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

The proposed project will build on the foundational work Bellevue Hospital has done over the last several years to infuse trauma-informed care into NYC juvenile detention settings. Reflecting NYC's long term efforts to reduce detention for youth, there has been a steady decline in placement in NYC secure (2 sites) and non-secure detentions (13 sites) settings. Bellevue Hospital Center's foundational work has focused on increasing the identification of traumatic exposure and PTSD in youth placed in both secure and non-secure detention settings through evidenced-based screening, and, in the two secure detention sites, enhancing the knowledge and skills of facility staff through Think Trauma training and ongoing staff skills building and increasing the coping skills of youth through the implementation of evidenced-based trauma skills groups (Brief STAIR-A). The current proposal seeks to enhance and expand on the work as follows: 1) the implementation of a NCTSN evidence-based trauma intervention (TARGET), which broadens our impact through the addition of T4 training for frontline staff, trauma skills groups suitable for longer stay youth, and importantly, the addition of trauma psycho-education groups for families of detained youth; 2) expansion into all 13 non-secure detention sites with Think Trauma training and T4 training for staff; 3) the development and implementation of a "Trauma-Informed Care Passport" to establish continuity of communication and care as detained traumatized youth transition to community care or placement; and 4) the implementation of systematic trauma screening and T4 training for the Westchester County juvenile secure detention facility.

The proposed project will build on the foundational work Bellevue Hospital has done over the last several years to infuse trauma-informed care into NYC juvenile detention settings. Reflecting NYC's long term efforts to reduce detention for youth, there has been a steady decline in placement in NYC secure (2 sites) and non-secure detentions (13 sites) settings. Bellevue Hospital Center's foundational work has focused on increasing the identification of traumatic exposure and PTSD in youth placed in both secure and non-secure detention settings through evidenced-based screening, and, in the two secure detention sites, enhancing the knowledge and skills of facility staff through Think Trauma training and ongoing staff skills building and increasing the coping skills of youth through the implementation of evidenced-based trauma skills groups (Brief STAIR-A). The current proposal seeks to enhance and expand on the work as follows: 1) the implementation of a NCTSN evidence-based trauma intervention (TARGET), which broadens our impact through the addition of T4 training for frontline staff, trauma skills groups suitable for longer stay youth, and importantly, the addition of trauma psycho-education groups for families of detained youth; 2) expansion into all 13 non-secure detention sites with Think Trauma training and T4 training for staff; 3) the development and implementation of a "Trauma-Informed Care Passport" to establish continuity of communication and care as detained traumatized youth transition to community care or placement; and 4) the implementation of systematic trauma screening and T4 training for the Westchester County juvenile secure detention facility.

By creating a Health Home we improve access, clinical quality, and the efficiency of health care delivery by: improving communication and coordination of care; reducing unnecessary tests and procedures; leveraging information technology and process improvement techniques to reduce operational and administrative redundancies; and fostering research and evaluation. Goals include: 1. Improve health status, increase life expectancy and quality of life for consumers 2. Improve management of chronic conditions 3. Achieve efficiency in utilization of health care resources resulting in cost savings 4. Enhance consumer's experience of care 5. Transform health care systems by coordinating community resources and influence flexibility in funding of care coordination. We are expanding our current integrated care program that began in 1994 with collocated primary care services in our clinic, but with limited interactions between physicians and behavioral health staff, to a second generation of increased collaboration, to this third generation that reflects integration of treatment plans, health promotion/education and introduces Care Support Specialists to promote enhanced coordination and integration of health care services. Care Support Specialists blend the roles of care coordinators and case managers. Of the projected 1,650 adults to be served, they reflect largely low-income, uninsured or Medicaid enrolled individuals who are Black/African American (85%), between the ages of 18 and 85 (75% between 18 and 64), and equally representative of females and males. We expect to reduce unnecessary health care services, resulting in an overall decrease in annual health care expenses by 25 percent of the Michigan average for persons with dual eligibility (Medicare and Medicaid).

The University of Utah and Primary Children's Center for Safe and Healthy Families are collaborating on the project, Pediatric Integrated Post-Trauma Services: an Evidence Based Care Process Model for Pediatric Traumatic Stress. The purpose is to develop and disseminate clinical algorithms and tools for medical providers to detect, assess and manage traumatic stress, facilitating timely treatment and referral and minimizing the misuse of medication. The area of trauma focus is Injuries and Medical Problems/Health Care Settings/Integrated Care. The project goals include 1) Develop an Evidence Based Care Process Model (EB-CPM) and decision support tools for pediatric traumatic stress; 2)Implement and assess pediatric traumatic stress EB-CPM for front line healthcare providers in primary care and children's advocacy centers; and 3) Provide national leadership on the use of care process models in trauma exposed children. In order to accomplish these goals, we will compile, synthesize and critically assess evidence for treatments of pediatric traumatic stress pertinent to front line medical providers, use a modified Delphi process to guide clinical decision points for which there is an absence of evidence, and create a pediatric traumatic stress assessment and management algorithm for front line providers,including decision support tools that will be piloted and implemented within primary care and children's advocacy center settings. This will allow us to measure the impact of EB-CPM on management of pediatric traumatic stress and identify facilitators and barriers to implementation. Additionally, we will lead a NCTSN work group on revising and disseminating care process models, including sustainability strategies for evidence based care and the use of psychotropic medication in trauma exposed children. Furthermore, we will engage outside the network with national pediatric healthcare provider organizations including the American Academy of Pediatrics and the American Academy o

The Pediatric Approach to Trauma, Treatment and Resilience, PATTER,is designed to educate pediatricians about childhood trauma to improve the identification, management and outcomes of millions of traumatized children who currently have limited access to mental health resources. PATTER is proposed and led by the Department of Pediatrics at UCLA, in collaboration with that of the University of Massachusetts and the American Academy of Pediatrics. In 2013, only 4 percent of pediatricians who responded to the Academy's national Periodic Survey were familiar with childhood trauma. Yet, pediatricians are likely to be the first, and often only, professionals who encounter the 68 percent of American children who have experienced trauma. Because pediatricians currently lack the knowledge and skills to undertake trauma care and there is a dearth of mental health trauma resources, the Departments of Pediatrics at UCLA and the University of Massachusetts are partnering with the American Academy of Pediatrics to achieve PATTER's 3 primary goals - 1. To develop and adapt curricula to train pediatricians about the trauma-informed approach to pediatric care in every interaction with children and families, 2. To educate pediatricians recruited nationally about the PATTER curriculum via multiple American Academy of Pediatrics' venues to create a trauma-aware pediatric workforce, and 3. To educate a subset of nationally representative pediatricians using an advanced PATTER curriculum to create a trauma-responsive system of care. Specifically, trauma-responsive leaders will receive training about quality improvement to promote the implementation of trauma screening and evidence-informed trauma-specific anticipatory guidance, known as Child Health Advice for Trauma, in their offices. Trauma-responsive leaders will also acquire the knowledge and skills to train their colleagues, thus expanding the population of trauma-informed pediatricians. In a trauma-responsive system

The Adapt for DD Initiative aims to improve well-being of youth with developmental disabilities (referred to as youth with DD) who are impacted by trauma by increasing caregivers' sensitivity and increasing the availability of clinicians who can provide treatment for this double vulnerable population. Strategies include cross-training for developmental disabilities and trauma as well as development of and delivery of DD-appropriate trauma-related assessment tools and treatment adaptations. The project will facilitate dissemination of the recently developed NCTSN toolkit, Road to Recovery, to increase awareness of the impact of trauma on youth with DD, adapt these materials and develop additional materials based on our needs assessment. Initial target audiences are agencies specializing in services for children with developmental disabilities and community-based clinical providers. Our efforts will be expanded to other providers in special education, child welfare, and medical and other clinical fields, and we will specifically address needs of military/veteran families coping with both service-related issues and developmental disabilities. We will collaborate with identified partners already working to adapt assessment and intervention tools for youth with DD in our catchment area and clinics of our identified partners, and seek additional centers to create a collaborative group focusing on this clinical group. The collaborative group will involve stakeholders (i.e., families, service providers, policy makers) on both regional and national level. By the end of the project, we aim to develop a service guide or road mad to assist in matching type of disability with best available practices and develop a methodology for communities to assess their unique combination of needs and resources and to come together to try and fill in gaps and provide more coherent coordination of services to enhance services for the DD youth, their families, and their providers.

The Terrorism and Disaster Coalition for Child and Family Resilience (TDC4CFR) will create effective products, programs, and partnerships to enhance national capacity to prepare for and respond to the unique needs of children, families, and communities after terrorism and disaster. As a major objective, the TDC4CFR will create regional coalitions among key stakeholders within 3 selected terrorism-vulnerable or disaster-prone areas to identify regional strengths and service gaps, map resources and network linkages, develop strategies for enhanced social messaging, and create and implement a strategic plan to optimize regional planning and behavioral health response. It will develop enhanced training curricula in evidence-based assessments and interventions, including Psychological First Aid and Skills for Psychological Recovery, for child and family post-incident response, adapt standardized training materials, facilitator guides, and training platforms, design training curricula for intervention with selected vulnerable groups, and utilize an Advisory Board to review training materials for cultural and linguistic relevance. In regard to training, TDC4CFR will identify and establish 3 communities of practice to implement training targeted to child-serving providers within the targeted coalition regions. An estimated 500 providers will be trained each year on Psychological First Aid or PFA for Schools. Further, it will create resources for child-serving providers, parents, and youth to provide information and strategies for preparedness and response to terrorism and disaster, including adding additional terrorism and technological disaster response content to Help Kids Cope. It will create content and implement dissemination strategies for fact sheets, children's activities, and other tools, and develop a toolkit, including elements to implement and sustain post-disaster/terrorism recovery programs. The TDC4CFR will provide consultation and support to regional co

The Center for the Study and Prevention of Violence (CSPV), University of Colorado, proposes to develop a TSA Center for the Rocky Mountain Region. With a focus on trauma in schools, the “Center for Resilience and Well-being in Schools” will be a national leader and resource hub to facilitate creation of safe, supportive school environments that use a “whole-school” approach to promote mental, emotional, and social health in trauma-sensitive and culturally responsive ways. We propose to bridge a significant gap in the field by helping schools transform their whole school climates through the comprehensive Trauma Sensitive-Safe Communities, Safe Schools (TS-SCSS) conceptual model and implementation framework. Our TSA Center will target all children and youth in grades K-12. Overall goals will include: 1. Build the TSA Center for Resilience and Well-Being in Schools with the infrastructure to implement whole-school approaches to address trauma and promote resiliency and well-being among children and staff. The TS-SCSS Model will be used to guide our TSA Center. 2. Build a school-wide approach to social emotional learning (SEL) to promote educator, staff, and student social and emotional competencies by adapting our NCTSN Promising Practice, Let’s Connect (LC) for use in schools (Let’s Connect for Schools: LC-S). 3. Implement a school-wide approach to build attunement to the signs of student trauma, mental health and safety concerns and to increase staff skills to match students with appropriate services by adapting our Project Focus Colorado training program for use with schools. We will use a Multi-Tiered System of Support to match students to services. 4. Build capacity in schools and communities throughout our region to deliver trauma-focused, evidence-based treatments (TF-EBTs) and disaster preparedness and response programs using our existing Evidence-Based Practice Training Initiative (EBPTI) infrastructure. The TSA Center will increase school system capacity and support evidence-based, trauma-informed mental health services in five ways. We will: 1) provide schools with the TS-SCSS Model as a roadmap for building trauma-informed schools; 2) infuse universal SEL strategies to strengthen the social and emotional competence of individuals within school systems; 3) increase recognition and response to student trauma and mental health needs in schools; 4) offer training to build school and community capacity to deliver culturally competent, evidence-based treatment for underserved minority and rural populations; and 5) partner with the Department of Education at the University of Colorado to develop an interactive curriculum for undergraduate/graduate students and future teachers that will promote the skills necessary to build trauma-sensitive schools. We expect to impact over 94,000 children (18,800 annually) and 6,300 educators (1,260 annually) in the Rocky Mountain region with direct project activities, with potential to reach many more with large-scale dissemination of products developed.

The Center for Resilient Families, a Category II Treatment Services and Adaptation center of the National Child Traumatic Stress Network aims to raise awareness of and increasing access to family interventions to promote resilience in traumatized children. The Center is a partnership of Ambit Network at the University of Minnesota, and developers of evidence-based family programs at Arizona State University’s REACH institute, Implementation Sciences International, and the Research Consortium on Gender-based Violence. The Center will reduce disparities in service access, use, and training by targeting trauma-informed family interventions to isolated families in transition: those with a parent deployed to war, Native American families on reservations, immigrant and refugee families, families involved in the juvenile justice and child welfare systems, and families in which a parent has been killed. We will provide national leadership within and beyond the NCTSN by developing products aimed at helping families, those who provide them with services, and communities, to understand the impact of traumatic stress on parents, and the crucial role of parenting in strengthening children’s resilience. We will work with other Category II sites, the National Center for Child Traumatic Stress, multiple Category III sites, and national organizations to develop and disseminate products and to implement evidence-based parenting programs. We will lead a new NCTSN collaborative group aimed at reducing disparities in access to family programs, and will work closely with other groups. We will adapt and widely implement an array of five evidence-based parenting interventions, all of which have been rigorously tested and shown to be effective at strengthening resilience among traumatized families but none of which have hitherto been available to the NCTSN. These interventions are: Family check-up/FCU; Parent Management Training-Oregon model/PMTO, and its validated adaptations for military

Summary: The Pediatric Integrated Care Collaborative will disseminate trauma-informed integrated care for families with young children. It will promote an expanded model of integrated care that includes core family partnerships and linkages with community services addressing the social determinants of healthy development. PICC will support self-sustaining practice transformation suited to evolving health care financing and policy.Background: Primary care plays an essential role in the primary and secondary prevention of childhood trauma and its long-term impact on children’s healthy development. Much progress has been made integrating primary care with mental health and trauma services, and changes in health care financing and policy continue to make integration more desirable and feasible. However, the process of practice transformation to trauma-informed integrated care remains difficult, and integration needs to additionally include services that are multi-generationally focused and that provide interventions that simultaneously target social determinants of health.Goals: The application seeks to extend the work of the currently-funded NCTSN Category II Pediatric Integrated Care Center (PICC) to a) enroll an additional 30 teams from sites wishing to initiate or expand trauma-informed integrated care for families with young children; b) expand the integrated care model being disseminated to include methods for addressing social determinants; and c) promote sustainable integration efforts through enhanced documentation of outcomes, links to community organizations and policy-makers, and support for long-term sharing of expertise among sites. We anticipate that over the lifetime of the project, the participating teams will directly serve upwards of 8,000 children/families (an average of 2-3,000 per year) with the potential to serve considerably more as they take on their own dissemination roles.

The Center for Treatment of Developmental Trauma Disorders (CTDTD) brings together developers and disseminators of leading evidence-based child developmental trauma treatments, to enable all NCTSN Centers and their affiliated providers nationally to achieve competence in DTD assessment (with NCTSN DTD screening and interview protocols) and treatment (with systematic integrative best practice algorithms for child/family-centered outcome-based care).Over the 5-year funding period, CTDTD will enhance the ability of more than 40,000 peer and professional counselors to treat more than 100,000 children safely and effectively for DTD, operationalizing the Network’s Clinical Competencies guidelines and extending Network Core Concepts/Components initiatives with guidelines for DTD-informed clinical decision-making. In Year 1, CTDTD will: (A) provide all NCTSN centers a DTD screening/assessment guide and protocols developed in the DTD Field Trial (which was conducted by the CTDTD Director and Co-Director) at the new grantees’ and 2017 All Network Conference meetings and through the Affiliates Network and website; (B) survey all NCTSN centers/affiliates and conduct key-informant interviews with providers, children and families to identify critical clinical dilemmas that can lead to: (1) impasses or ruptures in engagement and the therapeutic alliance, (2) crises and significant increases in risk, and (3) ineffective developmental outcomes; and, (C) develop and disseminate a report with integrative practical treatment strategies and al 4-year plan for informing the public, policymakers, and professionals about effective treatment for DTD. In Year 2, CTDTD will collaborate with the NCTSN National Center to present/archive 10 national webinars each with 4 CTDTD faculty, moderated by the Director/Co-Director, and introduced with a youth-written/performed dramatization, across all developmental epochs and emphasizing children facing health disparities, for (i) families an

The Urban Youth Trauma Center’s Project T.R.I.U.M.P.H. (Trauma Resiliency through Integrated Urban Models: Partnerships for Hope) seeks to disseminate evidence-based practices to reduce and prevent behavioral health disparities resulting from community violence and traumatic stress with co-occurring substance abuse and behavioral problems among underserved youth and their families, with a special emphasis on low-income urban, ethnic, linguistic, and religious minority communities. Using a comprehensive socio-ecological model of trauma-informed, evidence-based best practices to serve the continuum of needs of underserved minority youth and families, UYTC’s goals are to: a) raise public awareness through NCTSN collaborations and a national media campaign that includes youth-oriented messages; b) provide specialized training and consultation to clinicians and youth serving providers; and c) engage and mobilize partners in strategic collaborations that include clinical, community, and policy constituents spanning across youth service system sectors to address community violence and behavioral health disparities. UYTC will emphasize public awareness, specialized training, and strategic engagement with local and national partners with the following measurable objectives: 1) reach 8000 people (1600 per year) from youth serving systems and general audiences with public awareness messages disseminated in person, online and through social media,2) train 500 clinicians (100 per year) to provide mental health services to 1500 underserved urban youth and families (300 per year) using the two UYTC family-focused treatment protocols of Trauma Systems Therapy for Adolescent Substance Abuse (for co-occurring substance abuse) and STRONG Families (for co-occurring disruptive behaviors); and 3) train 1000 youth-serving providers and community members (200 per year) in best practices promotion to 5000 underserved urban youth and families (1000 per year)

The Center for Child Trauma Assessment, Services and Interventions (CCTASI) at Northwestern University provides national expertise on interventions for the developmental effects of trauma with an emphasis on building infrastructure for trauma-informed, child-serving systems, including child welfare, behavioral health, educational and juvenile justice settings. Our population includes providers, caregivers, and youth from early childhood through transition age youth (TAY); the majority are racial/ethnic minority youth, many with a range of trauma-related needs. We will use a culturally sensitive lens and address gaps in trauma-informed practices for specific subpopulations, including foster care, residential, early education, juvenile probation and diversion, and programs for TAY. Our goals are to 1) enhance trauma-informed screening and assessment practices; 2) offer training and consultation for front line/non-clinical staff on NCTSN interventions/service approaches, including the Resource Parent Curriculum (RPC) and Think Trauma Toolkit (TTT); 3) adapt interventions and services to support culturally diverse and underserved populations; and 4) develop and disseminate trauma-informed products to increase public awareness. Extending the work of our existing NCTSN Center, we will continue to specialize in trauma screening and assessment with an enhanced focus on the meaningful use of tools in practice. The Child and Adolescent Needs and Strengths-Trauma Comprehensive (CANS-Trauma), an assessment strategy developed by our Center and national partners, will be further adapted, implemented and integrated into practice across our targeted systems. We will also develop an early childhood CANS-Trauma version in partnership with NCTSN early childhood experts and systems partners. Our focus will broaden to include a range of screening/assessment tools as we develop resources to support meaningful use of tools in practice. We will also emphasize training and widespread dissemination.

Experiencing the death of a loved one is the most common and most distressing form of trauma among both clinic-referred and non-referred youth. However, few health service facilities are equipped to offer evidence-based, bereavement-informed assessment and treatment. Access to quality care is also a significant barrier, especially in disadvantaged cities in which deaths are most rampant. The overarching goal of this proposal, "The University of Texas Childhood Bereavement Resource Center (CBRC): Toward the Development of Bereavement-Informed Best Practices", is to raise the standard of care for bereaved youth and families through the dissemination of bereavement-informed, developmentally attuned and culturally appropriate best practices. Primary objectives include: (1)conduct a series of trainings focusing on bereavement-informed risk screening and assessment; (2) convene a series of Learning Collaboratives dedicated to implementing and evaluating three bereavement-informed interventions for grieving youth in a variety of contexts (e.g., bereavement in conjunction with other forms of trauma, deaths occurring under violent circumstances, anticipated deaths of loved ones); and (3) collaborate with NCTSN sites and other national organizations to raise public awareness regarding childhood bereavement, grief, and bereavement-informed best practices. Special attention will be given to disseminating these practices in high-risk populations, including military families and underserved minority youth. With Houston as our hub, we will build upon ongoing dissemination efforts across a highly diverse network of cities, each with high prevalence rates of youth bereavement. Primary partnering organizations will include those located in San Antonio and Brownsville, TX; Detroit and Ypsilanti, MI; Oakland and Richmond, CA; and Durham, NC. The city of Houston (19% Black, 51% Latino, 5% Asian) is the fourth largest city in the U.S., with 27% of youth living below the poverty

The proposed project, the University of Southern California Adolescent Trauma Training Center (USC-ATTC), will train over 5,000 clinicians and disseminate information to over 10,000 professionals throughout the United States on the assessment and treatment of trauma in socially marginalized and ethnically-diverse adolescents, including those with, or at risk for, substance abuse, suicide, and self-injurious behavior. Clinicians receiving training and products from this TSA Center of the National Child Traumatic Stress Network (NCTSN) will include those in mental health, substance abuse, child welfare, juvenile justice, and military intervention environments. USC-ATTC will disseminate previously developed treatment guides on the evidence-based model, Integrative Treatment of Complex Trauma for Adolescents, including the revised Integrative Treatment of Complex Trauma for Adolescents (ITCT-A) Treatment Guide and Treating Substance Use Issues in Traumatized Adolescents and Young Adults: Key Principles and Components. We will consult with a Consumer/Family Advisory Council and an Expert Panel twice a year on cross-cultural, behavioral health disparity, and LGBT issues relevant to the development of USC-ATTC products and trainings, including two additional treatment guides: Treating Suicidality and Self-Injurious Behaviors in Traumatized Youth and Mindfulness Training for Traumatized Adolescents. This project will also (1) develop a certification program, whereby at least 1,500 clinicians will be certified as competent in ITCT-A over the five-year grant period, (2) develop a Train-the-Trainer program to more widely disseminate ITCT-A throughout the NCTSN and beyond, with an estimated new 100 trainers over the grant period and at least 1,000 new ITCT-A informed clinicians over five years, (3) collaborate with other TSAs to develop and disseminate educational materials and co-conduct at least one training a year on preventing and treating suicidality, self-harm,

In response to the extraordinarily high rates of severe and prolonged trauma experienced by youth treated in residential treatment settings, the Institute for Adolescent Trauma Treatment & Training will utilize its expertise to 1) intensively train multidisciplinary providers to deliver four trauma-informed evidence-based interventions to youth in residential settings across the United States, 2) develop and disseminate multi-media products (e.g. treatment protocols, fact sheets, workshops, webinars, youth-led videos) and specialized resources for youth, families, and providers in various types of residential settings (e.g., juvenile detention, substance abuse treatment), and 3) promote sustainability of these practices through the development of policies and procedures (including creation of internal training teams) that will embed services within residential systems on an organizational level. Training in four leading trauma-specific interventions used in residential settings will be delivered through ongoing Learning Collaboratives/Communities in: 1) Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS), 2) Real Life Heroes (RLH), 3) Think Trauma, and 4) Attachment, Regulation, and Competency (ARC). Systems-level training in Think Trauma and ARC will be delivered first to agencies to help establish a trauma-informed organizational culture and provide foundational support for bringing in trauma-specific clinical interventions. Client-level clinical treatment interventions will then be provided via more intensive Learning Collaboratives for SPARCS and Real Life Heroes. In addition to the extensive training activities, the Institute will focus on creating general and specialized resources for use in various types of residential settings (e.g., intervention adaptations for settings with short-lengths of stay) and with specific subpopulations (e.g., unaccompanied refugee minors). This Project will train 8000 multidisciplinary provide

ABSTRACT: Project FORECAST Foundations for Out Reach through Experiential Child Advocacy Studies Training Project FORECAST (Foundations for Out Reach through Experiential Child Advocacy Studies Training) will simultaneously train undergraduate university students and community professionals in Problem-Based Learning Simulations (PBL-S) to develop Trauma-Informed Experiential Reasoning Skills (TIERS) in a workforce capable and competent at responding to trauma in a manner that promotes resiliency and reduces further trauma. Project FORECAST will incorporate the Core Concepts for Understanding Traumatic Stress Reactions in Children and Families into the development of PBL-S packages which will be disseminated to interdisciplinary Child Advocacy Studies (CAST) higher education programs and communities across the nation. CAST communities will include CAST University instructors and local workforce trainers. Both face-to-face and mobile/tablet-application teaching tools will be included in the packages. Additionally, communities will be equipped with materials to help supervisors assist CAST students’ transition to the child-serving workforce. Project FORECAST will train over 20 CAST communities, consisting of 6-10 instructors and workforce trainers as part of each community team. Following their participation in FORECAST Learning Communities, instructors and workforce leadership will sustain the Core Concept PBL-S curriculum in their courses and trainings each semester. Project FORECAST anticipates that over 9,000 higher education students and workforce members will improve their decision making skills. If each of those trainees interacts with even 20 children and families in a more trauma-informed manner during their careers, FORECAST will increase trauma-informed care for 180,000 individuals. Project FORECAST also predicts significant cost savings, as workforce retention in child-serving sectors should increase due to better preparation prior to college

United American Indian Involvement, Inc. (UAII) will utilize SAMHSA Native Connections funding to build an integrated and community-driven approach that will address suicide and substance abuse prevention. UAII serves the second largest AI/AN population in the United States that includes an inter-tribal community representing approximately 125 federally recognized tribes. Similar to multiple AI/AN communities throughout the country, alcohol and substance abuse continues to have a devastating effect. During 2014 in LAC, 60% of youth suicides had a documented mental health diagnosis and 20% were receiving mental health services at the time of death. Of increasing significance is the prevalence of bullying, and in particular, various types of cyber- bullying, and the correlation between cyberbullying and recent suicides. In Los Angeles County, of the youth who died by suicide in 2014, 50% had reported being a victim of bullying. UAII's primary strategy is to build an integrated and community-driven approach to addressing youth suicide and substance abuse prevention that involves multiple systems of client engagement. The ultimate goal is to provide a culturally appropriate, comprehensive and coordinated system of care that addresses the complex needs of AI/AN youth who are, or may be at-risk for suicidal behavior, those who are in the early process of alcohol and substance use experimentation or abuse, and those who have experienced early childhood traumatic experiences. UAII's proposed approach for this project includes: I) Increase agency capacity to provide outreach and disseminate information related to substance abuse and suicide prevention 2) Develop policies and protocols for a comprehensive and integrated service delivery system of care, and 3) Expand capacity to meet the needs of at-risk populations for suicide and substance abuse.

Oklahoma, a state with the second-highest American Indian (AI) population, has a suicide rate that is one of the highest in the nation. Despite this, there remain significant gaps in prevention, intervention and postvention treatment of AI youth ages 10-24. The Central Oklahoma American Indian Health Council, Inc, dba Oklahoma City Indian Clinic (OKCIC) proposes this five-year Native Connections project. The first year of the project will entail convening community stakeholders throughout central Oklahoma to conduct a service delivery systems analysis; a community needs assessment; a community readiness assessment; and a community resource/asset map that addresses both suicide prevention and substance abuse and misuse prevention. This work will culminate in a plan the uses the SAMHSA Strategic Prevention Framework planning process to guide the selection, implementation and evaluation of effective, culturally appropriate and sustainable prevention activities that encompass Tier 1, Tier 2 and Tier 3 of this project. In subsequent years, OKCIC will use the plan developed in Year 1 to provide services to AI youth in central Oklahoma. Evaluation will be a key part of this project, which will be overseen by the OKCIC Director of Quality Improvement. The OKCIC Behavioral Health Department will conduct this project. Staff are well trained on evidence-based practices as well as experienced in culturally appropriate treatment. Staff members in this department are very active in community efforts to create positive impacts. Staff will leverage these existing relationships to recruit a wide range of community members, including youth and their families, to the planning activities. Throughout the project, OKCIC will continue to screen all patients ages 11+ for depression, domestic violence, suicide ideation and other risk factors. Patients who are considered at-risk will continue to receive immediate care and/or referrals.

Oklahoma, a state with the second-highest American Indian (AI) population, has a suicide rate that is one of the highest in the nation. Despite this, there remain significant gaps in prevention, intervention and postvention treatment of AI youth ages 10-24. The Central Oklahoma American Indian Health Council, Inc, dba Oklahoma City Indian Clinic (OKCIC) proposes this five-year Native Connections project. The first year of the project will entail convening community stakeholders throughout central Oklahoma to conduct a service delivery systems analysis; a community needs assessment; a community readiness assessment; and a community resource/asset map that addresses both suicide prevention and substance abuse and misuse prevention. This work will culminate in a plan the uses the SAMHSA Strategic Prevention Framework planning process to guide the selection, implementation and evaluation of effective, culturally appropriate and sustainable prevention activities that encompass Tier 1, Tier 2 and Tier 3 of this project. In subsequent years, OKCIC will use the plan developed in Year 1 to provide services to AI youth in central Oklahoma. Evaluation will be a key part of this project, which will be overseen by the OKCIC Director of Quality Improvement. The OKCIC Behavioral Health Department will conduct this project. Staff are well trained on evidence-based practices as well as experienced in culturally appropriate treatment. Staff members in this department are very active in community efforts to create positive impacts. Staff will leverage these existing relationships to recruit a wide range of community members, including youth and their families, to the planning activities. Throughout the project, OKCIC will continue to screen all patients ages 11+ for depression, domestic violence, suicide ideation and other risk factors. Patients who are considered at-risk will continue to receive immediate care and/or referrals.

The proposed Native Connections project is geared towards serving rural tribal American Indian/Alaska Native (AIAN) communities of California, specifically 16 tribes and 9 tribal health programs affiliated with California Rural Indian Health Board (CRIHB). California is home to 109 federally recognized tribes and the largest number of AIAN in any state. Nationally, suicide is the second leading cause of death among AIAN ages 10-34. In California, suicide attempts is greater among AIAN than the general population. The overall purpose of the proposed project is to prevent and reduce suicidal behavior and substance abuse, reduce the impact of trauma, and promote mental health among AIAN young people up to and including age 24. This project will incorporate AIAN community involvement to support the implementation of culturally appropriate, community-based mental health promotion, suicide prevention, and substance use or misuse prevention interventions for AIAN youth people up to and including age 24. The project will focus on screenings, cultural responsiveness of care training for tribal health program behavioral health staff, historical trauma and trauma-informed care, postvention strategies, community partnership development, access to care, and data infrastructure development. The proposed Native Connections project will address the following activities in Year 1: 1) conduct a Service Delivery Systems analysis, a community needs assessment, a community readiness assessment, 2) create a community resource/asset map, 3) implement SAMHSA's Strategic Prevention Framework to guide the project, 4) develop processes to incorporate local traditional healing practices, and 5) develop culturally-appropriate postvention protocols and suicide attempt follow-up protocols. It is estimated that 400 individuals will be served through the program annually, totaling 2,000 over the five-year period.

The proposed Native Connections project is geared towards serving rural tribal American Indian/Alaska Native (AIAN) communities of California, specifically 16 tribes and 9 tribal health programs affiliated with California Rural Indian Health Board (CRIHB). California is home to 109 federally recognized tribes and the largest number of AIAN in any state. Nationally, suicide is the second leading cause of death among AIAN ages 10-34. In California, suicide attempts is greater among AIAN than the general population. The overall purpose of the proposed project is to prevent and reduce suicidal behavior and substance abuse, reduce the impact of trauma, and promote mental health among AIAN young people up to and including age 24. This project will incorporate AIAN community involvement to support the implementation of culturally appropriate, community-based mental health promotion, suicide prevention, and substance use or misuse prevention interventions for AIAN youth people up to and including age 24. The project will focus on screenings, cultural responsiveness of care training for tribal health program behavioral health staff, historical trauma and trauma-informed care, postvention strategies, community partnership development, access to care, and data infrastructure development. The proposed Native Connections project will address the following activities in Year 1: 1) conduct a Service Delivery Systems analysis, a community needs assessment, a community readiness assessment, 2) create a community resource/asset map, 3) implement SAMHSA's Strategic Prevention Framework to guide the project, 4) develop processes to incorporate local traditional healing practices, and 5) develop culturally-appropriate postvention protocols and suicide attempt follow-up protocols. It is estimated that 400 individuals will be served through the program annually, totaling 2,000 over the five-year period.

IHC's client population of over 5,000 registered patients is typical of that of many California American Indian clinics, with youth comprising over one-third (34%) of all patients. Through the Native Connections program, IHC will potentially reach up to 15,000 AI individuals through health promotion messages and outreach. Through Year 1, Community Needs and Readiness Assessments using the Colorado State University model, targeting 45 interviews, multi-stakeholder planning and selection of evidence- based methodologies for improved clinical therapy and capacity building. Planning activities will prepare the clinic to provide Tier 1 health promotion activities, including culturally positive alternative activities for youth; Tier 2 level services that include school-based and community- based postvention counseling follow a suicide or suicide attempt to prevention contagion; and Tier 3 level improved post-treatment counseling of youth in transition from residential treatment through on-site aftercare. In program years 2-5, it is anticipated that 400 community members will benefit annually from health promotion services, 30-50 youth will be served annually through learning and cultural/recreational programming and 20-30 young persons will receive one-to-one prevention and/or post-treatment services each year. Program objectives are: (1) Identify service gaps through a Community Needs and Readiness Assessment; (2) Develop a plan to support the results and evaluation of the Community Needs and Readiness Assessment; (3) Design and deliver effective suicide and substance use prevention messaging via social media and community outreach; (4) Develop protocols and procedures, with supportive materials for postvention response and contagion prevention; (5) Increase the capacity to deliver extended (6-month) aftercare services.

IHC's client population of over 5,000 registered patients is typical of that of many California American Indian clinics, with youth comprising over one-third (34%) of all patients. Through the Native Connections program, IHC will potentially reach up to 15,000 AI individuals through health promotion messages and outreach. Through Year 1, Community Needs and Readiness Assessments using the Colorado State University model, targeting 45 interviews, multi-stakeholder planning and selection of evidence- based methodologies for improved clinical therapy and capacity building. Planning activities will prepare the clinic to provide Tier 1 health promotion activities, including culturally positive alternative activities for youth; Tier 2 level services that include school-based and community- based postvention counseling follow a suicide or suicide attempt to prevention contagion; and Tier 3 level improved post-treatment counseling of youth in transition from residential treatment through on-site aftercare. In program years 2-5, it is anticipated that 400 community members will benefit annually from health promotion services, 30-50 youth will be served annually through learning and cultural/recreational programming and 20-30 young persons will receive one-to-one prevention and/or post-treatment services each year. Program objectives are: (1) Identify service gaps through a Community Needs and Readiness Assessment; (2) Develop a plan to support the results and evaluation of the Community Needs and Readiness Assessment; (3) Design and deliver effective suicide and substance use prevention messaging via social media and community outreach; (4) Develop protocols and procedures, with supportive materials for postvention response and contagion prevention; (5) Increase the capacity to deliver extended (6-month) aftercare services.