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The Pennsylvania Project AWARE Initiative will utilize the three-tiered public health model to expand both suicide prevention and training programs, as well as, to develop a better pathway to mental health supports and services. This project has identified three key goals that are aligned with Pennsylvania’s Statewide Suicide Prevention Plan. These goals include: increasing opportunities for students in all grades (K-12) to participate in suicide prevention training programs, ensuring school districts have appropriate mental health screening tools and personnel trained to assess mental health needs in students, and developing an electronic system to expand referral pathways to connect school-based practitioners with mental health providers with available capacity to serve new patients. This project will focus on Carbon, Lehigh, Luzerne, and Montgomery Counties in the Commonwealth of Pennsylvania. It is expected that the outcomes of this project will be replicable to other parts of the state in future years. The region selected for this project represents a diverse geographic footprint with 347,005 children under the age of 18 living within the region and 47 individual public-school districts. According to the 2021 Pennsylvania Youth Survey, approximately 1 in 5 students in grades 6-12 reported that they had suicidal thoughts in the past twelve months. Additionally, 1 in 3 Pennsylvania school districts report not providing suicide awareness and prevention training to students (according to a September 2022 needs assessment). The same needs assessment provided data to demonstrate that more than 400 students were awaiting behavioral health services because the school-based professional could not find a service provider with available capacity. This project will seek to provide 50% of the K-12 students within the region with a research-based suicide-prevention program in year 1. This will increase to 75% in year 2 and 90% in year 3. Additionally, this project proposes to start 5 “I’ve Got Your Back” student clubs in year 1. These clubs encourage student-led efforts towards suicide prevention within their schools. This will increase to 10 clubs in year 2 and 15 clubs in year 3. A key component of this project is to ensure that all school districts have appropriate mental health screening tools, as well as, personnel trained to utilize these tools. Therefore, this project will seek to provide at least 75% of the schools within the region with these tools and to provide training to build capacity within the schools to deliver the screenings & assessments. Given that parent input is also vital to support positive student mental health, this project will create a parent task force in each of the geographic regions to obtain parent and caregiver feedback regarding the screening/assessment tools. Finally, this project will seek to expand the existing Resource Connects website to add behavioral health services. The goal will be to not only add the contact information for these behavioral health providers to the site, but to also develop the site as a way for school-based professionals to seek out available resources to meet student needs. This will support ensuring that all students are able to receive the mental health supports they need in a timely manner.

The purpose of Utah Project AWARE 2022-2026 is to develop a sustainable infrastructure for school-based mental health programs and services in Utah. The Utah Department of Human Services- Office of Substance Use and Mental Health (OSUMH) will build collaborative partnerships with the Local Education Agencies (LEAs), including Tooele County School District, North Sanpete School District, and San Juan School District. Partnerships will also be built with community-based providers of behavioral health care services, community organizations, families, and school-aged youth. OSUMH will support the three school districts in building a three-tiered system of support and increase the number of students who receive evidence-based social emotional learning curriculum, suicide prevention training, and evidence-based mental health services. OSUMH and the LEAs will also provide training to adults supporting youth to increase mental health literacy and access to quality mental health care. As a result of this project, depressive symptoms, suicide ideation, and needs for mental health treatment will be reduced in youth, in the three targeted LEAs, while access to services and knowledge of suicide prevention skills and resources will increase.

Black Family Development Inc. (BFDI) is proposing to expand Detroit Public School Community District’s (DPSCD’s) well established mental health services and support to improve the networks response to risk factors associated with suicide to include addressing social determinates of health, reducing public stigma related to receiving mental health services and enhancing protective factors to mitigate the risk of suicide including the impacts of Adverse Childhood Experiences through Detroit AWARE. On average, 10,000 students in 27 schools within DPSCD will have access to Detroit AWARE each funded year. Two (2) of the highest racial/ethnic student populations within DPSCD are Black/African American (82%) and Hispanic/Latinx (13.6%). Seventy-eight percent of students are eligible for free and/or reduced lunch wherein the city of Detroit has a 33.2% poverty rate. From a recent survey of students, it was determined that approximately 18% of the student body identifies as LGBTQIA. In a recent survey, 14% of DPSCD students responded as having experienced homelessness during the past year and 24% of students do not feel safe traveling to school. In addition, people of color are more likely to experience health and mental health difficulties and have a heightened risk of suicide. BFDI’s mission is to strengthen and enhance the lives of children, youth, and families through partnerships that support safe, nurturing, vibrant homes, schools, and communities. Aligning with BFDI’s mission, the following goals of Detroit AWARE will be achieved through a collaborative partnership with DPSCD, Michigan Department of Education, and Michigan Department of Human Services: Goal 1: Increase awareness of suicide prevention and behavioral health concerns amongst school-aged youth to reduce stigma and normalize seeking out support. Goal 2: Decrease suicidal ideations and self-harmful behaviors amongst school-aged youth with strength-based prevention and behavioral health treatment service supports. Goal 3: Increase mental health literacy with behavioral health education training and support to individuals who interact with school-aged youth. Goal 4: Increase culturally relevant behavioral health services and support that are provided to school-aged youth and families through diverse partnerships that foster wellness. Based upon each school-aged youth’s individual needs, BFDI uses the Strengths and Difficulties Questionnaire (SDQ) and Patient Health Question (PHQ-9) to determine the right pathway/level of care for school-aged youth. The three-tiered public health model for Detroit AWARE will be executed using eight (8) distinct interventions to include Screening, Prevention (including Cognitive Behavioral Intervention for Trauma in Schools), Treatment, Parent Workshop, Crisis Intervention, Referrals, Coordination of Care and Professional Development, including providing educators with Question, Persuade Refer (QPR Evidence-based suicide prevention training). BFDI’s mission emphasizes the importance of partnerships to elevate families to achieve strong outcomes. These relationships are to include community groups, peer support services, behavioral health support, and local businesses.

Summary: AWARE in Mississippi (AWARE MS) is a partnership between the MS Department of Education (MDE), the MS Achievement School District (MASD), MS Department of Mental Health (MDH), our state’s Federation of Families organization, community providers, and multiple programs across three MS universities (MSU, USM, UMMC). AWARE MS aims to increase mental health awareness, foster resilience, and strengthen access to trauma-informed, culturally responsive, and family driven mental health services and supports in Humphreys County and Yazoo City School Districts (the LEAs). Both districts are housed within the MASD, a distinct SEA that aims to transform persistently failing MS public schools. Led by the University of Mississippi Medical Center, AWARE MS will collaborate to develop and improve a school-based continuum of awareness, prevention, training, and service linkage and delivery focused on the MASD and primed to scale to other Mississippi LEAs across the state. Population: 3250 school-aged youth (K-12) and 535 school staff in Humphreys and Yazoo City School Districts. Both MASD districts are located in the Mississippi (MS) Delta region, a rural and underserved region with significant rates of child adversity and poverty. MASD districts have significantly higher proportions of Black youth (Humphreys = 97%; Yazoo City = 98%) than state averages. Prevalence of childhood mental health (MH) disorders in MS is higher (20%) than U.S. estimates, and nearly 66% do not receive treatment—the worst rate in the U.S. Both MASD districts are in HRSA-designated mental health professional shortage areas. Goal 1. Increase awareness and literacy among teachers, school-based staff, caregivers, and community organizations to identify and respond effectively to school aged youth MH problems and co-occurring needs. Key Objectives: Implement MH awareness, suicide prevention and postvention programs; disseminate a trauma-informed toolkit for school staff and parents. Expected to reach a 4-year total of 2200 unique individuals. Goal 2. Enhance resiliency and MH well-being for all school-aged youth through implementation of a social-emotional learning (SEL) curriculum integrated into general curriculum and linked to school-wide implementation of trauma-informed principles. Key Objectives: Implement SEL curriculum and training with teachers to promote SEL in students. Offer trauma-informed trainings to youth serving adults and parents. Expected to reach a 4-year total of 1830 unique individuals across students, teachers, school staff, and parents. Goal 3. Improve a multi-tiered system of support via a robust suite of training and workforce capacity building activities to school staff and parents that provides MH promotion, prevention, and intervention services along a public health continuum to meet students’ needs. Key Objectives: School-wide universal screening for MH, adverse childhood experiences and suicidality; implement suite of universal prevention programs; provide on-demand consultation and distance learning for mental health therapists. Expected to reach a 4-year total of 9100. Goal 4. Increase and improve student and family access to culturally relevant, and trauma-informed school and community-based activities and services through a coordinated system of care across LEAs, community agencies, and LEA, SEA, and school-based policy development. Key Objectives: Coordinate community referral pathways, develop/implement (a)crisis response and (b) school safety and threat/violence prevention plan with multidisciplinary team. Expected to reach a 4-year total of 200 individuals.

Educational Service Unit 2 (ESU2) is in Fremont, NE and serves 16 school districts in Burt, Cuming, Dodge, Sunders, and parts of Lancaster Counties. ESU 2 will partner with our 16 districts, the Nebraska Department of Health and Human Services, Nebraska Department of Education, our Regional Behavioral Health Systems, local mental health service delivery agencies, and local universities to build a capacity and sustainability for comprehensive school mental health services through evidence based practices. Through this project, over 12,000 students, their families and 958 teachers will be impacted by the development of ESU 2 ACCESS Project AWARE. Mental Health IS Health. This is the rallying cry for members of the ESU 2 ACCESS team. Charged with supporting the ever-increasing requests for mental health and behavioral supports from schools, ESU 2 assembled team ACCESS. ACCESS stands for All Children Celebrated, Educated, Save, and Secure. The project goals include: 1) Prevent development of mental health and behavioral disorders among students at each district by providing a positive, supportive, and trauma-informed learning environment; 2) Increase development of student skills fostering resilience and pro-social behaviors at each district through strength-based approaches and/or social emotional learning (SEL); 3) Increase the school-based mental health services available to students at each district site; 4) Increase each district's capacity to identify and immediately respond to the mental health needs of students exhibiting behavioral or psychological signs requiring clinical intervention; and 5) Establish school-based, culturally relevant, and evidence-based suicide awareness, prevention, and postvention for secondary schools. Through the implementation of evidence-based, trauma-informed practices in mental health screening, assessment, interventions, and treatment, up to 13,000 students will be served through the project each year.

The Washington State Office of the Superintendent of Public Instruction’s Project AWARE - “Help is Down the Hall: A Sustainable School-based Mental Health Model” is committed to developing and sustaining infrastructure for school-based mental health programs and services. The Washington Project AWARE initiative proposes to enhance existing collaborative partnerships between state and regional systems to promote the healthy development of school-aged youth and to prevent youth violence through an integrated tiered school-based mental health (SBMH) service delivery model that is recovery-oriented, trauma-informed and equity-based. The overarching goals of the project are to: 1) Increase awareness of behavioral health issues among school-age youth, school staff, and families by growing mental health literacy and fostering resilience through culturally relevant, developmentally appropriate, and trauma-informed training and de-stigmatization efforts; 2) Increase access and connect youth and families to integrated school-based based behavioral health services and supports.; and, 3) Implement policy to enhance school supports that promote and sustain healthy social and emotional development of school-aged youth. The population served through this initiative is K-12 students and school staff in three regions in Washington State, including Educational Service District 112 (southwest); Educational Service District 105 (central); and Spokane Public Schools (northeast). These Local Education Agencies (LEAs) serve nearly 200,00 students in 56 public school districts, representing a broad and diverse student population. Data indicate considerable mental health related issues among these populations, including 35% to 40% of youth across the three LEAs reporting current depression, and 16% to 22% having contemplated suicide in the past year (HYS, 2021). The LEAs included in this proposal are strategically ready to advance school-based mental health support systems in Washington by having integrated licensed Behavioral Health Agencies within their core service delivery systems. This regional service delivery model will allow for quick launch and placement of licensed mental health staff, accustomed to providing school-based supports, and allowing for sustainability to be a focal point from day one of the project. Project activities will include conduct of LEA needs assessments, use of the SHAPE system, training and awareness activities, including targeted destigmatization efforts, and a focus on youth safety and wellness including trainings in Hazelden’s Lifelines Suicide Prevention Curriculum. Through the SBMH systems framework, LEA employed MH therapists will work in collaboration with school staff to assess, refer, triage, case manage, provide treatment, and monitor student progress. School staff, with support from the LEA project managers, will deliver Universal/Tier 1 supports, while SBMH therapists, in coordination with existing school staff, will deliver Tier 2 and Tier 3 services; SBMH therapists will be embedded into the school system delivering MH services that are recovery-oriented, trauma-informed, and equity-based. To meet project goals, objectives will measure the implementation of Universal/Tier 1 best-practices; the number of trauma-informed and resilience focused social emotional learning professional development opportunities offered; and the number of mental health prevention and awareness trainings (Goal One); the implementation of early intervention and treatment best-practices; including the number of youth screened, referred, and engaged in SBMH services (Goal Two); and the number of policy changes implemented because of this funding, as well as the number of schools that adopt and implement suicide awareness and prevention training policy (Goal 3). Across the 3 LEAs, the project will serve nearly 24,000 school-aged children and their families, and over 3,000 school staff each year, with nearly 108,000 persons engaged by the end of the grant.

Union County Project AWARE Project Abstract This application, Union County Project AWARE, is submitted by the Mental Health and Recovery Board of Union County (MHRBUC), the behavioral health planning and funding authority (political subdivision) for Union County, Ohio. Union County Project AWARE will provide the needed enhanced infrastructure and integration of community and school-based behavioral health services by strengthening the multi-tiered system of support and student assistance program structures and processes and embedding school navigators, family peer support specialists, shared data, and increased access to services and effective training and support for youth services in Union County. This project includes a partnership between the MHRBUC, three LEAs; Marysville Exempted Village School District (MEVSD), North Union Local Schools (NULS), and Fairbanks Local Schools (FBLS), the State Education Association Ohio Department of Education (ODE), the State Mental Health Agency Ohio Department of Mental Health and Addiction Services (OhioMHAS), and four local behavioral health providers; Maryhaven, Prevention Awareness Support Services (PASS), Wings Support and Recovery (WINGS), and Council for Union County Families (CUCF). This funding will allow Union County to develop the infrastructure and processes needed to infuse the state-level recommendations to increase sustainability of the best practices for student behavioral health. Union County Project AWARE will serve approximately 7,600 students in three Union County School districts and will encompass behavioral health services across the Institute of Medicine’s Continuum of Care from preventions to treatment and recovery supports (IOM, 2009). In 2019, MHRBUC began a significant plan to link child serving systems, behavioral health providers and public/private payers to support expanded mental health services to ALL Union County youth across the full Institute of Medicine’s Continuum of Care (IOM, 2009). This innovative and collaborative program took several years to stand up to begin serving families. One of the primary tenants of this model is to ensure that all youth and families had access to this service no matter their location or payer source. Union County Project AWARE will expand Mosaic and further provide the most cost-effective and responsive approach of embedding behavioral health services at the school building level. This project will address data-driven areas of need including enhanced collaboration and partnership, mental health literacy, continuum of care access, multi-tiered system of support, and expanded services and support. The goals of the project include; Goal 1: Enhance collaboration and partnership between student, family, school, and community behavioral health service providers to increase awareness of mental health, substance use, and co-occurring issues among school-aged youth, Goal 2: Identify and create opportunities to support school staff and community members’ mental health literacy and skill acquisition to support student and school staff wellness, Goal 3: Identify and remove barriers to access, engagement, and service delivery for services across the IOM continuum of care to promote and foster resilience building and mental health well-being, Goal 4: Establish and expand student assistance program with evidence-based and trauma-informed prevention and behavioral health interventions as a part of the school districts’ multi-tiered system of support framework, and Goal 5: Sustain and expand critical System of Care supports and services across the Institute of Medicine’s Continuum to connect school-aged youth with behavioral health issues, including SED or SMI, to the right service at the right time.

2022 Project AWARE Colorado aims to increase the mental health awareness and literacy of school-aged youth, and individuals who interact with them, and connect youth and families to culturally-responsive, trauma-informed, and equity-based strategies, services, and interventions. The Colorado Department of Education in partnership with Colorado's Behavioral Health Administration along with two identified Local Education Agencies LEAs and a Tribal Education Agency TEA will address systemic barriers to school-aged youth receiving mental and behavioral health interventions through state and local-level infrastructure improvements. Service gaps will be addressed through state and local partnerships and the implementation of evidence-based or informed policies, practices, and or programs EBPs. The LEAs are Poudre School District, the 8th largest in Colorado, with 28 percent minority students and 27 percent of students receiving free reduced lunch and Westminster Public Schools, a suburban district with 84 percent minority students and 76 percent of students receiving free reduced lunch. The TEA is the rural-based Southern Ute Education Department, serving Southern Ute Tribe students and families. Project goals and objectives include: Goal 1 Enhance school-based SB mental and behavioral health infrastructure within Colorado Multi-Tiered Systems of Support for an equity- based, culturally-responsive, and trauma-informed approach including SEA objectives: 1.1.1 Create a SB Mental Health Professionals' Early Career Pathways Strategic Plan; 1.1.2 Convene a SB Mental & Behavioral Health Alignment Advisory Board; 1.1.3 Convene a Trauma Recovery and Resilience Promotion Advisory Board to address effects of COVID-19 and other traumas; and LEA TEA objectives: 1.2.1 Develop a multi-disciplinary mental health leadership team; 1.2.2 Convene local partners to enhance behavioral and mental health infrastructure; and 1.2.3 Conduct a needs assessment of systems that support service delivery. Goal 2 Increase mental health awareness and literacy of school-aged youth and individuals who interact with them to promote wellbeing and detect signs and symptoms of mental illness, substance use or misuse, and co-occurring disorders including SEA objectives: 2.1.1 Train adults to promote wellbeing and detect signs and symptoms for youth, particularly youth who have systematically experienced greater obstacles to health, resulting in behavioral health disparities.; 2.1.2 Partner with the Mental Health Technology Transfer Center to develop training for youth and families; and LEA TEA objectives: 2.2.1 Offer psychological safety and belonging training for LEA TEA school community members; and 2.2.2 Train the school community in mental health literacy or identity-affirming learning. Goal 3 Increase the capacity for and quality of implementation of EBPs, mental health services and suicide prevention efforts that are culturally-responsive and trauma-informed including SEA objectives: 3.1.1 Train SB mental health staff on evidence-based, SB mental health programming, and appropriate supports for marginalized students and 3.1.2 Develop a cross-agency partnership to create a training plan aligned with a Student Suicide Prevention & Awareness Training Policy; and LEA TEA objectives: 3.2.1 Create a Tier 2 or 3 improvement strategy; and 3.2.2 Train building level mental health staff on EBPs. Collectively, TEA LEAs will reach approximately 38,000 per year and 51,600 school-aged youth over the lifetime of the grant. Additionally, the SEA & SMHA will offer approximately 10 training opportunities each year of 2022 Project AWARE Colorado.

Based on both alarming statewide data indicating poor student mental health outcomes, and each of the 4 LEA's unique student populations and needs, Indiana's priority needs are to 1) increase access to and promote sustainability of school-based mental health infrastructure, programs, services, and supports, 2) increase the capacity of LEA partner schools' staff and students to employ evidence-based tools and systems of support, 3) increase partner schools' early identification of mental health needs, interventions to address them, referral pathways, and the number of students identified, referred, and receiving SEL/mental health services, and 4) increase student/family awareness of mental health needs, services and engagement through efforts that enhance partnerships and reduce stigma associated with mental health needs.

Summary: SCAN, Inc. in conjunction with the Laredo Independent School District (LISD) will implement the SCAN-LISD AWARE Project in Laredo, Webb County, Texas. This project will increase SCAN's ability to foster mental health awareness and resiliency among youth and their families by implementing a three-tiered public health model, which includes evidence-based universal and secondary prevention and tertiary intervention strategies. Project Name: SCAN-LISD AWARE Project. Population to be served: Laredo ISD students and their family members and employees of the school district. Statement of the Problem: Webb County has been designated as a Health Professional Shortage Area (HPSA) for mental health services. Youth and their families face significant barriers to mental health identification and treatment, since there are great shortages of mental health professionals including psychiatrists, psychologists, and licensed counselors. Since 1990, Webb County has been designated as a High Intensity Drug Trafficking Area (HIDTA). Great quantities of illicit drugs are smuggled into the area from Mexico, making these drugs easily available and very affordable. Severe poverty, limited resources, and unique social and political issues make residents of this areas of Texas very vulnerable to substance use and misuse. Webb County has very limited mental health and substance use prevention/intervention resources available, and there is a dire need to enhance the local infrastructure to ensure that school-aged youth and their families are provided with increased access to evidence-based prevention and intervention services. Moreover, adults who work with school-aged youth need ongoing and coordinated workforce capacity building training focused on fostering mental health awareness and prevention. Strategies/Interventions: The project's Advisory Board, consisting of SCAN, LISD, the State Education Agency, the State Mental Health Agency, and other key collaborative partners will guide the development and implementation of the project. The Advisory Board will meet in an ongoing manner; conduct a needs assessment; develop an implementation plan based on a three-tiered public health model; develop a sustainability plan; and provide a variety of evidence-based and culturally appropriate prevention and intervention services and activities to meet the comprehensive needs of the target population; and monitor and evaluate the project in an ongoing manner. Project Goals & Objectives: The overarching goal is to develop a sustainable infrastructure for the provision of school-based mental health programs and services that target mental health, substance use, and co-occurring disorders among students in the Laredo Independent School District. The primary objectives include: -establish and maintain an Advisory Board that meets in an ongoing manner: -assemble a specialized team made to conduct a detail needs assessment and generate a formal report: -develop an implementation based on the needs assessment that includes a three-tiered public health model; -implement the plan to ensure that students are provided with access to evidence-based universal and secondary prevention strategies and tertiary intervention strategies; -provide student' parents and other adult caregivers with access to universal prevention strategies; -provide school employees with access to Mental Health First Aid and Psychological First Aid for Schools training; -develop a plan to sustain the project after federal funding ends; and *integrate the project with the Webb County Community Coalition to help create awareness of the project and enhance efforts to link students to community resources. Persons to be Served: Annually, 16,000 students and family members will receive universal prevention, 3,200 students and 500 employees secondary prevention, and 200 students tertiary intervention. Overall, an estimated 15,600 "unduplicated" students and employees will receive services.

The Federally Recognized Tribe of Lac Courte Oreilles, as the Tribal Education Agency for Ojibwe students, will implement the Lac Courte Oreilles Project AWARE program, a sustainable school-based mental health program that will build the necessary culturally and trauma informed care infrastructure in all Ojibwe serving LEA’s in Sawyer County, including, Lac Courte Oreilles Ojibwe Schools, Akii-gikinoo'amaading Charter school, Hayward Community Schools, and the school District of Winter who together, serve over 2,500 students. Lac Courte Oreilles Project AWARE program will increase the capacity for sustainable trauma informed mental health infrastructure in educational agencies that serve Lac Courte Oreilles Ojibwe students on and off reservation that will address the contributing factors that result in negative outcomes from untreated and suppressed mental health to improve the lives and futures of our students to improve the lives of those in our community by ensuring the implementation plan accomplishes: 1) universal prevention for our student population to promote healthy social and emotional understanding and skills; 2) selective interventions for our exhibiting risky behaviors to reduce the cause of problem behaviors, and build social and emotional skills for healthier functioning; 3) and indicated interventions for individual students that exhibit severe problem behaviors and emotions. Lac Courte Oreilles’ Community Health Center’s behavioral health provider, Bizhiki Wellness, will support School-Based Mental Health Therapists to provide direct services to participating LEA’s along with the creation of policies & procedure, workforce building plan, student suicide awareness training policy, and prevention and intervention services. By the end of each project year, 75% of students identified by mental health issues or at-risk behaviors will progress in treatment plans with counselors, counselors will have maintained contact and continued treatment plans with at least 65% of students needing care, 80% of staff at participating LEA’s and 95% of students will have at least maintained an understanding of culturally relevant trauma informed care, mental health literacy, mental health and substance abuse awareness. The project objectives address students' success in treatment plans, and promoting mental health awareness and resilience, prevention and interventions activities and pathways, and address student needs by ensuring that the impoverished and rural Ojibwe community students have equity in access to mental health providers who are historically, culturally, and trauma informed experts that prioritize building trusting effective relationships with our students and families.

Central Susquehanna Intermediate Unit is working to address the increasing needs of student mental health in their 5-county service region, located in central Pennsylvania. Behavioral and mental health concerns have been significantly impacting students in the 17 school districts and 3 Career and Technical Centers served by CSIU since pre-pandemic and student needs have only been exacerbated by the ripple effects of isolation, loss, and changes in learning modalities throughout COVID-19. Through the work of Project AWARE IMPACT (Improving Mental health Practices Across Communities Together), CSIU will partner with the Pennsylvania Department of Education, the Office of Mental Health and Substance Abuse Services, the Office of Safe Schools, Geisinger Behavioral Health, and community resource agencies to create sustainable infrastructures of support to address the growing mental health needs of students and staffing shortages in school-based mental health. To meet this challenging goal, the Project AWARE IMPACT team will provide school specific action plans and associated resources to all participating districts which explicitly reflect 1) A three-tiered model for providing supports to promote positive behavioral health supports, targeted services to those who need more support, and indicated-intensive services for those in need; 2) A workforce capacity-building plan aligning the ECHO learning model to increase the mental health awareness and literacy of school staff, administrators, parents, and community-based partners who interact with students to recognize the signs and symptoms of mental health issues and link them to appropriate services; 3) Referral pathways via SAP and Geisinger telehealth services to ensure that students in need of services receive necessary school-based and/or community mental health, substance use, and co-occurring supports and services; 4) A Geisinger Bridge Clinic intervention plan to ensure that school personnel can respond immediately if a school-aged youth requires crisis-level medical intervention and that parallel structures exist in the healthcare system to support the student during and following clinical intervention; and 5) A clear description of the alignment of each building’s behavioral health action plan with their respective school safety and threat/violence prevention plan. As per Project AWARE IMPACT’s goals and objectives, it is anticipated that in the 5-county service region of CSIU, upwards of 1,768 students will receive clinical services via Geisinger telehealth with 4 follow-up appointments, approximately 800 students will receive care via Geisinger Bridge Clinic, and at least 1,250 students will receive evidence-based mental health and resiliency training and suicide prevention education annually. This will amount to over 15,172 students served throughout the life cycle of Project AWARE IMPACT, in addition to the potential to increase the mental health knowledge and skills of over 1,000 educators and school leaders across a rural 5-county region.

Rhode Island Project AWARE (Advancing Wellness and Resiliency in Education) The Rhode Island Department of Education (RIDE), in partnership with the Department of Children Youth and Families (DCYF), proposes to work with: Chariho, East Providence, Newport, and Warwick school districts impacting 18,396 students, to increase awareness of MH issues among school-aged youth; provide training for school personnel and other adults who interact with school aged youth to detect and respond to MH issues, and connect their families to needed services. This project will build on the successes of the current Project AWARE districts (2018 and 2021 cohorts) with successfully established collaborative partnerships at the state, district and local level to raise awareness and address mental health needs of youth in four high need communities. In Rhode Island, one in five (19%) children ages 6-17 has a diagnosable mental health problem and one in 10 (10%) has a significant functional impairment. RIDE, DCYF, and its partners will continue to build strong collaborative partnerships to oversee BH efforts in LEAs who serve school-aged youth with BH disorders. The collective impact of our state partnership will be mirrored by a similar partnership within the four LEAs, in partnership with local community MH treatment provider agencies, to ensure that school prevention and intervention programs and services are linked to existing resources and/or new capacity to support students is created. The following goals will support the process: Goal 1 Increase awareness and identification of mental health, substance use, and co-occurring issues among school-aged youth through systemic enhancements. Goal 2 Increase mental health literacy of individuals who interact with school-aged youth to understand and detect the signs and symptoms of mental health, substance use/misuse, and co-occurring disorders as part of a Tier 1 approach. Goal 3 Support LEAs in promoting and fostering resilience building and mental health well-being for all school-aged youth using Tier 1 strategies. Goal 4 Support LEAs in providing positive behavioral health supports; targeted services to those who need more support; and intensive services to those who need them within a multi-tiered system of supports (MTSS). Goal 5 Develop and enhance referral pathways that connect school-aged youth who may have behavioral health issues, including symptoms consistent with a SMI or SED, and their families to needed services to support Tier 3 interventions. Goal 6 Increase access to culturally competent, developmentally appropriate, and trauma informed school and community based AWARE grant activities and services.

Maryetta Public Schools is a dependent district in Northeastern Oklahoma that serves 551 K-8th grade students (82% American Indian, 11% Caucasian, 7% Hispanic), with 78% of students qualifying for the free or reduced lunch program. Maryetta, in partnership with the Oklahoma Department of Education (OSDE), Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), Phoenix Counseling, and Cherokee Nation will collaborate to develop a sustainable infrastructure for school-based mental health programs and services to meet the needs of Maryetta students. Through Maryetta AWARE, 551 students and their families will be served. Project goals are as follows: Goal 1: Improve school personnel’s awareness and knowledge of trauma-informed mental health and trauma-informed instruction. Goal 2: Implement a Multi-tiered System of Supports (MTSS) incorporating Positive Behavioral Interventions and Supports (PBIS) and collaborative partnerships with community partners to build a supportive school culture and provide comprehensive support for students in need of mental health support through the Interconnected Systems Framework (ISF). Goal 3: Promote a positive school climate to improve student attendance and discipline. Maryetta, along with AWARE partners, will develop an implementation plan for a three-tiered public health model, integrate evidence-based best practices for tiered services and supports (Tier 1, 2, & 3), implement a student suicide awareness and prevention training policy, provide trauma-informed training to school personnel, engage families and the community through mental health training and awareness programs, develop a sustainability plan, and further develop collaborative relationships to broaden and link community resources to school-aged youth and their families.

Summary: Ta'sunke Witko Owayawa Project AWARE will serve Native American K-12 students by implementing the trauma-informed school model and promoting a recovery-oriented, tiered system of school- and community-based mental and behavioral health interventions. The project will provide counseling, cultural mentorship, suicide awareness and prevention, and related trainings to students, school staff, families, and members of the community. Project Name: Ta'sunke Witko Owayawa Project AWARE Grantee: Crazy Horse School Additional Partnership Members: Oglala Sioux Tribe Health Administration Program, Oglala Sioux Tribe Education Agency, and Mahpiya Sinakiya Win Services. Geographic Catchment Area: Jackson County, South Dakota, and the portion of the Pine Ridge Indian Reservation contained within Jackson County’s borders. Population of Focus: Universal prevention services for Native American K-12 students, with tiered interventions for students experiencing trauma and related mental/behavioral health needs. Number of Individuals Served: 400 students, school staff, and community members annually with the total number of individuals served at 1,600. Goals & Objectives: Goals include (1) increasing child/youth access to school-based trauma-informed, culturally-informed mental and behavioral health services; (2) increasing the knowledge of children/youth and adults to recognize and report signs of at-risk behavior to promote positive personal development; and (3) decrease child/youth measures of suicidality, substance use, and disruptive behaviors. There are three objectives to help measure progress toward each goal, summarized: (1a) implementation rate of individual and small group counseling; (1b) adoption of a 24/7 on-call, crisis-response phone line; (1c) rate of completed informed consent within LEA; (2a) rate of LEA staff trained in trauma-informed model; (2b) number of community members trained annually; (2c) rate of students receiving Tier 1-level, universal prevention services, (3a) decrease in rate of student suicide attempts and completions; (3b) decrease in frequency of substance use among students with substance use disorders; and (3c) decrease in recorded instances of disruptive behavior in school. Strategies & Interventions: The Pine Ridge Indian Reservation is the poorest place in the United States, and our residents experience many historical and contemporary traumas. This project is designed to intervene in this reality and equip students with the prevention, intervention, and postvention to promote recovery and reduce the prevalence and impact of trauma-induced mental and behavioral health challenges, substance use, and suicidality. This will be accomplished through school-based mental health counseling, behavioral health counseling; substance use disorder counseling; screening, third-party service referrals, and cultural mentorship; teacher and school staff trainings; family and community member trainings. We will use evidence-based programming to promote positive behaviors among students, especially with curriculums and programs designed for use with Native American students. This includes the Reconnecting Youth program and the Healing Journey of the Canoe; both are small group-based facilitated counseling sessions to promote positive development. All students will receive universal prevention services, and students screened and determined for higher tiers of service will receive individualized counseling plans and the support of a wraparound support specialist to provide coordinated care and community connections. The project will also launch a 24/7 monitored crisis response phone line to provide immediate intervention to students in need.

Alaska serves as the 49th state, gaining statehood in 1959, and is larger than the three next largest states combined. The geographical makeup of this state includes many isolated, largely roadless, and rural areas that make accessing needed services a difficult goal to achieve. The Anchorage Municipality serves as the “urban hub” for Alaska with the Anchorage School District (ASD) gaining the title of Alaska’s largest, most urban district, educating 44,325 students over 2,000 square miles with minority students comprising more than 50% of our student population. While Anchorage serves as the “urban hub” for many services in Alaska, residents are often faced with wait times to access services exceeding six months. Specifically, 62.9% of Alaskan youth who had depression in 2021 did not receive behavioral health services. Additionally, Alaska ranks 43rd on the Overall Child Well Being Scale and has the second highest rate of suicide in the country. To address these gaps in services, ASD has partnered with the Alaska Department of Education, Alaska Division of Behavioral Health, Providence, Volunteers of Alaska, Azevedo Consulting, and Alaska Behavioral Health to build a district wide evidence-based comprehensive school mental health system to improve school climate, increase mental health awareness, and reduce violence and suicide rates in our schools. ASD’s Comprehensive School Mental Health Systems Project will serve students in Elementary, Middle, High School, and Alternative settings with an average of 10,778 students served per year of the grant and a total of 44,527 students served over the lifetime of the grant. The first goal of the project is to build system infrastructure and capacity through interagency collaboration to increase quality and sustainability of mental health services for students. ASD will utilize the evidence-based Interconnected Systems Framework (ISF) to develop a comprehensive implementation plan, advisory board, and community needs assessment to achieve this goal. The second goal of this project is to increase the capacity of schools to directly respond to mental health needs of students. ASD will implement universal behavioral health screening using SAEBRS (Social, Academic, Emotional Behavior Risk Screener), embed school-based mental health clinicians who will utilize evidence-based interventions including CBITS and Bounce Back and implement the evidence based Positive Behavior Interventions & Supports (PBIS) across all project schools to achieve this goal. The third goal of this project is to promote wellness and resiliency among students and staff by fostering healthy environments and providing comprehensive prevention (Tier I), early intervention (Tier II) and intensive individualized services (Tier III). ASD will facilitate district wide training for 100% of ASD project staff on PBIS, Youth Mental Health, and ISF to reach this goal. The fourth goal of this project is to ensure effectiveness of program activities through program monitoring and reporting. ASD will accomplish this goal through the universal implementation of Tiered Fidelity Inventory at all project schools.

Youth in Illinois experience a significant amount of mental health challenges. Approximately 40% of students report experiencing depression and Illinois youth have reported higher rates of seriously considering suicide than the rest of the nation (Jones, 2022). Data trends indicate that our targeted areas serve students experiencing other mental health services disparities as well, including high rates of poverty, abuse and neglect, and youth from racial/ethnic minority groups. The Illinois State Board of Education (ISBE) has identified two LEAs in Illinois that will partner with us on Project AWARE 2.0 to develop sustainable infrastructures for school based mental health programs and services. Project AWARE 2.0 will complement other programs and initiatives targeted towards supporting the mental health of our 1.8 million students.

The Kentucky Educational Development Corporation (KEDC) proposes THRIVE: KEDC Project AWARE that focuses on, first, creating and, second, implementing, and, finally, sustaining a mental health and youth substance use/misuse program. Implementing THRIVE would ensure that students and their families in three Kentucky (KY) districts—Bell, Floyd, and Johnson have improved access to mental health resources. Our identified population of focus would be ~14,510 students and their families in the three identified KY school districts across four years. The targeted districts have been hit hard with high unemployment, reductions in populations, and students are identified as experiencing high rates of free- and reduced-price lunch. In addition to being identified as “Distressed,” two of the three targeted districts experienced deadly flooding in July 2022. Thousands of students, families, and educators in Floyd and Johnson counties lost their homes and all their possessions. Not only was normalcy lost in their home lives, but their schooling was also disrupted. Some students and educators had to be moved into temporary locations for schooling because some of their schools will not be inhabitable for at least a year and possibly longer. The goals for THRIVE were identified in the Notice of Funding Opportunity. To accomplish these goals, we propose to provide high-quality, research-based professional learning opportunities and access to coordinated state and local services and/or resources. Goal 1. Increase awareness of mental health, substance use, and co-occurring issues among school-aged youth. Goal 2. Increase the mental health knowledge of individuals who interact with school-aged youth to understand and detect the signs and symptoms of mental health, substance use, and co-occurring disorders. Goal 3. Promote and/or foster resilience building and mental health well-being for all school aged youth. Goal 4. Provide high-quality, relevant, and useful positive behavioral health supports by providing targeted services to those who need more support and intensive services to those who need them. Goal 5. Connect school-aged youth who may have behavioral health issues, including serious emotional disturbance (SED) or serious mental illness (SMI), and their families to needed services. Goal 6. Increase and improve access to culturally relevant, developmentally appropriate, and trauma informed school and community-based AWARE grant activities and services. The strategies we will be utilizing include evidence-based, informed, and/or promising practices focused on (1) increasing awareness of mental health issues among school-aged youth, (2) providing technical assistance and training for educators so that they may better detect and address mental health issues, (3) connecting youth who are experiencing behavioral health concerns and their families to helpful services, and (4) cultivating and growing partnerships and collaborations between local and state resources to promote healthy development.

The proposed project Resilience in School Environments (RISE) is a multi-faceted program designed to select and consistently implement trauma-sensitive practices that promote mental wellness, improve and increase access to mental health services for students, expand community mental health services within schools, increase the visibility of mental health providers in the 38 schools serving kindergarten through twelfth grade, establish relationships with staff and families, normalize mental health, and increase mental health literacy and increase collaboration with local mental health centers to facilitate coordination of care during transitions between in- patient or crisis care and school. Milwaukee Public Schools’ demographics include 0.4% Native American, 50.2% African American, 27.8% Hispanic, 9.6% White, 8.1% Asian, Native Hawaiian or Other Pacific Islander – 0.1% and 3.8% Two or More. A total of 19.6% of students are identified with special education needs, 76.6% are economically disadvantaged, and 12.5% of students are limited English proficiency. For students with mental health needs, staff frequently identify and make referrals for families to community-based services. MPS has established School Community Partnership for Mental Health (SCPMH), which is a school-based mental wellness model for collaboration between schools, parents, and community mental health providers. While the SCPMH model has been effective in improving outcomes for students served by the project, there have not been noticeable improvements for the rest of the students served in those schools. Project RISE seeks to systematize mental wellness supports across Tiers 1, 2, and 3 at the project schools, and use the experiences to expand those systems to other SCPMH schools as well. The proposed Project RISE will accomplish the following goals: (1) promote mental wellness through the creation of safe, equitable, and engaging schools where staff is equipped with the knowledge and resources to support student wellbeing; (2) improve and increase mental health services to students through a process of continuous improvement and expansion of community mental health services within project schools to better meet the mental health needs of students; and (3) increase the capacity of the local school district to recognize students in need of a continuum of mental health services and to provide those services in a timely fashion. Several outcomes will be measured throughout the grant project. In addition to the outcomes, there will be an increase in the number of students receiving Tier 2 or Tier 3 interventions. School ratings based on the Trauma Sensitive Schools assessment tool will increase each year as more staff is trained and the program is implemented. Finally, there will be an increase in contact between mental health facilities and schools.

The Board of Education of the City of Chicago, District 299, Chicago Public Schools (CPS) proposes the Sustainable Infrastructure for Crisis Response & Continuum of Care project. Through a SAMHSA Project AWARE grant the district could create a much-needed permanent crisis intervention and prevention infrastructure. The population of focus is the district’s high school communities, including students and their families and caregivers, staff, and educators in geographic Networks 14, 15, 16, 17. While these schools span the city, the majority are on the south and west side, and encompass communities of color, of which, most are historically disinvested. Demographic data shows that the majority of CPS high school students, 80% on average, come from families facing economic hardship, while 14% are learning English, 17% live with a disability, and 89% are youth of color. CPS needs to enhance its crisis response infrastructure to: 1) ensure students have the social and emotional learning supports and resources they need, and 2) fill the gaps in our existing response mechanisms to ensure the continuity of care for students during the school day. CPS proposes the Sustainable Infrastructure for Crisis Response & Continuum of Care project to create a coordination of care response team within the Office of Social Emotional Learning that coordinates across CPS departments, high school staff, and our community behavioral health services partners. This team will become the anchor of support throughout the lifecycle of a crisis. By the end of the award period our partnerships with community behavioral health service providers will achieve a ratio of 1 clinician for every 2 CPS High Schools within their assigned network. Goals include: 1. Ensure every CPS high school student referred for crisis intervention, receives group and/or individual social-emotional counseling services through school-based community partners at identified school sites. To do this, we need each community partner to be responsible for a smaller number of schools. Eventually, reaching a 1:1 ratio. 2. Expansion of certified Youth Mental Health First Aid trainers in the district to provide and train additional related service providers. 3. Provide universal CPS staff training on student substance use and supportive measures 4. The Mental Health Training Specialist will train school staff (nurses, social workers, counselors, discipline staff) on Screening, Brief Intervention, & Referral to Treatment. CPS proposes to: 1) Serve all high school students in need both annually and throughout the project. The district’s current high school population is 16,600+ students; and 2) Provide social and emotional mental health response and awareness trainings to 2,300 staff, teachers, and other educators.

In the rural communities of eastern Washington, current K-12 behavioral health prevention and intervention programs serve only 541 of 92,138 students, and even fewer have access to mental health treatment services. Yet, over a third of students in the region have self-reported feeling nervous, anxious or over the edge or not being able to stop or control worrying in the past two weeks. Even more alarming, one in every four 10th grade regional students reported considering suicide in the last year. In one regional district, over a third of 10th grade students not only considered suicide, but planned for suicide, and 21% of the 10th graders in the same district reported attempting suicide in the last year. All school districts identified for this project have more than 60% of students self-reporting feelings of anxiousness or worry lasting two weeks or more. There are rarely any service providers within the school district boundary lines and limited or no access to public transportation options. The overarching goal of the AWARE NorthEast project is to increase school-based access to mental health prevention, intervention, treatment and recovery support by making it available to the 5,669 students enrolled in six school districts, specifically in rural and underserved school districts in Spokane, Lincoln, Stevens and Whitman counties for over four years. Through this project, up to 450 students annually will have access to behavioral health intervention services, and up to 90 students annually will have access to on-site school-based mental health treatment. All 5,669 students in the identified districts for this project will receive universal Tier 1 mental health awareness strategies. A secondary goal for this project is to increase educator efficacy and effectiveness relative to trauma informed teaching practices. Through contracting with Washington State University Child and Family Research Unit, we anticipate increasing the educators exposed to trauma informed practices by up to 692 teachers and other school staff. Over the four years of the grant, 5 new schools will also have the opportunity to engage in a three-year school climate transformation professional development and coaching consultation program called CLEAR Collaborative Learning for Educational Achievement and Resilience. A third goal is to increase exposure and familiarity to mental health awareness, suicide signs and symptoms recognition, and referral processes to students, staff, and families. This goal will be accomplished by training up to 100 educators to be Teen Mental Health First Aid instructors, training up to 4450 teens and adults in Teen Mental Health First Aid (tMHFA). TMHFA is an evidence-based curriculum that teaches teens how to identify, understand and respond to mental health and substance use challenges among their friends and peers. Teens will learn skills to have supportive conversations with their friends and how to get help from a responsible and trusted adult. NEWESD 101 will utilize: 1) the three-tiered pyramid public health model for providing supports to school-aged youth to promote wellness (universal/promotion); 2) targeted services to those who need more support (secondary prevention); and 3) intensive services to those who need them (tertiary intervention) directly within the school system is the best method for meeting the needs of students, especially those who live in rural communities with disproportionate access to services.

Memphis-Shelby County Schools (MSCS) joins with its partners (the TN Department of Education, the TN Department of Mental Health and Substance Abuse Services, the SMART Center at the University of Memphis, and the Center for Youth Advocacy & Well-Being at the University of Tennessee) as Memphis-Shelby County Schools’ Project AWARE to expand access to school-based mental health services for some of the nation’s most disadvantaged schools in one of the nation’s cities with the highest childhood risk. By building on the existing MSCS implementation of Tennessee’s multi-tiered system of behavioral supports (RTI2-B), and addressing gaps in service and need for sustainability activities, MSCS’s Project AWARE will implement strategies and interventions that bring awareness to mental health through student, parent, and staff trainings, a developed and implemented suicide training policy, and community activities. The proposed project will serve MSCS’s population of 104,983 students comprised of 70.5% African American, 18.5% Hispanic/Latino, 6.0% white, 2.3% multiracial, 1.0% Asian, and 1.3% other. The six goals and associated measurable objectives to guide activities are as follows: (G1) Increase mental health awareness to reduce stigma and promote help-seeking for mental health among school-aged youth. (1.1) # of students demonstrating knowledge of mental wellness self-care increases by 5% yearly. (1.2) # of students receiving suicide prevention & intervention training doubles in Year 1 and thereafter increases by 5% yearly. (1.3) Student-initiated usage of ReSET Rooms increases by 5% yearly. (1.4) Student-or family-initiated usage of Family Wellness Centers increases by 5% each year. (1.5) High school YRBS respondents report 5% decreases in risk behaviors tied to mental health awareness campaigns in administrations of the YRBS in 2023 and 2025. (G2) Increase the mental health literacy of individuals who interact with school-aged youth to understand and detect the signs and symptoms of mental illness, substance use/misuse, and co-occurring disorders. (2.1) At least 10 Tier 1 trainings are offered yearly, with # of trainees increasing by 5% yearly. (2.2) School staff self-describe as more confident (on pre-and post-surveys) in their ability to identify risk factors for mental health, substance use/misuse, and co-occurring issues in students. (2.3) Staff-initiated usage of ReSET Rooms increases by 5% yearly. (G3) Promote and foster resilience building and mental health well-being for all school-aged youth. (3.1) % of students participating in resiliency building and mental well-being programs through the SEL curriculum is 75% or higher yearly. (3.2) Students’ positive responses on school climate instruments related to Tier 1 interactions increase by 5% yearly. (G4) Connect school-age youth to trained, mental health literate staff and professionals guided by Tennessee’s RTI2-B three-tiered behavioral model. (4.1) Teachers’ positive responses on school climate instruments related to school-level interventions increase by 5% yearly. (4.2) At least 15 Tier 2 trainings are offered yearly, with # of trainees increasing by 5% yearly. (4.3) Tier 3 student compliance with requirements increases by 5% yearly. (4.4) Exclusionary suspensions, as a % of all suspensions, decreases by 5% yearly. (G5) Enhance collaborative partnerships to include expanded Tier 2 targeted services and Tier 3 intensive services among school-age youth. (5.1) # of students receiving external post-referral care increases by 5% yearly. (5.2) Advisory Board partners with at least two external referral providers yearly. (G6) Develop infrastructure to sustain and expand culturally relevant, developmentally appropriate, and trauma-informed school and community-based mental health services. (6.1) A sustainability plan for successful Project AWARE components is in place by project end. (6.2) Policy on student suicide prevention/intervention training is adopted by project end.

Seattle Public Schools (SPS), an urban district encompassing the entire City of Seattle, King County with a diverse student population in grades Pre-K through Grade 12. SPS will advance wellness and resiliency across the K-12 spectrum by developing a sustainable infrastructure for school-based mental health programs and services. We will provide training to increase awareness and the mental health literacy of individuals who interact with school aged youth, promote and foster resilience and mental wellbeing for students through social emotional learning in all classrooms, build partnerships, identify students in need of support and connect them with appropriate resources, and focus services on those students with highest needs such as our Native American and LGBTQ+ students. This comprehensive approach will significantly shift the ways in which student behavioral health has historically been approached in SPS.