WY Discretionary Funding Fiscal Year 2023

The Eastern Shoshone 988 Tribal Response program will increase awareness and use of the 988 Lifeline on the Wind River Reservation located in central Wyoming. The program will train at least 20 individuals over the course of two years along with serving the Eastern Shoshone tribal members with an enrollment of 4,368 members. Access to mental health services, substance use treatment and behavioral health therapies is limited on the WRR due to rural location, limited transportation, stigma, digital inequality, and long-wait times. Foundational guidance from needs assessments, quality improvement plans, and linkage to local, state, and national resources are needed. These gaps directly impact tribal members in crisis. Data from the WRR Indian Health Service indicate that 246 individuals were treated at the clinic due to intentional self-harm diagnosis from 2016 - 2020. In 2021 there were 17 deaths by suicide in Fremont County, this was three times greater than the national average. A 2022 WRR community survey reported that the number one health concern was opioid use followed by unresolved trauma. This same survey reported that 22% do not have access to the internet and 19% are not aware of the telehealth services available (like 988), and 9% do not have access to a phone. Tribal members feel that most providers could benefit from cultural competency training. The overall goal of the ESR 988 project is to save lives through the 988 Lifeline on the WRR. Though the implementation of six specific objectives, ESR will: • Complete a tribal readiness or needs assessment and a comprehensive strategic plan based on the most current epidemiological data for the WRR to address the gaps in crisis response services. ESR will utilize SAMSHA’s Tribal Action Planning guidelines as a resource. • Assist local 988 crisis centers with a quality improvement plan focusing on policies, first contact, assessment, referral, and access to local care to ensure there is a comprehensive and coordinated response to individuals at imminent risk for suicide. • Establish collaborations with states, territories, and local crisis centers to improve effective 988 response and linkage to local resources, including cases of emergency intervention. This will result in 20 individuals referred to ESR for services from the 988 Lifeline. • Provide training for 10 crisis call center staff per year that specifically addresses the needs of the WRR and tribes in Wyoming. • Will develop and implement a plan for sustainability which includes ongoing collaboration with the Wyoming DOH 988 Lifeline team. • Will create a tribal specific community resource from the Path to Wellness App that links to Lifeline 988 crisis centers. The ESR 988 project will continue to work with existing partners, current SAMHSA grants, and the Indian Health Services to offer evidence-based prevention, treatment, and recovery practices to the Eastern Shoshone community

Wyoming Trauma-Informed Services in Schools will partner with two LEAs (Sweetwater County School District #1 and Sweetwater County School District #2) and one Behavioral Health Partner (Wyoming Behavioral Institute) to deliver trauma-informed services primarily within the student population aiming to serve 300 unique students annually. The 300 student estimate is based on 4% of the total student population of the districts of approximately 7500 students. Tier 1 services will not be counted unless SAMHSA requests this counting. There will be processes developed that will impact the entire student population.

The Wyoming 988 State and Territory Cooperative Agreement is an opportunity for the two Wyoming lifeline call centers, Central Wyoming Counseling Center and the Wyoming LifeLine, to enhance their workforce in order to meet upcoming demands of the 988 transition. The first priority is to bring the in-state answer rate up to 90 percent. The project will strengthen the call centers' capacity for suicide prevention as well as strengthen reporting and communication efforts between the call centers and the Wyoming Department of Health. To achieve the long-term goal of preparing state response to 988 contacts including calls, chats, and texts originating in Wyoming, the following goals have been outlined: Goal 1: Expand lifeline crisis center staff and response structure needed for successful implementation of 988 by June 15, 2022. Goal 2: Enhance planning efforts for the implementation of a new, national 988 number by March 30, 2023. Goal 3: Increase state capacity to meet 988 crisis contact demand by March 30, 2023. Through the development of a sustainability and implementation plan following the grant award, Wyoming is hopeful that the collaboration between the State, both lifeline centers, and other partners will also improve follow-up services, referral resources, and communication, as well as standardize data collection.