Expanding Access to Trauma-Informed Parent-Child Mental Health Care in NYC Family Justice Centers is a model for large urban cross-system collaboration to increase access to mental health screening and evidence-based, trauma-informed, multi-generational, mental health care for intimate partner violence (IPV) exposed children ages birth to five who have an IPV survivor caregiver with an identified mental health disorder. The project is a collaboration between the Department of Child and Adolescent Psychiatry at New York University (NYU) Langone Health, the New York City (NYC) Family Justice Centers (FJC) under the auspices of the NYC Mayor’s Office to End Domestic and Gender-Based Violence, NYC Health + Hospitals, and STEPS to End Family Violence/Rising Ground, that enhances and integrates existing siloed programs to create a streamlined referral pathway and direct service provision for very high risk, very young children. The NYC Health + Hospitals-FJC-Mental Health Collaboration (MHC) program is co-located at each NYC FJC site and provides psychiatric assessment and treatment for adult survivors of IPV. Nearly 60% of MHC clients are parents of children 0-18, with 30% having children under age 5. MHC families are 27% African American, 64% Latinx, and 9% Caucasian, with 92% living below the federal poverty line, 73% having a history of housing insecurity, 82% having immigrant status, and approximately 30% speaking a primary language other than English. To increase screening, MHC providers will administer early childhood parent-report behavioral and trauma symptom screening measures. To increase access to mental health care, a facilitated referral pathway, with ongoing leadership and oversight by NYU, will be established between MHC providers and community Child-Parent Psychotherapy (CPP) providers. Where indicated, dyads will be referred to CPP providers at NYC H+H sites in the appropriate borough. At the Staten Island FJC, identified dyads will be referred to the co-located CPP providers at STEPS to End Family Violence. Where child screening measures do not indicate the need for CPP, but parents would significantly benefit from support in parenting their young children after trauma, parents will be referred to Circle of Security (COS) groups at each FJC site conducted by the grant-funded clinician. Over the life of the project, a total of 710 children birth to age five and their 710 caregivers will be screened via caregiver report; a total of 475 children and 475 parents will be referred for CPP at partner sites; a total of 350 children and 350 parents will engage in and receive CPP treatment; and a total of 240 parents will receive the COS group intervention. Over the project period, 350 FJC providers will receive training on the impact of IPV in early childhood; 14 MHC providers will be trained in early childhood mental health screening; and 45 CPP providers will receive ongoing consultation and supervision. The total number of unduplicated individuals to be served by the project is 1,829.

Seasons Center is a comprehensive Community Mental Health Center (CMHC) and Certified Behavioral Health Clinic (CCBHC) offering a broad range of psychiatric and behavioral health services (medication management, outpatient therapy, substance use treatment, crisis services, specialized trauma care, specialized family services, wraparound services, nursing support, school-based services, Assertive Community Treatment, Intensive Psychiatric Rehabilitation, education and outreach, and specialized services for foster, adoptive, and kinship families) to individuals, families, and communities in Northwest Iowa since 1959. Seasons Center serves 19 (rural) counties, and 1 (urban) county with offices in 11 of these counties across Northwest Iowa. Mission: Guiding Individuals and families toward a meaningful and fulfilling life. Values: Innovation, Impact, Influence. Through the SAMHSA NCTSI - Cat III funding, Seasons Center is working to enhance partnerships in rural Northwest Iowa with local child-serving agencies to increase access to specialized, trauma-informed, and evidence-based mental health services for foster, adoptive, and kinship children and their families. By walking alongside families to provide family-centered service to support and resolve the unique challenges families are facing.

Olive View provides a care process model for pediatric trauma stress (CMPT) and trauma-reminder focused interventions, including Trauma and Grief Component Therapy for Adolescents (TGCTA), a Family Intervention for Suicide Prevention (FISP), and a Reminder Focused Positive Psychiatry intervention (RFPP) - in collaboration with NCTSN Category II Centers for adolescents with PTSD and their families at Olive View UCLA Medical Center (OVMC). Clinicians and nurses at Pediatric Clinics, Los Angeles Unified School District (LAUSD), and Barry J. Nidorf Juvenile Hall mental health clinics will achieve trauma-informed skillset and competency to implement. Trauma-informed screening: CMPT will be primarily implemented in pediatric and mental health clinics, screening 1,500 at-risk adolescents for PTSD per year for a total of 7,500 adolescents. Adolescents at risk for PTSD will be evaluated using the Pediatric Traumatic Stress Screening Tool, and based on the adolescent's trauma symptom severity and the presence of functional impairment in the adolescent's life, adolescents with PTSD will be assigned to one of three treatment interventions, including protective – for mild symptoms, - resilient – for moderate symptoms - or restorative – for severe symptoms. Trauma Reminder Interventions: FISP, TGCTA, and RFPP interventions will be implemented at OVMC. The project will provide evidence-based interventions to 210 youth with PTSD and their families per year for a total of 1,050 youth. The population of focus is trauma-exposed adolescents 9 to 18 years old. This includes children of military families, children involved in the child welfare system, children in pediatric clinics, and adolescents with co-morbid substance use disorders across underserved youth in north Los Angeles.

Penfield Children's Center (PCC) provides evidence-based home-based trauma-focused treatment in Milwaukee County, WI, as well as expand services to neighboring Waukesha County, for children, ages 0 to 6, who have been exposed to (experienced or witnessed) potentially traumatic events and have trauma symptoms. The EBP, Early Pathways (EP), was developed specifically at PCC to treat very young children exposed to trauma by Marquette University (MU) faculty. The success of this home-based approach for this population has been well-documented in multiple studies, including four randomized controlled trials (RCTs) documenting effectiveness for reducing disruptive behavior disorders and externalizing/antisocial behaviors, improving the family-child relationship, improving general functioning and well-being, improving social functioning/competence, reducing unspecified and other mental health disorders, and improving parenting behaviors.