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AWARE Arkansas will (a) enhance awareness of mental health issues in youth, (b) provide training for stakeholders to identify mental health issues and provide services to youth, (c) promote the healthy development of youth, and (d) reduce violence. Three educational communities from disparate parts of the state are part of the initiative to improve the mental health of 7,000 students, roughly 10% of whom are experiencing mental health difficulties. AWARE Arkansas will work with school districts in the northern hills, the Mississippi Delta, and the Texas border of Arkansas to improve the mental health of students in 5 school districts (3 forming a consortium) by providing awareness, identification, and prevention of mental health issues to all students, and providing evidence-based mental health services for those students in need. Key elements of the project are increased screenings and expanded services within and outside of schools to address immediate needs while implementing Positive Behavioral Interventions and Supports to provide long-term prevention to reduce mental health issues and violence, as well as enhancing engagement with and the involvement of families and communities. The goals of AWARE Arkansas are as follows: Goal 1: To increase coordinated referrals, mental health services and programs, and follow-up for children by (a) increasing access to mental health services and (b) increasing screenings and early intervention. Goal 2: Increase outreach and engagement among youth, families, schools, and communities to increase awareness and implementation of mental health identification, services, and programs by conducting outreach to and engagement of youth and families, connecting families and communities to support youth mental health, and increasing links across community resources for youth and their families. Goal 3: Develop the infrastructure that will sustain mental health among youth and maintain mental and behavioral health services when federal funding ends by fostering skills in youth and schools that promote resilience, pro-social behaviors, and reduce youth violence; promoting early intervention; developing ongoing and sustainable tiered processes and programs to screen for and address mental and behavioral disorders; ensuring that a critical mass of family and community members are aware of and trained in mental health issues; and increasing coordination and integration of local and state efforts to support mental health programs.

Our project will increase and improve access to culturally competent and developmentally appropriate mental health services, for children and youth with emotional disturbance or mental illness, caregivers and school staff in three communities. The Puerto Rico Department of Education has established a Consortium Agreement with Mental Health and Anti-Addiction Services Administration (MHAASA) and Albizu University (CAU)- Instituto Tercera Misión (IM3) to implement Project AWARE in our jurisdiction.

Nebraska’s AWARE Project addresses the high level of mental and behavioral health needs of school-aged children in rural schools, including depression, anxiety, suicide ideation, trauma, and substance use. Educators statewide feel unprepared to handle the severity of mental health issues arising daily in schools. Training for school staff to better address students’ mental and behavioral health needs has been identified as a critical priority. In response, the Nebraska Department of Education (NDE) and Nebraska Department of Health and Human Services – Division of Behavioral Health (DHHS-DBH) are partnering at the State level to collaborate with the three Local Education Agencies (LEA) to improve school-based mental health services. The LEAs of Chadron, Hastings, and South Sioux City are demographically and geographically diverse, with varying levels of poverty and scarcity of mental health resources. Two sites have higher free/reduced lunch, indicative of poverty and student mobility. Each differs in racial/ethnic composition, with higher proportions of Hispanic and Native American students. All three LEAs have strong, long-standing track records of successful collaborations with State and local partners, including mental health providers, community coalitions, civic organizations, the business and private sector, and stakeholders, including students and families. State-level project staff include the NDE and DHHS-DBH Project Coordinators. Each LEA will employ or contract for a Community Project Manager and mental health treatment provider. Both NDE and DHHS-DBH are actively involved in several similar statewide efforts, such as Nebraska’s System of Care (NeSOC), Governor’s School Safety Task Force, Legislature’s Children Commission, and Nebraska Supreme Court Commission on Children in the Courts - all of which have aligned their resources to maximize sustainability through policy change. The project’s goals include: 1) prevention of mental health and behavioral disorders among students by providing positive, supportive, and trauma-informed learning environments; 2) increasing student resilience and pro-social behaviors; 3) increasing availability of school-based mental health services; 4) increasing schools’ capacity to identify and immediately respond to the mental health needs of students exhibiting behavioral or psychological signs requiring clinical intervention; and 5) increasing schools’ capacity to identify and intervene in bullying and aggressive or violence behaviors of students which may contribute to school violence. Through the implementation of evidence-based, trauma-informed practices in mental health screening, assessment, interventions, and treatment, up to 8,506 students will be served through the project each year, with up to 11,123 served in the schools across five years. Selected practices to enhance school climate, student resilience and pro-social behaviors, such as Positive Behavioral Interventions and Supports (PBIS), Lion’s Quest, Calmer Classrooms, and Well-Managed Schools will be employed in each of the three districts, accompanied by Functional Behavioral Assessment, and Cognitive Behavioral Intervention for Trauma in Schools (CBITS).

The District of Columbia's Project AWARE Program will leverage and build upon the District's Comprehensive School Mental Health Plan to build an integrated service-delivery reaching at least 11,000 youth, implement comprehensive training opportunities reaching at least 1500 educators and administrators, and engage the voices of youth and families in evidence-based, culturally-responsive, and developmentally-appropriate mental health infrastructure design and implementation. Key outcomes will include increased rates of screening and referral of students with concern for mental health need; development of integrated networks of school- and community-based mental health providers; increase in knowledge of mental health among students, families, and educators; and the implementation of state- and local-level policies, procedures, and systems.

Through South Dakota Project AWARE, the South Dakota Department of Education (DOE) in partnership with the South Dakota Department of Social Services, Division of Behavioral Health (DSS-DBH), community mental health centers (CMHCs), educational cooperatives and LEA-based mental health professionals aim to build a trauma-informed interconnected systems framework in support of children and their mental health across the state. There are significant gaps between needs of students in South Dakota and providers within school settings, requiring a systematic prevention and response effort to best address this critical need. South Dakota is one of the top three states in youth suicide deaths in the country, an issue that can be positively impacted by enhanced access to integrated mental health supports within communities, particularly where kids are most – at school. Targeted efforts will support and evaluate shared services through several interconnected system models: (1) LEA ? CMHC, and (2) LEA ? Educational Cooperative ? CMHC. These models will implement a multi-tiered systems of support approach: universal prevention programming for students, families/caregivers, and community members; universal screening to assess student risk for social-emotional and behavioral problems; followed by tiered strategies that allow for integrated supports within schools and enhanced, coordinated partnerships between schools and community mental health centers using a Systems of Care approach. Beginning with four identified partner LEAs in Year 1, the project will expand throughout the five-year award period to include additional partner LEAs (school districts and regionally-based educational cooperatives) across three cohorts, creating systemic and sustainable impact beyond the initial three required LEA partners. Partner LEAs committing to Cohort I of the project total more than 3,100 students as of Fall 2017 enrollment figures: in aggregate, 64% are economically disadvantaged, 57% are white/Caucasian, 19% are American Indian/Alaskan Native, and 8% are Hispanic/Latino. Six total partner LEAs and a projected 21 schools will be supported by the end of the grant period, impacting nearly 70,000 educators, community members, and students (predominantly middle schools but in same cases K-12) throughout the grant period (3,515 individuals in each of Years 1, 3 and 5; 28,150 individuals in each of Years 2 and 4).

The Lummi Advancing Wellness and Resiliency in Education project is designed to decrease mental health issues and increase wellness and resiliency for Lummi and other-tribal school-age youth. The project will help increase awareness of mental health issues faced by youth, provide education to adults interacting with youth to better detect and respond to mental health issues, and connect school-age youth to mental health services. The population of focus includes Lummi school-age youth and non-Lummi other-tribal youth attending the three LEAs: Lummi Nation School (LNS), Ferndale School District (FSD), and Bellingham School District (BSD). The goals of the project are 1) connect youth, families, schools, and community to increase engagement and involvement in the promotion of wellness of school-age youth and their families; 2) conduct outreach and engagement with school staff, caregivers, and community to increase awareness and identification of mental health issues and promote wellness; 3) increase the capacity of the three LEAs to identify school-age youth with potential mental health needs through standardized and culturally appropriate screening measures; 4) develop a school-based mental health referral process; 5) provide access to traditional and spiritual healing practices for school-age youth and their families to promote wellness and resiliency; and 6) increase capacity to provide immediate school-based and community-based mental health services to school-age youth and their families. Four community based steering committees (youth, caregiver, school staff, and elders) will be formed, and will provide guidance for every aspect of the project. The project proposes to utilize several empirically based practices to achieve these goals including Youth Mental Health First Aid, Family-based Prevention and Mentoring, Canoe Journey, and Multisystemic Therapy (MST). Additionally, steering committees will identify, and project staff will administer, school-based mental health wellness education and training programs that meet the needs of the community. Lummi Behavioral Health (BH) will partner with and coordinate services between the three LEAs. Services will include continued outpatient mental health services provided by Lummi BH clinicians, on-site staff to provide immediate services, community mentors, case management, cultural and spiritual healing practices, youth prevention activities, and intensive wrap-around family therapy. It is anticipated that at least 10% (100 per year, 500 total) of the project population school-age youth will complete mental health screening measures each year of the grant, and youth requiring additional project services including mental health intervention will be immediately referred. It is anticipated that, during the entire course of the project, at least 100 (10 first year, approx. 22 years 2-5) youth will receive community mentorship, 100 (10 first year, approx. 22 years 2-5) youth and families will receive case management services, and 40 (10 per year, years 2-5) youth will receive intensive wrap-around family therapy (MST). Program progress will be continually monitored and modified as needed to improve services to youth and families.

Utah's mental health needs, suicide data, youth violence, and substance abuse data indicate a high need for a culture shift toward mental health literacy, self-help and coping, help-seeking, professional treatment, and crisis intervention. Utah State Board of Education (USBE) Project AWARE SEA will provide a comprehensive approach to mental health awareness and intervention in coordination with Utah's Division of Substance Abuse and Mental Health. Three Local Education Agencies (LEA)s, who have current mental health partnerships, have been selected to participate in this grant according to their demographics, safe schools incidents, and mental health needs. This grant will provide a tiered model of programming to address all levels of mental health: (Tier 1) universally to all stakeholders through curricula and trainings; (Tier 2)small group and individual interventions to selected students identified through Local Case Management Teams; (Tier3) treatment and clinical services to youth and families with acute needs. Data collection and program evaluation will be managed by Project Grant Managers in conjunction with University of Utah to ensure ongoing program effectiveness. USBE Project AWARE will provide the funds to hire mental health professionals: Family Resource Facilitators in each district to connect families with the appropriate mental health agency when needed and full time mental health counselors for each district to aid schools in crisis intervention and clinical services. Project AWARE will be critical in creating school cultures and communities that are dedicated to increasing mental wellness, early identification, and continued treatment and interventions to all students in a culturally inclusive environment that is conducive to optimal mental, emotional, and behavioral wellness.

The Pine Ridge Indian Reservation has experienced its disproportionate share of trauma. An author for The New York Times once described this land, home to the Oglala Lakota Nation, as little more than “a catalog of social ills: Unemployment exceeds 80 percent, poverty affects more than 90 percent of those living on the reservation and alcoholism is rampant. By some estimates, one quarter of children born on the reservation have fetal alcohol syndrome.” The students in our schools suffer from this trauma; it frequently takes precedence over academic learning. A representative sample of students who took the Adverse Childhood Experiences questionnaire found terrifying results—all who took the test identified at least one childhood trauma, and more than half identified with more than four (of twelve total). A high score such as this does not bode well; it correlates to increased drug use and alcoholism, a higher chance of perpetrating an abusive relationship, and ultimately leads to an early death. Project AWARE will change this narrative. As a partnership between three schools on the reservation (Little Wound, Crazy Horse, and American Horse) and the Oglala Sioux Tribe Telehealth program, we will expand our abilities to provide needed mental, behavioral, and cultural health support to students, but also do so in a broader framework: the Trauma Informed School Model. This project will train school staff, students, and community members to understand trauma, identify its consequences, and respond properly to demonstrations of trauma-induced mental/behavioral health issues. Indian Health Services has two full time behavioral/mental health counselors for the entire eastern half of our reservation. While our schools try to compensate, adequate response is impossible without expanded funding—this grant provides the funding. This project will include a Project Coordinator, Project Co-Coordinator, and a Community Project Manager for each site. Additionally, each school will hire (a) a Trauma-Informed School Implementation Specialist, (b) a teca kin Lakolyakel wiyokihi wicaye (to provide cultural mentorship), and (c) two to three wayawa kin slolic’iya wicaye (depending on school size) to give one-to-one support for students in crisis and provide follow-up. The Trauma-Informed School will serve as our primary implementation text, providing a proven framework for schools to follow. Incorporating cultural elements is appropriate for this model and leads to improved student outcomes. Our schools and students are consistently, negatively impacted by outsized trauma in our communities—Project AWARE changes our schools’ response to this reality. Implementation of the proven model will demonstrably change student outcomes and provide needed supports for students experiencing trauma in their lives.

The New York State (NYS) Department of Education (NYSED) in collaboration with the NYS Office of Mental Health (OMH) will create and implement Project AWARE in the Rensselaer City School District, Buffalo City School District (Burgard High School), and the New York City Department of Education (Brooklyn Academy of Global Finance, Whitelaw Reid Middle School [MS 57] and Brooklyn Emerging Leaders Academy). The identified local education agencies (LEA’s) have several common service gaps: a) Each falls short in its ability to identify, screen and refer students who would benefit from appropriate mental health (MH) services. This often results in students in psychiatric emergency rooms or leaving school. According to the Department of Health, NYS loses an average of 80 students to suicide each year. There are nearly 5,000 emergency room visits each year in New York for suicide attempts among school age youth. b) Evidence-based trainings pertaining to student MH issues are rarely, if ever, provided to school staff which hinders their ability to identify students in need of evaluation and sustain a positive school climate; c) Schools have inadequate capacity to educate families about MH issues, provide outreach, or to obtain buy-in once a child is referred. c) Once students are referred, schools lack the capacity to, if appropriate, follow-up to see if they are adherent to treatment; and d) schools lack adequate infrastructure to collect student mental health data to measure the number of students being identified, referred for treatment and, where appropriate, treatment progress. During the grant period, approximately 1,805 unduplicated individuals (361 annually) will be served, including 1,445 students (289 annually), newly enrolled students, 289 family members (58 annually), and 144 school staff (29 annually). Through the creation of safe and respectful environments for learning and promoting mental health for students, this grant will support LEAs in achieving the goals of the project: 1) implementing evidence-based trainings for and school staff so they may increase recognition of MH issues among students and improve their ability to respond appropriately; 2) increasing onsite identification, screening and referral to culturally competent and developmentally appropriate school-based and community-based MH services for students and their families; 3) increasing outreach and engagement of students and their families through involvement in school-based and community-based MH education program planning; and 4) developing a sustainable infrastructure for MH services by building on existing resources, such as county systems of care and the community schools model, and identifying new resources. Students will be children in middle and high school, and eligible for the free and reduced price lunch program (69% to 100%). Many students projected to be served are students of color, particularly Black/African American and many students participating in the program will have behavioral issues consistent with Serious Emotional Disturbance and/or Serious Mental Illness.

Maine-AWARE implements a multi-tiered system of interventions that integrates school positive behavior supports, social emotional learning, and mental health literacy and intervention strategies in order to maximize school/community capacity to identify and serve school aged children with mental health needs. The three LEAs selected to pilot and build a statewide comprehensive approach to school mental health are representative of the challenges by Maine's typically small, rural school districts - notably reliance on community mental health partners who do not have the ability to participate in broader school prevention/intervention activities and shortages of qualified mental health professionals. Maine-AWARE supports the co-training of community and school based clinicians and nonclinical staff in compatible evidence based practices, supports multiple opportunities for collaborative problem solving, and addresses policy/funding stream issues create barriers to interagency collaboration and funding flexibility. The project culminates in the development of a statewide comprehensive school mental health framework that can be sustainably implemented and supported within the local control environment that characterizes Maine education.

Oklahoma AWARE Abstract: The Oklahoma State Department of Education in collaboration with the Oklahoma State Department of Mental Health and Substance Abuse Services is applying for an Oklahoma AWARE project to serve 7,215 students enrolled in 17 school sites, in three western Oklahoma rural school districts - Elk City, Weatherford, and Woodward. The program will focus on promoting mental wellness and combating stigma, building awareness of indicators of mental health concerns, and early intervention with coordinated supports. The targeted LEAs have higher than average students suffering from mental health conditions, and an extremely low access to mental health professional and providers (5 of 108 providers statewide). Oklahoma will collaborate with Oklahoma State University, Project ECHO, the Center for Family Resilience, and Southwestern Oklahoma State University to provide a multi-tiered system of support covering prevention, intervention, and treatment services to the students enrolled in K-grade 12 within the LEAs. The 2016 average of all three LEAs’ adults and children with mental health issues indicates a serious mental illness (SMI) rate of 8.85% which is higher than the state average of 8.23% and a students with severe emotional disturbance (SED) rate of 8.95% which is higher than the state average of 8.52%. The western focus for this grant has 10% of its children under the age of 18 without health insurance and a childhood suicide rate triple the state average (OSDH 2017). In the political and cultural conservatism of the area frequently known as the Bible belt, mental illness and cultural differences are often stigmatized and not supported or understood by adults, educators, or community members. Goals for the project include developing community and family mental health awareness and outreach campaign incorporating activities designed to engage youth and families to increase knowledge of mental health issues and awareness of school and community based resources designed to support improved mental health in the community, refine school discipline policies to reduce loss of instructional time and school removals, and maximize student’s social, emotional and behavioral self-management skills. Objectives for the project include an increase in student, parent and community awareness of mental health issues, an increase in policy changes, an increase in the mental health workforce in the target area, an increase in program partnerships, a decrease in student discipline rates, an increase in the number of students who complete a universal screener, and the number of students who demonstrate a positive response in intervention services.

North Carolina's (NC) Project ACTIVATE (Advancing Coordinated and Timely InterVentions, Awareness, Training, and Education) will implement evidence-based mental health supports and services through a full school-and-community continuum, emphasizing universal prevention/awareness/school climate, early intervention, referral/treatment/reentry, and comprehensive professional learning for school staff. Consequently, the grant activities in three LEAs will create transformation zones to scale mental health services throughout the state. The timing of the SAMHSA Project AWARE grant could not be more ripe and congruent with NC's school mental health improvement efforts, which began with the NC School Mental Health Initiative (NCSMHI) in June 2015. Since then, the state-level, collective impact partnership- led by the NC Dept of Public Instruction and DHHS Div. of Mental Health- has spearheaded an NC State Board of Education School Mental Health policy and pending legislation. Thus, NC Local Education Agencies (LEAs) are currently engaged in exploration and installation of school mental health programs/practices within a Multi-Tiered System of Support (MTSS) framework, building a firm foundation for grant activities. As LEAs progress toward initial and full implementation, the need for focused support in select transformation zones is both critical and logical. Project AWARE funding will provide the exact, needed-now, local resources, infrastructure, and evaluation elements for building scalable and sustainable practices. The three selected LEAs (Beaufort, Cleveland, and Rockingham Counties) typify total school populations in about 40% of NC's 115 LEAs. Their combined 68 schools will serve 34,008 students throughout the five year project. The racial, ethnic, and socio-economic status of students across these LEAs also reflects the plurality of NC's LEAs. Suicide prevalence in all three ranks in the highest third among NC counties, while juvenile delinquency and violent crime rates are particularly prevalent in two of the three sites. All three LEAs have a history of partnership with local providers and the SEA, and serve as pilot sites for NC's exploration of the SHAPE system. Each LEA has prepared an initial implementation plan for improving local mental health supports/services which together encompass the following project goals for improvement: global mental health awareness; curriculum-based pro-social prevention activities; coordinated staff training to detect student mental health risk factors; evidence-based counseling practices; effective and timely supports for students in crisis, monitoring of intensive services to include more outcome variables (e.g., progress on goals, increased attendance, positive impact on grades, reduction of disciplinary referrals); and access to/coordination with community services. These areas will form the core of NC's project ACTIVATE initiatives. In addition to direct services for students, infrastructure development and evaluation activities-particularly local workforce training to improve school climate, mental health awareness, prevention, and early intervention- will inform scaling and sustaining effective practices across all NC LEAs.

The Connecticut AWARE-SEA plan will improve the delivery of mental health services through dissemination of evidence-based interventions; increased staff/adult knowledge of mental health risk factors and indicators of need; increased social-emotional competencies of students through delivery of school climate and social emotional programming; strengthened school-family-community connections relating to student wellbeing; and data collection and analysis to drive decision making and prioritization of resources. CT AWARE-SEA will identify unique strengths and vulnerabilities inherent in the individual communities being served and adapt training and accountability systems contributing to comprehensive supports for students experiencing mental health related needs to best suit each district’s population needs. The Connecticut State Department of Education (CSDE) has selected three districts based upon the following specific criteria, each district: is among of the 30 lowest performing districts in the state; maintains a positive relationship with their local youth service bureau; has above median Title I students for the state, has a student population between 3,000 and 5,000; and has had prior supportive interventions through the Safe Schools/Healthy Students (SS/HS) project, the CT School-based Diversion Initiative (SBDI) or the School Climate Transformation Grant (SCTG). The selected districts for participation in this initiative are: Middletown with a student population of 4,588 and 792 school-based staff; Naugatuck with a student population of 4,244 and 565 school-based staff; and Windham with a student population of 3,349 and 640 staff. In partnership with the Department of Children and Families (DCF), the children’s mental health provider for the state of Connecticut, the CT AWARE-SEA has prioritized the development of school-based structures addressing trauma, substance use disorders and establishes proactive and preventive school climate efforts.

Through a state partnership between the Alabama State Department of Education (ALSDE) and the Alabama Department of Mental Health (ADMH) along with other agencies, we will support Conecuh County Schools, Homewood City Schools and Jackson County Schools as they create and sustain comprehensive mental health services in schools and communities for children and adolescents using the comprehensive, integrated, three-tiered (Ci3T) models of prevention (Ci3T). The Ci3T framework addresses the academic, behavioral, and social/emotional needs of students using a continuum of supports. (Lane, Menzies, & Oakes, 2010). Based on the Ci3T evaluations of student needs, students may receive additional supports from a School Based Mental Health therapist. The state agencies working with these three local education agencies expect to build a model program that will allow for expansion statewide. We expect to create a database of community services and programs that will allow the ALSDE and ADMH to better coordinate services statewide to meet the needs of all the students, families, and communities.

Project Abstract Summary Louisiana’s School Mental Health Support Project (SMHSP) is a collaborative effort of the Louisiana Department of Education (LDOE), the Louisiana Department of Health-Office of Behavioral Health (LDH-OBH), the Local Education Agencies (LEAs) and the regional mental health service provider organizations, to enhance and expand mental health services for school-aged youth and families that are experiencing mental health issues that are impacting the quality of their life. The three partner LEAs are Jefferson Parish Schools, St. Bernard Parish Schools, and Monroe City Schools which are representative of small, medium and large school districts in rural and urban geographical regions. The partner LEAs were selected due to their out-of-school suspension rate over the past three years that were more than 2 times the national average, specifically for student subgroups disproportionally impacted by exclusionary discipline practices. The foundation for SMHSP is the incorporation of trauma informed practices in schools to instill an understanding of the impact of current and past experiences on the school-aged youth’s current behavior and mental health. This practice promotes positive, pro-active engagement strategies to increase student engagement which supports the development overall mental health. The SMHSP model is based on the multi-tiered system of support (MTSS) framework which promotes increasing awareness of mental health issues through education at the lowest level, to providing more intensive direct services for school-aged youth at the highest level. The SMHSP will also use Social Emotional Learning (SEL) curricula and data based decision making to provide a clear framework to address mental health and behavior issues while promoting a healthy school climate and culture. The goals of SMHSP are: 1. Increase awareness of mental health issues impacting students and families through a comprehensive workforce development plan for partnering LEAs and participating school. 2. Establish a network of mental health providers to increase student access to services in the school and community. 3. Ensure partner LEAs will implement a screening and referral process to identify and address potential mental health needs of school-aged youth. 4. Ensure three partner LEAs are providing direct services to students with mental health needs and their families no later than January 30, 2019. Objectives to accomplish these goals include: the development and implementation of comprehensive workforce development plans at the state and local levels; promoting increased collaboration between the LEAs and the mental health provider organizations; contracting with an in-state university to develop and implement a comprehensive data collection and performance measurement system; provide technical assistance to the LEAs to implement project objectives and activities with fidelity. Funds from this project allocated to the LEAs will be used to increase the number of mental health providers and mental health services for students. During the initial year of the project, 1463 students will be served in the participating schools with an estimated .25% increase in subsequent years for a total of 2783 students overall.

Rhode Island Project AWARE The Rhode Island Department of Education (RIDE), in partnership with their Department of Children Youth and Families (DCYF), proposes to work with: Providence, Pawtucket and Woonsocket school districts, impacting 38,795 students, to increase awareness of MH issues among school-aged youth; provide training for school personnel and other adults who interact with school aged youth to detect and respond to MH issues, and connect their families to needed services. In Rhode Island, one in five (19%) children ages 6-17 has a diagnosable mental health problem and one in 10 (10%) has a significant functional impairment. RIDE, DCYF, and its partners will build strong collaborative partnerships to oversee BH efforts in LEAs who serve school-aged youth with mental disorders. The collective impact of our state partnership will be mirrored by a similar partnership within the three LEAs, in partnership with local community MH treatment provider agencies, to ensure that school prevention and intervention programs and services are linked to existing resources and/or new capacity to support students is created. The following goals will support the process: Goal 1 Through programs, policies and system changes RIDE, DCYF and its partners will increase access to culturally competent and developmentally appropriate school- and community-based BH services, particularly for children and youth with Serious Emotional Disturbance (SED) or Serious Mental Illness (SMI) for the 38,795 students and ultimately the 142,949 RI school aged youth statewide. Goal 2 RIDE, DCYF, the 3 LEAs, along with partners, will have school-based MH programs staffed by behavioral health specialists to screen, provide early intervention, and address any ongoing MH needs of children with symptoms consistent with a SMI or SED. Goal 3 RIDE, DCYF, the 3 LEAs, along with partners, will see an increase in awareness and identification of MH issues and the promotion of positive MH. Goal 4 RIDE, DCYF, the 3 LEAs, along with partners, will have the capacity to connect families, schools, and communities to increase engagement and involvement in planning and implementing school and community BH and prevention programs for school-aged youth. Goal 5 RIDE, DCYF and partners will have the capacity to support LEAs in helping school-aged youth develop skills that will promote resilience and promote pro-social behaviors; avert development of mental and behavioral health disorders; and prevent youth violence. Goal 6 Schools will have the ability to immediately identify students and respond to their needs if they exhibit behavioral/psychological signs of a severity indicating the need for clinical intervention. Goal 7 Systems will be established to expand and sustain BH services and supports for school-aged youth beyond the Project AWARE funding period.

The Texas Education Agency (TEA) will implement AWARE Texas to pilot evidence-based practices that address mental health challenges in 15 schools where communities were impacted by Hurricane Harvey. TEA will evaluate the effectiveness of services and interventions, including examining links to student’s academic performance and achievement. The project will build TEA’s capacity to support school mental health throughout the regions served and the State of Texas. Goals of the project include: (1) Increase and improve access to school and community-based mental health services, particularly for students with symptoms of severe emotional disturbance (SED) or serious mental illness (SMI); (2) Increase awareness and identification of mental health issues among all adults working with youth and promote positive mental health for students, families, school staff and community; (3) Help students develop skills that will promote resilience, self-regulation and pro-social behaviors; avert development of mental and behavioral health disorders; and prevent youth violence; and (4) Develop an infrastructure that will sustain services and build statewide capacity for promoting mental health awareness and evidence-based practices in Texas schools. AWARE Texas is a collaboration between the Texas Education Agency, the Texas Health and Human Services Commission, education service centers, local mental health authorities and local education agencies. The project will strengthen partnerships with community service organizations, families and businesses to support school mental health. AWARE Texas seeks to: increase mental health awareness, promotion and services; increase capacity for educators to integrate trauma-informed and resiliency-building strategies into the curriculum; coordinate school-wide prevention activities and training that strengthens wellness for the school community and supports a positive school climate; increase student engagement and family voice in program services; decrease disciplinary referrals and actions; increase attendance and grade level promotion that leads to high school graduation, college, a career or military service. AWARE Texas will provide rapid on site access to clinical services including screening, assessment and treatment, with parent consent, for all students exhibiting symptoms of mental health challenges. The project will promote mental health awareness through various trainings including, Youth Mental Health First Aid and Trauma-Informed Schools Training. AWARE Texas will implement evidence based practices by linking school mental health services with Positive Behavior Interventions and Supports (PBIS). Clinicians will implement various evidenced-based practices when serving students and families, including: Cognitive Behavioral Interventions for Trauma in Schools (CBITS), Collaborative & Proactive Solutions and PAX Good Behavior Game. Additionally, training will be provided in Psychological First Aid for Schools (PFA-S) to equip educators with skills to respond to mental health needs after a natural disaster or traumatic event. AWARE Texas will serve at least 10,000 individuals over the five-year period of the grant.

Indiana’s Whole State for Whole Child Proposal will increase: awareness, capacity, early identification & intervention, and student/family access to mental health supports through school-based and community-based initiatives. Primary target populations to be served are rural, suburban and urban K-12 students within 42 partner schools. An estimated 25,400 students and their families will be served each year. The goals and objectives of the proposal are: Goal one: Increase awareness of mental health issues by developing and expanding school-based mental health infrastructures within partner LEA schools. 1.1 By the end of year one, 100% of LEA partner schools will have established a Multi-Tiered System of Support team (MTSS), 1.2 By the end of year five, 100% of LEA partner schools will demonstrate increased mental health infrastructure, based on annual School Health Assessment and Performance Evaluation System (SHAPE) assessment domain ratings. Goal 2: Increase the capacity of partner schools’ staff to employ evidence-based tools and systems of support to detect and respond to mental health issues. 2.1 By the end of year five, 100% of school MTSS teams will be instructed by a certified trainer on using the evidence-based Mental Health First Aid, to immediately recognize and appropriately respond to youth in need of intervention. 2.2 Each project year, PD trainings provided to LEA partners will be rated “highly useful” by at least 80% of event survey respondents. Goal 3: Increase the capacity of partner schools’ staff to employ evidence-based tools and systems of support to detect and respond to mental health issues. 3.1 Partner schools will universally screen at least 90% of their student population to identify those in need of mental health supports. 3.2 By the end of year one, at least 21 of 42 partner schools (50%) will have defined evidence-based mental health tiered interventions for staff to implement with identified students; at least 31 schools (75%) by year two; and 42 (100%) by year 3. Goal 4: Increase partner schools’ early identification of mental health needs and interventions to address them, and increase student/family access to treatment, wrap-around resources, and services for vulnerable school aged youth, who may have behavioral health issues. 4.1 Each year, at least 90% of partner schools will annually increase the percentage of students served through the school-based treatment services. 4.2 By the end of year two, Indiana will develop and implement at least one new collaborative initiative for engaging students and families. 4.3 By the end of year three, the IDOE/SMHA collaborative webpage will be a robust hub for community-specific mental health treatment resources and a repository for evidence-based practices for mental health. After five years Indiana educators, students, parents and community members will be taking a proactive and preventive approach towards mental health supports.

The Arizona Department of Education (ADE) and Arizona Health Care Cost Containment System (AHCCCS) will work together to build capacity to detect and respond to mental health issues among school-aged youth across Arizona schools and communities. The population to be served includes 3 LEAs across the region of Arizona as well as internal and external partners. The LEAs represent three major geographical regions of the state and are within zip codes identified to have high to very high percentage of determinants of health. The goals of the program are: • GOAL#1: Build and maintain infrastructure for mental health services in Arizona schools for school-aged youth. • GOAL#2: Conduct outreach and engagement with school-aged youth and their families to increase awareness and identification of mental health issues and to promote positive mental health. • GOAL#3: Provide professional development to school personnel, SEA staff, community partners and other adults who interact with school-aged youth, to detect and respond to mental health issues Arizona Department of Education will be to create and sustain a statewide coalition of behavioral health partners to assist in providing resources to all schools in Arizona. The coalition including private and public partners will develop resources and collaborate to increase and improve access to culturally competent and developmentally appropriate school- and community-based mental health services. We will conduct outreach and engagement with school-aged youth and their families to increase awareness and identification of mental health issues and to promote positive mental health. ADE will partner with 3 LEAs over the course of 5 years to develop infrastructure in each school to enable them to respond and recognize mental health behaviors. We will develop meaningful ways to engage students and their families by involving them in the design and implementation of education and community initiatives related to youth mental health such as participating in family engagement activities and other community events. Additionally, ADE will provide professional development to school personnel, state education agency staff, community partners and other adults who interact with school-aged youth. We believe that providing professional development in the context of the evidence based practices will model not only to LEA’s, but to internal and external partner’s statewide. Throughout the lifetime of the project we plan to serve over 100,000 individuals.

Vermont Project AWARE is a joint effort between the Agency of Education (AOE) and the Agency of Human Services, Department of Mental Health (AHS/DMH) and three communities to promote: on-going collaboration at the state and local level regarding best practices to increase awareness of mental health issues; enhance wellness and resiliency skills for school age youth; and support system improvements for school based mental health services. The project will establish planning teams with each of three LEAs and their Designated Mental Health Agency (DA) partner. Target communities include: Orleans Southwest Supervisory Union, partnering with Lamoille County Mental Health; Addison Rutland Supervisory Union and Greater Rutland County Supervisory Union, who will both partner with Rutland County Mental Health Services. Each LEA/DA team will work with state staff to: improve access to school and community mental health services for school age children and their families; develop school-based mental health programs to screen for, provide early intervention and address ongoing mental health needs of youth; conduct outreach and engagement activities to increase awareness and identification of mental health issues and to promote positive mental health; include families, schools, and community stakeholders in planning and implementing project activities; help school-aged youth develop skills that promote resiliency and pro-social behaviors and prevent youth violence. The overall objectives of the project are to address issues in each community related to: access to services; service or knowledge gaps, such as becoming trauma responsive; and troubling trends in Youth Risk Behavior Survey results such as, the percent of youth who report being bullied, not feeling safe, having planned or attempted suicide, or misuse of prescription drugs. Vermont’s Project AWARE will rely on several evidence based practices to support its success, including: Youth Mental Health First Aid®; Umatter® youth suicide prevention activities; Positive Behavioral Interventions and Supports (PBIS); Interconnected Systems Framework (ISF); and Attachment, Regulation, and Competency (ARC) framework for complex trauma. Vermont expects these activities to impact 350 individuals in year one and 875 individuals in each of the remaining grant years or approximately 3350 LEA staff, parents, youth and community members over the course of the five year grant period.

The Pueblo of San Felipe is ideally positioned to expand it’s the capacity to serve school-aged Native American youth via partnerships with three local education agencies (LEAs), including: the San Felipe K-12 Community School, Bernalillo Public Schools (Bernalillo Middle School and Bernalillo High School), and the Santa Fe Indian School. Advancing Wellness and Resiliency in Education State Education Agency Grant (Native AWARE) will focus on partnerships and collaboration between tribal, state and local systems to promote the healthy development of school-aged youth and prevent youth violence. The population of focus for Native AWARE are Native American (NA) youth aged 12-18 years old with mental illness and/or co-occurring substance use disorders, with a special focus on individuals with serious emotional disturbances and serious mental illnesses. The goals of Native AWARE are to: (1) Increase and improve access to culturally competent, community-based mental health services; (2) Develop school-based mental health screening for early intervention and identification of mental health needs; (3) Conduct outreach and engagement with NA school-aged youth and families to increase awareness and identification of mental health issues and promote positive mental health; (4) Connect families, schools, and communities to increase engagement and involvement in planning, implementation, and continuous quality improvement; (5) Help school-aged Native American youth develop skills to promote resilience and pro-social behaviors; avert development mental and BH disorders; and prevent youth violence; (6) Equip three LEAs with the ability to immediately respond to the needs of youth exhibiting behavioral/ psychological signs indicating need for clinical intervention; and (7) Develop an infrastructure to sustain and expand mental health and behavioral health services and supports for Native American school-aged youth after funding ends. These goals will be accomplished by implementing evidence based prevention and intervention programming in the three LEAs, including health promotion activities such as Mental Health First Aid and Project Venture; Screening using the PHQ-9 and AUDIT C, and clinical intervention for youth at risk of mental illness, co-occurring substance abuse, trauma and school violence using Trauma Affect Regulation: Guide for Education and Therapy (TARGET) which is a trauma treatment BH model, and Cognitive Behavioral Therapy (CBT). Native AWARE is expected to annually serve 1,000 Native American youth with Project Venture, 300 with behavioral health screens, and 100 with direct services (CBT and/or TARGET), resulting in 7,000 students served over the life of the grant. Native AWARE will also provide Mental Health First Aid training to 200 school staff and youth caregivers annually, with 1000 over the life of the grant.

The Saginaw Chippewa Indian Tribe, in partnership with Tribal K-12 Education Department, Mt. Pleasant Public Schools and Shepherd Public Schools will implement a trauma-informed school model to serve the mental health needs of youth and their families. Community Coordinators will build strong relationships between schools, mental health providers, businesses, agencies and community members. Counselors will provide mental health services within the schools to students and use relationships with providers to refer students for intensive mental health treatment if needed. Trauma informed services and practices will be taught to school staff and community members for a solid foundation in mental health recognition and care for students. Mental Health First Aid and Crisis Intervention skills will be taught, and project staff will be trained to become trainers in order to sustain trauma informed community practices beyond the life of the grant. Additionally, schools and communities will work together to develop a mental health action plan for youth in order to identify further needs in the community, as well as develop universal trauma informed policies and procedures across school districts.

Delaware’s Project AWARE State Education Grant or Project DelAWARE proposes to build on existing collaboration between the state’s Department of Education (DOE) and child mental health system (Division of Prevention of Behavioral Health Services: DPBHS) to improve access to effective mental health services in three of the state’s LEAs and improve outcomes, both emotional and academic, for youth with serious emotional disturbance (SED) or serious mental illness (SMI). More specifically, the aims of Project DelAWARE are to (1) implement evidence-based mental health services in school settings within the context of integrated, systems model; (2) increase student access to mental health services through the addition of new staff and resources; (3) educate relevant staff in public school settings about how to access mental health services for students that need them; (4) reduce the stigma associated with mental health and increase recognition of mental health problems through alliance-building with state and local programs that promote mental health wellness and care; (5) build alliances between newly implemented services with more established school mental health programs and initiatives to promote integration and efficiency; (6) engage school-aged youth and families (including those with lived experience) and community programs as active partners in the development, implementation and maintenance of behavioral health services in schools; (7) engage local businesses and a community organizations as added supports for children and parents struggling with mental health problems, and (8) develop and implement a plan to sustain improvements to behavioral health services after grant funds end. To achieve the aims listed above, DOE, in partnership with DPBHS, and other identified community agencies (including, but not limited to, Children and Families First (CFF)) will use the Multi-Tiered System of Support (MTSS: (https://www.pbis.org/pbis/tiered-framework) as a general framework for organizing outreach, awareness, family engagement, and behavioral health services in 3 LEAs across the state.

The purpose of South Carolina’s AWARE: Advancing Wellness and Resilience in Education (SCA) is to build the state’s capacity to increase awareness of school mental health services statewide, to provide a multi-tiered system of supports (MTSS) to address mental and behavioral issues within the partnering local education agencies (LEAs)—Anderson School District 2, Florence School District 1, and Sumter School District—and their schools, and to provide evidence-based practices (EBPs), training, and supports to help them respond appropriately to students, families, and caregivers. Reaching approximately 67,000 unduplicated individuals each year and approximately 78,450 unduplicated throughout the project, SCA will improve mental health services in these LEAs where more than 60% of students are living in poverty and in-school suspension rates exceed the state’s average. SCA will reach approximately 500,000 individuals through marketing at the community and state levels. Using an interconnected systems framework (ISF), SCA will bring together MTSS offered by School-Wide Positive Behavioral Interventions and Supports (SWPBIS) and integrate them into school-wide mental health plans that include EBPs, mental health professionals, and an organized system to identify, screen, and refer students for mental health services and follow up with families and caregivers through outreach activities. Goals include (not inclusive): 1. Increase and improve access to culturally competent and developmentally appropriate school- and community-based mental health services, particularly for children and youth with severe emotional disturbances (SED) or serious mental illness; 2. Develop school-based mental health programs staffed by behavioral health specialists to screen for, provide early intervention for, and address any ongoing mental health needs of children with symptoms consistent with a mental disorder(s) or SED; 6. Equip schools with the ability to immediately respond to the needs of youth who may be exhibiting behavioral/psychological signs of a severity indicating the need for clinical intervention; and 7. Develop an infrastructure that will sustain and expand mental health and behavioral health services and supports for school-aged youth when federal funding ends. Objectives include (not inclusive): 1. By September 2023, at least 90% of the partner LEAs’ 56 schools will implement School-Wide Positive Behavioral Intervention and Supports with fidelity to foster a positive mental health learning environment, promote resiliency, and prevent serious behavior problems; 2. At least 25,000 students in the partner LEAs will receive training annually to increase their awareness of mental health issues and their knowledge of how to get assistance; 3. At least 400 people who interact with students will receive training annually in youth mental and psychological health evidence-based practices; 4. By September 2023, the partner LEAs will have established consistent screening processes; 5. Access to in-school and community-based mental health services for students and their families in partner LEAs will increase substantially, as demonstrated by placing more MHPs in schools, increasing referrals, services, and follow-ups, and implementing telehealth in schools; 6. During the project period, at least 15 memoranda of agreement (MOAs)/memoranda of understanding (MOUs) will be established between the partner LEAs and community mental health service and resource providers; and 7. During the project period, at least 75,000 individuals (family members, community members, students) will be contacted through program outreach efforts and at least 500,000 individuals will be reached though mental health awareness marketing.