NM Discretionary Funding Fiscal Year 2018

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, Inc. is a non-profit 501(c)3 tribal organization. Through CBI's Assertive Community Treatment project, partners will expand the reach of existing supportive services to link an additional 40 individuals annually (200 over 5 years) to comprehensive recovery services for SMI, including Case Management, addiction and mental health services, educational services, cultural services, healthy relationship training, mentoring, and peer alliances. Targeting individuals across the Navajo Nation, recruited through the Department of Justice, Sexual Assault Victim Advocates, and Navajo Nation Department of Corrections, programming will fill a desperate need, increasing access to behavioral health. Services will be offered to all individuals with SMI who are experiencing homelessness as categorized under HEARTH or will be experiencing a “doubled-up” scenario living on the couch of a friend or extended family member – a residential status that places individuals at imminent risk for becoming homeless. At least 95% of participants will be of Navajo descent, and at least 95% will be low-income. CBI will bring full and part-time Case Managers, and a Housing Alliance Coordinator to the Reservation, conducting intake and ongoing follow-up meetings to maintain a responsive Service Plan for all participants. Through the CBI ACT initiative, program services will include outreach and awareness activities that impact at least 300 unduplicated individuals annually (1,500 over the length of the project period). Annually, at least 40 unduplicated individuals will be enrolled in program services (200 over the length of the project period). One-on-one services, delivered by mental health professionals with deep experience delivering culturally-appropriate services within Navajo communities, will ensure National CLAS Standards are met, placing priority on respect for the whole individual, and responsiveness to individual health needs and preferences. CBI ACT services will meet individual needs in real-time with 24/7 service availability, preventing crisis through a responsive, multi-stakeholder service team that ultimately reduces hospitalizations and recidivism, strengthens family connections in alignment with Navajo cultural expectations, and supports participants as they pursue healthy social interactions. Evidence-Based Practices will include: CAGE-AID Screening Tool during mental health / addiction intake; and Integrated Dual Disorder Treatment. Partners will include Second Chance Counseling and Dine Introspective, in addition to numerous internal CBI initiatives. In addition to linking 40 vulnerable individuals to evidence-based supportive services annually, measurable project outcomes will include: By Month 12, CBI have delivered Mental Health First Aider trainings to 100% of agency outreach and direct services staff; By Month 12, at least 80% of clients will report increased perception of familial or community connectedness, as demonstrated through pre- and post-surveys; Annually, at least 15% of program participants will achieve sustainable permanent housing.

Albuquerque/Bernalillo County Assisted Outpatient Treatment (AOT) Project

Bernalillo County (NM) Department of Behavioral Health Services (BC) is ideally positioned to develop a system of care to expand the capacity to serve youth at high risk for psychosis, with the aim of improving current function and delaying or preventing onset of psychosis. The core clinical service will be the COllaborative INterdiscipliNary Evaluation and Community-based Treatment (CONNECT) program, located at the University of New Mexico Hospitals (UNMH). The goals of CONNECT are to 1) Increase the capacity to provide outreach and other engagement strategies to youth 12-25 years old at high risk for psychosis and their families, 2) Increase the capacity to screen and assess youth who may be at high risk for psychosis and co-occurring disorders, 3) Increase the capacity to provide evidence-based interventions using a stepped-care model to youth that addresses symptoms and behaviors associated with psychosis, 4) Increase the capacity to collaborate across UNMH program and community agencies and programs to ensure coordinated care, and 5) Demonstrate improved outcomes among enrolled individuals. Specific EBPs include use of a two-step screening process, in which the Prodromal Questionnaire-Brief is followed by the Structured Interview for Prodromal Syndromes. Interventions will be based on the NAVIGATE program, modified for high-risk youth, including psychoeducation, cognitive behavioral therapy and behavioral skills training; supportive education and employment, and evidence-based pharmacotherapy. Additional EBPs to be added as indicated include Whole Health Action Management for health promotion, Trauma Affect Regulation: Guide for Education and Therapy for youth with a trauma history. Peer and Family Support Workers will provide many of the support services. CONNECT will work closely with the UNM First Episode Clinic and other health services to streamline referrals for youth developing psychosis and transitions between child and adult services. Other critical components of the system of care such as community-based crisis intervention, community engagement programs, and housing support will be performed through other BC Behavioral Health Services programs and community partners. Client level outcomes will be regularly assessed using validated outcome measures. Specific outcomes tracked will be improvement in social and occupational/educational functioning, decrease in overall behavioral health symptoms, decrease in duration of untreated psychosis prior to referral to UNM First Episode Clinic. BC and UNMH have committed in-kind matching funds to supplement the services through access to BC funded behavioral health and support services and UNMH administrative and supervision supports. CONNECT is expected to screen 450 youth at high risk for psychosis, conduct 225 assessments, and enroll 130 youth in services over the life of the grant with 20 enrolled in year 1, 30 in year 2, and 40 each in both years 3 and 4.

The Dona Ana County Assisted Outpatient Treatment (DAC AOT) program is a collaborative effort among the county health department, judicial system leaders, treatment providers, the local university, and consumers. Dona Ana County is the ideal size to pilot an AOT program. As a result of 2016 state legislation, for the first time courts in New Mexico can participate in AOT programs. Focusing on people that have been hospitalized two or more times in the most recent two years, or have repeated interaction with the courts as a result of a mental illness, it is anticipated the program will serve 30 to 40 people a year, for a minimum of 150 people after four years. The program will formalize the relationship among the county, court, treatment providers, and the evaluator to create a process for identifying participants, holding hearings, accessing treatment, and monitoring progress. It is anticipated to reduce the number of hospital readmissions and civil inpatient commitments, while enhancing available intensive treatment services and quality of life indicators; ultimately reducing the number of people at the detention center with mental illness and law enforcement responses. The diversity of our county is a unique strength, valued highly by the community but also engenders often-stark cultural differences in the way mental health and criminal behavior are conceptualized and handled. Situated in the southernmost part of New Mexico and sharing 64 miles of border with Mexico, the county had an estimated population of 214,178 in 2014, much of which is dispersed among rural communities. Majority of residents (66%) identify as Hispanic or Latino, one of the highest proportions in the U.S., and 17.1% are foreign-born. Another factor affecting the county is the proximity to several military bases, with a population of nearly 5,000, and a public university with enrollment of nearly 18,000.

ABSTRACT Circle of Life?s Circles of Care Grant Project (COL CoC) will strategically plan and design a comprehensive, integrated, and community driven cross systems collaboration of care to support and promote the mental health and wellness of the 8 Northern Indian Pueblo Youth and Families of New Mexico. Goal #1 of COL CoC is to develop Task Forces of Tribal Members to provide a ?community voice?. The Task Forces will include: Children, Adolescents, Transitional Aged Youth, Parents, and Caregivers along with: Tribal Service Providers, Leadership, and Stakeholders. Group input will be gathered through Tribal traditional and innovative, solution-based processes. Goal #2 is for Task Forces to develop and utilize: a Resource Asset Map, Community Needs Assessment, and Community Readiness Assessment to identify community issues and trends. Goal #3 is to develop a Social Media and/or a Community Education Plan to promote COL CoC?s objectives. Goal #4 is to identify and review existing policies to formulate new policies and/or ordinances to promote mental health and wellness for Tribal Youth and Families. COL CoC is proposing a minimum of 80 Community Members be involved in the Task Forces: Meetings, Summits, Forums, and Roundtables. COL CoC is also proposing a minimum of 24 Stakeholders receive training in mental health related best practices. COL CoC also proposes: a minimum of: 8 MOAs, 4 Strategies, and 4 Policies/Procedures/Processes be developed. COL CoC will promote mental health and wellness for Tribal Youth and Families through a series of Forums about the impact of Historical Trauma to promote finding a ?path? that leads the Tribal Community to healing and wellness. COL CoC Grant Team will also coordinate a series of Summits for Tribal Youth and Families where the Youth Task Force (YTF) and Family Task Force (FTF) will process the information gathered in the Community Resource Asset Map, Community Readiness Assessment, and Community Assessment to develop priorities to promote wellness. COL CoC Grant Team, with YTF and FTF, will gain an understanding of Cultural and evidence based practices to promote wellness. A Tribal Leader Task Force (TLTF) will also form to represent Tribal Leadership, Service Providers, and Stakeholders to support YTF and FTF. Groups will meet regularly to engineer a ?System? reflecting the 3 Task Force?s recommendations to better address the Tribal Youth and Family?s mental health and substance abuse issues in the 8 Northern Indian Pueblos. COL CoC?s approach will include a review of the current policies, programs, and procedures regarding Tribal Youth and Family wellness to strategically plan and coordinate services for efficient utilization of Tribal community resources and Cultural approaches. COL CoC?s collaborative approach will mirror the current collaborative leadership of Eight Northern Indian Pueblo Councils (ENIPC) to lay the foundation of a strategic plan for future program development. COL CoC?s 3 Task Forces will provide input supporting policy development and Cultural Logic Model work, outlining the implementation of a culturally and linguistically appropriate approaches, following CLAS principal standards towards Youth and Family wellness.

Families ASAP

First Nations Community HealthSource’s (FNCH), an urban Indian Title V health center, proposes to conduct the Native Connections Project (NCP), a suicide and substance use prevention and treatment program, to target American Indian/Alaskan Native (AI/AN) students, ages 5-18 years, attending the Native American Community Academy (NACA), in Albuquerque, New Mexico. In addition to students, NCP’s target population will include faculty, staff, parents and community members. With 60 faculty and staff members and a student enrollment of 400 spanning from kindergarten to grade 12, NACA is the only Native American Charter School in Albuquerque. Community participation and planning for NCP has already occurred. NACA has analyzed and assessed their substance use data and the school’s campus based coalition, HOPE, comprised of students, faculty, staff, community partners and parents, has met monthly to assess and plan for community wide initiatives to prevent alcohol-related suicide and its related behavioral health risk factors. FNCH will increase NACA’s capacity to develop and implement a strengths-based approach that incorporates EBPs, is coordinated, culturally appropriate and honors Native traditions and cultures to address substance use related suicides in NACA’s community. NCP will provide trainings using the Second Step curriculum to NACA’s 300 elementary and middle school students, Youth Mental Health First AID training to 20 parents and 25 urban Indian community members, Natural Helpers training to 12 middle school students Question, Persuade and Refer training to 60 NACA faculty and staff and 20 parents/family members in Question, Persuade and Refer and clinical behavioral health treatment and care coordination to youth determined to be at risk for substance use and/or suicide. A process and outcome evaluation will be completed.

Five Sandoval Indian Pueblo, Inc. (FSIP) is one of the oldest Native American non-profit organizations in New Mexico serving their consortium of 5 tribal communities of Cochiti, Jemez, Sandia, Santa Ana, Zia, and within the surrounding tribal and non-tribal communities in Sandoval County. FSIP provides Behavioral and Prevention services in rural communities where populations are small and access to care is limited. FSIP is generally the primary resource to these tribal communities for these services. FSIP’s program will provide prevention and treatment interventions in tribal communities to prevent and reduce suicide and substance use behaviors, reduce the impact of trauma and promote mental health among tribal youth through age 24. The majority of FSIP services are provided by tribal members and in such a manner that the value of tribal sovereignty, traditional culture, and community integrity are respected and preserved. The project will include tribal community members to be involved in all grant activities including planning, program implementation and evaluation. The program includes culturally responsive evidence-based models in both prevention and treatment interventions. Programming will be accomplished through a community-based approach using universal, selective, and indicated prevention and intervention strategies by enhancing service delivery systems. The enhancement of service delivery systems include: developing appropriate standards of care (the standards of care will specifically address suicide, substance use, and trauma in both prevention and treatment interventions); implementing advocacy strategies through promoting wellness among tribal youth and their families; creating post-intervention protocols in response to suicide attempts as well as suicide contagion/cluster suicide; and promoting overall community health. The target goal of FSIP’s Program is to serve 25% of the youth in tribal communities served annually. Additionally, through conducting the community readiness assessment (CRA), strategies including community engagement and outreach will be identified extending outreach efforts and engaging more youth and their families into programming. FSIP is committed to partnering with both tribal and non-tribal entities to maximize wellness.