By Patricia Rodriguez California State University, Long Beach May 2013

1. “STEPPING STONES”: EMPOWERING MENTAL HEALTH PATIENTS THROUGH CONNECTIONS WITH SIGNIFICANT OTHERS: A GRANT PROPOSAL By Patricia Rodriguez California State University, Long Beach May 2013

2. Introduction Problem • In the United States, approximately 57.7 million individuals 18 y/o and older, or about 1 in 4 adults, suffer from a diagnosable disorder. • This population is most likely to use tobacco, alcohol or drugs to cope with their mental illness, are more prone to self-harm or accidental injuries, co-occurring disorders, incarceration, high school drop out, and re-hospitalization. • Individuals with a mental illness 18 y/o and older are adults making their own decisions to continue or not to follow up with mental health treatment and family involvement in treatment planning and discharge is minimal or non-existent • This populations faces negative stigma from their families, friends, and communities often lacking support and significant connections with people to help them cope with their illness and provide the stepping stones. • There is insufficient resources or support for significant others/caregivers others to continuously provide stepping stones after discharge for their loved ones. (Callaly, Trauer, Hyland, Coombs, & Berk, 2011 ,Centers for Disease Control and Prevention, 2011, Jivanjee, Kruzich, & Gordon, 2008, & National Alliance on Mental Illness, 2010 )

3. Social Work Relevance • Young adults with mental illness being discharged from psych-hospitals need social workers to advocate for services and provide support for the difficult transition back into their communities. • Identify obstacles that contribute to barriers of stabilization or to vicious recidivist cycles. • Engagement of young adults with services that meets their needs and adequate discharge planning. (Neale, Worrell, & Randhawa, 2005).

4. Cross-cultural Relevance • Social workers need to provide services that are culturally sensitive by learning the level of awareness and understanding on mental illness of minority groups. • Individuals who identify as gay, lesbian, bisexual, transgender, intersex, come from foster care system, minorities groups face various challenges in accessing adequate services. • Provide equal opportunity of services to minority groups that can be easily accessible . (Jimenez, 2009, Neale, Worrell, & Randhawa, 2005 ).

5. Methods • Target population • The target population are young adults ages 18-29, males and females, who do not have a significant other at discharge from psychiatric hospitalization. • Strategies to Identify & Select Funding • Google search engines were used to search potential funding, grant-making foundations were also examined. • websites such as www.grant.gov,, www.dmh.ca.gov,, www.foundationCenter.org,www , fundsnetservice.com, and www.tgci.com to determine funding options. • Identify the funding source selected • Through The Grantsmanship Center, The California Endowment center was selected. • The California Endowment has invested 10% of its grants since 1997 into direct services to increase the size and quality of mental health work force. It has focused on promoting equality of services of those underserved. (California Endowment, n.d.)

6. Methods Cont. • Sources used for the needs assessment • Scholarly articles were used to address the barrier that contributed to recidivism of clients and burnout of their significant other. • Statistics on Recidivist Psych-hospitalization among young adults with a mental illness were reviewed. • The grant writer interned at a psychiatric hospital. • . Stepping Stones: Line-Item Budget Stepping Stones Line-Item Budget (Expenses Only) Salaries and Wages Program Director $ 50,000 Employee-Related Benefits (@25%) $ 12,500 Program Manager $ 40,000 Employee-Related Benefits (@25%) $ 10,000 Honorarium Psychiatrist $ 2,400 Total Salaries and Wages $ 114,900 Other Operating Expenses Telephone, fax, postage, and shipping $ 2,400 Supplies $ 4,800 Printing and duplicating $ 4,200 Equipment $ 2,300 Travel $ 3,600 Food $ 3,000 Miscellaneous $ 1,200 Total Budget $ 21,500 Stepping Stones In-Kind Resources Rent $ 24,000 Utilities $ 8,400 Mentors (MSW) $ 30,000 BSW interns $ 5,000  Total In-Kind $ 67,400  Subtotal Project Costs $203,800 Administrative Costs (@ 10%) $ 20,380 Total Project Costs $224,180

7. Grant Proposal • Program Summary and Description • The Program will attempt to make connections or reconnection with clients and their significant others if connections are not made they will be provided a mentor. Each group will be provided with group where: • Individuals with mental illness will attend pscyhoeducational groups: (a) a safe forum to discuss issues they experience; (b) education on mental disorders; (c) coping skills to avoid risk factors, such as drugs, survival sex, incarceration; (d) importance of following through with medical care and medication; and (e) strategies to safely integrate into their neighborhoods. • While significant other will attend support groups that will provide education and training information on an array of issues, such as: (a) engaging and supporting individuals who have mental illnesses; (b) skills for crisis prevention and intervention; (c) resources in the community; and (d) a safe forum to address issues, frustrations, and achievements. • Population Served • Young adults ages 18-29 both males and females who do not have significant others at discharge. Participants may come from all socioeconomic statuses, identify with any ethnic and/or sexual minorities, and may also have a physically handicapping condition.

8. Grant Proposal Cont. • Sustainability/Program Evaluation • Program director will collaborate with the psychiatric hospital. • Clients will be given a survey of program satisfaction and significant others will take pre and post test. • The Program Director will evaluate data and share with collaborating agencies to see program strengths and areas of improvement. • A second year grant will be written to ensure funding. • Program Objectives 1.Individuals with a mental illness will learn about mental health disorders and the symptoms. 2.Individuals with a mental illness will learn coping skills to avoid risky behavior. 3.Individuals with a mental illness will learn the importance of psychiatric medication and mental health aftercare treatment. 4.Individuals with a mental illness will acquire the strategies and resources to safely integrate into their neighborhoods. 5.Individuals with a mental illness will take a program satisfaction questionnaire at the end of their program; these individuals will decrease mental health symptoms and improve coping by 15% as noted in progress notes and self-reports. 6.Significant others and/or mentors will learn skills to deal with crisis preventions and intervention thus helping decrease stress. 7.Significant others and/or mentors will increase knowledge of mental health disorders and symptoms improving understanding. Significant others will take a pre-test at the beginning of the first session. At the end of the program significant others and/or mentors will take a post- test. Significant others and/or mentors will increase education and skills in mental health issues by 20%. 8. Significant others and/or mentors will be linked and learn how to access mental health treatment for their loved ones.

9. Lessons Learned/Implications for Social Work • Improvement in discharge planning and connections to a loved one is crucial to helping provide the stepping stone to community transition. • Young adults are in dire need of support from their family, friends and communities. • There is a major lack of education about mental health in our society. • Social workers need to engage this population with services that help reduce barrier to stabilization. • Serviced need to be provide to the client and their families to reduce compassion fatigue. • Improve after care treatment and skills for safe transition into client’s communities. • Increase engagement, skills and education to empower these individuals and their significant others.

10. Reference California Endowment. (n.d.). The California Endowment. Retrieved February 8, 2013, from http://www.calendow.org/ Callaly, T., Hyland, M., Trauer, T., Dodd, S., & Berk, M. (2010). Readmission to an acute psychiatric unit within 28 days of discharge: Identifying those at risk. Australian Health Review, 34, 282–285. Centers for Disease Control and Prevention (2011). Fact sheet. Retrieved from http://www.cdc.gov/mentalhealthsurveillance/fact_sheet.html Jimenez, J. (2010). Social policy and social change: Toward the creation of social and economic justice. Los Angeles, CA: Sage Press. Jivanjee, P., Kruzich, J., & Gordon, J. L. (2008). Community integration of transition- age individuals: Views of young with mental health disorders. The Journal of Behavioral Health Services and Research, 35(4), 402–418. National Alliance on Mental Illness (2010). Mental illness: facts and numbers.Retrieved from http://www.nami.org/template.cfm?section.Abiut_MentalIllness. Neale, J., Worrell, M., & Randhawa, G. (2005). Reaching out: Support for ethnic minorities. Mental Health Practice, 9(2), 12–16.