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The 44th Judicial Circuit Court is the court of general jurisdiction for Livingston County, Michigan. The Livingston County Adult Drug Court (ADC) is a program of the 44th Judicial Circuit Court, started in January 1999, and has accepted over 750 participants. The ADC targets adult non-violent felony and misdemeanor defendants with substance use disorders. All persons must have a moderate or severe substance use disorder and be high-risk. This project will enroll a minimum 40 new participants per year (200 unduplicated new enrollments total). A minimum 15 additional participants will be served per year as a result of this expansion. The following goals and objectives will be accomplished: Goal 1: Increase capacity of the ADC. Objective 1: Increase program capacity by 20 participants (70 participants total) within 12-months of award. Objective 2: Minimum 40 new and unduplicated participants will be enrolled (per year) between the expanded misdemeanor and felony dockets. Objective 3: Minimum 10 additional defendants with an opioid use disorder will be admitted per year. Objective 4: Minimum 10 additional defendants with a stimulant use disorder will be admitted per year. Goal 2: Provide intensive case management to 100% of participants (within 4-months of award). Objective 1: 2 part-time resource coordinators (case managers) will be hired within 4-months from date of award (to remain on staff for the life of this project). Objective 2: 1 part-time peer recovery coach will be hired to serve both dockets within 4-months from date of award (to remain on staff for the life of this project). Objective 3: 80% of successful participants will improve overall social functioning, from time of admission to graduation (measured pre/post). Objective 4: 80% of successful participants will improve employment status from time of admission to graduation (measured pre/post). Objective 5: 80% of successful participants will improve housing status from time of admission to graduation (measured pre/post). Objective 6: ADC retention rate will increase 10% from, when compared to historical program rates (pre- enhancement cohort of participants) Objective 7: ADC graduation rate will increase 10% from, when compared to historical program rates (pre- enhancement cohort of participants) by the end of this project, September 30, 2029. Goal 3: Implement two new evidence-based treatment programs to address trauma and addiction. Objective 1: Increase by 10% the average number of hours of treatment services received by participants, from time of admission to discharge. Objective 2: 100% of participants (who voluntarily choose) will have access to trauma focused therapy using Eye Movement Desensitization Reprocessing (EMDR), within 4-months from grant award (and to continue for the life of this project). Objective 3: 100% of participants will have access to Moral Reconation Therapy (MRT), within 4-months from grant award (and to continue for the life of this project). Objective 4: 100% of participants (who voluntarily choose and are medically eligible) will have access and be permitted to use MAT. Objective 5: 100% of participants (who voluntarily choose) will have access to HIV and Hepatitis screening and confirmation testing, within 4-months from grant award (and for the life of this project).

Centerstone’s Treatment and Recovery Court (C-TRC) will expand substance use disorder (SUD) treatment and recovery support services in Giles, Lawrence, Maury, and Wayne counties, Tennessee. C-TRC will serve an unduplicated 200 adults (ages 18+) with SUD as their primary condition participating in Tennessee’s 22nd Judicial District Recovery Court (i.e., Y1-5: 40, yearly). Focus population demographics are expected to mirror those of current drug court participants, with 47% male, 53% female, 91% White, and 3% Black individuals. Each year, the Court serves 34 and another 76 may be eligible for drug court participation; of those, at least 30% (10) are expected to have opioid use disorder (OUD) and up to 40% (14), co-occurring SUD and mental health disorders (COD). At rates per 100,000, Black/African Americans (ages 15-64) in Lawrence represent 1,067 of the population yet 6,063 of those incarcerated (vs. White individuals at 92,716 yet 1,100). The 62 unsheltered homeless individuals in the TN-503 Continuum of Care, which includes all C-TRC counties, are 9 times more likely to spend time in jail than those in shelters; from 2013-2019, adult incarceration rates increased in rural areas (26%), while urban (-22%) and suburban (-6%) rates decreased. In the U.S., compared to adults overall, 3 times as many LGB adults are incarcerated and 7% (vs. 4%) had past year opioid misuse. C-TRC’s culturally appropriate and evidence-based strategies will be implemented in alignment with NADCP’s Defining Drug Courts: Key Components and guided by SAMHSA’s Harm Reduction Framework and TIP 59: Improving Cultural Competence. Treatment interventions include the Matrix Model for Criminal Justice Settings and will be complemented by Hazelden’s Co-Occurring Disorders Program; Moral Reconation Therapy; Dialectical Behavior Therapy; Seeking Safety; Parent Management Training; Medication Assisted Treatment, as guided by SAMHSA’s TIP 63: Medications for OUD and TIP 49: Incorporating Alcohol Pharmacotherapies into Medical Practice; and DIMENSIONS: Tobacco Free Advanced Techniques Program. Case management services will be guided by the TASC Specialized Case Management Model, and SAMHSA’s Opioid Overdose Prevention and Response Toolkit will inform harm reduction education. C-TRC’s goals include: 1) Implement a comprehensive project to expand access to SUD treatment and recovery support services; 2) Implement capacity-building activities to expand, enhance, and sustain services; 3) Use evidence-based Treatment & Case Management Planning (TCMP) to address behavioral health disparities; social determinants of health; and diversity equity, inclusion, and accessibility; 4) Improve client health status/outcomes via evidence-based, population appropriate treatment services; and 5) Develop/disseminate a documented service model for agency replication/adoption throughout the state. C-TRC will achieve the following measurable objectives: provide training for 5 C-TRC staff and 50 Centerstone/other providers in SUD/COD identification, culturally/linguistically-appropriate care, harm reduction, and relapse prevention; provide/facilitate comprehensive screening/assessment, drug testing, TCMP, and evidence-based SUD treatment for an unduplicated 200 focus population adults; link 100% of those in need to appropriate resources (e.g., housing/recovery housing, employment, transportation, language access services); increase substance use abstinence among 70%; reduce mental health symptoms among 60% with COD; reduce tobacco/nicotine use among 30% with such goals; improve employment/education status among 60% who received such services; improve housing stability among 60% who received such supports; reduce past 30-day criminal justice involvement among 60%; improve individual/family functioning among 70%; increase social connectedness among 70%; and retain 60% in service for treatment/completion.

Centerstone’s Comprehensive Treatment Court (C-CTC) will expand substance use disorder (SUD) treatment and recovery support services for an unduplicated 240 adults (ages 18+) with SUD as their primary condition participating in Florida’s Manatee County Drug Court (i.e., Y1: 40; Y2-5: 50, yearly). Focus population demographics are expected to mirror those of current drug court program participants, with 69% male, 31% female, 63% White, 19% Black, and 13% Hispanic/Latino individuals. Manatee County Drug Court serves 164 yearly, and another 100+ may be eligible for drug court participation; of those, at least 50% (132) are expected to have moderate to severe opioid use disorder (OUD) and up to 40% (106), co-occurring SUD and mental health disorders (COD). By 2023, area homelessness had increased 300% from 2021. Compared to area White adults, area Black adults have lower rates of past-year SUD and are incarcerated for drug charges at higher rates; HIV diagnosis rates are 6 times higher for Black vs. White males. In 2017-21, area injection drug use resulted in a 366% increase in acute Hepatitis C infections; from 2013 to 2022, syphilis rates grew by 360%. C-CTC’s culturally appropriate and evidence-based strategies will be implemented in alignment with NADCP’s Defining Drug Courts: Key Components and guided by SAMHSA’s Harm Reduction Framework and TIP 59: Improving Cultural Competence. Treatment interventions include Cognitive Behavioral Therapy; Motivational Interviewing; integrated COD treatments (e.g., SAMHSA’s Integrated Treatment for COD EBP KIT, TIP 42: SUD Treatment for Persons with COD); supplemented by Moral Reconation Therapy; Dialectical Behavior Therapy; Seeking Safety; Medication Assisted Treatment as guided by SAMHSA’s TIPs 63: Medications for OUD and 49: Incorporating Alcohol Pharmacotherapies into Medical Practice; and DIMENSIONS, as appropriate. Case management services will be guided by the TASC Specialized Case Management Model and include, as appropriate, Housing First and SSI/SSDI Outreach, Access, and Recovery. SAMHSA’s Opioid Overdose Prevention and Response Toolkit will inform harm reduction education. C-CTC’s goals include: 1) Implement a comprehensive project to expand access to SUD treatment and recovery support services; 2) Implement capacity-building activities to expand, enhance, and sustain services; 3) Use evidence-based Treatment & Case Management Planning (TCMP) to address behavioral health disparities; social determinants of health; and diversity equity, inclusion, and accessibility; 4) Improve client health status/outcomes via evidence-based, population appropriate treatment services; and 5) Develop/disseminate a documented service model for agency replication/adoption throughout the state. C-CTC will achieve the following measurable objectives: provide training for 5 C-CTC staff and 50 Centerstone/other providers in SUD/COD identification, culturally/linguistically-appropriate care, harm reduction, and relapse prevention; provide/facilitate comprehensive screening/assessment, drug testing, TCMP, and evidence-based SUD treatment for an unduplicated 240 focus population adults; establish an Advisory Council comprising 51% focus population/individuals with lived experience; outreach to 200 stakeholders; develop a sustainability plan with linkages to 2 funding mechanisms; link 100% of those in need to appropriate resources (e.g., housing/recovery housing, employment, transportation, language access services); increase substance use abstinence among 70%; reduce mental health symptoms among 60% with COD; reduce tobacco/nicotine use among 30% with such goals; improve employment/education status among 60% who received such services; improve housing stability among 60% who received such supports; reduce past 30-day criminal justice involvement among 60%; improve individual/family functioning among 70%; increase social connectedness among 70%; and retain 60% in service for treatment/completion.

The Health Equity and Improvements Gained through Holistic Treatment (H.E.I.G.H.T), a project of the Fourth Judicial Circuit of Intervention Court (formerly drug court) that serves three Mississippi Delta counties (Leflore, Sunflower, and Washington), will expand the program's service delivery model to address the growing needs of the region’s adult population, particularly court involved Black/AA men and women between 18 to 49 years of age. The objectives of this expansion are to: (a) increase participants’ self-efficacy, resilience, and health outcomes by 70% through the development and implementation of a whole-person-centered, holistic curriculum; (b) increase the early identification and prompt placement of unduplicated participants who are either directly contacted or who are referred to the Fourth Judicial Circuit Intervention Court by 30%; (c) increase visibility of alumni personal narratives across the Fourth Judicial Circuit by raising awareness of stigma and the path to success by 30% through a deliberate media and messaging campaign; and (d) increase alumni and stakeholder integration of community engagement by establishing Community Action Partnership for Encouragement (C.A.P.E.) to assess and provide feedback on the Intervention Court’s implementation and practices Overall, the Mississippi Delta has a majority Black/AA population, and social determinants of health (SDOH) shape access to health, quality of education, and employment. Health behavior and decision making, including the use of substances such as alcohol, drugs, and even tobacco contributes to overall lower health outcomes. Most participants in the Intervention Court are Black/AA males, who are more likely to have lower reported socioeconomic statuses than other demographic groups. Mississippi law allows for each circuit to determine how it will implement its Intervention Court services. Current statutes allow participants up to five years to complete the program. State statute defines eligibility as offenders who have been charged with or convicted of felony non-violent offenses, including drug offenses, drug or alcohol abuse or dependence, and drug related property crimes. According to the Mississippi Opioid and Heroin Data Collaborative, in the first quarter of 2023, the Fourth Judicial Circuit ranked near the top among all districts for reported non-fatal drug overdoses for opioids, heroin, and stimulants per 100,000 people. By expanding the Intervention Court’s services, we will be able to increase our roster of eligible participants by 30%. We also propose to use more wraparound services, assuming a whole-person approach to addressing factors that may contribute to a participant’s inability to complete the program. We will use innovative interventions such as a multimedia strategy that engages alumni to tell their stories of substance use disorder and the path it took for them to complete the Intervention Court program. We will also engage more cross-sector partners, including law enforcement, defense attorneys, prosecutors, alumni of the Fourth Judicial Intervention Court, and community members. We project that we will serve 150 unduplicated individuals over the five years, with an average of 30 participants per year.

The Grant for Transformative Change through DBT Implementation aims to revolutionize services within the McHenry County Specialty Court System by integrating Dialectical Behavioral Therapy (DBT). In its inaugural year, the grant targets serving 45 clients, with a planned annual increase of 20% to expand coverage each subsequent year. This program is committed to reaching all clients within the Specialty Court System, offering tailored support to address substance abuse challenges. DBT is a powerful tool in this endeavor, providing a structured framework that enhances emotional regulation and coping skills. By combining Cognitive Behavioral Therapy (CBT) techniques with mindfulness and acceptance concepts, DBT equips individuals with skills in emotion regulation, interpersonal effectiveness, distress tolerance, and mindfulness. The dialectical aspect emphasizes finding a balance between acceptance and change, fostering a more adaptive approach to coping with life's challenges. Through DBT implementation, individuals are supported in addressing both addiction and underlying mental health issues, paving the way for lasting transformative change within the Specialty Court System.

Brandywine Counseling and Community Services, Inc. (BCCS) is proposing the implementation of an ATDC Program and Capacity Enhancement Project with funding from the U.S. Department of Substance Abuse and Mental Health Services Administration (SAMHSA) through its Notice of Funding Opportunity (NOFA) No. TI-24-004 entitled Grants to Expand Substance Use Disorder Treatment Capacity in Adult and Family Treatment Drug Courts (Short Title: SAMHSA Treatment Drug Courts). BCCS is proposing to implement evidence-based programmatic enhancements to expand substance use disorder (SUD) treatment and recovery support services in Delaware's established Court of Common Pleas DUI Treatment Court. Through this funding opportunity, SAMHSA recognizes the need for treatment instead of incarceration for individuals with SUDs. BCCS will provide prevention, harm reduction, treatment, and recovery services for individuals with SUD referred to BCCS by Delaware's DUI Court. Objectives of the expansion include improved rates of abstinence from substance use, increased rates of housing stability, improved rates of employment status, increased social connectedness, and reduced rates criminal justice involvement and recidivism in enrolled participants. Through this expansion of SUD treatment and recovery services, BCCS will screen and assess clients for the presence of SUD and/or co-occurring substance use and mental disorders and use information obtained from the screening and assessment to develop culturally and linguistically appropriate prevention, harm reduction, treatment services; screen for infectious diseases for which those with SUDs are at high risk, including, but not limited to, Human Immunodeficiency Virus (HIV), viral hepatitis (hepatitis A, B, and C), and syphilis and provide appropriate referral and follow-up to ensure treatment if screening tests indicate infection, and vaccination for those infectious diseases for which a vaccine is available; provide evidence-based and culturally and linguistically appropriate treatment services to meet the unique needs of diverse populations at risk (treatment services will include the use of FDA-approved medications in the treatment of opioid use disorder and medication management in outpatient, day treatment (including outreach-based services) and intensive outpatient); provide peer recovery support services that provide emotional and practical support to maintain client/participant remission; provide family engagement opportunities (e.g., parenting classes, fatherhood programming, family-centered or relational-based therapy, etc.); provide comprehensive case management plans that directly address risks for recidivism, as determined by validated risk assessments, and include delivery or facilitation of services to appropriate clients, including substance use and cognitive behavioral interventions, to address needs and reduce those risks (case management will include assisting eligible uninsured clients with applying for health insurance); provide language access services (to include interpretation, translation, disability accommodations, and accessibility) to support required activities, as applicable Available funding is $400,000 per year for five (5) years, for a total of $2M. BCCS will serve a minimum of forty (40) referred Superior Court Diversion Drug Court participants per program year for a total of two-hundred (200) unduplicated participants.

Summary of Project: The Arkansas Rural Health Partnership (applicant) will partner with two Adult Treatment Drug Courts located in rural Arkansas (Monticello & DeWitt) to strategically expand substance use treatment and recovery support services to drug court clients. To accomplish efforts, diverse cross-sector partners including rural hospitals, federally qualified health centers, behavioral health treatment facilities, and workforce agencies will be engaged. Project Name: Breaking Free from Substance Use: Rural Arkansas Drug Court Project Population(s) to be Served: The target population is adults (age 18 and above) diagnosed with substance use disorder (SUD) as their primary condition who participate in selected Adult Treatment Drug Courts (ATDC) in Arkansas and Drew Counties, Arkansas. The adult drug court client population is largely male (67%), Caucasian (68%) (followed by African American (30%)), English-speaking, and between the ages of 20 to 40 (75%). Strategies/Interventions: The proposed project will support and expand successful best-practice drug court efforts. This will be accomplished by 1) hiring dedicated staff to support the coordination, implementation, and evaluation of efforts, 2) facilitating the convening of project partners and key stakeholders to enhance communication and coordination of service delivery, 3) providing individualized peer support to drug court clients to promote successful engagement in the treatment and recovery process, and 4) improving the collection of relevant data across multiple partners to support demonstrated improvements in access to health and health-social services (including but not limited to substance use treatment and recovery) in drug court clients. Project Goals & Measurable Objectives: Goal 1. Beginning October 2024, strengthen and expand existing infrastructure to provide comprehensive health and health-social support (including Substance Use Disorder treatment and recovery support) to adults diagnosed with substance use disorder (SUD) as their primary condition who participate in selected Adult Treatment Drug Courts (ATDC) in rural Arkansas. Objectives: 1) In the pre-award phase, the Arkansas Rural Health Partnership (applicant) will develop formal partnerships with participating Adult Treatment Drug Courts, health, health-social, and workforce organizations; 2) Upon notice of award, the Arkansas Rural Health Partnership (ARHP) will transition existing staff (4) and assign a Capstone student (1) to support the coordination, implementation, and evaluation of project efforts; and 3) By December 31, 2024, establish and disseminate clearly defined processes, work flows, referral patterns, and data collection tools to support best-practice improvements within the drug court process. Goal 2. Throughout the five-year period of performance, improve the health and wellness of at least 240 individuals with SUD involved with participating drug courts in rural Arkansas. Objectives: 1) Beginning January 2025, provide prevention, harm reduction, treatment, and recovery services for 40-50 individuals with SUD involved with the courts each year; and 2) Beginning January 2025, provide targeted peer recovery support services to 40-50 individuals with SUD involved with the courts each year to strategically improve health, health-social, and criminal justice involvement outcomes. Number of People to be Served Annually: Yr 1: 40; Yrs 2-5: 50 Number of People to be Served for the Entire Project: At least 240

The Eastern Shawnee Tribal Mental Health Program will deliver SAMSHA Public Health Model including Tier 1 Universal Prevention Strategies Awareness Campaign, Tier 2 Selective and Targeted Prevention Strategies and Tier 3 Indicated Prevention Strategies focused on youth who are at high risk for suicide and/or substance misuse or have already attempted suicide or may be misusing substances to youth age 10-24 in Ottawa County Oklahoma. The program will conduct suicide prevention and alcohol and drug misuse prevention at community gatherings, program activities that include prevention messaging. The program will also provide individual therapy and drug and alcohol counseling. The program will provide program activities and mental health services to at least 40 youth annually and 160 youth throughout the five years of the project and will provide prevention messaging to 1,000 youth. There are nine federally recognized tribes including the Eastern Shawnee Tribe of Oklahoma in Ottawa County. The program will be located at the Eastern Shawnee Wellness Center and will serve anyone in Ottawa County. The population of Ottawa County is 30,338 according to U.S. Census Bureau 2022 Quick Facts. 25% of the population is under eighteen. 13% of the population is 20-29. 21% of the population is Native American. 50.6% is female. According the the Oklahoma Health Department Oklahoma has the 7th highest rate of suicide. 31 individuals from Ottawa County committed suicide between 2018-2021. There were 33 unintentional overdose deaths between 2018-2021. Goal: Decrease the number of deaths in Ottawa County by suicide and accidental overdose by increasing Tier 1 Universal Prevention Strategies Awareness Campaign, Tier 2 Selective and Targeted Prevention Strategies and Tier 3 Indicated Prevention Strategies as determined by community planning. Objective 1: The ESTOO Planning Team will conduct a Community Needs Assessment by January 30, 2025. Objective 2: The ESTOO Planning Team will conduct a Community Readiness Assessment by March 30, 2025 Objective 3: The ESTOO Planning Team will complete the Tribal Strategic Action Plan by June 30, 2025. Objective 4: The ESTOO Tribal Mental Health Program will begin to implement actions identified in the Strategic Action Plan by September 30, 2026.

The Scammon Bay Native Connections project will utilize our ancestral strengths and traditional Yup'ik ways of life to deliver an evidence-based prevention service program for our youth called Qungasvik (Tools for Life). Our vision for substance abuse prevention, suicide prevention and mental health promotion in Scammon Bay is to strengthen our identity as Yup'ik people. Our vision aligns with SAMHSA’s National Tribal Behavioral Health Agenda (TBHA) which, ""elevates the importance of tribal identities, culture, spiritual beliefs, and practices for improving well-being."" Our overall goal is to reduce the unacceptable burden that suicide and alcohol abuse has placed on our community and our youth. To accomplish this goal, we propose to implement the Qungasvik (Tools for Life) evidence-based intervention that has been shown through research and data to reduce risk for alcohol use and suicide and to promote protective factors, reasons for life and sobriety in Alaska Native youth. Our Scammon Bay Native Connections project will serve the entire community of 600+ members through universal prevention strategies and Tribal gatherings. Culturally-centered selective and indicated prevention strategies will focus on engaging 180 young people 10-24 years who are at risk in the community in peer-based and Elder-led activities that promote positive behavioral health and holistic well-being. Young people at the highest risk ages 15-24 will also receive a referral into a new behavioral health cultural services project called Because We Love You (BeWeL), a brief virtual intervention adaptation of the Qungasvik (Tools for Life) prevention model. Our community has already shown in our first Native Connections project (Cohort 2) that we can be change leaders, and that we can come together to surround our young people with teachings, practices, and resources from our culture and our ancestors. We seek to build on our growing foundation of hope and healing with this new Native Connections project and become a model for sustained community change.

FITE FOR THE FORGOTTEN THE SACRED HOOP OF HEALING NATIVE CONNECTIONS, SM23-021 Abstract In addition to supporting mental health and healing for Native American children, teens, and their families, the Sacred Hoop of Healing will equip Native American communities with the knowledge, skills, and materials required to develop a coordinated, evidence-based, and comprehensive approach to preventing suicide and substance abuse and misuse. The Sacred Hoop of Healing will boost mental health programming to successfully serve Native Americans in the targeted service region by drawing on community and culture. Additionally, the goal of this initiative is to reduce the disparity between Native American youth's need for services and their availability. Cultural methods, family, youth, and community resource integration, as well as cross-system collaboration, are highly valued in the Sacred Hoop of Healing. This trauma-informed system will integrate traditional Western medicine with Native American healing. traditions to address underage drinking and suicide, strengthen preventive capabilities, and offer intervention services to American Indian youth and emerging adults, aged 0-24, living in Delaware and Cherokee Counties. The Sacred Hoop of Healing will improve the provision of services, practices, and cultural. experiences that lower suicide and substance misuse and support a whole-body approach to health and healing through community partnerships and interactions by: 1. Enhancing the ability of Native American communities to supply tools, services, and resources that boost the mental well-being of Native American youth by expanding collaborations and information the community about methods to prevent suicides and increase its awareness. 2. Strengthening relationships across different community sectors, implementing referral protocols, and promoting cross-system cooperation, Native American children and their families aged 0 to 24 will have greater awareness of and access to mental health services. 3. Reducing the number of suicides, attempted suicides, and suicidal thoughts among Native American students and their peers by working with schools to use screening procedures, a text intervention, an evidence-based, peer-to-peer, strengths-based prevention program, and a message of hope for all school systems. 4. Incorporating the four sections of the medicine wheel (Sacred Hoop): spiritual, emotional, physical, and mental, to promote a holistic approach to improving mental health of Native American Youth. Family, community, culture, and tradition are also included in the Sacred Hoop of Hope’s approach. 5. Taking a ‘nothing for the people without the people’ approach to all planning, implementation, and evaluation procedures of the grant. The project anticipates serving a minimum of 500 Native American youth through services provided in the school systems and 2500 through other strategies like information dissemination, provider training, and a podcast annually.

Population of Focus: Tribal Youth 24 Years of Age and Younger in the Houston Metro Area Number of Individuals to be Served: 150 Native Healthcare Center seeks funding to reduce the risk of suicide among tribal youth tribal youth and young adults ages 24 and below facing mental health issues and those with co-occurring substance misuse. Funding from this project will provide tribal youth suffering from ADD, ADHD, depression, bi-polar disorder, and other mental/behavioral health disorders access to culturally appropriate services to improve behavioral health outcomes. Through the implementation of this program, Native Healthcare Center hopes to accomplish five goals: 1)Enhance access to treatment services for tribal youth 24 and younger with behavioral health/mental health/substance use disorders due to lack of available health insurance plans, CHIP/Medicaid, or health care policy restrictions. 2)Initiate a network of local and community outreach partners to cooperate in mental health awareness training and to develop an ongoing implementation of community-wide awareness to learning about mental health well-being in tribal youth communities. 3) Development of tribal behavioral health/mental health/substance misuse guidelines and procedures to improve outreach programs and treatment services for tribal youth and young adults living in urban communities to help reduce the risk of suicide and self-destructive behaviors. 4)Partner with school systems within tribal communities to implement culturally appropriate, evidence-based programs that reduce youth substance misuse., and 5)Establish evidence-based practice-based programs for youth 24 and younger in several areas by providing presentations on anti-drug and drinking materials, suicide gatekeeping, and prevention activities focusing on creating and maintaining positive mental health and culturally appropriate lifestyles in tribal communities.

This proposal and funding aim to address a crucial need for the Leech Lake Band of Ojibwe. The objective is to coordinate efforts of services and programs within the Leech Lake Reservation to specifically address suicide, substance abuse, and the traumatic impact it has had on our youth. The Leech Lake Band of Ojibwe currently has programs that provide services in alignment, which Native Connections funding aims to address. However, due to the operational structure of the Leech Lake Band of Ojibwe, these services are scattered among divisions. These services are under the Health Division, Behavioral Health Division, Addictions and Dependency Division, and the Educational Division. The divisions each operate in a siloed capacity but face similar programming challenges. The challenges include reachability, accessibility, adherence, utility, and, most of all, being ill-informed about the services due to a lack of opportunity to consult or advise on which services or practices are best to participate in or promote. Native Connections funding will allow a consortium of community members, services, youth advisory council, and the scattered divisions address the burdens are impacting the youth of the Leech Lake Band of Ojibwe.

The program aims to strengthen community bonds and well-being by integrating traditional knowledge from Elders with youth initiatives. It seeks to extend outreach to schools and community programs to tackle prevalent issues effectively. Evidence-based interventions like Red Road to Wellbriety, QPR Suicide Prevention, and Trauma-Focused Cognitive Behavioral Therapy are employed to address high-risk behaviors such as suicide ideation, substance abuse, and truancy. Through targeted outreach events and educational campaigns, substance use awareness is heightened and reduced within the community. Furthermore, mental health literacy is advanced in schools through comprehensive education covering substance abuse, suicide prevention, and overall mental health. The Strategic Prevention Framework (SPF) from SAMHSA guides the program's selection, implementation, and evaluation of culturally appropriate prevention activities, ensuring a holistic and culturally sensitive approach to community well-being. In terms of demographic profile, the AI/AN youth within this catchment area reflect the rich cultural heritage of the Ahtna Tribes. They primarily identify as Alaska Native or American Indian, a majority of which speak English and very few speaking their native languages such as Ahtna Athabascan, which is one of the driving factors for using cultural connections as a driving force for preventing suicide. The youth population encompasses individuals of various sexes, gender identities, and ages, typically ranging from adolescents to young adults aged 12 to 24 years old. While data on sexual orientation may be limited, our program aims to be inclusive and supportive of all AI/AN youth, irrespective of sexual orientation. Moreover, the socioeconomic status of these communities face significant economic challenges due to factors such as remoteness, limited employment opportunities, and lack of infrastructure. In fact, the per capita income of households is 10% lower than that of the rest of the United States, and the poverty rate of children under 18 is 33% higher than the national average. These factors greatly contribute a 5% less likelihood of obtaining any level of college education within our communities.

Population To Be Served: Our NC Project will serve the 12,350 youth, age 24 and under, of the Yukon Kuskokwim (Y-K) Delta region of Southwest Alaska, an area covering 75,000 square miles, is larger than the state of Washington. This region includes 58 federally recognized tribal communities and has one of the highest concentrations of indigenous Native Americans in Alaska and the Lower 48 states. Strategies / Interventions: Calricaraq, our Yup’ik ancestral way of healthy living, is being reintroduced to our people through the traditional healing staff of the BH Prevention Department at YKHC. Calricaraq is an Elder-driven program that encompasses our Yup’ik ancestral wisdom and knowledge and is our holistic approach to help people heal from the impacts of colonization. Calricaraq serves community members of all ages, but we focus most of our efforts on parents and school-age youth. We also provide training to service providers who work with our Tribal members, i.e., health care and social service workers, Elders, hospital patients and their families, schoolteachers, first responders and others. In addition, our staff are trained in crisis response, responding to communities and family members involved in traumatic incidents (homicide, suicide, plane crashes, etc.), where we intervene for those going through times of crisis, guiding them through grief in healthy ways using cultural strengths. If funded, the Native Connections staff will have a direct focus on the youth of our region and will be part of our BH Prevention team. Project Goals and Measurable Objectives: In Year 1 of the grant, the NC staff will 1) conduct a Community Needs Assessment, 2) Community Readiness Assessment; and create a Strategic Action Plan based on these assessments that addresses suicide prevention, substance use prevention, and mental health disorders. Secondly, we will revise our YKHC BH Postvention Protocols, including suicide, suicide attempts, suicide clusters, and substance misuse and overdose to reflect the traditions and culture of the Yup’ik, Cup’ik, and Athabaskan people of the Y-K Delta region. Finally, and what we believe will be most impactful to our youth is the traditional and cultural youth outreach services and activities to our Y-K Delta Region villages. This outreach will be provided through Calricaraq workshops, Qaruyun (healthy Yup’ik living and coping skills) workshops, and QPR Suicide Awareness Training. Number of people to be served annually: 300 Number of people to be served through the lifetime of project (5 years): 1,500 Summary of Project: Calricaraq (“living well”) is an Elder-driven program using Yup’ik ancestral wisdom and knowledge to help people heal. We serve the Yup’ik, Cup’ik and Athabaskan youth in the fifty-eight villages of the Yukon Kuskokwim Delta of Southwest Alaska. Our intervention includes Calricaraq workshops, Qaruyun (healthy Yup’ik living and coping skills) workshops, and QPR Suicide Awareness Training. We aim to provide outreach to 1,500 youth over the 5-year grant.

Abstract Kiowa Prevention Network 2024 In describing the extent of problems within the Kiowa Tribe geographic catchment area would be the various impacts of substance use despite the strengths of American Indian and Alaska Native (AI/AN) families and communities. Other problem is suicide, which remains a devastating and all too frequent event. Complex, interrelated factors contribute to an increased suicide risk among Native American people and include mental health disorders, intergenerational trauma, and community-wide issues. According to a report from the Oklahoma Department of Mental Health and Substance Abuse Services. The report further states, “Emotional disturbances and substance abuse among youth (ages 10-19) occur at alarming rates. About 10% of Oklahoma youth have a mental health disorder and an additional 10% have a substance abuse issue.” The report also reveals that local teens don’t have enough activities to participate in to keep them out of trouble; (3,000) three-thousand teens admitted they were bored. The 2023. Caddo Health Department conducted community meetings and surveys within Caddo County. The results from the Carnegie Health Care Assessment Survey found that the top health concern was under the category of mental health and substance abuse. The three areas were: prescription drug abuse, methamphetamine, suicide, and suicide attempts. The survey reported that in the area of social and economic factors—children were living in poverty in Caddo County. And that the rates are at a 19% level higher than the rate of 15% within the state of Oklahoma. The Anadarko Physicians Hospital also conducted a Health Care Assessment Survey. Community members expressed their top health concerns were: Mental Health and Depression to Suicide, Lack of Resources, and Alcoholism. According to the Oklahoma Department of Mental Health’s Substance Abuse (ODMH) reported that $1 spent on prevention saves $14 in taxpayer money. The report from ODMH in 2016-2020, indicated 162 suicide deaths in the state of Oklahoma between the ages of 10-24 years old. Also, a report from ODMHSAS states that in Caddo County 67% of mental health issues go untreated for the ages of 17 and under, and 89% of mental health goes untreated for the ages 18 and over. In 2015, the highest U.S. suicide rate (15.1) was among Whites and the second highest rate (12.6) was among American Indians and Alaska Natives. Much lower and roughly, similar rates were found among Hispanics (5.8), Asians and Pacific Islanders (6.4), and Blacks (5.6). The Oklahoma State Department of Health (OSDH) reports that youth suicide numbers continue to rise in Oklahoma Between 2010 and 2014, youth suicide death from ages 10 to 24 years of age has increased by 31% with an average of 85 youth dying each year by suicide. In addition, the Kiowa Tribe Elder Program conducted a survey that reflected that the Native American Youth and Young Adults need the following protective factors against suicidal behavior, the findings are as follows: A sense of belonging to one's culture, a need for strong tribal/spiritual bond, the opportunity to discuss problems with family or friends, feelings to experience a connection to a family and a need for mentorship and positive emotional health. The Kiowa Teen Suicide Prevention Program understands the current service gaps within the target counties and is trying to provide the needed support to at-risk youth. Some of the gaps are a lack of: traditional and other resources to support the community grieving process, addressing suicide stigmata and provide an increase QPR training for targeted youth to response to a suicide crisis, increase communication between behavioral health services and a school-community collaboration. The Kiowa Teen Suicide Prevention Program has been key to develop a community prevention....**PLEASE SEE ATTACHMENT FOR COMPLETE ABSTRACT

ABSTRACT: Background: The Alaska Native communities in the Bering Strait Region are facing a critical public health crisis characterized by high rates of suicide, pervasive substance misuse, and the debilitating impact of intergenerational trauma. Traditional mental health and substance abuse interventions have often fallen short due to a lack of cultural sensitivity and community-centric approaches. Objective: Kawerak Inc. seeks to revolutionize mental health and substance abuse interventions among Bering Strait youth up to the age of 24. With the funding from this Native Connections, Tribal Health Grant, the Circle of Hope Project aims to prevent and reduce suicidal behavior and substance misuse, mitigate the impact of trauma, and promote mental health through the integration of culturally sensitive practices. It strives to build a robust network of systems, services, and partnerships tailored to the community’s unique cultural, resource, and readiness needs, with the ultimate goal of pioneering a sustainable model for community change. Methods: This initiative will employ a multi-faceted approach, deeply ingrained in Native Alaska cultural practices and values. Key strategies include the implementation of culturally relevant preventive interventions, community and family engagement activities, capacity building for local leaders, and the establishment of partnerships with both tribal and non-tribal organizations. Furthermore, the program will leverage traditional knowledge and practices in healing and wellness, complemented by evidence-based mental health interventions. Expected Outcomes: The Kawerak Wellness Program anticipates a measurable reduction in instances of suicidal behavior and substance misuse among the targeted youth population. It also aims to enhance community readiness to address these issues, strengthen the cultural connectedness and resilience of Alaska Native youth, and increase the availability of and access to culturally appropriate mental health resources, Ultimately, the program endeavors to establish a reproducible model of community-driven change that significantly improves the overall well-being of Alaskan Natives communities in the Bering Strait Region and beyond. Conclusion: The urgency and complexity of the mental health and substance abuse crisis in Alaskan Natives communities in the Bering Strait Region demand innovative, culturally integrated solutions. The Kawerak Wellness Program represents a forward-thinking response to this crisis, promising not only to address the immediate needs of Alaskan Natives youth but also to lay the groundwork for long-term community resilience and health. Through its comprehensive, culturally rooted approach, the program holds the potential to transform the landscape of mental health and substance abuse intervention in indigenous communities.

The goal of this project is to utilize the foundation that Native Connections has given us and continue to build unique and culturally tailored systems of care for our immediate and surrounding tribes in northern New Mexico. Northern New Mexico Pueblo's are in some of the most geographically isolated locations in the state, with access to resources being moderately available to extremely limited or unavailable. Our goal is to make resources to mental health and prevention services widely available and accessible to individuals, families, communities, and Native American programs.

Project Abstract Summary Summary: The Quapaw Nation will partner with Northeastern Tribal Health Systems, local schools located within Ottawa County, and eight Federally recognized Tribes headquartered in Ottawa County to engage in comprehensive planning efforts to develop and implement an array of coordinated, integrated services and supports to prevent and reduce suicidal behavior and substance use, reduce the impact of trauma, and promote mental health among Native American youth. Project Name: Quapaw Nation Native Connections Youth Program Population to be served: Native American youth ages 5-24 located in Ottawa County, OK. Strategies/interventions: Engage the community to update and revise the Community Readiness Assessment, and a Strategic Action Plan to determine the level of support needed and guide the implementation of coordinated, comprehensive, holistic treatment to effectively prevent and reduce the impact of mental and substance use disorders and complex trauma. Project goals and measurable objectives: Goal: To expand the existing Quapaw Nation Youth Program by providing a holistic approach and addressing the needs of the children we serve in terms of behavioral health, connected coping abuses, and co-occurring issues. This will be done by meeting the following objectives: Objective 1: by the end of month four, conduct a Community Needs Assessment, revise and update policies and procedures, develop at-risk and postvention protocols, develop an action plan addressing the appropriate tier(s) of prevention and intervention strategies, and implement a targeted PR campaign. Objective 2: by the end of month six, conduct a Community Readiness Assessment, determining how prepared our area is to address the issues of youths who are experiencing behavioral health issues because of: exposure to domestic violence, child abuse/neglect, childhood sexual assault, and other forms of trauma that effect our youth. Objective 3: by the end of month six, hire a counselor who has experience in servicing youth who have experienced trauma and is willing to acquire a certification to provide a forensic interview within 12 months of hire. Objective 4: by the end of month nine, develop a tribal strategic action plan that addresses the community needs and readiness and addresses the issues of youths who are experiencing behavioral health issues because of: exposure to domestic violence, child abuse/neglect, childhood sexual assault, and other forms of trauma that effect our youth. Objective 5: by the end of month twelve, complete improved and expanded policies and procedures for the Youth Program. Objective 6: By the end of month twelve, Create and disseminate program materials to schools and tribes within Ottawa County, Oklahoma. Objective 7: By the end of month sixty, implement at least five action items from the Action Plan, reaching at least 250 at-risk youth.

Name of Applicant: Texas Native Health • Mailing Address: 1283 Record Crossing Road, Dallas, Texas 75235 • Contact Name and Title: Adam Shorter, Chief Operations Officer • Phone Number: (214) 941-1050 • Fax Number: (214) 946-4738 • Email: coo@texasnativehealth.org Proposed Project Title: Native Connections in Texas Area(s) served: North Texas; Texas (statewide) Project Summary: Texas Native Health, the sole Urban Indian Organization (UIO) in Texas, is seeking support from the Substance Abuse and Mental Health Services Administration (SAMHSA) for its Native Connections in Texas project. This multi-year endeavor aims to provide American Indian Life Skills (AISL) programming and enhance access to culturally relevant mental health services for AI/AN (American Indian/Alaska Native) youth in Texas. The project builds upon Indigenous culture as a strength and protective factor to combat high rates of suicide, complex trauma, and substance abuse among this demographic. The objectives of the project are twofold: to increase Texas Native Health's capacity to mitigate high-risk behaviors contributing to substance abuse or suicide among AI/AN youth, and to promote the use of culture and evidence- based practices for prevention within this population. The initiative, the first of its kind in the state, will introduce ongoing life skills intervention and cultural enrichment activities to AI/AN adolescents and youth from an early age as a preventive measure. Native Connections in Texas will leverage local Indigenous cultures and traditions to bolster resilience and coping skills among AI/AN youth. Additionally, Texas Native Health plans to recruit a dedicated Family Physician to provide culturally attuned prevention, intervention, and postvention treatment and care to AI/AN adolescents and youth in primary care and specialty settings. The proposed project also supports existing needs, data analysis, and best practices in Indian Country to achieve the following goals: 1. Increase the capacity of Texas Native Health to reduce high-risk behaviors that may contribute to substance abuse or suicide amongst AI/AN youth in Texas. 2. Increase the use of culture and evidence-based practices for the prevention of substance abuse and suicide prevention amongst AI/AN youth. Eligible Entity: Urban Indian Organization (UIO), as defined by 25 U.S.C. § 1603(29) Length of Project Period: 5 years Total Funds Requested: $250,000.00 (annually)

The Yakama Nation Behavioral Health Native Connection program overarching goal is to prevent and reduce suicidal behavior and substance use, reduce impact of trauma, and promote mental health among American Indian and Alaska Native youth (through the age of 24 years) residing on and near the Yakama Reservation. The goals are Goal1: Establish & Engage our youth advisory boards and community members in all decisions regarding project activities, including planning, implementation, and evaluation. Goal 2: Update our Community Needs Assessment, Community Readiness Assessment and Tribal Strategic Action Plan that addresses suicide prevention, substance use prevention, and mental health concerns. Goal 3: Implement plan to sustain established Tier 1 prevention strategies to reduce community-wide risks and increase resilience. Goal 4. Revise pre and postvention protocols to reflect the traditions and culture of the community that include procedures for drug overdose or near overdose to ensure at-risk youth are assessed for suicide and substance misuse warning signs and connect them and if desired their families to appropriate services (Tier 2). Goal 5: Implement PC-CARES-DO, a community outreach, informational and skill building intervention to close our gap in services for those at moderate risk whose needs have not been adequately addressed through other programming (Tier 3).

The Ponca Tribe of Nebraska is pleased to submit a request for $250,000 to the DHHS-SAMHSA for the Tribal Behavioral Health Native Connections funding opportunity. The Ponca Tribe of Nebraska Native Connections (PTN-Native Connections) project will improve outcomes for Tribal youth up to and including age 24 with prevention, intervention, and postvention training, resources, and programming, including evidence-based intervention services integrated health care, mental health and substance use screening, and therapy services within the Ponca Tribe of Nebraska's fifteen-county service delivery area. Reestablished as a federally recognized tribe in 1990, the Ponca Tribe of Nebraska has approximately 4,200 members and its service delivery area (SDA) covers thirteen (13) counties in Eastern Nebraska, two (2) in Iowa, and one (1) in South Dakota. The PTN Native Connections project will focus on the American Indian and Alaska Native (AI/AN) youth (aged 0-24) population residing in this SDA. The PTN’s health care entity, Ponca Health Services (PHS), will implement this project in coordination with PTN Social Services Department and PTN’s Youth Council. PHS aims to support healthy Tribal members’ children, adolescents, and young adults throughout its SDA. Integrating the foundational elements, priorities, and strategies of the National Tribal Behavioral Health Agenda, PHS’s mission is to provide holistic, caring, family-centered, and culturally-sensitive services through a quality clinical and educational approach. PHS offers integrated medical, dental, behavioral health care, and wrap-around services throughout the lifespan for Ponca tribal and other tribal members. PTN-Native Connections project goals include: 1) identify existing resources and programs for suicide prevention and substance misuse as well as gaps in current policies, systems, and environmental change strategies related to suicide prevention, metal health promotion, and substance misuse for AI/AN youth; 2) Identify and implement effective strategies for addressing suicide and substance misuse prevention and intervention; 3) Develop postvention protocols that reflect the traditions and culture of the community while also addressing coordination of care and intervention for both immediate and follow-up care for AI/AN youth; 4) Increase availability of behavioral health services aimed at expanding youth social networks and reducing stigma of mental health and substance misuse; 5) Work with key Tribal community members across the lifespan to provide guidance and feedback regarding project activities. Key PTN-Native Connections project objectives include: 1) complete a community needs and readiness assessment; 2) develop a Tribal Strategic Action Plan (TSAP) addressing the three tiers of prevention and intervention; 3) implement strategies identified in the TSAP, including marketing the 988 Suicide and Crisis Lifeline; 4) utilize the Primary Care Behavioral Health Model to provide screening, brief intervention, and referrals to treatment; 5) engage at-risk youth in outpatient therapy and/or substance use programming; and 6) launch successful evidence based, culturally relevant youth program, family events, and annual GONA events. The PTN-Native Connections projects aims to provide impactful mental health and substance misuse prevention, early intervention, treatment intervention, and postvention to 325 Tribal children, adolescents, and young adults, train 2/3rds of the PHS Staff in postvention protocols, and train 75 community members in appropriate prevention and postvention.

Abstract Project title: Native Connections Applicant organization: Native Village of Tyonek Project Director: Cassandra Kroto Address: P.O. Box 82009, Tyonek, Alaska 99682 Funding requested: $250,000/yr for 5 years Contact: 907 583-2225 Project period: October 1, 2018 to September 30, 2023 Email: nvt.health.director@gmail.com The Native Village of Tyonek, a federally recognized tribe in Alaska, will serve a population of 373 community members and other residents in the area by expanding services to address suicide and substance abuse among young people. The NVT Native Connections Team will engage with the Tribal Youth and Elders to identify urgent or emerging substance use issues; identify project strengths and resources; assess community needs and resources; identify gaps in services; and coordinate available resources and programs. The Peer Outreach will additionally facilitate a plan of action to provide integrated behavioral health screenings to youth ages 24 and younger in primary care settings at Indian Creek Health Center; link youth and to QPR, safeTALK and ASIST suicide prevention and intervention trainings; and provide referrals to Learning Circles, local youth-serving organizations, and other SCF programs and services in Anchorage. This work will be sustained and advised by NVT's Elders and Youth Committee, a group tribal members and youth in an effort to engage in traditional knowledge bearing and community wellness. The project will be directed by the Tribal Health Director and the Tribal Council’s Administrative Support and will add a Program Coordinator and Peer Outreach. The goal of NVT’s Native Connections program is to prevent and reduce suicidal behavior and substance use among tribal and/or American Indian/Alaska Native youth ages 24 and younger. The following objectives will support the program’s goal: develop a three-tiered Tribal Action Plan (TAP) that addresses evidence-based prevention and intervention strategies to serve American Indian/Alaska Native Youth; develop partnerships with various youth serving or health organizations and traditional healers/cultural teachers for easy transition and/or referrals to substance abuse or mental health services, life skills training, cultural activities, and family wellness; recruit and work with at least 5 tribal youth and two Elders for participation in the NVT Native Connections Tribal Youth and Elders Committee to discuss policies and procedures to present to the Tribal Council to promote culturally sensitive suicide postvention and prevention work in the village; train at least 40 tribal members (youth and adults) in age-appropriate suicide prevention and resiliency building strategies, including Question, Persuade, and Refer (QPR), safeTALK, or traditional learning circles as provided by the Program Coordinator/Peer Outreach; recruit and train at least five tribal members in suicide crisis response to include Critical Incident Stress Management (CISM), safeTALK, and ASIST; and, collect, document, analyze behavioral health service data related to services provided by the Native Connections Program.

Project Name: Kalispel Native Connection Project Population To Be Served: (Demographics and clinical characteristics) The Kalispel Tribe of Indians (KTI) is located on the banks of the Pend Oreille River in rural northeastern Washington state, not far from Idaho’s western border, and the communities of Cusick and Usk. We have 484 Tribal members in total, and 214 youth, age 24 and under. Tribal members live between the reservation and the major city of Spokane, 40 miles to the south. The KTI Camas Path Behavioral Health Clinic has two locations, one on the reservation and the other in the Spokane suburb of Airway Heights. Our Native Connections Program will focus on serving the 214 Kalispel youth up to and including 24 years of age, and any other Native or non- Native youth who engage with our Kalispel NC Program. The NC Program will 1) increase BH services capacity by adding two BH staff members who will serve Kalispel youth and families. The NC staff will also 2) collaborate with the immersion school in Cusick to provide after school cultural activities for the youth, and 3) the NC Program will work closely with the Kalispel Culture Department to facilitate several youth cultural activities, such as teaching young boys about traditional fishing skills, and how at one time this was at the center of their way of life that provided for their families and community. Project Goals and Measurable Objectives: In Year 1 of the grant, the NC staff will 1) conduct a Community Needs Assessment, 2) a Community Readiness Assessment; and 3) create a Strategic Action Plan based that addresses suicide prevention, substance use prevention, and mental health disorders. Secondly, the NC staff will review and revise the KTI Camas Path BH Postvention Protocols, including responding to suicide, suicide attempts, suicide clusters, and substance misuse and overdose. The protocols will reflect the traditions and culture of the Kalispel people. Finally, the NC Program staff will provide traditional and cultural activities to assist and encourage the Kalispel youth to make the choice to live a life of wellness. This outreach will be provided through the Immersion School in Cusick and in partnership with the KTI Culture Department to show and teach the youth what it was like to be raised Kalispel prior to colonization, and how their ancestors lived abundantly using fishing skills, living off the land, making their own clothes and catching their own food. The NC Program will teach the KTI youth the strengths and coping skills of their own culture, and how they can use these skills in today’s world to live a healthy and meaningful life. Number of people to be served annually: 75 Number of people to be served through the lifetime of project (5 years): 400 Summary of Project (5 lines or less): The Kalispel Tribe’s Native Connections Program will serve the 214 Kalispel youth and other non-Kalispel youth, up to age 24, providing behavioral health services for the youth and their families. In addition, we will provide activities aimed at teaching them how it was to be raised Kalispel before colonization, so they can learn skills and coping skills used by our people long ago which helped them live healthy, so our youth can apply those same skills in today’s world.

Round Valley's tribal community has been deeply affected by trauma and substance use, evidenced by two recent youth homicides and multiple youth suicide attempts. The Lighting the Way project will provide needed resources to prevent and reduce suicidal behavior and substance misuse, reduce the impact of trauma, and promote mental health among American Indian youth, by building a healthy network of systems, services, and partnerships to positively impact youth. The first year of the program will focus on building the necessary foundation toward a healthier, more vibrant, and safer community for young people. This work will be done in collaboration with key partners - Round Valley Indian Tribes, Round Valley School District, and Tis'Bil Family Resource/Indian Education Program - to develop a community and culturally based team to conduct planning, implementation, policy development, postvention and crisis response. In year 1, Lighting the Way will conduct needs assessment and readiness work with partners and community and will write a tribal strategic action plan inclusive of workforce development and sustainability planning, to address suicide prevention, mental health promotion, and substance misuse for AI youth using a public health tiered model. By the end of year 1, Lighting the Way will implement this strategic plan. Tier 1 services will include a Youth Center at the high school, providing SafeTALK, Question-Persuade-Refer, and Indigenous Youth Mental Health First Aid as part of a school-based suicide awareness and prevention training program for students, family, and community, a workforce capacity-building plan to increase the mental health awareness and literacy of school staff, administrators, parents, and others who interact with school-aged youth to recognize the signs and symptoms of mental health concerns, and a social marketing strategy to promote awareness and education about mental health activities and services. Tier 2 will focus on building out the process at the Youth Center to screen and identify youth in need of mental health services and supports and (Tier 3) ensure a referral pathway for school-aged youth that require more intensive services. Program impact will be measured by 1) number of policy changes, 2) number of organizations collaborating, 3) number of individuals contacted through outreach efforts, 4) number and percent of individuals receiving mental health services because of the grant, 5) number of individuals who attempted suicide, and 6) number of individuals who died by suicide.

Rural California is literally killing itself. In the far north of the state, Indian Country is tragically at the leading edge of that trend. The Karuk Education Department (KED) staff are effectively first responders in the Tribe's efforts to promote mental health, reduce trauma, and to develop leadership skills through cultural and community engagement among the tribe's school-aged youth. Their network puts them in an ideal position to collaborate and build systems that will have a positive impact on all the young people of this region who are most at risk. The Native Connections Grant would enable the Karuk Education Department to create Yáan'iiftihansa Thaanêen (to be around youth) a program designed to build connectedness between different school-age cohorts while including elders, as the foundation for a model for community change that prevents suicide through self-efficacy and cultural resilience.