The Expanding Culturally Responsive Care initiative, a new project funded through a 2022 Washington State legislative proviso, aims to strengthen the lived experience behavioral health workforce and create a culturally responsive care curriculum for statewide implementation in Medicaid-serving organizations. This initiative was developed in response to Washington State’s urgent need for more culturally responsive, effective public behavioral health services–services that many families do not currently have access to. Ideally, this initiative will allow for more families to receive care that promotes true healing, mental health wellness and health equity. Curriculum and strategy development will be done through a participatory, collaborative co-design process with broad ranging input from across the state, and will center community voice, transparency, and accountability throughout all stages of the process. This project is part of a broader Leadership Initiative for Quality.
Geographic Area: Washington
Housing stability for youth
The Housing Stability for Youth (H-SYNC) model was developed by the UW CoLab team in collaboration with Snohomish and Kitsap County workgroups and is intended to serve as a prevention tool for youth homelessness. Specifically, it’s designed to identify youth at risk of or currently experiencing homelessness within existing processes in juvenile court systems and refer youth and their families to appropriate prevention and housing services via a stepped-care navigation model. The court system serves as a pivotal resource for the identification of these populations in need due to the high frequency of police and court contact these populations experience. This model is being implemented in four counties in Washington State, including King, Snohomish, Kitsap, and Okanogan Counties and in collaboration with community-based organizations such as the YMCA of Greater Seattle, Cocoon House, and Kitsap Mental Health Services.
As of 2022, H-SYNC prevention program is coordinated by the Y Social Impact Center at the YMCA of Greater Seattle. H-SYNC now represents a state-wide partnership between juvenile courts and local social service providers across counties including King, Snohomish, Peirce, Spokane, Okanagan and Kitsap.
Opportunity Based Probation
Opportunity-Based Probation (OBP) is a new juvenile probation model that expands on adolescent development research by leveraging adolescents’ drive towards independence as well as their heightened receptivity to rewards. In collaboration with their probation officers, youth create meaningful goals and incentives that reward the development of prosocial behavior. Probation officers scaffold prosocial behavior by reinforcing success and constructively addressing probation violations and problem behaviors. OBP was originally developed through a collaboration between UW CoLab and juvenile court leadership in Pierce County, Washington with funding from the Annie E. Casey Foundation and is now being implemented, refined, and tested for acceptability, implementation, and preliminary effectiveness. In 2021, a second OBP site was started in Hartford County, Connecticut and is currently undergoing co-design and implementation efforts with an eye for eventual testing and expansion statewide.
COVID-19 Student Survey
This project involved an anonymous needs assessment for 6th through 12th graders in Washington to collect data on what students thought was going well, what challenges they had encountered, and what their needs were as schools replied to largely in-person instruction following a largely virtually year because of the COVID-19 pandemic.
Workforce Innovation and Leadership in Forensic Mental Health
The Center for Mental Health, Policy, and the Law (CMHPL), through an operations grant, is developing programming in Workforce Innovation and Leadership in Forensic Mental Health to address the forensic mental health workforce shortage.
The CMHPL anticipates the programming will have a direct impact on recruitment and retention of mental health professionals who work in forensic settings, as well as other public sector and psychiatric leadership roles. Through development of high-quality training, mentorship, consultation, and leadership development programming, the CMHPL is growing the number of clinicians with knowledge and aptitude to work with persons involved in the criminal justice system. In turn, this will engender high-quality patient services to improve access and care delivery to persons involved with the justice system and reduce the risk of prolonged or repeated cycles through the system.
Development of an interactive, web-based drinking to cope intervention and tools to assess coping skill utilization
This project will develop and test an interactive web-based intervention with text-message reminders for young adults who drink to cope with negative affect. The intervention will include interactive modules on CBT coping skills, assignments to practice the skills, text-message reminders, and weekly assessments on coping skill utilization and barriers to use. A total of 120 young adults will be randomized to the 4-week, web-based drinking to cope intervention (n=60) or an assessment only control (n=60) and complete a 1- and 3-month follow-up.
WA state parent network to prevent youth suicide and improve student mental health
Rates of suicide and mental health challenges among youth have never been higher. An essential part of youth well-being, mental health and suicide prevention is that parents and other caregivers of youth are prepared to support their children in these challenging times. Asking IS Caring is a parent-caregiver network started in Eastern Washington to provide community education, peer to peer support to families struggling with youth suicide behavior/ death, and input to districts implementing mental health programming and supports. This grant will help put into place essential infrastructure to further develop and to sustain the parent-caregiver network as well as to evaluate programming stemming from the network’s activities. Asking Is Caring is supported by a curriculum designed to offer parents-caregivers an invitation to be present with their child. It offers opportunities for participants to problem solve, and questions they can ask of their child, the parent’s friends, and of themselves. Asking IS Caring provides practical steps to build protection from suicide in the home.
Impact of the Preventing Addiction-Related Suicide (PARS) Intervention on patients who receive community-based addiction treatment
Persons with substance use disorders are 5-10 times more likely to die by suicide than the general public. Recognizing this, Rick Ries, MD, Katherine (Kate) Comtois, PhD, MPH, and the UW Center for Suicide Prevention and Recovery (CSPAR) staff developed the first and only suicide prevention intervention successfully developed with and tested in community addiction treatment centers. The primary outcomes of the multisite PARS clinical published in JAMA Network Open in April 2022. Led by Dr. Ries, Kevin Hallgren, PhD, Amanda Kerbrat, LICSW, and Yanni Chang, MD, this project will fund a more detailed secondary analyses to better characterize which patients respond best to the PARS intervention, which in turn will help inform intervention improvements.
Understanding the support needs of gender expansive youth
Approximately 35% of youth who identified as transgender report having attempted suicide in the past 12 months. Despite this high risk, few preventive interventions have been developed specifically to address the unique needs of this group who experience high rates of marginalization, victimization and social isolation based on their gender identities. This study will use human centered design principles to adapt the Caring Contacts intervention for suicide prevention for transgender and gender expansive (TGE) youth and user test this intervention with suicidal ideation who are identified via a Zero Suicide-based screening program in the Seattle Children’s Gender Clinic.
Role of criminal defense attorneys in suicide prevention following defendant arrest
This study will explore the role that criminal defense attorneys could play in reducing risk of suicide amongst recently arrested criminal defendants. Suicide is the leading cause of death in jails and the period after recent arrest may be a particularly vulnerable time for suicide. For many persons with recent arrest, their attorney is one of only a small number of persons that they encounter in the days following arrest. This proposal aims to better understand the experience of the criminal defense attorney in working with clients who have suicidal thinking or behavior; training they have received in the past; desired training (such as suicide risk identification, trauma-informed care, resources); and challenges in disclosures in light of their professional responsibility to preserve client confidences.
