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Project Name: Honoring our Children and Families Population served: Native Americans in Lassen County, California ages 0-25 and their families. We will serve a minimum of 30 households the first year, 40 households the second, and 50 households the last year for a total of at least 50 households over the grant cycle. Vision: A community that honors its children by making a commitment to assure all children reach their full potential in a nurturing, health, family environment. Project Goal: Design a holistic, community based, coordinated system of care to support mental health and wellness for children, youth, and families ages 0 – 25 years. Objective 1 Engage the community as partners by identifying at least 4 community partners and establishing a monthly focus group to discuss and collaborate on our missions. Objective 2 Develop a system of care that is family driven, strengths based, and builds upon assets and resources within the community by building and implementing a variety of programming. Success will be measured by participation rates in the proposed activities. We anticipate serving at least 30 families in the first year, and increasing by 10 additional families each subsequent year. Objective 3 Create at least 3 opportunities to train community members to deliver services by the end of the grant period. The Susanville Indian Rancheria Lassen Indian Health Center will develop a system of care that offers prevention, promotion, treatment, and recovery services that is consumer driven, family focused, evidence and strengths based, and culturally focused for children, youth, and families ages 0-25. We will strive to reduce social stigma, embrace a wellness model, and communicate that recovery is possible.

The Toiyabe Circles of Care Project (Toiyabe CoC), led by Toiyabe Indian Health Project, Inc. (Toiyabe), will design a Native American-guided, family driven, consumer youth-informed mental and behavioral health system of care for the children and youth (birth - 25) of seven tribes and two tribal communities in remote Inyo and Mono Counties, California. Strategies include: Talking Circles, consumer satisfaction, and mental health perception surveys. Project Goals: Working alongside a collaborative of 31 Native Americans (e.g., Red Horse Nation therapist, Fatherhood is Sacred director, RAVE coordinator, sweat lodge leaders, consumer youth, young adults with lived experience, etc.) and 12 child-serving agency representatives (e.g., judges, Sheriff, probation, Child Protective Services, Re-Entry Coordinator for Inmates, school liaisons, medical providers, etc.), the Toiyabe CoC will be a catalyst of systemic change through policy reform and mental health infrastructure development guided by community-based and culturally relevant planning processes and through the engagement of consumer youth and family members. Strategies: As a planning and development grant, no participants receive services. However, a minimum of 240 Native Americans will be involved in Talking Circles, key informant interviews, consumer satisfaction surveys, Native American mental health perception surveys, collaborative work groups for needs assessment, community readiness assessment, resource/asset map, Blueprint, implementation plan, and feasibility study efforts. The Toiyabe CoC Public Education Plan will invite tribal mental health consumers and those with lived experience to share their stories face to face, in groups, and on social media to raise awareness of the need for a new system of service provision, and to spotlight positive stories of recovery among youth and families. The language, content, tone, faces, and voices of the Public Education Plan will be grounded in local tribal culture. Collaborative work groups will design the Outcome Measurement Plan based on extensive community input from tribal communities about what criteria they prefer to use to measure the success of proposed services (e.g., which measures indicate increased mental well-being of tribal children/youth and enhanced stability of tribal families, what measures reflect authentic cultural competency within Toiyabe CoC system provider services, etc.). To implement the Mental Health Systems of Care Blueprint, the Toiyabe CoC Collaborative will establish work groups, including Native American and consumer members, to develop policies, procedures, and other infrastructure needs as follows: 1) standards of care for child/youth mental health services and supports; 2) credentialing, licensure, core training requirements, and accreditation requirements; 3) the role of local traditional healing/helping practices in supporting children, youth, and families; 4) the role of western/clinical mental health practices for children, youth, and families; and 5) support of ongoing family and youth leadership and involvement. Memoranda of Agreement will document Native and non-Native partner commitments to long-term, collaborative care for mental health.

Native American Community Health Center, Inc. (NATIVE HEALTH) will collaborate with community partner agencies and individuals to facilitate a program to determine the mental health service needs and initiate a response as appropriate to American Indian children, youth (including young adults) and families residing in Maricopa County, Arizona. The three year project will increase capacity for American Indian & Alaskan Native targeted behavioral health services. The program will also endeavor to improve service provision to be culturally responsive to the unique needs and traditions of American Indians. NATIVE HEALTH will form a Community Advisory Board to assess the county’s gaps for services, resources available and cultural relevance to the local American Indian/Alaska Native population. Urban Indians at present do not have adequate, culturally relevant services available for numerous emotional and psychiatric concerns. Services with cognizance for the special aspects of the American Indian condition including recognition of historical trauma and ongoing oppression continue as limited. The project will address the mental health care at numerous levels including policy reform, infrastructure development and community engagement based upon the system of care principles, and trauma informed care. The project will engage a wide range of American Indians through all aspects of the proposed and required activities. The project will place an emphasis on a community based system that is guided by American Indian families, inclusive of youth perspectives to assure relevance to the American Indian youth experience consciences of cultural and linguistic perspectives. Project Name: NATIVE HEALTH Circles of Care Project Population to be served: The program will target network expansion to serve urban dwelling American Indian/Alaska Native (AI/AN) Children, Youth, Young Adults and affected Families that reside in Maricopa County, Arizona. Maricopa County has a population of approximately 33,265 AI/AN residents that are 25 and younger. Strategies/interventions: The program will assemble an Community Advisory Board, facilitate a Community Needs Assessment relative to behavioral health needs and gaps for services, facilitate a community readiness and resource/asset mapping through key informant interviews and focus groups, facilitate Strategic Planning to address programmatic needs and implement activities to Expand and Culturally Enhance local Behavioral Health Services, utilizing a focus group setting for capacity building and system strengthening. The program will engage youth in assessments for acculturation and development of youth-led media campaign. The media campaign will provide graphic material for the Marketing & Social Media Plan and Campaign. The agency will utilize a community based participatory research methodology in evaluation and system development. The final output of the proposal will be a blue print of a system of care model that includes an implementation plan for feasibility and sustainability. Project Goal: NATIVE HEALTH will design, develop and implement a system of care model that is based on the needs of the community, resulting in the development of a ‘blue print’ for a system of care model that meets the needs of the Maricopa County urban Indian community.

According to a 2010 report by the State of Kansas, which ranked all counties in the state according to eight federal risk categories, Brown County, where the Kickapoo Tribe in Kansas (KTIK) reservation is located, was classified as a “high-risk community” and ranked in the lowest quartile for poverty, crime, domestic violence, high-school drop-out rate, and substance abuse. Of the more than 1,600 enrolled KTIK members, over 60% are children and youth, who will in turn become tomorrow’s community elders. Building strong supports for children and their families is critical to the continued health and success of the Kickapoo community. Nationally, Native American communities face substantial mental health inequities and challenges. Such challenges include higher rates of suicide, serious psychological distress, hopelessness, worthlessness, and substance abuse-related behavioral health issues. While behavioral health data is limited on the KTIK community, a community health assessment was conducted with KTIK community stakeholders in 2014, where respondents noted that primary health concerns included among other concerns: depression/anxiety, suicide, and posttraumatic stress disorder. Though some programs and services currently exist in the community to help address these concerns and support community members, access issues included loss of transportation, lack of trust in service providers, and the absence of a cohesive infrastructure to pull all wellness programs and supports for children and families together have, reduced effectiveness and efficiencies in community programs. The Kickapoo Tribe in Kansas (KTIK) proposes the “Kickapoo Circle of Care” to help build a Kickapoo Child and Family Programs infrastructure. The goals of this three-year project are to: 1) Develop and strengthen a system of behavioral health and wellness care for Kickapoo children and families; 2) Improve availability and accessibility of behavioral health and wellness programs in the Kickapoo community; and 3) Engage community leaders and members in building strong connections to promote Kickapoo culture and tradition.

The FPST Circles of Care (COC) will provide the FPST community as well as the communities of the Lovelock Paiute Tribe and the Yomba Shoshone Tribe with tools and resources to plan and design a holistic, community-based, coordinated system of care approach to support mental health and wellness for children, youth, and young adults from birth through age 25 and their families. The COC project will focus on the need to reduce the gap between the need for mental health services and the availability and coordination of mental health, substance use, and co- occurring disorders. The project will promote and facilitate youth, families, community members and tribal leaders to be involved, participate and have a voice in the planning and development of a system of care model. COC will also focus on resources to reducing the impact of substance abuse and mental illness on American communities and address the behavioral health impacts of trauma and provide opportunities for the Fallon, Lovelock and Yomba tribal communities to support youth and young adults as they transition to adulthood by facilitating collaboration between child and adult serving agencies. The COC project will also participate in the development of a Tribal Action Plan, promote tribal program collaborations and cross-agency collaborations, and develop policies, procedures, and other infrastructures that will result in system-wide improvements and support implementation of the system of care model such as, standards of care for child/youth mental health services and supports. Trainings include a Gathering of Native Americans (GONA) will serve as a “kick-start” for community participation, in addition to coordinating Systems of Care trainings for community members, youth and families and for workforce development. Additional community and workforce development trainings will focus on increasing awareness of child/youth mental health and wellness issues, the need for a coordinated approach to services, and promote increased access to mental health and wellness supports and services through a system of care approach.

The Winnebago Tribe of Nebraska will take a leadership role to work with several project partners in Sioux City, Iowa to plan and develop a working system of care model for Native American children, youth, and their families that face behavioral health access and coordination of service gaps and barriers. Approximately 20% of the Native American population in Sioux City are Winnebago Tribal members. This group of individuals and families are challenged in working through a complex system of care that is cumbersome and challenging in the best of circumstances. The Four Directions Circle of Care Project will engage Native American children, youth, and their families from Sioux City in assisting in the development of workable solutions that will increase the capacity and effectiveness of mental health systems serving the Native American community in Sioux City, IA. We will focus on addressing the need to reduce identified gaps, barriers, and challenges for mental health services and the availability and coordination of mental health, substance use, and co-occurring disorders for children, youth, and young adults from birth through age 25 and their families that will lead to wellness. The Tribe requests $643,914 over a three year period from the U.S. Health and Human Services Substance Abuse and Mental Health Services Administration under the Planning and Developing Infrastructure to Improve the Mental Health and Wellness of Children, Youth and Families in American Indian/Alaska Natives (AI/AN) Communities, also known as Circles of Care VII funding opportunity announcement. The services and products developed which is planned to include a fully developed “blueprint” including policies and procedures that service providers have a voice in developing to assure the identified needs are met. Trainings for service providers and others from the project will be supported and complimented by two current SAMHSA grants awarded to the tribe to minimize training costs to the project and to facilitate smooth transition of services for tribal members that move between Sioux City and the Winnebago Reservation.

Utah will develop and implement the Utah Assisted Outpatient Treatment Program (U-AOT) in two Local Mental Health Authorities, by developing a system of coordination and communication across community services, and the provision of a combination of Evidence Based treatment and support services. The population of focus will be adults with serious mental illness who are on civil commitment, with poor treatment compliance, and a history of multiple hospitalizations and/or incarcerations. Goal 1: Demonstrate that AOT will result in improvement of treatment outcomes for adults with SMI, under civil commitment, with a history of treatment non-compliance. Individuals receiving AOT will decrease service/system utilization. Goal 2: Establish and implement Assisted Outpatient Treatment in two communities (Davis Behavioral Health and Weber Human Services) within Utah. The AOT Program will be characterized by the enhanced relationships, communication, and coordination for in-person, legal, electronic and functional exchanges with the courts, police, hospitals and other community partners. Staff will be trained in each community in the AOT model of treatment. Nationally recognized training curricula for EBPs will be integrated into target communities. Goal 3: Establish and strengthen the necessary infrastructure to maintain and expand AOT throughout Utah, and to increase the number of individuals with serious mental illness who receive sufficient services and supports to remain in the community. An Assisted Outpatient Treatment Steering Committee (AOTSC) will be established at the State Level and the AOTSC will create a Strategic Plan for ongoing community AOT services. Goal 4: Collection and analysis of program data, with results used to modify program and maximize effective strategies. Program data will be collected and analyzed in target communities with intent to generalize data collection process and lessons learned state-wide.

Utah will develop and implement the Utah Assisted Outpatient Treatment Program (U-AOT) in two Local Mental Health Authorities, by developing a system of coordination and communication across community services, and the provision of a combination of Evidence Based treatment and support services. The population of focus will be adults with serious mental illness who are on civil commitment, with poor treatment compliance, and a history of multiple hospitalizations and/or incarcerations. Goal 1: Demonstrate that AOT will result in improvement of treatment outcomes for adults with SMI, under civil commitment, with a history of treatment non-compliance. Individuals receiving AOT will decrease service/system utilization. Goal 2: Establish and implement Assisted Outpatient Treatment in two communities (Davis Behavioral Health and Weber Human Services) within Utah. The AOT Program will be characterized by the enhanced relationships, communication, and coordination for in-person, legal, electronic and functional exchanges with the courts, police, hospitals and other community partners. Staff will be trained in each community in the AOT model of treatment. Nationally recognized training curricula for EBPs will be integrated into target communities. Goal 3: Establish and strengthen the necessary infrastructure to maintain and expand AOT throughout Utah, and to increase the number of individuals with serious mental illness who receive sufficient services and supports to remain in the community. An Assisted Outpatient Treatment Steering Committee (AOTSC) will be established at the State Level and the AOTSC will create a Strategic Plan for ongoing community AOT services. Goal 4: Collection and analysis of program data, with results used to modify program and maximize effective strategies. Program data will be collected and analyzed in target communities with intent to generalize data collection process and lessons learned state-wide.

Tropical Texas Behavioral Health (TTBH) is located in deep South Texas just ten miles from the Texas Mexico border in the Rio Grande Valley (RGV), a culturally rich region that has a predominately Hispanic population and faces cyclical poverty. A third of the region's population live below the poverty line and many residents are Limited English Proficiency (LEP). Access to treatment for serious mental illness is limited in the Rio Grande Valley, designated as a 2016 Health Professional Shortage Area. More than one third of residents did not have health insurance in 2011, the third-highest rate in the country. In the face of these many challenges, TTBH served 22,253 (22,041 Hispanic) seriously mentally ill people in 2015 with gold standard person-centered care with a culturally appropriate service delivery system. However, there is no assisted outpatient treatment for the seriously mentally ill with criminal justice issues in the area. TTBH and its partners propose the Valley AOT Care Program to serve Cameron and Hidalgo Counties. TTBH will rigorously apply the protocols and standards of the Evidenced Based Practices of AOT, as a court-ordered treatment. The Valley AOT Care Team will screen at least 200 referrals annually and serve at least 125 clients annually, for a total of 500 over the life of the grant cycle. The program will offer a variety of comprehensive services including Cognitive Behavioral Therapy, Case Management, Psychiatric Services, Crisis Intervention, Supported Employment and Housing Services, and Skills Training and Development. By the end of the grant cycle, at least 90% clients will participate in person centered recovery planning (PCRP) and 75% of clients will be compliant with their PCRP. Other expected outcomes are the reduction of the incidence and duration of hospitalization, reduction of arrests and incarcerations.

Tropical Texas Behavioral Health (TTBH) is located in deep South Texas just ten miles from the Texas Mexico border in the Rio Grande Valley (RGV), a culturally rich region that has a predominately Hispanic population and faces cyclical poverty. A third of the region's population live below the poverty line and many residents are Limited English Proficiency (LEP). Access to treatment for serious mental illness is limited in the Rio Grande Valley, designated as a 2016 Health Professional Shortage Area. More than one third of residents did not have health insurance in 2011, the third-highest rate in the country. In the face of these many challenges, TTBH served 22,253 (22,041 Hispanic) seriously mentally ill people in 2015 with gold standard person-centered care with a culturally appropriate service delivery system. However, there is no assisted outpatient treatment for the seriously mentally ill with criminal justice issues in the area. TTBH and its partners propose the Valley AOT Care Program to serve Cameron and Hidalgo Counties. TTBH will rigorously apply the protocols and standards of the Evidenced Based Practices of AOT, as a court-ordered treatment. The Valley AOT Care Team will screen at least 200 referrals annually and serve at least 125 clients annually, for a total of 500 over the life of the grant cycle. The program will offer a variety of comprehensive services including Cognitive Behavioral Therapy, Case Management, Psychiatric Services, Crisis Intervention, Supported Employment and Housing Services, and Skills Training and Development. By the end of the grant cycle, at least 90% clients will participate in person centered recovery planning (PCRP) and 75% of clients will be compliant with their PCRP. Other expected outcomes are the reduction of the incidence and duration of hospitalization, reduction of arrests and incarcerations.

The Hinds County Mental Health Commission (d.b.a. Hinds Behavioral Health Services), court and community providers will implement and evaluate the Assisted Outpatient Treatment program delivering evidence-based practices to reduce the incidence and duration of psychiatric hospitalization, homelessness, incarcerations, and interaction with the criminal justice system, while improving the health and social outcomes of individuals with serious mental illness (SMI) and their families. Project Name: Assisted Outpatient Treatment. Population(s) served: Adults (18 years and older) and their families, who reside in Hinds County, are diagnosed with SMI and in need of court-ordered outpatient treatment. Evidence-based services: AOT, Motivational Interviewing, Stages of Change, Person-Centered Treatment, Seeking Safety, Wraparound/Full Service Partnership, peer/family supports, recovery coaching, Crisis Intervention Training, cultural competency cross-systems training and Mental Health First Aid training. Project Goal: Implement culturally competent, trauma-informed, multi-disciplinary community-based outpatient mental health treatment team services to individuals with SMI and their families with a flexible, continuous quality improvement approach utilizing court intervention, person-centered case management, systems navigation and evidence-based practices and programs delivered in the most fully-integrated and least restrictive environment. Number to be served. 75 per year, 300 across four-years.

The Hinds County Mental Health Commission (d.b.a. Hinds Behavioral Health Services), court and community providers will implement and evaluate the Assisted Outpatient Treatment program delivering evidence-based practices to reduce the incidence and duration of psychiatric hospitalization, homelessness, incarcerations, and interaction with the criminal justice system, while improving the health and social outcomes of individuals with serious mental illness (SMI) and their families. Project Name: Assisted Outpatient Treatment. Population(s) served: Adults (18 years and older) and their families, who reside in Hinds County, are diagnosed with SMI and in need of court-ordered outpatient treatment. Evidence-based services: AOT, Motivational Interviewing, Stages of Change, Person-Centered Treatment, Seeking Safety, Wraparound/Full Service Partnership, peer/family supports, recovery coaching, Crisis Intervention Training, cultural competency cross-systems training and Mental Health First Aid training. Project Goal: Implement culturally competent, trauma-informed, multi-disciplinary community-based outpatient mental health treatment team services to individuals with SMI and their families with a flexible, continuous quality improvement approach utilizing court intervention, person-centered case management, systems navigation and evidence-based practices and programs delivered in the most fully-integrated and least restrictive environment. Number to be served. 75 per year, 300 across four-years.

The state of Wyoming Department of Health proposes Project REACH, a comprehensive Assisted Outpatient Treatment (AOT) program in Natrona County for 75 adults annually [300 adults over the life of the project] who may be safely deflected from restrictive placements and served in a community-based program. This program is intended to demonstrate best practices and influence assisted outpatient treatment infrastructure development throughout the state of Wyoming. The target population will include persons, defined under Wyoming law as having severe and persistent mental illness [SPMI], experiencing psychiatric crises who are currently placed on inpatient psychiatric holds, sometimes for 3 months or longer. Expected demographic profile of participants will reflect Natrona County, so approximately 87% will be European- American, 8% Latino, and 2.3% non-native born. Most participants will live in poverty and a subpopulation will experience episodic homelessness and incarceration. The goals of Project REACH are to assist persons with SPMI achieve recovery by reducing placement in restrictive institutional settings and implementing a continuum of evidence-based community interventions, residential alternatives, and engagement strategies, including Assisted Outpatient Treatment. Objectives include: developing formal AOT agreements and training to facilitate deflection to appropriate levels of care, implementation of a Mobile Crisis Outreach Team, development of new Supportive Housing resources, training and implementation of evidence-based practices, developing a customized quality improvement system and sharing findings and future funding recommendations through the sustainability planning process. Evidence-based practices will be: AOT, Mobile Crisis Response, Crisis Stabilization, Supportive Housing, Supportive Employment, Motivational Interviewing, and Wellness Action Recovery Planning.

The state of Wyoming Department of Health proposes Project REACH, a comprehensive Assisted Outpatient Treatment (AOT) program in Natrona County for 75 adults annually [300 adults over the life of the project] who may be safely deflected from restrictive placements and served in a community-based program. This program is intended to demonstrate best practices and influence assisted outpatient treatment infrastructure development throughout the state of Wyoming. The target population will include persons, defined under Wyoming law as having severe and persistent mental illness [SPMI], experiencing psychiatric crises who are currently placed on inpatient psychiatric holds, sometimes for 3 months or longer. Expected demographic profile of participants will reflect Natrona County, so approximately 87% will be European- American, 8% Latino, and 2.3% non-native born. Most participants will live in poverty and a subpopulation will experience episodic homelessness and incarceration. The goals of Project REACH are to assist persons with SPMI achieve recovery by reducing placement in restrictive institutional settings and implementing a continuum of evidence-based community interventions, residential alternatives, and engagement strategies, including Assisted Outpatient Treatment. Objectives include: developing formal AOT agreements and training to facilitate deflection to appropriate levels of care, implementation of a Mobile Crisis Outreach Team, development of new Supportive Housing resources, training and implementation of evidence-based practices, developing a customized quality improvement system and sharing findings and future funding recommendations through the sustainability planning process. Evidence-based practices will be: AOT, Mobile Crisis Response, Crisis Stabilization, Supportive Housing, Supportive Employment, Motivational Interviewing, and Wellness Action Recovery Planning.

The Assisted Outpatient Treatment Program (AOT) is designed to provide increased support and services to at least 75 adult individuals with a serious mental illness per year in Baldwin County, Alabama. The target population is individuals who have a history of multiple involuntary psychiatric hospitalizations, frequent encounters with law enforcement which include arrests, limited social support, limited insight into their diagnosis, homelessness, poor physical healthcare access, and a history of failed treatment compliance with traditional outpatient services. Individual's enrolled in the AOT program will have a treatment team to closely monitor treatment compliance, provide extended hours service delivery, utilize existing services such as the Assertive Community Treatment (ACT) Team and Intensive Day Treatment, provide diagnosis and medication education, teach appropriate daily living skills, and link them to appropriate community resources. The goals of the AOT program are to 1.) Reduce the incidence and duration of psychiatric hospitalizations. Individuals enrolled will meet regularly with their treatment team, who will monitor symptoms, and teach effective symptom management. 2.) Reduce the interactions with the criminal justice system and maintain treatment within the least restrictive environment. By encouraging and monitoring treatment compliance and providing psycho-education, individuals enrolled in AOT will be less likely to have encounters with law enforcement. 3.) Reduce the incidence of homelessness for individuals with a serious mental illness. Individuals, who are identified as homeless will be linked to supportive housing services. 4.) Improve access and compliance with healthcare. Individuals involved in AOT will meet with a benefits specialist to assist in obtaining healthcare benefits, and be linked to an affordable local healthcare provider. 5.) Improve social outcomes for all participants.

The Assisted Outpatient Treatment Program (AOT) is designed to provide increased support and services to at least 75 adult individuals with a serious mental illness per year in Baldwin County, Alabama. The target population is individuals who have a history of multiple involuntary psychiatric hospitalizations, frequent encounters with law enforcement which include arrests, limited social support, limited insight into their diagnosis, homelessness, poor physical healthcare access, and a history of failed treatment compliance with traditional outpatient services. Individual's enrolled in the AOT program will have a treatment team to closely monitor treatment compliance, provide extended hours service delivery, utilize existing services such as the Assertive Community Treatment (ACT) Team and Intensive Day Treatment, provide diagnosis and medication education, teach appropriate daily living skills, and link them to appropriate community resources. The goals of the AOT program are to 1.) Reduce the incidence and duration of psychiatric hospitalizations. Individuals enrolled will meet regularly with their treatment team, who will monitor symptoms, and teach effective symptom management. 2.) Reduce the interactions with the criminal justice system and maintain treatment within the least restrictive environment. By encouraging and monitoring treatment compliance and providing psycho-education, individuals enrolled in AOT will be less likely to have encounters with law enforcement. 3.) Reduce the incidence of homelessness for individuals with a serious mental illness. Individuals, who are identified as homeless will be linked to supportive housing services. 4.) Improve access and compliance with healthcare. Individuals involved in AOT will meet with a benefits specialist to assist in obtaining healthcare benefits, and be linked to an affordable local healthcare provider. 5.) Improve social outcomes for all participants.

The Scammon Bay Native Connections Project aims to partner with the University of Alaska Fairbanks (UAF) to deliver prevention services using a Yup'ik Alaska Native promising practice to serve the 160 youth between the ages of 10 and 24 years old. Through partnership with the university our Tribe seeks to accomplish the following project goals: 1) community mobilization for wellness and readiness assessment, 2) community adaptation of SAMHSA's Strategic Prevention Framework (SPF) to identify strategies and outcomes for substance abuse and suicide prevention that are specific to our local context and standards of care for young people, 3) revision of the Qungasvik (Toolbox) Yup'ik community-driven and cultural prevention model to address current needs, readiness and gaps in localized youth services, 4) revision of the Qungasvik (Yup'ik Toolbox) model to include indicated suicide prevention and postvention strategies for youth and community members, 5) implementation of universal prevention strategies utilizing the Qungasvik (Toolbox) prevention model to service 561 Tribal community members, including Elders, adults and youth, 6) implementation of selective prevention strategies with high-risk, transition-age youth between 18 and 24 years, 7) performance and local evaluation to determine impacts of our strategies on wellbeing and resilience and in the reduction of risk among youth for substance abuse and suicide. For nearly two decades, suicide and alcohol-related injuries have been the leading causes of death for Alaska Native youth between the ages of 15 and 24 years. Our community's long-term partnership with UAF led to the development of the Qungasvik (Toolbox) prevention model with evidence demonstrating how our Yup'ik culture is prevention and can protect our young people against the spirit of suicide and substance abuse.

The Scammon Bay Native Connections Project aims to partner with the University of Alaska Fairbanks (UAF) to deliver prevention services using a Yup'ik Alaska Native promising practice to serve the 160 youth between the ages of 10 and 24 years old. Through partnership with the university our Tribe seeks to accomplish the following project goals: 1) community mobilization for wellness and readiness assessment, 2) community adaptation of SAMHSA's Strategic Prevention Framework (SPF) to identify strategies and outcomes for substance abuse and suicide prevention that are specific to our local context and standards of care for young people, 3) revision of the Qungasvik (Toolbox) Yup'ik community-driven and cultural prevention model to address current needs, readiness and gaps in localized youth services, 4) revision of the Qungasvik (Yup'ik Toolbox) model to include indicated suicide prevention and postvention strategies for youth and community members, 5) implementation of universal prevention strategies utilizing the Qungasvik (Toolbox) prevention model to service 561 Tribal community members, including Elders, adults and youth, 6) implementation of selective prevention strategies with high-risk, transition-age youth between 18 and 24 years, 7) performance and local evaluation to determine impacts of our strategies on wellbeing and resilience and in the reduction of risk among youth for substance abuse and suicide. For nearly two decades, suicide and alcohol-related injuries have been the leading causes of death for Alaska Native youth between the ages of 15 and 24 years. Our community's long-term partnership with UAF led to the development of the Qungasvik (Toolbox) prevention model with evidence demonstrating how our Yup'ik culture is prevention and can protect our young people against the spirit of suicide and substance abuse.

The Toksook Bay Native Connections Project aims to partner with the University of Alaska Fairbanks (UAF) to deliver prevention services using a Yup'ik Alaska Native promising practice to serve the 180 youth between the ages of 10 and 24 years old. Through partnership with the university our Tribe seeks to accomplish the following project goals: 1) community mobilization for wellness and readiness assessment, 2) community adaptation of SAMHSA's Strategic Prevention Framework (SPF) to identify strategies and outcomes for substance abuse and suicide prevention that are specific to our local context and standards of care for young people, 3) revision of the Qungasvik (Toolbox) Yup'ik community-driven and cultural prevention model to address current needs, readiness and gaps in localized youth services, 4) revision of the Qungasvik (Yup'ik Toolbox) model to include indicated suicide prevention and postvention strategies for youth and community members, 5) implementation of universal prevention strategies utilizing the Qungasvik (Toolbox) prevention model to service 660 Tribal community members, including Elders, adults and youth, 6) implementation of selective prevention strategies with high-risk, transition-age youth between 18 and 24 years, 7) performance and local evaluation to determine impacts of our strategies on wellbeing and resilience and in the reduction of risk among youth for substance abuse and suicide. For nearly two decades, suicide and alcohol-related injuries have been the leading causes of death for Alaska Native youth between the ages of 15 and 24 years. Our community's long-term partnership with UAF led to the development of the Qungasvik (Toolbox) prevention model with evidence demonstrating how our Yup'ik culture is prevention and can protect our young people against the spirit of suicide and substance abuse.

The Toksook Bay Native Connections Project aims to partner with the University of Alaska Fairbanks (UAF) to deliver prevention services using a Yup'ik Alaska Native promising practice to serve the 180 youth between the ages of 10 and 24 years old. Through partnership with the university our Tribe seeks to accomplish the following project goals: 1) community mobilization for wellness and readiness assessment, 2) community adaptation of SAMHSA's Strategic Prevention Framework (SPF) to identify strategies and outcomes for substance abuse and suicide prevention that are specific to our local context and standards of care for young people, 3) revision of the Qungasvik (Toolbox) Yup'ik community-driven and cultural prevention model to address current needs, readiness and gaps in localized youth services, 4) revision of the Qungasvik (Yup'ik Toolbox) model to include indicated suicide prevention and postvention strategies for youth and community members, 5) implementation of universal prevention strategies utilizing the Qungasvik (Toolbox) prevention model to service 660 Tribal community members, including Elders, adults and youth, 6) implementation of selective prevention strategies with high-risk, transition-age youth between 18 and 24 years, 7) performance and local evaluation to determine impacts of our strategies on wellbeing and resilience and in the reduction of risk among youth for substance abuse and suicide. For nearly two decades, suicide and alcohol-related injuries have been the leading causes of death for Alaska Native youth between the ages of 15 and 24 years. Our community's long-term partnership with UAF led to the development of the Qungasvik (Toolbox) prevention model with evidence demonstrating how our Yup'ik culture is prevention and can protect our young people against the spirit of suicide and substance abuse.

Link2Health Solutions (L2HS), in partnership with the National Association of State Mental Health Program Directors (NASMHPD), the National Council for Behavioral Health (NCBH), Living Works (LW), the National Association of Crisis Organization Directors (NASCOD) and CONTACT USA (CUSA), will manage the National Suicide Prevention Lifeline (Lifeline) and the Disaster Distress Helpline (DDH), to further enhance and strengthen the Lifeline and DDH's capacity to effectively reach and serve the total potential number of persons at risk for suicide and/or disaster-related distress who might seek telephonic, chat or text-based (SMS) help within the U.S. L2HS will work with West, Inc.-the nation's top telephony systems vendor for connecting 911 calls--to maintain a system of toll-free suicide prevention lines that efficiently links callers to the nearest networked center for local assistance. L2HS will continue to facilitate 24/7 provision of chat (Lifeline) and SMS (DDH) technology platforms through SiteMax and iCarol (chat) and Mosio (SMS) systems. L2HS will continue to regularly provide data to SAMHSA and the network demonstrating connectivity and other user trend reports to monitor service activity and quality. Towards the goal of building network communications, capacity and cohesion, L2HS and its partners will utilize a variety of remote (e.g., web-based newsletters, online Network Resource Center, telephonic and email outreach and education) and direct (conferences, workshops) communications approaches that have proven effective in attracting valuable centers from underserved areas of the country and building a "community of practice" for crisis centers.

Link2Health Solutions (L2HS), in partnership with the National Association of State Mental Health Program Directors (NASMHPD), the National Council for Behavioral Health (NCBH), Living Works (LW), the National Association of Crisis Organization Directors (NASCOD) and CONTACT USA (CUSA), will manage the National Suicide Prevention Lifeline (Lifeline) and the Disaster Distress Helpline (DDH), to further enhance and strengthen the Lifeline and DDH's capacity to effectively reach and serve the total potential number of persons at risk for suicide and/or disaster-related distress who might seek telephonic, chat or text-based (SMS) help within the U.S. L2HS will work with West, Inc.-the nation's top telephony systems vendor for connecting 911 calls--to maintain a system of toll-free suicide prevention lines that efficiently links callers to the nearest networked center for local assistance. L2HS will continue to facilitate 24/7 provision of chat (Lifeline) and SMS (DDH) technology platforms through SiteMax and iCarol (chat) and Mosio (SMS) systems. L2HS will continue to regularly provide data to SAMHSA and the network demonstrating connectivity and other user trend reports to monitor service activity and quality. Towards the goal of building network communications, capacity and cohesion, L2HS and its partners will utilize a variety of remote (e.g., web-based newsletters, online Network Resource Center, telephonic and email outreach and education) and direct (conferences, workshops) communications approaches that have proven effective in attracting valuable centers from underserved areas of the country and building a "community of practice" for crisis centers.

Switchboard of Miami Inc. proposes to implement and sustain a collaborative trauma initiative: PACTT (Providing Adolescents and Children with Trauma-focused Treatment). This initiative was specifically data-driven to identify and address well-documented, unmet needs of trauma-affected children, adolescents and families, which are identified as disparity subpopulations. The other disparity populations PACTT will reach are a large domestic violence shelter and a juvenile justice services department that have specifically requested trauma services to address high unmet needs and military families. While Switchboard has an existing TF-CBT program, it is over-capacity, as is the other major trauma services provider in our large county. PACTT is guided by two overarching goals and many objectives too numerous to mention in the constraints of this abstract. Services Goal 1: Reduce the unmet need for trauma-focused services for Miami-Dade County children, adolescents, and their families; and infrastructure; Goal 2: Strengthen the capacity of the child and youth service delivery system to deliver high quality, evidence-based, trauma-focused care. PACTT proposes to screen (n=1800) and assess (n=1118) for trauma and provide evidence-based TF-CBT services to 475 of these children, youth and families (100 per year minus start-up) whose screening and assessment document internalizing problems, such as depression or anxiety, and/or externalizing problems, like aggression, conduct problems, and oppositional or defiant behavior. Moreover, PACTT will enhance system capacity to become better trauma-informed by training 1350 or more local health and human service professionals and will build trauma-focused infrastructure through creation of an Initial Advisory Leadership Council. The University of Miami Comprehensive Drug Research Center (CDRC), a nationally and internationally recognized research team, will lead the process and outcome evaluation.

Switchboard of Miami Inc. proposes to implement and sustain a collaborative trauma initiative: PACTT (Providing Adolescents and Children with Trauma-focused Treatment). This initiative was specifically data-driven to identify and address well-documented, unmet needs of trauma-affected children, adolescents and families, which are identified as disparity subpopulations. The other disparity populations PACTT will reach are a large domestic violence shelter and a juvenile justice services department that have specifically requested trauma services to address high unmet needs and military families. While Switchboard has an existing TF-CBT program, it is over-capacity, as is the other major trauma services provider in our large county. PACTT is guided by two overarching goals and many objectives too numerous to mention in the constraints of this abstract. Services Goal 1: Reduce the unmet need for trauma-focused services for Miami-Dade County children, adolescents, and their families; and infrastructure; Goal 2: Strengthen the capacity of the child and youth service delivery system to deliver high quality, evidence-based, trauma-focused care. PACTT proposes to screen (n=1800) and assess (n=1118) for trauma and provide evidence-based TF-CBT services to 475 of these children, youth and families (100 per year minus start-up) whose screening and assessment document internalizing problems, such as depression or anxiety, and/or externalizing problems, like aggression, conduct problems, and oppositional or defiant behavior. Moreover, PACTT will enhance system capacity to become better trauma-informed by training 1350 or more local health and human service professionals and will build trauma-focused infrastructure through creation of an Initial Advisory Leadership Council. The University of Miami Comprehensive Drug Research Center (CDRC), a nationally and internationally recognized research team, will lead the process and outcome evaluation.

Switchboard of Miami, proposes to implement Project on the MDC Wolfson Campus in Downtown Miami (33132) through Mental Health First Aid (MHFA) training. Given that MDC transition-aged students are predominantly female (58%), Hispanic (64%), and low income (64%), they are especially at risk for mental health issues and/or substance use disorders. A 2013 NIDA report noted a disturbing trend in injection drug use among a new, young adult cohort of prescription opioid injectors, heroin initiates, and methamphetamine users in Miami-Dade County. Though the need is great, MDC has no student counseling centers or formal process to connect students in distress to the behavioral health services they require. There is no record of any MHFA Instructors or First Aiders within the 33132 zip code and only 6 Instructors and 441 First Aiders "located in and around Miami." The newly trained First Aiders will saturate the MDC Wolfson campus and Downtown Miami (33132) with an estimated ratio of 1 First Aider to every 15 transition-aged youth on campus. Project AWARE goals are to: increase the mental health literacy of adults who interact with the transition-aged youth who attend MDC's Wolfson campus; increase the capacity of adults within our geographic catchment area to respond to the behavioral health issues of transition-aged youth; conduct outreach and engagement strategies with transition-aged youth and their families to increase awareness of and promote positive behavioral health; link transition-aged youth with behavioral health issues to mental, emotional, and behavioral health assistance and services; increase collaborative partnerships with youth-serving agencies and programs.