Project ACTIVATE (Advancing Coordinated and Timely InterVentions, Awareness, Training, and Education)
- Need: To improve students' access to behavioral health services in rural North Carolina.
- Intervention: North Carolina Project ACTIVATE provides three tiers of behavioral health supports in the school setting.
- Results: The six pilot sites (Cohorts 1 and 2) have created or revised 64 mental health policies, and 33,074 school-based and related employees have received training in different topics and protocols.
The North Carolina Department of Public Instruction and
the North Carolina Department of Health and Human
Project ACTIVATE (Advancing Coordinated and Timely
InterVentions, Awareness, Training, and Education) to
reduce disciplinary events, dropout rates, suicide rates,
and substance use.
Project ACTIVATE promotes innovative service delivery
based on the recommendations of the NC School Mental
Health Initiative for behavioral health services,
including continuum of services/supports (as opposed to
only offering support after a crisis), strategies to
foster sustainability, and engagement of all
Project ACTIVATE works to provide mental health services
and improve existing services in the school setting. The
six pilot sites are the following rural school districts:
- Cohort 1
- Beaufort County School District
- Cleveland County Schools
- Rockingham County Schools
- Cohort 2
- Jackson County Public Schools
- Nash County Public Schools
- Sampson County Schools
This project is funded by a
SAMHSA Project AWARE State Education Agency Grant.
North Carolina was one of 24 states, territories, or
tribal organizations selected for the 2018-2023 grant.
North Carolina is currently running two concurrent
grants, as it was also selected as one of 17 states or
tribal organizations for the 2021-2026 grant. This
funding allows each district to hire one full-time
Project ACTIVATE Director and one full-time Professional
Learning Coordinator/Evaluation and Data Manager.
Project ACTIVATE focuses on promotion of mental wellness,
prevention of mental health problems, and interventions
to reduce the effects of a mental illness and restore
mental health through:
- Early identification and referral systems
- Prevention and early intervention programs
- Memorandums of Agreement (MOAs) between school
districts and local mental health agencies to provide
- New policies and improved infrastructure to sustain
the program after the grant period
- Connections with existing state and local programs
- Outreach and awareness campaigns
to educate students and their families about mental
For students, Project ACTIVATE includes the following
tiers of services:
- Tier 1 (Core), for all students:
- Social-emotional learning
- Bullying prevention programs
- Schoolwide mindfulness education
- Mental health screening
- Prevention and wellness promotion
- Tier 2 (Supplemental), for students needing
- Targeted social skill
- Group counseling and support groups
- Coordinated referral process and progress
- Tier 3 (Intensive), for students needing intensive
mental health supports:
- Individual social skill
- Crisis counseling
- Wraparound services
- Individual support teams and plans
To access videos discussing specific programs and
projects as well as Year End Reports, visit the Related
Content section of the
Project ACTIVATE website.
In the first four years of the grant, Project ACTIVATE
sites have revised and/or created 64 school mental health
policies in areas including crisis protocol, local
suicide ideation response and assessment protocol, and
therapeutic support and intervention classroom policies.
In addition, 33,074 school-based and related workforce
have been trained in topics including
Youth Mental Health First Aid, Question. Persuade.
Refer., suicide risk protocol, Say
Something Anonymous Reporting, crisis intervention,
adverse childhood experiences (ACEs), system of care
principles, Resiliency Room protocol, Calming Corner
protocol, and trauma-informed care.
Sixty-four MOAs have been entered to provide
on-campus/outpatient therapy to students referred by
school counselors and behavioral liaisons and to provide
day treatment programming.
Project ACTIVATE was named a
Promising Practice by the Association of Maternal &
Child Health Programs.
The Project ACTIVATE staff is building an infrastructure
that will sustain the project after the grant period has
ended. Each pilot site has set up teams that include both
grant-funded and non-grant-funded staff in order to help
with cross-training as well as selection and
implementation of the chosen evidence-based practices. By
training and including non-grant-funded staff, NC Project
ACTIVATE is ensuring that there will be staff in place to
continue with training and delivery of the chosen
practices and interventions after funding has ended.
Strategies to promote replication across the state
- Utilize existing university-school partners to
replicate sustainable practices
- Create incentives for MOAs between schools, community
providers, and payers
- Build mental health and
substance use awareness education into professional
Other advice for program success:
- Build district infrastructure and capacity to ensure
that the supports, services, and alignment of school
initiatives are taking place to support the behavioral
health, substance use, and overall social-emotional
learning for all students.
- Establish strong relationships and leverage community
partnerships before initiating implementation. These
relationships will help carry the program forward and
will lead to sustainability once funding has ended.
- Take time with local MOAs. Since grant funds are
limited in amount and time, the key to program
sustainability and ensuring maximum impact is to develop
strong and clear MOAs with local agencies and groups.
Often, local agencies are looking for partners in this
work, and identifying these agencies and engaging them
early will help with expansion and reaching the targeted
- Embed the work within other state initiatives. North
Carolina has embedded the ACTIVATE grant into the state
Multi-Tiered System of Supports (MTSS) initiative,
allowing for the continuation of evaluation.
Heidi E. Austin, EdD, MCHES®, CFLE, Project ACTIVATE Director
Office of Exceptional Children, NC Department of Public Instruction
Children and youth
December 3, 2019
Date updated or reviewed
February 2, 2023
Suggested citation: Rural Health Information Hub,
Project ACTIVATE (Advancing Coordinated and Timely InterVentions, Awareness, Training, and Education) [online]. Rural Health Information Hub. Available at:
[Accessed 29 November 2023]
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.