Project Grant H79SM088755

TRIBAL BEHAVIORAL HEALTH - NATIVE CONNECTIONS - SAN DIEGO AMERICAN INDIAN HEALTH CENTER (SDAIHC) IS A PRIVATE, NON-PROFIT 501 (C) (3) FEDERALLY QUALIFIED HEALTH CENTER (FQHC). SDAIHC WAS FOUNDED IN 1979 BY A GROUP OF NATIVE AMERICAN COMMUNITY LEADERS, WHO RECOGNIZED THE NEED FOR IMPROVED ACCESS TO CARE FOR SAN DIEGO NATIVE AMERICANS/ALASKAN NATIVES (AI/AN) AND LOW-INCOME POPULATIONS IN THE SAN DIEGO AREA. THE NATIVE CONNECTIONS PROJECT, PROPOSED BY THE SAN DIEGO AMERICAN INDIAN HEALTH CENTER (SDAIHC), WILL DEVELOP AN INTEGRATED AND CULTURALLY RESPECTFUL SYSTEM OF CARE THAT IDENTIFIES AND RESPONDS TO THE MENTAL HEALTH, SUBSTANCE USE DISORDERS, AND CULTURAL TRAUMA NEEDS OF AMERICAN INDIAN AND ALASKA NATIVE (AI/AN) YOUTH THROUGH THE AGE OF 24 YEARS RESIDING IN THE SAN DIEGO METROPOLITAN AREA. THE PROPOSED PROJECT WILL SERVE URBAN INDIANS, A POPULATION THAT HAS BEEN DESCRIBED AS "INVISIBLE" BECAUSE THEY ARE NOT AFFILIATED WITH A SINGLE TRIBE, RESERVATION, OR CULTURAL TRADITION. THE AI/AN POPULATION WITHIN SAN DIEGO COUNTY AS RACE ALONE OR IN COMBINATION WITH ONE OR MORE OTHER RACES IS REPORTED AT 96,918 BY THE U.S. CENSUS BUREAU. AI/AN RACE ALONE ARE REPORTED AT 38,916. AN ESTIMATED ONE FOURTH OR 25% OF THE POPULATION ARE YOUTH AGES 10 - 24 YEARS OF AGE. THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) JULY 2022 MMWR REPORTS AN INCREASE IN DEATHS FROM OPIOID OVERDOSES FROM 14.4 TO 16 PER 100,000 POPULATION BETWEEN 2019 AND 2020. THE SAME DEATHS AMONGST AI/AN YOUTH AGES 10-24 YEARS WERE HIGHER THAN OTHER RACE OR ETHNIC GROUPS IN 2020. SUICIDE RATES WERE HIGHER AS WELL AT 42.6 DEATHS PER 100,000 PEOPLE FOR MALES AND 13.8 DEATHS FOR FEMALES AS REPORTED BY CDC FOR THE YEAR 2021. BOTH PREVALENCE OF DRUG ABUSE AND SUICIDE ARE INFLUENCED BY NEGATIVE SOCIOECONOMIC CONDITIONS INCLUDING POVERTY, LACK OF AFFORDABLE HOUSING, FOOD INSECURITIES, LIMITED EDUCATIONAL AND EMPLOYMENT OPPORTUNITIES AND LIMITED ACCESS TO PHYSICAL AND MENTAL HEALTH SERVICES. OTHER FACTORS MAY INCLUDE ADVERSE CHILDHOOD EXPERIENCES, VIOLENCE, GANG INFLUENCES, LOW SELF ESTEEM AND BULLYING AND OTHERS. THE SDAIHC NATIVE CONNECTIONS PROJECT TEAM WILL IMPLEMENT THE EVIDENCED-BASED SAFE-T MODEL TO INCLUDE UNIVERSAL PREVENTION STRATEGIES AND INTERVENTIONS TO SUPPORT THE: (1) ESTABLISHMENT OF AN INTEGRATED CROSS-COMMUNITY BEHAVIORAL HEALTH PROGRAM SUPPORTING AWARENESS AND PREVENTION OF MENTAL HEALTH DISORDERS, AND SUICIDAL AND SUBSTANCE USE BEHAVIORS WITHIN THE AI/AN YOUR POPULATION RESIDING IN SDAIHC'S SERVICE AREA; (2) ENGAGEMENT WITH LOCAL AI/AN COMMUNITY AGENCIES AND NON-NATIVE ORGANIZATIONS, INCLUDING PUBLIC AND PRIVATE AGENCIES, TO ESTABLISH A MULTI-SECTORAL SYSTEM LEADING TO IMPROVED COORDINATION OF CULTURALLY RESPONSIVE MENTAL HEALTH AND TRAUMA BASED SERVICES FOR AI/AN YOUTH; AND (3) DEVELOPMENT OF A SUSTAINABLE CONTINUUM OF CARE SERVICES MODEL FOR AI/AN YOUTH AS THEY TRANSITION TO ADULTHOOD. TO REACH ITS OVERARCHING GOALS, SDAIHC WILL UTILIZE ITS EXISTING YOUTH AND COMMUNITY ADVISORY BOARDS AND EXPAND TO INCLUDE AN INTER-AGENCY ADVISORY GROUP TO FACILITY COMMUNITY COLLABORATION AND HOST AN ANNUAL GONA. OTHER ACTIVITIES AND TRAINING WILL BE IDENTIFIED TO INCREASE AWARENESS OF CULTURAL PRACTICES AND PREFERENCES.