NC Discretionary Funding Fiscal Year 2023

With an aim to reduce the proportion of youth who felt sad or hopeless almost every day for more than two weeks in a row from 29.7% in 2019 to 27% in 2025, The Mental Health Awareness for Wake County and Johnston County, North Carolina project will increase the capacity of families and adults who serve youth (ages 10 - 19) in Wake and Johnston Counties to provide support for youth experiencing mental health or addiction challenges or crises, increase the capacity for first responders and medical professionals to respond to youth in mental health crises, and will increase the capacity of youth to provide mental health support for their peers by implementing evidence-based programs within community organizations with youth groups. The project will train community members on Youth Mental Health First Aid (YMHFA), Teen Mental Health First Aid (tMHFA), and Question. Persuade. Refer. Gatekeeper Training (QPR) as evidence-based strategies for raising awareness about mental health. Trainees will have access to a network of mental health service providers that are ready to receive referrals. The project will reduce stigma around seeking mental health support services. Measurable objectives include training four Poe Center staff and four community partners in Youth Mental Health First Aid by April 2022 and June 2023, respectively, and eight staff and partners in Question. Persuade. Refer. Gatekeeper Training (QPR) by June 2023. By the end of the project period in September 2026, training will be provided to 1420 youth-serving adults in Youth Mental Health First Aid, 250 medical professionals and first responders in QPR Training, and 585 youth in Teen Mental Health First Aid. Further, the project will disseminate print and electronic referral tips and reference guides by June 2022 and encourage adoption of organizational policies that prioritize mental health awareness training for staff and volunteers by June 2025. The project will serve 150 adults and 60 youth in year 1, 270 adults and 75 youth in year 2, 350 adults and 100 youth in year 3, 400 adults and 150 youth in year 4, and 500 adults and 200 youth in year 5.

The CCS Care Team will provide mental health awareness training to those who come in contact with our youth, their caregivers and siblings the most often who exhibit signs and symptoms of mental disorders, particularly serious mental illness (SMI) and/or serious emotional disturbances (SED); The team will establish linkages with community-based mental health agencies to refer individuals with the signs or symptoms of mental illness to appropriate services; and educate individuals about resources that are available in the community for individuals with a mental disorder.

Operating within an Appalachian context, the Madison Mental Health Awareness Training (MHAT) will increase community capacity to identify, support, safely de-escalate, and engage youth and adults exhibiting signs and symptoms of SMI/SED by equipping 500 residents with evidence-based training. Madison MHAT will develop a clear pathway through which individuals can be readily connected to appropriate care. Madison MHAT is firmly rooted in the cultural context in which it operates. Consistent with the distinct culture of Appalachia and its influence on the context of well-being, Madison MHAT will use Mental Health First Aid (MHFA), Youth Mental Health First Aid (YMHFA), and Question, Persuade, and Refer. (QPR). Equipping those who regularly interact with youth and adults, Madison MHAT will train 350 local educators, school nurses, and paraprofessionals; public and community health and social services staff; emergency services personnel; and other professionals. With a cultural emphasis on relationships, Madison MHAT will also train 150 community members, including coaches and 4-H leaders, to whom an individual may turn or engage positively. To advance its goal of supporting community well-being, Madison MHAT will deploy a Leadership Team that collaborates with the Madison Substance Awareness Coalition (MSAC) in quarterly meetings. In partnership with RHA Health Services, the county’s only comprehensive mental health provider, Madison MHAT will develop a process that outlines how trained participants can refer individuals or encourage self-referral to appropriate care. A Mental Health Awareness Training Plan will be used as a project framework with annual updates. With its structure in place, Madison MHAT will convene its first training by Project Month 4 and equip 350 professionals in 12 trainings by Project Month 36. Four local professionals will become certified MHFA/YMHFA instructors by Project Month 36. Local instructors will train 100 community members, 50 of whom will be unduplicated, by Project Month 60. To expand community capacity, MHAT will partner with Vaya Health to provide QPR training to 100 community members. This schedule will yield 500 unduplicated participants, with 100 in Year 1, 150 in both Years 2 and 3, and 50 in both Years 4 and 5. Training will be sustained after the grant ends with 4 local MHFA/YMHFA instructors and Vaya’s ongoing QPR classes. To capture its work, Madison MHAT will use data collected after trainings, self-reports by trained participants, and referral data generated by RHA Health Services. With this data, Madison MHAT will use descriptive analytics to identify (1) the number of people in the mental health and related workforce that are trained; (2) the number of individuals who have received training in prevention or mental health promotion; and (3) the number of individuals referred to mental health and social services.

Mecklenburg County Public Health Department, commonly referred to as Mecklenburg County Public Health (MCPH), is applying for the Department of Health and Human Services Substance Abuse and Mental Health Services Administration FY2022 Resiliency in Communities After Stress and Trauma (ReCAST) (SM-22-019) grant opportunity. MCPH is a NC Health Department Accredited with Honors in 2019 by the NCLHDA Board, is managed by Health Director, Raynard Washington, PhD, MPH, and is comprised of 940 employees serving approximately 1.2 million Mecklenburg County residents, including the City of Charlotte with a population of 874,579 (Source: 2020 Census). MCPH is in its fifth year of the 2018 ReCAST grant and experienced in promoting resilience, trauma-informed approaches, and equity within Mecklenburg County, the second most populous county in North Carolina, which includes Charlotte. In the aftermath of the 2016 fatal shooting of Keith Lamont Scott by a Charlotte Mecklenburg police officer and hundreds protesting in Uptown Charlotte regarding police tactics and brutal, unjust treatment of African Americans, the impact of secondary trauma from direct and indirect exposure of traumatic events may be contributing factors to collective trauma. Then, on September 7, 2021, just over a year ago, several suspects fired nearly 150 rounds into a home, mortally wounding 3-year-old Asiah Figueroa and striking his 4-year-old sister. This incident was related to a string of five drive-by shootings involving Charlotte Mecklenburg high school students firing into occupied homes. The community grieved with candlelight vigils and protested that more must be done to prevent this type of escalating violence across Charlotte. Three ReCAST staff members have made large strides in promoting trauma-informed and resiliency trainings to 3,016 community stakeholders, thus far, and worked with community stakeholders who, in turn, worked with County Commissioners to get violence deemed a public health issue in our County. Thus, the Mecklenburg County Office of Violence Prevention (OVP) launched in 2021 within the Mecklenburg County Public Health Department, the first OVP to reside in a public health department within NC. This is because between 2017-2020, there has been a 70% increase in gun-related assaults. In this grant proposal, OVP and ReCAST aim to reduce violence in Mecklenburg County by collaborating with County, City, and community partners to increase opportunity and build healthier, more resilient communities and provide community engagement opportunities for high-risk youth and their families. OVP and ReCAST worked with over 13 community violence prevention advocates to create the FY2023-FY2028 Community Violence Prevention Strategic Plan. ReCAST staff work in tandem with OVP to provide violence prevention advocates the tools needed to build resiliency in their communities, especially those who have faced events of violence and have collective trauma from a history of exposure to violence. ReCAST is the behavioral health link that many violence prevention organizations lack; thus, ReCAST partners with community-based organizations to assist high-risk youth and their families by engaging youth in violence prevention advocacy efforts and provides faith-based communities navigators for linkage to behavioral health and trauma-informed resources and support networks. ReCAST priorities align with the Community Violence Prevention Strategic Plan by providing more equitable access to trauma-informed community behavioral health resources. Community stakeholders are engaged to implement the Community Violence Prevention Strategic Plan. ReCAST is positioned to better support community healing by promoting and orchestrating community and youth engagement opportunities and disseminating culturally and developmentally appropriate information about behavioral health resources for those impacted most by collective trauma.

The We Heal Together initiative seeks to promote resilience and equity for the area’s high-risk youth and families most impacted by adversity and trauma by addressing the systems and organizations at the mezzo level in East Winston Salem, NC. In tackling the root causes, not just the aftermath of violence, the We Heal Together initiative seeks to promote resilience and equity by strengthening the work already occurring in the community and working collaboratively across systems, agencies, and with community stakeholders to identify new opportunities for support and sustainable change. WinstonSalem, like much of the country, responded to the deaths of George Floyd and Breonna Taylor with protests and marches in the streets demanding just and fair treatment by law enforcement. The anger and unrest were magnified when it was learned that a Black man, John Neville, died while in custody at the Forsyth County Detention Center. The Winston-Salem Journal first told the story of John Neville’s death on its front page on June 27, 2020, 7 months after his death. This information caused the community to focus their protests on local law enforcement and what they see as an unjust system. Activists began a 49-day occupation at a city park only blocks away from the Forsyth County Detention Center where John Neville died. The anger, associated trauma, and grievance remain and were exacerbated by the Covid-19 pandemic and the disproportionate response to the needs of Black and Brown citizens in East Winston. To understand and address the resulting escalation of community violence and continued civic unrest, We Heal Together seeks to employ a community driven resilience framework to mitigate the impact of trauma and violence that continues to afflict the East Winston community. Through geographical design, East Winston lacks equity in employment, education, access to health care and behavioral mental health services and has the highest percentage of minority residents, highest poverty rates, and highest death rates in the city. The neighborhoods’ high-risk youth and families have repeatedly experienced in-school, at-home, and on-the-street violence, resulting in ongoing exposure to traumatic stress and adversity. We Heal Together will co-create a community centered approach to addressing and meeting identified needs through the following goals: 1) increase participation of East Winston residents and stakeholders in community-based research to identify the community’s needs and resources, 2) enhance traumainformed systems of care through training the Trauma Resilient Communities Model to Backbone Agencies serving East Winston, 3) reduce high-risk behaviors and increase protective factors for East Winston youth exposed to adversity and trauma by implementing a comprehensive advocacy and mentoring strategy, 4) increase first responders’ and youth-involved workers knowledge of youth mental health risk factors through trainings to improve their outreach and interactions with East Winston youth, 5) increase capacity of mental health and health practitioners working in East Winston to incorporate trauma-informed care approaches into their youth and family services and 6) evaluate the impact of the initiative. Crossnore’s Center for Trauma Resilient Communities (CTRC), working along with Backbone Agencies and other community partners, will be at the center of this four-year initiative. The successful implementation of We Heal Together will create a community driven process that addresses the social determinants of health and builds and sustains an integrated system of community care that promotes resilience, well-being, and trauma-informed community health in East Winston. By the completion of this project 1,165 East Winston participants will have received We Heal Together services. The collective impact will have a positive ripple effect, benefiting the greater Winston-Salem community.

Freedom House Recovery Center, Inc. in partnership with Franklin and Granville county public schools and Cardinal Innovations Healthcare will provide Youth Mental Health First Aid training to 400 people per year and for a total of 1,900 Franklin and Granville school district teaching staff, counselors, administrators and school resource officers. By training a vast array of district staff serving youth, we will increase the number of public school children with identified behavioral health needs by 10% and connect them to appropriate behavioral health services.

Johnson C. Smith University (JCSU) is working with partnering organizations in their effort to provide the Health Education for Advanced Living II (HEAL II) Project. This effort will provide Mental Health Awareness Training (MHAT) and related referral support services for at least 1,000 mental health workers, school personnel, emergency first responders, law enforcement, veterans, armed services members and their families and others who come in contact with the citizens of Mecklenburg County. The HEAL Project II, building on the success of the original HEAL project, will provide MHAT for a minimum of 200 mental health workers and other individuals annually. Instruction will be offered utilizing the evidence-based Mental Health First Aid Training Program through an 8-hour training course at either project partner location or at the office of the company being trained. The program objectives are: 1) By the end of each project year to train at least 200 targeted mental health workers and other individuals to recognize the signs and symptoms of mental disorders, particularly serious mental illness and serious emotional disturbance. 2) By the end of each project year to establish or maintain linkages with school and community based mental health agencies to refer individuals with the signs or symptoms of mental illness to appropriate services. 3) By the end of each project year to train at least 200 targeted mental health workers and other individuals to employ crisis de-escalation techniques with the individuals they have identified with mental disorders. 4) By the end of each project year to educate and follow up at least 200 MHAT trained mental health workers and other targeted individuals about resources that are available in the community for individuals with a mental disorder. JCSU the lead agency, has been responding to the needs of at-risk populations in the Metropolitan Charlotte area for many years, including leading the original HEAL project. HEAL II staff members will include a part-time project director who will supervise the overall project, and act as the primary contact with the federal funding source. A full-time project coordinator will assist with training and follow up on all referrals made to the project to help facilitate treatment and address issues. The project will also include one mental health licensed individual to provide the MHFA Training. An independent evaluator will be contracted to collect performance data and assess completion of project objectives.

The Kellin Foundation, in partnership with Guilford County Schools, will build and implement a comprehensive training plan called Project RISE (Resiliency in Student Education). Project RISE will provide targeted and evidence-based mental health awareness training that builds the capacity to: (1) identify the signs and symptoms of mental illness, and (2) connect students with resources available in the community that can help that youth and family thrive in school, at home, and in the community. Project RISE will focus on two target populations: (1) school personnel (with a particular focus on school support staff); and (2) parents of middle and high school students. Guilford County Schools has provided essential services to students and their families to meet learning needs, even during the COVID-19 pandemic, including additional support for teachers. However, there is a particular need to focus on school personnel that youth interact with every day who are not teachers, but nonetheless have key relationships in students’ lives such as bus drivers, cafeteria staff, custodians, coaches, tutors, and others. In addition, prior training efforts have not focused on parents. Project RISE will help to fill those gaps by providing targeted, evidence-based, and trauma-informed mental health awareness trainings to these essential groups to create a wraparound approach to mental health awareness. Project RISE will train 1,800 individuals over the five year period and has four primary training objectives, including: (1) increased awareness of the signs and symptoms of mental health disorders, particularly serious mental illness (SMI) and/or serious emotional disturbances (SED); (2) increased understanding of evidence-based de-escalation techniques for students with a mental health disturbance and demonstrated increase in confidence using these techniques when needed; (3) increased awareness of available community resources for students with mental illness; and, (4) increased knowledge of how to make a referral to for needed mental health services. To reach these objectives, careful attention has been given to selecting evidence-based trainings that are culturally and developmentally appropriate for our target populations. These will include Youth Mental Health First Aid, Community Resource Model (CRM), Wellness Recovery Action Plan (WRAP) (targeted for parents to support their children), and Crisis Intervention Training (CIT). In addition, given that the Kellin Foundation is an NCTSN – Category III site, Trauma-Informed Care Training (based on SAMHSA’s model and framework) will also be offered given the strong connection between mental health and trauma. These trainings can be offered in-person or virtually.

OVERVIEW: Metropolitan Community Health Services (MCHS), a 501(c)(3) non-profit Federally Qualified Health Center (FQHC) that is a Certified Community Behavioral Health Clinic, is applying for the Mental Health Awareness Training Grant to increase mental health awareness and train populations in rural eastern North Carolina on how to appropriately and safely respond to individuals with mental disorders, particularly individuals with serious mental illness (SMI) and/or serious emotional disturbance (SED). As part of this project, MCHS will coordinate with appropriate state and local health agencies including the Division of Mental Health, Developmental Disabilities and Substance Abuse at DHHS. OVERVIEW OF MCHS: MCHS provides mental health services as well as primary and preventive medical, dental, pharmacy, behavioral health, and substance abuse services to vulnerable and indigent populations in eastern North Carolina on a sliding fee scale. MCHS serves the rural counties of Beaufort, Hyde, Martin, Tyrrell, and Washington in North Carolina. PROJECT NAME: Mental Health Awareness Training Project in Rural Eastern North Carolina POPULATIONS TO BE SERVED: MCHS will serve populations throughout its five-county service area, with a focus on vulnerable, low-income, and uninsured populations; these counties share significant health care, economic, geographic, and educational challenges. According to the Uniform Data System Mapper Report of MCHS’s service area, 43% of the population are low-income residents, 22% live in poverty, and 11% are uninsured, and the County Health Rankings shows that all counties in the service area have numerous core health indicators that are worse than those of the state of North Carolina. In these counties, the average number of poor mental health days is worse than the state’s average, the percentage of the population reporting frequent mental distress of 14 or more days each month ranged from 13% to 15%, and there are high suicide rates. The need for awareness of and referral to mental health services is exacerbated as all five counties are designated by HRSA as Health Professional Shortage Areas (HPSAs) for mental health. In addition, the COVID-19 pandemic is having a devasting impact on this rural area where the number of positive cases and the case rates per 100,000 have been drastically increasing. STRATEGIES & INTERVENTIONS: MCHS plans to utilize a Project Manager/Trainer and three Trainers to provide Mental Health First Aid (MHFA) training to community members, including school personnel, emergency first responders, law enforcement, veterans, armed services members and their families, and others to recognize the signs and symptoms of mental disorders, particularly SMI and/or SED. As part of the trainings, MCHS will teach individuals to identify persons with a mental disorder and employ crisis de-escalation techniques, and will provide education about community resources for individuals with a mental disorder. MCHS will also establish and strengthen linkages with school- and community-based mental health agencies to refer individuals with the signs or symptoms of mental illness to appropriate services. PROJECT GOALS: To increase mental health awareness; to increase referrals of individuals with the signs or symptoms of mental illness to appropriate services; and to increase the appropriate utilization of crisis de-escalation techniques for persons with mental disorders. OBJECTIVES: 1) To provide MHFA training to 330 individuals annually and 1,650 individuals through the lifetime of the project. 2) Within four months of the project’s implementation, to establish or strengthen linkages with 12 school- and community-based agencies to refer individuals with the signs or symptoms of mental illness to appropriate services. 3) To increase the number of referrals of individuals with the signs or symptoms of mental illness to appropriate services to 125 individuals annually and 625 individuals total.