NM Discretionary Funding Fiscal Year 2017

The Intergenerational Intertribal (I2 ) Positive Solutions for Native Health, aims to decrease suicide and substance misuse among American Indian youth, through age 24, whom have been impacted by trauma. Through the adaptation (year 2) and pilot implementation (year 3) of the evidence-based "Storytelling for Empowerment" intervention, youth in three consortium Tribes of the Albuquerque Area Indian Health Board, Inc., will improve cognitive decision making, achieve positive cultural identity, and strengthen resiliency. By honoring "who they are" youth will be equipped to make informed decisions to prevent substance misuse and promote positive mental health outcomes. This project will be guided by an intergenerational community advisory panel (ICAP), made up of recognized community leaders, advocates and professionals, including both youth and adults, in each participating community. I2 Positive Solutions for Native Health will prioritize both Tier I and Tier II prevention strategies to maximize its reach and impact in the participating communities. It is anticipated that these universal prevention strategies will reach approximately 750 AI youth age 10-24, and family members annually. The primary Tier II strategy (Storytelling for Empowerment Intervention), will focus on providing a culturally-centered intervention to at least 10 at-risk young people in each participating tribal community in project years 4 and 5. In addition to benefiting participating youth, the project will also produce a culturally adapted Storytelling PowerBook that can be utilized beyond the 5-year funding period, and shared with other tribal communities in our region. Project staff will also mobilize SAMHSA's Strategic Prevention Framework (SPF), a five-step planning process, to guide the selection, implementation, and evaluation of effective, culturally appropriate, and sustainable prevention activities throughout all five project years.

This grant will support expansion of Families ASAP current activities, enabling greater family and system level advocacy. We believe in engaging Families and youth in their own service planning and decision-making, in order to ensure service effectiveness. Thus, the goals of this grant are to: (1) strengthen network organizational business management skills and relationships; (2) foster leadership skills among families of children with SED; (3) identify and address technical assistance needs necessary to help families understand the impact of behavioral health service planning issues, and how to work effectively with policy makers and service providers that support the needs of children and adolescents with SED; (4) promote peer-support and social inclusion of families with children and adolescents with SED in the community; (5) assist parents to work with policymakers and providers to improve services; and (6) promote workforce development.

Capacity Builders will train 600 First Aiders in the Central Consolidated School District, including Kirtland, Shiprock, Naschitti, and Newcomb. The targeted community is located in northwest New Mexico on the Navajo Nation. The overall goal of the project is to improve mental health outcomes for CCSD students. Specific objectives include: 1. Increase awareness of mental health issues among youth ages 12-18 via the approved SAMHSA YMHFA training. 2. Conduct outreach and engagement strategies with youth 12-18 and their families to increase awareness of and promote positive mental health. 3. Increase the mental health literacy of school personnel and other adults who interact with youth 12-18 via YMHFA training.
4. Increase the capacity to respond to the behavioral health issues and developmental needs of youth ages 12-18. 5. Increase community-wide awareness of suicide prevention strategies and early warning signs through a culturally-aligned Public Awareness Campaign. The project will build the capacity of the Central Consolidated School District community to detect and respond to behavioral health issues impacting adolescents, and to connect those with behavioral health issues to needed services before crisis level is reached.

Las Cumbres Community Services will expand its breadth and depth of trauma screening, assessment and treatment, and strengthen its comprehensive network of evidence-based, trauma-informed service providers through the Healing Early Adversity through Resilience and Treatment (HEART) program. Las Cumbres will provide direct trauma-focused services to approximately 1,200 individuals over the project's five-year course across six counties in northern New Mexico.

Las Cumbres will provide integrated evidence-based, trauma-informed therapies to families with children ages prenatal to six, with treatment available to older siblings. Las Cumbres will also increase the availability of intensive case management services, as well as trauma screening, referral and care coordination within regional primary care clinics. Las Cumbres will support family resilience through: treatment engagement and retention strategies; the early identification of Adverse Childhood Experiences; improving parent-child relationships, safety and stability; resolving traumatic stress symptoms in children and their caregivers; decreasing parental stress and mental health concerns; and restoring normal developmental trajectories within children. Las Cumbres will improve the children's system of care through leadership efforts to: increase awareness of the impact of trauma and risk exposure; increase multi-disciplinary workforce specialization in trauma-informed infant and early childhood mental health practice; and increase client and community participation in system design, implementation, and advocacy.

The purpose of Mescalero Systems of Care II (MSOC II) is to improve behavioral health outcomes for children and youth (birth-21) with serious emotional disturbances (SED) and their families. MSOC II will support the wide-scale operation, expansion, and integration of the SOC approach by creating a sustainable infrastructure and services required as part of this grant initiative. MSOC II will support the provision of mental health and related recovery support services to children, youth, and families with SED and those with early signs and symptoms of serious mental illness (SMI), including first episode psychosis (FEP).

Among local community data sources, from 2010 to present, the Mescalero Apache Tribe community reported 94 total calls regarding suicide reported to Law Enforcement BIA in Mescalero. Two of those were suicide completions, 56 suicide attempts and 36 suicide threats.

There exists a gap in the tribe's current services to actively and directly address our youth and engage them in depression awareness and suicide prevention. Giving credence to the current environment of services available at MAT, the vision of the MAT Suicide Prevention Program is to keep suicide prevention alive and vigilance sharp using a school-based system as our anchor.

The proposed project will be managed by the Mescalero Apache Tribal Human Services Department, which is important because it directly and consistently interfaces with our target audience at high risk of substance abuse and suicidal behavior.

Year 1 activities will primarily involve Tier 1 (universal prevention strategies), as MAT will integrate the SOS Signs of Suicide Prevention Program (SOS) into the curriculum of the Mescalero Apache School (housing both middle and high school students) and will therefore reach all young people enrolled in the community school system.

Year 2 will utilize Tier 1, Tier 2 and Tier 3, as our work will collaborate, refer and partner with the MAT Behavioral Health Program that provides therapy, counseling, and family group meetings for higher risk young people and their families.

Collectively, Project Staff have deep and long-standing experience supporting MAT programs - they have worked in substance abuse clinical services, cultural programs, and health education.

The Mescalero Apache Tribe is committed to providing the services and resources necessary to make our people healthier and happier. From tribal leadership to the Program staff, we pledge our best work, enthusiasm and dedication to improving the lives of tribal youth.

The MPP plans to address four measurable objectives over the five years of Native Connections program funding: Goal: Increase health and well-being among Mescalero youth and young adults based on the revitalization of their language culture and traditions. Objective 1: Decrease the rate of suicide completions among Mescalero youth from 50.0 per 100,000 people to less than 13.88 per 100,000 people by September 30, 2018. Objective 2: Decrease the rate of suicide attempts among Mescalero youth from 789 per 100,000 people to less than 50.0 per 100,000 people by September 30,2018. Objective 3: Increase the involvement of Mescalero people in the traditional activities by 20% by September 30, 2018. Objective 4: Decrease the percentage of Mescalero youth who start drinking alcohol before the age of 13 years from 38% to less than the New Mexico state rate (30.7%). MPP will hire a Suicide Prevention Coordinator, a Youth Coordinator and part-time Data Analyst to address the objectives. Year 1 will focus entirely on calling together the Mescalero Native Connections Consortium (NCC) that includes representatives from each of CSAP's 12 sectors to begin the process of coordination, protocol development I revision and needs assessment. MPP also will conduct the Community Readiness Assessment (Tri-Ethnic Center, University of Colorado). The Mescalero NCC will meet twice a month during Year 1. The NCC also will develop a needs assessment using a strengths based model I methods. All process and outcome data collected will be confidential and will be useful for program replicability. Tribal Leadership has signed on to support the implementation of the project and will be involved directly through the NCC.

Name: Pueblo of Nambe Suicide Intervention Project; Project Goals Year 1: Hire staff; Develop a process and structure that involves the community in guiding all grant efforts, including planning, carrying out the plan, and evaluation; Conduct a Community Needs Assessment, a Community Readiness Assessment, and create a Community Resource/Asset Map; Develop a plan for Years 2-5 and obtain approval to begin those activities; Develop protocols to ensure that youth who are at high risk for suicide, including those who attempt suicide, receive follow-up services to ease their transition into treatment; Develop protocols for responding to suicides, suicide attempts, and clusters that are designed to promote community healing and reduce the possibility of contagion. These protocols will reflect the traditions and culture of our tribe. How we plan to reach those goals: Project staff will work with the project advisory groups, cultural mentors, and other stakeholders to assure that our activities reflect the traditions and culture of our community while promoting community healing and reducing the possibility of suicides following and connected to an initial suicide. To reinforce our tradition and culture, the protocols will express and connect to the following teachings: 1) Conduct services with respect 2) Be honest and helpful 3) Be acknowledging and affirmative 4) Be sensitive to the needs of others. We anticipate serving approximately 300 youth, families, and other community members and stakeholders annually. Our activities will include, implementing the Gathering of Native Americans (GONA) model with which we are already familiar, using members of our existing Teen Coalition to act as mentors to other youth at risk, and addressing the barriers of silence that make discussing the topics of suicide, substance abuse and mental health difficult to discuss.

The community's vision for suicide prevention, substance abuse prevention, addressing trauma, and mental health promotion is to have services, programs and campaigns readily available for the Navajo by the Navajo. The Navajo Technical University envisions providing learning and career opportunities for its students and community members in suicide prevention, substance abuse prevention, addressing trauma, and mental health promotion through a Substance Abuse certificate program, the development of a Suicide and Crisis Management certificate program, activities (e.g. youth conferences, trainings, guest speakers, etc.), and mental health promotions (e.g. mental health awareness 365). The emphasis of the programs is to increase the workforce for its graduates who will be able to function on Tier 1, Tier 2, and Tier 3, including suicide education and promotion, direct services to individuals at-risk, and working with suicide survivors post-attempt. The university is an active institution within the communities of the main campus - Crownpoint, NM, branch campuses - Chinle, AZ, Teec nos pos, AZ, and has a working relationship with the Office of Departmental Youth.

New Mexico Children Youth and Families Department (CYFD) is implementing NM AWARE in partnership with the University of New Mexico. The purpose of NM AWARE is to support the training of a broad array of stakeholders who interact with transition-aged youth (18-24 years of age) through their programs at the community level, with a special focus on law enforcement, and also including parents, teachers, and other adults, in Mental Health First Aid (MHFA) training. Approximately 4% of NM's transition-aged youth 18-25 report Serious Mental Illness (SMI), 6% report illicit drug dependence, and approximately 7% report needing but not receiving treatment (SAMSHA, 2104). The goals of NM AWARE are to: expand the capacity of law enforcement and juvenile justice staff to detect and respond to behavioral health issues of transition-aged youth in order to connect those with behavioral health issues to needed services; increase access to basic MHFA training to youth-serving adults; increase the mental health literacy among youth-serving adults, policy-makers, and administrators of programs serving youth; increase the number of collaborative partnerships with relevant youth-serving community agencies and programs; and utilize a continuous quality improvement process to monitor progress toward reaching goals on an ongoing basis. NM AWARE anticipates training 15 MHFA instructors annually and over 900 Mental Health First Aiders over the life of the grant.