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The Tennessee Department of Education (TDOE) and its partner, the Tennessee Department of Mental Health and Substance Abuse (TDMHSAS), are requesting federal funds to expand access to school-based mental health services for some of the state's most disadvantaged schools and communities. TDOE seeks to build on its proven track record of success under the first AWARE-SEA grant and current AWARE-SEA grant by expanding school-community mental health partnerships and school-based programs and services within a multi-tiered system of support (MTSS) framework. TDOE and TDMHSAS will partner with three rural districts across Tennessee's three Grand Regions- Scott County Schools in East Tennessee, Bledsoe County Schools in Middle Tennessee, and Haywood County School in West Tennessee. Districts were selected based on need criteria and a demonstrated willingness, readiness, and commitment to build comprehensive, quality mental health initiatives in schools. The comprehensive project plan will guide local implementation of an array of evidence-based, school and community mental health services and professional development opportunities appropriate for school settings and populations served. The project, as proposed, represents a strong opportunity for Tennessee to build on its AWARE foundation and continue to refine models for integrating mental health into schools to more effectively address unmet needs for treatment.

This Minnesota AWARE-SEA Project will expand previous work in school-based mental health by implementing evidence-based practices which will positively impact student mental health across the continuum from prevention to treatment services. LEA partners are: Northeast Metro 916 Intermediate District (1,000 of the most high-need students from 14 eastern metro districts), Duluth Public Schools (8,358 students in NE MN), and St. Louis County Schools (1,956 students in rural N MN). Working together and learning from these different types of districts will help MDE and its’ state partners build our capacity to develop effective policy and provide high-quality training and technical assistance to all districts in Minnesota. MN Project AWARE staff will also support LEAs in establishing the infrastructure necessary to bill Medicaid for school-based mental health services and collaborate to make the policy changes needed for such Medicaid expansion to occur to address sustainability of direct services to students. This project will serve: 75 new students in Year 1, 100 new students in both Year 2 and 3, and 125 new students in both Year 4 and 5 for 525 new students total; 11,314 indirectly in the 3 LEAS; and 850,000 statewide. Project goals and objectives include: 1) Increase capacity of the three LEAs to implement comprehensive school mental health systems. a. By December 2021, train-the-trainer cadres will be developed for Youth Mental Health First Aid (YMHFA) and for Sources of Strength (SOS). b. By February of 2022, two key staff from each LEA will be trained on Cognitive Behavior Interventions for Trauma in Schools (CBITS) and Bounce Back (BB). c. By April 2022, all school staff in each of the LEAs will receive training in the school mental health referrals pathways protocol. d. By September 2022, all school staff will receive training on trauma informed schools and adverse childhood experiences (ACES). e. By September 2022, student supports teams from each LEA will be trained on CBITS and BB. 2) Increase access to quality, sustainable, culturally responsive, and developmentally appropriate school-based mental health services and supports. a. By August 2023, the LEAs will have defined the Interconnected Systems Framework (ISF). b. By October 2022, CBITS and BB will be utilized as a Tier 2 interventions for students who have been exposed to trauma. c. By December 2021, all LEAs will participate in the School Health Assessment Performance and Evaluation (SHAPE) system. 3) Improve policy, practices, and sustainability for Comprehensive School Mental Health (CSMH) Systems across Minnesota. a. By January 2023, MN Project AWARE staff will have developed two statewide train-the-trainer cadres in YMHFA and for SOS. b. By August 2023, MN Project AWARE staff will train 100 licensed school staff from across Minnesota on identified evidence-based programs (EBPs), outside of the three LEAs. c. By August 2024, MN Project AWARE staff will train 100 district staff on the PREPaRE Model to increase their capacity to respond to school crises. d. By September 2026, 150 districts across the state of Minnesota will have completed the SHAPE assessment and CSMH curriculum training. e. By August 2026, six partner LEAs will have established infrastructure f. By August 2024, a model for reflective consultation for teachers supporting student mental health will be established, piloted, and assessed 4) Increase outreach and engagement with school-aged youth and their families to promote mental health awareness across Minnesota. a. By December 2021, each of the LEAs will have a Project AWARE Advisory Group b. By May 2022, each Project AWARE LEA will host two community-wide mental health awareness events. c. By October 2022, MN Project AWARE staff from each LEA will train a student group on the YMHFA and SOS peer-to-peer programs. d. By August 2022, MN Project AWARE staff will build capacity of LEAs to conduct inclusive family engagement on CSMH

The Oklahoma State Department of Education, in partnership with the Oklahoma Department of Mental Health and Substance Abuse Services, will address the mental health of children, youth, families, and communities by coordinating and integrating mental health services to 15,212 students per year enrolled in three high-need LEAs (32 school sites) including Lawton, Davis, and Sulphur Public Schools in south central Oklahoma. The LEAs have been targeted based on their lack of mental health service availability and access, their high incidence of suicide attempts and ideation, and multiple high risk factors such as high minority populations (predominately American Indian students), chronic absenteeism and access and availability of drugs and alcohol. The project goals are to (1) Provide training for school personnel and others who interact with school-aged youth to detect and respond to mental health issues; (2) Improve student discipline; and (3) Build a comprehensive mental health infrastructure and conduct outreach and engagement with school-aged youth, families and community to increase awareness and identification, and increase needed services. The objectives include a minimum of 15 hours of mental health professional development for teachers per year, a decrease in student discipline and suspensions, and an increase in positive responses to tiered intervention supports for students. The project will provide statewide services such as trauma-informed training and the development of an Interconnected Systems Framework (ISF), a coordinated system of resources, stakeholders and partnerships so LEAs can support all students by working together. The ISF is an implementation framework developed by national leaders in the field of school mental health and academic support to advance a more effective and efficient system of social emotional, behavioral health and academic success. LEA services will include the hiring of licensed counseling staff to provide intervention support to students, community, student, and parent engagement activities led by a community manager, professional development in creating a multi-tiered system of support for mental health services to students, universal mental health screenings for all students, and prevention and intervention mental health services. Evidenced-based training that will be provided to teachers, mental health staff, youth, and members of the community will include the PAX Good Behavior Game, Structured Psychotherapy for Adolescents Responding to Chronic Stress, and Mental Health First Aid training for adults and youth. In addition, mental health intervention teams in each LEA will utilize formal processes for selecting a continuum of additional evidence based programs based on the likelihood of desired impact on identified needs.

Project AWARE operates on South Dakota’s Pine Ridge Indian Reservation to serve K–12 students that experience disproportionately high rates of historical and contemporary traumas. By implementing a trauma-informed school model, the project equips students, parents, families, and community members to appropriately respond to trauma and provide mental and behavioral health interventions. PROJECT NAME: Project AWARE on the Pine Ridge Indian Reservation TOTAL NUMBER OF PEOPLE TO BE SERVED: 2,522 (lifetime). 1,210 (unduplicated individuals to be served in year 1); 328 (unduplicated individuals to be served in year 2, 3, 4, and 5). POPULATION TO BE SERVED: This project will serve K–12 students enrolled at four schools on the Pine Ridge Indian Reservation: 99% of students are Native American. Students served have high rates of traumatic backgrounds as measured by the Adverse Childhood Experiences (ACE) questionnaire; all surveyed students had backgrounds that included some significant trauma. STRATEGIES AND INTERVENTIONS: To address this trauma, Project AWARE will implement the trauma-informed schools model, an evidence-based best-practice. This will permit intervention with mental and behavioral health counseling to help students cope with trauma, heal, and refocus on academic learning. The trauma-informed schools model will be implemented in a culturally relevant manner and include training and services for students, school staff, families, and community members. Our schools partner with a tribally chartered organization, the Oglala Sioux Tribe Health Administration Program, which provides access to telehealth and related services. GOALS AND OBJECTIVES Goals: (1) Increase knowledge of local school district staff members to identify, report, and support students demonstrating behavioral/mental health consequences of trauma; (2) Increase student access to culturally competent, evidence-based, behavioral/mental health counseling in their own schools; and (3) Increase positive student perception of the school environment. Each goal has two measurable objectives: (1a) By the end of 2026, all staff members will have received an annual training about the trauma-informed schools model from a certified professional in the subject; (1b) By the end of each year, at least 190 community members will have attended a training about the trauma-informed schools model from a certified presenter. (2a) By the end of December 2021, every school will have at least one full-time wayawa kin slolic’iya wicaye (“WKSW”) focused on mental and behavioral health; (2b) By the end of May 2022, project will develop a common framework for responding to trauma-induced mental/behavioral health concerns displayed by students; (3a) By the end of each year, student Tripod Surveys will increase by at least 5% annually, demonstrating increased positive perception of school environment; and (3b) By December 2021, all schools will be providing individual and small group counseling support sessions for students identified at risk for trauma-induced mental/behavioral health warning signs.

West Virginia Department of Education's (WVDE) 2021 Project AWARE will advance the wellness and resilience of West Virginia students by collaborating with local educational agencies, schools, communities, and families to address the social-emotional, behavioral, and mental health needs of our students. By leveraging stakeholders' resources we will use our varied talents, strengths, and funds to serve our most precious resource - our students. Project AWARE will enable state and local partners to develop a model of sustainable plans and strategies to improve school culture statewide, increase student well-being and success, prepare educators, strengthen collaboration between the state and LEAs, and forge community connections to link and leverage available community resources that serve children and families. This grant will serve 10,000 students and 1,500 educators and other adults annually; serving 50,000 students and 7,500 educators and other adults over the five-year course of the project. West Virginia (WV), home to about 1.8 million people across 24,038 rugged square miles, ranks 44th of 50 states in overall child well-being. Its economic deterioration has been exacerbated by the state's substance misuse crisis, which alone costs the state's economy $8.8 billion a year - the highest per-capita burden in the country, The project will focus on three counties - Fayette, Logan, and Wirt-which in 2019 were Health Professional Shortage Areas (HPSA) in mental health. Wirt students have high needs and few resources; 28% of youth are living in poverty and 11% are homeless. Their child and ten death rate is 77.1 per 100,000. Fayette also has 28% of its children living in poverty. The teen birth rate in 2020 was 39.7 per 1,000. In 2019 it ranked 6th in WV for the highest number of overdose fatalities; 61 per 100,000 deaths. In Logan County, 15.5% of babies were born exposed to drugs. Their teen birth rate is 44.2 per 1,000 births; 31% of children live in poverty. The county ranked 4th in WV for the highest number of fatal overdose deaths at 81 per 100,000. WVDE's Project AWARE will meet its overall project goals of increasing the capacity of state and local educational and behavioral health systems to provide direct, comprehensive services to students and to increase awareness of and training in mental health through evidence-based practices including Positive Behavioral Interventions and Supports (PBIS) and Expanded School Mental Health (ESMH). The project schools will receive focused guidance, support, and technical assistance to improve, increase, and strengthen the mental health services available to students and their families, as well as licensed mental health professionals to provide direct, on-site services and to coordinate care through outside service providers. Project evaluation will consist of both process and outcome measures, assessing, among other things, infrastructure development, service delivery, and sustainability in addressing students' mental health needs to ensure goals are met, initiatives are effective, and to promote wide-scale adoption of successful practices and programs.