Indians (MBCI), Choctaw Health Center's Behavioral Health Program is submitting application for an Emergency Grant to Address Mental and Substance Use Disorders During COVID-19. Much like the rest of the country, MBCI can expected to experience an increase in the number of consumers affected mentally and emotionally by COVID-19. Therefore, the Choctaw Health Center's Behavioral Health Program is seeking to apply for funding to enhance crisis intervention services such as establishing a sustainable crisis response system or develop partnerships that will be culturally aware and sensitive to the unique needs of tribal members. Such resources can permanently establish a functioning telemental health system to add to the existing traditional mental and substance use disorder treatment model-of face-to- face services, that have been dramatically disrupted by the social distancing required to decrease the spread of the current pandemic. These resources will allow for the enhancements and improvements to care s for consumers and healthcare workers impacted by the COVID-19 pandemic. The proposed Project's local name will be the Choctaw Emergency Mental Health and Substance Use Disorder Project (CEMHSUD). CEMHSUD will implement the following required activities: Develop and implement a comprehensive plan of evidence-based mental and/or substance use disorder treatment services for individuals impacted by the COVID-19 pandemic. Ensure that service provision may occur in a telehealth context including the use of telephone given the current emergency situation. Screen and assess clients for the presence of mental and substance use disorders and/or co-occurring disorders, and use the information obtained from the screening and assessment to develop appropriate treatment approaches Provide evidence-based and population appropriate treatment services.. Provide recovery support services (e.g., linkages to nutrition/food services (funds may not be used to actually purchase food/meals), individual support services. Grantees must ensure the ability to provide these services virtually where needed. Develop and implement Crisis mental health services). This project will help to improve the MBCI mental health infrastructure well into the future, while positioning it to accommodate the increasing technology demands being place on modern communications. The project is expected to serve an estimated 550 consumers, this is approximately 5% of the total enrolled tribal membership, and at least 20 healthcare workers, this is 5% of the healthcare population for MBCI, making a total of 570 with the expanded reach through telehealth and contracts.

The COVID-19 pandemic has generated mass infections, staggering death totals, social disruption, and economic fallout not seen since the 1918 flu pandemic. Public health experts have identified COVID-19 as the most formidable health crisis of the twenty-first century. Mississippi (MS) has experienced significant increases in COVID-19 cases and deaths while trailing nearly all other states in coronavirus testing. These challenges have been magnified by MS' poverty rates, pronounced health disparities, longstanding racial-ethnic stratification, and rural remoteness. These factors have long placed MS atop state rankings in negative mental health indicators. Under normal circumstances, MS faces formidable mental health (MH) adversities, substance use disorder (SUD) vulnerabilities, and co-occurring disorder (COD) problems. The COVID-19 pandemic, coupled with social distancing directives, shelter-in-place orders, and mass unemployment, has raised these threats to critical levels in the nation's poorest state. Given these challenges, the Mississippi Department of Mental Health (DMH) proposes the MERC-19 (Mississippi Emergency Response to COVID-19) project. MERC-19 proposes a three-pronged approach to enhance and expand the continuum of care for people with SMI, SED, SUD, and COD while also improving service delivery to frontline workers directly battling this pandemic. MERC-19's use of a three-pronged approach will enable MS to (1) to ensure that community-based services are provided with an emphasis on telehealth offerings and ensure that they are initiated and expanded for a wide range of feasible MH, SUD, and COD services provided to clients of CMHCs funded by this initiative; (2) facilitate the expansion of sustainable tele-MAT capacities statewide with special attention to socially isolated current or prospective MAT clients located in remote rural areas; (3) support the proactive delivery of MH and SUD services to healthcare professionals, crisis hotline workers, and first responders who have been traumatized by their efforts to combat COVID-19. Culturally competent service delivery will also be enlisted to reduce COVID-related health disparities that have already emerged. Current data supports the prioritization of African American adults and residents living in remote areas lacking treatment services. Planned evidence-based interventions include, among others, Peer Support Services, Mobile Crisis Teams, Crisis Stabilization, Wraparound Facilitation, Trauma-Focused Cognitive Behavioral Therapy, Assertive Community Treatment, Intensive Care Management, Community Outreach and Recovery Support Teams, Outpatient Therapy, Supported Employment, and Supported Housing, all delivered with a focus on telehealth/telemedicine modalities wherever feasible. High-risk and rural areas of the state will also be subject to a targeted communication campaign designed to help the most vulnerable residents, including healthcare workers. MERC-19 promises to enhance COVID-related treatment and recovery services rapidly while improving the quality of life among MS residents in the wake of this public health crisis.

Project Abstract Summary Summary. The North Mississippi Commission on MI/MR (d.b.a. Communicare/Region 2 Mental Health), an established, accredited political subdivision with 50 years of experience, robust infrastructure and proven track record, in partnership with the 18th Chancery Court, and stakeholders involved in the civil commitment process will implement, and evaluate the Assisted Outpatient Treatment program delivering evidence-based practices to reduce the incidence and duration of psychiatric hospitalization, homelessness, incarcerations, and interactions with the criminal justice system while improving the health and social outcomes of individuals with serious mental illness (SMI) and their families. Project Name: Assisted Outpatient Treatment. Population(s) served: Adults (18 years and older) and their families who reside in Lafayette County, are diagnosed with SMI and in need of court-ordered outpatient treatment. Strategies: (1) develop strategies to eliminate disparities and improve social determinants of health reducing inpatient hospitalization, substance abuse, criminal justice involvement, homelessness, suicide fatalities and limited family and social connectedness; (2) develop, implement and sustain civil court commitment process and community-based mental health treatment with oversight from an AOT Coalition; (3) promote flexible, 24/7 on-call, community-based, multi-disciplinary team and in-home mental health services resources; and (4) implement cross-sector workforce training. Evidence-based: Trauma-informed, culturally competent and linguistically appropriate AOT, MI, ACT, EMDR, IMR, Wraparound/Full-Service Partnership, peer/family supports and Crisis Intervention Training/MHFA community trainings. Goal: Implement culturally competent, trauma-informed, multi-disciplinary community-based outpatient mental health treatment team services to individuals with SMI and their families with a flexible, continuous quality improvement approach utilizing court intervention, person-centered case management, systems navigation and evidence-based practices and programs delivered in the most fully-integrated and least restrictive environment. Objectives: 1) Establish and equip new intercept point for centralized intakes including assessment, referral and linkage coordination for eligible SMI adults with 80% or more stakeholders attending AOT Coalition meetings; 2) Family Advisory Committee meets quarterly and two new family supports are trained in advocacy each year; 3) Ensure 80 % of participants receive GPRA/NOMS assessments at intake, 6-months post-intake, every 6-months thereafter and at discharge; 4) Hire, train and certify clinical team on EBPs and train community providers on mental health and recovery practices with 85% of attendance at each training and 80% demonstrating adherence to the model; and 5) Evaluate and monitor improvements in health and social outcomes of individuals with a SMI and reductions in the incidence and duration of psychiatric hospitalization, homelessness, incarcerations, and interactions with the criminal justice and document AOT cost-savings. Number to be served. 50 per year, 200 across 4-years.

The proposed HYPED 4 Change System of Care will serve 6 rural underserved North Central Mississippi counties (Calhoun, Lafayette, Marshall, Panola, Tate, and Yalobusha) to support the implementation, expansion, and integration of the SOC approach by creating sustainable infrastructure and services. The SOC will improve mental health outcomes for children and youth, birth through age 21, children and youth with serious emotional disturbance and those with early signs and symptoms of serious mental illness, including first episode psychosis and their families by focusing on mental health and related recovery support services, sustainable financing, cross-agency collaboration, EBPs: TF-CBT; Wraparound; MYPAC; Youth-Guided/Family Driven-Peer/Family Support Services; FEP; MI; Person Centered Planning; CPI; Child-Parent Relationship Therapy; Love and Logic; Family Systems and Structural Family Therapies; MHFA; MHFA for Public Safety; Youth Mental Health First Aid; Teen Mental Health First Aid; QPR; BE COOL: The Whole School; Safe Zone-LGBTQ; and enhanced policy and infrastructure with youth-guided and family driven leadership. Strategies: HYPED 4 Change System of Care seeks to expand trauma-informed, cultural and linguistically appropriate EBPs, supports and policies with a cross-agency approach of coordinated service delivery and integration of mental health services, ensuring effective cross-agency expansion and the provision of mental health and related recovery support services to participants with SED and those with early signs of SMI, including FEP to include an array of non-mental health supports, i.e. vocational counseling, afterschool programming, health-related services, substance abuse prevention, stable housing, independent living skills and advocacy. Each participant will work with a care team that facilitates the identification and implementation of an individualized service plan in partnership with the child/youth, family, natural supports and professional supports to achieve their personal goals. HYPED 4 Change SOC will develop a cross-agency infrastructure through an integrated system of care and ensure national and local evaluation and performance assessments are conducted. Goals: 1) Expand Region 2 Mental Health cross-agency collaboration to serve SED individuals and those with early signs and symptoms of SMI, including FEP; 2) Provide a broad array of accessible and coordinated services/supports; 3) Ensure individualized, managed care; Plan, deliver, and evaluate these services with the full participation of families and youth in a culturally and linguistically sensitive manner; and 4) Facilitate broad-based, sustainable systemic support for the population of focus. To serve 100 in Year(s) 1-4, totaling 400 in 4 years.

NFusion Metro System of Care will serve Hinds County a rural medically underserved Mississippi area to support the implementation, expansion, and integration of the SOC approach by creating sustainable infrastructure and services. The SOC will improve mental health outcomes for children and youth, birth through age 21, children and youth with serious emotional disturbance (SED) and those with early signs and symptoms of serious mental illness (SMI), including first episode psychosis (FEP) and their families by focusing on mental health and related recovery support services, sustainable financing, cross-agency collaboration, evidence-based practices and programs: Trauma-Focused Cognitive Behavioral Therapy; Wraparound; Peer Support Services; Motivational Interviewing; Person Centered Planning; Supported Employment; Mental Health First Aid; Youth Mental Health First Aid; Question, Persuade, and Refer; FEP training; LGBTQ/Safe Zone training and enhanced policy and infrastructure with youth-guided and family driven leadership. Project Name: NFusion Metro System of Care. Populations served: Birth to 21 years of age; 80% African American; 2% Hispanic; 2% Multi-racial; 1% Native American; 1% Asian and 2% LGBTQ; 85% below poverty level; 5% (0-5) and 95% between ages 6-21. Strategies: The SOC expands trauma-informed, cultural and linguistically appropriate EBPs, supports and policies with a cross-agency approach of coordinated service delivery and integration of mental health services, ensuring effective cross-agency expansion and the provision of mental health and related recovery support services to participants with SED and those with early signs of SMI, including FEP to include an array of non-mental health supports, i.e. vocational counseling, financial literacy, afterschool programming, health-related services, substance abuse and suicide prevention, stable housing, independent living skills and advocacy. The cross-agency integrated infrastructure will ensure national and local evaluation and performance assessments are conducted. Goals: 1) Expand Region 9 Mental Health cross-agency collaboration to serve SED individuals and those with early signs and symptoms of SMI, including FEP; 2) Provide a broad array of accessible and coordinated services/supports; 3) Ensure individualized, managed care; Plan, deliver, and evaluate these services with the full participation of families and youth in a culturally and linguistically sensitive manner; and 4) Facilitate broad-based, sustainable systemic support for the population of focus. Objectives: Annually and over 4-years: 1) 80% will improve diagnosis; 2) 80% will improve mental illness symptomatology; 3) 80% will improve employment/education; 4) 80% will reduce criminal justice involvement; 5) 80% will housing stability; 6) 80% will reduce readmission to psychiatric hospitals; 7) 80% will improve social connectedness; and 8) 80% will report a high client perception of care. # served: 100 in Year(s) 1-4, totaling 400 in 4 years.

The MSU It Takes a Community initiative is a new multidisciplinary program at Mississippi State University – Starkville designed to make suicide attempts and death by suicide a never event. Informed by the 2012 National Strategy for Suicide Prevention and based off the SPRC’s comprehensive suicide prevention program, this new initiative aims to reduce suicides by 1. Increasing student connectedness and fostering belongingness; 2. broadening our mental health network by providing gatekeeper training to student leaders, faculty, and staff; and 3. creating new health and wellness initiatives aimed to help reduce suicidal ideation and encourage help-seeking behaviors. MSU is the largest university in the state of Mississippi with an enrollment of 21,883 students and growing. Although a majority of our students are from the state of Mississippi, 65 percent, we have a large number of out-of-state, 32 percent and international students from 80 countries around the world, 4 percent. Our campus is extremely diverse with 18.6 percent of students being African American and 28.3 percent affiliating with an ethnic minority group. The MSU Initiative has nine primary objectives based upon the SPRC evidence-based model. The project aims to 1. increase our ability to identify and assist students in distress, 2. increase student help-seeking behaviors, 3. provide evidence-based, effective care, 4. improve links between providers to ensure seamless transitions, 5. increasing connectedness, 6. teach new life skills and increase resilience, 7. reduce access to suicide means, 8. implement a postvention plan, and 9. utilize an evidence-based crisis response plan. The focus of the project will be building the infrastructure for a sustainable, evidence-based comprehensive suicide prevention program. Through this funding we aim to train at least 1,000 students, faculty, staff, and community members. We will also build a strong infrastructure through further development and validation of our gatekeeper training, developing a first year student course designed to teach life-skills and improve resilience, improving the mental health services offered on campus, and implementing service-learning opportunities designed to increase connectedness and reduce burdensomeness. Although the grant funding will last only three years, the focus of our initiative is to create a permanent and sustainable suicide prevention network at MSU aimed at making suicide a never event. The project is based upon the recommendations in the 2012 National Strategy for Suicide Prevention, inspired by Zero Suicide, and takes advantage the SPRC’s evidence-based model for comprehensive suicide prevention.

The North Mississippi Commission on MI/MR (d.b.a. Communicare), an established political subdivision with 52 years of experience and a 30-year track record as an experienced SAMHSA prevention provider with proven ability to strengthen prevention capacity to address underage drinking, proposes the Northcentral Region Partnerships for Success to prevent the onset and reduce the progression of underage drinking in Calhoun, Marshall, Lafayette, Panola, Tate and Yalobusha counties, designated as High-Need Communities (HNCs). Name. Northcentral Region Partnerships for Success. Population. High-risk individuals, ages 9-20, focusing on racial/ethnic minorities; 35% African American; 5% Hispanic; 2% LGBTQ; and 10% in need of substance abuse services. Strategies/Interventions: 1) Complete data-driven SPF planning within first 6 months; 2) Implement a comprehensive prevention approach, including S-BIRT, Project Northland, LifeSkills Training, Alcohol Literacy Challenge, policies, and/or practices that address the selected prevention priorities; 3) Identify TA and training needs and develop responsive activities; 4) Build capacity to address underage drinking among participants identified through SPF; 5) Collect and report community-level data to monitor progress in addressing SPF-PFS prevention priorities; 6) Utilize coalition building strategies to advance substance abuse prevention efforts; 7) Develop prevention messaging and other strategies and disseminate via a social media campaign; and 8) Utilize and share effective resources with the Prevention Technology Transfer Centers to enhance dissemination/adoption of substance abuse prevention best practices. Goals. Aligned with MS SPF PFS goals: 1) Prevent the onset and reduce alcohol use by participants in HNCs by implementing EBPs, policies, and practices that address individual, relationship, community, and environmental domains; 2) Reduce underage drinking consequences by participants in HNCs by implementing EBPs that address individual, relationship, environmental, and societal domains; 3) Increase the capacity of HNCs to reduce underage drinking consumption, consequences, and risk factors for participants by building coalitions that will employ a comprehensive prevention approach; 4) Strengthen and sustain the capacity of the prevention data management and systems infrastructure at state and community levels; and 5) Increase HNC stakeholders willingness to leverage, and align area prevention funding streams/resources. Objectives. Following completion of the SPF, annually and over 5-years: 1) 85% of prevention providers will participate in bi-monthly community prevention activities that address individual, relationship, environmental, and societal domains; 2) At least 85% of youth leaders will participate in community prevention activities that address individual, relationship, environmental, and societal domains; 3) 80% of participants will achieve abstinence from substance use; 4) 80% will improve employment status; 4) 80% will improve housing stability; 5) 80% will reduce criminal justice involvement. # of people to be served. 50 = Year 1 and 100/Year(s) 2-5, totaling 450 within 5 years.

Drug Free Starkville Collaboration