OR Discretionary Funding Fiscal Year 2023

Lines for Life’s YouthLine Program plans to build capacity to meet the mental health needs of youth ages 10-24 across Oregon and nationwide. SAMHSA funding will support: - Growing capacity at existing YouthLine sites in Portland and Central Oregon by training additional volunteers and expanding education/outreach in underserved communities across Oregon. - Creating and expanding satellite sites that support youth development/volunteerism to marginalized and distanced youth. This includes initiating a fellowship program and contributes to the workforce development of a new generation of behavioral health workers while also building diversity among youth volunteers supporting youth in crisis. - Providing mini-grant support to schools across Oregon working to implement their School Suicide Prevention, Intervention, and Postvention Plans. - Building systems and infrastructure that can serve 25,000+ teens in crisis with teen-to-teen peer crisis help by the end of 2024. - Disseminating information to students in educational settings and directly to schools and school districts for distribution to community. Future goals include: 1) The continued expansion of the YouthLine National Program by expanding the hours the YouthLine is available with peer support. 2) To reach and support more youth in the mid-west and east coast, raising awareness nationwide through education, outreach, marketing, and building partnerships with national stakeholders that promote mental wellness and the national YouthLine. Within 3-5 years, the YouthLine hopes to engage with 100,000 teens via outreach and through the call center. Youth suicide is a national crisis in the U.S. – it is the second leading cause of death for youth ages 10-24 nationally and in Oregon. The suicide rate for tweens aged 10-14 has nearly tripled from 2007 to 2017. The suicide rate increased 36% from 2000 to 2017. We know the pandemic contributed to feelings of isolation, anxiety, depression, and suicidal ideation for our youth. It also has shed light on the ongoing lack of mental health support for youth in America. As experts, we know the earlier we can intervene with a youth, the more likely we are to get them help, normalize reaching out, and decrease stigma around mental health. This is where YouthLine comes in. Since 1999, Lines for Life’s YouthLine program has been supporting youth experiencing mental health issues across Oregon and nationwide. YouthLine has 128 youth volunteers ranging in age from 15 to 21 who receive extensive training and mentoring throughout their volunteer experience. YouthLine classroom/community education is well-established across the Portland Metro area, Central Oregon, and statewide. In 2022, YouthLine's peer-to-peer crisis line connected with over 24,000 youth – a 140% increase in the last 5 years. This rapid growth indicates the need to elevate the National YouthLine presence to expand capacity and directly address barriers and access to mental health, volunteerism, and workforce development particularly for vulnerable youth in minoritized communities in Oregon. This expansion will directly address the ongoing mental health needs facing youth in America.

Over 3 years, the NPAIHB 988 Tribal Response project will facilitate increased access to behavioral health on-call crisis services through the 988 Suicide & Crisis Lifeline call centers in the NW & increase the connection & support felt by Tribes when engaging with these call centers. The NW Tribes & partnering call centers are deeply committed to completing this scope of work & sustaining partnerships to assist in improving the response to mental health & substance use emergencies for tribal people. The NPAIHB is a tribally designated non-profit organization representing the 43 federally-recognized tribes in WA, OR, & ID. Housed at the NPAIHB, the THRIVE project has worked with the NW Tribes to prevent suicide since 2009 & the TOR team has worked to prevent substance misuse since 2018. In collaboration with NW Tribes, regional partners, & 988 call centers, the NPAIHB will build regional suicide & substance use disorder (SUD) crisis response partnerships to prevent & improve the response of suicide & SUD emergencies among AI/AN ppl. Our approach builds upon our strong tribal network & expertise in culturally-relevant behavioral health strategies as well as on strategies to promote suicide & SUD resources. The project will reach at least 10,000 ppl. annually & 30,000 throughout the life of the grant. Our goals and objectives are to: G1 Improve intertribal & interagency collaboration & communication about the 988 Suicide & Crisis Lifeline, suicide prevention, & treatment to share & maximize limited resources, by collaborating with local, regional, & state partners. 1.1 Coordinate qtly. partner calls with local 988 call centers, Tribes, & State representatives to improve effective 988 response & linkage to tribal resources. 1.2 Create 1 opportunity in each State for Tribal staff and community members to meet call center staff & learn how the call center operates. 1.3 Review current 988 crisis call center training & continuing education curricula/materials to ensure they are culturally appropriate and trauma-informed. 1.4 Work with partners to create 988 response documents which will assist with continued partnership & sustainability after funding concludes. G2 Promote mental health & improve social acceptability of mental health services for AI/AN ppl. 2.1 Develop, update, print, & disseminate suicide prevention social marketing & media campaign materials tailored to AI/AN ppl., reaching at least 10,000 ppl. across Indian Country. 2.2 Across the 43 NW Tribes, staff will promote local crisis call centers with relationships with Tribes in their area to increase the usability of the 988 call line. G3 Through partnerships, increase capacity of local 988 centers to implement a comprehensive & coordinated response to AI/AN ppl. at risk for suicide. 3.1 Fund 2-5 Tribes & 3-5 NW Crisis Call centers to facilitate partnerships & work to improve call center response for tribal members calling in. 3.2 Host qtly. partner calls with local 988 call centers & Tribes to improve linkage to tribal resources & develop necessary documents, policies, and/or procedures for partnerships. 3.3 Assist all sub-awarded 988 crisis centers with creating a plan to identify & track referrals & develop a response for staff to establish follow-up contact protocols for AI/ANs after crisis encounters. 3.4 Develop quality improvement plan focusing on procedures, policies, assessment, referral, & access to local care to ensure a comprehensive & coordinated response to AI/AN ppl. at imminent risk of suicide. G4 Increase tribal capacity & expand their delivery of suicide & SUD prevention/early intervention/crisis intervention strategies in NW tribal settings. 4.1 Provide TA to 15 NW Tribes to improve & expand their delivery of suicide and/or SUD prevention/screening/intervention/recovery strategies in their community. 4.2 Host a SUD & a suicide prevention, intervention and/or crisis training for those working with or at NW Tribe & include 988 call center information.

The state of Oregon will enhance hiring and training of the 988 and Behavioral Health Crisis System workforce, strengthen coordination and cross state partnerships, launch a statewide communication and community engagement campaign, and build a comprehensive 988 evaluation framework so that all 988 contacts, especially audiences at higher risk of behavioral health crises and suicide, receive trauma informed care during and after any crisis. Oregon's 988 and Behavioral Health Crisis System must especially reach people who live in rural areas; veterans and individuals and families who have served in the military; communities of color; Tribal communities; people who identify as LGBTQIA2S; older adults; young adults; people living with depression, anxiety or other mental health conditions; people with substance use disorders; people with disabilities; people employed in the construction industry; and people who identify as male. Through annual investments in 988 call centers and Oregon Health Authority (OHA) staff, improved coordination with Nine Federally Recognized Tribes of Oregon, Mobile Crisis Intervention Services, substance use program, Emergency services, and suicide prevention initiatives; and statewide marketing and community engagement efforts, OHA expects that 988 call, text, and chat volume will significantly rise in 2023 to 2026, potentially reaching 85,000 additional contracts through 988 directly, while also improving satisfaction with the entire Behavioral Health Crisis System through strengthened referral process and follow-up care. Understanding community needs and increasing integration among support services will ensure the experiences of populations most in need of 988 services and supports are embedded in communication and service improvement plans.

Project Name: Mental Health First AID (MHFA) for First Responders, Frontline and Essential Workers in Multnomah County, Oregon. Overview: Cascadia will provide MHFA, over five years, for 2,500 first responders, frontline and essential workers in Multnomah County, Oregon who encounter adults who have mental health and substance use challenges, including those with serious and persistent mental illness (SPMI) and serious emotional disturbances (SED). Population(s) to be served: Cascadia’s Mental Health Awareness Training Project will serve: • Employees, volunteers, and/or constituents of Cascadia community partners that serve as First Responders, Frontline and Essential Workers. • Individuals,18 years of age and older, who have mental health and substance use challenges, including those with SPMI and SED who face significant disparities in health, often resulting from poverty, homelessness, trauma, racism, justice system involvement and stigma. Strategies/interventions: Cascadia will implement MHFA and MHFA “Train the Trainer” instructor courses for employees, volunteers, and constituents of partner agencies engaged in direct community support including: homeless services/affordable housing, public safety and justice, public and secure transportation, culturally specific providers, and the local business community. Project goals and measurable objectives: Cascadia proposes to conduct MHFA for a minimum of 500 partner constituents per year, totaling 2,500 trained in five years; and 16 MHFA instructors trained each year, totaling 80 instructors trained in five years. Cascadia proposes the following goals for this grant: • Goal 1. Increase awareness of risk factors and warning signs of mental health and substance use disorders. o Measurable Objective: 75% of trained partner agency staff will report greater confidence in their ability to recognize the risk factors and signs. • Goal 2. Increase trainee comfort level in responding to individuals experiencing a crisis, or mental health or substance use challenges. o Measurable Objective: Attendees report 25% greater confidence in interacting with individuals in crisis or struggling with mental health or addictions, and o 10% of partner agency staff will apply the strategies over five years. • Goal 3. Inform trainees about resources available and encourage referrals to services. o Measurable Objective: 5% of trainees report a referral to professional resources. • Goal 4. Support partners in implementing a sustainable model for training staff and additional community members and partners. o Measurable Objective: % Partner agencies train staff within their organizations to become MHFA Instructors, and % Partner agencies provide MHFA internally.

The Empowerment, Prevention, and Sustainability Project aims to prevent and reduce suicidal behavior, substance misuse, and the impact of trauma while promoting mental health among American Indian/Alaska Native (AI/AN) youth up to age 24. The project will use Gathering of Native Americans (GONA) services to achieve its objectives, with a focus on prevention, intervention, and trauma-informed and culturally appropriate services. The project will include a 1 FTE Education Behavioral Health Coordinator, an Education Outreach Advocate, and an Experiential Education Specialist to implement outreach programs within the CTCLUSI 5-county service area. Additionally, the project will incorporate Project Venture and ACEs services. Project Venture promotes positive youth development and leadership skills, building resilience and cultural identity to reduce substance misuse and suicidal behavior while improving mental health outcomes. ACEs services provide trauma education, support, and resources to improve well-being and promote community resilience. Together, these services can address the root cause of mental health issues, particularly historical and intergenerational trauma, promoting healing and resilience among American Indian/Alaskan Native youth.

The Culturally Responsive Latinx Mental Health Training Program is a grassroots, place-based effort to address barriers to care through providing Spanish-language MHFA, YMHFA, and QPR trainings with a focus on improved cultural responsiveness, neighborhood engagement, and resource referrals. The program will train at least 225 community members and service providers in the first year and over 1600 participants in five years. To build additional training capacity and in response to needs identified by Oregon’s existing Latinx mental health trainers, the program will also include monthly, web-based Spanish-language learning collaboratives for MHFA and QPR trainers across the state. Health and economic disparities have been exacerbated by Covid-19, leaving Oregon’s already underserved Latinx communities in need of more focused, accessible support. 13% of Oregon’s total residents, and 25% of Oregon’s youth, identify as Latino/a/x. In Oregon’s urban hub, Multnomah County, Latinx families are 154% more likely to live in poverty than Whites and roughly one-third are without health insurance. For these communities, delivering trainings at natural contact points such as faith-based organizations, community centers, and schools is critical, and it empowers community members to care for one another through culturally responsive training to promote increased awareness of mental health distress and improved understanding of available resources. This program will be supported by a full-time Bilingual Community Training Specialist (BCTS). Lines for Life’s statewide network of QPR trainers and our long-standing relationship with Oregon’s MHFA Statewide program positions us well to dynamically assess and respond to needs across the state. QPR has proven to be a strong introductory training while MHFA provides a broader training with added time for discussion. Offering both trainings will allow individual participants and organizations to engage in programming that best fits their needs. This flexibility will allow Lines for Life to provide timely, focused response to the needs of the Latinx community. The BCTS will also support Spanish-speaking trainers already participating in our statewide network with outreach, culturally responsive resource lists, and learning collaboratives to provide sustainable and extensive training reach across Oregon. The BCTS will also promote QPR and MHFA Train-the-Trainer opportunities to grow the network of Spanish-language trainers.

Project Summary: Multnomah County Health Department (MCHD), Behavioral Health Prevention Program’s (BHPP’s) proposed Mental Health Awareness Training (MHAT) project will provide mental health awareness training to individuals who live and work in community settings serving people at high risk for mental health issues based on multiple factors. Project Name: Multnomah County Mental Health Awareness Training Populations to be served: Populations of focus will be those research shows have heightened and unique risk for mental health issues, with an overall racial equity lens recognizing that systemic racism is a significant threat to mental health for Black, Indigenous, and other People of Color (BIPOC). Namely, populations of focus include youth, especially LGBTQ youth and BIPOC youth; BIPOC adults; adults in the construction industry; military veterans; and older adults. Individuals to receive training will include people who live and work in community settings serving the populations of focus. Strategies/interventions: The project will use Mental Health First Aid, including the general adult version, military veteran version, and older adult version, as well as Youth Mental Health First Aid. These trainings are evidence-based public education programs. Project goals and measurable objectives: Goals are to 1) Increase community capacity to identify, understand, and respond to signs of mental illness and substance use disorders among youth and other vulnerable populations; 2) Reduce suicide and related risk disparities among at-risk populations, including BIPOC youth, LGBTQ+ youth, BIPOC adults, veterans, older adults, and others at risk; 3) Reduce stigma around mental illness to increase referral and access to appropriate treatment for people who may be at risk of suicide or self-harm. Objectives are to 1) Build internal capacity to support community-based MHFA/YMHFA trainings; 2) Increase the number of community members, through community-based organizations, schools, and other community settings serving populations of focus, that are trained to recognize the signs and symptoms of mental health disorders; 3) Ensure all MHAT trainers have in-depth working knowledge of the local mental health system, access points/process, and understanding of community perceptions of mental health services in general (myths, stigma, and the local mental health system) and develop a training module to supplement MHFA training. Number of people served annually throughout lifetime of project: The project will train 360 individuals a year for the first two years and 702 individuals a year for Years 3-5, totaling 2,826 over the entire project period.