WA Discretionary Funding Fiscal Year 2018

The goal of the project is to prevent and reduce suicidal behavior and substance abuse among
Chehalis Tribal member youth ages 24 and younger. The project will take a multi-dimensional approach that includes selective, indicated and universal targeting utilizing a range of interventions across a variety of settings including individual, family, school and community.
The project will introduce traditional plants and medicine through a healing garden, hands-on workshops and cultural teachings. Over 80 youth will participate in a variety of educational programs including suicide prevention, healthy living, life skills, and self-esteem building. The project will also train 100 community members as gatekeepers to learn how to recognize suicidal behavior, how to respond and where to find help.

Goal 1: Develop an infrastructure that involves the community in guiding all grant efforts, including planning, carrying out the plan, and evaluation. Goal 2: Design and implement a suicide and self-injury surveillance system on the Colville Reservation for tracking all suicidal ideation, suicide attempts, suicide completions and non-suicidal self-injury. Goal 3: Move the 4 Colville Districts from their current readiness to change levels of Vague Awareness to Community Ownership (9), by creating Community Mobilization Teams and training them how to conduct their own Community Readiness to Change Assessments. Goal 1 will feature the creation of an Interagency Task Force of 14 tribal departments and agencies. Measurable objectives will include a tribal vision statement for the prevention and reduction of suicidal behavior, alcohol and substance abuse and the promotion of mental health in our tribal youth age 16-24, a strategic plan addressing the same, and the number agencies/departments that adopt new policies, protocols, and standards of care as a result of this project. Goal 2 will feature the creation of the Colville Suicide and Self Injury Surveillance System, replicating the successful White Mt. Apache SSISS. Measurements will include the creation of a data base, forms, and number of staff and departments trained in data entry; number of staff and departments trained to use the three tiered risk protocol, and case management system, home visit protocol and interview. Goal 3 will feature the training of 15 tribal members in the use of the Colorado State University Tri-Ethnic Center Community Readiness Assessment. Measurements will be number of tribal members trained, number of community members surveyed, number of interviews scored, readiness scores for each community, and recommendations from each community on next steps. All three goals together will begin the process of reclaiming Kwu ctxtnwixw in our communities.

The project goals are to reduce the impact of substance abuse, mental illness, and trauma on the Yakama Indian Reservation and within its boundaries, through a public health approach. We will use a holistic approach bringing together Reservation communities, local agencies, and Yakama Nation agencies to support and provide wrap-around-services for Yakama/AI/AN youth and young adults, up to ages 24. We purpose to serve at least 200 Yakama and other AI/AN youth (8-24 years of age) annually. This will be achieved by: 1) Increasing our understanding across the reservation about suicide risk and protective factors, why they exist, and why each risk as well as protective factors must be addressed 2) Conduct a community assets, needs and readiness assessment from all seven towns across the reservation to bringing community members together to 2a) share how youth suicide and substance use impact the quality of life for everyone across the Yakama Reservation, 2b) to obtain an inventory of the resources currently available that can be leveraged to improve the quality of life for community members 2c) to Identify our community's strengths and weaknesses 3) Share assessment findings with the community to 3a) engage community members in discussions about needs, assets, and the community's response 3b) increase key leaders and community members awareness and how they can contribute to the community's assets 3c) use the information about community needs to assess our service delivery priorities 3d) use the data for decision making to address community needs and how to use the available assets; and use the data to inform strategic planning, priority setting, program outcomes, and program improvements.

The purpose of the proposed project is to develop and implement tribal youth suicide policies and evidence-based prevention programs that enhances awareness, identification, referral and treatment strategies. Activities will focus on youth 10-24 years of age and youth- serving systems. The program has 4 identified goals.
Goal 1: Strengthen our suicide community coalition
Goal 2: Conduct Suicide Prevention trainings across the Yakama Reservation.
Goal 3: Implement a reservation-wide EBP suicide prevention program - Sources of Strength.
Goal 4: In collaboration with coalition partners increase annual screening, identification, referral and support for youth at risk for suicide.

ABSTRACT Project Name Circles of Care VII Demographics/Clinical Characteristics The Yakama Nation is a federally recognized tribe with a reservation consisting of 1,130,000 acres in southwestern Washington. The reservation is located within the Yakima County and part of Klickitat County. There are four rural communities located within the reservation boundaries; Toppenish, Wapato, White Swan, and Harrah. Services are also provided to five communities bordering the Yakama Nation reservation; Yakima, Granger, Zillah, Goldendale, and Glenwood. There is a huge gap of between the need for mental health services and the availability and coordination of mental health, substance abuse use, and co-occurring disorders on the Yakama Reservation for children, youth, and young adults from birth through the age of 25 and their families. There is also a high rate of alcohol and drug abuse within the Native American community. Strategies/Interventions The Yakama Nation Behavioral Health will collect to capture reorganization, restructuring or turnaround of negative conditions. Measurable indicators are obtain from: 1) review of budget expenditures i.e. number of new staff hired, expansion of physical sites, etc. 2) As reported by the PD and project coordinator in the weekly data collection meetings the number of new policies developed or revisions of current policies, number of new partnerships developed or expansion of activities with current partners including the number of data sharing agreements drafted, signed, executed, 3) staff and client assessment / satisfaction survey. Goals/Measurable Objectives It is the Yakama Nation Behavioral Health?s goal to increase the capacity and effectiveness of mental health systems serving Yakama members and other AI/AN on the Yakama Reservation. Number of People Served Annually or Project Lifetime Yakama Nation Behavioral Health program provides services to all Native American and/or Native American descendants. Services are not limited to Native American and/or Native American descendants residing on the Yakama Nation reservations. According to the Yakama Nation Indian Health Services, there were a total of 12,485 patients in fiscal year 2015. This number includes 6,897 patients identified as Yakama Nation enrolled members, 3,005 patients were identified as Yakama Nation descendants, and 2,583 identified as Native American and/or Native American descendants from different federally recognized tribes. Indian Health Services estimated that 8,839 of the patient population reside on the reservation and 4,075 reside outside the reservation boundaries.

Developing Peer Support Communities (DPSC) is a partnership of two Washington State consumer-run organizations, Consumer Voices Are Born (CVAB) and United Peers of WA (UP of WA). The organizations will work mutually with adults experiencing serious mental illness (SMI) and behavioral health comorbidities from multiple WA Regional Service Area (rural and urban) to shape the development and implementation of recovery-oriented policies and practices, and ensure that peer-delivered services are a part of the array of healthcare and community-based supports. This project will emphasize the development of UP of WA and affiliates in rural regions, and CVAB’s Washington Peer Advancement Coalition (WAPAC) will continue its work to educate about and promote the use of a peer support services. Washington’s peer support opportunities need to expand in and beyond communities where it is presently available. To have a positive impact on the more than 300,000 individuals living with SMI, implementing regional networks as part of a statewide network of peer support communities is necessary to shape recovery-oriented practices and policies meeting the needs of the identified population. CVAB and UP of WA will collaborate in building a clear strategy for each part of the DPSC project and in each community as the projects unfold. This collaborative effort will use the strengths of each organization to support one another and for meeting the goals of project. DPSC anticipates engaging more than 1500 individuals over the lifetime of the grant resulting in a membership for UP of WA at approximately 1000. An anticipated outcome is that at the end of the three year grant, UP of WA will be a viable and strong organization with regional affiliates, and that CVAB can turn over future statewide network grant opportunities to UP of WA.

The DadsMOVE’s Washington State Family Network Expansion Project will increase and expand the organizational capacity of DadsMOVE to be a statewide intermediary organization that will educate, and empower parents and caregivers, and strengthens family-centered organizations, focusing efforts on the most rural and underserved regions of Washington State. This work will help to build a robust System of Care that supports children’s mental health. Over the next three years (May 2016 – April 2019), DadsMOVE will provide support, training and technical assistance to support parents and catalyze leadership development and capacity of local family organizations. Through trainings and collaborative partnerships, we will provide services to more than 3,000 parents, caregivers, and agency personnel during the grant period. This work is being carried out in three of the 10 most rural, and underserved Behavioral Health Organization regions of Washington State. This catchment area is home to families who are largely from poor, rural, Latino, Native American, and/or Veterans populations. Goal 1: Increase the capacity and business management skills of the organization. Objective 1.1: Expand staffing capacity to three full time equivalents. Objective 1.2: Increase the diversity of our leadership and staff. Objective 1.3: Provide train-the-trainer, workforce development trainings. Goal 2: Provide education to parents and professionals to address children’s mental health and co-occurring substance abuse issues in partnership with local family organizations. Objective 2.1: Provide in person parent trainings. Objective 2.2: Provide parenting skills training. Objective 2.3: Train local parents/caregivers to lead support groups. Objective 2.4: Train local trainers to provide educational support to parents and caregivers. Objective 2.5: Provide family events in partnership with local family organizations. Objective 2.6: Provide parent retreat weekends. Goal 3: Provide information through media and via local family organizations. Objective 3.1: Expand content to include Live webinars and online trainings. Objective 3.2: Increase database to expand dissemination Objective 3.3: Create, maintain, and support a 1-800 number and website Goal 4: Attend local, state, or national meetings and conferences Objective 4.1: Provide information about children’s mental health issues. Objective 4.2: Provide feedback about services and system planning.

Be the Change is an initiative to train citizens in rural counties of eastern Washington to be the bridge between a client, student, colleague, friend or family member who is suffering from a serious mental illness or serious emotional disturbance and the care that they need. Be the Change leverages Mental Health First Aid, an evidence-based practice, in training all citizens to identify and assess mental illness. Be the Change will teach 2650 residents of eastern Washington per year, with a total of 7950 residents trained within the three-year grant period. The population of focus is all citizens, with an emphasis on school-based personnel (teachers, administrators, resource officers, etc.), first responders (police, fire, EMT), and veterans, veteran-serving organizations, and families of veterans. According to a report issued by SAMHSA in 2015, 226,000 adults in Washington state had serious thoughts of suicide, and 232,000 had a serious mental illness within a year prior to being surveyed (survey year 2013-2014). Of these, only 44.4% received mental health treatment or counseling. Goal 1: Increase the capacity of school personnel to identify and address mental health issues before they become emergencies. Goal 1, Objective 1: By September 2021, 50% of teachers and relevant school personnel in the catchment area will be trained in Mental Health First Aid. Goal 2: Increase the capacity of first responders to serve as a bridge between citizens in need of mental health services and the services available. Goal 2, Objective 1: By September 2021, 25% of law enforcement and emergency services personnel in the catchment area will be trained in Mental Health First Aid. Goal 2, Objective 2: By the end of this project, 75% of law enforcement and emergency services personnel in the catchment area will carry a card that lists the mental health resources available in their area. Goal 3: Increase the capacity of rural communities to “care for their own” by providing education, resource cards, and referrals. Goal 2, Objective 1: By September 2021, all citizens in the catchment area requesting Mental Health First Aid training through this project will receive training.

Summary: The Ellensburg School District (ESD) and project partners will provide Youth Mental Health First Aid (YMHFA) training; Question, Persuade, and Refer Gatekeeper Training for Suicide Prevention (QPR training); and Hope Squad training in Kittitas County, Washington. Project name: Youth Mental Health Awareness Training in Kittitas County, Washington Population(s) to be served: The ESD and project partners will provide training and services to help adolescents and transitional aged youth (ages 12-21) with mental disorders in Kittitas County, a rural area in Washington. Compared to the youth population in Washington, the youth population in Kittitas County is more likely to have the following mental disorders: depression; suicidal consideration, plans, and attempts; and suicide. Strategies/interventions: The ESD and project partners will provide YMHFA, QPR, and Hope Squad training; have trained individuals refer adolescents and transitional aged youth with mental disorders to the ESD Referral Coordinator; track referrals to mental health provider organizations; provide outreach to and engagement of community members; access and leverage funding mechanisms and resources; develop and/or implement Bring Change to Mind, Change Direction, CureStigma, and/or other social marketing and awareness campaigns; and participate in School-Based Health Alliance and Telehealth Resource Center training and technical assistance. Project goals and measurable objectives: The project goals are to: 1) Foster integration between behavioral health and other systems; 2) Prevent or delay the onset of and complications from mental illness; 3) Disseminate education tools to address behavioral health issues; and 4) Support the efficient use of various financing models and mechanisms to address behavioral health services and activities. The project objectives are: 1.1) From September 30, 2018 to September 29, 2021, collaborate with at least six organizations and two consumers/family members to improve mental health-related activities; 2.1) From January 2, 2019 to September 29, 2021, increase from baseline the preparedness of 1,005 individuals to address the signs of mental disorders and actions to take in response; 2.2) From January 2, 2019 to September 29, 2021, increase from baseline the number of individuals receiving mental health services; 3.1) From January 2, 2019 to September 29, 2021, expose an estimated 4,400 individuals to mental health awareness messages; and 4.1) From January 2, 2019 to September 29, 2021, increase from baseline the amount of funding for mental health-related activities. The ESD and project partners will train 260 individuals in Y1, 335 individuals in Y2, 410 individuals in Y3, and 1,005 individuals over the project period.

King County will implement Cooperative Agreements to Benefit Homeless Individuals with two comprehensive behavioral health organizations to provide Assertive Community Treatment (ACT) and Housing First permanent supportive housing in geographically underserved regions. Program participants will be single adults experiencing chronic homeless and co-occurring serious mental illnesses and substance use disorders (SUDs). Approximately 350 individuals will be identified, screened and referred by King County's Coordinated Entry for All (CEA) program to SHARP over the life of the grant. This is expected to result in 224 individuals outreached and 140 individuals enrolled in intensive services. Participants will all have serious mental illnesses and co-occurring SUDs. SHARP will provide: 1) outreach, engagement, screening, and clinical assessment through an ACT model; 2) direct treatment, with trauma-informed practices, to address COD by the ACT team; 3) case management, ACT, SOAR methods, and supportive housing to enroll participants in SSI/SSDI, Medicaid, and other benefits and retain participants in housing and services; 4) peer recovery support to facilitate COD recovery as part of the ACT team; 5) collaboration across care entities to build bridges among partners in care; 6) recovery support services within ACT to improve retention and continue treatment gains; 7) Housing First permanent supportive housing through CEA; and 8) implementation of a steering committee for SHARP that will meet quarterly and monitor the goals and objectives of the program. Program objectives will include the degree to which referrals are outreached and enrolled, participants obtain Medicaid and other benefits, interventions have been implemented to fidelity, and participants increase housing stability while reducing COD symptoms, and use of crisis and emergency medical and psychiatric services, sobering and detox services, and jail.