Thursday, November 21, 2024
11/21/2024
To prevent the onset of psychosis and lessen the severity of psychotic disorders among American Indian and Alaska Native (AI/AN) youth and young adults at clinical high risk for psychosis, Fairbanks Native Association (FNA) has developed the Athabascan Outreach and Resilience program (AOR). AOR will provide trauma-informed, culturally resonant, evidence-based interventions using a stepped-care model and the Coordinated Specialty Care approach. Disparity data indicates AI/AN are one of the highest at-risk populations for Clinical High Risk for psychosis (CHR-P), which refers to a state in which an individual shows early signs or symptoms that suggest an increased likelihood of developing a psychotic disorder. AI/AN youth and young adults experience high rates of multiple risk factors for CHR-P including disproportionate mental illness, substance use, trauma, violence, poor maternal health, poverty, child abuse and neglect, and incarceration. Given these disproportionate risk factors, there is a critical need to prevent the onset of psychosis and lessen the severity of psychotic disorders among the target population. To accomplish this, AOR uses a stepped-care model for early psychosis that features lower intensity/lower-risk treatments as first-line interventions, with decisions regarding treatment completion, maintenance therapy, or step-up to more intensive care based on objective measures of treatment response. It also uses Coordinated Specialty Care, an evidence-based, multi-disciplinary approach that integrates medication management, psychotherapy, case management, family support, and educational and vocational support tailored to the individual needs of young people experiencing early symptoms of psychosis to improve outcomes and promote recovery. The goals of AOR are 1) implement a stepped-care model, 2) improve symptomatic and behavioral functioning; 3) enable youth and young adults to resume age-appropriate social, academic, and/or vocational activities; 4) delay or prevent the onset of psychosis; and 5) minimize the duration of untreated psychosis for those who develop psychotic symptoms. Objectives include 50% fewer psychiatric hospitalizations or use of emergency services for mental health crises annually from baseline and a 50% improvement annually from baseline in the following Infrastructure Development, Prevention, and Mental Health Promotion indicators: number of individuals screened for mental health or related interventions, number of individuals referred to mental health or related services, number of individuals contacted through outreach efforts, and number of people in the mental health and related workforce trained in mental health. Objectives also include 50% improvement from baseline to discharge in the following National Outcome Measurements: criminal and criminal justice status, perception of care, functioning in everyday life, stability in housing, severity and frequency of CHR-P symptoms, education and employment, and social connectedness. Due to the rigorous and specialized nature of AOR, which prioritizes the delivery of evidence-based, culturally resonant, trauma-informed care tailored to the complex needs inherent in CHR-P and psychosis treatment, we have kept the number of youth and young adults (Y/YA) served low. Fewer clients are seen in year one due to implementation activities, with services beginning by month four. Individuals served include youth and young adults (Y/YA) enrolled in AOR, their family members, and providers trained through AOR activities. It does not include the broader community or providers reached through the AOR Outreach Plan. At a minimum, AOR will serve four Y/YA in year one and six per year in years two through four for a total of 22 Y/YA. It will serve eight family members in year one and 10 per year in years two through four for a total of 38 family members. It will provide training/workforce development to 20 providers in year one and 10 per year in years
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
