Tennessees Homeless Family Services in Supportive Housing Program
The System of Care Across Tennessee (SOCAT) Initiative will institute policy and environmental change strategies, create statewide local interagency planning teams, and execute blended funding mechanisms to ensure the broad implementation and sustainability of a children's mental health system grounded in system of care values and principles. One of the primary goals of the SOCAT Initiative is to create and/or strengthen a local interagency planning team (i.e. SOCAT Team) in each of Tennessee's 95 counties, ultimately ensuring a statewide infrastructure for system of care. Minimally consisting of local community representatives from juvenile justice, child welfare, public health, education, vocational rehabilitation, community mental health centers, families, and youth, the SOCAT Teams will oversee a strengths-based, wraparound service planning process and provide an individualized SOCAT Care Plan developed in true partnership with participating families. Under the guidance and leadership of the SOCAT Technical Assistance Center, the initiative will provide ongoing and localized planning, implementation, and technical assistance support for the aforementioned local cross- agency bodies. Additionally, the SOCAT Initiative will finalize and implement a financing plan commissioned by the Tennessee Council on Children's Mental Health, promote and initiate policy and environmental change strategies that increase access to high quality care, launch a comprehensive SOCAT social marketing and communications campaign, and oversee the development and implementation of evidence-based and evidence-informed services and supports for children and youth with SED and their families.
Program Description: Sewanee Flourish The purpose of this project is to develop a sustainable campus infrastructure at The University of the South, rooted in the two continua model of mental health and illness (Keyes, 2007), designed to promote suicide prevention and enhance student mental health and flourishing. While flourishing is most commonly associated with individual health, a public health approach based on this model will seek to enhance not just individual flourishing, but collective flourishing by involving the community as a whole in the work of suicide prevention. Sense of belonging and social connection are important predictors of both well-being and flourishing (Keyes, 2007) and decrease risk for suicide and mental illness (Keyes et al., 2012). Sewanee Flourish seeks to improve student mental health and cultivate student flourishing by accomplishing the goals outlined below, and plans to pay special attention to at-risk student groups (LGBTQIA students, students from underrepresented racial/ethnic groups, students with disabilities, and male-identified students). Project Goals The goals of Sewanee Flourish are (1) to conduct a qualitative needs assessment of at-risk students (2) to develop a Wellness Task Force to activate the campus community in the work of suicide prevention (3) to increase the number of faculty, staff, and students trained as gatekeepers (4) to develop educational workshops and interventions to enhance student flourishing and resilience (5) to develop a social marketing campaign to increase awareness of crisis resources and (6) to develop accessible resources for families to promote mental health and flourishing and to increase awareness about the development of mental illness and suicide risk during college. Project Outcomes The anticipated overarching outcomes of Sewanee Flourish are the development of a sustainable campus infrastructure designed to identify and respond to students in distress, to reduce barriers to help-seeking among students, and to promote and improve student mental health and flourishing. All project goals will be systematically assessed to evaluate the impact of Sewanee Flourish on suicide prevention. Sewanee Flourish aims to train
The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) proposes Tennessee TARGET Zero Suicide 2 (TARGET2) to reduce suicide attempts/deaths among adults ages 25 and older by expanding and enhancing suicide prevention strategies, including rapid and enhanced follow-up for 2,750 unduplicated target region adults (Yr 1: 750; Yrs 2-3: 1,000/yr) and prevention training for 300 statewide providers and stakeholders. The statewide focus population ages 25 and older is primarily white (78%), with 15% African American and 2% Hispanic/Latino. Over 13% live below poverty, 14% lack health insurance, 15% lack a high school diploma, and over 7% are unemployed. Focus population clinical characteristics (e.g., SMI, SUD, COD) are risk factors for suicide attempt/death. The focus population?s suicide rate (20.9) exceeds the U.S. rate (18), and has consistently exceeded the national rate for 15+ years. Baseline data for Tennessee reveals that 937 adults ages 25 and older died by suicide, and 6,275 were discharged (inpatient, outpatient) after non-fatal suicide attempts in 2015. The adult (25+) suicide rate among Tennessee?s minority groups other than African Americans is 11.6 versus an 8.8 national rate, and Veterans comprise 17% of state suicides. TDMHSAS will implement the following strategies/interventions throughout TARGET2 in collaboration with project partners: Centerstone of Tennessee will provide rapid enrollment and follow-up prior to/within 24 hours of discharge and weekly for one month. Follow-up will include risk assessment, crisis management plan development, means reduction counseling, and referrals/linkages to treatment services utilizing best practices Applied Suicide Intervention Skills Training, Counseling on Access to Lethal Means, and evidence-based Columbia Suicide Severity Rating Scale. TARGET2 participants will be assessed and treated according to Centerstone?s Clinical Pathway for Suicide Prevention, and Centerstone will pilot and evaluate a suicide-specific clinical treatment for those on the Pathway. The Tennessee Suicide Prevention Network will provide suicide prevention trainings for clinical providers and adult-serving systems, and will assist in establishing/implementing a Gatekeeper Surveillance Network and Call Line for training participants. TARGET2 will expand the Zero Suicide framework statewide, and an existing Advisory Council, comprising suicide attempt/loss survivors, will support TARGET2?s goals, including: (1) enhance/expand rapid follow up for adults post discharge, (2) increase follow up and care transition/coordination for high risk adults, (3) train community and clinical service providers and systems, (4) collaborate with relevant sectors and with state departments/ systems to implement comprehensive suicide prevention, and (5) implement Goals 8 and 9 of the 2012 National Suicide Prevention Strategy. Measurable objectives include reductions in suicide attempts by 35%, suicide deaths by 20%, and service/utilization costs related to suicide by 30%. TARGET2 includes a comprehensive evaluation to develop and disseminate a thoroughly documented service model for replication and adoption.
Centerstone Integrated Treatment, Care, and Prevention (ITCP) will serve 500 unduplicated adults (18+) with serious mental illness (SMI) or co-occurring SMI and substance use disorder (COD) living with or at risk for HIV and/or hepatitis, including racial/ethnic minority communities in Montgomery County, Tennessee (Yr 1: 75; Yrs 2- 3: 150 each; Yr 4: 125). ITCP will provide integrated HIV/hepatitis prevention, SMI/COD treatment, HIV primary care linkages, and other supports at Centerstone's integrated/co-located primary/behavioral health care clinic. Among the 4,761 individuals comprising ITCP?s focus population with SMI, 25% (1,169) have a COD, including the 4% (207) diagnosed with an opioid use disorder. Individuals with SMI have a mortality rate up to 300% higher than the general population and experience disproportionate rates of substance use disorder. The focus population comprises 59% male, 41% female, 73% White, 20% African American and 4% Hispanic/Latino individuals, with 26% experiencing poverty and 6% unemployment. The estimated 6% (286) of focus population individuals with HIV risk worse outcomes due to non-adherence to HIV medication (est. 150 at risk), neuropsychological impairment (est. 143 at risk), etc. Among patients receiving SMI services at Harriet Cohn, approximately 17% (828) have hepatitis C. ITCP subpopulations include the 2.4% among the focus population who are Veterans and the expected 24% involved in the criminal justice system. Among these subpopulations, an estimated 4% of Veterans and up to 41% of individuals involved in the criminal justice system are expected to have hepatitis C. ITCP will implement direct mental and substance use disorder treatment via evidence-based, trauma-informed, and recovery-oriented Integrated Treatment for Co-occurring Disorders (ITCD); peer-led, evidence-informed Whole Health Action Management (WHAM); and evidence-based/informed HIV prevention/care continuity programing via Community-Friendly Healthy Recovery Program (CHRP) and Project Connect. Key ITCP program components include local provider and community collaborations; outreach/engagement; assembly of Advisory Council; screenings/assessments to screen for COD, assess for HIV/viral hepatitis risk, and other health conditions; development of Individual Treatment Plan; provision of HIV/hepatitis testing/prevention services and linkages; provision of SMI/COD treatment and supports, linkages to HIV primary care and other medical care, case management/care coordination, peer supports, and other supportive services (e.g., stable housing, employment assistance, benefits enrollment), sustainability planning; and dissemination of comprehensive evaluation. ITCP goals include: Integrate SMI/COD treatment with HIV primary care and prevention services; Develop infrastructure and capacity to integrate/sustain a comprehensive service continuum; Improve clients? health status and outcomes; and Develop/disseminate a replicable service model. ITCP will achieve the following measurable objectives: Conduct outreach to 750 individuals to increase participation in/access to services; provide training/workforce development for 250 staff/community providers; Achieve 90% rate of clients knowing their HIV/hepatitis status; Decrease mental health symptomatology by 45%; Increase substance use abstinence by 60%; Assist 100% in need to identify/secure stable housing and employment; Reduce involvement with the criminal justice system by 25%; Decrease risky behavior among 60%; Increase social connectedness by 70%; Increase service access by 90%; and Achieve 80% participant retention. ITCP has secured commitments from partners dedicated to the project?s success and will collaborate with local primary care providers, courts, social service agencies, and other stakeholders.
Treatment for Persons Experiencing Homelessness: Park Center will serve persons (ages 18 and over) experiencing chronic homelessness who have mental illness and co-occurring disorders (CODs) of mental illness and substance use in the metropolitan Nashville, Tennessee (Davidson County) area as its priority population. Utilizing outreach and engagement strategies, Park Center will serve 150 people per year to reduce barriers and increase access to basic medical and psychiatric care through a unique partnership with Vanderbilt University Medical Center; outpatient treatment and recovery services; affordable housing; disability benefits; and employment services. According to the Strategic Plan to End Chronic Homelessness in Nashville, the significant gaps in services for persons experiencing chronic homelessness in the Nashville area include: lack of affordable housing; lack of health insurance; lack of access to health and behavioral healthcare; a lengthy disability determination process; and a fragmented system of care. Park Center is a licensed, CARF accredited (Commission on the Accreditation of Rehabilitation Facilities) nonprofit organization with a proven track record of providing wraparound services for persons experiencing chronic homelessness who have mental illness and co-occurring disorders (CODs) of mental illness and substance use. Through this project, Park Center will provide outreach, psychiatric and basic medical care to 50 persons per year on the streets through the Street Psychiatry partnership with Vanderbilt University Medical Center; refer 20 persons to Park Center's Intensive Outpatient (IOP) or Outpatient (OP) treatment programs per year; move 40 persons experiencing chronic homelessness into permanent housing per year; utilizing a peer specialist, ensure that 32 out of 40 (80%) retain housing; Park Center's SOAR Coordinators will apply 40 people for disability benefits (social security income, SSI/social security disability income, SSDI) per year; ensure that 38 out of 40 (95%) of people who applied for SOAR benefits will receive an approval; and refer 20 people per year to Park Center's Supported Employment program.
Tennessee Voices for Children Statewide Rural Family Network will respond to children, youth, and young adults with SED and their families in NE TN Appalachian area and develop a model for replication in other rural areas by increasing the capacity to implement, expand, and improve effective family-driven mental health services with respect to their culture, traditions, and beliefs. Populations include children and youth and their families, birth through 26 with severe emotional disturbance within the North Eastern Tennessee (NE TN) Appalachian Mountain area with an emerging model that will be applied to rural areas statewide. Goals/Objectives: Develop a network of family and organizational leaders with management capacity that reflects the culture, traditions, and beliefs of NE TN and can be replicated in other rural areas: By Sept 2019 there will be a 100% increase in family leaders; by May 2020 TVC will have training materials reviewed and vetted by family leaders and representatives; by Oct 2020 NE TN will have 3 state trained/certified Family Support Specialists in each county; by the end of Oct 2020 there will be a database of 12 family storytellers. Increase family and organization partnerships and collaboration that will result in responsive support to the needs of children and youth with SED and ensure their participation and input into state and local mental health services planning and policy development: By the end of Year 1, 5 state and 10 local planning and policy development groups will have NE TN family leader involvement; by the end of Sept 2019 at least 25 families and youth will be trained on how to advocate and partner for systems change; by the end of the 2020 school year 75% of the child serving programs and agencies will be trained on how to partner, collaborate, and utilize families of children and youth with SED; by the end of Oct 2019, the project will host an annual Regional Mental Health Conference to a minimum of 100 families and professionals; by Sept 2021, all material developed will be shared with100% of the programs serving children, youth, and families living in rural areas for replication. Reduce stigma, bias, and superstition of mental illness and associated services that interfere with the utilization of networks of services and supports to families and their children: By Jan 2020 100% of the child serving programs surveyed to identify extent of bullying; by March 2020 a Town Hall Meeting will be held in each County to gather information on the incidence and impact of bullying; by Sept 2020 15 parents will be trained to assist and support other families who encounter bullying or stigma. Increase family capacity to access mental health services and utilize supports in their community while informed decisions on behalf of their children and youth within rural areas of TN: 100% of the counties will have a local contact for information and referral no later than Oct 2020; by Oct 2020 each county will have a 1 face to face and 1 web-based class on system navigation and local resources; five resources will guide families as they navigate the system, advocate for their needs, and understand the regional system. 2000 to be served annually and 6000 throughout the lifetime of the project.
Professional Care Services (PCS) is an outpatient mental health clinic, founded in 1971, that provides specialty behavioral health services to both adults and children with serious persistent mental illness or serious emotional disturbance. PCS plans to utilize funding for a Mental Health Awareness Training (MHAT) Project in order to train community stakeholders in the identified geographic catchment areas. The identified counties are Tipton, Lauderdale, and Fayette counties and were chosen because they are rural counties with notable service gaps for those with SPMI or SED and each county has a relatively large percentage of residents in poverty. Those with SPMI or SED are the identified population of focus. Stakeholders to be trained include employees at hospitals, government agencies, and other community agencies. The trainings are intended to increase capacity of community partners in each county to more accurately identify and refer to crisis and mental health services when mental health needs are identified. The trainings will also provide skills and strategies when responding to the population of focus and will include de-escalation techniques that are safe to administer. During PCS? tenure in the identified counties, there have been several requests from community partners for trainings on how to best intervene with those with mental illness. Per self-report, these agencies feel ill-equipped to intervene and have significant confusion about what outpatient mental health services are. PCS hopes to train 1235 individuals in year one. Years two and three combined will total another 630 community personnel trained for a total of 1,865 people trained over the course of the entire project. This grant proposal includes three key personnel and one support staff identified for this project. The key staff and their roles as follows: Sara Hawkins, Project Director; Katie Coleman, Program Coordinator; and Samantha Hammonds, PCS Clinical Director. The following proposal details PCS? plan to carry out the MHAT Project to successfully increase referrals for mental health services for anyone identified with an SPMI or SED.
The Center for Health and Human Services (CHHS) at Middle Tennessee State University proposes to create a culture of mental health awareness and promote access to mental health care on campus by providing Mental Health First Aid training for faculty, staff and MTSU students, with an additional focus on student-veterans and their families. CHHS will provide training to individuals selected from a variety of areas throughout MTSU's campus life: faculty, academic advisors, campus health services, clerical staff in Financial Aid, the Charlie and Hazel Daniels Veterans and Family Center, coaches, counseling services, and resident directors and assistants. The trainers will receive certification from the Mental Health First Aid training program with a base certification in Adult Mental Health and an additional module certification for either Veterans or Higher Education Mental Health Training. These certified trainers will host Mental Health First Aid training sessions on a quarterly basis for faculty, staff, campus organizations, students, student-veterans, and student-veteran families. The target population served through these trainings are students in higher education and veterans. The anticipated reach of this program is 880 individuals trained in Mental Health First Aid with the resources to refer individuals in crisis to mental health providers.
Appalachian Angel Aid is a Frontier Health mental health awareness training project. Frontier Health is the Northeast Tennessee leading provider of behavioral health, mental health, substance abuse, co-occurring, intellectual and developmental disabilities, recovery, and vocational rehabilitation services throughout Northeast Tennessee and Southwest Virginia. Frontier Health acknowledges Serious Mental Illness and Serious Emotional Disturbance impair functioning in everyday life leading to significant social, emotional, financial and physical health decline. We will aid in recovery by developing a strong alliance between faith-based communities and mental health treatment programs through mental health education. We intend to target anyone in the general public (i.e. children, adolescents, adults, veterans) exhibiting signs and symptoms of SMI or SED that may encounter the faith-based community and build a bridge with clergy to improve their skills to identify and intervene early. Mental Health First Aid USA (MHFA) has been selected because faith-based communities in Northeast Tennessee are the first to help those with needs and are often referred to as the First Responders. We want the faith-based community to understand the importance of mental health in overall health and their powerful role in promoting recovery by providing at least 10 outreach community activities each month for a total of 360 for the lifetime of the project. We will provide MHFA training to at least 300 individuals per year and 900 for the lifetime of the project. Disparities in Mental Health will be reduced by improved utilization of mental health services and supports. Faith-based communities will refer at least 50 people for mental health services and supports the first year and increase by 50 each year bringing the referral total to 300 for lifetime of the project. Individuals in community will show improved health status as a result of referral and treatment for mental health services by increased scoring in at least 2 areas on the National Outcomes Measurement System (NOMS). Frontier Health has extensive experience in data collection, management, analysis and reporting. The agency has a data analysis protocol in place and adequate computer systems to complete required data collection and analysis process.