Mental Health Services Act

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Mental Health Services Act

Prevention and Early InterventionSub Committee MeetingJuly 30, 2008

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Sharon Browning

Advocate – Planner Roles

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Advocate

ADVOCATES call attention to the needs of groups they represent and support targeting services to these groups.

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Advocate

Advocates are important to the process because they: Help ensure that attention is brought to

the needs of specific populations Question assumptions made by other

members (i.e., other advocates) Help ensure consideration of community

factors Help ensure appropriate strategies and

interventions for particular populations

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Planner

PLANNERS consider the needs of all target populations and subpopulations in Orange County, and prioritize needs and allocate resources to services based on sound data and objective criteria.

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Planner

Each person, as a planner is, responsible for:Managing conflict of interestTaking responsibility for an equitable

and sound process

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Advocate and Planner

Managing the personal struggle between advocate and planner is essential so priorities are based on demonstrated relative need, and not the power, influence, or advocacy skills of any single member.

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Advocate and Planner

The advocate in each member informs the process

The planner in each member makes the decision

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Sharon Browning

Requested Materials

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Kimari Phillips

PEI Community Survey Updates

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Survey Dissemination

Mailed over 3,000 surveys to OC organizations and community members

Handed out over 5,000 surveys throughout OC at meetings, clinics, community based organizations, etc.

E-mailed announcements regarding the online surveys (including a hyperlink for easy access)

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1,564 Community Surveys Received

Survey Type81.5% Print (n = 1,275)18.5% Online (n = 289)

Survey Language84.7% English (n = 1,325)11.7% Spanish (n = 183)

3.6% Vietnamese (n = 56)

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Information Gathered from OC Community (Residents/MH Consumers)

Demographic info (age, gender, race/ethnicity, annual household income, home ZIP code)

Satisfaction with amount & accessibility of PEI services in OC

Opinions regarding: Populations in greatest need of PEI in OC Priority PEI issues in OC communities Most effective settings for identifying OC residents

with a need for PEI services Best approaches for addressing PEI in OC

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1.4% 0.9%

50.2%

12.2%

26.9%

3.5%5.0%

0%

10%

20%

30%

40%

50%

60%

White/C

auca

sian

Hispan

ic/Lati

noAsia

n

Black/A

frica

n Amer

ican

Amer India

n/Nati

ve Amer

Pacific

Islan

der

OTHER / MULTIPLE

Race/Ethnicity of Community Respondents (n=1,514)

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Community Respondents’

Average Age (n=1,476)

43.5 years (15-91 yrs)

Gender (n=1,531)

66.8% Female33.1% Male

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Average Annual Household Income (n=1,429)

38.0%

32.0%

17.1%

12.9%

< $25,000 $25,000-$74,999 $75,000-$124,999 $125,000+

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There are enough existing PEI resources and services(n = 1,512 community/public responses, average = 2.25 on a 5-point scale, where 1=Strongly Disagree, 5=Strongly Agree)

17.8%

11.8%

23.3%

7.6%

39.5%

0%

10%

20%

30%

40%

50%

StronglyDisagree

SomewhatDisagree

Neither AgreeNor Disagree

SomewhatAgree

StronglyAgree

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There is enough information available about how to find and access existing PEI resources and services.(n = 1,527 community/public responses, average = 2.29 on a 5-point scale, where 1=Strongly Disagree, 5=Strongly Agree)

15.4%

6.4%

34.4%29.5%

14.3%

0%

10%

20%

30%

40%

50%

StronglyDisagree

SomewhatDisagree

Neither AgreeNor Disagree

SomewhatAgree

StronglyAgree

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Community Opinions Regarding Priority Populations for PEI in OC(n > 1,500, averages on a 5-point scale, where 1=Very Low Need, 5=Very High Need)

High to Very High Need for PEI

4.4 4.2 4.1 4.1

0

1

2

3

4

5

Risk for Suicide Serious Signs of MI Facing Trauma Youth in StressedFamilies

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Community Opinions Regarding Priority Populations for PEI in OC (n > 1,500, averages on a 5-point scale, where 1=Very Low Need, 5=Very High Need)

Moderate to High Need for PEI

3.98 3.97 3.92 3.75

0

1

2

3

4

5

Family History ofMI &/or SA

Underserved byMH Svcs

Risk of SchoolFailure

Risk of Arrest/Jail

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Community Opinions Regarding Priority Goals/Needs for PEI in OCREDUCTION OF…

34.1%26.2% 25.3%

33.3%

42.6%

30.4%

0%

10%

20%

30%

40%

50%

Suicide

Trauma &

Sufferin

g

Homeless

ness

Violence

School F

ailure/

Dropout

Undetecte

d MH Probs

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Community Opinions Regarding Priority Goals/Needs for PEI in OC REDUCTION OF…

20.3% 17.2%12.9%

5.9%4.5%

8.5%

0%

10%

20%

30%

40%

50%

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Community Opinions Regarding Effective Settings for Identifying OC Residents Needing PEI Services

30.6%

44.1%36.6%

34.3%26.0%

48.7%

0%

10%

20%

30%

40%

50%

60%

Schools DoctorOffices &

Clinics

SocialServices

Healthcare:Hospitals,

SNF

CommunityBased Orgs

LawEnforcement

& Legal

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Community Opinions Regarding Effective Settings for Identifying OC Residents Needing PEI Services

12.2%

1.5%

7.5% 6.6% 6.2%

0%

10%

20%

30%

40%

50%

60%

Un/employmentCtrs

In-home Faith-based Orgs Workplaces OTHER:Neighborhood,

Media

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Community Opinions RegardingBest Strategies for Addressing PEI in OC

39.3% 38.2%

9.1%

46.5% 45.7%

3.6%0%

10%

20%

30%

40%

50%

60%

Early S

creen

ing, Dx,

Tx

Training

for P

rofes

sionals

I & R

@ D

iverse

Settings

Parent

Educ / S

upport Svc

s

Work-bas

ed P

rogr

ams

OTHER: Colla

b, Housin

g, etc

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For more information regarding methods used for data collection, preliminary analyses, or this summary of results …

Contact:Kimari Phillips, MA, CHESResearch Analyst, OC Health Care AgencyOffice of Quality Mgmt – Planning & Research

[email protected]

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Alan Albright / Kate Pavich

PEI Roundtable

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Kate Pavich

PEI Categories and Definitions

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Outreach and Engagement Services

Projects/programs that actively identify members of the PEI priority populations who are at risk of emotional, behavioral or mental health conditions and provide easy and immediate access, information and referral assistance to culturally competent early intervention services as needed.

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Prevention

Programs and services occurring prior to a diagnosis for a mental illness which are designed to reduce risk factors or stressors, build protective factors and skills, and increase support. Prevention projects/programs promote positive cognitive, social and emotional development and encourages a state of well-being that allows the individual to function well in the face of changing and sometimes challenging circumstances.

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Prevention (cont.)

Prevention projects/programs may be classified according to their target groups: Universal: target the general public or a

whole population group that has not been identified on the basis of individual risk

Selective: target individuals or a subgroup whose risk of developing mental illness is significantly higher than average.

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Early Intervention

Projects/programs directed toward individuals and families for whom a short-duration (usually less than one year), relatively low-intensity intervention is appropriate to measurably improve a mental health problem or concern very early in its manifestation, thereby avoiding the need for more extensive mental health treatment or services; or to prevent a mental health problem from getting worse.

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Screening and Assessment Services

Projects/programs that incorporate the use of voluntary mental health screening and assessment tools, brief structured interviews, and other activities designed to identify individuals who may be at risk of developing emotional, behavioral or mental health conditions.

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Crisis and Referral Services

Crisis response projects/programs encompass a wide range of culturally competent, population-specific strategies aimed at reducing suicidal behavior and its impact on family, friends, and communities. This spectrum includes warmlines/hotlines; integrated mobile crisis response teams; promotion and prevention strategies that offer community education campaigns, foster resiliency, increase appropriate help-seeking behaviors and enhance protective factors in individuals and communities; build the capacity of providers and systems to offer appropriate services including interventions to address mental health problems early and to reduce suicidal behaviors; and follow-up care services for those who have survived a suicide attempt and for family members and others who have suffered the loss of a loved one.

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Training Services

Training projects/programs targeting staff and volunteers working in schools and universities, primary care setting and emergency medical services, refugee and recent immigrant programs, law enforcement, teen programs, violence prevention programs, sexual assault crisis centers, homeless programs, disaster assistance/response programs, grief support programs, to better understand, identify and address potential mental health needs of PEI priority populations and access/utilize local community mental health resources.

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Training Services

Training projects/programs may also target the general community and/or specific at-risk populations in an effort to increase the understanding and awareness of factors that contribute to the development of mental health problems, reduce the potential for stigma and discrimination against individuals with mental illness, and increase access to and awareness of local mental health resources.

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School-Based Services

Projects/programs that provide outreach and education to children, youth, families, and school staff to increase awareness of mental health issues and reduce stigma and discrimination; build resiliency and increase protective factors in children and youth; foster a positive school climate; prevent suicide; expand early intervention services; develop school-wide approaches to prevent bullying and violence; provide professional development/training on mental health for those working with children and youth in schools; and support policies and practices that demonstrate that students’ social/emotional health and competencies are a primary part of the school’s mission.

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Parent Education and Support Services

Projects/programs would specifically target mothers and fathers, as well as grandparents and others who have responsibility for caring for at-risk children and youth. These projects/programs would foster effective parenting skills and family communication, healthy identities and extended family values, child growth and development, and self-esteem.

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Parent Education and Support Services

Parenting support, education and skills training to parents or other adults who suffer from a mental illness and who are raising children should also be considered. Services may also include assisting parents in reducing the incidence of child abuse, substance abuse, juvenile delinquency, gang violence, learning disorders, behavior problems, and emotional disturbances.

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Alan Albright

Examples of PEI Projects

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Outreach and Engagement Services

Outreach efforts where consumers congregate (e.g., community centers, churches, Family Resource Centers, homeless shelters, etc.)

211 mental health resource line “Friendly Visitor” programs for seniors Mental health outreach to foster and probation youth Homeless shelter programs Care coordination/case management services

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Prevention Training on warning signs for suicide and how to intervene After school programs Nurse-Family partnerships Leadership and resiliency programs Peer counseling/mentoring Support groups for older adults who have lost a spouse Programs to reduce substance abuse, gang violence and

school failure Education for school-aged children and youth on mental

illnesses Mental health consultation to senior and child care centers Mental health resources for youth engaged in substance

use/abuse and children of substance-abusing parents

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Early Intervention Brief mental health interventions for at-risk individuals, families,

mothers and infants, etc. Cognitive-Behavioral Intervention for trauma victims Home-based intervention programs Mental health interventions for at-risk dependent children (SSA) Intervention programs for school attendance/adjustment

problems Mental health consultation with interventions in child care

environments Socialization programs with a mental health emphasis for home-

bound older adults with signs of depression Anger management programs “First Break” assessment and treatment programs Web-based program for transitional age youth

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Screening and Assessment Services

Preschool/early identification programsAdolescent mental health screeningsDepression, suicide and substance abuse

screening for older adultsDepression screening by primary care

physiciansScreening women for post partum depression

and targeting children of parents with depression for intervention

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Crisis and Referral Services

OC-based suicide hotlineCrisis warm linePTSD/substance abuse programsVeteran’s services

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Training Services

Mental health training for professionals (e.g., physicians, teachers, probation, etc.)

Peer mentoring trainingSenior peer counseling trainingFaith-based mental health trainingCommunity mental health

information/media programs

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School-Based Services

Positive Behavioral InterventionsSchool based mental health resourcesCurriculum on risk and protective

factorsParent-School collaboratives Programs for high risk children

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Parent Education and Support Services

Life skills trainingTeen parenting classes/support groupsFamily support servicesPositive parenting programs

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Kate Pavich

Workgroups Facilitator – Introductions

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Sharon Browning

Workgroup Decision Making Process

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