CN 988 2026 - The Comanche Nation (CN) will use this SAMHSA 988 Tribal Response award to close persistent gaps in crisis care access for its 18,100 tribal members and the broader 248,137-person catchment across Comanche, Kiowa, Tillman, Cotton, and portions of Caddo, Grady, Stephens, and Jefferson Counties, Oklahoma. Building on two prior TR988 grant cycles, CN will expand culturally responsive 988 crisis center training, same/next-day behavioral health follow-up, and cross-sector coordination through the statewide TR988 Workgroup, addressing suicide, depression, and unmet treatment need rates that exceed state and national averages among AI/AN community members of all ages. The geographic catchment area, the Comanche Tribal Jurisdiction Area, reflects a population where American Indian and Alaska Native individuals make up 11% of residents, more than five times the national average, and where 988 crisis infrastructure still needs deeper integration across call centers, schools, law enforcement, and Tribal behavioral health services. CN's 2023 needs assessment identified three persistent gaps this project addresses: inconsistent reach of cultural competency training to 988 staff, low warmline transfer and follow-up rates for Native callers, and incomplete integration between the TR988 Workgroup's statewide infrastructure and local systems. The population of focus is all ages, from youth through elders, within the CN service area, with particular attention to youth, adults in crisis, and older community members with limited access to services. Direct crisis services will also be provided: project staff include a dedicated Case Manager and Peer Recovery Support Specialist serving 988 callers across the full age range. Clinical need is significant: 23-26% of adults report depression and 17-19% report frequent mental distress, both exceeding national rates, and the unmet mental health treatment gap ranges from 80.9% to 89.8% across catchment counties. Youth-specific data shows 14-22% of students across catchment counties have seriously considered suicide in the past year. To build capacity, CN will implement culturally responsive training for 988 crisis center staff, embed a Tribal staff member within an Oklahoma 988 call center, formalize referral and data-sharing agreements with Solari and other 988 partners, expand the School-Based Suicide Prevention/Postvention Workgroup to new school sites, and develop a Tribal Crisis Response Best Practices Toolkit for statewide dissemination. The project's three goals are to: (1) ensure AI/AN community members have access to competent, trained 988 Crisis Center support; (2) improve access to care and follow-up navigation for CN and other tribal and community members; and (3) facilitate cross-sector collaboration with Tribal, state, and territorial health providers, law enforcement, first responders, and other key partners in a manner that respects Tribal sovereignty. Measurable objectives include annual cultural competency training for 988 crisis center staff with documented knowledge gains (Goal 1); 100% of 988 callers in the catchment area having access to same/next-day behavioral health appointments by Q1 of Year 1 (Goal 2); and execution of formal MOUs with Solari and at least two additional partner organizations establishing clear referral pathways by the end of Year 1 (Goal 3). These objectives advance SAMHSA's Strategic Priorities by strengthening crisis care infrastructure for a population with serious and complex behavioral health needs, expanding evidence-based workforce training, and using local data, including OPNA youth survey findings and county-level suicide data, to design targeted, sustainable outcomes.
