PROJECT SUMMARY/ABSTRACT: OVERALL The Healing Lodge of the Seven Nations (HL) is a Native American youth residential addiction treatment center. Youth come to HL from tribal communities including, but not limited to, the Coeur d’Alene Tribe, the Kootenai Tribe, the Nez Perce Tribe, the Confederated Tribes of the Colville Reservation, the Kalispel Tribe of Indians, the Spokane Tribe of Indians, and the Confederated Tribes of the Umatilla Reservation. Recognizing the lack of programmatic research regarding best practices for supporting adolescents’ recovery within tribal nations, HL has developed a research partnership with the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital. This partnership is the Center for Indigenous Research, Collaboration, Learning, and Excellence (CIRCLE). As part of CIRCLE’s NARCH VIII program, Promoting Cultures of Recovery in Tribal Communities, we worked with and learned from these seven tribal nations about how communities seek to support their youth in recovery from substance use disorders. Accordingly, CIRCLE’s NARCH X program, Building Cultures of Recovery in Tribal Communities, was a logical extension of this work. We used a Tribal Participatory Program Development approach to build a mental health first response system grounded in indigenous values, strengths, and needs called, xaʔtus (pronounced hah-toos; i.e., First Face) for Mental Health. Now, CIRCLE’s proposed NARCH XII program, Assessing Cultures of Recovery in Tribal Communities, seeks support for an Administration Core, Research Core, Capacity Building Core, and two Pilot Projects that will support advanced development and insight into xaʔtus for Mental Health, and unique understandings of tribal youth in recovery. More specifically, in the Research Core, we will complete community surveys and a large multi-wave randomized waitlist assessment of xaʔtus for Mental Health. The Capacity Building Core will use project-based educational experiences to help AI/AN students gain research experience and HL develop its own research and training unit, while also providing xaʔtus for Mental Health training and evaluation at HL. The Pilot Projects will use survey research methods to obtain essential information from tribal youth and adults about ideal intervention points for youth in recovery and perceived barriers to using xaʔtus for Mental Health. In addition to the many scientific knowledge gains of the research studies, the proposed set of activities will have an immediate public health impact, through the training of hundreds of tribal community members in mental health knowledge and situational awareness.

PROJECT NARRATIVE: OVERALL With proper training, people can stabilize mental health crisis situations, such as youth in recovery risking relapse, until professional help is available. However, tribal communities might require culturally-appropriate approaches to be most successful, which led to the development of a new mental health support training system for tribal communities, xaʔtus for Mental Health. To ensure that xaʔtus for Mental Health is an effective evidence- based public health intervention system, the proposed set of studies and capacity building activities will rigorously evaluate the program, further advance its development, and ensure its widespread use among tribal communities.