All Nations Health Tribal Behavioral Health Substance Use Prevention - All Nations Health Center (ANHC) will implement the five year All Nations Youth Substance Use and Overdose Prevention Initiative in Missoula County and nearby western Montana communities. The project will prevent and reduce substance use and overdose among American Indian and Alaska Native (AI/AN) youth and young adults through age 24 by building responsive prevention system that strengthens resilience, overdose readiness, early identification, and connections to care. Missoula is an urban hub for Native youth and young adults who live locally, attend the University of Montana, travel from rural or reservation communities, or move between Missoula and home communities for care, education, employment, court involvement, and family support. The population of focus includes middle school and high school youth; young adults ages 18 to 24; Native students and workers; youth and families involved with Family Treatment Court, child welfare, primary care, Behavioral Health, campus health, and community services; and young people experiencing early or episodic substance use, substance use disorder, co occurring anxiety or depression, grief, trauma exposure, overdose risk, housing or transportation barriers, or difficulty accessing age appropriate and responsive care. Families, caregivers, elders, teachers, peers, and youth serving professionals will participate as protective adults and partners. ANHC provides integrated medical, dental, behavioral health, substance use, youth, outreach, transportation, crisis, and care coordination services. The remaining need is a standing prevention structure with dedicated coordination, youth guidance, consistent education, trained staff and partners, written overdose and referral procedures, active follow up, shared data definitions, and regular performance review. Activities will include listening sessions and talking circles; a Youth Community Board; a Year 1 needs assessment and strategic prevention plan guided by SAMHSA's Strategic Framework; education on alcohol, cannabis, vaping, prescription medication misuse, fentanyl, stimulants, polysubstance use, safe storage, coping, help seeking, recovery, resilience, and protective factors; overdose recognition and response training, including opioid overdose reversal medication administration and Good Samaritan information; workforce development; public outreach; warm handoff procedures; and a data dashboard. Family Treatment Court, Curry Health Center and Clinical Psychology Center at the University of Montana, and the Montana Consortium for Urban Indian Health will support outreach, referrals, technical assistance, workforce capacity, data stewardship, and sustainability. The project will build a community directed Native youth prevention system, increase prevention education and resilience, improve overdose response readiness, strengthen linkage to care and support services, and increase workforce and partner capacity through data informed improvement. All required activities will begin within four months of award. By the end of Year 1, ANHC will complete the needs assessment and strategic plan, establish the Youth Community Board, hold at least four structured planning sessions, approve written overdose response protocols, and establish referral and data systems. Across five years, the project will serve 1,550 unduplicated direct participants, reach 20,000 people through indirect and population level prevention, train 1,150 people in overdose response and opioid overdose reversal medication administration, and actively link 235 youth and young adults to needed services. Staff will review data monthly, and youth, partners, and leadership will review a dashboard quarterly to guide improvement and sustainability.
