NM Discretionary Funding Fiscal Year 2020

With SAMHSA funding, First Nations Community HealthSource (FNCH), an Urban Indian Title V organization in New Mexico, will conduct the Behavioral Health Services COVID-19 (BHSPC) to address the behavioral health needs of a minimum of 80 individuals experiencing SMI, SUD, COD, and less serious SMI who are impacted by COVID-19 . The target population will consist of the most vulnerable populations impacted by COVID-19 in the geographic catchment area of Albuquerque, New Mexico. Seventy percent of the target population will experience SMI, SUD or COD, 10% will be health care practitioners with less severe mental disorders, and 20% will be individuals with mental disorders less severe than SMIs. BHSP will provide a continuum of mental health and substance abuse services that will be individualized to meet the clients' needs. Services will be integrated with case management and cultural wellness/Traditional Healing services. Performance data will be collected and monitored to ensure the effectiveness of BHSPC in meetings it goals and objectives.

The Pueblo of Nambe's Suicide and Substance Abuse Prevention Project is a proposed project designed to 1) create a resilient community in Nambe O-Ween-Ge through prevention techniques and 2) reduce the impact of mental health issues, suicide, and substance abuse through comprehensive experiential intervention techniques, clinical efforts and effective crises response. The project will fund application of therapeutic experiential education approaches, facilitation of youth engagement techniques, and development of a robust network of clinical and support resource. Nambe O-Ween-Ge, known as the Pueblo of Nambe, is a small American Indian tribe of less than 1,000 members and is located in northern New Mexico. Surrounded by native and non-native communities in a rural part of the state, Nambe residents, are at high risk for mental health challenges, substance use and abuse, and suicide. New Mexico is one of the states with the highest substance abuse and suicide rates in the nation and the impact to its American Indian communities is disproportionately high, requiring complex and comprehensive mitigation and prevention approaches. In addition, the youth are at great risk of suicide and substance abuse, requiring youth engagement in these approaches. If funded, this project will be managed by Nambe Pueblo's Tewa Roots Society, a collective of behavioral health and wellness program coordinators providing services in areas including domestic violence, substance abuse, suicide prevention, health and wellness, juvenile justice, and child welfare. To meet the immanent needs of the community, if funded, the programs strives to serve the entire community (500-1000 people for the duration of the project), American Indians in our service area, those at high risk of suicide and substance abuse, those with mental health needs, and those who have shown signs of or already attempted suicide or are already abusing substances. To meet these objectives, the programs goals include 1) Identify high-risk areas in Nambe and target programming to meet the needs of those areas. 2) Increase the engagement of tribal members and their families in the support and wellbeing of the tribe and its individuals. 3) Increase services offered by Nambe to combat substance abuse and mental health challenges. 4) Establish a crisis response protocol to effectively respond to various crises, as well as build resilience though supporting the wellbeing of the community during times of crisis. These goals will be met through actions including direct clinical services, outreach and promotion, and crisis intervention; application of a therapeutic experiential education approach; development of crisis response protocols; and development of a robust treatment network outside of what the program can offer.

New Mexico Behavioral Health Services Division Emergency Response to COVID-19 is a statewide initiative to ensure access to evidence based screening, assessment and behavioral health treatment during the COVID-19 pandemic. Strategies include implementation of uniform screening and assessment practices and dissemination of evidence based practices including Cognitive Behavioral Therapy, Community Reinforcement Approach, Dialectical Behavioral Therapy, and Medication Assisted Treatment. The populations of focus for this initiative include individuals with SMI, SED, SUD, and those with co-occurring SMI/SED and SUD. An additional priority population is individuals with mental health disorders less severe than SMI, including health care professionals impacted by COVID-19 and others impacted by COVID-19 throughout NM. NM is the most ethnically diverse state in the continental US, with 49.1% of the population identifying as Hispanic, 37.1% as Non-Hispanic White, 10.9% as American Indian/Alaska Native (AI/AN), 2.6% as African American, 1.8% as Asian, and 0.2% as Native Hawaiian/Pacific Islander. According to the SAMHSA Uniform Reporting Systems Tables, 83.2% of adults served by NM's public behavioral health system meet criteria for an SMI (roughly 72,000 adults) and 72.1% of youth meet criteria for an SED annually. Additionally, 30% of adults and 6% of youth meet the criteria for a COD annually. Project goals are to 1) train and provide ongoing coaching to providers on evidence based practices that can be delivered via telehealth; 2) rapidly implement these practices; 3) enhance our statewide crisis and access line (NMCAL) to screen, assess and serve the health care workforce and others impacted by COVID-19; 4) implement peer recovery supports; and 5) support the network of crisis response currently being developed, including mobile outreach, crisis triage centers, and statewide access to telepsychiatry, with services offered via telehealth and face-to-face. Conservatively, over 500 individuals will be provided direct services (including treatment and recovery support services) and over 1000 will access services via the New Mexico Crisis and Access Line (including people with SMI, SUD and COD, health care providers, and others impacted by COVID-19) through this initiative. Metrics include: number of providers trained; delivery of services within 4 months of award; number of individuals engaged in recovery supports; number of individuals receiving treatment; diagnoses; services received; and outcomes such as changes in criminal justice status, hospitalizations, employment, mental health functioning, social connectedness, and substance use.

Family nurse practitioners are uniquely positioned to increase access to care for individuals and families suffering from substance use disorders, especially in rural regions of the country. This project will increase the number of primary care providers in the U.S.-Mexico border region who have advanced knowledge/training in screening for, and the evaluation and treatment of all forms of substance use disorder (SUD) with emphasis on opioid use disorder (OUD) prevention. Given the extreme shortage of mental health providers, New Mexico has a critical need for primary care providers with advanced preparation in the area of OUD and other SUD. Family nurse practitioners are also well positioned to prevention OUD by implementing evidence-based strategies for managing acute and chronic pain using non-opioid approaches. The family nurse practitioner (FNP) program at New Mexico State University (NMSU) is delivered in a distance education format so that nurses in rural New Mexico and the adjacent border region can earn their degree without relocating. Given the psychiatrist and primary care physician shortage in New Mexico, graduating FNPs with high level competencies in the identification, evaluation, and treatment of all forms of SUD with an additional focus on OUD prevention is a priority for the state and region. Project Goal 1: Increase the number of faculty at NMSU and other regional FNP programs who have the knowledge and expertise to deliver an integrated OUD/SUD curriculum with enhanced content on non-opioid alternatives for acute and chronic pain management. Project Goal 2: Increase the number of FNPs in New Mexico and the surrounding border region who are trained to effectively identify, evaluate and treat all forms of SUD and prevent OUD through acute/chronic pain assessment and management using non-opioid alternatives. Project Goal 3: Increase the number of evidence-based test questions on the topics of OUD and other SUD on the American Nurse Credentialing Center FNP certification exam. The FNP track at NMSU accepts up to 12 students per year in its 3-year DNP program and 6-12 students per year in its yearlong post graduate certificate program. The implementation of this proposed curriculum will result in an increase in the number of NMSU FNP graduates who obtain knowledge, skills and experience to holistically address the underlying causes of addiction and introduce SUD prevention, screening and treatment into their primary care practice. Seven NMSU faculty will complete a minimum of 24 hours of continuing education in SUD (including medication-assisted treatment) and/or non-opioid strategies for pain management. This project will expand the integration of SUD education into the standard FNP curriculum at NMSU and other FNP programs in New Mexico and the adjacent border region in Texas. By mainstreaming this education, NMSU will expand the number of nurse practitioners who are trained to deliver high-quality, evidence-based SUD treatment and reduce the stigma of SUD among primary care providers working in medically underserved communities.

The Ohkay Owingeh Project S.I.R.E will provide and increase access to support in providing crisis intervention services, mental and substance use disorder treatment, and other related recovery supports for adults and children impacted by the COVID-19 pandemic. In collaboration with the Ohkay Owingeh Health and Human Services Division (OOHHSD), Ohkay Owingeh COVID-19 Response Team, Circle of Life Behavioral Health Network, AASTEC, and Ohkay Owingeh Public Safety, we will annually address the needs of 150 Native community adult and youth. Our primary goal is to provide and increase access to effective trauma-informed treatment and service systems in the Ohkay Owingeh community adults and youth. The following objectives will allow Ohkay Owingeh to reach this goal: We will serve: 1) community members whose behavioral health services were disrupted due to the COVID-19 pandemic 2) community members with COVID- 19 trauma who have no family support or any supportive network.

The Pueblo of Pojoaque COVID-19 Emergency Mental Health and Substance Misuse Services Enhancement Project will complete three goals in crisis because of COVID-19: (1) expand direct services, including linkage to MH and SUD treatment, nutrition/food services, medication support; (2) implement a 24-hour Crisis Response Team to help de-escalate first responder contact with people struggling with MH or SUD issues; and (3) provide emergency/transitional housing for victims of domestic violence or others who become unsheltered as a result of COVID-19 related MH or SUD issues.

The Pueblo of Nambé Mental health Initiative is a proposed project designed to 1) create a resilient community in Nambé O-Ween-Gé through prevention techniques and 2) reduce the impact of mental health issues, suicide, and substance abuse through comprehensive experiential intervention techniques and effective crises response. The project will fund application of outdoor behavioral health & experiential therapeutic approaches, clinical development, facilitation of community engagement techniques, and development of a robust network of resources. Nambé O-Ween-Gé, known as the Pueblo of Nambé, is a small American Indian tribe of less than 1,000 members and is located in northern New Mexico. Surrounded by native and non-native communities in a rural part of the state, Nambé residents, and youth specifically are at high risk for mental health challenges, substance use and abuse, and suicide. New Mexico is one of the states with the highest substance abuse and suicide rates in the nation and the impact to its American Indian communities is disproportionately high, requiring complex and comprehensive mitigation and prevention approaches. In addition, the youth are at great risk of suicide and substance abuse, requiring youth engagement in these approaches. If funded, this project will be managed by the Nambé Tewa Roots Society, a collective of clinical, behavioral health, and wellness program coordinators providing services in areas including domestic violence, substance abuse, suicide prevention, health and wellness, and child welfare. To meet the immanent needs of the community, if funded, the program strives to serve the entire community (500-1000 people for the duration of the project), those at high risk of suicide and substance abuse, surrounding Native American communities with lack of resources, and those who have shown signs of or already attempted suicide or are already abusing substances. The program is targeted specifically at youth and their families but extends to the entire community of Nambé. To meet these objectives, the programs goals include 1) Identify high-risk areas in Nambé every two years and target programming to meet the needs of those areas. 2) Increase by 10% each year the engagement of tribal members and their families in the well-being of the tribe and its individuals. 3) Increase services offered by Nambé to combat substance abuse and mental health challenges. 4) Establish a crisis response protocol to effectively respond to various crises, as well as build resilience though supporting the wellbeing of the community during times of crisis. These goals will be met through actions including outreach and promotion; establishment of a Native Youth Council; Development of evidence based clinical services; application of an experiential therapy approach; development of crisis response protocols; and development of a robust treatment network outside of what the program can offer.

Opening Doors Through Services and Supports for Homeless Individuals with SMI or CODs (Opening Doors) will support the development and expansion of local implementation of an infrastructure that integrates behavioral health treatment and recovery support services for individuals with serious mental illnesses (SMI) and co-occurring substance use disorders (hereafter referred to as CODs) who are experiencing homelessness, with a priority population of emerging adults aged 18-24 years old. Opening Doors will implement three evidence based practices: Housing First, Seeking Safety and Integrated Dual Disorder Treatment. The program will screen 2,400 homeless individuals and enroll 600 individuals with SMI and CODs in services (unduplicated, 300 per site) over the life of the grant (FY1=100, FY2=130, FY3=140 FY4=130, and FY5=100). Given that the prevalence of CODs among homeless populations ranges between 20% and 50%, we anticipate 35% (N = 210) of enrollees will have a COD. Our goals are the following to: (1) increase the capacity to provide outreach and other engagement strategies to identify homeless individuals with SMI or CODs, with a focus on youth 18-24 years old; (2) increase the capacity to assist with identifying sustainable permanent housing for homeless individuals with SMI or CODs; (3) increase the capacity to provide evidence based, trauma focused services to homeless individuals with SMI or CODs that address symptoms and behaviors associated with homelessness and housing retention; (4) increase the capacity to screen and refer individuals with SMI or CODs experiencing homeless for primary health indicators; (5) increase the capacity to EBPs to homeless individuals with SMI or CODs to address symptoms and behaviors associated with homelessness & housing retention; (6) increase the capacity to collaborate across agencies to ensure coordinated care and share lessons learned with the larger statewide Housing Leadership Group; and (7) demonstrate improved outcomes among enrolled individuals.

Ohkay Owingeh Tribe’s "Baygi Seegi-i" (Circles of Care) project will plan, implement, improve, and sustain a holistic, evidence and community-based, coordinated system of care to support positive mental health for children, youth, and families. We will focus on reducing the gap between our community’s need for mental health services and the availability of such services for the target population. We will be focusing on providing tele-behavioral health services for 100 youth ages 1-18 in Ohkay Owingeh’s Indian Child Welfare and Social Services program in year 1 and expand and increase by 25 additional youth annually throughout the life of the grant. The program has a strong emphasis on cross-system collaboration, inclusion of family, youth and community resources, and cultural approaches. Through the proposed project Ohkay Owingeh Health and Human Services Division (OOHHSD) and a myriad of community partners will address the unmet mental health needs of our community. We will plan and develop infrastructure through our KeYa He Haa Teh Systems of Care Taskforce to create overall systems change and enhance local capacity building to improve mental health, substance abuse prevention and wellness services, and supports for children, youth, and families. Activity highlights include hiring of skilled staff, training of staff, education of community members, implementation of evidence-based program, Let’s Talk Counseling (LTC), a tele-behavioral health service for youth, and connecting with service providers to allow the Tribe to implement 3rd party billing.

Santo Domingo Pueblo is located between Albuquerque and Santa Fe on the east bank of the Rio Grande. Native Connect will reach approximately 500 high-risk Kewa youth in Grades 6-12 and will also provide direct services to at least 20 families with prevention, mental health, and whole child wellness programming that is currently unavailable and inaccessible. The overall goal of Native Connect is to improve mental health outcomes for Santo Domingo Pueblo youth. The initiative will create a sustainable support network for Pueblo Members through evidence-based trainings, establish a formal referral policy and conduct training to ensure implementation with fidelity, increase access to prevention and mental health services, and strengthen the safety net for Pueblo youth by increasing awareness of mental health crisis warning signs, substance use warning signs, and appropriate next steps. Annually, 500 youth will take part in Peer Helpers and mentoring. Annually, at least 40 youth will receive intensive Case Management services.