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Project Title: HI-AWARE2. HI-AWARE2 will support the Hawaii Department of Education (HIDOE) as a SEA and as an LEA with seven districts (DI) statewide using the Hawaii Multi-Tiered System of Support (HMTSS) to implement mental health related awareness, prevention, intervention and resilience activities to ensure students have access and are connected to appropriate and effective behavioral health supports through Positive Behavior Intervention and Support (PBIS), Social Emotional Learning (SEL), Trauma Informed Care and School-Based Behavioral Health (SBBH). Populations Served: Complex Areas (CAs) served will be Castle Kahuku Complex and Nanakuli Waianae Complex (Oahu) and Kau-Keaau-Pahoa Complex (Hawaii Island), with expansion to four other districts (Central, Honolulu, Maui, Kauai) to serve 20,400 annually in years 1 and 2 and 174,700 students statewide annually in years 3-5. Hawaii is considered high need, with approximately 1 in every 2 students eligible for Free or Reduced Lunch, 195 Title I schools and 75,666 students residing in homes classified as low socio-economic status. Strategies/Interventions. Continue to implement and enhance the HMTSS Framework which provides universal, targeted and intensive supports to school-aged youth who need them; assess and enhance the HMTSS system for cultural competence, trauma-informed care, being developmentally appropriate, evidence-based and evidence-informed; and address the effects of COVID-19 and the impact to schools and school-aged youth through a revised statewide HMTSS Guide. In partnership with HIDOE, CAMHDA, Hale Kipa and targeted CAs, HMTSS referral pathways between tiers will be enhanced to ensure students receive the level of support necessary. HI-AWARE2 will create a Crisis Prevention Plan for CAs, establish an advisory board to support improvement and implement a school-based student suicide awareness and prevention policy, including a plan for evidence-based training for students in 6-12th grade in coordination with school-based mental health resources. Project Goals and Objectives. GOAL 1: Increase awareness/knowledge of staff and school-aged youth to understand and detect signs/symptoms of mental health, substance use, and co-occurring disorders. Obj 1: Establish capacity building plan to increase mental health awareness for staff/students in the three complex areas. Obj 2: Establish threat assessment and violence prevention plan. Obj 3: All complex areas/schools statewide identify point of contact and methods of collaboration. GOAL 2: Increase/improve access to school and community-based trauma informed and developmentally relevant SEL based on Na Hopena A’o (HA). Obj 1: Embed HA framework into SEL Curricula through Trauma informed lens. Obj 2: 80% or more schools include Adult SEL Component. Obj 3: 80% or more schools in 3 CAs integrate SEL within HMTSS and establish integrated SEB PBIS framework. GOAL 3: Improve/expand three-tiered public health model. Obj 1: Establish collaborative partnership to assess and address the needs and service gaps. Obj 2: Develop referral pathway system within HMTSS connecting youth and families to services. Obj 3: Establish advisory board and develop sustainability plan GOAL 4: Establish school-based, culturally relevant and evidence-based suicide awareness and prevention training policy in secondary schools. Obj 1: Establish school-based student suicide awareness and prevention training policy in alignment with the National Health Standards. Obj 2: Assure staff are trained in Suicide Prevention as dictated by 302A-856 Hawaii Revised Statutes and plan in place for school age youth Suicide Awareness Prevention training to increase from baseline to 80%. Obj 3: A coordinated Suicide Prevention training program in place, available to secondary students and schools, including new 988 Suicide Hotline Number and the Crisis Textline 741741 to increase from baseline to 80%.

The Strengthening Mental Health in Education Initiative (SMHiE) addresses the considerable need for a robust, community-driven, linguistically, and culturally responsive behavioral health infrastructure in Oregon school communities. The work is guided by Oregon Department of Education's (ODE) Integrated Model of Mental Health (IMMH), which roots mental health promotion, and suicide and substance use prevention efforts in 4 key pillars of practice: (a) strengths-based, (b) trauma-informed, (c) SEL-focused, and (d) equity-centered. The proposed Project AWARE work will augment Oregon's SMHiE Initiative by fortifying state and local project management infrastructure and extending the existing ESSER III-funded 2-year project period to 5 years. Project AWARE resources will support additional community engagement, co-design, and program development, extend the implementation, iterative evaluation, quality improvement and sustainability phases, and provide additional state and local project management capabilities. The Initiative will serve roughly 560,917 public school students, 70,198 staff, 2,340 administrators, and CBOs that support Oregon's 197 school districts, and consist of 4 primary components: (1) Increasing mental health literacy via an asynchronous, digital learning educational program and accompanying resources; (2) Developing and deploying credentialed, behavioral health courses and professional learning communities; (3) Co-designing and implementing of a Community Care project (CCP) to enhance behavioral health infrastructure in 4 school districts that represent the racial/ethnic, linguistic, geographic, and socio-demographic diversity of Oregon's school communities; and (4) Understanding formative and summative project impact and recommendations for implementation, sustainability, and continuous quality improvement. Implementation efforts will be guided by ODE's Community Engagement Toolkit and the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. The Engagement Toolkit provides a systematic strategy for engaging communities in the decision-making and co-design processes. The EPIS framework builds on this engagement approach by accounting for and documenting the multilayered and interactive nature of the socioecological context of mental health promotion and suicide prevention across and within Oregon's school districts. This project will also rely heavily on research-practice partnerships (RPP) that promote long-term collaborations among community partners. The RPP approach incorporates research into decision-making so that goals for addressing district needs focus on addressing meaningful problems of practice. RPPs will be applied according to tenants of Design Based Implementation Research (DBIR), where implementation and research teams closely partner with districts and school staff in a co-design process to ensure continuous engagement between researchers and practitioners. Measurable outcomes include increased mental health literacy, better identification of youth needing support, improved service referral, augmented suicide prevention, intervention and postvention efforts, enhanced student and staff health and well-being, school climates embodying belonging, care and connection, fewer disciplinary referrals, and improved academic success.

Arkansas AWARE 2022 will impact educators, students, and community stakeholders by developing sustainable infrastructure for school-based mental health programs, including implementing a best practice public health model site and a statewide training model. Both efforts will promote healthy social and emotional development of school-age youth, prevent youth violence in school settings, and support educator wellness across the state of Arkansas. The best practice public health model component of the project will focus on, and serve, the entire Berryville School District, which includes 4 schools with a total enrollment of 1,832 students, many of whom indicate significant risk factors for mental health issues based on an annual needs assessment survey conducted. The work at the Berryville School District will inform efforts in other Arkansas schools as best practice models are developed. The state-wide training model component of the project will focus on 261 districts across the state (1042 schools) that employ over 34,000 certified teachers, approximately 37,000 other support staff, and close to 475,000 students. The state currently ranks 47th in the prevalence of youth mental illness (and has one of the highest rates of traumatized youth). In addition, Arkansas is 42nd in access to mental health services; thus this state-wide approach is expected to help address those deficiencies by equipping those who work with school-age youth to be able to better assist the youth. As part of this component, 6,000 individuals are expected to be trained per year (200 training sessions with at least 30 people attending each session), with 30,000 being trained across the entire project period. The specific goals of Arkansas AWARE 2022 are as follows: Goal 1: Increase resilience and mental health well-being for school-aged youth in Arkansas, starting with the Berryville School District by (a) increasing access to direct mental health services for students, (b) increasing staff and student knowledge of resilience and mental health well-being, and (c) developing a school safety and threat/violence prevention plan. Goal 2: Increase knowledge in those who interact with school-aged youth in Arkansas to understand and detect the signs and symptoms of mental health, substance use, and co-occurring disorders by (a) establishing a statewide training model, (b) ensuring all trainers have appropriate certifications, (c) providing trainings to teachers and community members. Goal 3: Increase and improve access to culturally relevant, developmentally appropriate, and trauma informed school and community-based services, starting with Berryville School District by (a) developing a collaborative partnership/Advisory Board to guide and support project efforts, (b) conducting a needs assessment of the Berryville District (leading to both implementation and sustainability plans based on the results), (c) developing a three-tiered public health model, and (d) developing screening and referral processes, including training for teachers and paraprofessionals on the procedures.

Project AWARE Ohio will implement a Behavioral Health and Wellness Coordinator model to serve students, families, and staff in 13 counties. Building upon Ohio's School Wellness Initiative and Early Intervention efforts, the program includes student assistance programs, tiered supports, and employee wellness activities to provide equitable, collaborative, and sustainable solutions to address needs and gaps that impacts behavioral health and wellness. Goal 1: Increase awareness of mental health, substance use, and co-occurring issues among school-aged youth. Objective 1.1: Through training and resources support, a statistically significant increase (Pre-post) in awareness of mental health, substance use and co-occurring issues among school-aged youth, will be seen in LEA community members by September 30, 2027. Objective 1.2: By September 30, 2023, the number of LEAs with community specific, school-based student suicide awareness and prevention training policies will increase from the baseline to 5. Goals 2: Increase the knowledge of individuals who interact with school-age youth to understand and detect the signs and symptoms of mental health, substance use, and co-occurring disorders to promote resilience building and mental health well-being for all school-aged youth. Objective 2.1: Through capacity and infrastructure building (training, resources, partnerships, Community of Practice)and technical assistance activities, a statistically significant increase in knowledge, and therefore detection, of the signs and symptoms of mental health, substance use, and co-occurring issues to promote resilience building will be seen in LEA community members by September 30, 2027. Objective 2.2: Through collaborative partnerships in the BHWC Model, an increase in positive social connections with students, families and staff will be reported by BHWCs by September 30, 2027. Goal 3: Create, implement, and sustain a school-based mental health system that is based on a three-tiered public health model that includes a referral pathway system that connects school-aged youth who may have behavioral health issues, including serious emotional disturbance (SED) or serious mental illness (SMI), and their families to needed services. Objective 3.1: LEAs will complete a needs assessment, collaborative on the development of a local resource map, and develop an implementation plan by April 1, 2023. Objective 3.2: Through capacity and infrastructure building (BHWC, SAP and staff wellness resources) an increase in the number of schools implementing a model student assistance program and a staff wellness program will be seen from baseline to 10 by September 30, 2027. Objective 3.3: Through the establishment of a referral pathway, an increase in the number of social-aged youth screened and referral will be seen from baseline to (TBD based upon baseline) by September 30, 2027. Objective 3.4: Through the support of BHWCs, an increase in the number of LEAs utilizing restorative justice practices will be seen in from baseline to 5 by September 30, 2027. Goal 4: Increase and improve access to culturally relevant, developmentally appropriate, and trauma-informed school and community-based activities and services. Objective 4.1: Ensure by September 30, 2027, the SAP, staff wellness and BHWC models provide culturally relevant, developmentally appropriate, and trauma-informed school-and community-based activities and services. A minimum of 650 students, families and school professionals will be engaged in services each year, for minimum total of 3,250.

The Pueblo of San Felipe is ideally positioned to expand its 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 II (Native AWARE II) 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 in grades K-12 with mental illness and/or co-occurring substance use disorders. The purpose of Native AWARE II is to develop a sustainable infrastructure for school-based mental health services though collaborative partnerships. Based on a public health model, these partnerships will implement mental health related promotion, awareness, prevention, and intervention activities to ensure students have access and are connected to appropriate and effective behavioral health services. Native AWARE II will promote the healthy social and emotional development of school-aged youth and prevent youth violence in school settings. Thus, the goals of Native AWARE are to: (1) Increase awareness of mental health, substance use, and co-occurring issues among school-aged youth; (2) Increase the knowledge of individuals who interact with school-aged youth to understand and detect the signs and symptoms of mental health, substance use, and co-occurring disorders; (3) Promote resilience building and mental health well-being for all school-aged youth; (4) Create and sustain a school-based mental health system based on a three-tiered public health model; (5) Develop a referral pathway system that connects school-aged youth who may have behavioral health issues, including serious emotional disturbance (SED) or serious mental illness (SMI), and their families to services; and (6) Increase and improve access to culturally relevant, developmentally appropriate, and trauma informed school and community-based activities and services. These goals will be accomplished by implementing evidence based prevention and intervention programming in the three LEAs, including health promotion activities such as Teen and Youth Mental Health First Aid, QPR and Project Venture; Screening using the PHQ-9 and CRAFFT, and clinical intervention for youth at risk of mental illness, co-occurring substance abuse, trauma and school violence using Screening, Brief Intervention, and Referral to Treatment (SBIRT) and Attachment, Self-Regulation, and Competency (ARC) which aims to reduce symptoms related to trauma and other mental health related issues, increase adaptive and social skills in youth, and reduce distress in caregivers. Native AWARE is expected to annually serve 700 Native American youth with Project Venture, 250 with behavioral health screens, and 75 with direct services, resulting in 1025 students served annually. Native AWARE will also provide Mental Health First Aid training to 200 school staff and caregivers and 200 students annually.

The Emma Pendleton Bradley Hospital (Bradley) in partnership with the Rhode Island Department of Education (RIDE), the Rhode Island Department of Children Youth and Families (DCYF), other community-based providers of behavioral health services, school personnel, community organizations, families and school aged youth propose to work on developing a sustainable infrastructure for school-based mental wellness programs and services. Bradley and its partners propose to build on efforts underway toward this goal as the pandemic has increased both the challenges in implementation and the need for the services. Based on a public health model, this five-year effort will be focused in three school districts; namely, Pawtucket, Providence, and Woonsocket. Focusing on these three districts will annually impact 35,447 students and 3,051 school personnel as the partners implement professional and paraprofessional training, mental health related promotions, awareness, prevention, intervention, and resilience activities to ensure that students have access and are connected to appropriate and effective behavioral health 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. Bradley, RIDE, DCYF, and its partners supported by this grant funding will continue to build strong collaborative partnerships to oversee behavioral health efforts in target districts in service of school-aged youth with mental disorders. The collective impact of our state partnership will be mirrored by a similar partnership within the three school districts, in collaboration with local community mental health 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. Detailed corresponding measurable objectives to each goal have been developed. Goal 1 Through systemic enhancements Bradley, and its partners, will increase awareness and identification of MH, substance use, and co-occurring issues among school-aged youth. Goal 2 Bradley, and its partners, will continue to increase the knowledge of individuals who interact with school-aged youth to understand and detect the signs and symptoms of mental health, substance use, and co-occurring disorders. This will include all faculty and staff at the school and district level and community members. Goal 3 Bradley and partners will have the capacity to support LEAs in helping school-aged youth promote resilience building and mental health well-being through the development of skills that will work to avert development of mental and behavioral health disorders and prevent youth violence. Goal 4 Bradley, and its partners, will enhance and sustain the school-based mental health system that is based on a three-tiered public health model. Goal 5 Bradley, and its partners, will develop and enhance referral pathway systems that connect school-aged youth who may have behavioral health issues, including symptoms consistent with a SMI or SED, and their families to needed services. Goal 6 Through programs, policies, and system changes, Bradley, RIDE, DCYF and its partners will increase access to culturally competent, developmentally appropriate, and trauma informed school- and community-based BH services.

Tulare County Office of Education Special Services (TCOE-SS) designed Project AWARE Tulare to create a sustainable infrastructure to promote mental health awareness, provide drug and alcohol abuse prevention and intervention activities, and ensure access and connection to appropriate and effective behavioral health services for children and youth (grades K-12) and their families. The project will be implemented in 20 schools and the Juvenile Detention Facility in Years 1-2, serving over 16,000 students. By the end of the funding period, the project will serve all TCOE districts (44) and more than 100,000 students and nearly 10,000 educators. The districts serve a significant population of students living in poverty and English learners. Over eighty percent of the schools in the region are rural schools, predominantly located in impoverished areas, isolated from urban and suburban support systems. Nearly one-third of the households in the San Joaquin Valley earn less than the Federal Poverty Level, a higher proportion than any other region in the state. Tulare County is facing an alarming mental health crisis among young people as evidenced by a 23% increase in youth psychiatric hospitalization in 2020 and a suicide rate of 10.5/100,000 youth, one of the highest youth suicide rates in the State. The following goals and objectives will guide the project. Goal 1: Increase awareness of mental health, substance use and co-occurring issues. Obj: Number of students demonstrating knowledge of mental wellness self-care 5% increase each Year; Number of students indicating awareness of school-based mental health services at 75% or higher each Year; Number of school professionals indicate awareness of school-based mental health services at 90% or higher each Year; School staff self-describe as more confident (on pre-and post-surveys) in their ability to ID risk factors for mental health, AOD, and co-occurring issues in students; Number of students indicate awareness of harmfulness of substance use exceed 50% or higher each Year. Goal 2: Increase knowledge of educators to understand and detect the symptoms of mental health, substance abuse/co-occurring disorders. Obj: 5% each Year; 10 trainings each year. Goal 3: Increase access to and availability of culturally competent programs to promote resilience building and mental well-being; Obj: Number of students participating in resiliency building and mental well-being programs 75% or higher each year. Goal 4: Create and sustain school based mental health system, based on three-tiered public health model; Obj: Participating districts will increase each year to 44 (all) districts in Year 5; Tier 2 service providers receive 15 trainings each Year; Number of students receive positive behavior supports increase by 5% each Year; Ratio of students to school based mental health providers increase by 5% each Year. Goal 5: Develop referral pathway system; Obj: Number of students receiving external post-referral care increase by 5% each Year; Advisory Council will partner with at least two external referral providers each Year. In a rural county such as Tulare, the schools are often the first and only resources for students and families to access mental health services due to a lack of transportation to the larger urban areas. However, in these rural schools where poverty, substance abuse, and trauma are far too common, many students who struggle with mental health issues never get the treatment they need either through lack of awareness of available services or a need of services beyond the scope of current mental health support structures at the schools. Project AWARE Tulare will address these needs by providing awareness, education, and mental wellness activities, a three-tiered support structure, and pathways to services in the schools and surrounding communities.

Summary: This project will provide support to local districts and schools in the Ottawa Area Intermediate School District (OAISD) service area around preventative behavioral supports using the Positive Behavioral Interventions and Supports (PBIS) framework with the integration of mental health supports through the Interconnected Systems Framework (ISF) model. This model is a three-tiered framework designed to create and guide linkages between educational systems and mental health systems; streamline the referral process for students to receive services; support school-based social, emotional, and behavioral supports; and respond to students suffering ill effects from traumatic events and crises by providing services within the school setting. Population to be Served: Ottawa County student demographic information: total count: 47,4721; American Indian/Alaskan: 0.20%; Asian: 2.8%; African American: 2.3%; Hispanic/Latinx: 16.79%; Native Hawaiian/Other Pacific Islander: 0.09%; Two or More Races: 4.45%; White: 73.43%; Male: 48.68%; Female: 51.32%; Gay or Lesbian: 3%; Bisexual: 11%; Other Sexual Orientation: 4%; Languages Spoken: 14; English Learners: 4.92%; Students with Disabilities: 11.9%; Families in Transition/Homeless: 423; Economically Disadvantaged: 34.4%; Ages Served: birth-26 (Sources: MDE/DEPI/MISchoolData; Ottawa County Youth Assessment Survey(YAS), 2021). The 2021 Ottawa County YAS reported the following information of national (N), state (S), county (C), and Holland Public Schools (HPS) data: Students with depression - 36.7% (N), 36.4% (S), 31.4% (C), and 33.8% (HPS); Suicide Attempts - 8.9% (N), 7.8% (S), 7.8% (C), and 8.7% (HPS); Seriously thought about suicide - 18.8% (N), 18.7% (S), 19.5% (C), and 19.2% (HPS); Made a suicide plan - 8.9% (N), 7.8% (S), 7.8% (C), and 14.9% (HPS). Strategies & Interventions: Implementation of PBIS with the ISF model for integration of mental health services in schools. Specific trainings will be provided around district systems, data, and practices; Tiers 1, 2, and 3 of PBIS; PBIS implementation in the classroom; social and emotional learning; mental health awareness and response; SWIS; QPR; staff wellness; Restorative Practices; CHAMPS; TRAILS; Trauma Sensitive Schools; Functional Behavior Assessment and Positive Behavior Support Planning; Therapeutic Crisis Intervention; Blue Envelope; and Crisis Prevention Intervention. Project Goals: Goal 1: Create effective, comprehensive systems & structures to support ISF installation & implementation at a model demonstration district. Goal 2: Create an effective & efficient three-tiered system of supports for students using an ISF model within a PBIS framework at the school level. Goal 3: Establish & continuously improve an effective & efficient single system for referrals for mental health supports/services in districts & schools. Goal 4: Increase knowledge & awareness of district/school staff, students, families, & communities around issues related to mental health, substance abuse, & co-occurring issues/disorders among school-aged youth.

KanAWARE is a collaboration of the University of Kansas school-based Telehealth ROCKS program, the Kansas State Department of Education (SEA), the Kansas Department of Aging and Disability Services (SMHA), three Local Education Agencies (LEAs), three community-based behavioral health providers, and their communities. The aspirational mission for this collaboration is for every child to have the exact same opportunity for success in school and in life. More specifically, the overarching goal is to improve student mental health needs through evidence-based interventions across the multi-tiered service model. KanAWARE supports interventions for students and school personnel and family/community members living in southeast Kansas (Coffeyville, Pittsburg, and districts served by Greenbush). Additional LEAs will be added in years 2 through year 5. The selected rural school communities have a significant impact from the COVID19 pandemic, long-standing health disparities, and unmet needs. KanAWARE will focus on the southeast Kansas region as the poorest and least-resourced area of the state, with high needs around social determinants of health and trauma-informed approaches. The cross-organizational team brings over twenty years of school-based telebehavioral health experience, most recently with Telehealth ROCKS school-based telebehavioral health services across specialties (e.g., psychology, psychiatry, developmental medicine, applied behavior) and a statewide capacity-building and primary prevention initiatives using the Project ECHO telementoring model. Based on the overwhelming need to address social determinants of health as part of the successful implementation of the multi-tier system, KanAWARE schools and communities will integrate school-based community health workers into the behavioral health approach and workflows to support the students/families and to meet all KanAWARE goals. Kansas leading experts will provide technical assistance in the range of evidence-based/ evidence-informed approaches related to resilience for students and school personnel; school-based mental health; post-trauma approaches; parenting; prevention collaboratives partnering family, school, and community; child behavioral health advances; substance use prevention/treatment advances; and multi-stakeholder advisory groups. Goals include: Goal 1: To strengthen partnerships across key school-based behavioral health stakeholders in southeast Kansas, the poorest and least resourced rural area of the state. Goal 2: Leveraging existing evidence-based/evidence-informed resources identified by the KanAWARE partners and securing additional resources based on need assessment findings, increase the number of students served across each of the three tiers of the pyramid model. Goal 3: Leveraging an online referral tracking and outcomes system, develop/refine and implement KanAWARE multi-system referral pathways to advance evidence-based/informed, equity-based, trauma-informed, recovery oriented services Goal 4: Building on KanAWARE partner input, resources, and adult learning best practices such as Project ECHO telementoring and QI coaching, advance a professional community of learning that advances capacity building and an effective workforce across child-serving systems. Goal 5: Building on KanAWARE partner input, resources, and adult learning best practices, build a family community of learning that meets needs related to child behavioral health and social determinants of health.