Alaska Native Tribal Health Consortium (ANTHC) will partner with the Lower Yukon School District (LYSD) on the “Promoting Resilience Education in Villages to Enhance Native Traditions (PREVENT)” project. The project will focus on 10 rural Alaska Native (AN) communities in the Yukon Kuskokwim region in southwest Alaska. The project will develop, implement, and evaluate a trauma-informed, community-based system of care for AN children and youth (grades K-12 in the LYSD) with mental health challenges and their families. The goals of the project are to: 1) design a community based coordinated system of care to support mental health for children, youth, and families in up to eight sites in the LYSD, and 2) increase the capacity of LYSD to address mental health challenges of youth and promote resilience of LYSD youth and families through implementation of the system of care. The PREVENT project will focus on development of a community-based system of care for children and youth with mental health challenges, and their families. The Extension for Community Healthcare Outcomes (ECHO) model will be adapted to support a cohort of LYSD employees as they learn and integrate Calricaraq (a traditional Yup’ik approach to individual and community wellbeing) and the Attachment, Self-Regulation, and Competency framework (ARC, an evidence-based approach to trauma treatment) into a coordinated system of care in the district. The project will serve a total of roughly 2,030 students in the 10 schools of the LYSD. A needs assessment of all schools in year one will determine which eight schools will be the target of the pilot program in years two and three. It is estimated that 871 students will receive services in year two and 974 new students will receive services in year three. Due to the limitations of grant funding, two schools will not be reached by the end of the grant period.
Project Name: Confederated Salish and Kootenai Tribes Circle of Care Project Population to be Served: Individuals of all ages who have unaddressed substance abuse and mental health needs who are enrolled members of the Confederated Salish and Kootenai Tribes, descendants, or members of other American Indian/Alaska Native Tribes residing on the Flathead Indian Reservation. Strategies/Interventions/Objectives: The Confederated Salish and Kootenai Tribes' Department of Human Resource Development, Health Department, and Early Childhood Services Department will collaborate to implement the Circle of Care Project. Strategies/Interventions will include convening a task force toto guide the project; providing staff development training in the systems of care approach; using a community-based process that includes cultural activities and actively engages community members, key stakeholders, youth, elders, and tribal leaders in program development; conducing community outreach/education to sectors such as schools, the faith community, the housing community, and the justice system, in addition to healthcare systems; provide network development and collaboration activities; implement a community-base system of care model that is holistic, community-based, culturally competent, family-driven, and youth-guided across multiple agencies; and implement a pilot project to provide mental health consulting to professions/families, assess 100 individuals from the population of focus during the grant award period for substance abuse and mental health unmet needs and facilitate expedited services t meet these needs in collaboration with partner agencies. Project Goal: The Circle of Care Project will increase the capacity and effectiveness of the mental health service delivery system by implementing a holistic, evidence and community-based , coordinated system of care, thereby reducing the gap between the need for substance abuse/mental health services and the availability of such services for enrolled members of the Confederated Salish and Kootenai Tribes, descendants, or members of other American Indian/Alaska Native Tribes residing on the Flathead Indian Reservation. Number of People Served: Yr 1: 20 individuals provided with direct services; 30 individuals provided with training, network development , collaboration, consensus development, or other outreach/educational activities. Yr 2: 40 individuals provided with direct services; 50 individuals provided with training, network development, collaboration, consensus development, or other outreach/educational activities. Yr 3: 40 individuals provided with direct services; 50 individuals provided with training, network development, collaboration, consensus development, or other outreach/educational activities. Other the Entire Project Period: 230 will be served.
Fort Defiance Indian Hospital Board, Inc., (FDIHB) is a tribally chartered, 501(c)(3) nonprofit healthcare organization that operates and manages three facilities in the southeastern region of the Navajo Nation; Tsehootsooi Medical Center (TMC), Nahata’ Dziil Health Center (NDHC) and the Nihi Dine’é Bá Wellness Center. FDIHB serves community members in the Fort Defiance Agency which has a population of 47,213. The goal of the Circles of Care Grant Program is to build a solid systems of care infrastructure in two communities in the Fort Defiance Service Area so that mental health services are readily available to youth and their families. FDIHB proposes to implement the following primary activities to meet program objectives for the Circles of Care Grant Program: • Formulate an interdisciplinary Task Force; • Conduct a Community Needs Assessment • Develop a coordinated system of care; • Place a School-Based Mental Health Specialists in the Navajo, New Mexico community; • Provide evidence-based training to staff, task force members, administrators, educators, and parents in the communities within the service area. Includes Botvin Life Skills Education, Applied Suicide Intervention Skills Training (ASIST), Youth Mental Health First Aid, and Question, Persuade, Refer (QPR); • Implement a Navajo Culturally-Sensitive Suicide and Substance Abuse Prevention Education Series to integrate into evidence-based training The Fort Defiance Agency encompasses a 3,000 square mile area and is divided into 27 chapter communities which are spread across four counties in two states. FDIHB provides services to community members living in 16 of the 27 chapter communities. There are approximately 25 schools in the Fort Defiance service area. They include seven Bureau of Indian Education (BIE) schools, one charter school, two private schools, and 14 public schools belonging to four school districts in Arizona and New Mexico. Based on school demographic profiles, the total population is approximately 5,619 students grades PreK to Grade 12. The geographic area is designated as a “Health Professional Shortage Area” by the Arizona Department of Health Services, signifying as having a shortage of dental, mental, and primary health care and also designated as an Arizona Medically Underserved Area (AzMUA). FDIHB proposes to serve approximately 1,000 unduplicated individuals (youth and adults) per year and over 3,000 over the entire project period through School-based Mental Health services, evidence-based training curriculums, prevention activities and outreach efforts. The vision is to gradually create a systems of care in the remaining 14 communities in the Fort Defiance service area.
Ohkay Owingeh Tribe’s "Baygi Seegi-i" (Circles of Care) project will plan, implement, improve, and sustain a holistic, evidence and community-based, coordinated system of care to support positive mental health for children, youth, and families. We will focus on reducing the gap between our community’s need for mental health services and the availability of such services for the target population. We will be focusing on providing tele-behavioral health services for 100 youth ages 1-18 in Ohkay Owingeh’s Indian Child Welfare and Social Services program in year 1 and expand and increase by 25 additional youth annually throughout the life of the grant. The program has a strong emphasis on cross-system collaboration, inclusion of family, youth and community resources, and cultural approaches. Through the proposed project Ohkay Owingeh Health and Human Services Division (OOHHSD) and a myriad of community partners will address the unmet mental health needs of our community. We will plan and develop infrastructure through our KeYa He Haa Teh Systems of Care Taskforce to create overall systems change and enhance local capacity building to improve mental health, substance abuse prevention and wellness services, and supports for children, youth, and families. Activity highlights include hiring of skilled staff, training of staff, education of community members, implementation of evidence-based program, Let’s Talk Counseling (LTC), a tele-behavioral health service for youth, and connecting with service providers to allow the Tribe to implement 3rd party billing.
South Dakota Urban Indian of Health (SDUIH) Society of Care (SOC) is focused on planning a holistic, comprehensive, coordinated behavioral health system of care for American Indians and Alaska Natives (AI/AN). The primary population focus for the Project is 600 (150 Year 1, 200 Year 2, 250 Year 3) AI/AN children and youth aged 0-25 and their families located in Sioux Falls and Pierre, South Dakota. Many health disparities are even more severe in AI communities in the Great Plains region who face multiple challenges in meeting healthcare needs of rural and underserved communities. Gaps in services and a shortage of qualified behavioral health providers continue to challenge and burden AI children, youth and families in accessing mental health and substance abuse services. Community Natural Helpers are untapped resources in our tribal communities who hold valuable lived experiences that demonstrate positive health behavior. Community Natural Helpers can support gaps in services yet require strategic training and support to develop culturally-based, community-based behavioral health knowledge and skill. Goal 1: To plan a process that will enhance and improve partner capabilities in providing trauma-focused, culturally competent coordinated services through a Society of Care framework. Objective 1. SDUIH will expand its current Community Cultural Advisory Committee (CCAC) to include youth and additional community members to provide guidance and feedback in developing the SDUIH Society of Care. Objective 2. SDUIH will plan and implement a three-year Comprehensive Community Strength and Needs Assessment in partnership with the CCAC, Tribal and community partners and other key stakeholders. Objective 3. SDUIH will hold quarterly Community Partner meetings to educate on topics that address client needs such as systems of care, trauma-informed care and cultural competency. Goal 2: To increase Community “Natural” Helpers knowledge and skills in areas of identifying and responding to psychological distress, mental health issues and substance use issues in the community through evidence-based and culturally tribal best practices. Objective 1. SDUIH will pilot the Positive Indian Parenting curriculum biannually. Objective 2. SDUIH will pilot the Family Spirit curriculum biannually. Objective 3. SDUIH will pilot quarterly trainings focused on improving community knowledge and skill to identify and respond to individuals who experience psychological distress, mental illness and substance use issues. Goal 3: To improve access to the SDUIH Cultural Healing Program Objective 1. SDUIH will develop a social marketing campaign to increase participation. Objective 2. SDUIH will work directly with the CCAC to plan specialized evaluation methods focused on culture and healing within Community Needs Assessment to identify barriers, challenges and strengths of the current Cultural Healing Program to improve access. Objective 3. SDUIH will expand his current transportation policy and procedure to encompass all proposed planning activities for the SOC.
The largest Urban Indian Clinic in the nation, Central Oklahoma American Indian Health Council, Inc, dba Oklahoma City Indian Clinic (OKCIC) proposes its first Circles of Care project in the 20+-year history of the grant. This project will allow OKCIC to develop infrastructure support in central Oklahoma to plan and design a holistic, evidence and community-based coordinated system of care to support mental health for children, youth and families. Nearly 100,000 American Indians (AIs) live in central Oklahoma and more than 20,000 use OKCIC as their medical home. As the trusted provider of healthcare across the lifespan, OKCIC is also considered the center of cultural life for central Oklahoma AIs. OKCIC will leverage its excellent reputation along with community partnerships to recruit and convene an advisory board (the Council) that represents all aspects of the community dealing with mental health issues of AIs children, youth and families. Representatives include, but are not limited to, OKCIC personnel, local tribal leaders, educators, mental health and public health experts, university researchers, the faith community and AI families impacted by mental health issues. OKCIC will work with community members to create a holistic, community-based, coordinated system of care model that will better serve the mental health needs of AI youth and families, increase the capacity of OKCIC programs, and improve workforce training. Based on the blueprint that is developed, OKCIC will launch a pilot program that addresses an identified community need and gathers data on its process and outcome measures. Therefore, the Circles of Care program will empower OKCIC to uphold its vision, “To be the national model for American Indian health care.”
Iowa Tribe of Oklahoma’s goal is to develop the infrastructure necessary to implement a comprehensive, culturally-based and coordinated behavioral health system of care for American Indian/Alaska Native (AI/AN) children, youth and their families living in Lincoln, Logan and Payne Counties in rural central Oklahoma. The Iowa Tribe of Oklahoma will build collaboration between families, youth, and partners who serve children and families to equip the local behavioral delivery system to support youth mental health and wellness. The purpose of this project is to bring the local American Indian community together to plan a system of services and care that will improve mental health and wellness outcomes for American Indian children and their families. The service community has high rates of poverty, suicide, substance use, physical and behavioral health disparities, and lasting impacts of historical trauma. This project has the following target numbers: Youth - 10 youth per year and 30 over the life of the grant; Parents/caregivers/family/elders/community - 40 per year and 100 over the life of the grant; Service partners - 20 per year and 20 over the life of the grant. The project goals are to: 1) Create a culturally relevant approach for gathering input into mental health and wellness services planning among AI/AN youth, with input from youth, families, caregivers, adults, tribal elders, traditional people, agencies, and behavioral health providers in Lincoln, Logan and Payne Counties; 2) Develop a community-based blueprint/system for how mental health and wellness services and supports for AI/AN children/youth will be provided in Lincoln, Logan, and Payne Counties; and 3) Build local knowledge of a system of care approach, best practices in family-driven and youth-guided care, and community-based participatory evaluation through trainings. The project objectives are to develop a community-based, culturally-appropriate, consensus-based process and basis for planning Native youth mental wellness services. This process will include the expansion of advisory capacity at all levels in the community. This will include the development of a process for engaging youth more deeply and effectively to promote ownership of the project and overall knowledge about mental wellness. The measurable deliverables and intended outcomes for this program are: the development of a Community Needs and Strengths Report; creating a community approved Blueprint for the provision of services that will promote and coordinate mental wellness services for AI/AN youth and families; creation of a plan for implementation and evaluation of pilot services to be provided more broadly under the Blueprint; development of Memoranda of Understanding with key partners in order to provide pilot services; and evaluation of those pilot services.
Goal 1: Increase the capacity of the local community to provide tools, services, and resources that promote the mental health of AI/AN children, youth, and families. Complete an assets-based assessment to measure the community’s capacity to deal with mental health issues affecting AI/AN children, youth, and families. The advisory board will host focus groups or listening sessions to engage the community around mental health promotion and stigma reduction. The advisory board will hold at least two meetings with stakeholders to address the mental health professional shortage and the community mental health center shortage in Pushmataha County. The advisory board will disseminate at least 300 surveys to measure the availability and effectiveness of mental health services. The SPTHB and community partners will sponsor at least two culturally relevant events for the community to reduce high-risk behaviors that may contribute to mental health issues. The advisory board will create and/or disseminate culturally relevant community and/or family education printed and digital materials to at least 500 AI/ANs pertaining to protective mental health factors. Goal 2: Increase access to mental health services for AI/AN children, youth, and families by enhancing cross-system collaboration across various sectors. The SPTHB will identify partners from at least five sectors of the community to participate in building the systems of care approach. The SPTHB will identify or create an advisory board and a process that will provide ongoing guidance and promote community ownership for the Circles of Care (COC) program. The SPTHB will disseminate at least 300 surveys to measure mental health and wellbeing. The SPTHB will host at least one orientation or training on the systems of care framework for advisory board members, program staff, and community partners. The advisory board will work with its members to implement a community-based system of care model for how mental health and wellbeing services and supports for the population will be provided through cross-system collaboration. The advisory board will participate in at least one network development event for providers and support providers. Goal 3: Decrease suicide among AI/AN students and their peers by implementing an evidence-based, peer-to-peer school-based program that provides knowledge, skills, and resources in suicide prevention. The SPTHB will identify 50 students and six staff at three schools in the local school district to take part in the Hope Squad program. Staff at three schools will be trained in QPR (Question Persuade Refer) and how to deliver the Hope Squad curriculum. The SPTHB, with the advisory board, will identify community partners from various sectors to provide a circle of care for AI/AN students and their peers at-risk for suicide and other mental health issues. The 50 Hope Squad members within the schools will participate in two school-wide, messaging campaigns to raise awareness around suicide prevention. At least two of the three schools participating in the Hope Squad program in the catchment area would have completed the Oklahoma Prevention Needs Assessment survey. Goal 4: Decrease substance use among AI/AN youth and families by implementing evidence-based programs that address substance abuse and associated behaviors. The SPTHB will disseminate at least 300 surveys to measure substance use. The SPTHB and community partners will sponsor at least two events for the community that promote skills which strengthen resilience, cultural identity, and serve as protective factors against substance abuse. The advisory board disseminate culturally relevant education materials to at least 500 AI/ANs regarding increasing protective factors and reducing high-risk behaviors that may contribute to substance abuse. The advisory board will sponsor one evidence-based commercial tobacco and e-cigarette cessation training for community providers.
The Behavioral Health Aide project is an initiative of the Confederated Tribes of Coos, Lower Umpqua, and Siuslaw Indians to increase and enhance access to behavioral health services to Tribal members and other AI/AN persons living in southwestern Oregon. The three interconnected elements of this project are 1) enhancing the use of trauma-informed and cultural based services; 2) developing a community-based integrated approach to behavioral health services with in the catchment area; and 3) expanding access to behavioral health services by recruiting, training, and deploying certified Behavioral Health Aides to this designated Medically Underserved Area. The goal of this project is to increase the capacity of the CTCLUSI in order to reduce high risk behaviors of Tribal children, youth, and families that may contribute to substance abuse, depression, and/or suicide. To address this goal the CTCLUSI will focus on three measurable objectives: Objective 1: Within 36 months of project launch, the CTCLUSI will formally collaborate with a minimum of 20 organizations and agencies in coordinating the delivery of cultural-based behavioral health services for Tribal members and other AI/AN persons. Objective 2: Within 36 months of project launch, the CTCLUSI will develop and deploy a minimum of 2 Behavioral Health Aides to serve Tribal and other AI/AN populations within the five-county service area. Objective 3: Within 36 months of project launch, the CTCLUSI will provide cultural-based and trauma-informed behavioral health services to a minimum of 150 Tribal families and other AI/AN individuals on an annual basis.
United Indian Health Services, Inc. (UIHS) is a 501(c)(3) non-profit health clinic servicing tribal people including the Yurok, Tolowa, Wiyot, Big Lagoon, Bear River, Blue Lake, Elk Valley, Resighini, and Table Bluff; which provides services to approximately 11,000 current active clients, of which 4,725 are youth under the age 25. The SAMHSA Circles of Care grant is necessary to assist us in the planning and design of a holistic community-based, coordinated system of care approach to support mental health and wellness for children, youth and families in order to address the startling statistics of our local American Indian/Alaska Native (AI/AN) population which include: the highest rates of suicide from 2012-2016; the largest number of youth in foster care due to neglect and child abuse, and an identified 6,326 clients with generalized anxiety disorder, PTSD, Depression, and/or Substance Use Disorder. UIHS will utilize the Circles of Care funding to serve as a catalyst in order to increase the capacity and effectiveness of mental health systems and reduce the gap between the need for and the availability of mental health, substance use, and co-occurring disorders in our local AI/AN communities (which covers a land mass nearly equivalent to the size of Connecticut). In order to achieve our goals UIHS’ He-wo-lo’ (We Survive) Project will focus primarily on a system of cross-collaboration, and development of a strong cultural component which will allow our Native population to build upon their strengths and a more effective use of our own traditional ecological knowledge. Program goals include increasing the capacity and effectiveness of UIHS services through the development of a resource map/blueprint in order to locate and identify resources more effectively; increase the capacity of service providers through training and proven culturally effective methodology; increase cultural knowledge, understanding, and sensitivity of UIHS service providers to provide more effective services through the development of a cultural training curriculum. Over 1,100 individuals will be served by this grant.
The Circles of Care Project will serve the San Carlos Apache Indian reservation and community. The San Carlos Apache Tribe has approximately 16,874 enrolled members, and has a 1.8-million-acre reservation located in Gila, Graham and Pinal counties in southern Arizona. The goal of the program is to highlight and advance the mental health resources in a culturally-specific manner that will draw from our ancestral knowledge to build resilience, prevent and increase care and service coordination for Apache youth. The Wellness Center, the Tribe’s behavioral health provider, seeks to do so through partnership, policy development, and linking evidence-based practices to ancestral knowledge and cultural activities. Through community engagement, coalition building, and planned prevention events the team will incorporate and ensure that youth prevention is built on evidence-based practices that will be culturally and developmentally appropriate as the community sees fit. The project will utilize a community-based approach to determine the readiness of the community to instill a trauma-informed systems of care approach. The project will provide direct prevention services to 50-60 tribal youth in year two through three. The project will also train community members over a period three years on topics related to trauma informed care, system of care approach, historical trauma, adverse childhood experience, resiliency, and indigenous well-being. The project further seeks to develop and implement six collaborative agreements, sustained youth prevention, and a tobacco free workplace policy.
"Learning to Thrive" (LtT) will focus on building a strategically effective blueprint that will allow for efficient planning to increase and develop the Round Valley Indian Health Centers (RVIHC) capacity and infrastructure to provide the necessary mental health services. Our Target population for the proposed program are those residing within the Tribal territory of the Round Valley Indian Tribes (RVIT) specifically those residing on the Round Valley Indian Reservation and adjacent town of Covelo, CA. Over the lifetime of the LtT we anticipate serving 500 Tribal community members. Annually we hope to serve an initial amount of 100 in 2020 and increase to 200 in subsequent years. The Round Valley Indian Tribes is a nation of seven confederated tribes established by Executive Order in 1873; homeland to the Wailaki, Nomalaki, Yuki, Pomo, Littlelake, Concow and Pit River Tribes. There are nearly 400 households on the reservation with a total population 1,500 men women and children. Our current Behavioral Health capacity is not sufficient to meet the needs of the community. Currently we have one full-time psychologist in a community that consists of 1,200 men, women and children. This is only accounting for the Native American community. Findings from our 2019 Tribal Community Health Assessment reported that the majority of respondents would like to have higher level mental health services offered. Building our capacity would include increasing our ability to provide these initial critical counseling services that would aid in preventing higher level crises. Implementing a wraparound team approach will keep all entities informed and build a community network of resources. The goals and strategic interventions will be organically developed to increase the capacity and effectiveness of our behavioral health professional and paraprofessional staff to promote a holistic community based coordinated system of care; plan and design a youth mental health service department under the current Health and Human Services Department of the Round Valley Indian Health Center; create a sustainable partnership with the Round Valley Indian Tribes Child and Family Services Department to support mental health and wellness for children, youth and families; work closely with the Tribal Coordinating Committee (TCC) to ensure that Learning to Thrive is actively engaging a wide range of community members of the Round Valley Indian Tribes.
The Pueblo of Nambé Mental health Initiative is a proposed project designed to 1) create a resilient community in Nambé O-Ween-Gé through prevention techniques and 2) reduce the impact of mental health issues, suicide, and substance abuse through comprehensive experiential intervention techniques and effective crises response. The project will fund application of outdoor behavioral health & experiential therapeutic approaches, clinical development, facilitation of community engagement techniques, and development of a robust network of resources. Nambé O-Ween-Gé, known as the Pueblo of Nambé, is a small American Indian tribe of less than 1,000 members and is located in northern New Mexico. Surrounded by native and non-native communities in a rural part of the state, Nambé residents, and youth specifically are at high risk for mental health challenges, substance use and abuse, and suicide. New Mexico is one of the states with the highest substance abuse and suicide rates in the nation and the impact to its American Indian communities is disproportionately high, requiring complex and comprehensive mitigation and prevention approaches. In addition, the youth are at great risk of suicide and substance abuse, requiring youth engagement in these approaches. If funded, this project will be managed by the Nambé Tewa Roots Society, a collective of clinical, behavioral health, and wellness program coordinators providing services in areas including domestic violence, substance abuse, suicide prevention, health and wellness, and child welfare. To meet the immanent needs of the community, if funded, the program strives to serve the entire community (500-1000 people for the duration of the project), those at high risk of suicide and substance abuse, surrounding Native American communities with lack of resources, and those who have shown signs of or already attempted suicide or are already abusing substances. The program is targeted specifically at youth and their families but extends to the entire community of Nambé. To meet these objectives, the programs goals include 1) Identify high-risk areas in Nambé every two years and target programming to meet the needs of those areas. 2) Increase by 10% each year the engagement of tribal members and their families in the well-being of the tribe and its individuals. 3) Increase services offered by Nambé to combat substance abuse and mental health challenges. 4) Establish a crisis response protocol to effectively respond to various crises, as well as build resilience though supporting the wellbeing of the community during times of crisis. These goals will be met through actions including outreach and promotion; establishment of a Native Youth Council; Development of evidence based clinical services; application of an experiential therapy approach; development of crisis response protocols; and development of a robust treatment network outside of what the program can offer.
The Oglala Sioux Tribe (OST), headquartered in Pine Ridge South Dakota in partnership with the OST Attorney General's Office, Courts, Child Protective Services (CPS), Department of Corrections, Tribal Educational Department, Housing (Prevention), Rapid City mental health providers, youth and family consumers, and many others, proposes to implement a Circle of Care initiative in Pine Ridge, South Dakota. While our reservation's population is constantly influx, the total OST enrollment is about 38,332, with 19,639 living on the reservation. In Oglala Lakota County, labeled the "poorest" county in the nation, the per capita income of our residents is $8,768. Fueled by poverty and addiction, the unemployment rate hovers around 80%. Addiction is endemic. In addition to opioid and meth problems, for years 11,000 cans of beer a day were poured into the Pine Ridge reservation (liquid genocide), causing untold damages. Up to two-thirds of adults live with alcoholism. While progress has been made since 1990 when one in four newborns was affected by prenatal alcohol exposure, Pineridge newborns are still at a disproportionately high risk for Fetal Alcohol Spectrum Disorders (FASD). The suicide rate for South Dakota young people, ages 13 to 30, is four times the average rate in the nation and in 2014, the Reservation declared a state of emergency after 14 youth killed themselves. These and other health disparities informed the selection of our population of focus: OST children, youth and young adults (Y/YAs) up to 25-years of age, and their families (300 or more in Yr. 3 pilot). Despite incremental improvements to both access and quality of health and behavioral health care for our OST members, the continued development of mental health and co-occurring (COD) infrastructure is essential in order to keep pace with growing demand. We must rely on the limited resources of our current systems which include the department of public safety, tribal courts, IHS, Anpetu Luta Otipi (a comprehensive alcohol and substance abuse prevention and treatment program for the OST), and other tribally operated social service agencies which continue to experience respective service challenges. In too many cases, mental health service access for children, youth and young adult (Y/YA) necessities up to a two-hour drive to Rapid City. While we have many strengths on which we continue to build, we have many challenges, gaps, and infrastructure needs: Behavioral health myths. An increasing volume of clients. Misunderstanding about treatment and treatment processes. Limited resources stretched over many sites and large geography. Workforce (esp. licensed) recruitment, retention, and mentoring challenges. Bureaucracy which threatens our agility and autonomy. Our overarching goal is: Develop our own capacity and infrastructure to plan, design, pilot, evaluate, and sustain an effective system of care (SOC) to improve the mental health/COD, and wellness of our Y/YAs up to age 25 and their families (300 in Year 3 pilot). Our process and outcome evaluation will involve data collection that will be utilized to manage, monitor and enhance this important initiative.
Circles of Care Milwaukee will have four overarching goals. Goal 1: Create a Community Advisory Board that guides Circles of Care Milwaukee through the planning, implementation, and evaluation phases of project activities, ensuring a culturally appropriate program and high community accountability. Objective 1: Identify local individuals and organizations with which GLIIHC will partner on an ongoing basis to provide oversight and culturally relevant input into the Circles of Care Program. Objective 1: Identify local individuals and organizations with which GLIIHC will partner on an ongoing basis to provide oversight and culturally relevant input into the Circles of Care Program. Goal 2: Identify needs, gaps in local care systems for AI/AN children, youth and families. Address these needs through increased cross-training, interagency collaboration and referrals, and family-centered educational events. Objective 1: Engage in ongoing meetings with individuals and organizations to gauge the level of readiness to address existing and anticipated mental health and substance abuse prevention needs in AI/AN children, youth and families. Goal 3: Using lessons learned from needs/gaps analysis and community input, create a model that addresses a broad range of mental health and substance abuse/misuse prevention and treatment for AI/AN children, youth and families. Objective 1: Increase screening, referral, and treatment referrals and build capacity to accommodate increased numbers of patients across the life span. Goal 4: Pilot the care model at the Indian Community School during the 2021-2022 school year, analyze and improve the model in the interim summer months, and re-implement the program during the 2022-2023 school year. Objective 1: Pilot a care model focused on the primary and secondary prevention of mental health and substance abuse/misuse in the AI/AN community, with a special focus on youth at the Indian Community School. Over three years, 5,340 people will be served.
The Shingle Springs Band of Miwok Indians, a Federally Recognized American Indian Tribe located in El Dorado County, California, is requesting a three year grant to plan and design a holistic, community based, coordinated system of care to support mental health wellness for children, youth and families in the Tribe's catchment area.
Native American Community Clinic (NACC) in Minneapolis MN proposes a 3-year community-based participatory research (CBPR) project entitled, “Building infrastructure and workforce development for American Indian youth and community.” Resulting in a comprehensive and culturally responsive mental health system of care for urban-dwelling American Indian and Alaska Native (AI/AN) children and their families. Services will focus on crisis response and school-based care to support family preservation. AI/ANs children are 17.6 times more likely to experience out-of-home care than their white counterparts were. Children under age 2, the most vulnerable, and youth between 15 and 17 years of age were more likely to experience out-of-home care. Likewise, AI/ANs youth between ages 15-18 experience the highest rates of suicide. A substantial portion of children entering the child protective system (23.4 percent) and those continuing (39.8 percent) have a documented disability. This will be accomplished through three goals 1) Increase access to culturally informed community-based crisis response and system of care model for children and youth, and their families, experiencing unmet mental health crisis needs; 2) Increase the communities’ capacity to respond to the needs of urban Native American children and youth in crisis and with high-risk behavior, by training service providers and informal support providers; and 3) Develop a framework and tool for crisis intervention and determining need for mandated reporting, based on the Native American communities’ needs and cultural norms. The CBPR approach will support the capacity building within the community, and workforce development. Targets by year and total: Y1=60; Y2=85; and Y3=110 for a total of 255 unduplicated participants. Together these three goals will enhance the quality and improve access to culturally responsive care provided to AI/AN children and youth, and also reduce the impact of historical trauma and ongoing systematic oppression and structural racism through training and resources.
Wichita and Affiliated Tribes Circles of Care Initiative The Wichita and Affiliated Tribes, a sovereign Native nation, proposes to convene an inter tribal planning group, the Tribal Wellness Work group (TWW), to complete a Blueprint to address unmet need for Native children’s mental health services in Caddo county Oklahoma. The county is a mental health shortage area and has no psychologist, psychiatrists, or mental health facilities for Native youth. This will be an intensive three year culturally appropriate planning effort. A large sample of over 6,000 Native youth surveyed in the 2018 Oklahoma Prevention Needs Assessment (OPNA) survey in the Caddo County region, found that in grades 6, 8, 10, and 12 American Indian children reported substantially higher levels of anxiety, depression and early initiation of substance use than Non Native students. In addition, the Oklahoma Department of Mental Health and Substance Abuse Services has determined that both youth and adults in Caddo county are in the top 20% of Oklahoma counties needing mental health treatment. Native poverty in the county is more than double the rate for White Non-Hispanic citizens, alcohol and drug related crime by Native youth and adults is higher than for Non-Natives and there are no mental health professionals to serve this large group of children. The challenges are many and include 1) assessing the actual needs of Native children in the county, 2) finding funding streams to provide services, 3) integrating mental health screening with primary care, and 4) providing culturally appropriate services that will resonate with Native youth and their families. Children’s mental health is a family and a community issue. Many Native children live in homes where one or more adults have substance abuse or mental health disorders. Circles Of Care provides the space and resources needed for Native people to plan and design a holistic, Native friendly, evidence and community based system to support mental health in Caddo county for our families and our youth. Circles of Care is designed to increase the capacity of mental health systems in Native communities which are currently fragmented into separate Tribal programs. Through an intensive three-year process, the Tribal Wellness Work group (TWW) will identify and implement strategies to reduce the gap between the need for mental health services and the availability of children’s mental health services. The TWW will use Inter agency Agreements, parent and community training, strategic planning of a service delivery structure, and inter tribal cooperation to 1) develop a mental health delivery system designed by Tribal members, 2) to train Tribes to strengthen their ability to evaluate their own services, and 3) to develop a Native body of knowledge that assists all child serving groups in the County. Each year we will serve between 100 and 150 Native community members through training and participation in the Gathering Of Native Americans program for youth and adults. Over the life of the program between 300 and 450 American Indian youth and adult persons will be served.
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