SD Discretionary Funding Fiscal Year 2016

The Great Plains Tribal Chairmen's Health Board (GPTCHB) - Native Connections Program will provide prevention services to the Crow Creek Sioux Tribe and Crow Creek School District located in South Dakota over a five year period. The Native Connections Program aims to provide culturally-relevant prevention services to youth ages 10 -18 that are enrolled in the Crow Creek School District.

In order to provide prevention services the Native Connections Program will collaborate with three identified prevention programs, Lifeways, Oceti Wakan and the Network of Support to implement community support system, which will help educate the targeted community to ensure the success of American Indian's (AI). By creating stronger community linkages, the Native Connections Program will provide much-needed prevention services that will be utilizes by the Crow Creek Sioux Tribe and the Crow Creek School District.

The Native Connections Program seeks to implement prevention services by increasing access to resources and to ensure high-quality education and training services to promote a healthy and positive lifestyle for at risk youth. The Native Connections Program will also implement measures of internal accountability to ensure that it meets or exceeds professional standards for program objectives, fulfills SAMHSA requirements for mandatory reporting of performance data, and develops and implements the GPTCHB data-driven quality improvement plan.

The goals, objectives and prevention strategies outlined in this grant proposal will allow for strong collaborations between the GPTCHB, Crow Creek Sioux Tribe, Crow Creek School District, Community Steering Committee and Contracted Providers. The strengthened collaborations will provide increased resources and services to AI's within the targeted community and allow AI's to have a productive and successful future.

This project is titled Suicide Prevention. The project goals of this program is to prevent and reduce suicidal behavior and substance abuse, reduce the impact of trauma, and promote mental health among American Indian young people, up to and including age 24 years. Our target population will be those youth 24 years old and younger who are Native American and living on, or near, the Sioux reservation. This population will be at-risk of suicide attempts or substance abuse, or they may already have these issues. The number of people to be served annually will be 100 individuals, and 500 over the lifetime of this project. Project goals for year one are to develop the program with policies and procedures, as well as protocols. A diverse task force of community partners will lead the direction and development of this program. The ultimate goal is to reduce the suicide rates and substance abuse among our tribal youth. The project will use a collaboration of different evidenced based program, a prevention program, a treatment modality and an education program for our Suicide prevention, substance abuse prevention, addressing trauma, and mental health promotion. By using collaboration of programs, our community will benefit in numerous ways and we will be able to accommodate different learning types and several levels of wellness. It is our community's vision to provide our youth with the skills to become stable adults in all areas of their lives.

The Lower Brule Sioux Tribe will use the resources provided by the Circle of Care VI grant initiative, the proposed Hocoka Ahopa (Taking Good Care of the Sacred Circle) program, design and plan a mental health service delivery model that will combine traditional Lakota cultural healing ceremonies and practices with modern therapeutic mental and social practices. A wraparound approach will be utilized which will help intertwine cultural knowledge and western mental health modalities. This approach will enable families to better help themselves and heal in a more culturally appropriate manner.

Wakikcanpta

The Tiwahe Glu Kini Pi (TGKP) System of Care on the Rosebud Reservation in South Dakota serves the Sicangu Lakota Oyate, known as the Rosebud Sioux. TGKP will expand services to "Bring the Family Back to Life" (Tiwahe Glu Kini Pi) by providing a Lakota-centric System of Care with service-delivery to the 700 children enrolled in the Todd County Elementary School in Mission, SD., particularly those affected by substance use/abuse, create a school-based community mental health center at the Elementary School, and serve 50 children/year with SED. Within the TGKP Expansion, there are three goals and 14 objectives. Goals and objectives include: GOAL 1: Collaborate with local tribal, regional, and state policy makers to affect infrastructure change so that the TGKP System of Care can be sustained and serve as a model for tribally-based Community Mental Health Centers. GOAL 2: The Sicangu Oyate believe that all of our children are sacred and deserve supportive and culturally relevant opportunities to benefit and thrive. As the school systems are primary institutions, expand TGKP services by developing and implementing a School-Based Mental Health Center at the Todd County Elementary School. GOAL 3: Build community support and aftercare for children by restoring the relationship to the Sunkawakan Oyate (Horse Nation) with Lakota people.

The Tiwahe Glu Kini Pi (TGKP)System of Care on the Rosebud Reservation in South Dakota, serves the Sicangu Lakota Oyate, known as the Rosebud Sioux. TGKP will add a Native Connections Project that will work with the TGKP partner organizations to address suicide and substance use/abuse prevention.

The vision that drives efforts on the Rosebud are collaborative in nature and include a commitment to stronger, healthier and happier families, and to a strong and vibrant tribal nation. TGKP's Goal for a Native Connections program is twofold: 1) to design a cohesive and collaborative approach to mental health, 2) to institutionalize the approach so that all tribal and other agencies acting on the Rosebud on behalf of the Sicangu Oyate work to reduce substance use/abuse among all residents so that an improved environment leads to a reduction in mental and physical illness, especially a reduction in suicide completions, attempts, and ideation among youth and young adults ages 5-24. TGKP will work with the assigned SAMHSA Government Project Officer (GPO) and the Tribal Training and Technical Assistance Center staff to complete the required Community Needs Assessment, a Community Readiness Assessment, and create a Community Resource/Asset Map.

Using the information from the Assessments, TGKP expects to propose Native Connections activities in all three Prevention Tiers beyond Year 1: Tier 1 Universal Prevention
Strategies, Tier 2 Selective Prevention Strategies, and Tier 3 Indicated Prevention
Strategies

As a member of the Great Plains association, the Sisseton Wahpeton Oyate plan to use the grant funding requested with this application to access all available resources to develop a Community Mental Health Center (CMHC) in accordance with the Administrative Rules of South Dakota for CMHC (Article 46:20). Dakotah Pride is the only behavioral health program within the tribal government. As a AOD treatment center, its addiction counselors specialize in addiction treatment. For those clients needed individual mental health counseling, DPC schedules and transports these clients to the Indian Health Service clinic mental health program, which is staffed with two social workers who primarily do case management. Youth outpatient clients are also referred to the Indian Health Service for assessment and counseling. Neither service is sufficient to meet the needs of our tribal population age 24 and under as neither DPC or IHS have trained mental health (psycho) therapists on staff and/or who specialize in treating young children and youth. However, as we have a large target population with tribal students in several public school systems as well as two tribal schools, in 11 separate tribal communities/districts/housing developments, we know that to be effective and to develop and maintain tribal community support our plan will require all three tiers of suicide prevention services; with a focus on serving those of greatest need in relation to greatest risk indicators as our first priority.

The populations of focus include youth who have made a suicide attempt or expressed suicidal ideation at an emergency department or inpatient psychiatric unit, youth attending institutions of higher learning, immigrant youth, LGBTQ youth, youth at K-12 school districts, American Indian youth in the juvenile justice system and military family members and veterans. The project strategies include: 1) Partnering with hospitals to provide extended follow-up support services to youths admitted to emergency departments and inpatient psychiatric units for suicide attempts or suicidal ideation. 2) Partnering with three institutions of higher learning to introduce a crisis texting program for students and training staff in identifying, supporting and connecting students at risk. 3) Providing training to clinical service providers on assessing, managing and treating at risk youth. 4) Providing training to youth serving organizations to identify and refer youth at risk. The objectives of the project include: 1) Improving the continuity of care and follow-up with youth identified at risk for suicide discharged from emergency departments and inpatient units. 2) Increasing the number of staff at juvenile justice programs, colleges, universities, high schools and middle schools that are trained to identify and refer youth at risk for suicide. 3) Increasing the number of clinical service providers (behavioral health providers and health professionals) trained to assess, manage and treat youth at risk for suicide. 4) Increasing the number of behavioral health referrals and the utilization of behavioral health services for youth at risk by improving the system across the state. 5) Increasing the access points for youth at risk to receive assistance through a public awareness campaign, promoting the NSPL crisis line and promoting a crisis texting service.

The South Dakota "Now is the Time" Project Aware Training Initiative will focus on increasing the mental health literacy of adults who interact with 12 to 18 year old adolescents. The plan is to train 12 Behavioral Health professionals who are currently Mental Health First Aid (MHFA) Instructors, to also become Youth Mental Health First Aid (YMHFA) instructors. South Dakota ranked 16th in the nation among the states for the rate of suicides in 2013 and has consistently had a higher rate of suicide than that in the United States over the past decade. Suicide is the second leading cause of death in South Dakota for those under age 35 (South Dakota Department of Health, 2013). Youth ages 10-24 had a national suicide rate of 8.1 per 100,000 in 2013, while South Dakota's youth of the same age had a rate of 21.9 per 100,000 (Centers for Disease Control and Prevention). The suicide rate for South Dakota youth ages 15 to 19 for the period of 2010 to 2013 was 24.3 per 100,000 which is three times higher than the national rate of 8.1 per 100,000 for the same time period. The project objectives include: increase the mental health literacy of youth-serving adults; increase the capability of youth-serving adults to respond to the behavioral health needs of youth in their community; foster and support referral of youth with behavioral health needs by linking youth to behavioral health support services; increase the number of collaborative partnerships with youth-serving agencies. During the first year of the grant, there will be 12 individuals who had previously been trained in Mental Health First Aid trained in Youth Mental Health First Aid. They will train 900 First Aiders during year 1 and 2,946 First Aiders in the 3 years of the project.

Youth & Family Services (YFS) Youth Trauma Center will provide and increase access to effective trauma-focused treatment and services for children, adolescents, and their families who experience or witness traumatic events. Populations of focus are military, American Indian, and rural families. The project expects to serve about 300 clients per year or 1,500 over a five-year period in Rapid City and the surrounding seven counties in western South Dakota.

Interventions include Trauma-Focused Cognitive Behavioral Therapy, Child-Parent Psychotherapy, Child-Family Traumatic Stress Intervention, Integrative Treatment of Complex Trauma, Cognitive Behavioral Intervention for Trauma in Schools, and Alternatives for Families: A Cognitive-Behavioral Therapy. The goal of the project is that children, adolescents, and their families who have experienced or witnessed traumatic events will have access to effective trauma-focused treatment and services in the community in order to achieve trauma resolution. Measurable objectives are: 1: Screen and identify children, adolescents, and family members who experience or witness traumatic events; 2. Provide trauma-focused training and resources for YFS Counseling Center/Youth Trauma Center staff and partner mental health service providers; 3. Provide trauma-informed training and resources for youth-serving organizations and service systems, including health, social, and education services; 4. Annually, provide trauma-focused assessment or treatment for at least 300 children, adolescents, and their families who experience or witness traumatic events (trauma-focused services will be provided within selected schools that have high student numbers from the populations of focus); and 5. Reduce disparities in access to effective trauma-focused treatment and services for children, adolescents, and their families who have experienced or witnessed traumatic events.