The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services created the Transformation Transfer Initiative (TTI) in a continued effort to assist states in improving their mental health systems of care. The TTI provides, on a competitive basis, modest funding awards and intensive technical assistance to states, the District of Columbia, and the territories to identify, adopt, and strengthen innovative initiatives to better serve children and youth with Serious Emotional Disturbance (SED) and adults with Serious Mental Illness (SMI).
Through SAMHSA guidance, the TTI focuses on critical areas which are priorities to SAMHSA and vital to states and territories: such as expanding and enhancing crisis services, with particular emphasis on justice-involved individuals, youth at risk of suicide, and children with complex needs.
The six priority topics in FY25, chosen by SAMHSA, promote collaborative, innovative solutions to address workforce challenges, system mapping, and treatment needs. TTI offers comprehensive support, including funding, technical assistance, training, and networking opportunities, to empower teams to achieve their goals and enhance their service delivery systems.
The FY25 TTI awards to U.S. states and territories focus on the following six (6) topics directly related to implementing and expanding 988 and crisis services for those with SMI or SED:
- Community-based service approaches for justice involved individuals with SMI or SED
- Community crisis system mapping and implementation: building intra and inter-systems bridges for coordinated crisis care
- Crisis care and suicide prevention for youth with SED
- Crisis workforce wellness, and resilience and prevention of burnout
- Training and professional development for the non-clinical crisis workforce
- Treatment and supports for children with high acuity and/or complex needs at risk of out of home placements
For any questions, please contact tticontact@nasmhpd.org
| State | Topic | Summary |
|---|---|---|
| Alaska | 2. Mapping | Alaska seeks to develop separate crisis system mappings for youth and for adults, while also streamlining continuity of care processes and building bridges within the state’s current crisis system. Through a chosen vendor, Alaska plans to facilitate discussion and collaboration between regional crisis service providers, first responders, people with lived experience, Tribal entities, and other regional/community stakeholders with the goal of breaking down silos and creating a central engagement point for state partners. |
| Alaska | 5. Non-clinical | Alaska plans to train stakeholders and the non-clinical workforce that work with families in communities across Alaska in a Trust-Based Relation Intervention® (TBRI®) by utilizing a train-the-trainer model. These individuals will be supported to train the TBRI model in their communities, implement the model within their organizations, and support collaboration across agencies and disciplines to adapt the model to meet the needs of their community. |
| Alabama | 1. Justice involved | Alabama plans to use the TTI funds to expand the state’s jail and community-based competency restoration models by integrating peer services into the program. They plan to help expansion by hiring additional providers to deliver competency restoration services and integrating peers into the restoration model while including their expertise in improving and delivering training of the curriculum. This will also assist with establishing connections between peer specialists, individuals involved with the criminal justice system, and the criminal justice community. |
| Arkansas | 1. Justice Involved | Arkansas will develop an innovative and effective system of care to treat and divert those who have Intellectual/Developmental Disabilities (IDD) or who are dually diagnosed to more appropriate placements. They plan to develop and implement early access to examinations for IQ and adaptive functioning as a first step to identify individuals with IDD. Those identified will be provided transitional case management services and, when appropriate, alternative placement and diversion from the criminal justice system. This pilot will also provide education to local courts and law enforcement about the available options and resources for individuals with IDD and the potential for diversion while maintaining community safety. |
| American Samoa | 1. Justice Involved | American Samoa plans to transform how community mental health services are structured and delivered for justice-involved individuals with a Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED), to ensure that effective evidence-based care is received. They intended to do this by providing mental health screening and referral to treatment for incarcerated individuals, capacity-building for the community mental health workforce, and coordinating a Continuum of Care for community-based mental health services. |
| Commonwealth of the Northern Mariana Islands | 4. Workforce wellness | Commonwealth of the Northern Mariana Islands (CNMI) plans to implement a Crisis Workforce Wellness Project through a Wellness Clinic to promote wellness and resilience and prevent burnout amongst its crisis and mental health care providers. This will be done by creating a curriculum for crisis workforce and staff training to help increase knowledge and skills within the mental health field and provide mental health intervention services. |
| Commonwealth of the Northern Mariana Islands | 5. Non-clinical | Commonwealth of the Northern Mariana Islands (CNMI) plans to develop and implement a comprehensive training and professional program called Project Minetgot Marianas, for non-clinical crisis workforce members/recovery champions, with a focus on individuals and family members with Severe Mental Illness/Severe Emotional Disturbance/Substance Use Disorder. This initiative will include the development of a comprehensive training program, community education and outreach plan, and the establishment of a process for system mapping and implementation. |
| Connecticut | 3. Youth Suicide Prevention | Connecticut plans to develop and implement a suicide prevention initiative for youth and young adults. The State’s Suicide Advisory Board will collaborate with a youth-led advocacy organization, and student organizations to hold a statewide Empowering Leadership Initiative for high school and college-aged members of the community. The Initiative will engage youth directly in planning and developing effective outreach and peer support activities. A subsequent summit will be held several months later to provide an opportunity for attendees to share successes and challenges surrounding the implementation of their peer support activities. |
| Delaware | 1. Justice involved | Delaware aims to increase the state’s coordination of care by piloting the Evidence-Based Practice (EBP) Critical Time Intervention (CTI) Model, specifically targeting serious mental illness/serious mental illness-co-occurring substance use disorder clients with justice involvement. The goal of this project is to engage a consultant with subject matter expertise in CTI for development and implementation of the CTI model, review recommendations and create trainings and procedures for substance use disorder care navigators, develop implementation plan, and enhance program integrity, system integration, and quality monitoring infrastructure. |
| Delaware | 4. Workforce wellness | Delaware plans to expand their past work focused on workforce development by developing an interdisciplinary learning collaborative to expand the non-clinical workforce and training. They will have training on best practices for burnout prevention and wellness for case managers and peer recovery specialists. In doing so, they will include previous TTI project partners in the development and implementation phases, with a goal of creating a product that is accessible and can be shared broadly. |
| Georgia | 5. Non-clinical | Georgia will develop a training program called Georgia Partnership in Action for Co-Responder Training (“G-PACT”) for first responder and behavioral health professional (co-responder) programs. Georgia plans to use a train-the-trainer model and develop the first standardized certification process for co-responder teams in the state. |
| Guam | 1. Justice involved | Guam plans to expand their FY24 TTI work by developing and implementing a Peer Specialist certification program for justice involved individuals in custody who experience Severe Mental Illness (SMI) and are preparing for re-entry to the community. They will work with TOHGE (Transforming Ourselves through Healing, Growth, & Empowerment), Guam’s only peer-run organization, to support these individuals by training them to become Certified Peer Specialists who leverage their own lived expertise. They will establish program guidelines for and train Guam correctional/judiciary staff on the Certified Peer Specialist program, “Project Guiya mas Tumungo.” Peers will have opportunities to work with mobile crisis teams, 988 call centers, and outpatient programs. |
| Guam | 6. Children with high acuity | Guam will develop an evidence-based family systems training model for justice involved youth that will demonstrate the efficacy of evidence-based models of family intervention. TTI funds will be used to cross-train Guam’s juvenile justice team, Judiciary of Guam counselors, and Youth Affairs (DYA) social workers. This will help to establish a network of support across departments to ensure coordinated efforts that address both the youth and the caregivers. |
| Hawai’i | 1. Justice Involved | Hawai’i plans to support their Clubhouses throughout the state by funding education initiatives, outreach, and trainings/workshops to better engage and support young adults with severe mental illness. Clubhouses are voluntary, member-driven psychosocial rehabilitation programs that help prevent recidivism and assist with mental health stability through peer support, mentorship, community building, recreational activities, and supported employment opportunities. This funding will allow various Clubhouses to hire peers to engage with young adults with severe mental illness who are leaving court or jail. Jail Diversion staff will also be able to directly work with the Clubhouse to arrange enrollment in Clubhouse services and meet-ups with Jail Diversion participants as they are released from jail. |
Iowa | 3. Youth Suicide Prevention | Iowa will expand on their Youth Led Suicide Prevention and Crisis Initiative, which allowed the state to collect survey results on access to crisis services and complete a landscape analysis of the state’s crisis system. They intend to improve crisis care and suicide prevention for youth by engaging various youth-lead groups to inform suicide prevention activities through crisis care messaging, programming, and policies. This information will be used to create Iowa’s Youth Suicide Prevention and Crisis Plan, which will assist in determining the target audience, raising awareness, and providing suicide prevention training to youth and youth-serving entities. |
Iowa | 5. Non-clinical | Iowa will use their FY24 TTI project to inform this year’s plan to standardize training across crisis services. Experts will help in developing the Iowa Behavioral Health Crisis Service Training Curriculum for a variety of crisis staff and peer support specialists, with trainings focused on mental illness, substance use, and utilizing mobile crisis response without law enforcement. This initiative will also focus on expansion of the usage of peer support specialists and recovery coaches by developing a specific crisis training curriculum for peer support specialists/recovery coaches. |
| Indiana | 4. Workforce wellness | Indiana plans to provide support to the 988 Lifeline workforce by identifying barriers to, and placing focus on, the needs and mental wellness of Lifeline specialists. The TTI funds will assist in supporting the state to develop and implement methods of supplying specialists with needed support to ensure workforce resilience and prevent burnout. They plan to do this by conducting surveys to identify resources, needs, and barriers to accessing aid for Contact Centers across Indiana. In doing so, they plan to establish a committee to collaborate with contact centers and state administration staff, utilize evidence-based methods of preventing mental health crisis and burnout, and develop recommendations for crisis specialists. |
| Kansas | 5. Non-clinical [2] | Kansas plans to increase the capacity and effectiveness of peer workers by expanding infrastructure. This will be done by further developing their Peer Specialist Certification as a Family Peer Specialist Certification and implementing train-the-trainer programs for supervisors. Training may include Applied Suicide Intervention Skills Training (ASIST), Question Persuade Refer (QPR), and Project Extension for Community Healthcare Outcomes (ECHO). |
| Kentucky | 1. Justice involved | Kentucky plans to work with their Community Mental Health Centers (CMHCs), their Correctional Psychiatric Center (KCPC), and local law enforcement agencies to develop the Kentucky Forensic Assertive Community Treatment (KY FACT) implementation initiative to explore early implementation of a statewide FACT team. When discharged from KCPC, the state’s sole forensic psychiatric hospital, patients often engage with CMHCs for ACT services. KYFACT will leverage KCPC to incorporate FACT competencies into hospital-based treatment modules for person-centered discharge and re-entry planning. |
| Kentucky | 6. Children with high acuity | Kentucky plans to increase access and availability of youth peer support services to youth in crisis and increase the competency of Youth Peer Support Specialists serving this population. The state specifically is focusing on those experiencing serious emotional disturbance (SED) who are at risk of high-level placements. To achieve these goals, Kentucky plans to engage Youth Peer Support Specialists, design an outreach and engagement program for Youth Peer Support Specialists, and develop a curriculum for building out their Youth Peer Support Specialist groups across the state. |
| Louisiana | 3. Youth Suicide Prevention | Louisiana plans to implement the Youth Wellness Project, a comprehensive initiative aimed at reducing suicidal behaviors and deaths among youth populations in the state, specifically amongst high school students. They intend to use funding to partner with a local peer organization to expand student peer support programs throughout schools in multiple districts. This project will also support the identification and training of Suicide Prevention Champions from various community organizations (faith-based, recreational, etc.). Louisiana plans to gather and analyze data regarding suicide in the youth community, which will inform the creation of educational materials, community trainings, and other ongoing efforts to reduce youth suicide rates in the state. |
| Louisiana | 2. Mapping | Louisiana plans to work with a consultant to build intra and inter-system bridges for coordinated crisis care in two pilot areas of the state. The consultant will facilitate meetings with local providers and communities to map the collaborative partnerships necessary to address their local crisis needs, and to further develop processes to support collaboration, crisis services program expansion, and sustainability. The project will result in a community coalition plan and toolkit for supporting and sustaining community crisis services. |
| Massachusetts | 2. Mapping | Massachusetts seeks to conduct a systematic mapping of their mobile crisis intervention (MCI) to identify gaps, resources, and opportunities to increase the effectiveness of their MCI services for Deaf and Hard of Hearing individuals. Expanding the work of their FY24 TTI, Massachusetts will conduct an in-depth needs assessment of MCI services across the Commonwealth, identify barriers and gaps in current crisis care pathways for Deaf people, recognize existing strengths and facilitators of Deaf people’s crisis care, and develop a critical roadmap that identifies areas for future intervention and implementation. |
| Massachusetts | 5. Non-clinical | Massachusetts will train Spanish-speaking community members to deliver Mental Health First Aid (MHFA) to Spanish speaking youth, their families, and other community stakeholders. To do this, they will develop an outreach plan to identify Spanish-speaking, non-clinical crisis workforce and community members in Massachusetts who would participate in this training. They aim to provide MHFA training at no cost to community groups in these identified communities in both English and Spanish and to develop resources for mental health training and support among Spanish-speaking communities. |
| Maryland | 5. Non-clinical | Maryland plans to use the TTI funds to procure a vendor to expand and enhance their Mobile Response and Stabilization Services (MRSS) for children, youth, and families. The vendor will assist with developing a statewide strategy for implementing and financing MRSS and deliver statewide training and technical assistance for providers, by build local capacity and support sustainability with certified Advanced Practitioner MRSS Coaches. They will also assist in the training staff in the MRSS model to ensure they can effectively serve children and youth. |
| Mississippi | 1. Justice Involved | Mississippi plans to implement a Certified Peer Support Specialist/re-entry coordination program within state prisons that house women, with a focus on mothers struggling with serious mental illness (SMI). This initiative will provide essential resources and peer support to women as they transition from correctional settings to the community. The state will also partner with their local National Alliance on Mental Illness (NAMI) chapter to provide support groups to these women. In addition, Mississippi will develop a mental health resource guide for individuals with SMI re-entering communities (to be distributed to all Mississippi prisons, regardless of gender). |
| Mississippi | 3. Youth Suicide Prevention | Mississippi intends to build on the work of their 2024 SAMHSA Policy Academy to raise awareness of the rates of suicide among youth in rural counties and provide postvention support services to families and schools statewide. Mississippi plans to partner with organizations like Shatter the Silence: Suicide—The Secret You Shouldn’t Keep (STS), National Alliance for Mental Illness’ (NAMI) Open Up Mississippi, and the Pablo Foundation, to conduct education on suicide awareness and prevention, and engage in youth leadership training. |
| Mississippi | 5. Non-clinical | Mississippi aims to equip young people with the tools necessary to identify and mitigate a mental health crisis until an adult can be contacted to provide intervention. This initiative will facilitate empirically based mental health trainings for youth/young adults and certifications through collaboration with NAMI MS and Open Up MS: Youth Mental Health First Aid (YMFA), Applied Suicide Intervention Skills Training (ASIST), and Question, Persuade, Refer (QPR). |
| Montana | 1. Justice involved | Montana plans to improve community-based services approaches for justice involved individuals in the state with serious mental illness (SMI) or serious emotional disturbance (SED) in the state. Montana plans to do this by attending the 2025 Sequential Intercept Model Mapping Summit that is hosted by SAMSHA’s GAINS center, initiating communication with agency partners, enhance relationships across systems and agencies, and create a needs assessment and resource inventory. The overall goal will be to improve community-based service approaches for justice involved individuals with SMI or SED by creating connections and resource-sharing mechanisms. |
North Carolina | 3. Youth Suicide Prevention | North Carolina plans to use TTI funds to strengthen their youth suicide prevention strategies and enhance access to mental health and crisis care resources as an extension of their first ever Youth Suicide Prevention Action Plan. As a part of this project, NC will engage youth with lived experience and subject matter experts to establish a Youth Advisory Board and Community of Practice and Education Team, organize a statewide Youth Suicide Prevention training, and implement suicide prevention training for non-clinical providers, including community health workers and peers. |
| New Jersey | 6. Children with High Acuity | New Jersey will develop an Intellectual and Developmental Disabilities (IDD)-informed designation for inpatient units to provide staff with standardized resources and supports. Through this, a training and toolkit will be developed to support units in enhancing their ability to treat youth with IDD and acute behavioral challenges, which will then be used to assess the utility of the “IDD Friendly” designation. |
| New Jersey | 5. Non-clinical | New Jersey will build upon their FY24 TTI to develop a manual and curricula to train peer workers, administrators, and other non-clinical staff who are supervising peer workers in new and pre-existing crisis services. They aim to build a peer focused career ladder and in turn support job retention and help peers maintain recovery. |
| New Jersey | 4. Workforce wellness | New Jersey aims to enhance workforce wellness and resilience while preventing burnout by establishing a 988 crisis workforce learning collaborative. The learning community will be a complement of lessons designed to supplement crisis workforce foundational training, mitigating feelings of inefficacy, with work-performance related topics like trauma-informed care, active listening, and de-escalation. This project will build upon New Jersey’s FY24 TTI by expanding their already established Crisis Service Community of Practice (CSCoP) and will include the creation of a new Advisory Coalition and contracting with providers and subject matter experts on the learning collaboratives. |
| Nevada | 3. Youth Suicide Prevention | Nevada plants to use the TTI to support their Garrett Lee Smith (GLS) Youth Suicide Prevention grant’s efforts. The state’s Office of Suicide Prevention (OSP) will collaborate with Rural Clinics to implement project STAY in sports and youth associations throughout four rural communities. Project STAY (Say something, Take action, Ask about suicide, and You Belong Here) is a program providing suicide prevention and mental health training to youth sports coaches and clubs. |
| New York | 3. Youth Suicide Prevention | New York plans to partner with the Indigenous Unkechaug Nation to create a community-based model that addresses trauma that can lead to behavioral health challenges such as substance abuse, self-harm, and suicide. This model (survey) will include the full community in its design and implementation, to help develop the most appropriate intervention techniques. |
| Ohio | 3. Youth Suicide Prevention | Ohio plans to support and expand the efforts of their Youth and Young Adult Suicide Prevention Initiative, with a focus on engaging people with lived experience. Several state and local organizations are members of young adults and youth collaborations, all of whom will be engaged in this initiative to create learning opportunities for youth-serving community leaders, promote suicide prevention trainings for faith leaders, develop a resource toolkit for organizations, promote awareness campaigns, and empower youth to engage in youth-led programs using the Strategic Prevention Framework. The goal is to develop appropriate and trauma informed community-based services. |
| Oklahoma | 3. Youth Suicide Prevention | Oklahoma plans to enhance their strategic engagement and collaboration with its youth population, with a focus on programs that directly serve youth. Youth Coaches (adults who are in a consistent leadership role in the lives of youth) will be trained in data-driven programs such as Youth Mental Health First Aid and Talk Saves Lives. Youth Coaches will also be educated about youth suicide risk and protective factors, Oklahoma’s 988 services, and local Youth Mobile Crisis Response systems. |
| Oregon | 3. Youth Suicide Prevention | Oregon will support school implementation of Adi’s Act legislation requiring school districts to have a plan for suicide prevention, intervention, and postvention. Building on their FY24 TTI that supported the expansion of the state’s Big River Suicide Prevention programming, this phase of the TTI will be used to invest in Oregon’s Big River implementation capacity in school districts that need basic, annual suicide prevention training. This phase of the award will also support the implementation of suicide prevention training for staff, coaches, and community members. |
| The Republic of Palau | 5. Non-clinical | The Republic of Palau seeks to support individuals in the behavioral health workforce who are seeking certification in the Behavioral Health Aide (BHA) program and Pacific Mental Health 101 (MH101). Palau will formalize training programs, certification processes, monitoring systems, and an official network for the BHA certification program. The jurisdiction will implement a train-the-trainer model for MH101. Palau will also work with the Pacific Behavioral Health Collaborating Council (PBHCC) and Western Interstate Commission for Higher Education (WICHE) to expand the BHA to other Pacific Jurisdictions. |
South Carolina | 6. Children with High Acuity | South Carolina plans to use TTI funds to build the “Second Chances” program that will develop opportunities to expand youth peer support programs for teens and young adults, as well as assist young people re-entering the community. The goal of this project is to build the infrastructure for sustainable, statewide network of peer supporters who have lived experience, provide restorative youth peer support services to improve the processes of community re-entry, and to provide crisis prevention and transition planning services to improve the processes of community re-entry from a justice facility and/or a psychiatric services facility. |
| South Dakota | 6. Children with High Acuity | South Dakota will implement recommendations from their FY24 TTI landscape analysis to strengthen existing in-state, youth-serving facilities to meet identified gaps in service delivery. The goal is to increase South Dakota’s capacity to serve youth experiencing behavioral health crises and to service higher acuity youth in the right environment to address their behavioral health needs. TTI funds will support training and other educational opportunities for staff to support youth with high acuity needs, and workforce recruitment activities. |
| United States Virgin Islands | 3. Youth Suicide Prevention | The United States Virgin Islands will work to implement suicide prevention peer-lead curriculum, focusing on enhancing life skills, resilience, and connectedness. This will be done by implementing the Sources of Strengths curriculum, which focuses on protective factors through help-seeking behavior and connectedness within school-based classroom and community-based settings across the territory. |
| United States Virgin Islands | 5. Non-clinical | The United States Virgin Islands plans to establish comprehensive Crisis Intervention Team (CIT) through professional development and training of non-clinical staff within the school system and the broader community. The goal is to build a non-clinical crisis response workforce that can intervene during behavioral health emergencies, supporting school counselors, social workers, and community responders. The initiative will address the needs for a wide-ranging, community-based workforce to manage mental health and substance abuse crisis and reduce the burden on clinical professionals. |
| Vermont | 2. Mapping | Vermont is planning on expanding on their previous FY24 TTI by focusing on the formation and connection between of a crisis system that will integrate the state’s 988 Suicide and Crisis Lifeline with ten mobile crisis teams. Vermont will implement a technical solution called Behavioral Health Link to enable coordinated care between 988/crisis lines and mobile crisis teams which include the support of peer specialists and people with lived experience. The Behavioral Health Link aims to improve communication, ensure rapid response and dispatch, and provide GPS location tracking for mobile crisis teams to improve access to care for rural communities and services. The goal is to amplify the voices of peer supporters and empower them to address any areas for improvement in the support of their work and expand the peer workforce to integrate peer support into the fabric of their mental health system. |
| Utah | 1. Justice involved | Utah plans to develop a partnership between forensic peer support and employment support services for individuals with serious mental illness (SMI) leaving correctional settings. This pilot will place forensic peer support specialists (F-CPSS) with Individual Placement and Support (IPS) supported employment (SE) teams to serve as liaisons and engage justice-involved individuals with SMI in employment services. F-CPSS/IPS liaisons will develop relationships with reentry staff at their local county jail/Utah State Detention Centers and will meet with incarcerated individuals with SMI who are within 90 days of expected release date and have expressed interest in employment. |
| Washington | 2. Mapping | Having developed a 911-988 warm hand-off protocol and training plan for 911 telecommunicators in their FY24 TTI, Washington plans to create a toolkit to help assist public safety answering points (PSAPs) and their regional partners adapt the 911-988 warm hand-off protocols to their jurisdictions. The toolkit will provide four distinct sections with examples of and guidance on how to achieve a regionally tailored protocol. Washington also plans to provide technical assistance on developing and implementing the warm-hand-off protocol. |
| Wisconsin | 6. Children with High Acuity | Wisconsin plans to support children and youth at risk of out-of-home placement by issuing funding to counties and community-based agencies to implement the Family Centered Treatment (FCT) model. Each of the above groups will identify clinicians to complete the FCT certification, pilot the FCT model, and develop policies within their existing behavioral health system to allow appropriate services for families. Implementation of this project will allow for prevention, linkages, and follow-up services for crisis care while aligning with SAMHSA’s National Guidelines for Child and Youth Behavioral Health Crisis by keeping youth in their homes and keeping families intact with the implementation of the most effective, least restrictive services in the youth’s home and community. |
West Virginia | 4. Workforce wellness | West Virginia will build upon their FY24 TTI award to enhance and support its 988 and crisis service workforce. They plan to present their behavioral health workforce data brief and proposed plan to key stakeholders, finalize an action plan based on the data brief, implement a pilot intervention project, and create a manual for onboarding strategies and best practices for wellbeing and workplace environment. West Virginia also aims to offer intensive TA to certified community behavioral health clinics (CCBHCs) that do not have their National Health Service Corps site designation. |