Toiyabe Indian Health Project 988 Tribal Response - Project Name: Toiyabe Indian Health Project 988 Tribal Response Public Summary: In Inyo and Mono Counties, American Indian and Alaska Native residents die by suicide at nearly twice the national rate, yet no 988 crisis center in California currently provides a dedicated Tribal-specific response pathway. Toiyabe Indian Health Project (TIHP) will strengthen 988 crisis-center partnerships, culturally responsive training, and Tribal-specific data systems to close that gap for the seven federally recognized Tribes of this 13,277-square-mile frontier region. Geographic Area and Capacity Need: The project serves Inyo and Mono Counties, a 13,277-square-mile rural and frontier region in eastern California with no crisis stabilization unit, no inpatient psychiatric beds, and severe cellular and broadband gaps. 988 calls from this catchment are currently routed by area code to crisis centers 275–355 miles away with limited familiarity with local Tribal resources, reservation geography, or Tribal sovereignty protocols. The project will build the regional capacity, formal partnerships, training infrastructure, and data systems, needed to close this gap. Population of Focus: The population of focus is the approximately 3,950 enrolled members and descendants of the seven Tribes served through the TIHP consortium (Big Pine Paiute, Bishop Paiute, Bridgeport Indian Colony, Fort Independence, Lone Pine Paiute-Shoshone, Utu Utu Gwaitu Paiute, and Timbisha Shoshone), along with other AI/AN individuals eligible for TIHP services, spanning all ages and including elders, adults, and youth. Population Planned to Be Served: TIHP's existing clinical services reach individuals across the lifespan experiencing depression, co-occurring substance use disorders (alcohol, opioid, and methamphetamine), and suicide risk, using validated instruments (PHQ-9/PHQ-A) at intake and clinically indicated intervals, with services ranging from crisis intervention and suicide risk assessment to counseling and recovery support. Strategies and Interventions: TIHP will formalize MOUs with both regional 988 crisis centers; standardize culturally responsive crisis-response training across counselors and partner staff; build an end-to-end Tribal-specific 988 utilization tracking system with CRIHB/CTEC; expand its cross-sector Tribal 988 Task Force to at least 15 partner organizations; and redesign its community outreach strategy around trust-building, informed by TIHP's own 2025 community survey. Project Goals: 1. Formalize, strengthen, and expand TIHP's 988 crisis-center collaboration and training network; 2. Build an end-to-end 988 utilization tracking and outcomes system for Tribal community members; and 3) Increase Tribal community trust, engagement, and utilization of the 988-crisis system. Measurable Objectives: TIHP's measurable objectives are designed to advance SAMHSA's Strategic Priorities of access to high-quality services, data-driven practice, and prevention. TIHP will execute or update MOUs with both regional 988 crisis centers in Year 1, removing a key access barrier for Tribal callers; connect internal and partner data into the first Tribal-specific 988 dataset for the catchment by month six of Year 1; reach at least 100 Tribal community members and 50 Tribal youth annually through prevention-focused outreach; and increase community trust in 988 by at least 10 percentage points above a 22% baseline by the end of Year 2, further advancing access for elders and other underserved groups within the population of focus.
