Evaluating Mental Health Services

1. Evaluating Mental Health Services Veterans Campus Program County of Orange California Health Care Agency Behavioral Health Services 14 March 2014 MAJ(ret.) Ron Wilson, BSN, MA, MFT

2. Presentation Objectives • Gain state and county Veteran figures • Identify common roadblocks Veteran face toward seeking behavioral health services • Understand the mission, purpose, method of the Veterans Campus Program • Gain an understanding of the work being done in sessions • Closing Thoughts (Recommendations) • Questions & Comments

3. OC Behavioral Health Veterans Campus Program State and County Figures

4. OC Behavioral Health Veterans Campus Program State/County Figures: California has more ‘current conflict’ (post 9-11) veterans than any other state (11% of the military join from California (VA study ‘12) 2.2 million Veterans reside in California, with the majority living in the countiesof:Los Angeles, San Diego and Orange County Orange County has an estimated 150,000 veterans (all eras), and approximately 10,000 female veterans

5. OC Behavioral Health Veterans Campus Program Roadblocks to Seeking Behavioral Health

6. Stereotypes • All Veterans are in crisis! • All Veterans can obtain VA services • All Veterans have served in combat • You have to be in combat to get “PTSD” • All Veterans are angry and aggressive • All Veterans are “wounded”

7. Many Vets Do Not Seek ServicesFor Behavioral Health • Stigma: Career concerns • Lack of self insight: Warrior mentality, self-concept • Lack of resources: insurance, money, time, transportation • Do not know how to access • Symptoms prevent keeping appointments • Do not trust the VA or government

8. Concerns Related to Women Veterans • As of 2010… 1,840,380 female Veterans have served • 166,709 live in California (an estimated 10,000 reside in Orange County) • …receive little recognition • …more likely to get divorced • …likely incident(s) of Military Sexual Trauma • …less likely to find treatment groups • …less likely to find social cohorts that can relate to their experience. • 3X likely to commit suicide!!!

9. Veterans Campus Program • Drop Zone Slide Goes Here THE DROP ZONE

10. What is the Veterans Campus Program • A multidisciplinary team • Serving Veterans, service members and their families • Engage, assess and assist participants in overcoming identified barriers to achieving their educational goals.

11. What is theVeterans Campus Program • The Drop Zone… • Collaboration within an inter-disciplinary team of Academic, Administrative, and Helping Professionals • Established through a Memorandum of Understanding (MOU) between the County of Orange Health Care Agency and the School District Board

12. What is the Veterans Campus Program • It provides referrals and linkages to viable resources, both on and off campus • Coordinates various workshops • Facilitates Veteran ‘support groups.’

13. What is the Veterans Campus Program • Empowers the student Veterans’ day-to-day transition: • On campus • In their community • Towards their future

14. What is the Veterans Campus Program • Promotes ‘Wellness and Achievement’ • Through readiness and relationships • Provides ‘People who know people’

15. OC Behavioral Health Veterans Campus Program • The program is unique in that the clinician is a military veteran who is able to ‘normalize’ the act of seeking behavioral support for Veterans who often do not inquire about behavioral health services due to stigma concerns. • Mental Health Service Act (MHSA) funded program aimed at populations (culture) who are designated to have barriers to seeking behavioral health services.

16. Connecting a Student Veteran to the program

17. Connecting a Student Veteran to the program Academic Counselor (LMFT) administers a student questionnaire to identified student Veterans with concerns toward achieving academic success…

18. Initial Visit with BHS Counselor • Engage and Assess • 1:1 Conversations with the Student Veteran • Additional outside source information (faculty and administrative personnel, family, etc.) • Referrals to Resources (on- and off-campus) • Interests & Inquiries  Resource • Engage & Assessment  Resource / Program / Service • Establish regularly scheduled sessions and follow-ups

19. Connecting a Student Veteran to the program • Homeless • Un-employed • Substance Use Problems • Legal Involvement • Recently Released from jail • Mental Health Issues • Relationship Problems • States (depress, anxious, angry) • Severe/Chronic Medical Issues • Suicidal Ideation or History “Intake and Risk Assessments” performed on initial visit.

20. Connecting a Student Veteran to the program “Needs Assessment” performed on initial visit as well. • Employment Referral • Resume Development • Legal Assistance • Community Resources (VA/HUD VASH, DMV, SSA) • Housing • Shelter (short, long term) • Food • Financial Counseling • Service Connected Disability

21. Connecting a Student Veteran to the program • Aggressive Demeanor • Isolation/Loneliness • Relationship Issues • Financial Hardships • Legal Matters • Housing Concerns • Employment Barriers • Transition Difficulties (military-to-civilian life)

22. Assessment Instruments • WHO-5 • SBIRT • PCL-M (PTSD) • PHQ-9 (anxiety) • GAD-7 (depression) • PGIS (Personal Growth Initiative Scale)…self-resilience

23. Considered Outcome Measures • Life Success • GPA • College Retention • Sought Campus Mental Health Services • Mental Health Acuity?

24. OC Behavioral Health Veterans Campus Program • OC4Vets(MHSA Innovation program) • Co-located with the County’s Veterans Service Office • Claims Officers screen clients for behavioral health symptoms • Behavioral Health Clinicians screen, assess and enroll • Peer Veteran Navigators ‘buddy-up’ with participant to connect with appropriate resources • Housing specialist and job specialist (employment, job skill enhancement and job coach) on site 5 days/week • Work closely with community providers and VA Long Beach Health Administration.

25. OC Behavioral Health Veterans Campus Program • Outside agency collaboration • American Red Cross • Boys Town • Child Guidance Center • Goodwill • One-Stop • OneOC • St. Jude’s Brain Injury Network • VA Departments (MIRECC & Women’s Health Clinic) • Events featuring Student Veteran testimonials: • Santa Ana, Cypress, Fullerton Colleges and Chapman University.

26. Who Am I…?

27. Who Am I…?

28. Closing Thoughts

29. Closing Thoughts • “Network of Care for Behavioral Health” • “Network of Care for Veterans” • BHS subject matter specialists • BHS Veterans’ Services Coordinator • Avoid duplication of effort…Effective Networking • Evaluate performance outcomes and alter programs as needed

30. Closing Thoughts We have to get ready in Orange County for the tsunami of veterans that will be coming back. We need to coordinate with services available at our community colleges, the VA, our community, and then fill in those gaps.

31. Closing Thoughts • Broken marriages • Job loss • Incarceration • Homelessness • Suicide • Reliance on county/state/federal social-support programs • Repeated hospitalizations • Accidental death or severe medical issues

32. OC Behavioral Health Veterans Campus Program • Ron Wilson, BSN, MA, MFT • At Orange Coast College • Watson Hall, Room 119 (next to Veteran Service Center) • Phone: Ofc- (714) 432-6880; Cell- (714) 824-1996 • Email: rwilson@occ.cccd.edu • At OC Health Agency Clinic (REACH Program) • Address: 1725 W. 17th St., Ste 101-B; Santa Ana, 92626 • Phone: (714) 834-7782 • E-mail: rwilson@ochca.com

33. Questions/Comments?