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MHTTC Pathways

April 2019

Welcome to the monthly issue of the MHTTC Pathway Newsletter.  Please distribute to your contact list and encourage others to subscribe to the latest news from MHTTC.

In this issue, our first three articles focus on the strength, resilience, and healing that we hope will be the ultimate outcomes of trauma and tragedy. Mental health providers play a difficult yet essential role in helping people and communities recover from such events. 

Newsletter Content

  1. After a School Tragedy…Readiness, Response, Recovery, & Resources
  2. Trauma and American Indian and Alaska Native Youth
  3. Trauma and Mental Health: The Journey of Hispanic and Latino Populations
  4. School Mental Health News
  5. Spotlight: Our National Focus Area Centers
  6. Featured Product & Event

After a School Tragedy…Readiness, Response, Recovery, & Resources

While school shootings are rare, schools can and should be prepared to support students, staff, and families to recover from trauma related to school shootings, suicide, other acts of violence, and tragedies. Stoneman Douglas High School in Parkland, Florida is facing another wave of painful challenges after the recent death by suicide of two student survivors of the school shooting that resulted in 17 student and teacher deaths on March 14th, 2018. This is just one example of the wide-ranging impact that these types of unfortunate events have on the school community – an impact that extends far beyond the events of the day.

After a School Tragedy…Readiness, Response, Recovery, & Resources is a resource developed by the MHTTC Network designed to help schools better support students and families in the aftermath of violence and trauma. 

We provide strategies to assist schools with readiness, response, and recovery to help a school community support resilience in the event of a tragedy. We offer places to turn for more resources. We discuss terminology and concepts related to suicide and grief. Finally, we highlight the importance of providing culturally responsive services, with example cultural considerations for schools to help Hispanic/Latino students struggling with grief and trauma. 

To access this resource, please visit our Products and Resources Catalog on the MHTTC website here.

Below we have listed additional relevant MHTTC resources and upcoming events:

MHTTC Resources 
Suicide Prevention Addendum | Pacific Southwest MHTTC
This addendum provides referral resources for school personnel in the Pacific Southwest region. Many schools integrate universal screening for depression but lack the ability to refer students to mental health services. Resources focus on crisis intervention services that can meet immediate student needs. Where possible, state- and island-specific resources are included. Many of these organizations can also link students in crisis to no-cost or low-cost counseling services.
Support Resources After a School Shooting or Suicide | Pacific Southwest MHTTC
Visit the link for resources and learning sessions about how to navigate the intersections of school violence, trauma, and suicide.

Activities to Enhance School Mental Health | South Southwest MHTTC
This lists opportunities available from the South Southwest MHTTTC to enhance school-based mental health services and effective collaboration between schools and community mental health agencies.

MHTTC Upcoming Events
Understanding and Recognizing Student’s Mental Health Challenges and Building Resilience
Training hosted by Central East MHTTC in collaboration with Delaware Health and Social Services, Division of Public Health and Department of Services for Children, Youth, and their Families | April 6, 2019
During this training session, teachers will develop an understanding of the prevalence of mental health challenges among Delaware’s youth and how to recognize signs and symptoms of depression, anxiety, self-harm, and suicidality. In addition, this session will provide teachers with common-sense approaches to recognize when students might need additional support and a discussion of what resources are available in Delaware for students, their families, and school communities.

Youth Mental Health First Aid
Training hosted by Great Lakes MHTTC | April 18, 2019
Youth Mental Health First Aid teaches the school community, health and human services workers, and other caring citizens how to help an adolescent (age 12-18) who is experiencing a mental health or addictions challenge or is in crisis.

Supporting Students and Staff in the Aftermath of Crisis and Loss
Webinar hosted by Pacific Southwest MHTTC and the MHTTC Network Coordinating Office | April 23, 2019
This workshop will help school professionals learn basic skills in how to talk with and support individual students or the entire class/school as they struggle to understand and cope with a crisis or loss in their lives. The presenter, David J Schonfeld, MD, established and directs the National Center for School Crisis and Bereavement ( at the Suzanne Dworak-Peck School of Social Work at the University of Southern California; the Center Coordinates the Coalition to Support Grieving Students (, comprised of over 85 organizations including the major educational professional organizations. He will draw on over 30 years’ experience in school crisis response and pediatric bereavement to illustrate key points.

Trauma and American Indian and Alaska Native Youth

The following is an excerpt from our National American Indian and Alaska Native MHTTC’s Spring 2019 Newsletter. Click HERE to read the full article with references, and get the news from this national focus area center.

Trauma and American Indian and Alaska Native Youth by Ken C. Winters, PhD, with contributions from Mary K. Winters, MEd.

It is easy to focus on the challenges and the health disparities when working with Urban Indian and tribal communities across the country. However, the solutions to many of the health disparities in Native communities are found in the strength and resilience within the communities.  A community-based-participatory approach (CBPR) is the gold standard for working with tribal communities. Through listening to key stakeholders, we will better understand the strengths and facilitate buy-in from the Native community to address these challenges.
There are many obstacles when tribal communities seek to address trauma experienced by youth. Experts are encouraged that some community-based, tribal-adapted programs and practices exist, and there appears to be greater willingness by Native communities to seek mental health services when traditional healing practices are included (American Psychiatric Association, Office of Minority and National Affairs, 2010). While the evidence base of trauma informed care deserves more attention, several evidence-informed, knowledge-based programs exist. Given that tribes differ to some degree on their views as to how culture can support the healing process, forcing a specific treatment model or approach on a local community is not recommended. Rather, adapting programs with the inclusion of local traditions and practices and ensuring a holistic approach to treatment, while still retaining the core elements of the treatment model, is advisable (Brave Heart et al., 2011; Garrett et al., 2014; Goodking et al., 2010). 

The prevalence of mental health problems among American Indian and Alaska Native individuals, including youth, is much higher than in the general population and for us working in tribal and urban Indian communities it is very disheartening. Substance use disorders among Native adolescents and adults are significantly higher than among non-Native peers (American Psychiatric Association, Office of Minority and National Affairs, 2010; Beals et al., 1997; Brave Heart et al., 2016).  However, the rates of native people abstaining from alcohol and substance use is much higher than in the non-Native population, a fact that is not well known, and speaks to the strength of these communities as well (May, 1996).  

Similarly, there are higher rates of many behavioral and mental health disorders, including depression, anxiety, and PTSD among all age groups compared to non-Native populations (Boyd-Ball et al., 2006; Indian Health Service, 2011). Native people have the highest rates of suicide of any racial or ethnic group in the United States. Among Native youth, suicide is a leading cause of death. Despite these facts, it is estimated that there are significantly fewer Native mental health professionals available per 100,000 compared to the higher availability of mental health professionals for other groups. Three times as many Native people lack health insurance compared to whites (American Psychiatric Association, Office of Minority and National Affairs, 2010).

Native Youth and Trauma
The list and severity of trauma that numerous Native children and adolescents are exposed to is a national tragedy. Compared to their peers in other ethnic or racial groups, Native children are more than twice as likely to experience trauma (BigFoot et al., 2008). Sixty percent of Native children live in low-income families, and 18% live in deep poverty (National Center for Children in Poverty, 2016). An estimate from over a decade ago was that the rate of victimization via sexual or physical abuse of Native children is 20 per 1000, the highest rate among children in the US, and nearly twice as high as non-Hispanic and Caucasian children (Bureau of Justice Statistics, 2004). A major consequence of trauma is PTSD, experienced by Native adolescents at a rate of nearly 25% (Attorney General’s Advisory Committee on AI/AN Children Exposed to Violence, 2014), which is comparable to the rate of PTSD by veterans returning from Iraq and Afghanistan, and about three times the rate of the non-Native (Dorgan et al., 2014; Robin et al., 1996).

Trauma Programs for Native Youth
The high prevalence of trauma and behavior health disorders among the Native population, including youth, illustrates the extent and depth of disparities faced by this population. Comprehensive intervention and treatment efforts are needed that incorporate culturally-relevant, evidence-based and experience-based strategies at the individual, interpersonal, and community levels. A useful report was published by Mathematica Policy Research (Lechner et al., 2014) in which the authors identified programs that have been tested and documented. Interventions are summarized for trauma, suicide prevention, substance abuse, and parenting programs. The report also includes research and policy implications that can improve outcomes for Native youth. Four identified trauma-informed and trauma-specific programs specifically developed for youth are:  Honoring Children, Mending the Circle and Honoring Children, Respectful Ways (Indian Country Child Trauma Center,, Cognitive Behavioral Intervention for Trauma in Schools (CBITS) adapted for Native youth (Morsette et al., 2009), and Pathway to Hope (Payne et al., 2013). 

Trauma and Mental Health: The Journey of Hispanic and Latino Populations



On March 27, 2019 the National Hispanic and Latino MHTTC, in collaboration with Eastfield College, Dallas County Community College District, celebrated their first symposium titled Trauma and Mental Health: The Journey of Hispanic and Latino Populations in Dallas, Texas.  The symposium was developed to increase awareness about trauma- informed practices, immigration experiences and mental health services for the Hispanic and Latino population.  The presentations were conducted by Dr. Philip Ortiz and Daniel Ramirez from Eastfield College, Dr. Luis Zayas from the University of Texas, Dr. Roberta Leal and Dr. Luis Torres from the University of Houston, and Mr. Jose Juan Lara from Casa Esperanza.

The audience was inspired by Dr. Philip Ortiz, and his professional development journey as a Latino in the educational system. The participants were impacted by the presentation of the reality that many children and families face in the deportation centers and were encouraged by the resiliency observed through the life story and journey of Dr. Zayas.  Dr. Luis Torres discussed the impact of historical trauma experiences in the implementation of trauma-informed mental health service provision to Hispanics and Latinos.  Then, Dr. Roberta Leal shared her personal experience of growing up in a disadvantaged family setting and being able to overcome many obstacles to obtain a PhD and teach at a prestigious university.  Jose Juan Lara, MS, engaged the audience and discussed the impact of gender-based violence through his experiences with domestic violence survivors at Casa Esperanza. The Center will continue its commitment to increase awareness and help to reduce disparities in the provision of mental health services for Hispanic and Latino populations nationally.

School Mental Health News

We’ve kicked off the National School Mental Health Learning Collaborative!

The National School Mental Health Learning Collaborative officially commenced last week with an intensive 2-day In-Person Learning Session in Maryland. Over 160 participants were in attendance, including MHTTC Center staff as well as state and district mental health and education leaders representing 36 states. In addition, the Assistant Secretary of Mental Health and Substance Use, Department of Health and Human Services, Dr. Elinore McCance-Katz, was in attendance to provide opening remarks on the second day.

Co-facilitated by the MHTTC Network Coordinating Office and the University of Maryland School of Medicine National Center for School Mental Health (NCSMH), the intensive learning session included the release of the first iteration of the National School Mental Health Curriculum: Guidance and Best Practices for States, Districts, and Schools, a curriculum that is aligned with national Comprehensive School Mental Health Systems (CSMHS) performance standards. An overview of the curriculum was provided in order to equip MHTTC Center leaders and state teams to train states and districts in the foundational principles and strategies of CSMHSs and ongoing CSMHS quality improvement. Participants were also offered opportunities for cross-regional and cross-state networking and shared learning about best practices, successes and challenges of CSMHS implementation. 

Overall, it was a great presentation of a wealth of information that we hope will be helpful in advancing comprehensive school mental health policies and practices across the nation. 



What’s next?

The in-person learning session is just one component of the National School Mental Health Learning Collaborative. What follows are five Virtual Learning Sessions that all Learning Collaborative participants are invited to attend. Sessions will include didactic content aligned with the National School Mental Health Curriculum modules, and participants will be asked to share progress and lessons learned on specific improvement goals related to school mental health. In addition, participants will be asked to exchange resources, tools, templates, and other materials within the collaborative to promote shared learning. All participants are expected to ask for and provide feedback to peers within the learning collaborative.

See dates for the five Virtual Learning Sessions below:
Learning Collaborative Activity Date
Virtual Learning Session 1 Thursday, April 4, 2019 at 3:00 – 4:15 ET
Virtual Learning Session 2 Thursday, May 2, 2019 at 3:00 – 4:15 ET
Virtual Learning Session 3 Thursday, June 6, 2019 at 3:00 – 4:15 ET
Virtual Learning Session 4 Thursday, July 11, 2019 at 3:00 – 4:15 ET
Virtual Learning Session 5 Thursday, August 1, 2019 at 3:00 – 4:15 ET
Invitations to the Virtual Learning Sessions were sent to all MHTTC School Mental Health Leads and participants of the Learning Collaborative. 

Please note that all Virtual Learning Sessions will be recorded and archived on the MHTTC website.

If you have any questions regarding the Virtual Learning Sessions or the National School Mental Health Learning Collaborative in general, please contact Jessica Gonzalez at

National School Mental Health Curriculum


The curriculum is currently being finalized by the MHTTC Network Coordinating Office and the NCSMH to incorporate feedback that was provided by individuals at the in-person learning session. A huge thank you to all who provided suggestions and new resources to incorporate in the next revision of the curriculum.

Spotlight: Our National Centers

National American Indian and Alaska Native MHTTC

Our role is to work with organizations and treatment practitioners who deliver mental health services to American Indian and Alaska Native individuals, families, and tribal and urban Indian communities. We aim to distribute effective evidence-based, experience-based, and knowledge-based practices to individuals through training on culturally informed mental health practices, clinical supervision and leadership development. By enhancing culturally informed clinical skills, and providing clinical supervision, mental health organizations may be able to reduce turnover and compassion fatigue. We aim to provide training and technical assistance in these areas, and to encourage American Indian and Alaska Native individuals to seek careers in behavioral health fields.

What we are currently doing:
  • Native Veterans Event – A pilot event for Native veterans, treatment and service providers, and primary care staff in the areas of PTSD, trauma, and suicide along with cultural considerations and a historical overview
  • Brief introductory presentation of our school mental health efforts at the National School Mental Health Learning Collaborative, in Columbia, MD
  • Monthly mental health webinar series, most recently: March 13 - “Historical Trauma and Healing for LGBT-Two-Spirit People”
  • Newsletter on trauma informed care will be  published in March 2019.  (click here)
Click here to view our Webpage

National Hispanic and Latino MHTTC

We serve as a key subject matter expert and resource for workforce development across the U.S. and its territories to ensure that high-quality, effective mental health treatment and recovery support services, and evidence-based and promising practices are available to help reduce health disparities among Hispanics and Latinos experiencing mental disorders, particularly those with serious mental illness.  We work in the development and delivery of educational training events (in-person), synchronous/virtual technical assistance sessions and webinars for providers serving Latino communities.  To serve organizations and service providers throughout the United States, we assist programs in identifying facilitators and challenges as they pertain to the implementation of specific practice improvement towards mental health services for Hispanic populations and provide capacity building on cultural elements and competencies required by mental health service providers to deliver appropriate services.  Most importantly, we deliver comprehensive training and technical assistance to the specialized workforce of Hispanic and Latino indigenous & culturally grounded community health workers and/or promotors.

What we are currently doing:
  • The three most recent webinars we conducted are 1) School Based Mental Health Program for Hispanic and Latino Children and Youth by Scott Bloom, LCSW-R;  2) Cultural Humility: Where Being Human Matters in Serving Others by Miguel Gallardo, PsyD; and 3) How Culture Can Help in the Prevention and Management of Bullying by Francisco Javier Parga, PhD and Carlos Barsy MPsy
  • As part of our awareness activities during March, Women's History Month, we highlighted through social media posts (Facebook, Twitter and LinkedIn), the work in the field of mental health research and services of two distinguished investigators and community service providers: Dr. Margarita Alegría and Dr. Esther Calzada.
  • On March 27, 2019 we conducted the first in a series of symposiums addressing the relation of culture, trauma and mental health.  This first symposium took place in Eastfield College in Dallas, Texas.
  • To increase the communities that can be reached through our services, the Center will conduct a Training of Trainers between April 23rd to April 25th, 2019 in Houston, Texas.  We plan to train at least 15 professionals to deliver our core Culture and Mental Health curriculum and 15 professionals to deliver our core School-Based Mental Health Services curriculums.
Click here to view our Webpage

Featured Product and Event

Our MHTTC website has several great features including a Training and Events Calendar that lists all of the training and TA events across the Network [CLICK HERE], and a searchable Products and Resources Catalog that includes free curricula, fact sheets, recorded webinars, and other resources [CLICK HERE].  Each month we highlight a recently developed resource and an upcoming event.

Webinars: Part 1 & 2 Older Adults and Serious Mental Illnesses

Publication Date: March 20 & 27, 2019
Developed By: Northeast & Caribbean MHTTC

Dr. Michelle Zechner, PhD, LSW, CPRP is an Assistant Professor at Rutgers, School of Health Professions, Department of Psychiatric Rehabilitation and Counseling Professions. She has focused her 25 year career on supporting the recovery of people with mental illnesses and their families. She has worked in a variety of community and inpatient settings including nursing homes, outpatient mental health services, state psychiatric hospitals, and community services for older adults. In her current role she has focused on implementation of evidence-based psychosocial practices in psychiatric hospitals, developing and testing health and wellness promotion interventions in community settings, teaching students, training diverse mental health staff on best practice interventions for older persons with mental illnesses, and conducting research. Dr. Zechner's research includes the development of multi-domain wellness programs for people with mental illnesses, promotion of and adherence to physical activity in people with mental illness, use of peer health coaching strategies and identifying best practices for use with older adults with mental illnesses. She has co-authored peer-reviewed and technical publications on health promotion for people with mental illnesses, and has presented her work at local, national, and international conferences. She is passionate about supporting older adults with mental illnesses to improve their mental and physical health. 

Part 1 of the webinar addresses the following learning objectives:

  • Develop understanding of older adults with SMI
  • Describe this growing population
  • Identify unique concerns for this population
    • Health challenges
    • Psychiatric symptoms
  • Evaluate the strengths that develop with older age

Part 2 of the webinar addresses the following learning objectives:

  • Discuss evidence based practices (EBPs) for age onset depression
  • Identify EBPs and best practices for programming for older adults with serious mental illnesses
  • Discuss wellness as a framework for developing new programming
  • Explore knowledge, skills and attitudes needed for working with older adults 

Click here to view a recording of the webinar (Part 1) (Please note the recording begins a couple of slides in). 

Click here to view a recording of the webinar (Part 2)

Employment and Substance Use Disorders: The Individual Placement and Support (IPS) Model

12:00pm - April 16, 2019
Hosted By: Great Lakes MHTTC
Registration Deadline: April 16, 2019

Need more information?
Contact us at
Click HERE

Webinar Summary
This webinar will provide an overview of the evidence-based practice known as Individual Placement and Support (IPS) Supported Employment and its use in developing Recovery Oriented Systems of Care (ROSC) for individuals with substance use disorders (SUD).  While the majority of the research on this EBP has been conducted with individuals with serious mental illness, the practice is being adapted to provide high quality employment supports to individuals with SUD as well as co-occurring SUD and mental illness.  Presenters will describe the principles and evidence based for IPS, as well as infrastructure needs and implementation strategies and some case examples.

Presenter Information
Lou Kurtz, M.Ed.
Co-Director, Great Lakes MHTTC
Louis Kurtz is currently the Co-Director for the Great Lakes Mental Health Technology Transfer Center (MHTTC).  He has previously worked for the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities in a variety of roles as well as at Eastern Kentucky University.  From 2010 through 2015 Lou served as the mental health lead for the Kentucky IPS Supported Employment program – more recently he has conducted fidelity monitoring for local IPS programs in Kentucky and provided consultation services for a national Supported Employment Demonstration project.

Bob Meyer, MS. ISyE
Technology Transfer Specialist – STR/ORN
Bob Meyer is currently the Technology Transfer Specialist with the STR-TA region covering MN, WI and IL.  Bob was the state trainer for the Wisconsin Individual Placement and Support (IPS) project, a team effort with the Department of Health Services, Division of Vocational Rehabilitation and the UW-Madison Department of Rehabilitation Psychology and Special Education.  Bob worked with the IPS program in Wisconsin from 2010 to 2018, from the first three pilot sites, through expansion to community mental health programs that number has grown to over 65 sites in 26 counties – the average employment rate for individuals in the program also increased from 18% to 47% over that time.

MHTTC Network


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