HomeMy WebLinkAboutMINUTES - 06262012 - C.93RECOMMENDATION(S):
APPROVE and AUTHORIZE the Employment and Human Services Interim Director, or designee, to execute a
contract with STAND! For Families Free of Violence, a non-profit corporation, in an amount not to exceed $162,690
to provide shelter services for battered women and their children for the period July1, 2012 through June 30, 2013.
FISCAL IMPACT:
$162,690: 29% County General Fund; 71% Marriage License Fee
BACKGROUND:
This contract addresses the social needs of the County's population in that it provides a crisis call center number 24
hours per day/7 days a week, and provides at least 7000 emergency shelter bed days to a minimum of 100 women
and children in crisis situations. Contractor is a domestic violence shelter-based agency providing services to
domestic violence victims and their children in compliance with the requirements of California Welfare and
Institutions Code section 18294.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 06/26/2012 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I Supervisor
Candace Andersen, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Karen Mitchoff, District IV
Supervisor
Federal D. Glover, District V
Supervisor
Contact: Earl Maciel 3-1648
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board
of Supervisors on the date shown.
ATTESTED: June 26, 2012
David Twa, County Administrator and Clerk of the Board of Supervisors
By: Carrie Del Bonta, Deputy
cc:
C. 93
To:Board of Supervisors
From:Theresa Speiker, Interim Employment & Human Services Director
Date:June 26, 2012
Contra
Costa
County
Subject:Contract with STAND! For Families Free of Violence for Domestic Violence Shelters
CONSEQUENCE OF NEGATIVE ACTION:
Needy families will be unable to use this vital resource.
CHILDREN'S IMPACT STATEMENT:
This contract supports two of the community outcomes established in the Children's Report Card, 4) "Families
that are Safe, Stable and Nurturing" and 5) "Communities that are Safe and Provide a High Quality of Life for
Children and Families". Expected program outcomes include a safe environment where victims of abuse can
receive appropriate support and follow-up services.
ATTACHMENTS
MHSA 2012-13 Annual Plan FINAL
Fiscal Year 2012 – 2013
Mental Health Services Act
Plan Update
MENTAL HEALTH PLAN
2
Director’s Report
During this past year,
the Behavioral Health
Services Division was
created by combining
Mental Health, Alco-
hol and Other Drugs
and Homeless Ser-
vices into a single
system of care. With
increasing challenges
in serving complex populations with multiple
disorders, this integration is a response to the
growing desire to have improved client out-
comes through a systems approach that em-
phasizes “any door is the right door,” and that
provides enhanced coordination and collabo-
ration when caring for the “whole” individual.
Nowhere are health disparities more evident
than in the care of vulnerable populations.
We recognize that Contra Costa’s culturally
diverse individuals and families with complex
behavioral health needs are recognized as a
population with poorer outcomes and higher
costs in multiple clinical domains. In response
to these challenges, the Mental Health Ser-
vices Act served as a catalyst for the cre-
ation of a framework where members from
our community, working together to facilitate
change, established a culture of cooperation,
innovation and participation, leading towards
the further development of programs and ser-
vices that offer recovery and resiliency while
emphasizing prevention and early interven-
tion opportunities for engagement. As a re-
sult of these successes, and all that we have
learned thus far, we recognize the need to
enhance services for individuals and families
where addressing the complex behavioral
health needs are an expectation, not an ex-
ception as the major strategy for sustainable
transformation in Behavioral Health. There-
fore, we have agreed to challenge ourselves
to design the system to pay particular atten-
tion to individuals and families who need us
the most, and may have the most difficult time
accessing care within our system.
A new vision is emerging towards an accessi-
ble, integrated, comprehensive, and compas-
sionate system of care that will be designed
at every level to promote physical, emotional,
and social well-being. With change comes
opportunity! To take advantage of opportu-
nity, we need to embrace change and con-
tinue to find promise. With much appreciation
and respect for all community members who,
through their dedication and commitment to
best practices, and participation at any level
in the Mental Health Services Act process,
have laid the groundwork for the new vision
to emerge.
Cynthia Belon, L.C.S.W
3
MHSA
Acting Mental Health Director’s Report
The Mental Health
Services Act
(Proposition 63) is
now in its seventh
year. The Act has
supported expan-
sion of the commu-
nity mental health
system in Contra
Costa County, en-
hanced new and
continuing partner-
ships with community based organizations,
and supported inclusion of more consumer
and family voices in the planning and imple-
mentation of mental health programs. While
Contra Costa became a leader in promot-
ing wellness and recovery principles over 15
years ago, the Act has enabled us to further
build a service approach that recognizes the
importance of consumer strengths and appre-
ciates the central role consumers and family
members play in self-directing care.
The Mental Health Services Act (MHSA) has
created a number of significant accomplish-
ments in Contra Costa. These include:
• Full Service Partnerships which provide
intensive, in-community supports inclu-
sive of mental health services, vocational
and educational supports, and housing.
• Regional mental health teams to serve
older adults.
• A variety of health-mental health integra-
tion projects that promote whole health.
• Twenty-three Prevention and Early Inter-
vention programs that reach into under-
served communities, promoting wellness
in adults and increasing resiliency in
youth.
• A county -wide suicide prevention plan
and treatment interventions.
• Training and development of the mental
health work force.
• Innovative programs that encourage new
approaches and creativity.
• Hiring and training mental health consum-
ers and their family members to serve as
peer providers and to assist other fami-
lies navigate the mental health system.
• The introduction and expansion of ev-
idence-based practices that improve
treatment outcomes.
• Initiatives to decrease health disparities
in our culturally and linguistically diverse
communities.
The community planning process required
by MHSA has highlighted the importance of
transparency and community partnership in
developing and maintaining an effective spe-
cialty mental health system of care. It has
reinforced the importance of defining mean-
ingful treatment outcomes and program per-
formance measures as well as using appro-
priate data in making planning decisions.
It is with heartfelt gratitude we recognize the
hard work, commitment and diligence so
many community members, consumers, fam-
ily members, service providers, mental health
advocates and staff have demonstrated in
guiding the development of services and pro-
grams designed to provide appropriate and
effective resources to all we serve through
the annual planning and review processes.
Suzanne Tavano, PhD
Acting Mental Health Director
4
“Healthcare is a shared responsibility that is ground-
ed in our common humanity. In the bonds of our
family, we are created to be equal. We are guided
by divine will to treat each person with dignity and
to live together in an inclusive community. Affirm-
ing our commitment to the common good, we ac-
knowledge our enduring responsibility to care for
one another. As we recognize that society is whole
only when we care for the most vulnerable among
us, we are led to discern the human right to health-
care and wholeness…”
– Campaign for Better Healthcare, Illinois 2009
MHSA 2012-2013 Annual Update 1
– Campaign for Better Healthcare, Illinois 2009
Exhibit A
2
Winter Fruit
By Matthew Celestre
2
Table of Contents
MHSA 2012-2013 Annual Update 3
Table of Contents
Systems Transformation ..........................................................................................4
Community Supports and Services (CSS) .............................................................10
Peer and Family Delivered Services and Supports ................................................30
Prevention and Early Intervention (PEI) .................................................................38
Suicide Prevention..................................................................................................44
Workforce Education and Training (WET) ..............................................................46
CCMH Reducing Health Disparities (RHD) Workgroup..........................................51
Innovation ...............................................................................................................52
Inclusion Initiative ...................................................................................................59
Information and Technology (IT) ............................................................................63
Capital Facilities .....................................................................................................64
Barriers and Challenges .........................................................................................65
Stakeholder Input Opportunities .............................................................................70
2012-13 MHSA Budget...........................................................................................72
Acknowledgements ................................................................................................78
Appendix.................................................................................................................80
Table of Contents
4
Systems Transformation
The Mental Health Ser-
vice Act (MHSA), ad-
opted into law in January
2005, challenges com-
munities in California to
utilize MHSA resources
to facilitate the transfor-
mation of their mental
health systems. The
objective is to create a
system which is client and family member
driven, focuses on wellness and resiliency,
holds a vision in which recovery is possible,
and delivers culturally competent and linguis-
tically appropriate services. In order to create
an integrated care experience for the whole
person, services are planned in collaboration
with the community. MHSA services are fund-
ed along a continuum from Prevention and
Early Intervention programs aimed at identify-
ing emerging mental illness and preventing it
from becoming severe and disabling, through
supporting the Continuum of Care services
for children, transition age youth, adults and
older adults.
In Contra Costa County, systems transfor-
mation is an ongoing process. The County’s
first steps included funding of an Assessment
and Recovery Center, currently under devel-
opment, the addition of housing and housing
supports for those with mental illness, the ex-
pansion and development of Prevention and
Early Intervention services, the capital to fund
an electronic medical record system, new op-
portunities for education and training of the
mental health workforce, and an opportunity
to create and evaluate innovative approaches
to mental health service delivery. The values
adopted in MHSA have provided the frame-
work for this systems transformation through
community collaboration, stakeholder involve-
ment, reducing health disparities, consumer/
client and family member services, wellness,
recovery and resiliency, all with the aim to
transform the public mental health system.
4
MHSA 2012-2013 Annual Update 5
Community Collaboration
Community collaboration is the process
through which various persons, including
groups of individuals, families, persons with
lived mental health experience, representa-
tives of other public service organizations,
staff, providers and others who have an inter-
est in the public mental health system, work
together to create a mental health system
which best meets the needs of clients in Con-
tra Costa County. These persons are termed
stakeholders, as they have an interest in the
creation of services under MHSA. These
stakeholders are collaborators in designing a
shared vision of the system of care. The pro-
grams and services described within the An-
nual Plan have been reviewed and supported
by Contra Costa County MHSA stakehold-
ers. Additionally, the stakeholder process,
described in the “MHSA Annual Plan Devel-
opment and the Stakeholder Process” sec-
tion below, continues to guide and inform the
overall vision with an ongoing effort to em-
brace the principles embodied in MHSA.
In Contra Costa County, MHSA made several
notable community collaborations possible.
Examples include: the creation of a continu-
um of mental health services for older adults,
the development and expansion of wellness
and peer support programs, the development
of vocational support programs for those with
mental illness, the collaboration of housing
developers, service providers and county
agencies to build low income housing tied to
the provision of mental health and support-
ive services, support to homeless individuals
and families with co-occurring mental illness,
collaborations with law enforcement to pro-
vide Crisis Intervention Training (CIT) to local
law enforcement officers and prevention and
early intervention services within educational
settings.
Community collaborations and programming
involving traditionally underserved popula-
tions has been of particular focus over the
last year. For example, programs and servic-
es were developed for Lesbian, Gay, Bisex-
ual, Transgender and Questioning (LGBTQ)
youth and their families informed by the work
of Caitlin Ryan and the Family Acceptance
Project. Spearheaded by Rainbow Commu-
nity Center and other community-based orga-
nizations, a network of agencies throughout
Contra Costa County joined efforts to support
LGBTQ youth and their families to improve
the health outcomes of LGBTQ youth. Anoth-
er community collaboration effort under the
Prevention and Early Intervention program is
the creation of a suicide prevention commit-
tee. This committee is charged with creating a
countywide plan for suicide prevention. This
committee exemplifies community collabora-
tion, co-chaired by Behavioral Health and the
Contra Costa Crisis Center, a nationally certi-
fied crisis line provider, with representatives
from other local hospitals, community based
organizations and those with lived experi-
ence with suicide. Together the committee
believes their efforts will make a difference in
preventing suicide in Contra Costa County.
MHSA Annual Plan
Development and the
Stakeholder Process
There has been an ongoing stakeholder
process in Contra Costa County that began
with the establishment of the following work-
groups: Community Services & Supports
(CSS), Prevention & Early Intervention (PEI),
Workforce Education & Training (WET), and
Capital Facilities & Information Technology
(CF/IT). Information and input from the ini-
tial planning process formed the basis of the
initial three-year MHSA Plan. Building on the
Systems Transformation
MHSA 2012-2013 Annual Update6
MHSA
Contra Costa County
initial planning process, in February 2009, a
Consolidated Planning Advisory Workgroup
(CPAW) was formed to advise the Mental
Health Director on the continued transforma-
tion of the public mental health system. Care
was taken to ensure the knowledge and ex-
perience of those involved in the initial plan-
ning process would be preserved by inviting
representatives of the initial planning process
to participate in CPAW. CPAW continues to
review and provide input into the development
of the MHSA Annual Plan. In Fiscal Year
(FY) 2011-12, this included monthly program
presentations of the qualitative and quantita-
tive outcomes for all MHSA funded programs.
Refinements and revisions of programs, as
well as the development of new programs,
were reviewed throughout the year at month-
ly CPAW meetings. This included reviewing
the measures and outcomes of MHSA funded
services, reviewing proposals for redesign of
existing services, and planning for continued
development of needed services.
In preparing the Annual Plan for FY 2012-13,
the Research and Evaluation Unit provided
CPAW with the results of the annual Con-
sumer Satisfaction Survey and the Staff Prior-
ity Needs Assessment. In addition, staff and
stakeholders compiled and reviewed a list of
programs and services from the county’s orig-
inal stakeholder planning process identified
as needs that had not yet received funding.
This data formed the basis for the develop-
ment of a list of funding priorities for consider-
ation for future program development for FY
2012-13. Both members of CPAW and the
Mental Health Commission were invited to
participate in an input process for prioritizing
areas for growth used in the development of
the FY 2012-13 Annual MHSA Plan. It is an-
ticipated there will be a 20 percent increase in
MHSA funding in Fiscal Year 2012-13.
In accordance with Title 9 of the California
Code of Regulations you will find a complete
description of the stakeholder process in the
Stakeholder Input Opportunities section of
this plan.
Reducing Health Disparities
In a continuous effort to reduce health dispar-
ities, the Contra Costa County Mental Health
Plan (MHP) formed the Reducing Health Dis-
parities (RHD) Workgroup. The RHD Work-
group consists of Behavioral Health staff,
stakeholders, consumers and family mem-
bers - all representing various cultural and
ethnic backgrounds. The goal of the work
group is to create and implement strategies to
reduce racial and ethnic mental health dispar-
ities throughout the system of care. Through
increased engagement and partnership with
racial and ethnic communities, as well as
public entities, the MHP seeks to embrace
the richness of other cultures and seeks to
provide services which understand and uti-
lize the strength of culture in service delivery.
Culturally responsive programs and services
are viewed as a way to enhance the ability
of the whole system to produce the most ef-
fective outcomes and create cost effective
programs. MHSA has provided funding to
outreach to unserved and underserved ethnic
populations to assist in elimination of dispari-
ties in access to services. Reducing dispari-
ties in a culturally and linguistically appropri-
ate manner also applies to cultural groups not
defined by language or culture, such as the
LGBTQ community and isolated seniors. The
goal of RHD is to improve consumers’ experi-
ence utilizing Contra Costa Health Services
by treating people with respect and respon-
siveness in a culturally and linguistically ap-
propriate manner.
MHSA 2012-2013 Annual Update 7
Consumer/Client/Family
Member Services
The inclusion of consumers/clients and family
members has been integral to planning and
implementation of services. These individuals
offer the valuable perspectives of those with
lived experience with mental illness and seri-
ous emotional disturbance (SED). Client and
family member voices have been the driving
force behind the development and expansion
of MHSA programs and services. Clients/con-
sumers and family members have become an
invaluable part of the system of care through
the delivery of supportive services by way of
peer and family supports. MHSA created the
opportunity to expand the Peer Run Wellness
and Recovery Centers to each region in Con-
tra Costa County. Additionally, the County’s
first evidenced-based Clubhouse Program
was established and offers structured work-
days, among other services, for consumers/
clients. Many consumers and family mem-
bers are employed by the mental health sys-
tem and have received training and ongoing
support to provide services throughout the
system of care, including older adult services,
adult services, transition-aged youth services,
and services for children and their families.
Another notable development is the Office
for Consumer Empowerment (OCE), which
spearheads the anti-stigma efforts in the
County through the Committee for Social In-
clusion. This committee is a place where those
with lived mental health experience come to-
gether to develop strategies to reduce stigma
and promote social inclusion. Additionally, the
OCE established a Speakers Bureau to edu-
cate professionals and members of the com-
munity with the goal of reducing the stigma
associated with mental illness through direct,
person-to-person contact. OCE and the peer
run organization Mental Health Consumer
Concerns (MHCC) works with Contra Costa
College and local behavioral health organiza-
tions to teach the Service Provider Individu-
alized Recovery Intensive Training (SPIRIT)
courses taught by peers to peers. This series
of three accredited college courses teaches
mental health consumers the skills nec-
essary to become peer providers. OCE
also provides Peer Wellness Coaches
to support the development of self-man-
Systems Transformation
MHSA 2012-2013 Annual Update8
MHSA
Contra Costa County
agement skills to enhance recovery from co-
occurring behavioral and physical health dis-
orders.
These values guide the provision of services.
On an individual level, providers work in full
partnership with the clients and families they
serve to develop individualized, comprehen-
sive service plans. This increases clients
and family members’ choice and involve-
ment, thereby supporting personal responsi-
bility, creating incentive to obtain and sustain
recovery and shifting the system to one that
promotes learning, self monitoring and ac-
countability.
Wellness, Recovery and
Resiliency
Recovery refers to the process people who
are diagnosed with mental illness undergo to
promote their ability to live, work, learn and
participate fully in their communities. For
some individuals, recovery means regaining
certain aspects of their lives and the ability to
live a fulfilling, productive life despite a dis-
ability. For others, recovery implies the re-
duction or elimination of symptoms. Focusing
on recovery, in service planning encourages
and supports hope.
Resilience refers to the personal qualities of
optimism and hope as well as the personal
traits of good problem solving skills that lead
individuals to live, work, and learn with a
sense of mastery and competence. Research
shows resilience is fostered by positive expe-
riences in childhood at home, at school, and
in the community. When children encounter
negative experiences in these environments,
mental health treatments that teach good
problem solving skills, optimism and hope
can build and enhance resiliency in children.
(Source: California Family Partnership Asso-
ciation, March 2005.)
MHSA supports the philosophy that mental
health needs are not defined by symptoms,
but rather by a focus on achieving and main-
taining and promoting the overall health and
well-being of the individual and family. It is
a strengths-based philosophy that takes into
account and builds on those areas of life in
which the client is successful.
Expanding the Public Mental
Health System
One of the most significant changes that oc-
curred as a result of MHSA has been the de-
velopment of an expanded continuum of ser-
vices for individuals living with mental illness
or at risk of mental illness.
In many instances, the programs implement-
ed with Community Services and Supports
(CSS) and Prevention and Early Intervention
(PEI) funds have been used to provide new
services. This has allowed for early stages
of transformation and the development of a
continuum of care, starting from providing
services to those individuals who have not yet
been diagnosed, to a multi-level service sys-
tem for adults with serious mental illness and
children and youth with serious emotional dis-
turbance. The overall effort within the mental
health system is to develop an array of ser-
vices, enabling clients to obtain the most ap-
propriate level of care.
In addition to the number of levels of care
available to consumers, MHSA funding has
allowed for an increase in infrastructure. The
Capital Facilities funding will finance a state-
of-the-art Assessment and Recovery Center
(ARC), which will be integrated with primary
care at Contra Costa Regional Medical Cen-
ter. The technological needs funds have al-
lowed the County to make progress towards
the establishment of an electronic medical
MHSA 2012-2013 Annual Update 9
records system that will enhance and coordi-
nate client care through a more efficient and
coordinated health record and information
sharing system.
As the County moves forward, change will
continue to occur. Within the constraints of
the resources available, MHSA will play an
important role in strengthening and expand-
ing the transformation of public mental health
services in Contra Costa County and through-
out California.
The following pages detail the overarching
purpose of each of the MHSA programs,
the current services delivered, the outcomes
of services provided, and areas identified
for program expansion in Fiscal Year 2012-
2013, in the continuing work of transforming
the public mental health system.
Unnamed Poem
A poem by Ralph Hoffmann
For every hill I’ve had to climb,
For every stone that bruised my feet,
For all the blood and sweat and grime,
For blinding storms and burning heat,
My heart sings but a grateful song,
Those were the things that made me strong.
For all the heartaches and the tears,
For all the anguish and the pain,
For gloomy days and fruitless years,
For all the hopes that lived in vain,
I do give thanks for now I know,
These were the things that helped me grow.
It’s not the softer things in life,
Which stimulate our will to strive,
But bleak adversity and strife,
Do most to keep our will alive.
Over rose-strewn paths the weaklings creep,
But brave hearts dare to climb the steep.
Systems Transformation
10
The first major component to be implement-
ed was Community Services and Supports
(CSS). The initial community-driven planning
process began in 2005 with the final CSS
plan being formally approved by the Califor-
nia Department of Mental Health (DMH) in
June 2006. By State regulation, the major-
ity (51% or more) of the CSS funds must be
spent on Full Service Partnership Programs.
The remaining funds are to be allocated to
strengthen the overall infrastructure of the
mental health system. The strategies which
achieve this objective are part of the CSS
Systems Development Strategies.
The final CSS Plan for Contra Costa County
included six Work Plans. The first three Work
Plans are focused on Full Service Partnership
Programs; Work Plan Four includes programs
for Older Adults; Work Plan Five is focused
on housing for Full Service Partners (FSP);
and Work Plan Six includes the six Systems
Development Strategies. A brief overview of
each of the Work Plans and programs it com-
prises is below.
Community Services and
Supports (CSS) Overview
10
MHSA 2012-2013 Annual Update 11
CSS Work Plan Description of Program
Work Plan #1: Children’s
Full Service Partnership
Program
Currently, the Children’s FSP Program is being redesigned.
Work is underway to develop the framework and program
design for the new Children’s Full Service Partnership Pro-
gram. Planning is being driven by data which highlights the
children most in need of intensive outpatient services.
Work Plan #2: Transition
Age Youth (TAY) Full Ser-
vice Partnership Program
The TAY FSP Program, operated by Fred Finch, is locat-
ed in West County and provides services to young adults
between the ages of 16 and 25. Eligible youth are those
who reside in West County with a Serious Emotional Dis-
turbance (SED) or Serious Mental Illness (SMI). The young
adults exhibit key risk factors, especially: homelessness; co-
occurring substance abuse; exposure to trauma; repeated
school failure; multiple foster-care placements; and experi-
ence with the juvenile justice system. Services draw on sev-
eral evidence-based practices adapted for use with the TAY
population. These services may include case management;
educational and vocational support; wellness and recovery
peer programs; substance abuse treatment; financial coun-
seling; and community integration. The capacity of the TAY
FSP Program is 90 young adults.
Work Plan #3: Adult Full
Service Partnership Pro-
gram
The Adult FSP work plan is comprised of three separate pro-
grams: 1) Familias Unidas; 2) Anka Forensic Services; and
3) Bridges to Home, a collaboration between Rubicon, Anka;
Community Health for Asian Americans (CHAA) and Men-
tal Health Consumer Concerns (MHCC), providing Wellness
and Recovery support. Familias Unidas is located in West
County, Anka Forensic Services is located in Central County,
and Bridges to Home is located in both West and Central
County. Each program’s service delivery model is structured
slightly differently; however, all 3 programs provide services
to adults over the age of 18 who are diagnosed with a seri-
ous mental illness, are at or below 300% poverty and are
uninsured or receive Medi-Cal benefits. Services are deliv-
ered based on a “what-ever-ittakes” model and include flex-
ible funds; case management; educational and vocational
support; crisis intervention; psychotherapy and several other
supports. The capacity of all 3 programs combined is 185
FSPs.
Community Services and Supports
MHSA 2012-2013 Annual Update12
MHSA
Contra Costa County
CSS Work Plan Description of Program
Work Plan #4: Older Adult
Systems Development
There are two Older Adult Mental Health Programs funded
by CSS: IMPACT and Intensive Care Management Teams.
IMPACT, or Improving Mood: Providing Access to Collab-
orative Treatment (IMPACT), is an evidence-based program
delivering services, in collaboration with the primary care
clinics, to older adults who are experiencing symptoms of
depression. One LCSW staff member located in each region
of the County provides services to older adults using problem
solving therapy. The Intensive Care Management program
is comprised of 3 multi-disciplinary teams consisting of one
psychiatrist, one nurse, one mental health clinical specialist,
and one mental health community support worker. Services
are provided in the home or community and may include: in-
dividual therapy; family support; mental health assessments;
consultation services, medication monitoring and support;
transportation services, and linkages to other necessary re-
sources. The Older Adult Programs have the capacity to pro-
vide services to 225 older adults during the fiscal year.
Work Plan #5: Housing (for
FSPs)
Housing available in this program is intended for Full Service
Partners receiving services under Work Plans #1 - #3. The
priority is given to those who are homeless or imminently
homeless and otherwise eligible for the FSP programs. Spe-
cific housing elements include new facilities, housing vouch-
ers, and development of new housing options for all groups
in the future.
Work Plan #6: Systems De-
velopment Strategies (SDS)
Systems Development Strategies do not constitute stand-
alone programs; instead, they are a series of strategies for
overall systems improvement. There are six Systems Devel-
opment Strategies included in the approved CSS Plan:
• Enhancements to the Office for Consumer Empower-
ment (OCE)
• Planning for Future Systems Development
• Peer Benefits Advocates
• Expansion of the Family Partner Program
• Wellness Services
• Transformation Training
MHSA 2012-2013 Annual Update 13
CSS Program #1
Children’s Full Service Partnership
Program
Mental Health Administration is in the plan-
ning stages of developing a new framework
for the Children’s Full Service Partnership
Program with a goal of implementation of
services by July 1, 2012. The redesign of
the Children’s FSP program is driven by data
which highlights the children most in need of
intensive outpatient services, as evidenced
by multiple hospitalizations, psychiatric emer-
gency service visits or mobile response team
crisis services. Program services will follow
evidence-based practices specific to treat-
ment modalities proven most effective for the
target population.
Many people, groups and committees were
involved in the redesign of the Children’s FSP
Program. Various thoughts and ideas were
taken into consideration and worked into the
framework described below. In an effort to
work towards systems integration and elimi-
nation of treatment silos, the planning for the
Children’s FSP took into consideration the
current programs in the children’s system of
care, the gaps in service, and opportunities
for improvement and creativity.
County-wide Assessment Team
Develop and implement a County-wide As-
sessment Team. This team would consist
of Mental Health Clinical Specialists, Family
Partners and clerical support in each region.
The County-wide Assessment Team will
serve all regions of the County and will com-
plete a comprehensive assessment on all
youth Level 3 and above. The team will pres-
ent treatment recommendations to the family
based on diagnosis, environmental stressors
and likelihood of treatment adherence among
other factors.
The County-wide Assessment Team will com-
plete the CALOCUS and other assessment
tools during the initial assessment. They will
also participate in reauthorization of services
to help facilitate movement through the sys-
tem and ensure youth are receiving the ap-
propriate level of care. There may be 4 points
of entry to the Assessment Team: Access
Line, MRT, Hospital and Residential and the
Clinics.
FSPs and Personal Service
Coordinators:
Entry into a Full Service Partnership will oc-
cur through the County-wide assessment
team. In addition to treatment referrals for
those youth and families who are experienc-
ing severe stressors, such as out-of-home
placement, juvenile justice system, repeated
presentations at PES or hospitalizations, and
those experiencing co-occurring disorders,
may be referred to a Personal Services Coor-
dinators (PSC) and will be considered a Full
Service Partner. The previous FSP model
was program-based, meaning if the youth
was a participant of a particular program they
were considered a FSP regardless of current
level of need. The new FSP model attaches
the FSP status to the individual and not to any
particular program. Individuals who are FSPs
will receive additional support, such as 24/7
contact with their PSC, transportation support
and flexible funds but will access the same
treatment services as children/youth who are
not FSPs.
Community Services and Supports
MHSA 2012-2013 Annual Update14
MHSA
Contra Costa County
Evidence-based Practices
There are two evidence-based practices that
will provide services not currently being pro-
vided in any organized fashion in our system
of care. These programs will serve both FSPs
and non-FSPs and will receive their referrals
from the County-wide Assessment Team.
Multidimensional Family Therapy (MDFT):
Source: SAMHSA - http://nrepp.samhsa.gov/
ViewIntervention.aspx?id=16
MDFT is a comprehensive and multisystemic
family-based outpatient or partial hospitaliza-
tion program for substance-abusing adoles-
cents, adolescents with co-occurring sub-
stance use and mental disorders, and those
at high risk for continued substance abuse
and other problem behaviors such as conduct
disorder and delinquency. Treatment is deliv-
ered across a series of 12 to 16 weekly or
twice weekly 60 to 90 minute sessions. Treat-
ment modules target the following four areas
of social interaction:
• The youth’s interpersonal functioning with
parents and peers;
• The parents’ parenting practices and
level of adult functioning independent of
their parenting role;
• Parent-adolescent interactions in therapy
sessions;
• Communication between family members
and key social systems (e.g., school, child
welfare, mental health, juvenile justice.)
Multisystemic Therapy (MST) for Juvenile
Offenders:
Source: SAMHSA - http://nrepp.samhsa.gov/
ViewIntervention.aspx?id=26
MST for juvenile offenders focuses on those
factors in each youth’s social network that are
contributing to his or her antisocial behavior.
The ultimate goal of MST is to empower fami-
lies to build a healthier environment through
the mobilization of existing child, family and
community resources. Additionally, there are
three primary goals of this treatment model:
• Decrease rates of antisocial behavior and
other clinical problems;
• Improve functioning (e.g., family rela-
tions, school performance, peer interac-
tions)
• Reduce the use of out-of-home place-
ments such as incarceration, residential
treatment, and hospitalization.
The typical duration of home-based MST ser-
vices is approximately 4 months, with multiple
therapist-family contacts occurring weekly.
Specific treatment techniques used to fa-
cilitate these gains are based on empirically
supported therapies, including behavioral,
cognitive behavioral, and pragmatic family
therapies.
MHSA 2012-2013 Annual Update 15
CSS Program #2
Transition Age Youth Full Service
Partnership Program
The Contra Costa Transition Age Youth pro-
gram was implemented in March of 2007 and
is a partnership between Fred Finch Youth
Center, the Contra Costa Youth Continuum
of Services (CCYCS)/GRIP, The Latina Cen-
ter and Contra Costa County Mental Health
Services. The program utilizes the Assertive
Community Treatment (ACT) model as modi-
fied for young adults that includes a multidis-
ciplinary team of staff, including peer/family
mentors, a psychiatric nurse practitioner who
provides psychiatric services in the field, staff
with various clinical specialties, and bilingual
staff. In addition to mobile mental health and
psychiatric services, the program offers a va-
riety of services designed to promote “well-
ness and discovery,” including individualized
assistance finding housing, benefits advoca-
cy, assistance gaining employment or attend-
ing school, and support in connecting with
families. All staff are trained in motivational
interviewing and to be co-occurring capable
and thus able to confidently address the high
number of youth who experience both mental
health and substance use problems. All clini-
cal staff recently completed training on the
evidence-based practice of Cognitive Behav-
ioral Therapy (CBT) for Psychosis, in recogni-
tion of the high number of young adults in the
program trying to cope with psychosis, and
the need to intervene as early and effectively
as possible. As well as individual services,
the program offers a number of groups which
promote connections between otherwise iso-
lated young adults, and vary depending on the
needs of the participants. The newest group
is “Represent Your Shine,” which is a monthly
celebration of participant accomplishments,
and is organized by the 18-month-old Youth
Advisory Council (YAC), a group of partici-
pants who advise the program on its offer-
ings. As part of their leadership skills devel-
opment, this group has gone to Sacramento
to advocate for services for homeless youth.
In all, the program is designed to partner with
young adults to assist them to “find a life that
fits.”
At the time of enrollment, nearly all the TAY
FSPs have experienced at least one, if not
multiple, of the following: incarceration (48%);
hospitalizations (60%); and homelessness
(60%). Outcomes are derived by equalizing
the pre-enrollment and post-enrollment time
periods, thus creating a fair representation of
how the consumer has progressed since en-
rollment. The TAY program participants have
experienced a 271 percent increase in living
in an apartment of their own and a 42 per-
cent decrease in using emergency shelters
as their residence. Below is an illustration of
the decrease in Psychiatric Emergency Ser-
vice (PES) presentations and hospitaliza-
tions for FSPs post-enrollment. Additionally,
72 percent of the TAY FSPs participated in
at least one meaningful activity during their
enrollment. Meaningful activities are defined
as participation in any of the following activi-
ties: employment, school, volunteerism, and/
or vocational training.
Community Services and Supports
MHSA 2012-2013 Annual Update16
MHSA
Contra Costa County
17
17
The Contra Costa Transition Age Youth (CCTAY) program
wants to celebrate some of the many collaborations necessary
for young adults to succeed through the story of one of our par-
ticipants. CCTAY itself is a collaboration between Fred Finch
Youth Center, The Latina Center, and the Contra Costa Youth
Continuum of Services (CCYCS) including Bissell Cottages
transitional housing. We utilize the evidence-based program
model of Assertive Community Treatment to offer a wide range
of supports from a wide variety of staff, including Peer Mentors
and Family Partners, to our program participants. CCTAY ac-
tively works to partner with young adults so they can direct their
life decisions and take charge of their mental health care.
17
Success through Collaboration
MHSA 2012-2013 Annual Update18
MHSA
Contra Costa County
Tonnisha Frazier, who is now 21 years old,
was referred to Calli House, administered by
an MHSA TAY Collaborative, Contra Costa
Continuum of Youth Services. Calli House is a
youth shelter that was made possible through
one-time MHSA funding that paid for its pur-
chase and construction, which allowed shel-
tered TAYs to be housed in seperate quarters
from the adult shelter population at Brook-
side. CCTAY is an MHSA funded full service
partnership program and Calli house staffing
is supported through MHSA funding. Tonni-
sha had been on and off staying with relatives
and homeless in West Contra Costa Coun-
ty before she sought shelter at Calli House.
Like many homeless youth, she had survived
a childhood that featured abuse and neglect
by family members, resulting in involvement
with the foster care system (another common
source of referrals to the CCTAY program).
Notably, despite these obstacles, Tonnisha
managed to get through high school and ob-
tain her GED. One of her strengths is her abil-
ity to garner support from adults; her basket-
ball coach took an interest in her welfare and
started checking up on her class attendance
and performance. She found it embarrassing
at the time but ultimately appreciated it.
In June, 2009, Tonnisha was offered an
MHSA housing subsidized apartment from
another of our partners, Shelter Inc. Moving
from West County to Concord helped her to
escape from those in her life who were giv-
ing her messages of failure; it gave her some
important separation, helped her to build her
sense of self-sufficiency, and helped provide
her with a newfound sense of emotional and
physical safety. It also meant she was closer
to school and was therefore more able to at-
tend regularly.
Throughout this time, CCTAY staff has worked
with her to understand and manage her men-
tal health symptoms and to push herself to
succeed, despite the many messages she
receives that she could not do it, sometimes
from her family and sometimes from herself.
In particular, staff motivated her to overcome
her own sense of hopelessness and self-
doubt, enough that she enrolled in cosmetol-
ogy school. She occasionally needed to take
a couple of months off for self-care, but she
persevered and finished in Sept. 2010, and
just got her cosmetology license. When she
graduated, she chose to celebrate with the
CCTAY team – who have in some senses be-
come the supportive family she has lacked.
Through various team members and attend-
ing CCTAY groups, and most especially her
Personal Services Coordinator (PSC), she
has learned to find internal strength, to soothe
and take care of herself, to calm herself when
she is alone or frightened, and even to ex-
ercise, which she did at first with her PSC
and then by herself. The services emphasize
safety, resilience, and good coping skills. Not
only has she soaked up knowledge and guid-
ance for herself, but she continues to support
her sister and her younger brothers.
In keeping with the program’s value of de-
veloping youth leadership, CCTAY offered
to help Tonnisha gain experience as an ad-
vocate. Last month, this impressive young
woman went to Sacramento, supported by
staff, to meet with legislators to advocate for
more funding for homeless youth programs.
She shared her MHSA success story with
legislators. Her story was clearly impactful on
her audience, and we all hope it will result in
additional funding for homeless youth. Ton-
nisha truly enjoyed her experience and would
like to advocate again.
Success through Collaboration Community Services and Supports
MHSA 2012-2013 Annual Update 19
CSS Program #3
The Adult FSP Work Plan is comprised of
three separate programs: 1) Familias Unidas;
2) Anka Forensic Services; and 3) Bridges
to Home, a collaboration between Rubicon,
Anka; Community Health for Asian Ameri-
cans (CHAA) and Mental Health Consumer
Concerns (MHCC), providing Wellness and
Recovery support. Familias Unidas is locat-
ed in West County, Anka Forensic Services
is located in Central County, and Bridges to
Home is located in both West and Central
County.
Each program’s service delivery model is
structured slightly differently; however, all 3
programs provide services to adults over the
age of 18 who are diagnosed with a serious
mental illness, are at or below 300% pov-
erty and are uninsured or receive Medi-Cal
benefits. Services are delivered based on a
“whatever-it-takes” model and include flex-
ible funds, case management, educational
and vocational support, crisis intervention,
psychotherapy, and several other supports.
The capacity of all three programs combined
is 170 FSPs.
During FY 2010-11, a total of 230 consum-
ers were served by the Adult FSP programs.
Since implementation, almost 350 adults
have received services through the Adult
FSP programs. Ninety-eight percent of pro-
gram participants are diagnosed with either a
mood disorder or a psychotic disorder. Over
50 percent of the participants are either Afri-
can-American or Latino and the average age
is 42 years.
Shine Forth with Purpose
A poem by Carl Jones
Each Day I live,
I find more to give,
Be it a smile of such,
To transform and thus,
Be that the blessed touch,
Of love so much,
Shines forth and thus,
Grows more in trust,
Gives more through us,
To learn more we must,
Fear not in us,
Trust more in us,
Be present and thus,
More comes to us,
To share more I trust,
In loves powerful touch,
And thus,
Shine forth with purpose,
Should the sun way up high,
Fall far from the sky,
To teach us,
Shine forth with purpose
Community Services and Supports
MHSA 2012-2013 Annual Update20
MHSA
Contra Costa County
The FSP programs have been successful at
decreasing the percentage of participants who
are homeless (85% decrease) and increasing
the number who live in apartments or within
other community settings (156% increase).
For FSPs who are newer to enroll, the avail-
ability of housing is much more limited. This
creates challenges for the programs when
working with individuals who are homeless or
in need of a different living arrangement.
Additionally, the Adult FSP programs have
been successful in decreasing the number of
hospitalizations and presentations to Psychi-
atric Emergency Services (PES) when com-
paring an equal time period from pre-enroll-
ment to post-enrollment.
MHSA 2012-2013 Annual Update 21
CSS Program #4
Older Adult Mental Health
Older Adult Mental Health began program
implementation in 2008. There are two pro-
grams funded under CSS with a primary focus
on the Older Adult population: Intensive Care
Management Teams and IMPACT. These two
programs serve a vital role for older adults in
Contra Costa County, as mental health prob-
lems among older adults are associated with
poor health outcomes, higher health care uti-
lization, increased disability and impairment,
compromised quality of life and higher risk of
suicide. (Bartels SJ, et. al, 2005).
The Intensive Care Management Teams pro-
vide mental health services to older adults
in their homes, in the community, and within
a clinic setting, in order to support aging in
place, improve mental health, physical health
and overall quality of life. Additionally, the
teams provide services to those who are
homeless, living in shelters, or in residential
care facilities. Services are provided to Con-
tra Costa County residents with serious psy-
chiatric impairments who are 60 years of age
or older. The program provides services to
those who are Medicaid beneficiaries, Medic-
aid and Medicare beneficiaries, or uninsured.
Intensive Care Management is comprised
of three multi-disciplinary teams consisting
of one psychiatrist, one nurse, one Mental
Health Clinical Specialist and one Mental
Health Community Support Worker. Two of
the three psychiatrists are board certified ge-
riatric psychiatrists. The third psychiatrist po-
sition is filled by a geriatric/psychiatric nurse
practitioner, Contra Costa’s first Mental Health
Nurse Practitioner. The geriatric-specific ex-
pertise is an invaluable addition to Intensive
Care Management. The Community Support
Worker positions are filled by consumers of
mental health services. They contribute a
personal perspective and relatable experi-
ence that other members of the team may not
provide. The multi-disciplinary team provides
intensive care management services which
include: individual therapy; family support;
mental health assessments; consultation ser-
vices; linkage to primary care and community
programs; advocacy; educational outreach;
medication support; medication monitoring;
and transportation assistance.
During Fiscal Year 2010-2011, the Intensive
Care Management Teams provided services
to approximately 160 seniors throughout the
county. As illustrated on the graphs below,
the participants have experienced a reduc-
tion in Psychiatric Emergency Services visits
and hospitalizations post-enrollment. Addi-
tionally, increased numbers of older adults in-
volved with the Intensive Care Management
Teams are participating on a regular basis in
walking groups, brown bag lunches, consum-
er sponsored picnics, wellness centers, and
senior centers.
Community Services and Supports
MHSA 2012-2013 Annual Update22
MHSA
Contra Costa County
MHSA 2012-2013 Annual Update 23
IMPACT
In 2009, the second Older Adult program, IM-
PACT, was implemented. Improving Mood:
Providing Access to Collaborative Treatment,
also known as IMPACT, is an evidence-based
model providing evaluation and treatment of
depression in individuals over the age of 60
in a primary care setting. IMPACT is short-
term (8 to 12 visits) problem solving therapy
with up to one year of follow-up as necessary.
Services are provided in primary care clinics
by licensed clinicians with supervision and
support from the Older Adult psychiatrist. The
psychiatrist assesses for and monitors medi-
cations as needed and both the clinician and
psychiatrist work in collaboration with the pri-
mary care physician.
The target population for the IMPACT Pro-
gram is seniors, age 60 years and older; at
300% of the Federal Poverty Level or below;
and are covered by MediCal, MediCal and
MediCare, or are uninsured. The focus is on
older adults with depression and/or suicidal-
ity with co-occurring physical health impair-
ments, including cardio-vascular disease,
diabetes, and/or chronic pain.
IMPACT Program participants complete the
PHQ-9 at each appointment. The PHQ-9 cov-
ers 9 life domains in 9 questions and results
in a PHQ-9 depression score ranging from 0
to 27.
During FY 2010-2011 there were approxi-
mately 750 PHQ-9 assessments recorded
for 160 unique consumers. The data below
shows an improvement of approximately 36%
in PHQ-9 scores after an average of 6 assess-
ments. On average, at baseline, consumers
PHQ-9 score was equivalent to moderate to
moderately-severe depression. After an aver-
age of 6 assessments, consumers reported
mild depression on the PHQ-9 tool. Consum-
ers with only one recorded assessment were
excluded from the analysis.
0
5
10
15
Baseline Last
Assessment
14
9
PHQ-9 ScoreAverage PHQ-9 Score for
IMPACT Participants
Total Score Depression Severity
1 to 4 Minimal Depression
5 to 9 Mild Depression
10 to 14 Moderate Depression
15 to 19 Moderately Severe De-
pression
20 to 27 Severe Depression
Additionally, the PHQ-9 data can be analyzed
by domain area. Each question on the PHQ-
9, which refers to a specific domain area, can
be scored from a zero to three by the con-
sumer. The question and corresponding scor-
ing below is used to assess a score to each
domain.
“Over the past two weeks, how often have
you been bothered by any of the following
problems?”
3 – Nearly everyday
2 – More than half the days
1 – Several days
0 – Not at all
Community Services and Supports
MHSA 2012-2013 Annual Update24
MHSA
Contra Costa County
The areas of greatest concern for the con-
sumer at the time of program enrollment, in
order of severity, were: Energy, Depressed
Mood, Sleep and Negative Thoughts. Al-
(Graph 1) The PHQ-9 domain areas that show the greatest improvement after an average of 6
assessments were: Suicidality; Movement; and Anhedonia. (Graph 2)
though greatly improved, these same 4 do-
main areas were reported as the most trou-
bling to consumers during the last recorded
assessment.
MHSA 2012-2013 Annual Update 25
Senior Peer Counseling
Services are short-term in nature and free of
charge. Under the supervision of licensed
staff, approximately 40 volunteers county-
wide provide counseling support to older
adults who are isolated and would benefit
from someone to talk with. Staff are bilin-
gual and bi-cultural. Services are available in
English, Spanish, Mandarin and Cantonese.
Stats
• Microsoft Access database was created
in 2012
• Client information gathered during the in-
take process
• Data elements captured include:
Ambulatory status
Housing status
Language
ADL’s
• Database will also capture information
about volunteers such as:
Travel time
Number of individuals served
Activities i.e. work supervision, month-
ly in-service, health fairs, educational
work shops
Program Enhancements
In addition to Older Adult Mental Health’s
existing services, we are collaborating with
agency partners for the following:
Residency Rotation: In July, 2012 we will be-
gin a rotation for 2nd year residency students
with CCRMC Family Medicine who will shad-
ow our Intensive Care Management Teams in
the community providing outreach services to
the chronically mentally ill older adult popula-
tion. This new rotation is being referred to
as “Care of Older and Dependent Adults” or
CODA and will be invaluable to both the resi-
dents and OAMH staff in an effort to build a
healthy partnership for the future.
2012 Internship Program: Older Adult Men-
tal Health is partnering with California State
University, East Bay to provide two Master’s
level students with the opportunity to experi-
ence a clinical setting and to help in the devel-
opment of a future workforce with a passion
and expertise in working with older adults with
mental health issues and co-occuring medi-
cal conditions.
Reference:
Bartels SJ, Blow FC, Brockmann LM, Van Citters
AD. Substance Abuse and Mental Health among
Older Americans: the State of the Knowledge and
Future Directions. Older American Substance
Abuse and Mental Health Technical Assistance
Center, 2005;1-31.
Community Services and Supports
26
MHSA Housing Overview
CSS Program #5
Housing
The MHSA Housing Program is primarily in-
tended to provide funding to create perma-
nent supportive housing for individuals with
serious mental illness who are homeless or
at risk of homelessness. The program’s tar-
get population is low-income adults, or older
adults with serious mental illness, and chil-
dren with severe emotional disorders and
their families who meet the criteria for mental
health services and are homeless or at risk of
homelessness as defined below:
• Homeless is defined as living on the
streets, or lacking a fixed, regular and ad-
equate nighttime residence.
Individuals who are risk of homeless-
ness include:
Transition Age Youth (TAY) exiting
the child welfare or juvenile justice
systems.
Individuals discharged from institution-
al settings including:
Hospitals, including acute psychiatric
health facilities, skilled nursing facili-
ties with a certified special treatment
program for the mentally disordered,
and mental health rehabilitation cen-
ters.
Crisis and transitional residential set-
tings
Local city and county jails.
Individuals temporarily placed in
Residential Care Facilities upon dis-
charge from one of the institutional
settings cited above.
Individuals who have been assessed
and are receiving services at the
County Behavioral Health Division
and who have been deemed to be at
imminent risk of homelessness, as
certified by the County Mental Health
Director.
With the additional funding made available
through the MHSA Housing Program, the
County has worked collaboratively to produce
capitalized MHSA housing units, working
closely with Contra Costa County Department
of Conservation and Development, Rich-
mond Housing Authority, California Finance
Agency, housing consultants and developers.
Completed projects include:
• Villa Vasconcellos – Collaboration with
Resource for Community Development.
Newly constructed 70 unit complex lo-
cated in Walnut Creek designated for
low income older adults, 55 and older,
disabled persons and persons with HIV/
AIDS. There are three MHSA dedicated
one-bedroom units.
26
2726
• Lillie Mae Jones Plaza – Collaboration
with Community Housing Development
Corporation of North Richmond (CHDC)
and their development partner East Bay
Asian Local Development Corporation
(EBALDC). Newly constructed 26-unit
complex located in Richmond designated
for low income families and adults. There
are two 2 bedroom MHSA dedicated
units and six 1 bedroom MHSA dedicated
units. On-site service coordination is in-
cluded.
• Virginia Street Apartments – Collabora-
tion with Rubicon Programs. An existing
complex located in Richmond that con-
tains six 2 bedroom units. MHSA Hous-
ing Program funding was used for reha-
bilitation of the complex. All six units are
dedicated MHSA units.
There are also several housing projects un-
der development as well as a few that are at
various stages of development:
• Anka Behavioral Health, scattered sites
– Up to six homes of shared housing for
those 18 years of age and older.
• Additional MHSA units are in underwrit-
ing at various stages of development;
• Tabora Gardens, Antioch – New con-
struction. Five units for older adults.
• Robin Lane, Concord – Acquisition and
rehabilitation. Five units for families.
• Ohlone Gardens, El Cerrito – New con-
struction. Five units for families.
Thus far, Contra Costa County Behavioral
Health has used MHSA Housing Program
funds to create an additional 18 rental units
and four shared housing beds. At the pres-
ent time, we have an additional 15 rental units
well in development as well as at least 12
more shared housing beds.
Using CSS funding, CCCMH initiated a multi-
layered approach to meet the various housing
needs of consumers who are at various stag-
es of housing readiness. Funds were used to
develop new housing sites and to offer sup-
portive services to those in housing place-
ments. On-site services providers include:
physicians, nurses, clinical, and peer support
services. Transitional residential programs of
varied lengths focusing on TAY and young
adults were developed as places for relation-
ship and skill building. Additionally, MHSA
dollars have been used to provide temporary
shelter for mental health clients who are ex-
periencing homelessness. The shelter beds
have established the opportunity for outreach
and engagement opportunities to serve the
homeless population who may experience
co-occurring mental illness and substance.
Master-leased scattered site housing is iden-
tified as the priority request of consumers and
completes our current housing options.
27
MHSA 2012-2013 Annual Update28
MHSA
Contra Costa County
CSS Program #6
Systems Development Strategies
The original six systems development strat-
egies, noted below, were created during the
initial planning process in 2005. As the sys-
tem transforms and moves more towards in-
tegration, the categories of Systems Devel-
opment Strategies are too narrow in scope to
be effective in improving the system of care.
Systems Development Strategies do not con-
stitute stand-alone programs; instead, they
are a series of strategies for overall systems
improvement. There are six Systems Devel-
opment Strategies included in the approved
CSS Plan:
Current Strategies
Strategy #1: The Office for Consumer Em-
powerment (OCE) offers a range of trainings
and supports by and for consumers in all re-
gions of the County. The OCE aims to increase
access to wellness and empowerment knowl-
edge and skills through the SPIRIT program,
Leadership Academy, Advocacy workshops,
Mental Health Perspectives program,and by
educating staff on the client culture.
Strategy #2: Planning for Future Systems
Development: This strategy includes plan-
ning for increased access to transportation for
consumers to get to services and supports;
efforts towards integrating services for con-
sumers experiencing co-occurring disorders;
and transforming the system to be culturally
competent, recovery oriented, consumer-
driven through training, supports and possible
changes to organizational structures.
Strategy #3: Peer Benefits Advocates: The
Peer Benefits Advocates assist consumers
obtain benefits they are entitled to, educate
consumers on how to maximize the use of
those benefits, and assist consumers to navi-
gate the service system. The Peer Benefits
Advocates are located in each of the three
Adult County Clinics. They work with and are
trained by County Patient Financial Special-
ists.
Strategy #4: Expansion of the Family Part-
ner Program: The Family Partners assist
families with advocacy, transportation, navi-
gation of the service system, and offer sup-
port in the home, community, and county
service sites. The Family Partner Program
supports families with children of all ages who
are receiving services in the children or adult
system of care. Family Partners are located
in each of the regional clinics for children and
adult services. The Children’s Services Fam-
ily Partners often participate on Wraparound
teams following the evidence-based model.
Strategy #5: Wellness Nurses: The Well-
ness Nurses do not provide any direct medi-
cal care, but develop wellness supports such
as classes, groups, activities and educational
materials. The Wellness services aim to help
consumers to maximize their well-being and
minimize the negative effects of any psychi-
atric medications they may be on. The pur-
pose of this program is to educate and sup-
port adult consumers to proactively take care
of themselves for maximum mental health.
This includes such issues as fitness, relax-
ation, and ways to mitigate negative effects
of medications.
Strategy #6: Transformation Training: This
strategy is aimed at working towards estab-
lishing a strong mental health recovery envi-
ronment throughout the service system and
all staff.
MHSA 2012-2013 Annual Update 29
Moving Forward: In preparation for creat-
ing an integrated MHSA Annual Plan and to
make more efficient use of the funds moving
forward, including funding as part of the in-
creased allocation, Systems Development
Strategies will fall under four major catego-
ries:
• Direct Providers for Treatment and Case
Management
• Peer Support and Wellness Centers
• Improving the County Mental Health Ser-
vice Delivery System for all clients and
their families
Each of the existing Systems Development
Strategies will be included in newly defined
categories.
Artwork by Alita Van Hee
MHSA Housing Overview
30
Peer and Family
Delivered Services and Supports
Contra Costa Mental Health Plan (CCMHP) brings together
a rich array of peer and family-delivered services and sup-
ports for children, youth, adults, older adults, and their fami-
lies. Peers and family members work together to educate the
community to decrease stigma and discrimination for people
with lived mental health experience and promote social inclu-
sion. The following is an overview of CCMHP peer and family
supports, services and training opportunities.
30
MHSA 2012-2013 Annual Update 31
Peer or Family- Operated Mental
Health Services
Mental Health Consumer Concerns, Inc.
(MHCC) provides a range of recovery-fo-
cused, community-based mental health ser-
vices to adult consumers in Contra Costa
County. MHCC maintains three peer-run
Wellness and Recovery Centers, located
in Antioch, Concord and Richmond. It is a
membership-based organization directed
and operated by mental health consumers.
MHCC also facilitates the Contra Costa Net-
work of Mental Health Clients, to provide op-
portunities for education, advocacy, and sup-
port to local consumers. As a result, MHCC
provides extensive systems advocacy on the
local and state levels, and participates fully in
MHSA planning.
Each MHCC Wellness and Recovery Center
offers peer-led, recovery-oriented, behavior-
al health rehabilitation and self-help groups,
which teach self-management and coping
skills to visitors and members. The centers
also offer Wellness Recovery Action Plan
(WRAP) groups, physical health and nutrition
education; patient advocacy services and
advocacy training, arts and crafts, support
groups, community recreational outings, and
peer support, in addition to providing breakfast
and lunch to consumers that visit each center.
Additionally, MHCC collaborates closely with
the Adult Full Service Partnerships(FSPs)
Programs by offering the Tender Loving Care
peer support program for FSPs. Finally,
MHCC provides on-going trainings to peers
who are interested in becoming WRAP Fa-
cilitators. MHCC has two Advanced WRAP
Facilitators who offer WRAP Facilitator Train-
ing locally to peers, as well as individual and
group instruction to prepare for the training,
and post-training “in group” experience.
Putnam Clubhouse offers adults recovering
from mental illness respect, hope, and unlim-
ited opportunity to access the same worlds
of friendship, housing, education, health-
care, and employment as the rest of society.
Participants are partners in their own recov-
ery—rather than passive recipients of treat-
ment—and are intentionally called members
instead of patients, clients, or consumers.
Members share ownership and responsibility
for the success of the program by working to-
gether as colleagues with peers and a small,
trained staff to build on personal strengths,
rather than focusing on illness. Recovery
is achieved at the Clubhouse through work
and work-mediated relationships, which are
proven to be restorative and to provide a firm
foundation for growth, self-respect, and indi-
vidual achievement.
Throughout the work-ordered day—week-
days during typical business hours—Putnam
Clubhouse members learn and improve vo-
cational and social skills while collaborating
on everything involved in operating the pro-
gram: determining daily tasks and clubhouse
policy, office administration, reception, meal
planning/preparation, hiring staff, running
the career center, producing marketing and
advocacy videos, helping each other access
services, outreach, and serving on the Board.
Putnam Clubhouse offers a full array of pro-
gramming beyond the work-ordered day:
structured support for returning to school or
work and a variety of after-hours recreational
and wellness activities. Clubhouse participa-
tion is voluntary and at no cost to members.
Putnam Clubhouse follows the 36 Standards
of The International Center for Clubhouse
Development (ICCD) and is accredited in the
evidence-based ICCD model of social and
vocational rehabilitation.
Peer and Family
Delivered Services and Supports
MHSA 2012-2013 Annual Update32
MHSA
Contra Costa County
The Contra Costa Behavioral Health
Services Office for Consumer
Empowerment
Housed within Mental Health Administration
of the CCMHP, the Office for Consumer Em-
powerment (OCE) offers peer-led programs
that offer consumers opportunities to use their
lived behavioral health experience to support
others in their personal recovery and to en-
hance the behavioral health system of care
to be responsive to the diverse community of
consumers facing multiple health needs. The
Office for Consumer Empowerment seeks to
ensure that consumers throughout Contra
Costa County have a leadership role in the
development of MHSA funded and other clini-
cal services, as well as access to recovery-
oriented self-help and peer support services.
OCE staff members also seek to encourage
and support the role of peers as providers at
Contra Costa Behavioral Health Services
and throughout the Behavioral Health
System of Care.
Peer Provider Training
The Mental Health Service Provider Indi-
vidualized Recovery Intensive Training
(SPIRIT) is a recovery-oriented, peer-led
classroom and experiential-based college
accredited educational program for peers.
SPIRIT was established in 1994, by the OCE
and MHCC, for the purpose of increasing
collaboration between mental health clients,
family members, and county mental health
services to improve system planning and to
increase employment opportunities for cul-
turally diverse mental health clients in the
mental health field. Offered as a series of
three semester long courses at Contra Cost
College, SPIRIT teaches consumers peer
counseling skills, group facilitation, Wellness
Recovery Action Plan (WRAP) development,
wellness self-management strategies, and
other skills they need to gain peer provider
positions within community behavioral
health and peer or family-run organiza-
tions. The program is coordinated and
Peer and Family
Delivered Services and Supports
MHSA 2012-2013 Annual Update 33
overseen by the Contra Costa Behavioral
Health Services Office for Consumer Empow-
erment (OCE) in collaboration with Mental
Health Consumer Concerns (MHCC), Con-
tra Costa College,and more than thirty other
community behavioral/mental health provider
organizations and consumer and family sup-
port organizations. In addition to supervised
six-week internships to allow students to gain
hands-on experience working as a peer pro-
vider, community partners provide outreach,
guest speakers, and instruction to students
through site visits to their services. Students
receive a total of nine college credits and a
SPIRIT certificate upon graduation.
Over the course of the last four years, there
have been improved outcomes for SPIRIT
graduates. The percentage of graduates
who acquired behavioral health employment,
volunteered in behavioral health related ser-
vices, or attended college after graduation in-
creased from 50 percent of graduates in 2008
to 69 percent of graduates in 2011. Gradua-
tion from SPIRIT is a requirement for employ-
ment as a Community Support Worker (CSW)
peer provider at Contra Costa Behavioral
Health, and is valued by community behav-
ioral health organizations when hiring peer
providers. SPIRIT has increased the employ-
ment of consumers throughout the local sys-
tem of care, as evidenced by the increase in
employment of SPIRIT graduates. Evalua-
tion of the effectiveness of the program on
personal recovery is accomplished through
a recovery and wellness survey given to the
students during their first and last days of
class, and at one year following graduation.
Stigma and Discrimination
Reduction and Awareness
Convened in July of 2011, the Mental Health
Services Act (MHSA) Committee on Social
Inclusion was developed as an alliance of
community members, advocates, consumers,
family members, behavioral health providers,
and community behavioral health and sup-
port organizations collaborating to promote
social inclusion of persons with lived mental
health experience and their family members.
The committee guides projects and initiatives
designed to reduce stigma and discrimination
toward persons with lived behavioral health
experience and their family members. and to
increase social inclusion and acceptance in
the community in which they live and work.
The Committee for Social Inclusion employs
messages and projects for the community
and people who serve mental health con-
sumers in order to: 1) empower children and
adults with lived mental health experience to
achieve a full and inclusive community life; 2)
increase access to client-driven behavioral
health services that are respectful to each
individual, distinctive to each person’s needs
and values, and are inclusive to family mem-
bers; 3) promote a welcoming and recovery/
resiliency-oriented community environment
that eliminates barriers in access to medical
and mental health treatment, housing, edu-
cation, employment, and transportation for
people facing mental health issues; and 4)
reduce stigma and discrimination on both a
personal and societal level by creating an or-
ganized and unified mental health voice for
social inclusion.
Current projects include the planning and co-
ordination of a Social Inclusion Conference
to be held in the Fall of 2012, a PhotoVoice
project to advocate for connection and ac-
ceptance of behavioral health consumers in
the community, and a peer-led training for be-
havioral health providers to educate them on
ways to help consumers overcome and cope
with stigma.
Peer and Family
Delivered Services and Supports
MHSA 2012-2013 Annual Update34
MHSA
Contra Costa County
The Wellness Recovery Education for Ac-
ceptance Choice and Hope (WREACH)
Speakers’ Bureau is part of the Contra Costa
Mental Health Plan Stigma and Discrimina-
tion Reduction and Awareness Initiative de-
signed to reduce the internal, external, and
institutional stigma surrounding mental illness
that mental health consumers often face in
the workforce, behavioral and physical health
care systems, and in their home communi-
ties. Implemented by peers, the WREACH
program forms connections between people
in the community and people with lived men-
tal health experience by providing opportuni-
ties for sharing stories of recovery and cur-
rent information on mental health treatment
and supports. Targeted audiences include
behavioral health providers, high school and
college staff and students, law enforcement,
physical health providers, and community
members.
After development of the program in Janu-
ary of 2011 in collaboration with community
stakeholders, the OCE began holding two-
part workshops, titled “Tell Your Story” in the
community to teach mental health consumers
how to write and present their recovery story.
The ongoing workshops demonstrate how
to use examples of personal experiences to
encourage peers and give them hope, and
for advocacy to address personal needs and
improve the mental health system of care.
Then, 27 WREACH speakers represent-
ing various perspectives, such as parents or
caregivers of children who received services,
family members of adult clients, providers
and consumers, provided 55 presentations to
the public by the end of the 2011 calendar
year. Presentations were given by request
and through referral to community organiza-
tions. Additionally, OCE, in collaboration with
CCTV and several of the WREACH speak-
ers created a video presentation to increase
public awareness of mental health recovery
and to decrease stigma and misinformation in
the community. The OCE is in the process of
working with CCTV to produce several public
service announcements using portions of the
DVD program to be shown to CCTV audienc-
es in 2012.
Recovery
Education and
Outreach
The OCE, in col-
laboration with
the Putnam Club-
house, Mental
Health Consumer
Concerns, and
Rubicon, Inc., de-
veloped the Re-
ality Recovery
DVD Education
Program to pro-
vide outreach
and education on
resources and
strategies for well-
ness and recov-
ery to consum-
ers across Contra
Costa County who
use behavioral
health services
from county and
community con-
tract providers. In FY 2010/2011 and in FY
2011/2012, collaborative efforts among these
organizations resulted in the quarterly pro-
duction of four 30-minute videos on mental
health recovery in a news-show format. The
completed videos will be shown on monitors
located in the waiting rooms of behavioral
health clinics throughout the County and will
Peer and Family
Delivered Services and Supports
MHSA 2012-2013 Annual Update 35
also be available for a multitude of other edu-
cational uses, including websites, community
meetings, public access broadcast, and more.
Each of the first four 30-minute videos in-
cludes the following components: an inspira-
tional interview with mental health consum-
ers/providers;
a toolbox seg-
ment featur-
ing a recovery
technique or
skill; a healthy
cooking dem-
onstration,
a stigma-
busting PSA,
and a facility
tour of a local
mental health
provider. The
videos will be
first shown in
County Adult
Behavioral
Health Clin-
ics in 2012,
along with a
bulletin board
with informa-
tion that com-
plements the
videos, and a
peer newslet-
ter, “The Peer
Perspective”,
developed by the OCE and distributed in hard
copy at the County Behavioral Health Clinics,
as well as an electronic version. The videos
will also be offered to community behavioral
health organizations to show in their waiting
areas. The OCE, in collaboration with the
Putnam Clubhouse, is developing the next
four 30-minute videos in FY 2011/2012.
The OCE also offers behavioral health edu-
cation workshops and groups to consum-
ers in the community, and to behavioral health
care providers. In 2011, the OCE provided
96 training opportunities or groups on men-
tal health recovery to consumers and family
members, including presentations to con-
sumers enrolled in the SPIRIT peer provider
training program at Contra Costa College and
the two-part Tell Your Story Workshops de-
scribed above. The OCE plans to film OCE
recovery trainings and SPIRIT presentations
to display in adult behavioral health clinics,
beginning in FY 2012/2013.
The OCE collaborates with NAMI Contra
Costa to facilitate a monthly Writers’ Group,
which provides peer support and instruction
to anyone who wishes to learn to write about
their experiences. The OCE and NAMI Con-
tra Costa are also planning to partner in pro-
viding NAMI Connection support groups for
mental health consumers in Contra Costa
County, beginning in FY 2012/2013.
Client Involvement in MHSA
Planning Processes and Advisory
Committees and Commissions:
The OCE provides outreach and support to
County Adult Behavioral Health consum-
ers and family members to inform them of
upcoming MHSA planning committees and
subcommittees, Mental Health Commission
meetings, community forums, and opportuni-
ties for input into community services plan-
ning processes. OCE staff offers mentoring
and instruction to consumers who wish to
learn how to participate in community plan-
ning processes or to give public comments to
public advisory bodies. The OCE also collab-
orates with Contra Costa MHSA support staff
to offer orientation to consumers participating
in MHSA stakeholder meetings.
Peer and Family
Delivered Services and Supports
MHSA 2012-2013 Annual Update36
MHSA
Contra Costa County
County Peer Provider Employees
The CCMHP employs mental health consum-
ers as Community Support Workers (CSWs)
and other peer provider positions throughout
Behavioral Health. Peer CSWs provide peer
support, independent living skills training,
transportation, co-facilitation of groups, and
other support at the adult mental health clin-
ics, as well as in the community. They also
provide phone assistance to clients in Fi-
nancial Services, and provide support in the
Conservatorship, Transition Team, and in the
OCE. The OCE CSW positions are funded
by the MHSA. The OCE offers monthly group
training and peer support to all peer CSWs,
as well as individual training in documenta-
tion, psychosocial rehabilitation skills, peer
support, and group facilitation.
The CCMHP employs parents and caregivers
of children and youth who are mental health
consumers as Family Partners. Family Part-
ners share their own experiences of navigat-
ing multiple systems of care to provide ad-
vocacy and support services to parents and
families of children and youth with Severe
Emotional Disturbance. Family Partners work
as members of Wraparound teams and bring
their lived experience to support families in
their systems navigation, the cultivation and
development of natural supports within the
community, and the compassionate under-
standing of one who has successfully made
this difficult and rewarding journey.
37
The Other Side of Winter
A poem by Roberto Roman
As a child, I gazed at the flickering lights of a Christmas tree.
Their colors danced across a horizon of pine needles.
I had found a corner of the universe where I felt safe.
A mother’s voice...a grandmother’s embrace...a father’s example...
They gave me shelter from the winter torrents.
Yet for every season born, one must pass away.
As plumes strove with blazes beneath my feet,
I darted to the front door for the last time.
I watched my sanctuary turn to ashes.
The ones I had loved started to slip away, until they were gone.
So with nowhere to go, I started walking in the rain.
The wind tore my umbrella apart.
I pressed on with the clouds as my canopy.
I kept looking back.
I found a new sanctuary with new ones to love.
I kept looking back.
A new purpose had made my heart its resting place.
I kept looking back.
Then as daylight slipped out of my grasp, a man asked me,
“Why do you keep looking back?”
I answered, “Because there I was safe. There I wasn’t alone.”
He said, “You’re not alone. The only way to be free is to let go.”
I staked out my ground in the balance between seasons.
I looked in both directions.
I made my choice.
As night waned, I came across a mountain and started to climb.
I was afraid to fall, so I kept looking above.
As I stretched out my hand to pull up further, I remembered.
I stopped, and a tear caressed my face.
Then I realized that it had stopped raining.
The air wasn’t so cold anymore.
In the corner of my eye, I saw sunlight break through the fading clouds.
I saw a rainbow trace its arc along the horizon.
I saw an eagle rise, extending its wings into the widening blue of newborn spring.
I yearned to follow, and I knew it was time for me to go on climbing...
37
38
PEI Program Overview
Prevention and Early Intervention (PEI) pro-
grams were designed to include meaning-
ful involvement and engagement of diverse
communities, potential individual participants,
their families and community partners. Pro-
grams and projects were developed to build
capacity for providing prevention and inter-
vention services related to mental health at
sites where people go for other routine ac-
tivities (e.g. education facilities, community
based organizations, ethnic specific cultural
centers, health providers).
In May 2009, the California Department of
Mental Health approved the Contra Costa
County MHSA Prevention and Early Inter-
vention (PEI) Plan which consists of nine
programs addressing four key community
mental health needs and specific priority
populations: Fostering Resilience in Commu-
nities Initiative, Fostering Resilience in Older
Adults, Fostering Resilience in Children and
Families, and Fostering Resilience in Youth/
Young Adults Initiative.
Program Summary
Building Connections in Underserved
Communities focuses on strengthening un-
derserved cultural communities in ways that
are relevant to specific communities, with
the purpose of increasing wellness, reduc-
ing stress and isolation, and decreasing the
likelihood of needing services of many types,
and to help support strong youth and strong
families.
Coping with Trauma Related to Community
Violence provides community organizing and
a proactive approach to community violence.
Raises awareness, engages in culture-build-
ing activities, celebrates resilience, creates
opportunities for healing and restoration and
convenes public forums to respond to specific
incidences of violence within the West Contra
Costa community.
Reducing Stigma and Awareness Educa-
tion implements the WREACH (Wellness and
Recovery Education for Acceptance, Choice,
and Hope) Speakers’ Bureau. Speakers in-
clude consumers, family members, and pro-
viders, who share their experiences and facts
about mental illness and recovery to decrease
stigma and increase social inclusion in the
community. The Committee for Social Inclu-
sion guides a stigma reduction and aware-
ness initiative.
Suicide Prevention has been an important
focus for both our system of care and with-
in our community. Our original Stakeholder
Work Group and Steering Committee recog-
nized the need for a suicide prevention effort
that was universal at one level and targeted
to particularly high risk populations at anoth-
er. A Suicide Prevention Committee was es-
tablished to create a comprehensive suicide
prevention plan for Contra Costa County.
Under this initiative we were able to expand
the language and cultural capacity of our cri-
sis line provider, Contra Costa Crisis Center,
and have been able to sponsor training on
suicide prevention.
Supporting Older Adults in underserved
cultural populations who are trauma exposed,
isolated, depressed and experiencing onset
of serious psychiatric illness. The purpose of
the program is to help provide early interven-
tion when warning signs appear, linkage to
appropriate community resources in a cultur-
38 39
39
ally competent manner, and prevent mental
illness and suicide.
Parent Education & Support programs of-
fer effective parenting skills, family commu-
nication, health identities/family values, child
growth and self-esteem development to care-
givers who have responsibility to care for at-
risk children and youth in order to reduce inci-
dence of child and substance abuse, juvenile
delinquency, gang violence, behavioral prob-
lems and emotional disturbances.
Supporting Families Experiencing the Ju-
venile Justice System provides individual
and family supports to help the youth become
strong, healthy, law abiding members of their
communities. Early screening of youth identi-
fied as needing mental health support leads to
better coordination of after care that assures
appropriate linkages to services and supports
as youth transition back into their communi-
ties. The treatment staff provide direct short
term therapy and facilitate warm hand-offs
to Community Based Organizations and to
County MH Systems.
Supporting Families Experiencing Mental
Illness provides peer-based programming for
adults in recovery from psychiatric disorders
to develop support networks, life and voca-
tional skills training, respite and stress reduc-
tion for caregivers, restorative community for
their loved ones, support for recovery, inde-
pendence, increased socialization, educa-
tion, and employment support.
Youth Development increases prevention
efforts for at risk youth, responding to early
signs of emotional and behavioral health
problems, strength-based efforts that build
on youths’ assets and foster resiliency, as
well as to help youth build knowledge and
concrete life skills, development of a positive
identity, self-esteem and positive community
involvement.
Multi-Family Therapy – An Intensive Early
Psychosis Intervention provides early inter-
vention to transition age youth experiencing
or at high risk of the early onset of psychosis
providing psycho education, vocational, oc-
cupational, and psychiatric supports to the
individual and the family.
39
MHSA 2012-2013 Annual Update40
MHSA
Contra Costa County
PEI PROGRAM
Under the Prevention and Early Intervention
(PEI) Component of the Mental Health Servic-
es Act (MHSA), Contra Costa Mental Health
(CCMH) has contracted with twenty agencies
for the Fiscal Year 2010 to 2011. Three of the
twenty agencies have multiple contracts with
CCMH. There are a total of ten programs. Of
the initial nine programs in CCMH, eight were
available for full or partial funding through the
Request for Proposal (RFP) process. Pro-
gram 10 is a new PEI program that was ap-
proved in 2011. The following is a list of the
Providers of Services:
Program 1: Building Connections
in Underserved Cultural
Communities
• Asian Community Mental Health Servic-
es: Building Connections in API Commu-
nities
• Center for Human Development: African
American Health Conductors
• Jewish Family & Children’s Center of
East Bay: Community Bridges
• La Clinica de La Raza: Vias de Salud
(Pathways to Health)
• Lao Family Community Development,
Inc: Health and Well Being for Asian
Families
• Native American Health Center: Native
American Wellness Center
• Rainbow Community Center: LGBT
Community Mobilization & Social Support
• YMCA of the East Bay: One Family at a
Time - Building Blocks for Kids Collabora-
tive (BBK)
Program 2: Coping with Trauma
Related to Community Violence
• RYSE: Trauma Response & Resilience
System
Program 3: Reducing Stigma &
Awareness Education
• CCMH Office for Consumer Empower-
ment
Program 4: Suicide Prevention
• Contra Costa Crisis Center: Suicide Pre-
vention
• Suicide Prevention Pilot (Based on the
Henry Ford Health Model)
Program 5: Supporting Older
Adults
• CCMH Senior Peer Counseling
• LifeLong Medical Care: SNAP! Senior
Network and Activity Program
Program 6: Parenting Education
and Support
• Child Abuse Prevention Council: The
Nurturing Parenting Program
• Contra Costa Interfaith Housing, Inc.:
Strengthening Vulnerable Families
• Counseling Options and Parent Educa-
tion (COPE): Triple P-Positive Parenting
Program
• La Clinica de La Raza: Familias Fuertes
(Strong Families)
• The Latina Center: Primo Nuestros Ninos
(Our Children First)
MHSA 2012-2013 Annual Update 41
Program 7: Families Experiencing
the Juvenile Justice System
• Contra Costa Behavioral Health
Program 8: Support for
Families Experiencing Mental
Illness
• The Contra Costa Clubhouses, Inc.: Sup-
porting Families Experiencing Mental Ill-
ness
Program 9: Youth Development
• El Cerrito High School: James More-
house Program – Youth Development
• Martinez Unified School District: New
Leaf – Youth Development
• People Who Care: Youth Development
• RYSE Center: RYSE Health & Wellness
• STAND! Expect Respect
Program 10: Multi-Family Group–
An Intensive Early Psychosis
Intervention
• Contra Costa Behavioral Health
PEI Program Overview
(Demographics)
For Fiscal Year 2010 to 2011, our PEI Pro-
grams served 41,870 unduplicated partici-
pants ages 0 – 60+ in all regions of the County.
Twenty-five percent (25%) of the participants
were age 46-59. Sixty percent (60%) of the
participants are female. Participant’s primary
language spoken is English (77%). Forty per-
cent (40%) of the participants are Caucasian
and thirty percent (30%) are Latino / Hispanic.
Please see graphs and data descriptions be-
low for a breakdown of age, gender, region,
ethnicity, and language:
Ages of the Participants: (n=41,870)
Ages: 0-5 (2%), 6-12 (3%), 13-17 (7%), 18-21 (4%),
22-25 (3%), 26-35 (10%), 36-45 (16%), 46-59 (25%),
60+ (13%), and Unknown (17%).
Language of the Participants: (n=41,837)
Language: Predominately English (77%), Spanish
(16%), Asian (1%), and Unknown (6%). Not shown on
graph: Am. Sign (2) = (0.005%), Farsi (177) = (0.4%)
and Other (192) = (0.5%).
PEI Program Overview
MHSA 2012-2013 Annual Update42
MHSA
Contra Costa County
Region: (n=41,837)
Region: Central (29%), East (23%), West (17%), Oth-
er (2%) and Unknown (29%).
Ethnicity of the Participants: (n=41,837)
Ethnicity: Caucasian (40%), Hispanic/ Latino (30%),
African American (15%), Asian/Pacific Islander (4%),
Other (7%) and Unknown (4%). Not shown on graph:
American Indian / Alaska Native (190) = (0.5%).
PEI Overview CD Gender Chart
Gender: Male (38%), Female (60%), Unknown (2%).
Not shown on graph: Other (15) = (0.04%).
*** See Appendix for specific PEI program
outcomes.
43
Story of Hope
By Doug Kirk
Over a year ago I quit taking my medica-
tion which caused me to decompensate
and my symptoms of severe depression and
paranoia returned. Because of that I got
into trouble with the law and was arrested.
I was diagnosed with schizophrenia 25
years ago and have been in jails and in-
stitutions on and off
since then. After my
last time of going off
meds, I was in jail for
49 days.
When released, I
moved to a Concord
board and care home
and was referred to
Putnam Clubhouse
by my case manager.
At first I just attend-
ed once a week, but
I liked it so I started
going every day. The
people were really supportive there and
made me feel accepted and welcome.
During the time I’ve attended the Club-
house I’ve learned to use a computer and
to do data entry. I now enter data for the
monthly Clubhouse reporting. For the last
year I’ve been trying to resolve my court
case from the time I mentioned above
when I was off my medication. I am hap-
py to report that due to my improvements
since joining the Clubhouse, I’ve been able
to get the charges dropped.
I’ve learned to become more positive since
attending the Clubhouse and I’m finally sat-
isfied with how my life is going. When I’m
not at the Clubhouse,
I stay busy working
on my motorcycle,
which is my hobby.
And my relationships
have improved with
my family, too. My
daughters and grand-
kids have been very
supportive and have
noticed how much
better I’m doing now.
The Clubhouse gives
me a purpose, some-
thing useful to do
every day and a way to contribute to so-
ciety. Before, I sat around with nothing to
do. I also attend some of the evening and
weekend programs at the Clubhouse and
have made a lot of friends there. I’m satis-
fied now with the way my life is going on
all fronts. I finally believe that recovery is
possible.
43
44
Suicide Prevention
The formation of the Contra Costa County Suicide Prevention Committee is
outlined in the MHSA Initial 3-Year Plan as part of the Prevention and Early
Intervention (PEI) efforts. The committee is charged with drafting a county-wide
suicide plan aimed at reducing attempted and completed suicides. The mem-
bership is a broad representation of many stakeholders. The following groups
and/or agencies are represented:
• LGBTQ
• Older Adult Mental Health
• CCRMC
• John Muir Health
• Kaiser Permanente
• Alcohol and Other Drugs
• Veterans Administration
• NAMI
• Mental Health Administration
• Domestic Violence
• Youth Advocate
• Contra Costa Crisis Center
• Family Member
• Lived experience
• Central County Adult Mental Health
• Education (K-12)
44
MHSA 2012-2013 Annual Update 45
The Suicide Prevention Committee has
worked tirelessly for the last 18 months on
various projects to further the cause of sui-
cide education, awareness and prevention.
Focus groups were conducted with various
community groups including the faith-based
community, older adults and youth, revealing
poignant stories of struggle and survival. A
smaller sub-group of members worked to-
gether to review the medical charts of those
who took their own lives and had received
a mental health service within six months of
their death. This review gave insight into what
a person was experiencing prior to their death
and highlighted important areas of focus for
suicide prevention efforts specifically within
our mental health system.
With the philosophy in mind to do things that
work, the Committee reviewed many evi-
dence-based practices for suicide prevention.
During this process
the committee discov-
ered a program which
has reduced suicides
to zero for over two
years. The Perfect
Depression Care
program was imple-
mented at the Henry
Ford Health System
in Detroit, Michigan
and incorporates sui-
cide assessments for
all behavioral health
clients, same day psy-
chiatric appointments,
a focus on means
restriction, follow-up
phone calls, and drop-
in groups. During the
previously mentioned
chart review process,
the Review Team considered whether as-
pects of the Henry Ford Heath Model would
have made a difference in the life trajectory
of those who died by suicide in Contra Costa
County. The group unanimously agreed that
having services as modeled in the Henry Ford
Health System would be beneficial for people
at risk for suicide.
Many initiatives have grown from the work
and collaboration of the committee mem-
bers. Among other important projects, Con-
tra Costa Behavioral Health is piloting drop-
in groups and follow-up phone calls at the
Central County Adult Mental Health Clinic for
consumers at an increased risk for suicide.
The Committee is in the final stages of deter-
mining the prevention strategies to include in
the County-wide Suicide Prevention Plan. It is
anticipated that the plan will be finalized dur-
ing Fiscal Year 2012-2013.
Suicide Prevention
46
Introduction
Contra Costa Behavioral Health’s Workforce
Education and Training (WET) Plan was de-
signed to address the shortage of qualified
individuals who provide services in our Coun-
ty’s community mental health system. All
proposed education, training and workforce
development programs and activities contrib-
ute to developing and maintaining a culturally
competent workforce and to include individu-
als with client and family member experience,
capable to provide client and family driven
services.
The goals and objectives of Contra Costa
Behavioral Health’s (CCMH) WET plan’s five
program areas are consistent with and sup-
port the vision and values of the California’s
MHSA Workforce Education and Training
Strategic Plan.
Workforce Education and
Training Overview
46
MHSA 2012-2013 Annual Update 47
Program Area 1: Workforce Staffing
Support
The first program area of CCBH’s WET plan
is focused on activities to provide staffing and
support to CCBH’s WET component and to
enhance the County’s training infrastructure.
CCBH believes it is important to increase the
availability of information on regional edu-
cation and employment activities, including
internship opportunities as well as ensure
that family members, consumers and under-
served and underrepresented communities
are included as both trainers and participants.
Through this program area, CCBH is respon-
sible for coordinating training and technical
assistance efforts for County and community
based organization (CBO) staff as well as
network providers.
Notable activities during this reporting period
include:
• 6 Training Advisory Work Group meet-
ings were held during 2010-11 to support
the development of the activities in The
Plan.
• Development of CCMH Education and
Training Policy and Procedure
• Identification of county staff who are sub-
ject matter experts in a variety of topics
such as: motivational interviewing, cultur-
al competence, computer training, clinical
supervision, etc.
• Identified clinical supervisor to implement
and monitor fidelity of Evidence Based
Programs
Program Area Outcomes
• Development of 2010 and 2011 Training
Calendar
• In-house continuing education units spe-
cialists to review training content for CEU
appropriateness
• Partnered with California Institute of Men-
tal Health (CiMH) to provide training and
ongoing technical assistance for cultur-
ally and ethnically focused community
based organizations
Program Area 2: Training and
Technical Assistance
CCMH is committed to a philosophy of “grow-
ing our own’ with regard to workforce devel-
opment. A well-educated and well-prepared
public mental health workforce requires ac-
cess to current clinical, administrative, su-
pervisory and managerial information on
best practices in order to effectively serve
Contra Costa County’s dynamic and diverse
populations and regions. The identification
and development of new staff development
opportunities that advance staff competen-
cies, contribute to job satisfaction, retention
Workforce Education and Training Overview
MHSA 2012-2013 Annual Update48
MHSA
Contra Costa County
and service to attract new employees based
on personal and professional growth are the
goals of this portion of the WET plan. The
goal of the Training and Technical Assistance
Program area is to provide an array of training
opportunities to enhance the skills of current,
staff. In 2010-2011, CCBH created and coor-
dinated trainings for CCBH staff and contract
providers, collaborating with external agen-
cies as well as working with internal subject
matter experts, enhancing internal training
capacity.
Notable activities during this reporting period
include:
• Implemented online learning system for
staff, Essential Learning, with over 500
behavioral health courses available
• Implemented community educational
website, Community Access Site (CAS)
• Planned and hosted a Recovery and Re-
siliency Conference at the Crowne Plaza
Hotel in Fall of 2011 with over 200 partici-
pants that included county and CBO staff,
consumers, family members, stakehold-
ers and members of the public.
• Partnered with CiMH to provide ongoing
technical assistance to community based
organizations
• Offered Mental Health Training for Law
Enforcement (CIT Training)
Program Area Outcomes
• # of Trainings offered
Training Type # Offered
Total Trainings Offered in FY 10-11 150
Cultural Competency Trainings 58
Trainings by internal experts 28
Online Trainings via Essential
Learning 561
• Five Crisis Intervention Trainings were
held during this fiscal year.
Program Area 3: Mental Health
Career Pathways Programs
Contra Costa County has been a leader inthe
engagement of consumers and family mem-
bers as employees, offering consumer train-
ing programs as well as alternatives to a col-
lege degree. The focus of this program area is
to provide career track options into the mental
health field. Included in this program area are
the Service Provider Individualized Recovery
Intensive Training (SPIRIT) Program Expan-
sion and Enhancement, Family Member Em-
ployment Strategies, and Developing Mental
Health Concentration in High School Health
Academies. In addition, the development of
the Psychosocial Rehabilitation Certificate at
Contra Costa College and exploring a Psychi-
atric Technician Program is also a part of the
Work Plan to further develop staff skills.
Notable activities during this reporting period
include:
Workforce Education and Training Overview
MHSA 2012-2013 Annual Update 49
• Continuation of SPIRIT Program
• Completion of a pilot program of a Men-
tal Health Concentration in Dozier Libbey
Medical High School Health Academy;
plan for implementation in additional high
schools across the County for FY 2011-
12
• CCMH was awarded a Healthcare Career
Training Program Grant from the Office of
Statewide Health Planning and Develop-
ment (OSHPD), to support the develop-
ment of a mental health concentration
in high schools across all regions of the
County
• Continuation of Psychosocial Rehabilita-
tion Certificate program
• Continuation of the CCMH Internship
Program
• The County awarded a grant to the Na-
tional Alliance of Mental Illness (NAMI) to
develop a family psycho-education pro-
gram targeting Spanish speaking families
in Contra Costa County
Program Area Outcomes
• 27 students completed the SPIRIT pro-
gram
• Over 20 students enrolled in each of the
classes required for the Psychosocial Re-
habilitation Certificate program
• Over 85 students participated in the men-
tal health program at various high schools
in Contra Costa County
Program Area 4: Residency and
Internship Programs
Exposure to the community mental health
field through residency programs and intern-
ships is a key strategy to identify and recruit
professional staff. Engaging professionals
through training programs not only ensures
an infusion of current best clinical practices
but provides a replenishment source to bal-
ance staff attrition due to retirement. Gradu-
ate internship support and development of
both the psychiatry and psychiatric nursing
workforce are among the programs included
in this area.
Notable activities during this reporting period
include:
• Graduate-level interns placed in County
programs
• Funds were awarded to five (5) commu-
nity based organizations to recruit interns
into their programs [CBO Internship pro-
gram]
Program Area Outcomes
• 25 Graduate Interns for FY 2010-11 were
placed in various County clinic settings
for training, including Juvenile Hall, Older
Adult Program, Regional Medical Cen-
ter’s Crisis Unit, and Central County Chil-
dren’s Clinic.
• Through the CBO internship program for
FY 2010/11, 39 interns were hired. Most
of the interns represented various cultural
backgrounds.
Workforce Education and Training Overview
MHSA 2012-2013 Annual Update50
MHSA
Contra Costa County
Program Area 5: Financial Incentive
Programs
In line with CCMH’s commitment to growing
our internal capacity, the County provides fi-
nancial incentives to support staff that wish to
obtain a degree while employed through the
WET plan. This program allows for contin-
ued development of a proven and qualified
workforce, tapping those who already have
knowledge of the County mental health sys-
tem. CCMH plans to provide educational
scholarships for those who wish to pursue a
bachelors or master’s degree, specifically in
mental health-related areas. To further sup-
port these efforts, CCMH has worked to ex-
pand the professional shortage designation
areas to include more areas of the county.
This state designation allows for incoming
psychiatric staff to be eligible for various state
loan forgiveness programs, thereby mak-
ing Contra Costa a more attractive option for
employment new for graduates. To further
the financial incentive programs for potential
County staff, CCMH has also worked to in-
clude several clinic sites to be included in the
National Healthcare Service Corps (NHSC).
As an approved NHSC site, CCMH has the
ability to attract NHSC providers to communi-
ties who need it the most and provide training
opportunities and resources.
Notable activities during this reporting period
include:
• The County Board of Supervisors ap-
proved funds to be transferred to the
Joint Powers of Authority to act as a fis-
cal intermediary for the CCMH Scholar-
ship Program
• CCMH administration developed appli-
cations for the Bachelor’s and Master ‘s
Level Degree programs to be released
during FY 2011-12
• Approval of MSSA 17, which includes the
cities of Brentwood, Knightsen, Byron,
and Discovery Bay to be designated as
a Mental Health Professional Shortage
Area
• Approval of East County Adult Mental
Health Clinic and West County Children’s
Mental Health Clinic as National Health
Care Corps (NHSC) Approved Sites
Refinements and Revisions to WET
Plan in 2010-11
No notable refinements and revisions were
made to The Plan.
51
CCBH Reducing Health
Disparities (RHD) Workgroup
The CCBH Reducing Health Disparities
(RHD) Work Group is structured around the
guiding principles of the Health Services De-
partment’s Reducing Health Disparities Initia-
tive (RHDI). The goal of the Work Group is to
ensure that all Behavioral Health county staff
provides services that respect the values,
belief systems and cultural preferences with
cultural humility to our consumers and com-
munities. To accomplish this goal, the RHD
guiding principles will be incorporated into the
work of CCBH.
Below are some of the guiding principles of
RHD:
• We are committed to eliminating health
disparities because our mission is to care
for and improve the health of all who live
in Contra Costa County with special at-
tention to those who are most vulnerable
to health problems. Disparities based on
race, ethnicity, language, socioeconomic
status or other similar reasons are incon-
sistent with our mission.
• We recognize that differences in race,
ethnicity, age, gender, sexual orientation,
language, physical ability, socioeconomic
class, education, and many other factors
can affect how we relate to patients, cli-
ents, customers, consumers, communi-
ties and each other.
• Our employees participate in training and
related activities to increase our knowl-
edge and appreciation of diverse cultures
and to become comfortable and effective
in a diverse environment
• The RHD structure is designed to ensure
RHD efforts are integrated into day-to-
day activities of the department and all of
its divisions.
• There is a role for every employee, man-
ager, supervisor and Division Director.
The RHD Work Group strives to maintain
membership that includes: Consumers and
Family Members; Contractors and Network
Providers; Community Partners/Leaders; Cul-
tural Groups; Health Conductors; and County
Mental Health Staff.
The RHD workgroup is broken down into
seven sub-workgroups of which members
of the workgroup are spread across. These
sub-workgroups include: (i) Linguistic Ac-
cess; (ii) Workforce Development, Education
and Training; (iii) Partnership with Multicultur-
al Communities; (iv) Work Environment; (v)
Governance, Systems and Policy; (vi)Data
Collection; and (vii) Inclusion Initiative (LG-
BTQ).
The CCMH Reducing Health Disparities
WorkGroup has a Work Plan that is broken
down into different sections with goals and
objectives under each of those sections.
This Work Plan sets measurable goals for
the group to accomplish, with projected com-
pletion dates and benchmarks. The Work
Group also strives to have representation in
all boards, committees and decision-making
bodies within the Behavioral Health system.
51
MHSA 2012-2013 Annual Update52
MHSA
Contra Costa County
Innovation Section
Component Overview
Mental Health Services Act (MHSA) Innova-
tion (INN) funds provide counties with oppor-
tunities to learn from new approaches that
have the potential to transform the mental
health system. According to the California
Welfare and Institutions Code Section 5830,
INN programs must contribute to learning in at
least one of four areas by having at least one
of the following as an essential purpose for
the learning that occurs in the program:
• To increase access to underserved
groups
• To increase the quality of services, in-
cluding better outcomes
• To promote interagency collaboration
• To increase access to services.1
At this time, Contra Costa County has six INN
programs it plans to fund and/or continue to
fund in FY 2012/13. Below are summaries of
the programs as well as their intended out-
comes.
Program Overviews
INN01: Social Supports for Lesbian, Gay
Bisexual, Transgender, Questioning,
Queer, Intersex and Two-Spirit (LGBTQQI2-
S) Youth and Transition Age Youth (TAY)
This project is a three-year pilot currently in
its second year. The goal of the project is to
determine whether applying a “Social Sup-
port Model” (based on the Social Ecological
1 Innovation Clearing House. “About MHSA INN”.
2012. Available at: http://www.mhsainn.org/about/.
Accessed on March 2, 2012.
Model2) to services targeting LGBTQQI2-S
youth/TAY (up to 29 years of age) will im-
prove their health and wellness and prevent
poor health outcomes. The project seeks to
attempt to reduce family, peer, and/or com-
munity rejecting behaviors and increase ac-
cepting behaviors. It will test the effectiveness
of various modes of engagement and service
provision and will develop best practices tool-
boxes for engaging/serving youth and their
social supports. The program’s target popu-
lation is LGBTQQI2-S youth/TAY as well as
their families and caregivers, straight peers
and allies, providers, schools, faith-based
organizations and community-based organi-
zations. The program served approximately
1,800 people during its first year.
The goal for Year One was to determine if the
Social Support Model could access existing
social supports influencing the health of LG-
BTQQI2-S Youth/TAY populations by engag-
ing, educating, and increasing the participa-
tion of families, peers, and communities in the
lives and services of the youth. This goal was
met; during Year One, the program identified
2 The social-ecological model illustrates how
spheres of social influences interact and affect an
individual’s health.
MHSA 2012-2013 Annual Update 53
effective engagement, education and support
strategies it will continue to test during Years
Two and Three. See appendix for program’s
Year One Executive Summary.
INN01 Year One program activities included:
• Development of a Community Collabo-
ration among organizations that provide
services to LGBTQ youth
• Development of an LGBTQ-specific Men-
tal Health Counseling Program
• Identifying activities that promote accep-
tance and safety for LGBTQ youth in their
homes, communities and schools. This
includes identifying practices currently in
place as well as new opportunities to de-
velop social support services for LGBTQ
youth
• Learning how organizations can identify
and engage LGBTQ youth and their fami-
lies in community service programs
• Learning how communities, organiza-
tions and families can support LGBTQ
youth in ways that promote positive iden-
tity development
• Learning how organizations and commu-
nities can provide education and support
to parents of LGBTQ youth to increase
accepting behaviors
• Community Map of supportive agencies
The goals for Years Two and Three are 1) to
attempt to reduce family, peer, and/or com-
munity rejecting behaviors and increase ac-
cepting behaviors; and 2) to assess if these
changes promote positive health outcomes3
for LGBTQQI2-S Youth/TAY. There are no
revisions to these goals.
3 In this program, positive health outcomes include
outcomes related to physical and mental health as
well as wellness and resiliency.
INN01 Year Two and Three program activi-
ties include:
• Building the capacity of CCC communi-
ty-based youth services to promote the
health and well-being of LGBTQ youth
• Engaging youth voice and leadership
• Developing, implementing and evaluat-
ing core strategies and tools designed
to promote positive identity development
and reduce health risk factors for LGBTQ
youth
• Building County-wide awareness of the
risk factors of rejection and role models
for acceptance of LGBTQ youth
• Engaging youth and family voice and
leadership
• Developing, implementing and evaluat-
ing core strategies and tools designed to
reduce rejecting behaviors and increase
accepting behaviors among families and
caregivers
• Building the capacity of CCC schools to
create a climate of acceptance for LG-
BTQ youth
• Engaging youth voice and leadership
• Developing, implementing and evaluat-
ing core strategies and tools designed to
reduce rejecting behaviors and increase
accepting behaviors in the school com-
munity
• Community Map of supportive agencies
INN01 outcome measurements include:
• Lessons learned about effective engage-
ment and support strategies from inter-
views with collaborative partners
• Lessons learned about effective strate-
gies in collaborative partner logs
• Increased service utilization
Innovation
MHSA 2012-2013 Annual Update54
MHSA
Contra Costa County
• Increased event attendance
• Positive feedback from program partici-
pants
• Increased number of supportive agencies
on the Community Map
• Improved outcomes on the CC LGBTQ
Youth Advocacy Collaborative Youth
Survey which assesses:
demographics
service utilization
identity development
social support
accepting and rejecting behaviors
(from family and peers) experienced
by youth
community involvement
overall physical health
overall mental health
substance use
risky sexual activity
knowledge of resources
INNFT01: Promoting Wellness, Recovery
and Self-Management through Peers
This 12-month program will pilot using trained
Peer Wellness Coaches to provide wellness
services in mental health clinics. The target
population consists of consumers who re-
ceive services in the county-operated adult
mental health clinics. The goals of the project
are to learn if and how adding Peer Wellness
Coaches to health integration projects will: 1)
improve wellness and health outcomes for
consumers; 2) increase primary and mental
health care staffs’ understanding of mental
health “consumer culture” and recovery prin-
ciples; 3) increase the number of consumers
with wellness, recovery and/or self-manage-
ment goals; 4) reduce feelings of stigmatiza-
tion; and 5) enhance recovery.
This program is currently on hold due to hu-
man resource challenges.
INNFT01 program activities may include:
• Peer Wellness Coaches working with
clinic staff to:
Assist in the provision of wellness edu-
cation to consumers
Facilitate wellness groups
Educate consumers about recovery
Assist consumers in developing re-
covery goals and chronic disease self-
management plans
Provide Wellness Recovery Action
Plan (WRAP) training
Aid consumers with skill-building, in-
cluding mental health coping skills, to
promote the achievement of their well-
ness, recovery and chronic disease
self-management goals
Educate consumers about working with
primary and mental health care provid-
ers to promote wellness and increase
consumer’s participation in physical
and mental health treatment
MHSA 2012-2013 Annual Update 55
Link consumers to existing wellness
and recovery resources in the commu-
nity
Provide peer leadership support
Educate primary and mental health
care staff about mental health recov-
ery principles as well as mental health
“consumer culture”
INNFT01 outcomes measures will include:
• Increased number of wellness and recov-
ery plans
• Increased use of wellness and recovery
plans
• Increased participation in wellness and
recovery activities
• Changes in health-related behav-
iors
• Improved health outcomes
• Improved recovery scores
• Changes in client perceptions of
stigma
• Increased number of healthcare
linkages
• Changes in primary care providers’ un-
derstanding of consumer culture
and recovery principles
• Changes in consumer’s
perception of pri-
mary care provid-
ers’ understand-
ing of consumer
culture and re-
covery princi-
ples
INNFT02: Inter-
agency Perinatal
Depression Treat-
ment Program
This 12-month program is a collaboration be-
tween Contra Costa Behavioral Health Ser-
vices, Public Health Nursing and Women
Infant and Child (WIC) program. It will pilot
the integration of perinatal/post partum de-
pression services into the services currently
provided at the Central County WIC office.
The target population consists of mothers
who receive services from the Central County
WIC office who screen positive for perinatal
and/or post partum depression. The goals of
the program are to learn: 1) which elements
of the collaboration are most/least effective
and why; 2) if the collaboration leads to an
increase in awareness about mental health
services and a decrease in the mothers’ per-
ception of stigma associated with depression;
and 3) improved health outcomes for the
women participating in the collaboration.
This program began implementation in
April of 2012.
INNFT02 program activities will include:
• Implementing interagency collaboration
• Screening mothers for depression
• Providing one-on-one counseling servic-
es
• Providing group counseling services
• Providing medication services
• Providing referrals as
needed
INNFT02 outcome mea-
sures will include:
• Changes in depression
scores
• Improved treatment out-
comes
• Positive feedback from
mothers and providers
Innovation
MHSA 2012-2013 Annual Update56
MHSA
Contra Costa County
• Increased service utilization
• Changes in perceptions about stigma re-
lated to seeking mental health care
• Increased awareness about mental
health and mental health services
• Progress towards achieving wellness/re-
covery goals
INNFT03: Libby Madelyn Collins Trauma
Recovery Project
This 24-month program pilots the use of a
Trauma Recovery Group with consumers di-
agnosed with co-occurring Post-Traumatic
Stress Disorder (PTSD) and schizophrenia,
schizoaffective disorder, bipolar disorder and/
or cluster B personality disorders who receive
mental health services at the county-operat-
ed adult mental health clinics. The program
is currently in its first year. There are seven
individuals enrolled in the first group. Three
additional groups, each with no more than 10
participants, will begin in Spring of 2012. One
of the upcoming groups will be held in a board
and care facility and one will target Spanish-
speaking consumers. The goals of the project
are to determine: 1) if offering this group to
consumers will improve mental health out-
comes and promote recovery; 2) how peer
providers can support the group; and 3) if the
group is effective among various cultural pop-
ulations, particularly Spanish-speaking popu-
lations and TAY.
Program implementation began in November
of 2011. Therefore, outcome data is not yet
available. To date, there have been no refine-
ments or revisions made to the program or
program goals.
INNFT03 program activities include:
• Implementation of the Trauma Recovery
Group
• One-on-one case management services
and/or therapy as needed
• Training county and contract staff and
consumers about trauma and trauma
therapy
INNFT03 outcome measures include:
• Increased knowledge about PTSD (cli-
ents and staff)
• Changes in group and one-on-one atten-
dance
• Improvement in clinical assessments
and assessment scores (surveys include
the Beck’s Depression Inventory, PTSD
Checklist, Post Traumatic Cognitions In-
ventory, PTSD Knowledge Test, Trauma
History Questionnaire and Recovery As-
sessment Scale)
• Positive client feedback about the Trau-
ma Recovery Project services
• Progress towards achieving client goals
• Decreased number of involuntary hospi-
talizations
• Decreased number of involvements with
the criminal justice system
• Decreased number of evictions
• Decreased alcohol and substance abuse
INN04: Trauma Services for Sexually Ex-
ploited Youth (up to 25 years of age)
Creating a Safe Haven to Support Transgen-
der and LGBTQQI2-S Youth Involved in Sex-
ual Exploitation
This 36-month project will target LGBTQQI2-
S youth who are (or at high risk of) being
sexually exploited. The goal of this project is
to create a new street-based venue intended
to increase youth access to a comprehensive
array of social and support services, deliv-
MHSA 2012-2013 Annual Update 57
ered at a site specifically designed to support
their needs. This program will be piloted in
Central Contra Costa County and will develop
a safe space and drop-in program targeting
LGBTQQI2-S youth with a specific focus on
youth who are gender variant and/or trans-
gender identified and who engage in street
socialization, commercial sex work and/or
survival sex. Additional project goals include
developing replicable outreach methods that
support the ability to identify and reach this
underserved group; the development of as-
sessment tools that will support identification
of sexual exploitation in this population; and
establishment of a referral network that will
increase LGBTQ youth’s ability to integrate
into mainstream social service programs.
Reluctant to Rescue
This 36-month project will target sexually ex-
ploited youth in Central and East County. The
goals of the project are to: 1) gather informa-
tion from sexually exploited youth about their
backgrounds and reasons for entering and
remaining in sexually exploitative situations
as well as feedback on what would motivate
and/or help them to leave these situations; 2)
create a drop-in center to provide the youth
needed support and services; 3) develop a
training program for the care providers of sex-
ually exploited youth; 4) determine the most
effective ways of promoting and sustaining
youth engagement with services; 5) deter-
mine how programs can decrease the attrac-
tion of the lifestyle some sexually exploited
youth associate with their exploitation; and
6) determine what additional services and/or
interventions are necessary to increase the
ability of sexually exploited youth to access
healthy choices and increase the number of
youth who recognize they can make choices
about their risk behaviors.
At this time, contracts and Work Plans as-
sociated with Reluctant to Rescue are go-
ing through the County approval process.
Once approval occurs, the program will be
implemented. Creating a Safe Haven to Sup-
port Transgender and LGBTQQI2-S Youth
Involved in Sexual Exploitation has begun
implementation and will begin to provide ser-
vices to youth during Spring of 2012.
INN04 program activities will include:
• Creation of drop-in centers for sexually
exploited youth/youth at risk of sexual ex-
ploitation
• Outreach to youth
• Data collection about factors influencing
youth’s entrance into situations of sexual
exploitation as well as factors that will mo-
tivate/help youth to leave these situations
• Provision of mental health and support
services
• Development of assessment tools to
identify exploited and at risk youth
Innovation
MHSA 2012-2013 Annual Update58
MHSA
Contra Costa County
• Establishment of referral network
• Intensive caregiver training
• Educating law enforcement
• Form coordinated response team for sex-
ually exploited youth
INN04 outcome measures will include:
• Increased referrals into program(s)
• Increased number of youth utilizing ser-
vices
• Increased program retention
• Decreased relapse behaviors among
youth
• Decreased arrest rates among youth
• Increased knowledge of life skills among
participating youth
• Improved health outcomes
• Increased number of youth who recog-
nize they can make healthy choices in
their lives
• Positive feedback about services from
participants and staff
• Increased caregiver knowledge about
parenting issues related to caring for a
sexually exploited youth
• Increased length of home-stay among
youth whose caregivers attended the
caregiver training
• Changes in police policies/protocols for
dealing with sexually exploited youth
“Only a man who
knows what it is like
to be defeated can
reach down to the
bottom of his soul and come up with an
extra ounce of power it takes to win, when
the match is even”
– Muhammad Ali
59
59
– Muhammad Ali
Inclusion Initiative
The Contra Costa Mental Health’s Plan (CC-
MHP) Inclusion Initiative began in FY 2009-
2010. Its mission is to protect Lesbian, Gay,
Bisexual, Transgender, Questioning, Intersex
and Two-Spirit (LGBTQI2-S) consumers and
their families from discrimination and mistreat-
ment, and to ensure that they are welcomed in
culturally affir-
mative settings
where they will
receive clini-
cally compe-
tent mental
health care.
The Inclusion
Initiative has
three goals.
The first goal is
to protect LG-
BTQI2-S con-
sumers and
their families
from discrimi-
nation and mis-
treatment. Initiative activities promoting Goal
One ensure consumers requesting access
to treatment and care through CCMHP pro-
grams and contractors are guaranteed pro-
tection from discrimination and harassment
based on actual or perceived sexual orien-
tation, gender identity or gender expression.
The second goal is to ensure that CCMHP
and contracted providers provide culturally af-
firmative environments of care for LGBTQI2-
S consumers and their families. Initiative ac-
tivities promoting Goal Two ensure CCMHP
and contracted providers have the appropri-
ate cultural awareness, knowledge and skill
to create a welcoming environment for mental
health consum-
ers of every
sexual orien-
tation, gender
identity and
gender expres-
sion.
The third goal
is to ensure
clinically com-
petent mental
health care for
LGBTQI2-S
consumers and
their families.
Initiative ac-
tivities promot-
ing Goal Three ensure clinically competent
providers, care and resources are available
and accessible to serve the particular men-
tal health needs of Contra Costa residents of
every sexual orientation, gender identity and
gender expression, in every geographic re-
gion.
59
MHSA 2012-2013 Annual Update60
MHSA
Contra Costa County
In order to achieve its goals, over the last
several years, the Inclusion Initiative has de-
veloped partnerships, resources and policies
for the County’s LGBTQQI2-S population and
their families. The following are some of the
Initiative’s accomplishments to date:
• The development of the LGBTQI2-S In-
formation and Resource Website for the
EastBay (Contra Costa & Alameda Coun-
ties), www.EastbayPride.com
• Ongoing coordination with county-wide in-
formation and referral agencies to ensure
information is inclusive of LGBTQQI2-S
resources
• Development and implementation of CC-
MHP providers’ cultural competencies in
working with LGBTQI2-S individuals and
their families
• Incorporation of the LGBTQ Corner for
educating providers on issues in meeting
the needs of the community in the Mental
Health Director’s bimonthly report.
• Implementation of Prevention and Early
Intervention and Innovation programs
targeting LGBTQQI2-S individuals and
their families
• A pilot project which updated CCMHP
Network Provider forms to appropriately
collect data regarding gender identity, re-
lationship status and sexual orientation
was initiated
• Alcohol and Other Drugs began a pilot
project to train select programs and staff
to collect sexual orientation and gender
identity information as part of their Intake
process
• Creation of the LGBTQI2-S Cultural Com-
petency Self-Assessment & Planning tool
to assess the CCMH programs readiness
to serve LGBTQI2-S consumers and their
families, and to assist in the development
of a plan to improve their outreach and
services to this population
in the future
MHSA 2012-2013 Annual Update 61
• The publication of a Web page on the
CCMHP website which identifies Per-
sonal Navigators, Health Services staff
and contractors who are part of the LG-
BTQI2-S & Straight Allies communities
and able to provide personal assistance
to LGBTQI2-S consumers in accessing
and receiving services, in a safe and sup-
portive environment
• The CCMHP Consumer Perception Sur-
vey was amended to collect sexual ori-
entation and gender identity along with
other demographic information
• Publication of monthly CCMH Inclusion
Initiative eNewsletters which contain
timely information on local trainings, on-
line trainings, community events, surveys
and research studies, jobs and scholar-
ships, and new LGBTQI2-S resources
• In collaboration with the Health Services
Department’s Pride Initiative, the Inclu-
sion Initiative developed a non-discrim-
ination statement inclusive of sexual
orientation and gender identity--
“Contra Costa Health Services values
and respects all individuals. We do not
discriminate based on: age, sex, reli-
gion, sexual orientation (including les-
bian, gay, bisexual), gender identity or
expression (including transgender and
intersex), culture, education, race, eth-
nicity, language, former incarceration,
marital, economic or housing status,
physical or mental disability, or any oth-
er basis prohibited by federal, state or
local law.”
In FY 2012-2013, the Inclusion Initiative will
continue towards achieving its goals. Specific
activities will include; 1) the development and
implementation of a comprehensive two-year
training cycle to improve LGBTQI2-S compe-
tency across the CCMH programs on an on-
going basis; 2) the expansion of the number
of agencies completing the LGBTQI2-S Cul-
tural Competency Self-Assessment & Plan-
ning Tool; and 3) the development of a com-
prehensive set of LGBTQI2-S Policies and
Procedures for improving services to CCMH
consumers and their families.
Inclusion Initiative
62
Thank you for presenting and sharing your experiences with my class
and I. Your presentation taught me that being open and strong can lead
to a better life with or without people’s opinion. I really do hope I can
be more open and strong like you guys. I am really not gonna let people
get to me or put me down because I’m different. My appearance, race,
sexuality and personality are always judged by people and I’m afraid to
be open and strong. I want to change that. So thank you so much. You
really helped me in a way I couldn’t imagine.
“Love is for All”
- Anonymous High School Student
62
MHSA 2012-2013 Annual Update 6362
Information and Technology
The Information System replacement project
funded by MHSA was re-directed over the last
year. In light of the fact that the Epic system
is currently being implemented at the County
hospital (CCRMC), ambulatory care clinics,
and the Contra Costa Health Plan (CCHP)
and due to go live on July 1, 2012, senior
management required a feasibility determina-
tion to assess whether the Epic system would
work for Behavioral Health rather than use a
separate system for Behavioral Health. The
goal is to have a consolidated clinical record
to provide a more holistic picture of clients/
patients within the Health Services system.
Early analyses suggest the Epic system could
potentially work for most areas of clinical doc-
umentation and some aspects of managed
care, but there are significant gaps in terms
of Short-Doyle Medi-Cal billing, as well as
Managed Care reimbursement and payment.
In addition, it was questionable whether the
Epic system would be sufficient to handle
state mandated reporting requirements such
as CSI and CalOMS. If a system other than
Epic is decided on for Be-
havioral Health, the goal
will be to utilize tools for
ensuring interoperabil-
ity between systems such
that critical clinical infor-
mation is readily shared.
This functionality was built
into the original plan for
a new Behavioral Health
system to ensure optimal
clinical care for our clients
in an integrated health
care environment. Final
direction will be provided
by senior management in
the Spring of 2012.
The Behavioral Health IT project team has
continued on other work that is system neu-
tral, including:
• Acquisition and installation of new work-
stations where needed in compliance
with a new information system
• Development of a training program for
staff who need more proficiency on us-
ing computers. Training has been across
the board, including clerical, clinical, and
management staff, starting with small
classroom training and following up with
one-on-one training when requested.
• Development of a draft communications
plan for communicating IT project infor-
mation.
• Training Behavioral Health psychiatrists
and nurses on using the Epic system in
select areas, such as prescriptions, lab
results, and appointment scheduling.
Information and Technology
64
Capital Facilities Overview
Contra Costa County’s MHSA Capital Facilities
Project Proposal was approved by the Califor-
nia State Department of Mental Health (herein-
after “DMH”) on May 12, 2010. This approval
was granted after a long term local community
planning process to develop it’s Mental Health
Services Act (hereinafter “MHSA”) Capital Fa-
cilities Project Proposal as part of its Three Year
Program and Expenditure Plan.
The project, which was approved in May 2010
called for the new construction of a 6,000
square foot Mental Health Assessment and Re-
covery Center (hereinafter “ARC”) on a site lo-
cated at 20 Allen Street, Martinez. In addition,
business and operations support were included
(i.e., parking, medical records, dietary, house-
keeping, staff lounge, common area). The proj-
ect was projected to cost approximately $4 mil-
lion. Stakeholders had also requested that there
be two new programs located on the 20 Allen
Street site (the ARC and also a separately con-
structed/funded Crisis Residential Facility [here-
inafter “CRF”]). The originally approved project
did not include MHSA funding requested for the
construction of a CRF, but stakeholders were
very firm on their desire to have both options in
the county. The MHSA funds allocated to capi-
tal construction were not sufficient to cover the
building costs for a CRF, but there was enough
funding for the ARC.
The requested revisions were approved and
adopted through an update to the Annual Plan
Update on December 6, 2011. These revisions
included the construction of the ARC, co-locat-
ing it with another Contra Costa County Health
Services Department construction project for a
new Integrated Primary Care Center, resulting
in decreased construction cost of the ARC to $2
million.
The projected original cost of construction for
the ARC was based on new construction at the
20 Allen Street site. The new construction would
have included parking/garage space, business
offices and other supports required to operate
a free-standing facility. By co-locating the ARC
with primary care, multiple cost savings on the
project were realized.
The approximate $2 million construction sav-
ings from the ARC created an opportunity to
move forward with the construction of the CRF.
CPAW and the Mental Health Committee sup-
ported the action of obtaining construction bids
to determine the financial feasibility of building
the CRF. At the July 2011 CPAW meeting, the
stakeholders reached consensus to solicit con-
struction bids which would provide a detailed
analysis of the cost of this project. After the con-
struction proposals were received, it was deter-
mined that up to an additional $3,000,000 would
be needed to complete the building of the CRF.
Through the community planning process,
MHSA stakeholders recommended to the Health
Services Department that the Department con-
struct a 16-bed Crisis Residential Facility (CRF)
with integrated dual diagnosis services. With
stakeholder support, Contra Costa County is
moving forward with the building and will use
up to $3,000,000 from the prudent reserve. This
recommendation represents the culmination of
community planning and input as outlined in the
October 2011 Capital Facilities Update to the
FY 11-12 Annual MHSA Plan Update. The new
facility is needed to provide new mental health
resources in Contra Costa in order to better pro-
vide required care to mental health consumers
and their family members.
64
MHSA 2012-2013 Annual Update 65
System Challenges
Between March 2011 and April 2012, nine of
the Program Managers in Behavioral Health
retired. This created a significant loss of ex-
perience and talent in the mental health sys-
tem. The first manager was replaced March
2012. During this year-long period, program
Supervisors assumed the responsibilities of
Program Managers without the ability to back
fill their positions. The commitment of staff
during this challenging time was exemplary
but created stress on an already stressed
system.
Prevention and Early
Intervention Programs
Program 2: Coping with Trauma Related to
Community Violence: This initiative continues
to challenge us to develop more responsive
systems, to better meet the needs of those
who have been affected by the significant
impact of violence. The Community Mental
Health Liaisons for Violence staff were not
hired pending hiring of the Program Manager.
The program is being implemented, as com-
munity response teams which will provide
support following incidence of violence and
as liaisons for those who are experiencing
acute distress and are at risk of being held
involuntarily.
Program 7: Supporting Families Experiencing
the Juvenile Justice System. The community
based portion of this initiative is undergoing
redesign which has not been completed dur-
ing a period of Administrative staff retirement
and replacement. It is hoped that this initiative
will move forward in fiscal year 2012-13.
Innovation Programs
The implementation of The Perinatal/Post-
partum Depression Collaborative Program
with Public Health and the Women Infant and
Child Program was delayed in implementa-
tion due to the challenge of a county person-
nel system which has backlogged requests
for exams and position approvals. The staff
have been hired and the program was offi-
cially embarked upon on April 23, 2012.
Children’s Full Service
Partnership
As designed, the Children’s Full Service Part-
nership program was not reaching the in-
tended target population for Full Service Part-
ners as defined in the Welfare and Institution
Code. The program ended December 31,
2011 and planning for the revised Children’s
FSP is currently underway. The redesign of
the Children’s FSP program is driven by data
which highlights the children most in need of
intensive outpatient services as evident by
multiple hospitalizations, psychiatric emer-
gency service visits or mobile response team
crisis services. Implementation is anticipated
to begin July 1, 2012.
Systems Development
Strategies
The original MHSA planning process in 2005
resulted in six systems development strate-
gies for the Community Services and Sup-
ports (CSS) plan. As the system transforms
Barriers and Challenges
Barriers and Challenges
MHSA 2012-2013 Annual Update66
MHSA
Contra Costa County
Supervision of Evidence-Based
Programs (EBP):
The MHP does not currently have enough
clinical supervisors to supervise the imple-
mentation of all the Evidence Based Programs
(EBP) identified by the MHP. The intent of
these new EBPs is to introduce new evidence
practice to the workforce. The supervision of
these programs is important in order to main-
tain fidelity and proper implementation. The
MHP is currently looking at various options on
how to increase the capacity of EBP supervi-
sors in order to effectively implement identi-
fied EBP across all regions of the County.
Sustaining Knowledge Acquired at
Trainings:
Some staff members have expressed that
one-day trainings are not enough for them to
apply newly acquired knowledge to their work.
Staff have expressed that they want to apply
this knowledge at work but is often difficult be-
cause they get caught up with doing business
as usual and don’t necessary have a form
of reinforcement to emphasize the acquired
knowledge. Staff members have expressed
various options that would help them sustain
and utilize this knowledge; for example, hav-
ing follow-up trainings (brown bag seminars).
The MHP training committee will continue to
explore various options to help staff sustain
knowledge acquired from trainings.
and moves more towards integration, the cat-
egories of Systems Development Strategies
are too narrow in scope to be effective in im-
proving the system of care. Therefore, moving
forward, the strategies will be broadened to
be more inclusive of systems enhancements
within various areas and will be in agreement
with the Welfare and Institution Code’s defini-
tion of Systems Development Strategies.
Accessibility of Trainings:
CCMHP programs are spread out in all re-
gions of Contra Costa County (East, Central
and West), and because of how wide-spread
the county is, trainings are held in the cen-
tral region. This region is the most accessible
of the three aforementioned. However, some
staff still find it difficult to attend trainings held
in this region. To alleviate this issue MHP pro-
cured an on-line learning system called Es-
sential Learning, which is accessible anytime
at anywhere with internet access. The learn-
ing system has over 500 courses available to
staff. Another option the county is currently
looking at is the acquisition of a video con-
ferencing system that would allow staff view
live trainings from any county mental health
program location. Because we know the im-
portance of providing trainings to staff to in-
crease their knowledge and skill set, CCMHP
will continue to look at various options that
make trainings accessible by all staff at all re-
gions of the County.
67
My name is Jami, and after being given a men-
tal health diagnosis at fourteen years old I was
left feeling hopeless living in group homes
and a foster home. As time passed my future
seemed empty. When reaching adulthood I
became dually diagnosed and with four beau-
tiful children I could only pray they would be
proud of me one day, but I had no clue as to
how because I was not proud
of myself.
At 30 years of age I found
myself homeless and in a
residential drug treatment
program. Through the
years of my addiction and
illness, I had heard about
the Service Provider Indi-
vidualized Recovery Inten-
sive Training (S.P.I.R.I.T)
program. While in my resi-
dential program I asked my counselor for the
application but my counselor did not believe
I was ready for the class. However, I knew I
was ready and I filled out the application. I felt
empowered making this decision believing
that good could come from this choice. I was
finally doing something right for myself by ap-
plying for the S.P.I.R.I.T. program.
S.P.I.R.IT is a class for mental health consum-
ers, taught by S.P.I.R.I.T graduates. I was ac-
cepted to the program and there I began my
journey to recovery. I graduated the treatment
program and began the classes at Contra Cos-
ta College, taking S.P.I.R.I.T., a nine unit cer-
tificate course.
While learning so many things, what I was
really learning was how to believe in myself
and take care of myself. I remember telling
my instructor that “I want to be where you’re
at.” I worked hard through the class, never
truly thinking I could be an instructor how-
ever holding a new hope for myself as the class
came to an end with graduation.
To my daily amazement three
short months later I was hired
for a full time permanent po-
sition as a community sup-
port worker for the Office
for Consumer Empower-
ment as the instructor of the
S.P.I.R.I.T program. This was
my emerald city, my dream
come true.
My confidence has grown
and belief in myself comes from looking back
on who I was as a youth struggling, a young
woman and mother who was once lost and has
now come to life. I am the woman and moth-
er I was always meant to be. Although I have
been diagnosed with two serious and persis-
tent mental health diagnoses, I have found
pride and purpose and discovered my gift to
be an instructor in S.P.I.R.T holding the hope
for students who share similar experiences.
The S.P.I.R.I.T program gave me tools to help
myself maintain wellness and be an example to
others that although recovery looks different
for everyone, I know that Recovery IS REAL!
Today I believe in Recovery!
By: Jami Tussing
67
68
I have been a consumer since I was 18. For
20 years of my life I have been hospitalized
over 50 times just in Contra Costa County
and many of these times have led to me be-
ing restrained.
When brought into the hospital, I was usu-
ally restrained in a chair for long periods
of time during the admis-
sion process. After
that I would act out
because the process
would be long and
to keep me quiet
I would be placed
in seclusion, belt-
ed to the chair,
medicated, and
put into 5 point
restraint which re-
strained me to the
bed. Then I would
fall asleep from the medication and moved
to a regular unit.
What I found most helpful and am grate-
ful for was the people who worked with me
that were once like me, who listened and
supported and encouraged me to realize I
have choices and believed that I could lead
my own recovery and guided me through
the changes.
I started out with a referral from MHSA
Behavioral Health Court to a dual diag-
nosis residential program called Nevin
house operated by Anka Behavioral Health
and graduated from that program. I then
moved to a Anka Behavioral Health Sober
and clean living house and began working
at the Anka Phoenix Enterprise work pro-
gram.
I started my jour-
ney to help others
like myself and
began working
in the helping
profession pro-
viding peer sup-
port as an apart-
ment manager
for clean and so-
ber housing. I set
an example and
was promoted to case manager for behav-
ioral health court because they believed in
me. Now I have eight years clean and so-
ber and provide hope for people who didn’t
think that a life like this could be possible.
I believe in recovery and now I am working
with older adults to improve their quality
of life and prevent hospitalizations that can
become costly and traumatic.
I would like to leave you with a message
“Don’t’ Stop Believing”
“My Journey”
by Michael Aimans
68
6968
The day before my ninth birthday I was
taken from my home and put into foster
care. My sister and I were separated and
I would leave my foster homes looking for
my sister and especially my mom. All I was
told was that she had a mental breakdown.
I stayed in foster care except for the times I
would run to my grandma’s looking for my
mom until I aged out of foster care at 18.
I then moved back with my grandma and
mom who was using drugs and our house
was foreclosed, so once again we all became
separated.
There were no resources and no one helped
me exit the foster care system. At this time
I was using marijuana, and stealing and
breaking into homes to get my high.
I had been seeing my County Psychiatrist
who introduced me to Calli House (MHSA
funded), a homeless shelter for youth. I was
scared and never been in a shelter. I entered
into Calli House who helped me with anger
management, case management, employ-
ment, housing, food stamps, General As-
sistance, and savings. They have helped me
with my legal problems and helped me get
connected with additional services such as
a Personal Services Coordinator with Fred
Finch who also helps me with money man-
agement and encouraged me to take a class
at Contra Costa College called Serviced
Provider Individualized Recovery Intensive
training also known as S.P.I.R.I.T., taught
and funded by Mental Health Administra-
tion’s Office for Consumer Empowerment.
Today I am enrolled in SPIRIT and I help
do outreach to other youth. I am learn-
ing to advocate and speak to large groups
about my experiences and provide hope
and inspiration to other youth, as well as
participate in conference meetings with
other youth and staff.
I am 20 years old and plan to get my AA
degree in Dual Diagnosis, transfer to Sac-
ramento State, get a Master Degree in So-
cial work and open up a LGBT Homeless
shelter for youth.
Jonnel Gallon
69
70
Stakeholder Input Opportunities
70
The Annual Update is posted on the Contra Costa
County Department of Mental Health website from
May 15 through June 14, 2012. The public hear-
ing to confirm the community planning process is
scheduled to be held on June 14, 2012 at 5:00pm
in the 1st floor conference room at 2425 Bisso Ln.,
Concord CA, 94520.
http://cchealth.org/services/mental_health/prop63/
MHSA 2012-2013 Annual Update 71
Stakeholder Input Opportunities
A comprehensive communication plan was
implemented during this annual update that
includes:
• Email blast to Community Based Organi-
zations, the Contra Costa Mental Health
Commission, the Consolidated Planning
and Advisory Workgroup (CPAW), and
Behavioral Health Staff containing in-
formation updates and opportunities for
stakeholder or Behavioral Health Staff
input.
• From July 1, 2011 through May 3, 2012,
monthly stakeholder meetings were
hosted to inform stakeholders regarding
current MHSA programs and services
including reviewing measures and out-
comes for all MHSA Programs. Stake-
holders input and support for all program
refinements and redesign was included in
this process. The meetings were held at
2425 Bisso Ln. in Concord, California on
these dates:
Thursday, July 7, 2011
Thursday, August 4, 2011
Thursday, September 1, 2011
Thursday, October 6, 2011
Thursday, November 3, 2011
Thursday, December 1, 2011
Thursday, January 5, 2012
Thursday, February 2, 2012
Thursday, March 1, 2012
Thursday, April 5, 2012
Thursday, May 3, 2012
• In addition to the larger stakeholder body
meetings of the following subcommittees
provided input into program development:
Transportation
Housing
Suicide Prevention
Social Inclusion
Perinatal Depression
Aging and Older Adult
Data
Planning
Innovation
Capital Facilities and Information Tech-
nologies
Membership
Reducing Health Disparities
• This ongoing information and develop-
ment culminated with the review of the
Consumer Satisfaction Survey, the Staff
Priority Needs Assessment and MHSA
priorities identified in the initial planning
process which were not yet funded. The
priorities identified above formed the ba-
sis for recommendations for program ex-
pansion in Fiscal Year 2012-13.
• A joint Mental Health Commission and
CPAW meeting was held on April 5, 2012,
this meeting was also open to the pub-
lic. The meeting provided an opportunity
for additional input into the prioritization
which framed the basis for the program
expansion in Fiscal Year 2012-13.
72
2012-13 MHSA Budget
72
73
FY 2011-2012 Allocation
$22,156,300
Overhead (15%) - $443,126
Administration (10%) - $664,689
Total: $1,107,815
20% increased allocation
$26,587,560
An additional $4,431,260
$3,323,445
for MHSA growth
CSS – 80%
$2,658,756
PEI – 20%
$664,689
CSS FSP (51%)
$949,176
Housing (30%)
$797,627
CSS Non-FSP (49%)
$911,953
Innovation (5% of total)
$166,172
PEI
$498,517
PEI Children
$254,244
PEI Other Ages
$244,273
MHSA Increased Allocation
Flow Chart
FY 2012-2013
MHSA Increased Allocation
Flow Chart
FY 2012-2013
73
74
FY 2012/13
MHSA FUNDING SUMMARY
Date:5/16/2012
CSS WET CFTN PEI INN Local Prudent
Reserve
A. Estimated FY 2012/13 Funding
$12,691,753 $1,904,166 $9,409,013 $7,948,439 $3,826,100
2. Estimated New FY 2012/13 Funding $20,103,120 $5,156,280 $1,328,160
--
4. Access Local Pruduent Reserve in FY 2012/13
$32,794,873 $1,904,166 $9,409,013 $13,104,719 $5,154,260
B. Estimated FY 2012/13 Expenditures $22,403,305 $560,000 $7,200,000 $9,085,112 $4,045,340
C. Estimated FY 2012/13 Contingency Funding $10,391,568 $1,344,166 $2,209,013 $4,019,607 $1,108,920
$10,125,250
$0
-$3,000,000
$7,125,250
a/Per Welfare and Institutions Code Section 5892(b), Counties may use a portion of their CSS funds for WET, CFTN, and the Local Prudent Reserve. The total amount of CSS
funding used for this purpose shall not exceed 20% of the total average amount of funds allocated to that County for the previous five years.
4. Estimated Local Prudent Reserve Balance on June 30, 2013
County:
1. Estimated Unspent Funds from Prior Fiscal Years
3. Transfer in FY 2012/13a/
5. Estimated Available Funding for FY 2012/13
Contra Costa
1. Estimated Local Prudent Reserve Balance on June 30, 2012
3. Distributions from Local Prudent Reserve in FY12/13
2. Contributions to the Local Prudent Reserve in FY12/13
MHSA Funding
D. Estimated Local Prudent Reserve Balance
74
75
FY 2012/13
MHSA FUNDING SUMMARY
Date:5/16/2012
CSSWETCFTNPEIINNLocal Prudent
Reserve
A. Estimated FY 2012/13 Funding
$12,691,753$1,904,166$9,409,013$7,948,439$3,826,100
2. Estimated New FY 2012/13 Funding$20,103,120$5,156,280$1,328,160
--
4. Access Local Pruduent Reserve in FY 2012/13
$32,794,873$1,904,166$9,409,013$13,104,719$5,154,260
B. Estimated FY 2012/13 Expenditures$22,403,305$560,000$7,200,000$9,085,112$4,045,340
C. Estimated FY 2012/13 Contingency Funding$10,391,568$1,344,166$2,209,013$4,019,607$1,108,920
$10,125,250
$0
-$3,000,000
$7,125,250
a/Per Welfare and Institutions Code Section 5892(b), Counties may use a portion of their CSS funds for WET, CFTN, and the Local Prudent Reserve. The total amount of CSS
funding used for this purpose shall not exceed 20% of the total average amount of funds allocated to that County for the previous five years.
4. Estimated Local Prudent Reserve Balance on June 30, 2013
County:
1. Estimated Unspent Funds from Prior Fiscal Years
3. Transfer in FY 2012/13a/
5. Estimated Available Funding for FY 2012/13
Contra Costa
1. Estimated Local Prudent Reserve Balance on June 30, 2012
3. Distributions from Local Prudent Reserve in FY12/13
2. Contributions to the Local Prudent Reserve in FY12/13
MHSA Funding
D. Estimated Local Prudent Reserve Balance
Mental Health Services Act (MHSA)
Plan for Increased Allocation by Component
CSS – Full Service Partnerships
Total available: $949,176 --- Total Planned: $949,176
Component 1st Priority 2nd Priority
Strategy Action Strategy Action
TAY FSP
Expansion of TAY FSP
to all regions of the
County
Up to $379,670 Increase employment
opportunities for TAY
$200-450k
Consider funding
through innovation
Make available to all
FSPs
Adult FSP
Expansion of Adult FSP
to all regions of the
County
Up to $569,506 Addition of “step-
down” Personal Service
Coordinators to FSP
Programs
No additional
funding.
Incorporate this
concept into all new
FSP programs
Work towards
integrating into
existing contracts
CSS – Systems Development Strategies
Total available: $911,953 --- Total Planned: $2,190,280
Component 1st Priority 2nd Priority
Strategy Action Strategy Action
Children SDS
Implementation of
evidence based dual
diagnosis treatment
program
Included as part of
the Children’s FSP
contract for MDFT
Individualized service
for those between the
ages of 0-5
Up to $200k
TAY SDS
Transitional residential
program at the Oak
Grove facility
Up to $500k Implementation of
evidence-based dual
diagnosis treatment
program
Up to $150,000
Provide training for
County employees
and contract
agencies on EBPs to
treat co-occurring
individuals
(Example:
SAMHSA’s EBP for
Integrated Services)
Adult SDS
Rapid Access in each of
the adult Mental
Health Clinics
3 MH Clinical
Specialists - $370,482
1.5FTE Registered
Nurse – Experienced
(0.5FTE for each
region) - $228,834
Structured community
and crisis response
teams
Use approved/
funded, vacant
positions to
establish the crisis
response for Adults
3 MH Clinical
Specialists
Older Adult SDS
Increase access to
transportation
Create an Innovation
proposal for funding
Consider
transportation for all
age groups
Increase capacity of the
Intensive Care
Management Teams in
all regions
3 MH Clinical
Specialists -
$370,482
75
76
CSS – Housing
Total available: $797,627--- Total Planned: $150,000
Component 1st Priority 2nd Priority
Strategy Action Strategy Action
CSS Housing
Allocate 30% of all new
MHSA revenue to
housing
Residential aspect of
the TAY Transitional
Residential - $150k
N/A N/A
PEI - Children
Total available: $254,244 --- Total Planned: $646,988
Component 1st Priority 2nd Priority 3rd Priority
Strategy Action Strategy Action Strategy Action
PEI Children
Expansion of
alternative
education
programs that
integrate
mental health
and substance
abuse
treatment into
the school
program
Up to $50k Increase
independent
living skills
programs for
those
approaching
their 18th
birthday
Up to $350k
Work with
ILSP to
expand the
service they
provide for
foster youth
Integrate this
service into
the contract
for the
Transitional
Residential
program at
Oak Grove
Behaviorist in
ambulatory
care to screen,
provide short
term
treatment and
refer to
appropriate
treatment
services or
groups as
indicated
$246,988
2 MH
Clinical
Specialists
PEI – Other Ages
Total available: $244,273--- Total Planned: $350,000
Component 1st Priority 2nd Priority
Strategy Action Strategy Action
PEI – All other
programming
Additional support for
families accessing PES
services
Up to $200k Improve physical health
outcomes for
individuals with SMI
through peer supported
service models
Up to $150k
Innovation
Total available: $166,172--- Total Planned: $0
Component 1st Priority Additional Considerations
Strategy Action Transportation Employment
Innovation
Top Priority:
Integration
N/A Consider exploring
ideas to improve
transportation through
innovation funding
Consider proposals for
programs to improve
employment outcomes
for TAY and Adult FSPs
WET
Total available: $0 --- Total Planned: $0
Component 1st Priority 2nd Priority
Strategy Action Strategy Action
WET
Training for behavioral
health staff in co-
occurring AOD
treatment and
assessment
This is part of the
approved WET plan
Clinical supervisors in
each regional clinic to
monitor fidelity to EBPs
3 MH clinical
Specialists -
$370,482
Use CSS unspent
funds for these
positions
76
77
Unspent Funds Request
Community Services & Supports (CSS)
Over the span of several years, the actual CSS expenditures have been less than the planned CSS budget resulting in a
savings of funds which have been set aside for future use. As of FY 11-12, the unspent funds balance was
$12,691,753. It is important to use these funds for short-term projects, one-time expenses, or for projects capitalized
over several years to ensure the money is being utilized to support the system of care and those who access the
services.
The following is a list of strategies, supported by stakeholders, for which unspent funds will be used:
Item: Budget: (Up to)
Vehicles for programs within the system of care $338,000
Infrastructure and space $394,120
Additional support staff for programming $270,067
Increased allocation strategies requiring additional funding $1,278,327
Total funds requested $2,280,514
Unspent fund balance $10,411,239
Prevention and Early Intervention (PEI)
The Prevention and Early Intervention budget has an unspent funds balance of $7,948,439. The following is a list of
strategies, supported by stakeholders, for which unspent PEI funds will be used during FY 12-13.
Item: Budget: (Up to)
PEI Programming - Children $392,744
PEI Programming – All Other Ages $105,727
Existing PEI Programs #1-10* $3,430,361
Total funds requested $3,928,832
Unspent fund balance $4,019,607
*For additional information please reference the document referenced “Plan for Increased Allocation by Component”.
MHSA Prudent Reserve Request
Through the community planning process, MHSA stakeholders recommended to the Health Services Department that
the Department construct a 16-bed Crisis Residential Facility (CRF) with integrated dual diagnosis services. After the
construction proposals were received, it was determined that up to an additional $3,000,000 would be needed to
complete the building of the CRF. With stakeholder support, Contra Costa County is moving forward with the building
and will use up to $3,000,000 from the prudent reserve. This recommendation represents the culmination of
community planning and input as outlined in the October 2011 Capital Facilities Update to the FY 11-12 Annual
MHSA Plan Update.
Prudent Reserve (FY 11-12) $10,125,250
Allocation to building the Crisis Residential Facility $3,000,000 (up to)
Prudent Reserve Balance $7,125,250
The new facility is needed to provide new mental health resources in Contra Costa in order to better provide
required care to mental health consumers and their family members.
77
78
Acknowledgments
All of those who have shared their lived experience with us. You have inspired and chal-
lenged us to co-create systems which support the recovery and resiliency which you
demonstrate to us everyday.
With special recognition to the staff of the Office for Consumer Empowerment, Mental
Health Consumer Concerns, Members of the Putnam Clubhouse and the many con-
tributors to the planning and delivery of programs and services which are client cen-
tered.
To the staff of Contra Costa Behavioral Health and our partner provider organizations
for the work you do each day to improve the lives of those who experience mental Ill-
ness and serious emotional disturbance.
To the staff who have contributed to the development of this plan:
Mary Roy
Holly Page
Erin McCarty
Jeromy Collado
Ken Gallagher
Kennisha Johnson
Imo Momoh
Steve Hahn-Smith
Caroline Sison
Heather Sweeten-Healy
Susan Medlin
Sandy Rose
Vien Tran
Jennifer Tuipulotu
Leslie Ocang
Jisel Iglesias
To the leadership of Contra Costa Mental Health for your inspiration and tireless commit-
ment of service:
Suzanne Tavano
Victor Montoya
Vern Wallace
Jan Cobaleda-Kegler
Helen Kearns
Cynthia Belon
T H A N K
78 79
79
Heartfelt thanks to the members of our MHSA Stakeholder body, the Consolidated Plan-
ning and Advisory Workgroup for their passion, commitment and investment of time to
work as collaborators in the process of transformation through the Mental Health Services
Act.
Stephen Boyd Jr.
Lisa Bruce
Brenda Crawford
Courtney Cummings
Doreen Gaedtke
Tom Gilbert
John Gragnani
Steven Grolnic-McClurg
Molly Hamaker
Peggy Harris
Lori Hefner
Ralph Hoffman
John Hollender
Ron Johnson
Dave Kahler
Kimberly Krisch
Beatrice Lee
Anna Lubarov
Susanna Marshland
Kathi McLaughlin
Susan Medlin
Marianna Moore
Ryan Nestman
Teresa Pasquini
Annis Pereyra
Nayyirah Sahib
Tony Sanders
Thomas Sponsler
Connie Steers
Wayne Thurston
Sam Yoshioka
Special thanks to the members of the Mental Health Commission who are collaborators in
transformation of the Public Mental Health System.
Evelyn Centeno
Dave Kahler
Peggy Kennedy
Carole McKindley-Alvarez
Colette O’Keeffe
Floyd Overby
Teresa Pasquini
Annis Pereyra
Gina Swirsding R.N.
Sam Yoshioka
Supervisor John Gioia
Supervisor Mary Piepho
If you would like to receive email updates on new MHSA news please join our mailing
list by emailing us at: MHSA@hsd.cccounty.us
Y O U
79
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When I was in Junior High, I remember
loving to learn. I don’t know if it was being
an only child and growing up within a very
unstructured home life or just how nor-
mal high school is, but in my first semester
of high school I developed severe anxiety
about being in school and about what was
going on at home. I would often feel knots
in my stomach, feeling sick as if I needed
to through up. I remember feeling a deep
sense of hopelessness. I was lost and very
lonely. I failed every class that semester. I
started smoking pot every day after school
and using ecstasy. I think I used drugs to
deal with stress, home life because I really
didn’t know what I was doing so I just did
that. I wasn’t involved in any that had a
purposed or that really mattered. My dad
was in and out and my mom was doing the
best she could. As a child, I also suffered
from severe OCD and was a clean freak. I
was super afraid of germs. In 10th grade,
I started New Leaf and found something
I never knew I needed. I found a learning
structure that gave me the stability I need-
ed, but also was flexible enough for me to
make different choices of how to handle my
stresses and mental issues throughout the
school day. One of the things that helped me
a great deal was the personal and intimate
relationships I developed with my teachers.
PEI Success
Sophia’s Story
I remember the first time I cried to one of
them. It helped me so much knowing that
at school I could be in a family environ-
ment that supported all of me and not just
the part of me that need to do the academic
work. At New Leaf, I learned to “first seek to
understand” and other strategies for deal-
ing with my body and my mind. I now use
a variety of breathing strategies and media-
tion practices when I feel I need it. Now
every night it bed I do breathing exercises.
Learning how to do yoga and about other
natural remedies also helped me so much.
The particular way my teachers teach us re-
ally helps too. It is different than any other
school I’ve attended. Slowly I started to
see myself change and feel healthier and
my teachers helped me see my growth, not
only in academic credits, but in how I was
dealing with my feeling and my fears of not
having control. Also at New Leaf, I was ex-
posed to so many different careers and it has
helped me to imagine myself as having the
skills to create a different life than my par-
ents did. Now as a Senior, I am appreciative
of this life changing experience and I want
the younger students entering the program
to see all that they can be given if they fully
take advantage of all the resources we have
at New Leaf to change our lives.
80
81
Appendices
81
Appendix A
Prevention and Early Intervention Programs:
Building Connections in Underserved Cultural Communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Coping with Trauma Related to Community Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Reducing Stigma and Awareness Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Suicide Prevention. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Supporting Older Adults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 15
Parenting Education and Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Families Experiencing the Juvenile Justice System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Supporting Families Experiencing Mental Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Youth Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Multi-Family Group Therapy- An Intensive Early Psychosis Intervention. . . . . . . . . . . . . . . . . . . . . . . 40
Appendix B
Prevention and Early Intervention Scope of Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Appendix C
Suicide Prevention Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Appendix D
Year One Report Contra Costa LGBTQ Youth Advocacy Collaborative. . . . . . . . . . . . . . . . . . . . . . . . . 63
Appendix E
Public Hearing, Comments, and Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
41
Program 1: Building Connections in Underserved Cultural Communities
Agency: Asian Community Mental Health Services, Inc.
Name of Program: AFRC System Navigation Program
Scope of Services
Asian Family Community Mental Health will provide comprehensive and culturally-sensitive and
appropriate education and access to Mental Health Services for immigrant Asian communities,
especially the Southeast Asian and Chinese population of Contra Costa County. ACMHS will
employ multilingual and multidisciplinary staff from the communities which they serve. Staff
will provide Prevention Activities: community outreach, home visits to senior housing sites,
medication compliance education, community integration skills, older adult care giving skills,
basic financial management, Survival English communication skills, travel training, health and
safety education and computer education, structured group activities (on topics such as, coping
with adolescents, housing issues, aid cutoff, domestic violence, criminal justice issues, health
care and disability services)and health and mental health system navigation. Early Intervention
Services will also be provided to those who are exhibiting signs of Mental Illness early in its
manifestation. These services will be integrated into a recovery model framework assisting
consumers in actively managing their own recovery process. These services will be provided for
a period of under one year unless psychosis is present.
ACMHS will serve a minimum of 50 high risk and underserved Southeast Asian community
members within a 12 month period 10 of which will reside in East County with the balance in
West and Central.
Program 1: Building Connections in Underserved Cultural Communities
Agency: Center for Human Development
Name of Project(s): Mental Health Education/ System Navigation Support African American
Health Conductors; and Senior Peer Outreach Program
Scope of Services
The Center for Human Development will implement Mental Health Education/ System
Navigation Support African American Health Conductors that will provide a minimum of 120
individuals in Bay Point, Pittsburg, and surrounding communities with mental health resources.
Key activities include: culturally appropriate education on mental health topics through Soul to
Soul and Body and Soul support groups and other health education workshops. 20 to 30
individuals will receive navigation assistance for Mental Health referrals.
Program 1: Building Connections in Underserved Cultural Communities
Agency: Jewish Family & Children's Services of the East Bay
Name of Project: Community Bridges
Scope of Services
42
During the term of this contract, Jewish Family & Children's Center of the East Bay will
assist Contra Costa Mental Health to implement the Mental Health Services Act (MHSA),
Prevention and Early Intervention Program will address PEI Project #1 with the Community
Bridges Program to provide culturally grounded, community-directed mental health education
and navigation services to 350-400 refugees and immigrants of all ages in the Lat ino, Afghan,
Bosnian, Iranian, and Russian communities of central and east Contra Costa County. Prevention
and early intervention-oriented program components include culturally and linguistically
accessible mental health education; early assessment and int ervention for individuals and
families; and mental health system navigation assistance. Services will be provided in the
context of group settings and community cultural events, as well as, with individuals and
families, using a variety of convenient non-office settings such as schools, senior centers, and
client homes, In addition, the program will include mental health training for frontline staff
from JFCS/East Bay and other community agencies working with diverse cultural populations,
especially those who are refugees and immigrants, The Contractor's program shall be carried
out as set forth in the Work Plan for this Contract, which is incorporated herein by reference, a
copy of which is on file in the office of the County's Mental Health Director and a copy of which
the County has furnished to the Contractor.
Individuals receiving Contractor's services pursuant to this Agreement are hereinafter referred
to as "Clients". These clients are also Clients of the County's Mental Health Division and other
County-approved referral agencies.
Program 1: Building Connections in Underserved Cultural Communities
Agency: La Clinica de La Raza, Inc.
Name of Project(s): Vias de Salud (Pathways to Health )
Scope of Services
La Clinica de La Raza, Inc. (La Clinica) will implement Vias de Salud (Pathways to Health) to
target Latinos residing in Central and East Contra Costa County with: a) 3,700 screenings for risk
factors, such as symptoms of depression, anxiety, substance abuse, reactions to trauma,
domestic violence, sleep difficulties, and pain; b) 1,100 assessment and early intervention
services provided by a Behavioral Health Specialist to identify risk of mental illness or emotional
distress, or other risk factors such as social isolation; and c) psycho -educational groups
facilitated by a social worker for sixty-eight (68) adults to cover variety of topics such as
isolation, stress, communication and cultural adjustment.
Program 1: Building Connections in Underserved Cultural Communities
Agency: Lao Family Community Development Inc.
Name of Program: Health and Well Being for Asian Families
Scope of Services
Lao Family Community Development, Inc. will provide a comprehensive and culturally sensitive
Integrated Service System Approach for Asian and South East Asian adults. The Program activities
43
will include; Comprehensive Case Management, educational workshops and support groups. They
will provide outreach, education, and support to develop problem solving skills, and increase
families emotional well-being and stability. When necessary LFCD staff will supply support, in
order to access needed health and mental health services. The staff will provide a client centered,
family focused, strength based case management and planning process including home visits,
brief counseling, parenting classes, advocacy and referral to other in house services such as
employment services, financial education, and housing services. These services will be provided
in client homes and other community based settings as well as the offices of Lao Family
Community Development, Inc in San Pablo.
Program 1: Building Connections in Underserved Cultural Communities
Agency: Native American Health Center
Name of Program: Native Wellness Center
Scope of Services
Native American Health Center will provide a variety of weekly group sessions and quarterly
community events for youth, adults, and elders to develop partnerships that bring consumers,
families, community members and mental health professionals together and bui lds a
community that reflects the history and values of Native American people in Contra Costa
County. Community-building activities will include on elders support group, youth wellness
group (including suicide prevention and violence prevention activities), a traditional arts group
(beading, quilting, arts & crafts), and quarterly events tied to the seasons. Family
Communications activities will include weekly Positive Indian Parenting sessions, talking and
Gathering of Native Americans (GONA) to build a sense of belonging and cohesive community.
Family members who need supplemental treatment for mental health and substance abuse
problems will be referred to appropriate agencies. Mental Health Education/System Navigator
Support will include appropriate services (with follow-up), and educational sessions about
Contra Costa County’s service system. Facilitators and educators will be drawn from NAHC staff,
community members, consultants, and staff. Expected outcomes include increases in social
connectedness, communication skills, parenting skills, and knowledge of the human service
system in the county.
Expected results from these activities include increased culturally relevant mental health
services offered to the Native American Community in Contra Costa County. The Native
Wellness Center is designed to build a strong community, strengthen family communications,
and help Native Americans navigate the complex human service systems in Contra Costa
County.
Program 1: Building Connections in Underserved Cultural Communities
Agency: Agency: Rainbow Community Center
Name of Project: LGBT Community Mobilization and Social Cultural Communities
Scope of Services
44
Rainbow Community Center will provide a community-based social support program designed
to decrease isolation, depression and suicidal ideation among members of the Lesbian, Gay,
Bisexual, Transgender and Questioning (LGBTQ) community residing in Contra Costa County.
Key activities include:
a) Maintain and expand social and outreach program ming that promotes
development of social networks that are designed to promote resilience and build a sense of
community affiliation in an effort to reduce stigma and isolation
b) Develop and convene support groups that are designed to promote
resilience, self-efficacy and build a sense of community affiliation in an effort to reduce stigma
and isolation;
c) Maintain and expand individualized (one-on-one) services that provide
linkage and supports for LGBTQ community members, these services will include depressio n
and suicidal assessments and individualized wellness plans
d) Coordinate PEI services targeted to LGBTQ youth and LGBTQ seniors that
include outreach services, support groups and individualized support
e) Develop quality assurance and outcome measures to assure
program management
f) Create service opportunities for community volunteers and students.
Expected results include: increased skills to combat life stressors that result from
discrimination and greater communications and support among family members of LGB TQ
people and LGBTQ families of choice.
Program 1: Building Connections in Underserved Cultural Communities
Agency: Young Men's Christian Association of the East Bay
Name of Project: One Family at a Time
Scope of Services
The Young Men's Christi an Association in association with the Building Blocks for Kids
Collaborative will provide diverse households in the Iron Triangle neighborhood of Richmond with
improved access to health care, education, and Mental Health. This second year of the One
Family at a Time prevention and early intervention work addresses MHSA's PEI goal of building
communities in underserved cultural communities. Accordingly, the goals of the proposed second
year are two-fold: (1) to build capacity of residents in the Iron triangle to influence factors that bear
upon the healthy development and education of children from the community; (2) engage the
community in education and health decision-making and improve community participation in
education and health promotion, health protection, and violence prevention efforts; and (3)
Directly assist residents in building and accessing a network of supportive mental health
relationships among fellow residents and mental health service providers.
45
Program 2: Coping with Trauma Related to Community Violence
Agency: RYSE Center
Name of Project(s): RYSE: Trauma Response and Resilience System, and RYSE Health &
Wellness
Scope of Services
RYSE Center will continue to implement the Trauma Response and Resilience System (TRRS)
development process and implementation through: 1) deepening our work onsite as a critical
responder and crisis relief site for young people experiencing acute incidents of violence, as well
as engaging and supporting young people in realizing their individual potential and leadership,
strengthening peer and youth-adult relationships, and advancing young people's collective
capacity to advocate and organize for safe, vibrant, and youth-friendly communities; 2) further
leveraging our success to date of integrating the TRRS framework and approach into key cross-
sector stakeholder initiatives focused on addressing community violence, reintegration, and
systems change. The TRRS is designed to respond to the acute needs of youth from the diverse
communities of West County involved with incidents of violence by coordinating and mobilizing
the appropriate supports and services. The TRRS will also engage participants in deeper,
transformative work that recognizes and addresses the histories and inequitable burden of
trauma and violence experienced in West Contra Costa. Key activities include: continued
implementation and standardization of key components of RYSE's Youth Justice Project - the
initial pilot program of the TRRS that engages young people involved with, or at acute risk of
involvement, with the juvenile justice system; continued development and training for RYSE
adult staff, RYSE youth staff, RYSE members, partners, key stakeholders, and key cross-sector
initiatives in which RYSE participates. Training topics will include issues of trauma, trauma and
adolescent development, community violence, restorative justice and healing, systems change
and advocacy; continued awareness-building and outreach activities that includes culture-
building events, workshops and activities that engage communities in dialogue about and
celebrate resilience, and foster opportunities for healing and restoration; and deepened cross-
sector stakeholders/initiatives to to develop to further the work done to date and formalize the
TRRS. The ultimate aim of the Trauma Response and Resilience System development process is
to implement and sustain a coordinated, multi-level response to critical incidents, addressing
both the immediate and underlying conditions and impact of trauma and violence. The System
will include guidelines and protocols that delineate the role and relationship between
responders, incident assessment protocols, and communication protocols between and amongst
responders and stakeholders.
The contractor will continue to implement RYSE Health & Wellness program, to support young
people (ages 14 to 21) from the diverse communities of West County to become better informed
consumers and active agents of their own health and wellness, foster healthy peer relationships
and youth-adult relationships, and enable opportunities for youth leadership and advocacy. We
offer a continuum of support to our members beginning with ensuring an experience of safety
and respect, leading to education and self-reflection processes, through to goal-directed
activities. Our Community Health programs offer
tiered support for our members from community engagement to peer-to-peer education and
training to individualized treatment and support systems. Programs and services include drop-in,
recreational, and structured activities across areas of health & wellness; media, arts & culture;
education & career; technology; and youth leadership & organizing. Key activities include:
presentations, trainings, and outreach to schools, community organizations, and public agen cies;
46
virtual outreach and engagement through a repurposed website and virtual youth center,
monthly cultural events, and monthly membership meetings, expansion of the Contractor's
current intake, youth-centered assessment, referral, and follow up system, as well as expansion
of our data collection and evaluation system. We offer multiple peer-to-peer support groups
each week, facilitated by adult staff, covering themes of emotional regulation, mindfulness, grief
support, trauma support and education, LGBTQ support, and Young Women's and Men's Circles.
We will also develop formal referral systems with community partners for better utilization of our Health
and Wellness services and programming. Lastly, we will initiate Community Health education projects
that integrate health and wellness public education with creative arts and media outreach. Activities will
be developed and implemented in partnership between adult and youth staff.
Program 4: Suicide Prevention
Agency: Contra Costa Crisis Center
Name of Project: Suicide Prevention
Scope of Services
Contra Costa Crisis Center will provide services to prevent suicides throughout Contra Costa
County by operating a nationally certified 24-hour suicide prevention hotline. The hotline
lowers the risk of suicide at a time when people are most vulnerable, enhances safety and
connectedness for suicidal individuals, and builds a bridge to community resources for at -risk
persons. Key activities include: answering local calls to toll-free suicide hotlines, including a
Spanish-language hotline; assisting callers whose primary language isn't English or Spanish
through use of a tele-interpreter service; conducting a lethality assessment on each call
consistent with national standards; making follow-up calls to persons (with their consent) who
are at medium to high risk of suicide; and training all crisis line staff and volunteers in ASIST
(Applied Suicide Intervention Skills Training). As a result of these service activities: 95 percent or
more of people who call the crisis line and are assessed to be at medium to high risk of suicide
will still be alive one month later; the number of trained, multilingual/multicultural crisis line
volunteers will increase to 20 by the end of the reporting period, and the number of hours that
a minimum of one Spanish-speaking counselor is on duty will be 80 per week.
Program 5: Supporting Older Adults
Agency: Center for Human Development
Name of Project(s): Mental Health Education/ System Navigation Support African American
Health Conductors; and Senior Peer Outreach Program
Scope of Services
The Center for Human Development will implement Mental Health Education/ System
Navigation Support African American Health Conductors that will provide a minimum of 120
individuals in Bay Point, Pittsburg, and surrounding communities with mental health resources.
Key activities include: culturally appropriate education on mental health topics through Soul to
Soul and Body and Soul support groups and other health education workshops. 20 to 30
individuals will receive navigation assistance for Mental Health referrals.
47
Program 5: Supporting Older Adults
Agency: LifeLong Medical Care
Name of Project: SNAP! Senior Network and Activity Program
Scope of Services
LifeLong Medical Care will provide isolated older adults in West Contra Costa County with
opportunities for social engagement and linkage to mental health and social services. A variety
of group and one-on-one approaches will be employed to provide opportunities for
socialization that will appeal to different groups of seniors, and reach out to those most
reluctant to participate in social activities. SNAP! Senior Network and Activity Program will be
provided in three housing developments that currently lack other on-site services. These
activities will include regular incentivized on-site socials (3 per month for residents of each site),
quarterly outings, and outreach to invite participation in group activities and develop a rapport
with residents. Services will also include screening for depression and isolation and Information
& Referral services, The Elders Learning Community will be provided to at least 10 frail seniors.
The expected impact of these services includes: Reducing isolation and promoting feelings of
wellness and self-efficacy; increasing trust and reducing reluctance to revealing unmet needs or
accepting support services; and improving the quality of life by reducing loneliness and
promoting friendships and connections with others .
Program 6: Parenting Education and Support
Agency: The Child Abuse Prevention Council of Contra Costa
Name of Project: The Nurturing Parenting Program
Scope of Services
The Child Abuse Prevention Council of Contra Costa will provide an evidence-based curriculum
of culturally, linguistically, and developmentally appropriate, Spanish speaking families in East
County, and Central County's Monument Corridor. Four classes will be provided for 60 parents
and approximately 60 children under 5-years of age. The 23 week curriculum will immerse
parents in ongoing training, free of charge, designed to build new skills and alter old behavioral
patterns intended to strengthen families and support the healthy development of their children
in their own neighborhoods.
Program 6: Parenting Education and Support
Agency: Contra Costa Interfaith Housing, Inc.
Name of Project: Strengthening Vulnerable Families
Scope of Services
Contra Costa Interfaith Housing, Inc.(CCIH) will provide on-site, on-demand, and culturally
appropriate delivery of an evidence-based Strengthening Families Program to help 27 formerly
homeless families, all with special needs, at the Garden Park Apartments in Pleasant Hill to improve
48
parenting skills, child and adult life skills, and family communication skills. This program is designed to
help families stabilize, parents achieve the highest level of self-sufficiency possible, and provide early
intervention for the youth in these families who are at risk for ongoing problems due to mental illness,
domestic violence, substance addiction, poverty and inadequate life skills. Key activities include:
family support, support for sobriety, academic 4day-per-week homework club, pre-school program,
teen support group, and community building. The goals and outcome measures for Garden Park
program include: assisting families to stabilize in permanent housing and meet their individualized
goals related to self-sufficiency and sound parenting and to help the youth overcome the challenges
inherent to being in a family impacted by a variety of challenges. Anticipated impact of this program
will be a positive change in the social and emotional trajectory of these families, and the success
of children to meet the academic benchmarks for their grade level.
Further, CCIH will provide an Afterschool Program and limited mental health and case
management services at two sites in East Contra Costa County: Bella Monte Apartments in Bay
Point and Los Medanos Village in Pittsburg. These complexes offer permanent affordable
housing to low-income families. Anticipated impact for these East County services will be
improved school performance by the youth and improved parenting skills and mental health for
identified high risk families who live in these complexes.
Program 6: Parenting Education and Support
Agency: C.O.P.E. Family Support Center
Name of Program: PEI — Triple P — Positive Parenting Education and Support Program
Scope of Services
The C.O.P.E Family Support Center (Contractor) will provide services using the evidence-based
Triple P — Positive Parenting Program Levels 2, 4 and 5 Multi-Family Support Groups, at no cost
to parents. The program utilizes a self regulatory model that focuses on strengthening the
positive attachment between parents and children by helping parents to develop effective skills
to manage common child behavioral issues. Our targeted population includes caregivers residing
in underserved communities throughout Contra Costa County.
Contractor will deliver 28 Triple P-Positive Parenting workshops in Spanish and/or English, as
needed.
Contractor will provide orientation meetings as requested by MI-ISA. The orientation is
designed to provide a comprehensive overview of the Triple P multi-level system. A briefing
providing an opportunity to discuss the implementation of the program and ways to
effectively support staff using the Triple P program and use of referrals is included.
Contractor will provide weekly pre-accreditation group meetings designed to provide an
opportunity for individualized feedback on skill develo pment prior to accreditation. All trained
practitioners will be given the opportunity to practice specific competencies with peers in
preparation for demonstration of these same competencies on accreditation day in the
presence of the Triple P Trainer. These meetings will also clarify program content relevant to
quiz questions.
49
Contractor will provide weekly clinical/peer support meeting designed to provide supervision
of classes and families to problem solve issues related to the delivery of Triple P to fa milies
and provide practitioners with a supportive continuing education environment that will
facilitate the transfer of learning from the training course to everyday practice.
Program 6: Parenting Education and Support
Agency: La Clinica de La Raza, Inc.
Name of Project(s): Familias Fuertes (Strong Families)
Scope of Services
Contractor will implement Familias Fuertes (Strong Families), to educate and support Latino
parents and caregivers living in Central and East Contra Costa County so that t hey can support
the strong development of their children and youth. The project activities will include: 1)
Screening for risk factors in youth ages 0-18 (1,200 screenings); 2) 250 Assessment and/or
parent coaching sessions with the Behavioral Health Specialist will be provided to
parents/caretakers of children ages 0-18; and 3) Forty-eight (48) parents/caretakers will
participate in the parent education and support group that will be facilitated by a Social
Worker. The group will utilize an evidence-based and culturally relevant curriculum called Los
Nifios Bien Educados. All of the above services will be provided at two La Clinica Contra Costa
facilities, located in Pittsburg and Pleasant Hill (Monument Blvd).
Program 6: Parenting Education and Support
Agency: Agency: The Latina Center
Name of Project: Parenting Education and Support
Scope of Services
The Latina Center will provide culturally and linguistically specific parenting
education and support to at least 300 Latino parents and caregivers in West
Contra Costa County supporting the strong emotional, social and educational
development of children and youth ages 0-15, and reduce verbal, physical and
emotional abuse. The Latina Center will enroll primarily low-income, immigrant,
monolingual/bilingual Latino parents and grandparent caregivers of high-risk
families in a 12-week parenting class using the Systematic Training for Effective
Parenting (STEP) curriculum or PECES in Spanish (Padres Eficaces con
Entrenamiento Eficaz). The Parent Advocates will be trained to conduct two
parenting education classes, and 12 Parent Partners will be trained to offer
mentoring, support and systems navigation and will also provide family activity
nights, creative learning circles, at least two cultural celebrations, and two
community forums on a parenting topic.
50
Program 8: Support Families Experiencing Mental Illness
Agency: The Contra Costa Clubhouses, Inc.
Name of Project: Supporting Families Experiencing Mental Illness
Scope of Services
The Contra Costa Clubhouses, Inc. will provide peer-based programming for adults
throughout Contra Costa County in recovery from psychiatric disorders, helping them to develop the
support networks, vocational skills, and self-confidence needed to sustain stable, productive, and
more independent lives. The following services are provided with PET funding: Work-ordered day
programming weekdays Monday through Friday, during which participants gain prevocational skills,
social skills, healthy living skills, and access to career development options within the greater
community. Career Development Services include assistance with setting goals, returning to school,
finding/maintaining paid employment. On-site Life Skills, Recreational and Respite Services with
meals are provided three weeknights and Saturdays at the Clubhouse in Concord and include:
Multimedia Program honing new media skills in the multimedia lab; expressive arts, including music,
visual arts, and creative writing; TGIF Socials, including karaoke, dancing, games, conversation, and
movies; Healthy Living Program, including hikes, yoga, nutrition, and smoking cessation. Once
monthly, TGIF and/or Saturday outings are offered at other locations within the County easily
accessible to underserved groups. Transportation Services to and from the Clubhouse are provided at
no cost by van. In-Home Peer-to-Peer Outreach up to four hours in length provided at consumer or
caregiver request throughout the county. Young Adult Initiative provides special activities and
programming to attract and retain younger adult members in the under-30 age group. Outreach
Programs for the case managers and Social Service staff of county hospitals, medical providers, and
community-based organizations; Newsletter and website, and dissemination of written materials
through NAMI and other consumer- or caregiver-focused agencies, outreach events or ethnic media
opportunities targeting monolingual and LEP consumers and caregivers in their community.
Program 9: Youth Development
Agency: The James Morehouse Project, the school health center at
El Cerrito High School (fiscal sponsor: YMCA of the East Bay )
Name of Project: Youth Development
Scope of Services
The James Morehouse Project, the school health center at El Cerrito High School (fiscal sponsor:
YMCA of the East Bay),* will provide services that increase access to mental health/health
services and a wide range of innovative youth development programs for 300 multicultural youth
in West Contra Costa County. Contractor will provide a wide range of innovative youth
development programs through an on-campus collaborative of community-based agencies, local
universities and County programs. Key activities designed to improving students' well-being and
success in school include: Alcohol and Other Drug Use/Abuse Prevention; Teen Alive(anger and
violence); Arts/Spoken Word (incarcerated family members); Bereavement Groups (loss of a
loved one); Da Rainbow Clique (queer youth of color); Discovering the Realities of Our
Communities (DROC — environmental and societal factors that contribute to substance abuse);
Peer Conflict Mediation; Peer Counseling; Peer Health Education; Pregnant, Parenting &
Caretaker Teens Group; Yoga (learn to focus more effectively; reduce stress, and work more
skillfully with strong emotions, such as impulse control and frustration).
51
* In January 2010, the El Cerrito High School Community Project took James Morehouse's name
to honor his 35 years of service to the El Cerrito High School community. Mr. Morehouse loved,
mentored and inspired two generations of staff and students (from 1968-2003) and the James
Morehouse Project, in taking on his name, commits to carrying on his legacy of love, respect
and service for generations to come.
Program 9: Youth Development
Agency: Martinez Unified School District
Name of Project: Youth Development
Scope of Services
During the term of this contract, Martinez Unified School District will continue to assist Contra
Costa Mental Health in implementing the Mental Health Services Act (MHSA), Prevention and
Early
Intervention Program to address PEI Program #9 with the New Leaf (Youth Development) by
providing "career academies" which will include individualized learning plans, place-based
learning projects and career mentorships and internships for 46 high school adolescent youths in
Martinez of all cultural backgrounds. Key activities include: service-learning projects, career
preparation and internships where students, school staff, parents and community partners work
together on projects, all derived from California standards-based curriculum. Some of the results
of participation in the academies will be: A high school diploma, transferable career skills and
certification, acceptance into a college or post-high school training program, strong leadership
skills and the development of the assets necessary for holistic, sustainable living. The Contractor's
program shall be carried out as set forth in the Work Plan for this Contract, which is incorporated
herein by reference, a copy of which is on file in the office of the County's Mental Health Director
and a copy of which the County has furnished to the Contractor.
Individuals receiving Contractor's services pursuant to this Agreement are hereinafter referred
to as "Clients". These clients are also Clients of the County's Mental Health Division and other
County-approved referral agencies.
Program 9: Youth Development
Agency: People Who Care Children's Association
Name of Project: Youth Development
Scope of Services
People Who Care Children Association will provide work experience for 150 multicultural youth residing iti
the Pittsburg/Bay Point and surrounding East Contra Costa County communities, as well as, programs aimed
at increasing educational success among those who are either at-risk or high-risk of dropping out of school,
or committing a repeat offense. Key activities include: a six day a week after school, vocational, and
employment opportunity, The Hip Hop Car Wash, with referrals from Contra Costa Mental Health, Probation
52
Department, and Unified School Districts (Pittsburg, Antioch, etc.); will include monthly individual child
assessments, academic and educational support, and peer -based juvenile delinquency prevention.
Program 9: Youth Development
Agency: RYSE Center
Name of Project(s): RYSE: Trauma Response and Resilience System, and
RYSE Health & Wellness
Scope of Services
RYSE Center will continue to implement the Trauma Response and Resilience System (TRRS)
development process and implementation through: 1) deepening our work onsite as a critical
responder and crisis relief site for young people experiencing acute incidents of violence, as well
as engaging and supporting young people in realizing their individual potential and leadership,
strengthening peer and youth-adult relationships, and advancing young people's collective
capacity to advocate and organize for safe, vibrant, and youth-friendly communities; 2) further
leveraging our success to date of integrating the TRRS framework and approach into key cross-
sector stakeholder initiatives focused on addressing community violence, reintegration, and
systems change. The TRRS is designed to respond to the acute needs of youth from the diverse
communities of West County involved with incidents of violence by coordinating and mobilizing
the appropriate supports and services. The TRRS will also engage participants in deeper,
transformative work that recognizes and addresses the histories and inequitable burden of
trauma and violence experienced in West Contra Costa. Key activities include: continued
implementation and standardization of key components of RYSE's Youth Justice Project - the
initial pilot program of the TRRS that engages young people involved with, or at acute risk of
involvement, with the juvenile justice system; continued development and training for RYSE
adult staff, RYSE youth staff, RYSE members, partners, key stakeholders, and key cross-sector
initiatives in which RYSE participates. Training topics will include issues of trauma, trauma and
adolescent development, community violence, restorative justice and healing, systems change
and advocacy; continued awareness-building and outreach activities that includes culture-
building events, workshops and activities that engage communities in dialogue about and
celebrate resilience, and foster opportunities for healing and restoration; and deepened cross-
sector stakeholders/initiatives to to develop to further the work done to date and formalize the
TRRS. The ultimate aim of the Trauma Response and Resilience System development process is
to implement and sustain a coordinated, multi-level response to critical incidents, addressing
both the immediate and underlying conditions and impact of trauma and violence. The System
will include guidelines and protocols that delineate the role and relationship between
responders, incident assessment protocols, and communication protocols between and amongst
responders and stakeholders.
The contractor will continue to implement RYSE Health & Wellness program, to support young
people (ages 14 to 21) from the diverse communities of West County to become better informed
consumers and active agents of their own health and wellness, foster healthy peer relationships
and youth-adult relationships, and enable opportunities for youth leadership and advocacy. We
offer a continuum of support to our members beginning with ensuring an experience of safety
and respect, leading to education and self-reflection processes, through to goal-directed
activities. Our Community Health programs offer tiered support for our members from
community engagement to peer-to-peer education and training to individualized treatment and
support systems. Programs and services include drop-in, recreational, and structured activities
53
across areas of health & wellness; media, arts & culture; education & career; technology; and
youth leadership & organizing. Key activities include: presentations, trainings, and outreach to
schools, community organizations, and public agencies; virtual outreach and engagement
through a repurposed website and virtual youth center, monthly cultural events, and monthly
membership meetings, expansion of the Contractor's current intake, youth-centered
assessment, referral, and follow up system, as well as expansion of our data collection and
evaluation system. We offer multiple peer-to-peer support groups each week, facilitated by
adult staff, covering themes of emotional regulation, mindfulness, grief support, trauma support
and education, LGBTQ support, and Young Women's and
Men's Circles. We will also develop formal referral systems with community partners for better utilization
of our Health and Wellness services and programming. Lastly, we will initiate Community Health
education projects that integrate health and wellness public education with creative arts and media
outreach. Activities will be developed and implemented in partnership between adult and youth staff.
Program 9: Youth Development
Agency: STAND! Against Domestic Violence
Name of Project: Expect Respect
Scope of Services
STAND! Against Domestic Violence will provide services to address the effects of teen dating
violence/domestic violence and help maintain healthy relationships of at-risk youth throughout
Contra Costa County. STAND! will use two evidence-based, best-practice programs: Expect
Respect and You Never Win with Violence to directly affect the behaviors of youth (preventing
future violence) and enhance mental health outcomes for students already experiencing teen
dating violence, Primary prevention activities include, educating middle and high school youth
about teen dating through the 'You Never Win with Violence' curriculum, and providing
teachers and other school personnel with knowledge and their awareness of scope and causes
of dating violence, including bullying and sexual harassment and increase knowledge and
awareness of the tenets of a healthy dating relationship. Secon dary prevention activities
include supporting youths experiencing or at-risk for teen dating violence by conducting 20
gender-based, 15-week support groups. A referral system will also be set up at each site for
referring youth to the support groups. As a result of these service activities, youth experiencing
or at-risk of teen dating violence will demonstrate an increased knowledge about the difference
between healthy and unhealthy teen dating relationships; an increase sense of belonging to
positive peer groups; an enhanced understanding that violence doesn't have to be "normal"
and an increased knowledge of their rights and responsibilities in a dating relationship.
54
Appendix C
Suicide Prevention Summary
Suicide Prevention Initiative
Prevention and Early Intervention Statewide Project
Contra Costa County
Contra Costa County is the ninth most populous county in California, with its population reaching approximately
1,049,025 in 2010.1 Over 50 percent of the population is Caucasian, approximately 24 percent are Hispanic and 17 percent
are Asian.2 The median age is 39 years. The population is fairly distributed across all age ranges with an average of 27
percent of the population in each of the following age categories: under 18 years; 25 to 44 years; and 45 to 64 years.1 Nine
percent of the population is between 18 and 24 years old and 12 percent are 65 years or older.1 Lastly, approximately 9.4
percent of Contra Costa County residents live in poverty3; yet, the median household
income is close to $80,000.4
Contra Costa County is generally segregated
into three distinct areas: West, Central and East
County. Each region is geographically and
demographically diverse. In 2009, in the Central
region, White (64%) and Latino (20%) make up
the majority. The East region of the county is
largely comprised of White (39%) and Latino
(33%). In contrast, the West region of the
county is predominately White (26%), Latino
(24%), and African-American (24%).1 Figure 1
shows Contra Costa County separated by zip
code to detail the percent of suicides that occur
in each area.5 The suicide death rates within
Contra Costa County are highest among
residents of Walnut Creek and Concord in the
Central region; as well as Antioch in the East
region, with suicide death rates of 13.6, 11.7 and
10.6, respectively.3
In 2010, there were 119 reported suicide deaths in Contra Costa County6; that represents an 8 percent increase from the
previous year and a 40 percent increase from 2005. (Figure 2) Overall, males account for a far greater proportion of all
suicide deaths when compared to females in Contra Costa County. In line with California statistics, the highest numbers
of suicides in Contra Costa County are completed using firearms, followed by
hanging/suffocation,
and drug
overdose/poisoning.6
In 2007, the overall
suicide death rate for
Contra Costa
County was 11.3 per
100,000 population
which is higher than
the California
suicide death rate in
2009 of 9.8 per
100,000 population.7
Contra Costa
County is not
meeting the Healthy
People 2020 goal of
10.2 suicides per
100,000 population.8
Figure 1: Percent of Suicides by Zip Code
Figure 2: Suicide Death Trend 95-10
0
20
40
60
80
100
120
140
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Number of DeathsYear
Total Number of Suicide Deaths
Contra Costa County, 1995 -2010
Total
Male
Female
Since 2001, there has been a decrease the in number of reported suicide attempts.9 (Figure 3) In 2009, there were a total of
386 attempts suicides reported in Contra Costa County.9 Suicide attempts are thought to be drastically underreported
for several reasons. First, not all suicide attempts result in a hospitalization and thus may never be reported and recorded
as a suicide attempt. The Center for Disease Control and Prevention reports among young adults’ ages 15 to 24 years,
there are approximately 100 to 200 attempts for every completed suicide.10 For all ages, it is approximated that there is
one suicide for every 25 attempted suicides.10 If this statistic is applied to Contra Costa County, it can be inferred that
2,975 people attempted suicide in 2010 (given the number of suicides deaths in 2010 was 119). This means as many as
2,589 suicide attempts went unrecognized. Many organizations have acknowledged the underreporting of suicide
attempts and thus have recommended and advocated for increase sophistication of reporting methods.10,11
In 2009, of the reported suicide attempts in Contra Costa County, approximately 67 percent of non-fatal attempts were
among Caucasian people, 12 percent were among Latino and 10 percent African-American.9 In Contra Costa County,
more men die by suicide, however more women attempt suicide; 59 percent of all reported attempts in 2009 were women
in Contra Costa County.7 This statistic transcends the boundaries of this county and is true for the entire nation. Of those
who attempted suicide in Contra Costa County, 80 percent were a result of poisoning followed by cutting/piercing at 15
percent.9
Protective Factors and Risk Factors of Suicide
Suicide is an important and preventable public health problem. The World Health Organization has estimated that
815,000 people worldwide died by suicide in year 2000, far outnumbering the reported 520,000 homicide deaths.12 The
cause of suicide is an extremely complex issue in which multiple interacting risk and protective factors come into play. A
risk factor, in this context, may be thought of as leading to or being associated with suicide; that is, people who
experience the risk factors for suicide are at greater potential for suicidal behavior. However, it is important to note,
many people may have these risk factors, but are not suicidal. Figure 4 describes risk factors identified in relation to
suicide.
Biopsychosocial Risk Factors Environmental Risk Factors Sociocultural Risk Factors
• Mental Disorders
• Hopelessness
• Impulsive and/or aggressive
tendencies
• History of trauma or abuse
• Alcohol and other substance
use disorder
• Previous suicide attempt
• Family history of suicide
• Job or Financial Loss
• Relational or Social Loss
• Easy Access to Lethal Means
• Local clusters of suicide that
have a contagious influence
• Lack of Social Support and
sense of isolation
• Stigma associated with help-
seeking behavior
• Barriers to accessing health
care, especially mental health
and substance abuse treatment
• Certain cultural and religious
beliefs
• Exposure to, including through
the media, and influence of
others who may have died by
suicide
Figure 4: Risk Factors13,14
Figure 3: Trend of Reported Suicide Attempts
0
50
100
150
200
250
300
350
400
450
500
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009# of PeopleYear
Total Number of Suicide Attempts
Contra Costa County, 1991 -2009
All Ages
10-14
15-19
20-24
25-44
45-64
65-84
85+
There are several protective factors related to suicide. (Figure 5)
Protective factors reduce the likelihood of suicide. They can
enhance resilience and may serve to counterbalance risk factors.13, 14
Protective factors are quite varied and include an individuals’
attitudinal and behavioral characteristics, as well as attributes of
the environment and culture.14,15
Influence of Age on Suicide
Among Contra Costa County residents 15 to 34 years old, suicide is
the third leading cause of death, after unintentional injuries and
homicide.3 Studies show a dramatic decrease in the youth suicide
rate during the past decade. Research on this trend attributes the
decrease in youth suicide rate to the increase in antidepressants
being prescribed to adolescents during this same time period.4
Within Contra Costa County this same trend proved to be true
with an all time low number of youth suicide in 2003. There were only three reported suicides for residents under the age
of 25.6 Unfortunately, the trend reversed over the last several years in Contra Costa County. The number of suicides
within the same population has steadily increased since 2003 with 17 suicides being reported in 2010.6
For those residents between the ages of
45 and 64 years old, suicide remains a
leading cause of death with a death rate
of approximately 18 per 100,000
people.7 (Figure 6) This rate well
exceeds the State’s rate of 9.8 and the
County’s overall rate of 11.3 suicides per
100,000 people.6 Yet, suicide is not in
the top five leading causes of death for
Contra Costa County residents over
the age of 55 as the prevalence of
chronic diseases increases with age.3
However, when considering the
number of deaths by suicide within
each age range, it is apparent the older
adult population is a high-risk group
even though they are more likely to die
from a chronic disease than from
suicide.
Influence of Race/Ethnicity on
Suicide
In 2010, the majority of suicide deaths in
Contra Costa County occurred among
Caucasian residents with a suicide
death rate of 13.5 per 100,000 followed
by Latinos, Asians and African-
Americans with suicide death rates of
7.0, 6.6, and 6.2, respectively.7 (Figure 6)
When the suicide death rates are
converted to percentages,
approximately 70 percent of all suicides
are among Caucasians; 15 percent
among Latino; 8 perecnt are Asain and
just over 5 percent are African-
American.7
Protective Factors
• Effective clinical care for mental, physical and
substance use disorders
• Easy access to a variety of clinical interventions
and support for help-seeking
• Restricted access to highly lethal means of suicide
• Strong connections to family and community
support
• Support through ongoing medical care and mental
health care relationships
• Skills in problem solving, conflict resolution, and
nonviolent handling of disputes
• Cultural and religious beliefs that discourage
suicide and support self-preservations
Figure 6: Suicide Death Rate by Age Range in Contra Costa County
Figure 7: Suicide Death Rate by Race/Ethnicity
Figure 5: Protective Factors
0
2
4
6
8
10
12
14
16
18
10-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+Death Rate per 100,000 populationAge Range
Suicide Death Rate by Age
Contra Costa County, 2010
0
2
4
6
8
10
12
14
Caucasian Latino Asian African-
AmericanDeath Rate per 100,000 populationRace/Ethnicity
Suicide Death Rate by Race/Ethnicity
Contra Costa County, 2010
Influence of Gender on Suicide
In 2007, 68 percent of people who died by suicide in Contra Costa County were male.6 Although more men die from
suicide, more women attempt suicide. In 2009, approximately 59 percent of
reported attempted suicides in Contra
Costa County were female.13 Males and
females tend to utilize different means
for suicide. In most cases, males engage
in far more lethal means during the
attempt thus resulting in more male
deaths when compared to females.
(Figure 8) The method used during the
suicide attempt is a predictor of the
outcome of the action. In Contra Costa
County, when compared to men, women
are almost twice as likely to attempt
suicide by poisoning; whereas, firearms
are the predominate methods used
among males.6,13
One study suggests acts of deliberate
self-harm by females are more often
based on non-suicidal motivation, but for males, deliberate self-harm is more often associated with greater suicidal
intent.15 More research is needed to determine the extent to which social, genetic and biological factors, in association
with gender, contribute to the risk of suicide.
Suicide and LGBTQ Youth
As previously mentioned, suicide is the third leading cause of death for people ages 15 to 24 years16; however, more youth
survive suicide attempts then actually die.17 The overall rate of suicide among youth, ages 15 to 24 years, in California is
6.9 per 100,000.18 While Contra Costa County’s rate is the same as for the state as a whole, 6.9 per 100,000, the rate is
higher than its neighbor, Alameda County’s, rate of 6.4 per 100,000.18 The Suicide Prevention Resource Center reviewed
studies and reports about youth suicide and concluded LGBTQQI2-S (Lesbian, Gay, Bisexual, Transgender, Queer,
Questioning, Intersex and Two-spirit) youth are a high-risk group for suicide.18 Their research indicates LGBTQQI2-S
youth are two to four times as likely to attempt suicide as compared to heterosexual youth.18 Therefore, it can be inferred
that the expected rate of suicide for LGBTQQI2-S youth in Contra Costa County is 14 to 28 per 100,000 people.
Moreover, recent research conducted in California, concluded the degree to which a family rejects or accepts their
LGBTQQI2-S youth because of his or her sexual orientation during his or her adolescence has a correlation with the
adolescent’s health outcomes.19 Adolescents who experienced high rejection were 8.4 times more likely to attempt
suicide.19 The increase in suicide and suicide attempts for this specific population of youth can be attributed to an
increase the sociocultural risk factors that are present in the youth’s lives. The social and internalized stigma that is
intertwined with sexual identification of the youth can lead to isolation and rejection. Services available are inadequate to
meet the needs of this population and the lack of a social support network further compounds the issue.18,19
Influence of Economic Environment on Suicide
The current economic crisis being experienced worldwide, and especially in the United States, begs the question of
whether or not the economic environment influences the rate of suicide. The health effects of economic insecurity are
uncertain. Research conducted during the last U.S. economic depression was inconclusive. A study conducted in 1991,
concluded that evidence for effects on suicide is characterized as weak or sufficiently controversial to warrant
skepticism.20 Moreover, two studies conducted in 1978 and 1982 revealed small associations between economic stress and
suicide or suicidal ideation.21 Contradictory, an analysis conducted in 2009 reported suicide is cyclical, meaning rates go
up during an economic downturn; mental health also suffers during such periods.22 Lastly, a study published in 1995
stated people who died by suicide were more likely to be jobless when they died than were people who died from other
causes. However, it was difficult to show job loss triggered individual acts of suicide.23 Psychiatric illness can predispose
people to both unemployment and suicide; yet, economic insecurity may be an important variable in the causal chain
leading a person to harm himself or herself.23 It is apparent that the correlation between the economic situation and rates
of suicide is not clearly defined and lacks consensus; however, most research supports the idea that joblessness or
economic insecurity can be a risk factor for suicide, but not necessarily the primary cause of suicide.
Figure 8: Suicide Deaths by Method and Gender
0%
10%
20%
30%
40%
50%
60%
Firearm Poisoning Hanging/
Suffocation
OtherPercent of DeathsMethod
Suicide Deaths by Method and Gender
Contra Costa County, 2010
Male
Female
Possible Prevention Strategies
The US Department of Health and Human Services stated suicide prevention programs need to support and reflect the
experience of survivors, build on community values and standards, and integrate local cultural and ethnic perspectives.17
Prevention programs can be developed to target one or many risk factors and can target large populations or small sub-
cultures directly.
In order for prevention strategies to be effective, they must incorporate stigma reduction efforts into the prevention
programs. Stigma surrounding suicide has historical roots and dates back to Aristotle who argued suicide weakens the
economy and upsets the gods25,26; such an argument initiated the stigmatization of the act. Until 1961, suicide and
attempted suicide were punishable in court in England and until the early 1990’s two US states listed suicide as a
crime.25,27-29 Today, the stigma surrounding suicide is not as intense nor is it eliminated. The stigma remains just high
enough to discourage people from seeking help and instills hesitation to communicate suicidal thoughts. In addition to
the individual, families, friends and relatives all experience the stigma that follows a suicide or suicide attempt; this
further complicates the recovery process for all affected.24 Furthermore, the National Strategy for Suicide Prevention
report outlines a goal to develop and implement strategies to reduce the stigma associated with being a consumer of
mental health services and suicide prevention services. Educating the public about suicide should decrease stigma in
general, and providing survivors with such information should decrease internalized stigma.9,24,25
Additional possible inventions for suicide prevention are detailed in a matrix derived from the National Strategy for
Suicide Prevention report.24 (Figure 9) Research helps to determine which factors can be modified to help prevent suicide
and which interventions are appropriate for specific groups of people. A 2003 article published by Gould, et.al, identified
promising prevention strategies specific to the youth population. Recommendations include school-based skills training;
screening for at-risk youth; education of primary care physicians; media education; and lethal-means restriction.14
Programs aimed at improving the ability of primary care and mental health professionals to identify and treat those at
risk for suicide are recommended.30 Studies suggest as many as 90 percent of those who died by suicide have a mental
illness.31 Research also demonstrated about one-half of people who died from suicide had contact with a primary care
professional within one month of their suicide, and about three-quarters had contact within one year.32 More specifically,
older adults are more likely to seek primary care services within a month of suicide when compared to other age
groups32,33 and women, when compared to men, tend to have higher rates of contact with primary care providers prior to
suicide.32 By improving mental health professionals and primary care provider’s ability to recognize and treat risk factors,
specifically among older adults and women, suicides can be prevented.13,32
Matrix of Interventions for Suicide Prevention (Examples)
BIOPSYCHOSOCIAL ENVIRONMENT SOCIOCULTURAL
Universal
The intervention is
designed to affect everyone
in a defined population.
Incorporate depression
screening into all primary
care practice
Promote safe storage of
firearms and ammunition
Teach conflict resolution
skill to elementary school
children
Selective
The intervention is
designed especially for
certain sub-groups at
particular risk for suicide.
Improve the screening and
treatment for depression of
the elderly in primary care
practices
Reduce access to the
means for self-harm in
jails and prisons
Develop programs to reduce
despair and provide
opportunities (increase
protective factors) for high
risk populations
Indicated
The intervention is
designed for specific
individuals who, on
examination, have a risk
factor or condition that
puts them at very high risk.
Implement cognitive-
behavioral therapy
immediately after patients
have been evaluated in an
emergency department
following a suicide attempt
Teach caregivers to
remove firearms and old
medicines from the home
before hospitalized
suicidal patients are
discharged
Develop and promote
honorable pathways for law
enforcement officers to
receive treatment for mental
and substance use disorders
and return to full duty
without prejudice
Figure 9: Matrix of Interventions for Suicide
Incorporating the Statewide Strategic Plan
California Department of Mental Health released the California Strategic Plan on Suicide Prevention: Every Californian is Part of
the Solution in June of 2008.32 Several strategies for suicide prevention are detailed in the report with further detail for
recommended actions at the State and local levels. The report refers to the following as “Strategic Directions”: creating a
system of suicide prevention; implementing training and workforce enhancements; educating communities to take
action; and improving program effectiveness and system accountability. Additionally, six core principles were defined to
guide all levels of planning, service delivery and evaluation. The core principles are described below:
Core Principle Description Key points
One
Implement culturally
competent strategies and
programs that reduce
disparities.
• Goal is to reduce disparities in the availability, accessibility and
quality of services for racial, ethnic and cultural groups
• Planning processes should involve members of the target population
of focus
Two Eliminate barriers and increase
outreach and access to services.
• Information, programs and materials:
o Need to be accessible and available in a variety of languages and
formats
o Should ensure that all people of diverse backgrounds and
abilities, including physical, psychiatric and age-related
disabilities, have access to equitable services
Three
Meaningfully involve survivors
of suicide attempts; the family
members, friends, and
caregivers of those who have
completed or attempted suicide;
and representatives of target
populations.
• Include those who have survived a suicide attempt and their family
members, friends and caregivers as they bring important personal
experiences and unique perspectives to identify service needs and
gaps in the system
• Peer Support and education are invaluable components of a
comprehensive system for suicide prevention
Four
Use evidence-based models and
promising practices to
strengthen program
effectiveness.
• Attention should be given to replicating and disseminating or
adapting effective program models and promising practices.
• Program design should include consideration of how evaluation can
be used as a management tool to strengthen and improve programs
Five
Broaden the spectrum of
partners involved in a
comprehensive system of
suicide prevention
• Develop long-term partnerships with a broad range of partners that
transcend the traditional mental health system
• Examples of partnership include: business community; senior centers;
spiritual and faith communities; private foundations; Veterans Affairs,
etc.
Six
Employ a life span approach to
suicide prevention.
• Suicide prevention and intervention activities should be targeted to
people of all ages from children and youth, to adults, and older adults.
As previously mentioned, these six core principles are further organized by two levels of focus for suicide prevention:
strategic directions and recommended actions. When considered together, the core principles, strategic directions and
recommended actions are intended to lay the foundation for a comprehensive system of suicide prevention that builds on
existing infrastructure, expands capacity of co-existing systems and identifies and fills gaps in services and programs.
Citations:
1. US Census Bureau. (2010). American Fact Finder. Retrieved from http://factfinder2.census.gov/main.html
2. Nielson Claritas. (2009). Healthy City Datasource Quickstats. Retrieved from
http://quickfacts.census.gov/qfd/states/06/06013.html
3. Contra Costa County Public Health Department. (2007). Community Health Indicators for Contra Costa
County. Prepared by Community Health Assessment, Planning and Evaluation Group.
4. US Census Bureau. (2008). Small Area Income and Poverty Estimates (SAIPE). People and Households:
Estimates for California Counties. Retrieved from http://www.census.gov/cgi-bin/saipe/saipe.cgi
5. Nielson Claritas, Inc. (2009). Percent of Suicides by Zip Code. Retrieved from www.healthycity.org
6. Contra Costa County Coroner’s Office. (1995-2010). Suicide Deaths in Contra Costa County. Provided by Susie
Moore.
7. California Department of Mental Health – Office of Suicide Prevention. (2009), Data Summary Sheet on Suicide
Deaths and Nonfatal Self-Inflicted Injuries in Contra Costa County. Prepared and received by Data Management
and Analysis Section.
8. US Department of Health and Human Services. (2011). Healthy People 2020. Retrieved from
http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=28
9. California Department of Public Health, EPIC Branch. (2007). California Office of Statewide Health Planning and
Development, Patient Discharge Data – Non-fatal and Fatal Statistics. Retrieved from
http://www.applications.dhs.ca.gov/epicdata/
10. Centers for Disease Control and Prevention. (2009). Suicide Facts at a Glance. Retrieved from
www.cdc.gov/violenceprevention
11. Goldsmith, S., et.al. (2002). Reducing Suicide: A National Imperative. Institute of Medicine. Retrieved from
http://www.iom.edu/Reports/2002/Reducing-Suicide-A-National-Imperative.aspx
12. Mosciki, E.K. (2004). Opportunities of Life: Preventing Suicide in Elderly Patients, 164,1171-1172.
13. National Institute of Mental Health. (2009). Suicide in the US: Statistics and Prevention. Retrieved from
http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/
14. Gould, M.S. et.al. (2003). Youth Suicide Risk and Preventive Interventions: A Review of the Past 10 Years. Journal
of American Academy of Child and Adolescent Psychiatry, 42(4), 386-405.
15. Hawton, K. (2000). Sex and Suicide: Gender Differences in Suicidal Behavior. British Journal of Psychiatry, 177,
484-485.
16. Center for Disease Control and Prevention. (2008). Suicide Prevention. Retrieved from
http://www.cdc.gov/ncipc/dvp/Suicide/youthsuicide.htm
17. US Census Bureau. (2001). Profiles of General Demographic Characteristics: Population and Housing for Contra
Costa County, California. Retrieved from http://www.co.contra-
costa.ca.us/depart/cd/recycle/demog/contracosta.pdf
18. Lucile Packard Foundation for Children’s Health. (2009). Youth Suicide Rate 2005-2007. Retrieved from
http://www.kidsdata.org/data/topic/table.aspx?ind=213&dtm=122&loc=171&loc=2&loc=127&loc=217&loc=265&l
oc=4&loc=59
19. Ryan, C. et.al. (2009). Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian,
Gay, and Bisexual Young Adults. Pediatrics, 123(1), 346-352.
20. Catalano, R. (1991). The Health Effects of Economic Insecurity. American Journal of Public Health, 81(9), 1148-
1152.
21. Dooley, D. et.al (1989). Economic stress and suicide: multilevel analyses. Part 2: Cross-level analyses of economic
stress and suicidal ideation. Suicide Life Threat Behavior, 19(4), 337-351.
22. Besruchka, S. (2009). The Effect of Economic Recession on Population Health. Canadian Medical Association
Journal, 181(5), 281-285.
23. Jin, R.L. et.al. (1995). The Impact of Unemployment on Health: A Review of the Evidence. Canadian Medical
Association Journal, 153(5), 529-540.
24. US Department of Health and Human Services. (2001) National Strategy for Suicide Prevention. Retrieved from
http://mentalhealth.samhsa.gov/suicideprevention/
25. Tadros, G. & Jolley, D. (2001). The Stigma of Suicide. The British Journal of Psychiatry, 179, 178.
26. Alvarez, A. (1990). The Savage God: A Study of Suicide. New York: W.W. Norton, pages 59-93.
27. Levine, M & Pyke, J. (1999). Levine on Coroners’ Courts. London: Sweet & Maxwell.
28. Cvinar, J. (2005). Do Suicide Survivors Suffer Social Stigma: A Review of the Literature. Prospectives in
Psychiatric Care, 41(1), 14-21.
29. Simon, R, et.al. (2005). On Sound and Unsound Mind: The Role of Suicide in Tort and Insurance Litigation.
Journal of American Academy of Psychiatric Law, 33, 176-182.
30. Luoma, M.A. et.al. (2002). Contact With Mental Health and Primary Care Providers Before Suicide: A Review of
the Evidence. American Journal of Psychiatry, 159(6), 909-916.
31. Sudak, H. et.al. (2008). Suicide and Stigma: A Review of the Literature and Personal Reflections. Academic
Psychiatry, 32, 136-142.
32. Pearson, J.L. (2006). Progress in Identifying Risk and Protective Factors in Older Suicidal Adults. American
Journal of Geriatric Psychiatry, 14(9), 721-723.
33. California Department of Mental Health. (2008). California Strategic Plan on Suicide Prevention: Every
Californian is a Part of the Solution.
63
Executive Summary: INNOVATION 01
YEAR ONE Report
Contra Costa LGBTQ Youth Advocacy Collaborative
Increasing national media attention has highlighted the challenges and risks LGBTQ youth face in
finding support and acceptance. The experience of rejection and the lack of support across a wide
variety of settings, including home, school, faith groups and within peer social networks have harmful
impacts on the long-term health and mental health of LGBTQ youth. The Contra Costa LGBTQ Youth
Collaborative was formed to identify answers to critical questions regarding the needs of LGBTQ youth
and the stresses that impact their healthy development. Learning questions that guided this project
include:
o What are the most potent risks that threaten the health, safety, and mental health of LGBTQ
youth who live in Contra Costa County?
o What practice strategies may increase resilience and improve mental health outcomes for
LGBTQ youth and lead towards evidence-based practice?
o Can developing a community-wide, integrated Social Support Model improve health outcomes
and overall resilience for LGBTQ youth?
Background: The findings presented in the Background section of the full report reveal the harmful
impact of rejection on the health and resilience of LGBTQ youth, including:
o High levels of family and caregiver rejection often result in significantly increased levels of
depression, suicide attempts, illegal drug use and risky sexual behaviors.
o A strong correlation has also been found between high levels of harassment, victimization and
violence at school (and/or other social settings) and impaired health and mental health in young
adulthood.
o Victimization by both peers and school personnel has been documented and demonstrated to
negatively affect school attendance, sense of safety and overall academic performance.
o Institutional barriers to accessing culturally competent support services exacerbate the harmful
effects of rejection. Many health and social service professionals are not trained, or supported
by their agencies, to address issues of sexual orientation or gender identity with children, youth
and families. The result is a lack of inter-agency cooperation and ultimately under-utilization of
health and supportive services by at-risk LGBTQ youth and families.
o Minimal research has examined the impact of faith-group rejection on health outcomes for
LGBTQ youth; however, practice experience and emergent findings from this project suggest
that issues of faith and religious practice are significant factors that must be addressed in order
to increase family and community acceptance.
64
o Finally, while research has clearly identified the connection between rejection at home, school,
and in the community and health and mental health disparities among LGBTQ youth, there are
no evidenced-based intervention models in place to guide development of effective services.
In light of the compelling evidence about the harmful effects of rejection on LGBTQ youth, the Contra
Costa LGBTQ Youth Advocacy Collaborative has sought to identity effective strategies that will provide
support for LGBTQ youth throughout Contra Costa County, California. The lack of evidence-based
intervention models from the field underscores the vital importance of this project in identifying
promising strategies that have the potential to increase resilience and improve mental health outcomes
for LGBTQ youth.
Funding for this project has been provided through the Innovations component of the California Mental
Health Service Act of 2004 (MHSA). MHSA has defined Innovations as “novel, creative and/or ingenious
mental health practices/approaches that are expected to contribute to learning, which are developed
within communities through a process that is inclusive and representative, especially of unserved and
underserved individuals.”
Our work in Year 1 of the project embraced the following protective factors identified in the Background
review:
o The 2011 Institute of Medicine (IOM) Report, The Health of LGBTQ People, notes that “the few
studies that have examined protective factors for LGBT youth have considered individual and
interactional factors, such as self-esteem (Savin-Williams, 1989a,b), school support, and family
relatedness (Eisenberg and Resnick, 2006).” 1
o The IOM report also stressed that it is important to note that the majority of LGBTQ youth are
typically well-adjusted and able to thrive during their adolescent years.
2
o Eisenberg and Resnick (2006) studied suicidal ideation and attempts among high school students
with same-sex sexual experience. They found that family connectedness, adult caring, and
school safety were significantly protective against suicidal ideation and attempts.
3
o The importance of acceptance for LGBTQ youth is both supported by and made more explicit in
the work of Dr. Caitlin Ryan. Compelling ideas from Dr. Ryan’s work include the concepts that
acceptance and rejection can be framed on a harm reduction continuum and interventions that
reduce the rate and level of rejecting behaviors may lead to improvements in health and mental
health outcomes. This is the central paradigmatic framework that has guided partner activities
under this innovations Project.
4
1Institute of Medicine (IOM): The Health of LGBTQ People (2011), p. 164
2 IOM p. 147
3 Eisenberg ME. Resnick MD. (2006) Suicidality among gay, lesbian and bisexual youth: the role of protective factors. Journal of
Adolescent Health, 39: 662–668. 2006.
4 Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in White
and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123, 346–352.
65
Three year program design: The Rainbow Community Center of Contra Costa County (RCC), will work
with collaborative partners to develop and implement innovative, learning-oriented activities to
answer our learning questions and to identity potential practice methods that can lead towards
improved health and wellness and prevent mental illness among LGBTQ youth. Year one activities
focused on needs assessment and emergent design methods that mapped a baseline of services
available in the community, identifying both the strengths and services in need of further development.
Year two activities will focus and refine intended interventions and begin the collection of evaluation
data. Year three of the project will then focus on analysis of data collected in year two and promote
planning to sustain the most effective intervention methods identified during the project.
Year 1 Objectives: (activity summaries begin on page 35 of the full report)
Three core objectives were developed for Year 1 of the project:
1. Form and implement a learning community of key partners and collaborators who will work
together to develop a multi-level approach that promotes acceptance of LGBTQ youth
o The implementation of these learning goals and approaches in Year 1 has been
accomplished with the support of the following key partners: Rainbow Community
Center (RCC) (countywide), San Francisco State University-Marian Wright Edelman
Institute’s Family Acceptance Project (countywide), RYSE Center (RYSE) (west county),
Gender Spectrum (GS) (countywide), James Morehouse Project (JMP) (west county), and
Center for Human Development (CHD) (east county). During Year 1, six additional ally
organizations were identified and incorporated into learning activities.
o The core activities related to this objective include: 1.) Implement at least five social
support/community interventions that will reduce rejecting behaviors experienced by
LGBTQ youth; 2.) Develop a community mapping process that identifies community
organizations and service providers that interact with LGBTQQI2-S youth; 3.) Engage
community service providers in processes that change organizational practices to
promote accepting behaviors and engage key ally groups in the project; and 4.) Collect
formative and summative data on project processes and outcomes.
2. Develop an LGBTQ-specific Mental Health counseling program at the Rainbow Community
Center of CCC and countywide co-located sites
o The core activities related to this objective include: 1.) RCC will recruit and hire program
and support staff to provide mental health services; 2.) train service providers in
concepts based on family-inclusion and in efforts to reduce rejecting behaviors and
increase accepting behaviors across different social spheres; 3.) implement use of
Family Acceptance assessment instruments; and 4.) Collect formative and summative
data on RCC’s counseling processes and outcomes.
3. Disseminate educational materials developed by the Family Acceptance Project as part of one
or more of five piloted social support/community interventions
66
Summary of Emerging Findings from Year 1 Activities: (beginning page 81)
• Developing a collaborative process: The primary work in Year 1 was to form a collaborative
learning community to learn more about how a Social Support Model can improve health
outcomes for LGBTQ youth. Findings about the collaborative process: Innovative project designs
are critical approaches to program development when addressing the needs of marginalized or
hidden populations and in situations where minimal evidence-based practices are available. It is
recommended that funders of collaborative models support time for planning, development of
interventions, relationship-building activities and group facilitation. It must be restated that the
relationship-building phase almost always takes longer and is more complex than many funders
would like, however successful implementation plans incorporate this critical step into the
process. Setting clear guidelines for decisions made collaboratively and those made by the lead
agency or funder at the beginning of the project is a vital element of collaborative projects.
Partners reported that collaborative work strengthened their individual and organizational
capacity and insight. Participating organizations developed stronger intervention theories and
displayed organizational growth and development. Developing a shared yet flexible framework
for intervention is the best way forward. Partners should determine the capacity and
approaches appropriate for each strategy and then commit to a specific plan of action that fits
their organizational model and context.
• Promoting positive LGBTQ youth development: Much additional work must be done to develop
interventions that have clearly defined logic models defining interventions that support healthy
LGBTQ youth identity development. At their core, all partners serving LGBTQ youth are involved
in supporting their clients through the process of identify development. Yet, a key finding from
year one of our project is that agencies lacked explicit guidelines or a theory of change to help
guide this developmental work. Year 2 efforts must identify more explicit interventions, and the
methods needed to assess and measure the outcome goals in identity development work with
LBTQ youth.
• Developing LGBTQ youth-and family specific mental health services: Mental health services are
needed that assess for youth strengths as well as risks. Services must create clearer guidelines
for incorporation of identity development treatment goals with LGBTQ counseling clients. A
clearer theory of change must be developed that creates stronger assessments and treatment
plans for work with parents of LGBTQ youth and incorporates the newly developed FAPRisk
Assessment Tool. An additional key finding from year one efforts is that many clients request
mental health counseling services but that this request reflects an unidentified need for a range
of behavioral health services such as case management, vocational rehab, and HIV prevention.
More work is needed to properly assess client needs and as noted there is a serious lack of a
county-based referral network.
• Promoting community engagement: One of the core values and goals of this project is to create
an Integrated Service Experience county-wide for LGTBQ youth and their families. Building
awareness of the existence of the Collaborative is an ongoing challenge. As awareness has
67
grown, opportunities have emerged to overcome the isolation among supportive providers that
point toward the great potential of developing integrated assessment, referral and service
strategies. The Mapping Process established a baseline of LGBTQ-specific youth and family
services available in Contra Costa County when this project began. There has been some growth
in services through Collaborative efforts. The mapping process has identified an immediate
need for a unified approach to LGBTQ cultural competency training from both a service provider
and an administrative perspective. There is a significant need for deeper work in the education,
child welfare and juvenile justice systems with regard to cultural competence in addressing
sexual orientation and gender expression. Recent legislation on the federal and state level is
creating new opportunities to engage in work on behalf of LGBTQ youth and families.
• Building social support networks: The three-year goal of this project is to determine whether a
Social Support Model can improve health and mental health outcomes for LGBTQ youth. The
first year goal was to determine the key characteristics of and strategies to implement a Social
Support model for LGBTQ youth targeting families and caregivers, schools and faith groups.
Year one findings regarding social support networks:
o Families and caregivers: While significant effort went into forming support groups for
parents, these efforts had limited success in engaging family members with school-aged
children. The conclusion is that group-level interventions are not cost effective
strategies at this time. Instead it is our recommendation that the project evaluate
community mobilization strategies to raise awareness about the impact of rejection on
LGBTQ youth. At this time more efforts are needed to identify and create cohorts of
family members who are ready to participate in group-level interventions. Strategies
that promote individual-level services and training for all providers engaging with LGBTQ
youth and their families will also be explored in year 2 project efforts.
o Schools: Reported experience of all participating organizations makes it clear that
issues of harassment and victimization noted in the Background section of this report
are evident in public schools across Contra Costa County. School systems continue to
foster climates that promote the rejection of LGBTQ and gender non-conforming
children and adolescents. It also appears unlikely that schools will create needed
changes from within. Conversations with policy makers rarely move from consent to
committed action. There is an unmet need for organizations who can work effectively
with schools to advocate for the needs of LGBTQ youth. The Collaborative has formed a
Schools Strategy Team to work on these issues in Year 2.
o Faith Groups: All Collaborative partners have reported that youth in their programs
speak about the stigma and rejection they experience at church and report that they are
negatively affected by those experiences. Given the pervasive nature and importance of
issues of faith for LGBTQ youth, the Collaborative Strategy Teams will incorporate work
on these issues into their plans for Year 2. The work of our faith-based mini-grant
partners will form the basis of the dialogue and outreach.
68
Implications of Findings for Year 2 Strategies: (beginning page 88)
The Contra Costa LGBTQ Youth Advocacy Collaborative was formed to address the need to reduce the
harmful health disparities experienced by LGBTQ youth in Contra Costa County, CA. The three-year goal
of this innovations project is to determine whether a Social Support Model can improve health and
mental health outcomes for LGBTQ youth. On the basis of our analysis of lessons learned and our
summary of emerging findings, a plan for year two efforts has been established.
The primary target groups for year-two strategy implementation are: 1.) LGBTQ youth/TAY and their
straight peers and allies; 2.) families and caregivers; and 3.) community-based organizations, including
schools, faith groups and service providers. The overall goal is to create suggested strategy and
evaluation toolkits for use with each target group. The following recommendations form the basis for
strategy development and implementation in Year 2 to complete the infrastructure for a Social Support
Model for LGBTQ youth in Contra Costa County.
The goal with LGBTQ youth and peers is to build the capacity of CCC community-based youth services
to promote the health and wellbeing of LGBTQ youth; to engage LGBTQ youth voice and leadership; and
to develop, implement and evaluate core strategies and tools designed to promote positive identity
development and reduce health risk factors for LGBTQ youth. Key strategies include:
• Facilitate LGBTQ youth development and empowerment groups in all regions of the county in
order to promote an integrative program model supporting a culture of acceptance and healthy
LGBTQ identity development. These services will be provided by RCC, CHD, RYSE and JMP in
conjunction with a variety of mini-grant partners.
• A Youth Strategy Team will be formed to create a strategy and evaluation toolkit for use by
organizations providing youth development and support services for LGBTQ youth.
• A youth-designed and led digital and social media campaign will be developed to nurture new
support connections among a diverse group of LGBTQ youth and to build capacity to create a
unified message and voice for LGBTQ youth county-wide.
• Online resources and outreach will be established to build a strong social media strategy that
elevates LGBTQ youth voice in Contra Costa County.
The goal with families and caregivers is to build county-wide awareness of the harmful effects of
rejection and to promote positive parental role models for the acceptance of LGBTQ youth. It is also our
intent to engage the voice and leadership of LGBTQ youth and their families in developing and
implementing the proposed strategies. The strategies with families will be adapted from Community
PROMISE, an evidence-based community level intervention which was designed to mobilize social
networks to build trust and partnerships and reduce HIV risk behaviors. Key strategies to be developed
by the Families Strategy Team include:
• Promote community-level awareness of harmful effects of rejection by developing role models
stories about peer-family support and that highlight accepting behaviors for families and
caregivers of LGBTQ youth.
69
• Promote Education and Awareness events and forums to support the role models of acceptance
initiative and expand the influence and awareness of the FAP psycho-educational model.
• Family Counseling will be provided by RCC and accessed through a codified referral network
established among all service providers participating in the extended collaborative.
• Home-based outreach and support for families and caregivers will be developed based on FAP
research, including training on making contacts, home visits, crisis intervention and making
appropriate referrals for services.
• An online resource and referral network will be established based on an online service directory
and other resources developed and maintained by the Contra Costa Crisis Center.
The primary goal with community-based organizations (schools, faith groups and service providers) is
to build the capacity to create a climate of acceptance for LGBTQ youth. We will develop, implement
and evaluate strategies and tools designed to reduce rejecting behaviors and increase accepting
behaviors in schools, faith groups and service providers. Additionally, our intent is to engage LGBTQ
youth voice and leadership. Key strategies include:
• Build a base network of allies in schools county-wide by establishing two Inclusive Schools
Coalitions; one in west county and one in central-east county
• Develop and promote LGBTQ cultural competency assessment and training for administrators,
teachers and other school district staff based on collaborative funded training models.
• Develop and promote a tool kit of strategies and activities for action in schools countywide.
• Advocate for implementation of current CA education policies in order to create more inclusive
and accepting environments in county schools.
• Hold targeted forums to promote acceptance in West Contra Costa Unified School District
elementary schools.
• Prepare for a county-wide symposium for educators and allies in the fall of 2012.
• Build a base network of allies among faith group leaders; including networking opportunities
and awareness raising efforts based on the FAP model of family engagement.
• Develop and promote workshops and forums designed to address issues of faith, families and
acceptance of LGBTQ youth county-wide.
• Establish an individual counseling, case management and referral network to develop protocols
for intake and referral for assessment, counseling and case management services.
• Develop and deliver LGBTQ cultural competency assessment and training in partnership with
collaborative partners and all organizations receiving mini-grant funding.
The strategies listed above along with sustainability and evaluation strategies will be developed,
implemented and tested during Year 2 and Year 3 of the project.
PUBLIC HEARING
Draft MHSA 2012/2013
Annual Update to the 3-Year
Program and Expenditure Plan
June 14, 2012
Meeting Packet
70
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County of Contra Costa
Mental Health Services Act (MHSA)
MHSA Fiscal Year 2012/13 – ANNUAL PLAN UPDATE – Tracking of Public Comments &
Responses
Public Comment Compiled
Annual Update for MHSA FY 2012/2013 Annual Plan Update – Input from public& stakeholder comments, for
the period May 15, 2012 through June 14, 2012, and also for the Public Hearing conducted by the Mental Health
Commission on June 14, 2012, 5:30-7:30 p.m.
Reading from left to right: the first column references the comment number, the second column contains the
stakeholder name, and the third column identifies the public comment and/or stakeholder input received. County
responses to the following comments can be found on page 84.
No. Name Public Comment and/or Stakeholder Input and Response to Comments and/or Proposal
Changes to Draft:
1 Janet Marshall
Wilson
Public Comment:
• The unanimous rate for 30% increase in new funding being spent on housing
(CPAW & INH Commission) should help solve the housing challenges listed
on p.20. Also, housing must be developed (continuum of care) for out-of-county
placed conservatees as well as for county m.h. clients placed in substandard
living (eg Jackie Brown’s unlicensed homes in East County). Clients who need
care and supervision (as defined in Tittle 22) should be in licensed board +care
homes; those more independent (and efforts should be made to help clients,
become independent) should be placed in permanent subsidized housing with
the understanding that identified priority request of consumers is master-leased
scattered site housing, with available transportation. Housing for mental health
clients takes political will. Dually diagnosed clients (MH/AOD) should NOT be
co housed with “serious + persistent” mental health clients.
2 Melinda Oiday Public Comment:
• Need more advocates
• Need More peer to peer
• Need bus passes
3 Melinda Oiday Public Comment:
• We need a shuttle bus to pick up + drop off consumers
• We need more affordable housing
• We need more assistance with paying for medication
4 Marvin
Edwards
Public Comment:
• Transportation – 7 passenger van
• More peer to peer supporter
5
Scott,R
Public Comment:
• Transportation
• Support in recovery
6 Marvin
Edwards
Public Comment:
• More adults peer support program
• Leadership Academy
• Shuttle service- peer run
7 Christopher
Rollins
Public Comment:
• More peer counselor jobs will be appreciated thank you!
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8 Yvette E
Anderson
Public Comment:
• I think that we should use the funds toward affordable optometrist, dentistry;
orthodontist for Medical/Medicare, new groups for dentistry for example DVC
+ have medical county cards again for the Contra Costa County. People need
glasses + good hygiene(dentists)
9 Chelsey Holer Public Comment:
• I am a consumer provider for MHCC. Many of our consumers cannot get to the
center. We have even lost consumers because this issue. I get calls all the time
from consumers who are stuck in their house and cannot get to the center.
Please fund us for a consumer run shuttle program so that we can reach more
people. Also we need more peer counselors and full time assistants. Please
continue the leadership academy so we can continue to empower consumers to
advocate for others.
10 Peggy Harris Public Comment:
• I would like to see MHSA funds used for additional transportation needs to
support consumers to not isolate and be driver to wellness & recovery
community centers.
• I would also like money to be set aside for housing in Contra Costa County. It is
very rare in Central County.
11
David Selig
Public Comment:
• It would be good to have a shuttle to take consumers home because the public
transportation (busses) doesn’t run often
• It would be good if we could reach out to the local community so we could
educate them about mental health
12 Arthur Dell Public Comment:
• Better dental and vision coverage/ Medical
• Free shuttle bus from home to recovery centers and doctors
• More low income apartment for people with mental health
• Easier access to section 8 and shelter, plus care certificates for people
• I think it should be automatic sec. 8 or shelter plus care for people who are on
SSI because we have a limited income and cannot afford the high cost of rent
and be able to buy food and pay bills
13 James Faeman Public Comment:
• Need subsidized housing
• Cheaper medication
• Need transportation
• Need dental services
14 Susan Reyes Public Comments:
• Transportation
• Good doctors
• Increase benefits such as income
15 Jonathan Tran Public Comments:
• Coming for fun and meeting new people and help other out. Also, information
on how to get a good job and school.
16 Loretta
Winchester
Public Comment:
• Subsidized housing
• I need transportation
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• Cheaper medication
• I need transportation to run errands
• I need good doctors and therapist
• Increase benefits and medical benefits
17 Jose Saucedo Public Comment:
• Information on how to get housing
• Information on how to receive higher benefits
• Information on how to get back to work
• Information on how to get back to school
• Information for vocational job training
18 Dawn
Elizondo
Public Comment:
• I need cheaper medication, transportation and the therapist and good medical
doctors. Also, we need good apartments for people with cheaper rent for people
who cannot pay a lot of rent.
19 Judith J
Germany
Public Comment:
• As a coordinator for a wellness a recovery center I witness firsthand what the
consumers concerns are regarding their daily wants and needs. My consumers
express to me they wish they had more choices of permanent supporting
housing, more wrap around services, subsidized housing, transportation to and
from clinics, shopping, wellness centers. They want vocational training, better
medical care such as vision and dental services.
20
Michael
Reeves
Public Comment:
• We need transportation
• Housing needs
• More doctor’s help
21 Joy Witt Public Comment:
• We need more class B Drivers
• More vans for pick up for consumers
• Money for outing
22 Jeffrey Lawe Public Comment:
• I need affordable housing, transportation
• Better mental health care services
• Better medical coverage
• We need van transportation
23 Daniel Ben
Eliezea
Public Comment:
• Dental health care still is needed
• Subsidized housing
• Transportation
24 Camelle
Thompson
Public Comment:
• Better transportation
• Better medical care
• Better housing
• Raise more outing money
25 Yvette E.
Anderson
Public Comment:
• Smoke zero program , to ban smoking for mental health for good as well as
health in general
• Teach philosophy to have the power to quit smoking
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• We need teachers
26 Joseph Larkin Public Comment:
• We need transportation for consumers who have a hard time making to the
center. And when they cant get here sometimes they end up walking the street.
This is not right.
27 Anne Lang Public Comment:
• Everything on the board
• Peer counselors
• Wellness nurse / week days
• Shuttle services
• Older Adult support group
28 Loni Feldman Public Comment:
• Need a wellness nurse every week
• Older Adult Counselor
• Consume shuttle service
29 Peter Cordova Public Comment:
• Transportation is an issue for my family. Please recognize my family.
Transportation is needed for my family. Family member is going deaf and has
eyesight 4.1 and 4.0 for eyesight. Documents show this.
30 Hiram “Jack”
Feldman
Public Comment:
• More peer counselors
• Increase the wellness nurse
• Support the whole health model
• Consumer run shuttle service, purchase vans
• Three full time advocates
• Support for ongoing leadership training
• Older adult peer support program
31 Wayne Fens Public Comment:
• I think mental health services have helped me in my wellness and recovery.
32 Stan Baraghin Public Comment:
• Transportation / mini vans- 7 passengers
• Paid peer counselor
• Health & Nutrition assistance
• Transpiration will help consumer stay later at the centers
33 Ranier Butiong Public Comment:
• I would like to see the following:
1. Consumer run shuttle services- this will certainly help consumers get to and
from MHCC. It will help me the most because I live away from MHCC.
2. Housing Advocate- Independent Living- I definitely need help trying to get
my own housing and independent living. I need to get out of my board and
care living situation.
34 Dale W.
Hendrickson
Public Comment:
• What to say on an interview by themselves, it not just an application that you
fill out about yourself.
35 Julie Driscoll Public Comment:
• Social services
36 Dale
Hendrickson
Public Comment:
• How to write out an application for a job interview for some of the client that
don’t know anything about it
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37 Steven L.
Judkins
Public Comment:
• I would add. There is a need for transportation services. Also, educational
services. Such as education for independent living. As well in job training
services.
38 Daniel Gibson Public Comment:
• We need a van for consumer, to pick up and drop off at appointments
• Full time nurse
• 3 full time advocates
• Funds for the leadership program
39 Yvette Elaine
Anderson
Public Comment:
• We need help for the deaf and blind
• New board and care
They are treating them wrong.
Disability threatening ;ex “If you do this again you going to the hospital”
When all they need are resources. The communication between one another is
mediocre.
Also need new board and care directors
40 Sherry Bradley Public Comment:
• The new format, and content of the 2012-13 Annual MHSA Plan is very user
friendly, and not overwhelming. My hats are off to the staff that created the
content for this Annual MHSA Plan. Thanks to all of you for the good work
41 Michaela
Mougenkoff
Public Comment:
• Mary you deserve so much credit for identifying the need and designing these
very critical services, these will so benefit our consumers, thanks
42 Jan Cobaleda-
Kegler
Public Comment:
This is a good plan. It addresses needs and gaps in our system and provides a
reasonable array of services to meet those needs. Many thanks to the members of
CPAW for hanging in there and taking the time to look at the system as a whole and
design helpful sustainable solutions.
Outstanding is the Capital Facilities Plan to build the Assessment and Recovery Center,
a long-awaited milestone in our county! It will help so many families and consumers,
of all ages.
A few other items that are especially noteworthy:
-the redesign of Children’s Full Service Partnership program to include evidence-based
programs for youth across the county that will include adequate supervision of these
EVPs
-expanding services to very young children
-support to families using our psycyhiatric emergency services
-an independent living skills program for youth who are not in the foster care system.
These are all good ideas that leave me feeling hopeful for the future of our system of
care
43 Peggy Harris Public Comment:
I would like to see MHSA funds used for public anti stigma campaigns.
TRANSPORTATION vehicles for consumer. Most importantly independent affordable
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housing in Contra Costa County.
44 Tim
Richardson
Public Comment:
I would like to express that there are needs within the Mental Health services that are
crucial in providing for individuals in our communities. These are just a few of these
that I am seeing as absolutely necessary:
• A much more affordable and available public transportation system.
Individual’s agency shuttle would greatly relieve this situation.
• Housing is an ongoing need that must be considered as a top priority in budget
needs
• Continue and increase available funds for fitness + nutrition training programs.
This type of service makes a definitive difference in the life expectancy +
quality of life in the life of mental health clients and needs to be supported and
strengthened for the people in our communities.
45 Stephen Mark Public Comment:
Consumers in Contra Costa County, who do not live near public transit stops, need to
have transportation to all of the various mental health services for consumers. Many
consumers spend most or all of their time wandering in the vicinity of their board and
care residences and cannot afford to pay transit fare every day. With more vans and
drivers more people could receive services that might lead them toward actualizing
their life goals. It can also be another source of employment for consumers as the
drivers.
There is a need for advocates who can assist and mediate for consumers with their
discrepancies with board and care managers, room and board managers, conservators
and various service providers. And speaking of room and boards there is a crying need
for housing for consumers in this county.
Most WRAP groups in Contra Costa County have only one facilitator per group. They
need to be co-facilitated by two facilitators at each workshop. And there are plenty of
places, like the clinics, that need to have WRAP workshops too.
People in the Full Service Partnership need more peer support and life skills training
than they are currently getting.
46 Jim Baba Public Comment:
• Transportation
• Prescription
47 Clifford Clliott Public Comment:
• A large space to hold groups
• More mental health vans to take trips
• More Mental Health Events
• Needs more help to go to Dr.
48 Mark
Shadinger
Public Comment:
• West County Recovery Center needs a bigger place and provide transportation
I don’t want to have to pay for medication and to see the doctor
49 Mikal Vasin Public Comment:
• I would like more help in recovery, love to see others as well get help
• More education on Mental Health issue like understanding how to treat us
50 Wanda
Thomas
Public Comment:
I wish there was a place to go on the weekends, that’s when I am usually depressed. I
wish we had a van to go out on more outings. Also, they only approved my therapist
until November. I need her all the time!
Jude Yven, I see her every 2 weeks unless I’m too depressed to go.
Please be here to help us. Do not be like the governors.
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51 Nate Suchai Public Comment:
• Transportation
• Housing
• Advocates
52 Hector Castro Public Comment:
We need a bigger place, so that we can get space. We need more community activities
(the west county community center), so that we can continue to do mental health
activities. Have room to help new consumers. We also need housing programs, for
consumers, who need housing.
53 James Kizer Public Comment:
We need a bigger place to mingle more comfortable.
55 Charlotte
Allen
Public Comment:
We need a bigger building and parking lot MHCC-WCWRC more housing and
communication with Alameda county agency and transportation.
56 Andrea
Agredan
Public Comment:
I just started wellness and recovery, transportation would be well.
57 Theresa Marie
Repass
Public Comment:
• We need IHSS to be approved. Said she is not needy enough. She is!
• Building capacity is 14. Have 20 people here
• More groups are needed
• Need more transportation
• Housing needs to be more available
• More mental health centers around our county
• MHCC & WCWRC are needy of bigger space
• Internet access
• Door to door transportation for mental health
• More activities for mental programs
58 Monty Shelton Public Comment:
• More activities
• More social skills
• More transportation
• Big rooms and space
59 Tinsley Public Comment:
• The Community center needs more advising
• We would like more housing
• More transportation
60 Vicki Lynn
Legaux
Public Comment:
• I have (neuropathy) I don’t understand why I was denied IHSS. Due to my
health (fibromyalasis). Sensitive to light color, sound tough and taste. Due to
my neuropathy at times I do not feel my arms or legs, I fall a lot at times, and I
can’t even hold or lift items. I have chronic pain; chronic fatigue is hard for my
daily living. Even my hygiene and to cook for myself. At time I burn things. I
am hard of hearing have to wear hearing aids; I feel left out and left behind at
times.
MHCC-WCWRC- We need more space at the mental center. I have walker,
wheel chair, hearing aids and glasses.
61 Kathleen
Forsythe
Public Comment:
• We need bigger building
• We need transportation
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• We need housing
62 Peter Hodges Public Comment:
I have plenty of reason to thank (West County—MHCC). The program and
groups offered weekly have enabled me to get back on my feet and start looking
for a job. In Richmond, CA. the West County office, part of MHCC. (Mental
Health consumer concerns) is not large enough to fit additional and the current
number of members. I Peter would like to have a large size boiling still located
in the city of Richmond. The staff and members would appreciate our concerns
to be considered. Also, please consider more housing available for independent
living.
63 Jesse Hart Public Comment:
I want permanent affordable housing in Richmond for people with a mental health
diagnosis because there is a serious lack of housing for low income consumers. I want
regular psychiatrist at the county clinics, because I switch psychiatrist too often. I also
don’t have access to a therapist at any clinic and want that to change. I want the Mental
Health consumers on the West County to have a large site because it is very cramped
for the amount of people that go. I want transportation available for appointments here
is none warranty.
64 Monty Shelton Public Comment:
Through MHCC I want to be able to reach my goal and advance into learning more by
learning social skills through more activities and opportunities. Hoping to get to these
places with transportation, with lots of more friends and people, with more space and
big rooms.
65 Kevin Burns Public Comment:
Creating a part time jobs program would be wonderful. It would give consumers a
boost in self-esteem. Some extra cash, and the opportunity to meet new people, take on
some responsibility.
66 Carolyn Moore Public Comment:
There is an increasing need for more MH programs in West County due to the growing
number of MH participants. The West County facility needs more space in order to
serve a longer capacity. Each facility would benefit greatly from having a van to assist
members with transportation while increasing their social skills and interactive skills.
All staff, including part time workers need specialized training. There needs to be more
social interactions between agencies. Members should be acknowledged and celebrated
for their accomplishments. There should be more vouchers made available for MH
members receiving SSI.
67 Artis Swozya Public Comment:
They need more transportation, more Doctor help and help with education.
68
Frederick
Calapini
Public Comment:
• We need more art therapy
• Larger facilities
• We need more programs
• We need our van
69 Andrew Dyes Public Comment:
People in locked facilities should be allowed more free times. Or more trips,
like baseball, football, tennis, track, softball games. More control over
prescribed medications. We want to know what we are taking.
70 Carolyne
Moore
Public Comment:
The members and staff would benefit greatly from a larger facility that would allow for
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a greater capacity; a van for each center to assist members without transportation and to
increase and promote socialization. There is an increasing need for more.
71 Nayyirah
Sahib
Public Comment:
• There should be some type of system in place for those individuals who were
working consistently and were abruptly fired should be a way to bring them
back into recovery.
• Things they need (art, crafts, better cable stations, better music (stereo system).
• I have housing but there are many of my peers who do not have housing.
72 Renee Owens Public Comment:
MHCC-West County Wellness & Recovery Center is too small. It has a capacity of 14
persons. This center services up to 25 persons a day. We need a bigger space so that
continue to service our community.
73 Renee Owens Public Comment:
I think that there should be a transportation system. In Contra Costa County there are
many individuals that need to get to jobs, training, doctors, and recovery centers. Many
consumers cannot make it to appointment, programs, etc., due to transportation. There
should be more peer ran recovery centers to service the needs of all MH consumers.
MHCC need a van for each of the centers, because a part of wellness is adventuring
out, fresh air, site seeing,. On a weekly basis.
There should be more places where consumers can get used clothing, jobs, and training.
We need more recreations that bring us all closer (picnic, night movies, skating days
and dinners)
74 Mary Long Public Comment:
I would like to make the suggestion on that forms posted to site should be “writable”-
Whether an acrobat form or word template as some folks may not have the ability to
scan and email their written comments, or some may only have access to a fax
machine.
There is a huge need for either better public transportation
schedules/connections/holiday availability or some type of consumer shuttle service to
pick up and drop off at centralized locations (if not from their home). For instance,
many folks without access to a car or carpool would be challenged to get to this
meeting at this time 5:45pm)
County connections routes/schedules vary from 30/60/90 minutes and most stop
running after 6:30pm/7:30pm. If you have multiple connections it can be a disaster.
Another important need for consumers is access to more comprehensive dental care;
some have serious dental needs that affect not only whole body health but self-esteem
and employment. Housing & out of county placements: accessibility for consumers and
family members as well as expense. Need for more consumers/ patients’ rights
advocacy.
75 Sandra Wright Public Comment:
You need to be involved and listen to your people. Like us. Get your head out of the
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air. We are people.
76 Timohy
Royster
Public Comment:
Enjoy the program available. There is a lot to learn.
77 Steve Blum Public Comment:
Since November of 2011 have been working on implementing the Libby Madelyn
Collins Trauma Recovery Project. The project is the result of a prop 63 proposal
initiated by line staff at Central County Adult Mental Health. So far we have completed
the first group, and are working with numerous individual clients. In July we will start
the second and third groups with a Spanish language group scheduled to begin in late
summer or early fall. Additionally we have provided training on trauma related issues
within the SPIRIT program, and a training to assist clinicians in working with trauma
issues among the SMI population throughout the country is being planned for August
2012. Since we have begun working with clients both individually and in group work
there have only been two 5150s (one consumer) and no criminal justice contacts and no
evictions. Many of the clients are now either working (paid and or volunteer work), in
school, graduating from SPIRIT or hoping to be accepted into SPIRIT next year.
78 Ralph
Hoffman
Public Comment:
We need to reverse the discrimination against Mental Health Commission that has
occurred in the last 4 years!
79 Stan Baraghin Public Comment:
I think the no one issue is transportation for consumers mental health consumer
concerns, INC Community wellness & Recovery Center needs their own transportation
and second the Dental Care.
80 Marvin
Edwards
Public Comment:
More money for leadership academy
More peer to peer program
Transportation for consumer
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Dawn
Elizondo
Public Comment:
Transportation
Housing
82 Kenneth
Melbin
Public Comment:
Housing
83 John D. Allen Public Comment:
3 MHSA Projects at Central
Go MH Adult
84 Robyn
Gatshall
Public Comment:
Services need for funds for mental health consumer concerns consumers: Dental,
Transportation, Housing, more peer to peer run programs, more peer support staff,
continuous the leadership Academy, funding for more WRAP training for Wrap
certified staff.
85 Jack F Public Comment:
We need transportation
More peer to peer support
Cognitive therapy
86 Anthony
Brewer
Public Comment:
We need housing
We need transportation
We need the governor to balance the budget
87 Dean Spencer Public Comment:
I want to share my feelings regarding housing, transportation, the lack of consumer
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advocates.
88 Ralph
Hoffman
Public Comment:
Use shared housing
89 Patsy Taylor Public Comment:
Transportation – I want to briefly state a problem
90 Mental Health
Commission -
Recomendatio
n
After hearing comments at the June 14th, 2012 Public Hearing on the MHSA 2012-
2013 Draft Plan hosted by the Contra Costa County Mental Health Commission, a
motion was made by Peggy Kennedy and seconded by Teresa Pasquini for the Mental
Health Commission to make the following recommendations to the County Mental
Health Administration (MHA) and to the Board of Supervisors (BOS):
1. Provide funding for low cost or free transportation services for consumers as
well as for seniors
2. Provide funding for housing
3. Provide funding for peer-run programs
4. Provide funding for trauma services, including PTSD to prepare for returning
veterans
5. Provide funding for peer advocacy for mental, physical and vocational needs
6. Provide funding for training for the staff, as well as for the supervisors to
support the transference of learning
7. Provide funding for the expansion of services for older adults
8. Provide funding for effective evaluative measuring tools
By a unanimous vote of 7-0, the motion was approved.
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Contra Costa County Response to Public Comments and Mental Health Commission Comments and
Recommendations
Stakeholder participation during the Annual Update process, including the MHC Public Hearing, was
outstanding. Strong consumer participation was evident throughout the process with over 80 public
comments received. The MHC Public Hearing was attended by many consumers, community members
and Commissioners each having an opportunity to provide input into the Annual Plan Update.
Due to the large number of public comments, the comments were grouped into thematic areas allowing
for one general response to cover many similar comments.
Transportation:
There was an overwhelming response voicing the need for better transportation in Contra Costa County.
In October 2011, Stakeholders formed a Transportation Committee to analyze the barriers to
transportation in the community and explore potential solutions. Among many other items, the
Committee considered the benefit of additional bus basses, implementation of a shuttle service and the
inherent benefit of ensuring transportation support and services are driven by consumer input and
involvement.
As part of the MHSA Increased Allocation prioritization process, Stakeholders supported the idea of
considering MHSA Innovation funding for transportation support programs. Mental Health
Administration supports moving forward in developing solutions to some of the transportation problems
in our system. It’s important to coordinate with other community partners to ensure access to services
and share ideas on creating solutions to this challenge. This may involve several levels of response from
accessing bus vouchers to advocacy for the clients we serve. Mental Health Administration will be
soliciting innovative ideas through a Request for Proposal (RFP) process.
Employment:
Increasing opportunities for employment was a top concern expressed during the Public Comment
period. For many years, the Department of Rehabilitation for Contra Costa County has supported mental
health consumers in obtaining employment and they continue to be a valued resource to the mental
health community. Aside from that, other programs are being considered to expand the employment
opportunities available for consumers. Recently, an Innovation program was approved to being to work
with employers in the community to build relationships and support for successful employment
opportunities for those we serve. Additionally, through the increased MHSA allocation, Stakeholders and
Mental Health Administration supported using Innovation funds to consider employment programs to
create job opportunities and supports for consumers. This
Housing:
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The need for additional housing options and supports is an ever present problem as was expressed
during the public comment period. As part of the increased allocation prioritization process, CPAW and
the MHC agreed to allocate 30 percent of all new MHSA CSS revenue to housing. The additional housing
dollars available through the increased allocation will be planned for by way of a community input
process. Stakeholders supported the development of the Transitional Age Youth (TAY) Transitional
Residential Program which will provide additional housing opportunities for those age 18 to 25 years.
Lastly, there are additional housing projects underway that will increase the supply of housing options
for mental health consumers. There are independent, supported housing programs being developed in
West County and Central County for individuals and families, Older Adult apartment units in East County
and a shared housing complex in Central County. Mental Health Administration plans to continue
developing additional housing options and supports for successful independent living.
Physical Health:
The MHSA Increased Allocation plan includes funding for two behaviorists within primary care. It is with
hope that this integration pilot will invite more opportunities for coordination of care for mental health
and primary health clients. Overall the goal is to create a system which is responsive to the mental
health and physical health needs of the people we serve.
The need for dental care for mental health clients was a concern raised by both Mental Health
Commissioners as well as the larger Stakeholder group. It is recognized that dental benefits are no
longer covered for Medi-Cal beneficiaries creating barriers to receiving proper dental care which can
impact the physical health, mental health and overall well-being of consumers. Within the context of
MHSA there are funds available for dental care for those who are enrolled in a Full Service Partnership
program. Within the larger system of care, case managers and money managers have made a concerted
effort to encourage clients to participate low-cost dental insurance programs.
There were requests for additional medical staff at the Wellness and Recovery Centers in each region of
the County. Mental Health Administration is working to ensure existing resources are redirected to
provide support to consumer’s at all three regions of the County.
Medication Support:
Currently, the Mental Health Plan spends approximately $1.4 million annually to provide medication to
clients who are uninsured or for supplemental or gap coverage for those with an urgent medication
need. Additionally, the Financial Counseling Unit has worked to enroll clients in low-cost prescription
programs and is available to help access those resources.
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Evidence-based Practices:
The Mental Health Commission highlighted the importance of training mental health staff to meet the
evolving standard of treatment through evidence-based practices. Training and supervision to ensure
adherence to model fidelity is an integral part of the process. Currently, there are several evidence-
based programs implemented throughout the County including: Wraparound, Cognitive Behavioral
Therapy (CBT) for Depression, Trauma Focused CBT, Dialectical Behavioral Therapy (DBT), Cognitive
Restructuring Training, IMPACT for Older Adults with Depression, Assertive Community Treatment
(ACT), Triple P Parenting and others.
The Annual Plan Update includes several training initiatives which will enhance our current system of
care as well as that of community based organizations. The training initiatives include strategies for
treatment of co-occurring disorders and increasing the available service options for children zero to five
years and their families. In addition, three full time staff positions will be created to support ongoing
model fidelity in every region of the County.
Peer Advocacy:
The Stakeholder group and MHC recognized the importance of peer advocates in the system of care.
Contra Costa County was an early implementer and is a strong promoter of peer support at all levels of
care. The County currently contracts with a community based organization to provide advocacy in all
regions of Contra Costa County. Currently many of the Community Support Workers provide
transportation and other support services to consumers.
In order to meet both the need for additional peer supports and transportation, three Community
Support Worker positions will be created to focus on transportation support for consumers. These three
positions will focus on teaching consumers how to navigate existing transportation systems and provide
additional transportation support. In turn this will relieve time for existing community support workers
to provide more peer-support to promote recovery and wellness. The addition of the three CSW’s is the
only substantive change made to the Annual Plan Update after the Community Stakeholder and Public
Hearing Processes.
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Mental Health Services Act (MHSA)
Fiscal Year 2012-2013
Presented to Mental Health Commission for
Public Hearing – June 14, 2012
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