Project AWARE

Background

Project AWARE (Advancing Wellness and Resilience in Education) is a school-based mental health grant program administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the Department of Health and Human Services (HHS). Project AWARE is carried out through SAMHSA's general authorities in Title V of the Public Health Service Act (PHSA); the program is not explicitly authorized in statute. Project AWARE supports activities that promote youth and adolescent mental well-being in schools, identify school-aged youth needing mental health services, increase access to mental health treatment, and improve mental health awareness among teachers and school personnel.

Project AWARE originated as part of the Obama Administration's 2013 Now Is the Time initiative to reduce gun violence in response to the Sandy Hook Elementary School shooting. Project AWARE builds upon strategies from the preceding Safe Schools/Healthy Students initiative. These initiatives support community partnerships in school-based programming on violence and drug use prevention, safe school environments, early childhood social and emotional learning, and training and referrals to mental health services.

Project AWARE consists of several grants: (1) Project AWARE State Educational Agency (State or SEA) grants, (2) Resiliency in Communities After Stress and Trauma (ReCAST) grants, and (3) Mental Health First Aid (MHFA) grants (which have operated as a separate Mental Health Awareness Training grant program as of 2018).

Project AWARE State Grants

Project AWARE State Grants consist of competitive grants for school-based mental health programs and services. The State grants—the largest component of Project AWARE—aim to build SEA capacity, in partnership with state mental health agencies, to (1) increase mental health awareness among school-aged youth, (2) provide training for school personnel to identify mental health issues, and (3) connect school-aged youth and families with needed services.

Grantees are required to develop collaborative partnerships with local educational agencies (LEAs), the state mental health agency, and local community behavioral health service providers (including minority-serving community-based organizations, health and mental health centers, and/or Certified Community Behavioral Health Clinics).

Project AWARE supports the use of a three-tiered public health model for school-based mental health activities (Figure 1). This model includes universal mental health promotion for all students, early intervention for students at high risk for problems, and treatment for students with more intensive needs. More specifically, in Tier 1 of this model (primary prevention and mental health promotion), schools implement teacher trainings and/or broad school climate or classroom interventions that promote mental well-being for all students. In Tier 2 (secondary prevention and brief intervention services), school-based screenings and interventions target students with increased risk factors or moderate behavioral health needs. In Tier 3 (tertiary prevention and behavioral health treatment), students in crises or with greater needs can access more intensive services at the school or through collaboration with community partners.

Figure 1. Public Health Model of School-Based Mental Health Activities

Source: Substance Abuse and Mental Health Services Administration (SAMHSA). Notes: This public health approach for school-based mental health is referred to as the multi-tiered system of supports (MTSS) model.

This public health approach for behavioral health adopted by schools is referred to as the multi-tiered system of supports (MTSS) model. The MTSS approach is designed to provide a continuum of care that positively affects an entire school and creates a supportive school culture while offering specific interventions to meet the individual needs of each student. A comprehensive school-based mental health MTSS includes activities implemented across the three tiers to meet the various social, emotional, and behavioral needs of all students.

Project AWARE grantees have flexibility to implement a spectrum of programming within the public health MTSS model. Allowable Project AWARE activities can include, among others, training and self-care for school personnel, trauma-informed counseling, support services for LGBTQI+ youth, and developmentally appropriate training on prosocial communication, heathy relationships, and related subjects. Grantees may also implement evidence-based suicide awareness and prevention training programs.

From FY2014 to FY2021, eligibility for Project AWARE State grants included SEAs and Tribal Educational Agencies. In FY2022, eligibility expanded to include political subdivisions of states and other nonprofit entities. The President's FY2024 budget request articulated an aim to expand Project AWARE state grant eligibility to include college students and adults, as well as nontraditional educational settings.

ReCAST Grants

The ReCAST (Resiliency in Communities After Stress and Trauma) program consists of competitive grants for communities that have recently faced civil unrest, violence, or collective trauma. The program aims to foster collaboration of local community resources to improve behavioral health, empower community residents, and reduce trauma. ReCAST grants assists high-risk youth and families by promoting resilience through evidence-based violence prevention and youth engagement programs, as well as through linkages to community-based trauma-informed behavioral health services. ReCAST grantees engage a coalition of community stakeholders to determine drivers of local civil unrest, trauma, and violence. With these community partners, grantees (1) implement trauma-informed behavioral health services, evidence-based violence prevention initiatives, and community engagement programs, and (2) provide culturally specific and developmentally appropriate resilience-building initiatives.

SAMHSA has provided ReCAST grants through Project AWARE since 2016. Eligibility expanded in FY2022 from local municipalities (partnered with community-based organizations) that faced recent civil unrest to also include states, political subdivisions of states, community-based organizations, and tribes or tribal organizations.

Mental Health First Aid

The Mental Health First Aid (MHFA) program provided training for youth-serving adults to recognize students' mental health needs, provide initial help in a mental health crisis, and connect students to appropriate care. MHFA grants support the training of teachers and school personnel to detect and respond to mental health crises and other unmet needs through Mental Health First Aid training. Mental Health First Aid is structured similarly to standard first aid training: an eight-hour course on how to identify, understand, and respond to the signs of a crisis, mental health condition, or substance use issue. Under the Now Is the Time initiative, Project AWARE grants for MHFA were provided to LEAs and nonprofit entities.

In 2016, the 21^st Century Cures Act (P.L. 114-255) created a new Mental Health Awareness Training (MHAT) authority in Title V of the PHSA (§520J; 42 U.S.C. §290bb-41), codifying the MHFA training grant component of Project AWARE. The new authority applies to a more general population (beyond schools) to include training for school-aged youth, college students, veterans, armed service personnel, first responders, and the general public. Since 2018, the MHAT grant program has operated independently from Project AWARE. However, the Project AWARE State and ReCAST grant programs support use of MHFA training.

Authorization and Funding

Since Project AWARE is carried out through SAMHSA's general authorities and is not explicitly authorized in statute, authorization for the program and congressional direction—in addition to funding—has come through annual Labor-HHS-ED appropriations laws and accompanying report language (Figure 2).

Figure 2. Project AWARE Funding Annual and Supplemental Appropriations, FY2014-FY2023

Source: CRS analysis of Labor-HHS-ED appropriations laws and supplemental appropriations laws. Notes: ARPA=American Rescue Plan Act (P.L. 117-2); BSCA=Bipartisan Safer Communities Act (P.L. 117-159); COVID=Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (Division M of P.L. 116-260); MHAT=Mental Health Awareness Training; MHFA=Mental Health First Aid. BSCA funding is to be distributed in equal amounts across FY2022-FY2025. Beginning in 2018, the MHAT grant program has operated independently of Project AWARE.

In FY2021, Project AWARE received an additional $50 million through COVID-19 supplemental appropriations (Division M of P.L. 116-260) and $30 million through the American Rescue Plan Act (ARPA; P.L. 117-2). Through the Bipartisan Safer Communities Act (BSCA; P.L. 117-159), Project AWARE received $240 million, including $28 million specifically for increasing student access to evidence-based trauma support services as authorized in Section 7134 of the SUPPORT for Patients and Communities Act (P.L. 115-271). Per statute, Project AWARE appropriations provided in the BSCA are to be distributed in equal amounts across FY2022-FY2025.

CRS intern Amelia M. Parizek contributed to this report.