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The Pyramid Lake Paiute Tribe’s Native Connections project will focus on the provision of behavioral health services for students throughout their school day as well as building resiliency using traditional cultural practices and coping skills through evidence based programs. The cultural practices will include quillwork, drum making, art therapy language classes and traditional storytelling. Our population will be those youth who attend middle and high school on the reservation as well as those students who ride busses to attend school in Reno and Fernley. The students who ride the busses are often away from their communities for ten to twelve hours each day. The access to mental health services is provided outside of the hours they are available in their community. By providing these services to the students at their schools, we expect to add at least five hundred (500) mental health visits each school year to this population which has been unserved. The goal of increasing awareness for tribal leadership in suicide, substance abuse and mental health issues will be accomplished by providing Safetalk to all of the new council members after all elections. We will provide quarterly updates through attendance at Tribal Council meetings regarding our prevention efforts in the community and the schools. To increase awareness through outreach at community events about suicide prevention we will be providing a monthly program newsletter, a Gathering of Native Americans (GONA) in the fall and spring for all students, participation in sporting events and coaching teams where the student athletes will be learning coping skills and relationship skills through frequent interaction with prevention staff who also are coaches for the local middle and high school basketball teams. To increase the number of behavioral health visits to middle and high school aged students we will provide a Marriage and Family Therapist at the schools where our Tribe has students enrolled. This will allow students to have access to a mental health professional throughout their school day thereby increasing the availability of mental health care and reducing substance use and suicide risk. During the past school year, we had a therapist available for two school days a week. This therapist provided care at the elementary school and the high school for one day each. Our behavioral health visits saw an increase of over 500 individual visits from the prior year. The population we will be serving will be the 600+ youth up to the age of twenty four years old that reside on or near the reservation. Pyramid Lake students who begin their Senior year on track to graduate are graduating at a rate of 50%. It is our plan to increase graduation rates by offering the services at school for those youth who drop out when substance use and suicide issues arise in their lives.

The Shoshone-Paiute Tribes propose a comprehensive five-year Native Connections Project to identify specifically the gaps in service, needs, resources and protocols as they relate to suicide prevention, mental health, behavioral health, alcohol and drug services and community outreach / education. The project will address the profound need the Shoshone-Paiute Tribes have for the delivery of coordinated services and continuity across the service spectrum.

The overall goal of Kiowa Tribe Teen Prevention Network (KTTPN) is to reduce the rate of suicide deaths among adolescents and young adults ages 10-24. We are presently accomplishing this by training our staff in utilizing prevention techniques and developing a strategic plans with the community members and coalitions . We have established a Youth Prevention Network within the Kiowa Tribe of Oklahoma which provides evidence-based suicide prevention and early intervention programs to communities, tribes, places of higher learning; providing QPR and ASIST training among our Native Americans Youth. The KTTPN provides evidence-based curriculum for prevention and early interventions to communities; establishing Native community awareness events for various types of prevention and community readiness; to establish the Area Teen Suicide Prevention Crisis Team with key stakeholders in our community; establish suicide survivors support groups for teens and other family members of suicide; implement a suicide crisis prevention/intervention team for rural hospitals, schools, and tribes that do not have mental or adolescent behavioral health centers available in this rural area. The KTTPN’s main components of the community level is to provide training and assistance for the youth through the “American Indian Life Skills Development Curriculum”. This curriculum is derived from Dr. Theresa La Fromboise, and is an evidence-based resource by (SPRC) for best practice with youth coping and problem solving training. This accredited curriculum has been effective for high-risk youth behavior and has shown a significant decrease in reducing youth suicide ideation. The curriculum is taught to youth 12-18 for one hour per week for 5 months at 9 different counties throughout 5 year grant cycle. The process entails, “SOS Signs of Suicide”, student screening pre-testing form to measure effectiveness of curriculum and youth’s ideation also utilizing the Oklahoma Department of Mental Health’s Oklahoma Prevention Needs Assessment Survey.

By training youth in 21st leadership skills, based on the guiding principles of Traditional Cultural Values, we will address adverse childhood experiences that are prevalent in Alaska. Increase the awareness, and support those who need it through providing activities, training, and education. These youth, mentored by 7 leaders, will learn and pass their skill sets onto new youth the next year. We will also address other barriers for rural Alaska people, such as success in school, behavior health, and peer helpers.

The "Connecting Our Community with Culture and Hope: A Program for Suicide Prevention and Substance Use Reduction Promoting Mental Health within the Blackfeet Community" project aims to support suicide prevention, substance misuse prevention and mental health promotion within the Blackfeet Nation, Montana. Montana has almost twice the national average of suicide (23.49 vs. 12.97 per 100,000 in 2016, CDC). Suicide is the second leading cause of death for American Indians of all ages in the proposed project area. Our tribal community, The Blackfeet Nation, is located in Glacier County Montana. Glacier County is in the 90th percentile with regards to suicide rates in the nation. Glacier County’s average suicide rate is (25.9 per 100,000) with (38.5 per 100,000) for Native youth aged 15 – 24. Furthermore, for the 25 – 34 age group, this number jumps to (78.4 per 100,000). (MTDPHHS 2012). More specifically, the purpose of this proposal is to: 1) prevent and reduce suicidal behavior and substance use; 2) reduce the impact of trauma, and; 3) promote mental health among Blackfeet young people up to and including age 24. This will be accomplished by: 1) reducing the impact of mental and substance use disorders with culturally responsive models that will reduce and respond to the impact of trauma (both historical and current), and 2) fostering community support for youth and young adults through the facilitation of collaboration among local agencies. Focusing on recovery of Blackfeet ways of life we will disable some of the most pervasive risk factors within this population. With community, Tribal Elders, Veterans, Warrior Society members/mentors, Medicine People, and peers choosing healthy paths we will work to regain cultural identity and healthy role modeling. Positive health and well-being will be fostered by promotion of healthy lifestyle activities informed by tradition yet focused on a vibrant tomorrow. Our main interventions include a community-driven culturally significant Blackfeet Suicide Lifeline, Four Directions Traditional Healing Camps, “People of the Horse” Equine training. We will meet suicide and substance misuse reduction goals by reducing risk factors and blending adapted Evidence-Based Practice (EBP) methodologies relevant to AI/AN populations.

The Elbowoods Memorial Health Center Behavioral Health Department of the Three Affiliated Tribes in Central North Dakota otherwise known as the Mandan, Hidatsa, and Arikara Nation plans to establish a Central Intake Model of care that will encourage a continuum of care for youth and young adults ages 12-24 years old. The intent is to reduce the impact of mental and substance use disorders while fostering a culturally responsive model that will reduce and respond to the impact of trauma through collaborative efforts of the Three Affiliated Tribes' programs that provide service for youth and their families. Elbowoods Memorial Health will facilitate a Community Systems Analysis in conjunction with the development of policies and procedures that will promote the coordination of care and services for the targeted population whiles utilizing evidence based practice such as Zero Suicide which supports suicide prevention, substance use and misuse prevention intervention, and promotes wellness. Through this project the MHA Nation intends to further develop already initiated Plan of Action identified through the Gathering of Native Americans project to identify culturally appropriate prevention strategies in all communities on the Fort Berthold reservation. Collaborations and policies developed through input from the tribes youth council input will strive to reduce the impact of traumatic experiences.

This project is to build capacity and infrastructure to address substance abuse and suicide in our native youth population. Culturally appropriate therapies to build resiliency and increase prevention include equine therapy, art and music therapy. Training para professionals on response and assistance for suicidal attempts, threats and ideation will help the community have more resources available. Focus groups and surveys will be conducted and elders along with professional staff will help build resources and make them known to the community and youth. A campaign will be developed to help reduce the stigma of mental illness, depression and increase the community's confidence in seeking help.

Norton Sound Health Corporation’s Behavioral Health Services’ “Rural Implementation of Early Identification and Prevention Activities for Youth” proposes to reduce suicidal behavior and substance misuse by screening for and promoting behavioral health among regional Alaska Native youth ages 12-24 years. Through a combination of early intervention and prevention activities, youth and adults will access skills contributing to individual and community wellness. The Norton Sound Region, home to 9,400 people and comprised of 15 largely Alaska Native villages and the City of Nome, has high rates of suicide and substance misuse prevalent among youth and adults, and historical trauma has a significant impact on overall wellness. This project seeks to collaborate with stakeholders to conduct Community Assessments culminating in an Action Plan designed to address service gaps in the region. And Advisory Group and staff members will utilize information gained to develop protocols with youth-serving agencies for collaborative approaches to prevention, intervention, and postvention. A Project Director will oversee the activities with a Prevention Specialist and an Evaluator. Project staff members propose to implement Question Persuade and Refer (QPR) trainings for the Nome Public School and Bering Strait School Districts. Both staff members and students will receive the training with emphasis on developing peer leaders through the model. Project staff members will further offer the program to regional communities as the project progresses. The Adolescent Matrix Model is planned for substance use treatment of those 12-24 years. Project activities include the revision and deployment of a Depression Screener for early identification and intervention of behavioral concerns among the target population. By project’s end, the Screener will be implemented in all regional primary care and clinic settings. Project staff will collaborate with stakeholders to develop culturally-attuned crisis response and postvention plans for targeted communities. Project members will provide accessibility outreach in the communities and offer youth activities outside of the office setting. Activities will focus on strengthening the family core by reinforcing communication and engagement supports. At the conclusion of the project, it is expected that youth suicide attempts and completions in addition to chronic substance use will decrease as a result of community training and education, family engagement, and protocol development. NSHC expects to serve 150 youth annually or 750 over the life of the grant.

Kickapoo Traditional Tribe of Texas Native Connections Abstract The Kickapoo Traditional Tribe of Texas (KTTT), one of three federally recognized tribes in the State of Texas, and once considered as having a reputation as the most unassimilated tribe in the contiguous United States, is developing the ‘KTTT Native Connections’ program, a new initiative and significant step towards establishing a behavioral health program and a ‘Zero Suicide’ tribal culture. The Native Connections Initiative will target its efforts on the 544 tribal youth under the age of 24. At the end of 2017, this segment of the population accounted for approximately 54% of the 1001 KTTT members. While the tribe has made remarkable progress in providing safe and affordable housing, healthcare, outpatient alcohol/substance misuse program and a wellness center, the KTTT Health Clinic Executive Medical Committee has identified alcohol/substance misuse, mental health, and diabetes as the three most detrimental issues facing the tribe. The initiative will enhance existing programs/services by aiming towards the following goals over the life of the initiative: Goal 1-To engage the community in minimizing the health disparities of the tribe and promote healthy, empowered individuals and families. Holding regular quarterly Tribal Coordinating Committee meetings and community events that promote healthy living will be key objectives. Goal 2 - To build youth resilience by strengthening connections to community and culture through experiential learning and life skills development. Objectives will include the development and regular meetings of a Youth Advisory Council and activities that include development of a ‘suicide prevention’ media campaign developed by the young tribal community. Goal 3 - To initiate system change in the delivery of behavioral health services by providing integrated preventative and follow-up. Objectives will include re-strengthening relationships with external key players, and development of internal department policies and initiative participation. Goal 4 - To collect data to facilitate program improvement and assess impact by using the ZeroSuicide Toolkit and best practices from the National Action Alliance for Suicide Prevention. Objectives will target Tribal Coordinating Committee input, and development of a Tribal Action Plan using the Community Readiness Assessment and System Analysis, that addresses specific needs that work towards the improvement of the overall quality of health and wellness of the tribe. The KTTT Native Connections Program, as the Behavioral Health Units flagship program under the KTTT Community Health Center, is adopting SAMHSA’S Native Connections philosophy. This is a significant step towards establishing a culturally relevant program to address existing behavioral health issues. It will reinforce principles of the ‘Zero Suicide in Health and Behavioral Health Care’ philosophy started at the Health Center. Along with this evidence-based program, the initiative will utilize ‘To Live To See the Great Day That Dawns,’ a culturally appropriate suicide prevention guide to further strengthen the goals of the project. It will also look to ‘Gathering of Native Americans’ (GONA) for additional insight into incorporating culturally relevant activities.

The Red Lake Band of Chippewa Indians is proposing to conduct a Native Connections Project under this SAMHSA availability. The Red Lake Band is ideally situated to undertake this project at this time. We have recently completed a strategic planning process and have been named as a “Tiwahe” (Dakota for Family) Tribe by the Bureau of Indian Affairs, one of four tribes in the country to receive that designation. We propose to decrease suicidal behavior, substance abuse and effects of trauma among Red Lake youth by implementing evidence-based practices modified to be appropriate to Red Lake Ojibwe culture, and by providing Ojibwe based wellness counseling. We will be serving all eligible Red Lake youth but are adding a concentration on youth beyond high school age to the age up to and including 24 years of age. We will be marshalling all the resources of the Band to accomplish this goal. Guided by the Tribal Action Plan (TAP), we are approaching this task from a position of strength rather than weakness. It is we who must own our problems and we who must make the best uses of all available resources. Because we cannot bear the loss of one child we want to design systems that are equipped to help every child who is turning to thoughts of suicide or substance abuse because of depression or despair. All our children are subject to the same stressors, including those caused by an environment of growing levels of heroin, methamphetamine and prescription drug abuse and the family dysfunction that results. We need to reawaken the guiding forces of our traditional Anishinaabe values of Love, Honor, Respect, Truth, Honest, Humility and Wisdom which our ancestors upheld. This is a profound native connection which represents hope for all our people.

This project is titled Copper River native Association Elders-Youth Wellness (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 who are Native American and living on, or near, the villages that surround the Copper River Basin. 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 300 over the lifetime of this project. Project goals for year one are to develop the program with policies and procedures, as well as protocols as well as the Strategic Action Plan. . 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 Alaskan Native /American Indian 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 Blackfeet Native Connections project will improve coordination among behavioral health agencies across the Blackfeet Nation in Northwestern Montana to better respond to and care for individuals and families dealing with the issues of suicide, mental health crises, and substance use. The project will improve youth access to mental health care in rural schools and facilitate on-site mental health support during mental health emergencies on the Blackfeet Nation. The population of primary focus for the project will be youth aged 24 years or younger, a demographic represented within Blackfeet at nearly double the national average. The suicide rate among Blackfeet community members is nearly double the national average, and substance misuse in our young adult population is also disproportionately elevated. To address these pressing public health concerns, Blackfeet Native Connections will aim to improve substance use and mental health care coordination and collaboration among youth-serving agencies on the Blackfeet Nation by completing a systems analysis, needs assessment, and resources/asset map for youth behavioral health. Additionally, all youth-serving agencies will adopt standards of care for youth at risk for suicide, procedures for transitioning youth between agencies, a plan to facilitate connection to treatment and follow-up for youth who attempt suicide and use substances and “postvention” protocols for responding to suicides and suicide attempts. To guide this work, a diverse group of local stakeholders—to include behavioral health professionals knowledgeable in evidence-based clinical health practices, community members knowledgeable in traditional and cultural Blackfeet values, and youth from a local youth advisory board—will meet at least quarterly throughout the five-year project to provide guidance on all project activities. Blackfeet Native Connections will also work to reduce the traumatic impact of mental health and substance use disorders on the Blackfeet Nation through culturally responsive interventions aimed at universal prevention as well as selective and indicated intervention strategies. This will be achieved through comprehensive development and implementation of action plans designed to (a) train at least 50 school staff and 200 medical staff in evidence-based behavioral health literacy to improve universal prevention of substance use and mental health crises; (b) identify and offer universal and selected behavioral health services to 250 students in the Heart Butte and East Glacier Park School settings; (c) provide at least 500 youth with indicated mental health care and substance use interventions at the time of a mental health crisis through Mental Health Support Specialists embedded in school and law enforcement settings. This project will serve a total of 1,000 people on the Blackfeet Nation over the five-year period.

Tour de Ute Native Connections will serve the rural, isolated Ute Mountain Ute Tribe Tribal communities of Towaoc (Colorado) and White Mesa (Utah). Both communities are characterized by high poverty, high unemployment and few community resources. Both communities are Medically Underserved Populations and are Health Professional Shortage Areas. The number of children and youth living on the UMUT Reservation is about 600. Education levels are astonishingly low, and nearly one-in-three children live in poverty. Teen birth rates are among the highest in the nation, and the likelihood of low birth weight is significantly higher than averages for other regions. Native Connections will serve approximately 250 youth under the age of 24 over the life of the project. The overarching goal of Native Connections is to utilize culturally-relevant strategies to build the capacity of UMUT personnel to staff a behavioral health center focusing on preventing and reducing suicidal behavior and substance use, reducing the impact of trauma, and promoting mental health among UMUT youth through the age of 24 years. SMART program objectives are below. Objective 1: By the end of year one, conduct a Community System Analysis that addresses suicide prevention, substance use prevention, and mental health disorders. Objective 2: By the end of year three, develop policies and procedures to promote coordination among youth-serving agencies on the UMUT Reservation. Objective 3: By the end of year three, develop and/or revise protocols to ensure that UMUT youth at risk for suicide, including those who attempt suicide and use substances, receive follow-up services to ease their transition into treatment. Objective 4: By the end of year three, develop culturally-appropriate postvention protocols for responding to suicides, suicide attempts, and suicide clusters to promote community healing and reduce the possibility of contagion i.e., suicides following and connected to an initial suicide. Objective 5: By the end of year three, develop and implement a culturally-appropriate Action Plan that addresses Tier 1 and Tier 2 of prevention and intervention strategies. Objective 6: Annually, in collaboration with the University of Southern California, deploy at least one new culturally-relevant evidence-based practice focused on preventing and reducing suicidal behavior and substance use, reducing the impact of trauma, and promoting mental health among UMUT youth through the age of 24 years.

Summary: The purpose of the Integrated Prevention and Empowerment Project is to establish connectivity between existing youth prevention programs and to develop and deploy new programs where needed so that CTCLUSI Tribal youth can seamlessly move from age-appropriate program to program as they travel towards adulthood. Therefore, while the population focus is on all youth, there are distinct age brackets connected with various programmatic approaches. Project Name: Integrated Prevention and Empowerment Project Project Population: The project is designed to serve members of the Confederated Tribes of Coos, Lower Umpqua, and Sisulaw Indians ages birth to 24 years of age. Currently this population segment consists of 517 Tribal members or 43% of the Tribe's total membership. The preponderance of Tribal members served live within one of the five counties (Coos, Curry, Douglas, Lane, Lincoln) of the Tribe's primary service area all located in western Oregon. Strategies/Interventions: The Integrated Prevention and Empowerment Project is a capacity-building approach based on a number of specific phases and strategies including 1) Assessment Phase, 2) Policy and Procedure Development, 3) Protocols and Postvention Protocol Development, 4) Tribal Action Plan Development, and 5) Addressing Behavioral Health Disparities. With the direction of the Tribal Action Plan, the Project Coordinator will begin to work with CTCLUSI departmental staff, non-Tribal collaborative partners, and other stakeholders (including Tribal youth) to refine, enhance, and further integrate the cultural-based prevention and intervention programs and services in a manner that 1) improves accessibility to programs by all Tribal youth, 2) ensures high-risk Tribal youth receive focuses and personalized supports, 3) streamlines the flow between cultural-based programs, and 4) seamlessly coordinates service delivery. Project Goals: The goal of the Integrated Prevention and Empowerment Project is to increase the capacity of the CTCLUSI in order to reduce high risk behaviors of Tribal youth that may contribute to substance abuse, depression, and/or suicide. Measurable Objectives: To achieve the above-stated goal, the CTCLUSI will focus on fulfilling 3 objectives, including: Objective 1: Within 18 months of project launch, the CTCLUSI will adopt a Tribal Action Plan that identifies specific steps to be taken to enhance the integration of prevention and intervention programs for Tribal youth (ages 0 -24).. Objective 2: Within 3 years of project launch, the average number of Tribal youth (ages 0-24) participating in at least one CTCLUSI prevention or intervention program annually will increase by a minimum of 20 percent over the pre-project baseline. Objective 3: Within 5 years of project launch, the average number of hours a participating Tribal youth participates in a CTCLUSI prevention or intervention program annually will increase by a minimum of 40 percent over the pre-project baseline.

Summary: The Quapaw Tribe will partner with Northeastern Tribal Health Systems, Red Willow Counseling, four local schools, and seven Federally recognized Tribes in Ottawa County to engage in comprehensive planning efforts to develop and implement an array of coordinated, integrated services and supports to prevent and reduce suicidal behavior and substance use, reduce the impact of trauma, and promote mental health among Native American youth. Project Name: Quapaw Tribe Youth Suicide Intervention/Prevention Plan Population to be served: Native American youth ages 5-24 located Ottawa County, OK. Strategies/interventions: Engage the community to develop a Community System Analysis, Community Needs Assessment, Community Readiness Assessment; Community Resource/Asset Map, and a Strategic Action Plan to determine the level of support needed and guide the implementation of coordinated, comprehensive, holistic treatment to effectively prevent and reduce the impact of mental and substance use disorders and complex trauma. Project goals and measurable objectives: The goal of the project is to: prevent and reduce suicidal behavior in youth (primarily teens) by coordinating evidence-based treatment and services to promote mental health among Native American youth. This will be done by meeting the following objectives: • Objective 1: By the end of month 12, finalize MOUs with 10 project partners, all of whom will be directly related to the planning and implementation of the Action Plan, and hold a minimum of 6 planning meetings. • Objective 2: By the end of month 24, complete a community needs assessment, develop policies and procedures, develop at-risk and postvention protocols, develop an action plan addressing the appropriate tier(s) of prevention and intervention strategies, and implement a targeted PR campaign. • Objective 3: By the end of month 60, implement a minimum of 5 action items from the Action Plan in conjunction with a minimum of 6 partners, reaching a minimum of 250 at-risk youth.

The Southern Ute Health Clinic proposes implementation of a community project entitled "Native Connections", a five-year project to prevent and reduce suicidal behavior and substance use, and reduce the impact of trauma and promote mental health among American Indian/Alaska Native youth through the age of 24 years old.

The Mississippi Band of Choctaw Indians (MBCI), Choctaw Health Center’s Behavioral Health Program is submitting application for the Tribal Behavioral Health Grant Program (Short Title: Native Connections). This project will be titled Choctaw Native Connections (CNC). The project purpose will be to prevent and reduce suicidal behavior and substance use, reduce the impact of trauma, and promote mental health among MBCI youth through the age of 24 years, while improving transitioning outcomes as this group move into adulthood. This funding opportunity will assist with building capacity and collaborations to effectively treat and impact the identified population for the above listed issues through the use of culturally responsive models and approaches. The CNC Project is intended to reduce the impact of mental and substance use disorders, and respond to the impact of trauma. This project will enhance the MBCI infrastructure to improve collaboration among agencies to support youth as they transition into adulthood. The stated goals for the CNC project are as follows with a detailed set of objectives outlined within the

The Hooper Bay Native Connections project will utilize our ancestral strengths and traditional Yup'ik ways to conduct and deliver a prevention program for our youth called "Civuliamta Piciryarait" meaning Our Ancestral Way. Our vision for substance abuse prevention, suicide prevention and mental health promotion in Hooper Bay is to strengthen our identity as Yup'ik people. Our vision aligns with SAMHSA's National Tribal Behavioral Health Agenda (TBHA) which, "elevated the importance of tribal identities, culture, spiritual beliefs, and practices for improving well-being." Our overall goal is to reduce the unacceptable burden that suicide and alcohol abuse had placed on our community and youth. To accomplish this goal, we propose to utilize the Qungasvik (Tools for Life) model to promote resilience, reasons for life and sobriety among our 425 youth between the ages of 10 and 24 years of age residing in our community.

Project Abstract: Eastern Aleutian Tribes Project Name: Eastern Aleutian Tribes – Native Connections Population(s) to be served: Youth/young adults ages 12-24 living in the eight EAT clinical site communities, including representation from young adults working in the seafood industry. Strategies/Interventions: • Consistent community engagement, outreach and education • Solicitation of input from youth 12-24 • Youth advisory council (ages 18-24) • Youth clinical services Goals and Measurable Objectives: Goal 1. Raise community readiness scores for addressing the assessed areas of substance abuse and behavioral health and wellness concerns. Objective 1.1. By the end of Year 1, conduct outreach and education in 100% of EAT communities to raise awareness of behavioral health issues and challenges experienced by youth in the region ages 12 to 24. Objective 1.2. By the end of Year 1, conduct outreach and education in 100% of EAT communities to increase understanding of the concept of “behavioral health and wellness” and what is included, and common ways to address behavioral health issues. Objective 1.3. By the end of the 3rd quarter Year 1, perform a follow-up behavioral health readiness assessment in 100% of EAT communities that focuses specifically on alcohol abuse, drug use, and behavioral health and wellness concerns for youth ages 12 to 24. Goal 2. Decrease substance abuse among young people up to age 24 in or about to enter the seafood industry. Objective 2.1. By the end of the first quarter Year 1, identify and recruit at least 3 youth advisory council members who work in the seafood industry. Objective 2.2. By the end of the fourth quarter Year 1, identify and implement evidence-based strategies in 100% of EAT communities for increasing access to behavioral health services for seafood industry workers ages 24 and younger. Objective 2.3. By the end of Year 5, implement identified and prioritized evidence-based strategies in 100% of EAT communities. Number of people to be served annually: [289] Throughout lifetime of project: [382] Project Summary: Eastern Aleutian Tribes will increase behavioral health and wellness among youth and young adults ages 12-24 in its eight communities by soliciting youth input and establishing a youth advisory council; increasing ongoing community engagement, outreach and education about youth behavioral health and wellness; and increasing access to evidence-based interventions for youth experiencing behavioral health and wellness challenges.

Summary: The Fort Peck Assiniboine and Sioux Tribes Native Connections will implement comprehensive and culturally relevant strategies (outreach, training, life skills, traditional healing practices, equine therapy) designed to prevent and reduce suicidal behavior and substance abuse, reduce the impact of trauma, and promote mental health among American Indian youth on the Fort Peck Indian Reservation. Project Name: Fort Peck Assiniboine and Sioux Tribes (FPT) Native Connections Population to be served: American Indian (AI) youth through the age of 24 years, on the Fort Peck Indian Reservation, who are at risk of suicide or substance use; who have already attempted suicide; or who are using or misusing substances. Strategies/Interventions: Tier One: Community outreach campaign focused on substance abuse prevention, increasing public awareness of suicide, and reducing stigma surrounding behavioral health disorders; and training for providing trauma-informed serves for project staff and partners. Tier Two: Implementation of Tribal youth life skills curricula; and traditional healing practices (e.g. sweats, ceremonies, annual Creator's games). Tier Three: Coordinated referral and follow up care; equine therapy; and other strategies identified during the year one planning process. Goals and Objectives: The goal of the FPT Native Connections is "to prevent and reduce suicidal behavior and substance abuse, reduce the impact of trauma, and promote behavioral health among AI youth on the Fort Peck Indian Reservation." Objective 1: By the end of year one, FPT will conduct one (1) Community System Analysis; one (1) Community Needs Assessment; and one (1) Community Readiness Assessment; and will develop one (1) Community Resource/Asset map focused on addressing suicide prevention, substance abuse prevention, and behavioral health disorders on the Fort Peck Indian Reservation. Objective 2: By the end of year one, FPT will develop one (1) set of community-driven policies and procedures; one (1) set of revised protocols; and one (1) set of postvention protocols designed to address the standards of care for youth at risk of suicide. Objective 3: The FPT will develop (year one) and implement (years two through five) one (1) community-driven Action Plan that will address the three (3) tiers of prevention and intervention strategies: Universal Prevention Strategies, Selective Prevention and Intervention Strategies, and Indicated prevention and Intervention Strategies. Number of People to be served: At least 5,000 (tier one, duplicated count) per year; 7,000 (tier one) over the life of the project; 100 (tier two) per year; 500 (tier two) over the life of the project; 50 (tier three) per year; 250 (tier three) over the life of the project.

Summary of the Project: The purpose of this project is to prevent and reduce suicidal behavior and substance abuse , reduce the impact of trauma, and promote mental health among the youth and young adults in the Lingit village of Kake, Alaska. The project will reduce the impact of mental and substance abuse disorders by developing and implementing programs and activities that are rooted in Lingit culture, values, and traditions, and developed through a youth/adult partnership decision-making model. The geographic catchment area for this SAMHSA Native Connection project is the Village of Kake, in Southeast Alaska. The population that will be directly impacted by this project are the approximately 165 school-aged youth and young adults through age 24, as well as their families and extended families. Ultimately, all of Kake’s residents and Tribal members will be impacted by the proposed programs and activities outlined in this proposal. Key Strategies/Goals Include: Completing community analyses, assessments, and asset mapping that will inform the identification of Evidence Based Practices; Developing and implementing written Standards of Care among coordinating agencies for identifying and helping youth at risk for suicide; Creating effective youth/adult partnerships by involving and engaging youth and other community members to provide leadership and direction for the implementation and oversight of the program and activities; and Developing and implementing an array of culturally focused and integrated prevention and intervention strategies to prevent suicide and reduce the impact of mental and substance use disorders and complex trauma.

It has long been recognized that the population of Alaskan Native youth is at highest risk, bar none, for committing and completing various acts of self-harm including substance abuses and suicide. Alaska always ranks in the top two states for suicide, and our region is not immune, and the indigenous people of the extended Chugach Region are at extremely high risk. Further, Alaska has the most alcohol abuse with twice the annual consumption of alcohol per capita of the Lower 48. Our children are exposed to horrors that haunt and shape lives for generations. For this reason Chugachmiut seeks to address this most serious of problems through the current application for funding for the Substance Abuse and Mental Health Services Administration (SAMHSA) Tribal Behavioral Health Grant Program (Short Title: Native Connections) to promote early intervention strategies and implement positive youth development programming to reduce risk factors for suicidal behavior and substance abuse. Our program, Iguillrrapet, Lumacirpet “Our Kids, Our Culture”, will pair nationally recognized evidence-based best practices from the Brief Strategic Family Therapy (BSFT) within the homes with parents and siblings with community and school-based activities to promote acceptance of healing, to remove stigmas, and to educate on the many paths out of family troubles. Our plan is to hire a new itinerating Brief Strategic Family Therapy (BSFT) clinician who will travel out to each of the four village communities throughout the Chugachmiut catchment region on a rotating basis. The Brief Strategic Family Therapy clinician will be supported by our Child Welfare Systems Planner who specializes in ICWA and child protection matters, our itinerating Behavioral Health Clinician, and our itinerating Domestic Violence Advocate In efforts to reach the youth, we will provide services in the homes, the schools, and within the community. We will engage our regional youth with entire family involvement (to the greatest extent possible and allowable). We will help to remove existing problems such as home-based substance addictions within siblings and parents in order to (1) show “problem-solving in action” and (2) to remove the basis for home-based unhealthy modeling. During village visits, our Brief Strategic Family Therapy clinician and other clinical providers will provide community psycho-educational presentations on communications, breaking the cycle of addictions, parenting skills, and other topics with heart-connected stories, humor, and real approaches to the matters that affect them most. Then, once per year, at the request of our tribes, we will host two regional tribal gatherings; one for the men of the region and the other for the women. Both groups will give feedback on the program, the future directions they would like to see pursued, and reviewing the traditional pathways to healing. And, finally, we will be within the schools, giving presentations, gaining familiarity, hearing from the teachers as to whom they have greatest concerns for, and reaching out to the broadest swath of youth possible. This SAMHSA Iguillrrapet, Lumacirpet Our Kids, Our Culture project will make a difference in many, many lives.

First Nations Community HealthSource’s (FNCH), an urban Indian Title V health center, proposes to conduct the Native Connections Project (NCP), a suicide and substance use prevention and treatment program, to target American Indian/Alaskan Native (AI/AN) students, ages 5-18 years, attending the Native American Community Academy (NACA), in Albuquerque, New Mexico. In addition to students, NCP’s target population will include faculty, staff, parents and community members. With 60 faculty and staff members and a student enrollment of 400 spanning from kindergarten to grade 12, NACA is the only Native American Charter School in Albuquerque. Community participation and planning for NCP has already occurred. NACA has analyzed and assessed their substance use data and the school’s campus based coalition, HOPE, comprised of students, faculty, staff, community partners and parents, has met monthly to assess and plan for community wide initiatives to prevent alcohol-related suicide and its related behavioral health risk factors. FNCH will increase NACA’s capacity to develop and implement a strengths-based approach that incorporates EBPs, is coordinated, culturally appropriate and honors Native traditions and cultures to address substance use related suicides in NACA’s community. NCP will provide trainings using the Second Step curriculum to NACA’s 300 elementary and middle school students, Youth Mental Health First AID training to 20 parents and 25 urban Indian community members, Natural Helpers training to 12 middle school students Question, Persuade and Refer training to 60 NACA faculty and staff and 20 parents/family members in Question, Persuade and Refer and clinical behavioral health treatment and care coordination to youth determined to be at risk for substance use and/or suicide. A process and outcome evaluation will be completed.

Native Connection’s purpose is to increase access to culturally-appropriate substance abuse and suicide prevention programming and mental health services for American Indian/ Alaska Native youth and young people living in Siskiyou County especially those youth residing on the Quartz Valley Indian Reservation (QVIR), while increasing community engagement and strengthening service delivery. The Anav Tribal Health Center, (ATHC) provides medical, dental, counseling/therapy, equine therapy, and community/cultural based services and activities. Our philosophy is that culture is prevention which creates resiliency factors to prevent young American Indian/Alaska Native (AIAN) from becoming at-risk. Even more important is the belief that each individual may need a different level of care and engagement. ATHC currently serves ages youth ages 10-24 living in the Scott Valley Region of Siskiyou County, while the program has been successful in reaching at-risk youth staff continuously feel the need for more resources and a stronger collaborative system. The proposed project goal is to expand and strengthen the ATHC’s integrated programming capacity and community support systems that a) reduce the impact of trauma; b) prevents suicide/suicidal ideation and substance use; and 3) integrate mental health promotion for AIAN youth and transitional aged youth ages 10 – 24. Project components include: 1) Planning and building community engagement capacity specific community needs and readiness; 2) Address gaps in service and strengthening current service delivery by developing and implementing youth and transitional aged youth programming; 3)Engaging staff clinicians to participate in youth care coordination activities and programming; and 4) Engage community voice. Specifically, the Native Connections project will enhance and develop the ATHC’s current suicide and substance abuse and mental health service infrastructure and service delivery for our youth members by adding the following additional programming: 1) Support youth services and outreach activities; 2) Support annual youth GONA; 3) Develop and implement a transitional aged youth program and outreach ; 4) Support youth based trauma-informed care coordination, screening, assessment, and treatment. Native Connections will increase community voice and engagement through a variety of resource building and readiness activities which will increase the overall effectives of the ATHC’s suicide/ substance abuse prevention and mental health programming as well as identify needs and gaps in service. ATHC will proactively target challenges and disparities within current programming through member identification and assessment, enhanced outreach, and integration of traditional healing practices with evidence-based practices.

Aroostook Band of Micmacs (ABM), located in Maine's northern most county (Aroostook County), will provide youth with substance abuse and suicide prevention programming, in collaboration with the Penobscot Boys & Girls Club - Presque Isle Unit (PBGC), Pi'gunji'jg/Little Feather's Head Start and myriad of community partners that addresses the need of community Native Youth through the Aroostook Band of Micmacs Native Connections program. ABM will focus on youth aged 3-18 because these youth are most in need of additional programming in our community. Services will be provided to 260 Native youth annually including youth attending the Pi'gunji'jg/Little Feather's Head Start and PBGC with additional youth added throughout the lifetime of the project. The overarching goal of the Aroostook Band of Micmacs is to reduce the impact of mental and substance use disorders, foster culturally responsive models that reduce and respond to the impact of trauma in our Native community and allow our community to facilitate collaboration among agencies to support youth as they transition into adulthood. The primary goal is broken down into smaller, specific goals: Goal one- Reduce the impact of mental and substance use disorders in our community through increased participation of at-risk youths aged 3-18 in prevention programs. Goal two - Facilitate collaboration among community agencies to support at risk Native youth.