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“Now is the Time” Healthy Transitions (HT): Improving Life Trajectories for Youth and Young Adults with, or at Risk for, Serious Mental Health Conditions

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Short Title: NITT-Healthy Transitions (NITT-HT)
Initial Announcement Back to the Grants Dashboard

Notice of Funding Opportunity (NOFO)

NOFO Number: SM-14-017

Posted on Friday, April 11, 2014

Application Due Date: Friday, June 13, 2014

Catalog of Federal Domestic Assistance (CFDA) Number: 93.243

Intergovernmental Review (E.O. 12372):

Public Health System Impact Statement (PHSIS) / Single State Agency Coordination:


In support of the President’s “Now is the Time” (NITT) Plan, the Substance Abuse and Mental Health Services Administration (SAMHSA) is announcing a new grant program, “Now is the Time” Healthy Transitions: Improving Life Trajectories for Youth and Young Adults with, or at Risk for, Serious Mental Health Conditions (Short Title, NITT-Healthy Transitions (NITT-HT). The purpose of this program is to improve access to treatment and support services for youth and young adults ages 16 – 25 that either have, or are at risk of developing a serious mental health condition. Individuals who are 16 – 25 years old are at high risk of developing a mental illness or substance use disorder, and are at high risk for suicide. Unfortunately, these youth are among the least likely to seek help and, as a result, they may “fall through the cracks” and not receive the help they need to assume safe and productive adult roles and responsibilities.

Youth and young adults with serious mental health conditions or co-occurring mental and substance use disorders face an even more difficult transition to adulthood than their peers. As a result, it is important to identify these young people, develop appropriate outreach and engagement processes and create access to effective clinical and supportive interventions. Outreach and engagement is essential to these youth and young adults, 16 – 25, and their families, as many of them are disconnected from social and other community supports. These youth may not be working, in school, or in vocational or higher education programs. Some face the additional challenge of being homeless, or having contact with the juvenile or criminal justice system, increasing the likelihood of admissions to hospitals, mental health facilities and correctional facilities.& Once identified and engaged, it becomes essential to improve emotional and behavioral functioning so that youth and young adults can progress into adult roles and responsibilities and lead full and productive lives.

As part of the President’s overall NITT initiative, SAMHSA will create a continuum of outreach, engagement, awareness, prevention and intervention strategies. This continuum includes Project AWARE at the front end, which will focus on prevention and promotion with school age youth in educational settings, and Healthy Transitions (HT), which will extend this focus by creating treatment services and intervention approaches for disconnected youth and young adults that are transitioning to adulthood.

The overall goal of HT will be to provide services and supports to address serious mental health conditions, co-occurring disorders, and risk for developing serious mental health conditions among youth 16 – 25 years old. This will be accomplished by increasing awareness, screening and detection, outreach and engagement, referrals to treatment, coordination of care and evidence-informed treatment for this age group. Healthy Transitions will: increase awareness about early indications of signs and symptoms for serious mental health concerns; identify action strategies to use when a serious mental health concern is detected; provide training to provider and community groups to improve services and supports specific to this age group; enhance peer and family supports, and develop effective services and interventions for youth, young adults and their families as these young people transition to adult roles and responsibilities. When needed, these services are to be continuous so that young people and their families experience a seamless transition across age groups.

The Healthy Transitions program envisions three populations of focus: 16 – 25 year olds at risk of developing a serious mental health condition who may otherwise be unidentified; 16 – 25 year olds who have already been identified as experiencing a serious mental health condition; and the community-at-large (i.e., general public). For youth at risk, Healthy Transitions will focus on outreach and engagement strategies, including the use of peer-to-peer and family supports, social media, and coordination across care delivery systems, including vocational training and higher education. These strategies will connect young people to resources to help them maintain their health and develop skills to lead full, productive lives. Outreach and engagement will also create opportunities for early detection and intervention for those who begin to exhibit more serious problems over time. And, for youth with existing mental health conditions, including those experiencing early signs of serious mental illness, Healthy Transitions will improve access to relevant child- or adult-serving systems and implement effective evidence-based services and supports to improve outcomes and life trajectories. For the general public, this initiative will raise awareness about the early indications of serious mental health and substance use conditions among youth and young adults and identify action strategies to use when a serious mental health concern is identified for youth and young adults.

The critical point of focus is to increase outreach efforts to identify youth and young adults who either have untreated mental health conditions or are at risk of developing such conditions; with a goal of keeping young people from “falling through the cracks,” especially after they leave high school. This will be expected to occur at the state/tribal/territorial level and at the local level. These outreach efforts will involve raising awareness through social media and other existing natural networks, (e.g. YMCA’s, health fairs, primary care centers, faith organizations and teen centers) that can effectively target youth, family, and community members about the early warning signs of mental illness and action steps to identify needed resources, expanding access to care. It is anticipated that youth and family organizations will also have a significant role in promoting engagement and peer support strategies.

The NITT-HT seeks to address behavioral health disparities among racial and ethnic minorities by encouraging the implementation of strategies to decrease the differences in access, service use, and outcomes among these subpopulations of youth in this program. (See Appendix I of the RFA: Addressing Behavioral Health Disparities).

To accomplish program goals, NITT-HT will promote:

  1. Creation, implementation and expansion of services and supports that are culturally competent and youth-guided, involve and include family and community members (including business leaders and faith-based organizations), and provide for continuity of care between child- and adult-serving systems to ensure seamless transition.
  2. Infrastructure and organization change at a state/tribal/territorial level to improve cross-system collaboration, service capacity and expertise related to youth and young adults with or at-risk of, serious mental health and substance use disorders as they transition into adult roles and responsibilities.
  3. Public awareness, cross-system provider training, e.g. higher education/community colleges, behavioral health, law enforcement, primary care, vocational services and child welfare.

NITT-HT is one of SAMHSA’s services grant programs. SAMHSA intends that its services grants result in the delivery of services as soon as possible after award. Service delivery should begin by the 6th month of the project at the latest.

NITT-HT grants are authorized under Section 520A of the Public Health Service Act, as amended. This announcement addresses Healthy People 2020 Mental Health and Mental Disorders Topic Area HP 2020-MHMD and/or Substance Abuse topic Area HP 2020-SA.


Eligible applicants are:

State governments, Indian or tribal organizations (as defined in Section 4[b] and Section 4[c] of the Indian Self-Determination Act); District of Columbia government and the Commonwealth of Puerto Rico, Northern Mariana Islands, Virgin Islands, Guam, American Samoa and Trust Territory of the Pacific Islands (now Palau, Micronesia and the Marshall Islands). 

Tribal organization means the recognized body of any AI/AN tribe; any legally established organization of American Indians/Alaska Natives which is controlled, sanctioned, or chartered by such governing body or which is democratically elected by the adult members of the Indian community to be served by such organization and which includes the maximum participation of American Indians/Alaska Natives in all phases of its activities.  Consortia of tribes or tribal organizations are eligible to apply, but each participating entity must indicate its approval.

Eligibility is limited to states/tribes/territories because the goal is to have services and supports linked and integrated at the state/tribal/territory level in order to effect broad policy change and replication. 

Award Information

Funding Mechanism: Cooperative Agreement

Anticipated Total Available Funding: $15,840,000

Anticipated Number of Awards: 16

Anticipated Award Amount: Up to $1,000,000 per year

Length of Project: Up to 5 years

Cost Sharing/Match Required?: No

Proposed budgets cannot exceed $1,000,000 in total costs (direct and indirect) in any year of the proposed project. Annual continuation awards will depend on the availability of funds, grantee progress in meeting project goals and objectives, timely submission of required data and reports, and compliance with all terms and conditions of award.

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