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Summary. Viterbo University will implement a new program for its La Crosse campus: V-Hawk Strong: Removing stigma, embracing help, building resilience to increase their capacity to implement, sustain, and improve effective suicide prevention, mental health prevention and treatment, and substance use prevention and treatment services in the Viterbo community. Population served. Viterbo University students, faculty, and staff shall be served by this project. Student populations of focus are men, LGBTQI+, students of color, student-survivors of sexual and dating violence and stalking, first-generation college students, and student athletes. Strategies/interventions. Create a network infrastructure; develop a plan to seek input from relevant community stakeholders to implement the program; administer voluntary mental health and substance use disorder screenings and assessments; train students, faculty, and staff to identify, respond effectively, and make appropriate referrals; promote 24/7 crisis services; provide outreach services about mental health and substance use disorder resources and services; disseminate informational materials to students, families, faculty, and staff; develop and implement educational seminars for students to enhance life skills, resilience, and promote social connectedness in alignment with campus initiatives; implement strategies to reduce access to lethal means among students with identified suicide risk; and conduct an assessment of the mental health and substance use disorder needs of students. Project goals and objectives. Goal 1. To create a culturally-relevant network infrastructure for Viterbo students. Objective 1.1. Seek input from six new stakeholders. Objective 1.2. Partner with Coulee Region Psychiatric medication prescriber, create a referral list of mental health providers used for warm-referrals as appropriate, and distribute mental health access information packets for students with out-of-network insurance. Objective 1.3. Dietitian will meet with 40 students to address disordered eating as a serious mental illness and develop and support best practices at Counseling Services. Goal 2. To ensure responsive students, faculty, and staff and effective Viterbo practices. Objective 2.1. Train 200 students, 30 faculty, and 30 staff to identify and respond effectively to students experiencing crisis. Objective 2.2. Introduce the Mental Health Continuum Short Form (MHC-SF) assessment to students; screen students accessing counseling through appropriate diagnostic screens; screen for eating disorders using the SCOFF Questionnaire; double the use of the volunteer screening tool ULifeLine. Objective 2.3. Implement three strategies to reduce access to lethal means among students with identified suicide risk each year. Goal 3. To create an aware, knowledgeable, and resilient student body empowered to help themselves and their peers. Objective 3.1. Develop and implement four educational seminars for students to enhance life skills and resilience, and promote social connectedness, aligned with campus initiatives and activities. Objective 3.2. Provide outreach services through outreach events to inform students about suicide awareness and prevention and mental health promotion, mental and substance use disorders, and recovery services; educate and disseminate electronic informational materials to students, families, faculty, and staff to increase awareness about suicide, suicide prevention, mental health promotion, substance use, and mental health and substance use disorders. Objective 3.3. Promote access and the availability of three 24/7 crisis services through local and national suicide prevention platforms. Objective 3.4. Support campus student groups to engage in educational activities, reduce negative attitudes about behavioral health disorders, and promote mental health. Number of people to be served. Year 1: 1,100, Year 2: 1,160, Year 3: 1,160, Lifetime of the project: 1,800.

In response to the Funding Opportunity entitled Campus Suicide Prevention Grant Program (SM-24-004), Winston-Salem State University (WSSU) is submitting a single application to support a comprehensive public health evidence-based approach. The project will provide services at WSSU, a Historically Black College & University (HBCU) located in Winston-Salem, NC. The project title is WSSU Behavioral Health Enhancement And Lifesaving Tactics for Higher Education Young Adults (B-HEALTHY). Requesting $102,000 in annual funding from September 30, 2024, through September 30, 2027, Project B-HEALTHY’s primary goal is to enhance current mental health and substance use disorder prevention and treatment services provided to WSSU students through education and the expansion of the existing network infrastructure to identify students who are at risk for suicide and suicide attempts, prevent and reduce suicide and mental/substance use disorders, promote help-seeking behaviors, and reduce stigma so students can complete their studies. The measurable objectives for Project B-HEALTHY are to (1) expand the existing clinical network infrastructure by increasing community behavioral health partnerships and cultivating interdisciplinary collaborations with the counseling center, Project CHAMP, and community behavioral health agencies; (2) increase the utilization of mental health and substance use disorder prevention and treatment services for WSSU students through promoting existing policies and training student ambassadors to provide outreach services, lead mental health workshops, and promote awareness on campus concerning the availability of mental health and crisis services; (3) promote help-seeking behaviors and reduce stigma through providing evidenced based training, educational seminars, and outreach services, and disseminate information to faculty, staff, and students on the WSSU campus to respond effectively and make appropriate referrals for students experiencing mental and substance use disorders, distress, crisis, or at risk of suicide; and (4) improve the identification and treatment of at-risk college students by conducting research and administering comprehensive assessments, including screening and evaluating for mental health and substance use disorders in enrolled students. The format of Project B-HEALTHY will include an interdisciplinary cross-campus and community collaboration to support WSSU students and assist in their overall mental health wellness in four diverse ways: interdisciplinary collaborations, peer support to other classmates with the same resources, education and training, and increased screening and evaluations. WSSU focuses on educating students from nationally underrepresented backgrounds with a student population where 83% are African American and 93% of the freshmen identify as ethnic minorities. According to the WSSU Quarterly Insight Deck, 58% of students reported having no formal mental health support, and 74% reported not seeking support on campus. Between August 1, 2023, and February 12, 2024, 20% of WSSU students considered suicide in the past six months, and 26% considered self-harm in the past six months. At WSSU, 70% of our undergraduate students are first-generation, many less likely to persist to degree completion than non-first-generation students. Considering the previous research on first-year and first-generation students, coupled with the mental health data, incorporating more experiences with mental health and wellness programs into their college experience will increase awareness and decrease the number of adverse events. This project will address the need to enhance behavioral health services at WSSU, reduce suicide and suicide attempts, reduce the stigma associated with mental health, substance use disorders, and suicide, increase protective factors that promote mental health, reduce risk factors for substance use disorders and suicide, and improve the identification and treating students.

Monmouth College (MC) is a small private liberal arts school in rural Monmouth, Illinois, with 716 students in Fall 2023. This project—Scots POW – Prioritizing our Wellbeing—named after the collegiate mascot the Fighting Scots, is based on SAMHSA’s Suicide Prevention Resource Center’s model and an integrated health wellness model. Scots POW will address the mental and physical health wellness of MC’s students. Physical wellness is a protective factor for mental health (MH) and substance use disorders (SUD). Research has shown that college athletes and first-generation college students are more at risk of MH and SUD. Many MC students (68%) are athletes; 32% are first generation. Currently, MC does not have a college counselor; instead, the college uses TimelyCare telehealth services for students. This project has four goals and five objectives: GOALS: (1) Better meet student behavioral well-being needs, create infrastructure and programming centered on physical and mental health. (2) Improve awareness and training to recognize and help at-risk students, particularly those with substance use issues and suicidal ideations. (3) Build stronger, more robust systems of support for historically marginalized students, including LGBTQ+, first generation, athletes, and Fraternity and Sorority Life. (4) Improve student mental and physical well-being to increase student retention and graduation. OBJECTIVES: (1) The Project Director (PD) and MH peer educators, with support from a new MC MH Task Force, will train a minimum of 50% of students, faculty, and staff annually on MH, SUD, suicide, and integrated wellness. (2) The new PD and counseling intern will provide evidence-based MH and SUD intervention and treatment to 30% of the student population annually. (3) MC will reach 100% of enrolled students and 100% of faculty and staff annually via MH and SUD informational materials and social media. (4) A minimum of 33% of students will voluntarily be screened annually for MH and SUD issues, including suicidal ideation. (5) Half (50%) of students reaching out for counseling services will indicate it was due to screening or a referral from another student, faculty, or staff. For the purposes of this grant, MC will appoint an Integrated Wellness Coordinator to integrate physical wellbeing into this project. MC will focus outreach, assessment, and training efforts on the large Fraternity and Sorority Life and athlete populations. MC will pay faculty stipends to offer more classes focused on wellbeing; for example, MC currently has classes in walking, rock-climbing, and personal finance. Mental Health First Aid will continue to be an evidence-based training tool on campus. MC will provide training and informational materials for faculty and staff on how to help students in distress, and hotlines will be promoted widely. MC will continue to use a peer educator model to implement peer listening sessions and outreach. MC will hire a consultant to provide training to help resident assistants, orientation leaders, and first-year mentors understand mental health conditions and how to best support students in psychological distress. MC will also provide training for head residents, house managers, resident assistants, orientation leaders, and first-year mentors to understand their role as peer educators on campus. All students, currently 716, will be reached via programming from this project.

PROJECT SUMMARY: The Collin County CCBHC Improvement and Advancement Project will enhance its CCBHC crisis services to help improve access to community-based mental health and substance use disorder treatment and support for individuals ages 3 years and older in Collin County, Texas. POPULATION AND NEED: The population of focus will consist of individuals ages 3 years and older in Collin County Texas, who are experiencing or who have experienced a mental health or substance use related crisis episode. We anticipate the demographic profile served will be similar to the behavioral health population LifePath Systems served in 2022 (19,218 individuals), which was comprised of 90% or more low-income; 53% males, 44% females, and 2.9% unknown/not reported; 41.4% ages 3-17, 49% ages 18-59, and 6.5% ages 60+; < 1% LGBTQ+; 62% White, 19.3% Black/African American, 16.8% Hispanic, 7.7% Asian, and < 1% each American Indian/Alaskan Native and Native Hawaiian. Primary language spoken by individuals was English (80%) with the remaining 20% speaking one of 17 other languages requiring translation assistance. Per its standard practice and policies, LifePath Systems will serve all individuals and families regardless of race, ethnicity, federally recognized tribe, language, religious beliefs, sex, gender identity, sexual orientation, or ability to pay. STRATEGIES: The primary project strategies to enhance CCBHC services include: (1) improving access to care coordination and continuity of care services by hiring three care coordinators dedicated to serving the target population; (2) expanding timely access to psychiatric services by hiring an onsite mid-level prescriber at LifePath Systems' Crisis Center; (3) expanding workforce and community training to help address crisis needs; and (4) evaluating the project. These activities will improve the infrastructure required for the consistent delivery of intensive outpatient community-based behavioral health care for people (ages 3+) with mental health and/or substance use disorders or concerns. GOALS: The primary goal is to improve LifePath Systems' CCBHC crisis response in Collin County for people with mental health and/or substance use disorders or concerns in order to reduce relapse and risk of future crisis episodes. OBJECTIVES: (1) By the end of the project, 70% of participants will improve their ANSA or CANS score for current level of functioning in behavioral health and/or life domains compared to their baseline score; (2) By the end of the project, LifePath Systems' certified trainers in MHFA, ASIST, and CALM will have trained 400 community service organization staff and other community members in these 3 evidence-based suicide and mental health crises prevention curricula; (3) By the end of the first year of the project, LifePath Systems will become a licensed Clinical Training Institute to train team members interested in becoming LCDCs in order to increase the number of qualified LCDCs able to provide substance use treatment services; (4) By the end of the project, LifePath Systems' Clinical Training Institute will have trained 15 team members in the evidence-based substance use treatment curricula in order to become LCDCs; and (5) By the end of the project, 85% of individuals will report satisfaction with access and availability of CCBHC crisis services, as measured by satisfaction survey scores. TOTAL PEOPLE SERVED: Over the four-year project period, LifePath Systems anticipates serving 1,750 unique individuals, with up to 250 unique individuals served in year one and up to 500 unique individuals served per year in years two through four.

Project Summary: Johnson & Wales University (JWU) proposes to build its capacity to prevent suicide on campus. Activities will include creating an Advisory Council; increasing case management support; conducting ACHA-NCHA campus assessment, Mental Health First Aid (MHFA) and Question, Persuade, Refer (QPR) training; expanding community partnerships education and intervention; and enhanced screening. Project Name: Project PLUS (Prevention, Lowering stigma, increasing Understanding, and Support) Population to be Served: JWU's Fall 2023 enrollment was 4,380 students: 63% females, 37% males, 59% white, 14% Hispanic/Latino, 11% Black/African American, 4% Asian, ~2% two or more races, 0.5% American Indian or Alaska Native, and 5% unknown. Ten percent were student-athletes and 24% were first-generation college students (FGCS). Approximately 96% of all on-campus students receive financial aid (2023-24), and Pell Grants were awarded to 30% of undergraduate students. In the past five years, JWU lost a student to suicide and one student died due to substance overdose; 124 students went to the emergency room because of suicide attempts, suicidal ideation, or substance use (SU) crises, with 76 of those students admitted for in-patient treatment. From 2018 to 2023, ER visits related to substance overdose and/or suicide attempts have gone up 36% and inpatient hospitalizations have doubled. Project PLUS will address behavioral health disparities for LGBTQIA+ students, students of color, low-income, and FGCS, while also improving mental health for all students. Strategies/Interventions: 1) Create Advisory Council of campus and community partners with cross-cutting expertise in mental and substance use disorders; 2) Hire additional staff to provide case management and maximize outreach, education, and referrals; 3) Conduct ACHA-NCHA; 4) Formalize community partnerships to secure warm referrals for longer-term treatment and build continuity of care; 5) Increase the number of students, faculty, and staff trained in MHFA and QPR; 6) Enhance voluntary substance use screening; and 7) Increase student-led efforts to reduce stigma and negative attitudes about mental and substance use disorders. Project Goals: 1) Strengthen JWU's ability to prevent and reduce behavioral health crises, suicide, and substance use among student population and improve available services; 2) Improve campus-wide knowledge about suicide prevention and the ability to respond to substance use and mental health disorders; and 3) Reduce stigma and promote help-seeking behavior by engaging in combating negative attitudes towards mental and substance use disorders. Measurable Objectives: Provide JWU students with case management support by hiring a Project PLUS coordinator; Conduct ACHA-NCHA assessment; Create at least three MOUs/Statements of Understanding to secure ""warm"" referrals for long-term treatment and continuity of care; Purchase BetterMynd to increase telehealth access for the targeted student populations; Collaborate to implement Mental Health First Aid (MHFA) and expand Question, Persuade, Refer (QPR) training; Enhance voluntary screening efforts; Hold at least 9 student-led organization trainings to reduce stigma and negative attitudes about MH and SUD; Increase targeted outreach frequency and increase social media mental health posts by 50%; Offer at least 2 new workshops each semester in partnership with Residential Life and the Office of Student Affairs to reach at least 80% of new students each academic year. Number of people to be served annually and throughout the lifetime of the project: Project PLUS will train 100 students, faculty, and staff in MHFA or QPR each year, for a total of 300 students, faculty, and staff who will be trained. All students (4,000+) will receive educational materials on mental health, and 2,000 students will be reached in the target population.

The National Board for Certified Counselors (NBCC) Foundation proposes to continue the Minority Fellowship Program for Mental Health Counselors (MFP-MHC). The MFP-MHC will improve the quality and quantity of services for racial and ethnic minority populations by supporting post-baccalaureate training for mental health counseling professionals. The goals of the MFP-MHC are: 1) to increase the number of culturally competent mental health counseling professionals who teach, administer services, conduct research, and provide direct mental health counseling services to racial and ethnic minority populations; and 2) increase the knowledge of mental health counseling professionals on issues related to prevention, treatment, and recovery support for individuals who are from racial and ethnic minority populations and have a mental health disorder. The MFP-MHC will recruit underrepresented students and promote specialization in mental health services to underserved minority communities, particularly people with serious mental illness/serious emotional disturbance; child/adolescent, women’s, and geriatric groups; minority communities in inner cities and rural areas; refugee and migrant groups; minority persons including LGBTQI+; and those who are active-duty military, veterans, or from military families. The MFP-MHC will use federal funds to support master’s-level degree stipends, doctoral-level degree stipends, infrastructure development, and behavioral health care specialty training. Annually, 32 fellowships will be awarded to master’s-level mental health counselors-in-training and 20 fellowships to doctoral-level counselor educators-in-training at accredited institutions. Specialty training will be provided to an additional 1000 mental health counseling professionals. The MFP-MHC will assure that 60% of fellows graduate within two years of the fellowship award and 80% graduate within three years of the fellowship award. Further, 85% of fellows will be employed as mental health counselors or counselor educators increasing services to racial and ethnic minority communities within one year of graduation. Over the proposed 5-year period, 260 fellowships will increase the workforce and 5000 working professionals will be better prepared to provide mental health counseling services to racial and ethnic minority communities.

Project Abstract Summary - The REACH 2.0 project focuses on the professional field of addiction medicine and is inclusive of medical students, residents, and fellows in Addiction Medicine (AM), Addiction Psychiatry (AP), and other specialties who seek training in AM. The American College of Academic Addiction Medicine (ACAAM) formerly known as American Board of Addiction Medicine (ABAM) will implement the FY 2024 Minority Fellowship Program (MFP)1 under the leadership of the Principal Investigator/Project Director (PI/PD), Steve Smith, MS, CAE, FAAMSE, ACAAM Executive Director. The program consortium includes three academic partners, New York University Grossman School of Medicine (NYU Grossman SoM), Ayana Jordan, MD PhD.; Yale University School of Medicine, (Yale SoM), Jeanette Tetrault, MD; and Baylor College of Medicine (BCM), Daryl Shorter, MD. REACH 2.0 is based on the previously SAMHSA-funded “Recognizing and Eliminating Disparities in Addiction through Culturally-informed Healthcare (REACH)” program (Award #TI081358-01; 9/30/2018- 9/29/2023). As a result of this project (2024-2029), REACH 2.0 will train 200 scholars. Goal 1. To increase the knowledge of mental health and SUD behavioral health professionals on issues related to prevention, treatment, and recovery support for REM individuals with a mental health disorder or SUD. Obj. 1.1. In month 3, expand the Advisory Board to provide consultation for planning and monitoring (meeting quarterly). Obj. 1.2. In month 4, collaborate with the SAMHSA MFP Coordinating Center to enhance the effectiveness and visibility of the program. Obj. 1.3. In year 1 and ongoing, to provide annual training for 100% of staff, trainee scholars and Near Peers on cultural responsiveness within the provision of mental health and SUD care for REM populations with at least 75% participation. Obj. 1.4. In year 1 and ongoing, to have 100% of the 20 trainee scholars participate in a two-day trauma informed training for REM people with mental illness and SUD, provided by our partner APA with pre- and post-survey completion. Obj. 1.5. In year 1 and ongoing, 100% of the 20 Near Peer scholars attend a two-day best-practices intensive facilitated by Dr. Shorter on how best to mentor and advise our new scholars, with pre- and post-survey completion. Goal 2. To increase the overall number of racially just, culturally humble, and responsive REM addiction specialists in the AP and AM workforce (as teachers, administrators, researchers, and direct mental health and SUD service providers) for REM populations. Obj. 2.1. In month 1, to implement in-person, print, electronic, and social media recruitment strategies to annually identify at least 75 potential REM applicants to ensure we have a competitive group and can meet our goal. Obj. 2.2. In month 1, to collaborate with 100% of the ACGME accredited AP and AM programs in the U.S. to recruit new trainee scholars committed to serving REM populations with mental illness and SUD. Obj. 2.3. In month 1, to open applications for the new REM scholar cohort who will receive stipends for participation. Obj. 2.4. In month 3, to implement a tracking plan for 100% of scholars’ completion of post-graduate specialized training. Goal 3. To increase the number of racially just, culturally humble, and responsive REM addiction specialists in the AP and AM workforce who improve the quality of mental health and SUD prevention and treatment for REM groups. Obj. 3.1. In year 1, to select 20 REACH 2.0 Near Peers with at least 4 formal interactions (mentoring moments) per year with 20 new trainee scholars. Obj. 3.2. In year 1, to provide stipends to 20 Near Peers comprising a national network of REM professionals providing support to the new scholars annually. Obj. 3.3. In month 6, to identify internships and employment opportunities for 100% of graduating scholars (residents and Near Peers) in organizations serving historically excluded REM in collaboration with APA, AADPRT and AABHCoE

The Council on Social Work Education Minority Fellowship Program (CSWE MFP) strengthens and develops the behavioral health workforce by supporting Master (MSW) and Doctoral social work students committed to working with racial and ethnic minority populations who are living with or at risk of mental health and/or substance use disorders. The purpose of this program is to recruit, train and support MSW and Doctoral social work students to reduce behavioral health disparities, advance the quality of mental and substance use disorder prevention and treatment services, and improve health care outcomes for racial and ethnic minority populations. CSWE MFP prepares students with an enhanced level of cultural competence, greater awareness of disparities, and experience with advocacy and policy reform that shape the types of services and access in behavioral health available for racial and ethnic minority populations. The fellowship targets, but is not limited to, social work students who are members of racial and ethnically diverse communities including American Indian or Alaska Native, Asian, Black/African American, Hispanic/Latino and Native Hawaiian/Pacific Islander. CSWE will provide fellowship support and training to 40 MSW fellows and 30 doctoral fellows (new and renewed) during each one-year period. Doctoral fellows are eligible for fellowship renewal for up to three years. Therefore, CSWE intends to support approximately 200 MSW fellows and 58 doctoral fellows over the five-year award period. The project goals and objectives include: Goal 1: Increase the knowledge of mental and/or substance use disorder behavioral health professionals on prevention, treatment, and recovery support for individuals who are from racial and ethnic minority populations and have a mental or substance use disorder. Objectives include providing at least one annual in-person training opportunity for 100% of fellows; providing four quarterly virtual professional development trainings that address mental health and substance use disorders prevention, treatment and recovery for 100% of fellows; providing 100% of fellows with professional development and/or licensure funds; and having 80% fellows report an increase in their knowledge and skills related to mental and/or substance use disorder prevention, treatment, and recovery for racial and ethnic minority populations. Goal 2: Increase the number of culturally competent mental and substance use disorder professionals who teach, administer services, conduct research, and provide direct mental and/or substance use disorder services to racial and ethnic minority populations. Objectives include recruiting a diverse pool of applicants (100 MSW and 100 doctoral) and appointing a diverse cadre of fellows for the MSW (40) and Doctoral MFP Program (30) each year; providing 100% of selected fellows with financial, academic and career readiness support; achieving an 80% MSW fellow graduation rate and an 80% doctoral fellow degree progression rate; and 80% of graduating fellows reporting employment in mental health and/or substance use disorder services to racial and ethnic minorities. Goal 3: Improving the quality of mental health and substance use disorder prevention and treatment services delivered to racial and ethnic minority populations by strengthening the capacity and reach of the social work workforce. Objectives include connecting 100% of fellows with a social work mentor in the fellowship year; achieving an 80% participation rate from all fellows in two "MFP Alumni Series" workshops; providing 100% of fellows with resume coaching; and disseminating a virtual CV/resume viewbook to connect graduates with relevant internship and employment opportunities.

The mission of the Minority Fellowship Program (MFP) at the American Nurses Association (ANA) is to revolutionize behavioral health care by significantly increasing the number of post-baccalaureate nurses from underrepresented ethnic minority groups. By focusing on Asian American, Native Hawaiian and Pacific Islander, American Indian and Alaska Native, Hispanic/Latino, and African American nurses, we aim to create a diverse nursing workforce essential for improving the behavioral health of ethnic minority groups and achieving health equity. A diverse workforce is crucial for developing culturally appropriate interventions that meet the unique needs of these populations. This project will support at least 40 nurses annually (16 master's and 24 doctoral students) throughout its duration. We will prioritize recruitment from institutions with a strong track record of graduating minority nurses in behavioral health, including Historically Black Colleges and Universities, Hispanic-serving institutions, colleges with significant Asian American enrollments, and Tribal colleges. To enhance recruitment and engagement, the MFP/ANA has developed an innovative digital media strategy that leverages social media channels, the Mental Health Trailblazers Psychiatric Nurses Speak Up podcast, our website, and a forthcoming mobile application. We will also partner with the Psychiatric Mental Health Nursing Minority Fellowship Graduate Association, a 501(c)(3) nonprofit, to create a robust network of mental health nurse professionals who can serve as mentors, provide internship sites, and offer future employment opportunities. Our measurable goals include high graduation rates, positive feedback from mentor-mentee relationships, employment in behavioral health systems serving ethnic and racial minorities, and the ability to provide culturally competent care. Additionally, we aim to increase scholarly productivity, such as the number of invited presentations and publications in scholarly journals. Other objectives include the number of alumni serving as mentors, providing access to clinical practice or internship sites, acting as clinical supervisors, and volunteering on the National Advisory Committee and other professional boards.

The Minority Fellowship Program (MFP) at the Foundation for the Advancement of Human Systems (FAHS) aims to increase the number of culturally competent marriage and family therapy (MFT) professionals who provide direct mental health and substance abuse services to underserved minority populations, conduct research, and teach in these areas. Since MFTs are uniquely positioned to provide efficacious, culturally sensitive and relationship enhancing services to underserved communities, and generate scholarship in this area, the MFP’s objectives, goals, and mission were specifically established to meet this need. Additionally, this project will address mental health and substance abuse services disparities for racial and ethnic minority populations by increasing the knowledge of graduate students in MFT for prevention, treatment, and recovery support and improving the quality of prevention and treatment services delivered to underserved populations. The FAHS MFP objectives of the project are to: 1) Expand the delivery of culturally competent mental health and substance abuse services to ethnic minority communities and underserved populations by 2029, 2) Increase the number of doctoral-level culturally competent Marriage and Family therapists by 125 committed to advancing the mental health interests of ethnic minority communities and underserved populations by 2029, 3) Increase the number of masters’ level culturally competent Marriage and Family therapists by 150 committed to serving children, adolescents, and populations in transition to adulthood (aged 16-25) by 2029, and 4) Expand the delivery of culturally competent mental health services to children, youth, adolescents, and populations in transition to adulthood (aged 16-25) by 2029. The FAHS will measure these objectives through 1) the number of trained masters and doctoral Fellows, 2) the number of doctoral and masters Fellows who graduate and will practice, develop and disseminate research, and teach in the areas of mental health and substance abuse, 3) the number of culturally competent clinical hours to underserved populations, 4) the number of awards of doctoral fellowships, 5) the number of Fellow Client hours, and 6) number of doctoral and masters graduates. The measurement tools that the FAHS MFP will employ are 1) a 2-year service commitment, 2) impact, evaluation, and EOY surveys, 3) the number of research projects, 4) MFP alumni tracking surveys, 5) internship reports, 6) academic progress reports, 7) demographics and population surveys, and 8) number of Fellow Client hours. We will achieve the goals by providing financial support (stipends) and professional guidance to graduate students in marriage and family therapy. Our mission–consistent with the Surgeon General's Report on Mental Health and other federal initiatives to reduce health disparities—is to increase the pool of talented, culturally competent master’s-level practitioners and doctoral-level researchers, teachers and practitioners dedicated to assisting ethnic minority communities and underserved populations. Since 2007, the MFP has awarded Fellowships to over 800 Fellows from 116 academic institutions across 42 states. Our alumni work in community-based settings, hospitals, academia and other public/private mental health service/research organizations, ethnic minority populations, women, children, at-risk youth, underserved urban and rural communities. By the end of the project, the FAHS MFP expects to have provided training, education, mental health resources, stipends, and trained a number of 275 masters and doctoral Fellows who will increase mental health and substance abuse services to underserved populations.

The aim of the APA Minority Fellowship Program in Mental Health and Substance Abuse Services and Services for Transition Age Youth is to identify, select, and support the training of psychology doctoral and master’s students and postdoctoral trainees who will significantly contribute to the behavioral health outcomes within communities of color. This aim includes the need to reduce health disparities within communities of color in the U.S. specific to culturally competent and evidence-based mental health and substance abuse treatment. Thus, the APA MFP has two target populations at the center of its efforts: communities of color in need of mental health services and doctoral and master’s students and postdoctoral trainees in psychology committed to working with communities of color. To fulfill our aim, the APA MFP will: (a) Increase the number of master’s and doctoral level psychology professionals providing behavioral health services to underserved populations by identifying and selecting at least 2 postdoctoral, 26 doctoral, and 15 master's Fellows; (b) Provide culturally competent training and support to increase Fellows' knowledge, skills and abilities by hosting a professional development workshop to orient Fellows to MFP and SAMHSA, providing at least 8 training opportunities during the annual training summit and professional development workshop, hosting three training webinars, proving mentoring opportunities through the training advisory committee, and evaluating each training and mentoring experience in each year of the project; (c) Expand and maintain the infrastructure necessary to implement, sustain, and improve effective mental health and substance abuse services for the target population by implementing a robust marketing and social media strategy to increase program visibility and Fellow engagement, and conducting at least six recruiting presentations in regions with minimal MFP representation, including three site visits to HBCUs, HSIs, MSI, and TCUs. We will continue to implement an online database for more efficient tracking of Fellows and by year five of the project, MFP will receive at least 100 master's, 200 doctoral, and 20 postdoctoral applications for fellowships

The American Psychiatric Association (APA) Substance Abuse and Mental Health Services Administration (SAMHSA) Minority Fellowship Program (MFP) is dedicated to improving mental health outcomes for racial and ethnic populations by increasing the number of culturally informed and linguistically skilled healthcare providers. As the United States population diversifies, it is critical to expand the psychiatric workforce to better serve marginalized and minoritized communities, who continue to face profound unmet mental health needs. Structural barriers such as stigma, discrimination, and entrenched disparities in laws and public policies impede access to quality care. APA leverages its extensive network of psychiatrists and decades of experience managing the MFP to develop training infrastructure that directly addresses critical disparities in mental health care. Our goal is to recruit, train, and support future leaders in psychiatry, equipping them with the knowledge and skills necessary to enhance physician-patient relationships and improve mental health outcomes for racial and ethnic minority populations. Key strategies for the APA SAMHSA MFP include: (1) Increasing knowledge and awareness among psychiatrists about the unique mental health needs and challenges faced by marginalized and minoritized populations; (2) Ensuring that our future leaders are educated about recovery-oriented systems of care, trauma-informed approaches, and the need to address social determinants impacting mental health; and (3) Expanding the number of culturally sensitive and linguistically competent psychiatrists dedicated to serving marginalized and minoritized populations. To support this mission, the APA SAMHSA MFP will engage at least forty-five psychiatry residents and fellows per year, providing them with monthly didactic courses focused on prevention, treatment, and recovery for communities experiencing mental illness and substance use disorders. Learning opportunities will be framed around the historical and contemporary inequalities experienced by marginalized groups, using both experiential learning and the development of capstone projects. Additional leadership development will be fostered through participation in APA councils and committees, the Advocate/Protege Program for mentorship, and attendance at significant events such as the APA SAMHSA MFP Spring Leadership Summit in Washington, D.C., and the APA Annual Meeting. Through these efforts, APA aims to amplify its impact and continue to effect meaningful change in the mental healthcare system by preparing a cohort of psychiatrists who are well-versed in culturally relevant treatment approaches and capable of addressing disparities through research and administrative efforts.

The National Board for Certified Counselors (NBCC) Foundation, in partnership with NAADAC, the Association for Addictions Professionals, proposes to continue the Minority Fellowship Program for Addictions Counselors (MFP-AC). The MFP-AC will improve the quality and quantity of services for racial and ethnic minority populations by supporting post- baccalaureate training for substance use disorder and addictions counseling professionals. The goals of the MFP-AC are: 1) to increase the number of culturally competent substance use disorder professionals who teach, administer services, conduct research, and provide direct substance use disorder services to racial and ethnic minority populations; and 2) increase the knowledge of substance use disorder behavioral health professionals on issues related to prevention, treatment, and recovery support for individuals who are from racial and ethnic minority populations and have a substance use disorder. The MFP-AC will recruit underrepresented students and will encourage specialization in addictions/substance abuse services to underserved minority communities, particularly people with serious mental illness/serious emotional disturbance; child/adolescent, women’s, and geriatric groups; minority communities in inner cities and rural areas; refugee and migrant groups; minority persons including LGBTQI+; and those who are active-duty military, veterans, or from military families. The MFP-AC will use federal funds to support master’s-level degree stipends, infrastructure development and behavioral health care specialty training. Annually 43 fellowships will be awarded to master’s-level addictions counselors-in-training at accredited institutions and specialty training will be provided to 1000 other substance use disorder behavioral health professionals. The MFP-AC will assure that 60% of fellows graduate within 2 years of the fellowship award and 90% graduate within 3 years of the fellowship award. Further, 85% of fellows will be employed as substance use disorder professionals serving racial and ethnic minority communities within 1 year of graduation. Over the proposed 5-year period, 215 fellowships will increase the workforce and 5000 working professionals will be better prepared to provide substance use disorder services to racial and ethnic minority communities.

Centerstone’s Wellness on Wheels (C-WoW) will take a syndemic approach to providing portable clinical care focused on integrating low barrier substance use disorder (SUD) treatment; HIV and other infectious diseases/conditions testing and treatment; mental health care; and harm reduction services for an unduplicated total of 300 individuals experiencing unsheltered homelessness in rural DeSoto and non-rural Manatee counties, Florida, across the 3-year project period (Y1: 60; Y2: 110; Y3: 130). Demographics and clinical characteristics of focus population individuals will mirror those of the unsheltered population in Florida’s Continua of Care (CoCs) 500 and 517 serving catchment area counties, with 49% male, 51% female, 75% White, 24% Black, and 37% Hispanic individuals. Based on the FL-500/517 CoCs, C-WoW’s subpopulations are expected to include 242 racial/ ethnic minorities; 67 sexual/gender minorities; and 28 Veterans. Rates of health/behavioral conditions among focus populations are higher than catchment area individuals: HIV (0.5% vs. 0.3%, respectively), hepatitis C (22% vs. 0.04%), chlamydia (7% vs. 0.4%), and serious mental illness (14% vs. 6%). Co-occurring HIV and mental illness are expected among 50% of the focus population, and nearly 12% will experience SUD. Opioid misuse contributes to HIV prevalence, with nearly 17% of those who are HIV positive having had injected drugs. C-WoW’s evidence-based strategies/interventions include the San Francisco Department of Public Health’s Homeless Health Outreach and Mobile Engagement (HHOME) program, SAMHSA’s TIP 59: Improving Cultural Competence, and SAMHSA’s Harm Reduction Framework to guide overall activities; on-site Intensive Case Management, Motivational Interviewing, and SOAR; facility-based Community-Friendly Healthy Recovery Program; and other facility-based interventions at Centerstone available to C-WoW participants per their goals/ needs (e.g., Medication Assisted Treatment, Hazelden’s Co-Occurring Disorders Program, Whole Health Action Management, DIMENSIONS). C-WoW’s goals include: 1) Implement a pilot project for underserved populations experiencing unsheltered homelessness through the provision of portable clinical care, focused on the integration of behavioral health and HIV treatment and prevention services; 2) Develop/implement system capacity building activities to enhance and sustain project services; 3) Increase on-site point of care for the focus population; 4) Decrease barriers to care for the focus population; and 4) Develop/disseminate a documented service model/pilot program for replication/adoption. C-WoW’s measurable participant-related objectives include conducting screenings/assessments and/or testing for HIV, hepatitis, sexually transmitted infections (STIs), Mpox, tuberculosis, SUD/COD, and other mental health conditions; developing Individual Treatment and Service Plans; and providing case management, care coordination, linkage to services for 300 individuals. For 100% of participants per their needs/goals, C-WoW will provide on-site low-barrier SUD treatments, including FDA-approved medications, primary care health services, and infectious disease services; linkages to housing resources; and transportation to infectious disease treatment/vaccination and to PrEP/PEP, SUD/COD/mental health treatment, primary care treatment services, Mpox, and recovery support services. C-WoW will increase access to trauma-informed, culturally responsive, integrated mental healthcare services among 80% and to harm reduction education, supplies, and other related services among 100% of participants. Additional objectives include training 50 Centerstone/project staff and other providers in SUD/co-occurring disorders identification, culturally-/linguistically-appropriate care, harm reduction, HIV/infectious disease treatment/prevention, etc. and establishing an Advisory Council comprising 20% focus population/individuals with lived experience.

Brandywine Counseling & Community Services, Inc. (BCCS) proposes to implement a Portable Clinical Care Project (PCCP) to provide comprehensive and integrated behavioral health, human immunodeficiency virus (HIV) and viral hepatitis testing and treatment, mental health treatment, harm reduction & prevention services, low-barrier substance use disorder (SUD) treatment, care/case management, and basic primary medical care to underserved populations experiencing unsheltered homelessness throughout the state of Delaware. The PCCP's population of focus (POF) is exclusively people experiencing unsheltered homelessness throughout the state of Delaware (the PCCP Catchment Area). The PCCP will utilize a syndemic approach to healthcare delivery - focusing on infectious diseases - and will literally serve the POF ""where they are"", including outdoor and/or public locations where the POF congregate such as encampments, in parks and under bridges, transit stations (bus and train terminals), and in places not meant for habitation. The PCCP will serve a minimum of 75 unduplicated individuals per project year, for a total of 225 individuals over three years. By embracing a syndemic approach, the recognized key strategy of PCCP implementation is the provision of low-barrier substance use disorder (SUD) treatment; HIV and viral hepatitis testing and treatment; STI testing and treatment; HIV/STI prevention and education, mental health care; and harm reduction services. Goals include, but are not limited to, increasing access to and retention in primary medical and substance use disorder treatment in POF, reduce rates of new infections of HIV, Hepatitis, STI's and reduce and increase rates of treatment in active infections, reduce rates of substance abuse in POF by increasing access to care and focusing on co-occurring disorders, increase peer recovery support services through comprehensive case management focusing on POF's social determinants of health needs, and document and disseminate best practices and ""lessons learned"".

Summary. The North Jersey Community Research Initiative (NJCRI) is proposing a program to offer comprehensive healthcare for underserved and historically under-resourced populations experiencing unsheltered homelessness through the provision of portable clinical care in New Jersey. NJCRI will serve an average of 1,092 unduplicated individuals annually with grant funds and 3,276 over the entire project period. Project name. New Jersey Portable Clinical Care Pilot Project Populations to be served. NJCRI’s population of focus (POF) will be underserved people experiencing unsheltered homelessness. The geographic catchment area where services will be delivered is the Newark Eligible Metropolitan Area (EMA), which includes the five New Jersey counties of Essex, Morris, Sussex, Union, and Warren. Strategies/interventions. Program activities will include: 1) provide basic primary healthcare services; 2) low barrier SUD treatment; 3) take a syndemic approach to address infectious diseases; 4) provide evidence-based harm reduction education, supplies and services on- site; 5) conduct screening and assessment of mental health conditions and co-occurring mental and SUDs; 6) provide care coordination and case management services to address social determinants of health; and 7) document best practices and lessons learned. NJCRI will also implement the following EBPs: SBIRT; Motivational Interviewing (MI); and Cognitive behavioral therapy (CBT). Project goals and measurable objectives. The program’s goal is to provide comprehensive healthcare for racial and ethnic medically underserved people in New Jersey experiencing unsheltered homelessness through the delivery of portable clinical care delivered outside that is focused on the integration of behavioral health and HIV treatment and prevention services. Objectives include: 1) Conduct outreach and engagement strategies in the catchment area, reaching up to 900 persons from the POF in year 1, 1080 in year 2, and 1,296 in year 3; 2) Provide primary health care services and supplies, reaching at least 900 persons from the POF in year 1, 1,080 in year 2, and 1,296 in year 3; 3) Screen and assess at least 900 persons from the POF for substance use disorders and co-occurring mental and substance use disorders in year 1, 1,080 in year 2, and 1,296 in year 3; 4) Provide SUD and mental health treatment and referral for at least 80% of clients in need of services each year; 5) Screen clients and their drug-using and/or sexual partners on-site for HIV, viral hepatitis, Mpox, STIs and TB, reaching 900 persons from the POF in year 1, 1,080 in year 2, and 1,296 in year 3; 6) Provide peer support and case management to address social determinants of health to 90% of clients per year; 7) Provide evidence-based harm reduction services, including education and distribution of harm reduction supplies, to at least 900 persons from the POF in year 1, 1,080 in year 2, and 1,296 in year 3; 8) Provide mental health screening to at least 900 persons from the POF in year 1, 1,080 in year 2, and 1,296 in year 3; and, 9) provide mental health treatment and referral to at least 80% of clients in need of services per year.

Cornell Scott-Hill Health Corporation (CS-HHC) will serve 275 (75 Year 1; 100 a year in Years 2 and 3) unsheltered individuals with substance use disorder (SUD) who are at-risk for or have HIV/AIDS by providing integrated behavioral health care, HIV treatment, and prevention services to recipients ""where they are""-in the streets, in tent encampments, in parks, under bridges, etc.-to improve their health and quality of life. CS-HHC, a federally qualified health center, offers integrated medical (including infectious diseases [ID]), behavioral health, and dental services to over 55,000 people annually-of whom 2,730 are people experiencing homelessness—in Connecticut's Greater New Haven area. CS-HHC provides street outreach and integrated treatment services to people experiencing unsheltered homelessness (PEUH) in the region. -Project Name: Street HIV Outreach to engage Unsheltered populations in Treatment (SHOUT) -Population to be served: The project will offer integrated primary care, ID treatment and prevention, and behavioral health services to PEUH who are at risk of or have HIV. AIDSVu (AIDSVu.org) shows that the New Haven-Milford MSA has particularly high rates of people living with HIV (458 per 100,000 people), but that underestimates the risk in the City of New Haven alone. In the five City of New Haven zip codes (06510, 06511, 06513, 06515, and 06519) where most of our services will occur, the rate of people living with HIV is much higher at 1,112; 1,319; 895; 984; and 1,166 per 100,000, respectively. These high HIV prevalence rates coincide with an area with many PEUH, many of whom are at risk of or have HIV. For example, the local United Way's Coordinated Access Network (CAN) estimates that about 600 individuals in New Haven are ""literally homeless"", with 80% camping in parks, under bridges, along roadsides, etc. We anticipate that project clients will consist largely of racial and/or ethnic minorities (Black and/or Hispanic) who are living in poverty. -Strategies/Interventions: The project will use evidence-based practices (EBPs), such as SUD and mental health screenings, HIV screening, STI treatment and screening, PrEP, harm reduction (including condoms), motivational interviewing, case management, recovery coach, and medication assisted treatment (MAT). Treatment will be trauma-informed and occur in the field; at our SUD treatment facilities, the Recovery and Wellness Center (RWC), with its 52-bed therapeutic shelter component, and our South Central Rehabilitation Center (SCRC), with its residential detox programming and methadone maintenance services; and at our main care site where our Infectious Diseases Department is based. For those not ready for a higher level of service, we will meet them ""where they are"" and provide them with harm-reduction services at multiple points of access. -Goals and objectives: The project's main goals are to: 1) Hire project staff; 2) Increase access for PEUH to basic primary care and ID services; 3) Provide PEUH with low-barrier SUD/mental health treatments; 4) Increase STD screening, testing, education, and treatment for PEUH with SUD who have or are at risk of HIV; 5) Provide recovery coach, wraparound services, and/or harm reduction to encourage recovery. Key objectives include: 1) Hiring a program coordinator, clinician, street outreach worker, and recovery coach to implement the project; 2) Engaging 275 PEUH for primary care and ID treatment in the three-year project period; 3) Providing SUD and mental health screenings for 80% of PEUH to determine appropriate level of intervention; 4) Providing 80% of PEUH with HIV/STI testing, treatment, and prevention services in the three-year project period; 5) Providing PEUH with recovery services, referrals/linkages, and harm reduction materials to keep 75% engaged at their appropriate level of recovery at six months. -Number of People Served: The project will serve 275 people over the three-year project period.

Hays County is situated in the heart of Texas, just south of the state's capital. Hays County seeks funds to begin an Assisted Outpatient Treatment Program for adults suffering with Severe Mental Illnesses. The program will seek to serve Hays County residents, ages 18 and older who may or may not have a co-occurring substance use disorder. Hays County will partner with Hill Country MHDD in order to deliver services. The program will seek to serve 25 individuals in the first year, with the number growing to 35 in year two and 40 is years three and four. Over the course of 4 years, the program will serve 140 individuals. The program will operate under the Hays County, County Court at Law Seat #3 which serves as a specialty Mental Health Court. This court focuses on assisting individuals with serious mental illness and seeks to provide a pathway to treatment for individuals. This program will mark a cross-sector collaboration for Hays County with participation from law enforcement, community groups, individuals with lived experience, and mental health professionals. Staff will work with program participants to create an individualized treatment plan that offers them the greatest chance of success through individual and group therapy, medication management, and, if needed, substance abuse treatment.

The U.S. Territory of Guam requests funding for the project titled “Assisted Outpatient Treatment for Individuals with Serious Mental Illness”. In September 2015, the Assisted Outpatient Treatment Law, cited as the “Baby Alexya Law” was added to Chapter 82 of the Guam Code Annotated. Although annotated, this service has not been implemented. Individuals with Serious Mental Illness (SMI) in Guam who are at risk to themselves or others or are unable to make informed medical decisions, due to the symptoms of SMI, become either dangerous or incapable of making informed medical decisions concerning their treatment. In FY2023, GBHWC served 4,244 clients of that 1,758 clients were adults with SMI. A total of 296 clients were admitted to the Adult Inpatient Unit, of which 37 clients were re-admitted 2 or more times. A total of 15 individuals are in the current mental health court program of the Superior Court of Guam and are closely monitored by the probation office with coordination from Guam Behavioral Health and Wellness Center. In the 2023 U.S. Department of Housing and Urban Development Point-In-Time count, 12 homeless individuals were adults with SMI. It is estimated that there is a higher number of homeless SMI adults, however, many individuals chose to no self-disclose. The need for AOT stems from the challenges faced by individuals with SMI who struggle to adhere to treatment regimens necessary for their wellbeing and community safety. Despite the availability of outpatient services, a subset of individuals with SMI may experience significant barriers to consistently engaging in treatment, which can lead to recurrent crises, hospitalizations, and involvement with the criminal justice system. These individuals often cycle through periods of stability and decompensation, posing risks to themselves and others while experiencing diminished quality of life. Implementation and establishment of an AOT program consistent with the Baby Alexa Law will offer a structured and comprehensive approach to address the treatment needs of this population, providing intensive community-based services tailored to support individuals in adhering to treatment plans and maintaining stability in their lives. The core intervention of the AOT program is strategically aimed at achieving several critical goals: reducing psychiatric hospitalizations, preventing homelessness, decreasing incarcerations, and enhancing overall health and social outcomes. With a target to annually serve at least 20 individuals, the program priority will be continuous quality improvement to assess and enhance its effectiveness and outcomes, ensuring it adapts and responds effectively to the needs of the individuals. The AOT program represents a significant step forward in meeting the needs of Guam’s most vulnerable populations, providing critical community-based support and resources aimed at integrating and improving the lives of individuals with SMI. Estimated number to be served as a result of this award of this grant: 80

The Montgomery County Assisted Outpatient Treatment (AOT) Program aims to reduce the incidence and duration of psychiatric hospitalization, homelessness, incarcerations, and interactions with the criminal justice system while improving the health and social outcomes of people with severe mental illness. Montgomery County's AOT program is a multidisciplinary program working across sectors of the community such as the courts, behavioral health providers, and crisis services to support the evaluation of the psychiatric and social needs of the participants, development and implementation of the treatment plan related to the medical, psychiatric, and social needs of the participant, and the provision of referrals to appropriate case management, medical, and social support services to improve the overall health and social outcomes for the participant.

In Erie County, Ohio, there is a pressing need for a new program to address severe mental illness challenges. The proposed Assisted Outpatient Treatment (AOT) Program is designed to fill this critical gap by focusing on individuals who struggle with treatment adherence and may pose a risk of harm to themselves or others due to conditions such as schizophrenia, bipolar disorder, or severe depression. These individuals often find their ability to function in daily life significantly compromised, leading to a documented history of non-compliance with voluntary mental health treatment, including medication and therapy. Many have experienced repeated hospitalizations or encounters with the criminal justice system due to their untreated conditions. The initiative is led by a multidisciplinary team, drawing from key stakeholders such as the Erie County Common Pleas Court, ADAMHS Board, Firelands Counseling and Recovery Services, Serving Our Seniors, and the National Alliance on Mental Illness. This team plays a pivotal role in guiding the program's implementation, coordinating activities, and addressing challenges that may arise. Through formal agreements with various organizations—including courts, law enforcement, mental health agencies, and hospitals—clear roles, responsibilities, and commitments will be established to ensure seamless collaboration. Policies and protocols will be carefully developed to respect the civil liberties and privacy rights of participants while ensuring compliance with relevant laws such as HIPAA. The program's structure, processes, and goals are meticulously outlined, encompassing referral and screening procedures, assessment tools, treatment plans, and case management strategies. Additionally, comprehensive staff training plans will be devised to equip personnel with the necessary knowledge and skills to effectively support program participants. The program embraces evidence-based practices such as Cognitive Behavioral Therapy, Motivational Interviewing, Trauma-Informed Care, Individual Placement and Support, Integrated Dual Diagnosis Treatment, and Contingency Management. These approaches are chosen to address the diverse needs of the population, with clinical screening tools and assessments employed to identify treatment needs accurately and monitor progress effectively. To ensure cultural relevance and effectiveness, modifications will be made to adapt evidence-based practices to the unique characteristics and needs of the community. Community engagement, cultural competency training, and the involvement of individuals with lived experience will be prioritized to foster inclusivity and trust within the program. Comprehensive monitoring processes will be established to ensure fidelity to evidence-based practices, with ongoing data collection and analysis conducted to track implementation progress and measure outcomes. Continuous quality improvement efforts will involve collaborative review and refinement of practices based on stakeholder feedback, ensuring that the program remains responsive to the evolving needs of participants and the community. The program's budget includes provisions for the implementation of the Contingency Management model, patient transportation assistance, medication support, training/implementation of evidence-based practices, and employment and housing support. Leveraging existing resources and community partnerships will be crucial to maximizing program effectiveness and sustainability over time. In conclusion, the implementation of the AOT program in Erie County represents a strategic and collaborative effort aimed at providing effective and compassionate care for individuals with serious mental illness. By leveraging evidence-based practices, community partnerships, and data-driven approaches, the program seeks to improve outcomes and enhance the overall well-being of participants while upholding their civil liberties and privacy rights.

The proposed Gallatin County Assisted Outpatient Treatment (AOT) Program will serve adults with serious mental illness (SMI) who meet the criteria for outpatient civil commitment in Gallatin County, meaning the person is a danger to themselves or others, or cannot meet their own basic needs. The AOT program will create a multi-disciplinary, evidence-based approach to reduce the incidence and duration of Montana State Hospital commitments, homelessness, incarceration, and criminal justice system interactions while improving the health and social outcomes for adults with serious mental illness. The AOT Program will provide an effective community-based alternative to State Hospital commitments to 150 people over four years. The Gallatin County AOT Program will achieve the following goals: 1. AOT participants receive behavioral and social health services and supports that meet their needs and promote participant health, stability, and safety. 2. AOT participants are served in the least restrictive setting possible, and are diverted from the state hospital, homelessness, and the criminal justice system. 3. Individuals with SMI transitioning from AOT are healthy and stable in the community. 4. Community partners collaborate to effectively deliver coordinated behavioral and social health services. The Gallatin AOT Program will achieve these goals and related objectives through several key strategies, including: • Building community capacity to serve adults with SMI by implementing evidence-based screening, assessments, and treatment services in addition to social health services so individuals can be treated and recover safely in the community, including after exiting the AOT Program. • Enhancing formal partnerships between behavioral health, social health, and civil court stakeholders to effectively implement the AOT program with a strong focus on respecting the civil and privacy rights of program participants. This will occur through MOUs as well as formalized processes and procedures. • Strengthening training for collaborating behavioral and social health partners to implement evidence-based practices to fidelity, ensure consistent provision of trauma-informed, culturally-informed, person-centered care, and ongoing education and outreach to diverse community partners. • Engaging in rigorous evaluation and continuous quality improvement processes to optimize the AOT Program for community needs.

A coalition of local civil commitment process stakeholders, led by SMA Healthcare, Inc., proposes to develop and implement an Assisted Outpatient Treatment (AOT) program to serve citizens of St. Johns, Flagler, and Putnam Counties, Florida. AOT will be providing AOT to 220 individuals over the grant period (51, 70, 70 and 60 respectively for years 1-4) experiencing serious mental illness who have a history of repeated discharge from inpatient care in stable condition, only to be readmitted under a Baker Act at least twice in a 36-month period. AOT will be implemented adhering to the AOT model as presented in “Implementing Assisted Outpatient Treatment: Essential Elements, Building Blocks and Tips for Maximizing Results” (Treatment Advocacy Center, October 2019). Participants will be referred to local psychiatric outpatient services to include medication management and counseling services in three counties. Grant funds will be used to fund 3 targeted case managers utilizing evidence-based Intensive Case Management Model and three Recovery Support Specialist focused on engaging community support systems in the 3 counties with the following goals and objectives: Goal 1: Establish an AOT process supported by the local Baker Act judges, Baker Act receiving facilities, and treatment providers of Severe Mental Illness. Objective 1a - Establish an “AOT Management Team” within two months of grant award that will meet monthly in first year and quarterly thereafter. Objective 1b- Submit MOUs from “AOT Management Team” within 4 months of award. Objective(s) 1c, d and e- within first six months of award Establish a Steering Committee of stakeholders, evaluator, and consumers/family members, Complete the Program Implementation Plan including diagram of the workflow of the project and Develop and Submit a Project Staff Training Plan for all agency personnel involved with the participant. Goal 2: Identify and engage individuals who meet AOT criteria to increase participation in treatment services, especially those experiencing Anosognosia, and reduce psychiatric hospitalization, arrests, and homelessness. Objective 2a- 75% of AOT enrolled participants will not be admitted to an inpatient crisis unit or state psychiatric hospital in any one-year period while participating in AOT. Objective 2b and c- 75% of AOT Expansion enrolled participants will not be arrested and shall not experience homelessness subsequent to admission at six-month intervals and at discharge. Objective 2d- 85% of AOT participants will remain in treatment three months after admission. Objective 2e- 70% of participants will successfully complete the AOT program and meet statutory requirements to finish AOT. Objective 2f- 80% of participants will engage in ancillary services within three months of completing the AOT program.

Denton County MHMR Center’s Assisted Outpatient Treatment Project (AOTP) will serve court-mandated residents of Denton County, Texas with serious mental illness and/or serious emotional disturbance, who experience rapid re-hospitalization and reincarceration. AOTP will collaborate with local law-enforcement to identify court-mandated clients and will provide wrap-around services to meet the extensive needs of each unique individual to decrease symptoms of severe mental illness, reduce the recidivism in the jail, reduce rapid re-hospitalization, and increase safety for all individuals in our community. AOTP will allow for at least 75 unduplicated individuals in Year 1, 75 in Year 2, 75 in Year 3, and 75 in Year 4; totaling 300 individuals. AOTP has three primary goals: Reduce recidivism in the court and justice system; Reduce rapid re-admission to local and state psychiatric hospitals; Increase individuals’ participation in their treatment. AOTP aims to achieve several objectives including: Building a network of available referral sources to identify barriers that individuals experience in accessing outside services; Assessing 100% of the individuals referred for AOT service to ensure that AOT is the appropriate level of care; Reduce incarceration recidivism rates in individuals served by 40% over the next four years; Reduce hospitalizations and relapse in individuals served by over 40% over the next four years; Complete follow-up with 100% of individuals within 24 hours of admission to a psychiatric hospital; Provide wrap-around services, including intensive case management psycho-social rehabilitation services, provider services, medication management and continuity of care services to 100% eligible participants; Provide aftercare appointments to 100% eligible participants upon discharge from psychiatric hospital; Provide skills training services centered around vocational needs to 100% individuals and help connect individuals with employment opportunities; Provide services and help connect the individuals with resources that address identified barriers to treatment with 100% of the individuals served in AOT.; Encourage engagement with Peer Supports services in 100% of individuals served; Provide skills training on budgeting for housing expenses and follow-up routines to aid in maintaining employment and housing for the individuals served. The desired outcome is to make a life-long impact on the individuals we serve, thereby decreasing the strain on our current courts, law enforcement, and hospital systems in Denton County.

Washington City Orphan Asylum, doing business as Hillcrest Children and Family Center, proposes to implement the Hillcrest Assisted Outpatient Treatment (AOT) Project in Washington, DC to support adults with severe mental illness (SMI), including those with co-occurring substance use disorder, who meet DC-specific criteria for AOT. Within this broader population, the project will focus in particular on serving vulnerable populations including communities of color, transitional-age youth (ages 18-24), justice-involved adults, individuals experiencing homelessness or unstable housing, and those with chronic health conditions and/or disabilities. Hillcrest plans to serve 55 unduplicated individuals each year for a total of 220 individuals served over four years. The Psychiatric Institute of Washington - a short-term, inpatient care facility that includes crisis stabilization - and the Superior Court of the District of Columbia will join Hillcrest staff as part of the AOT Management Team, whose purpose is to coordinate the project's development, implementation, and evaluation, including regular review of AOT participants’ status and strategy sessions to develop and review procedures for fulfilling civil court orders and address challenges as they arise. The goals and objectives are as follows: Goal #1: Increase the capacity of Hillcrest staff to serve civilly committed individuals with SMI through the establishment of a formal AOT program. • Objective 1.1: By July 30, 2025, and every year thereafter through July 30, 2028, 100% of staff who will work with civilly committed individuals will have received forensic mental health training. • Objective 1.2: By July 30, 2025, increase the number of civilly committed individuals served by Hillcrest from an average of 12-15 to 55, maintaining this minimum average every year thereafter through July 30, 2028. Goal #2: Improve the whole health of civilly committed individuals served by Hillcrest, as evidenced by improved health and social outcomes. • Objective 2.1: By July 30, 2028, decrease the number of hospitalizations and Emergency Department visits by civilly committed individuals seen by Hillcrest by an average of 5% annually. • Objective 2.2: By January 30, 2025, establish an AOT steering committee comprised of community partners that address health and social disparities (e.g., jails, shelters), and add one additional partner each year thereafter through July 30, 2028.