Transforming Mental Health Care: Prevention & Early Intervention Guidelines

1. California Department of Mental Health Prevention and Early Intervention Guidelines Webcasts October 22, 2007November 2, 2007 Emily Nahat, Chief Prevention and Early Intervention Branch

2. PEI Guidelines Overview • Prevention and Early Intervention Guidelines • Part I – Purpose, Background and Definitions • Part II – Community Program Planning • Part III – PEI Projects • PEI Resource Materials • Part IV – Funding • Part V – Accountability and Evaluation

3. Prevention and Early Intervention Guidelines – Information Notice 07-19http://www.dmh.ca.gov/DMHDocs/docs/notices07/07_19_Notice.pdf PEI: Key to Transformation • Community Collaboration • Cultural Competence • Individual/family-driven programs and interventions, with specific attention to individuals from underserved communities • Wellness focus, which includes the concepts of resilience and recovery • Integrated service experience for individuals and their families • Outcomes-based program design

4. Part I: Purpose, Background and Definitions Key Community Needs: • Disparities in access to mental health services • Psycho-social impact of trauma • At-risk children, youth, and young adult populations • Stigma and discrimination • Suicide risk

5. Part I: Purpose, Background and Definitions PEI Priority Populations: • Underserved cultural populations • Individuals experiencing onset of serious psychiatric illness • Children/youth in stressed families • Trauma-exposed individuals • Children/youth at risk for school failure • Children/youth at risk of or experiencing juvenile justice involvement

6. Part I: Purpose, Background and Definitions Prevention • Involves reducing risk factors or stressors • Builds protective factors and skills • Promotes positive cognitive, social and emotional development

7. Part I: Purpose, Background and Definitions Early Intervention • Addresses a condition early in its manifestation • Is of relatively low intensity • Is of relatively short duration (usually less than one year) • Has the goal of supporting well-being in major life domains and avoiding the need for more extensive mental health services

8. Part I: Purpose, Background and Definitions Exception for ARMS (At Risk Mental State) or First Onset: • Specialized programs for individuals at risk of or who are experiencing first onset of a psychiatric illness • Based on transformational interventions from Australia, Europe, Canada • Identify and provide services to youth/TAY in non-stigmatizing, non-MH settings • Program is generally 2-5 years in duration

9. Part II: Community Program Planning Process Purpose and Logic Model • Identification and selection of Key Community MH Needs and related PEI Priority Populations • Assessment of community capacity and strengths • Selection of PEI programs to achieve desired outcomes • Development of projects with timeframes, staffing and budgets • Implementation of accountability, evaluation and program improvement activities

10. Part II: Community Program Planning Process • Process and timeline for funds in Information Notice 07-17 http://www.dmh.ca.gov/DMHDocs/docs/notices07/07-17.pdf • Involvement of required and recommended sectors • Outreach and engagement to underserved communities • Logic model • Required comment period and public hearing

11. Part II: Community Program Planning Process Form No. 2 • Describe Community Program Planning • Staffing • Stakeholder participation process • Training • Summary of the effectiveness of Community Program Planning • Public hearing • Summary and analysis of recommendations

12. Part II: Community Program Planning Process UC Davis Center for Reducing Health Disparities • Focused outreach and engagement to underserved racial and ethnic communities • Principles of community engagement • Outreach methods • Preliminary findings • Suggestions emerging for PEI Community Program Planning Process

13. Break for Lunch Back at 1:00 p.m.

14. Part III: PEI Projects • Connected to PEI priority populations and achieving outcomes • County selection of programs • Based on PEI Priority Populations and PEI Key Community Needs • Counties may select from the PEI Resource Materials • Counties may select alternative strategies with a rationale • Reducing disparities is an overarching goal • Priority age – 51% of funds to children and youth; small counties excluded

15. PEI Resource Materials Elements of the Resource Materials • Description • Prevention of mental health problems • Early Intervention for mental health problems and concerns • Linkage and support in navigating service systems and other providers as needed • System enhancements to improve and sustain MH programs and interventions • General resources

16. PEI Resource Materials • Program examples – by priority populations • Program examples – by key community needs • Chart of selected programs with outcomes • Draft PEI logic model • Potential outcomes of PEI programs

17. $ Part IV: PEI Funding • Planning estimates • $307.6M available funding through FY 2008-09 • Community Program Planning--$25M • Planning Estimate--$115M (includes $25M for Planning) FY 07/08, $192.6M FY 08/09 • Non-supplant • Allowable Expenditures • Non-allowable expenditures • Leveraging

18. Part V: Accountability and Evaluation Importance of Accountability and Evaluation: • Demonstrate accountability to the public • Document progress towards meetings overall aims of PEI • Inform both policy and practice about the PEI component of MHSA • Create a cooperative learning environment among stakeholders

19. Part V: Accountability and Evaluation Evaluation Questions: Individual Person/Family Level • Improved mental health status? • Reduced risk for emotional and behavioral problems? System Level • How is PEI money being spent? • What programs show promise and/or evidence of being effective especially with underserved populations? • What impacts are there from PEI on the mental health system and other organizations, agencies and systems?

20. Part V: Accountability and Evaluation • Tracking of expenditures at the PEI Project level • Semi-annual narrative reporting • Participation in on-site program reviews • Participation in surveying of PEI implementation, funding, and collaborative partners • Participation in special state evaluation of selected local programs • Conducting a local outcome evaluation of the programs within one PEI Project

21. PEI Projects Form No. 3

22. PEI Projects Form No. 3 • PEI Community Mental Health Needs • PEI Priority Population (s) • Data analysis • PEI Project description • List programs • Program title • Proposed number of individuals to be served • Provide unduplicated count

23. PEI Projects Form No. 3 • Alternate programs, if applicable • Provide rationale • Linkages to Community MH and providers of other services • Collaboration and system enhancements • Intended outcomes • Coordination with other MHSA components

24. PEI Projects PEI Revenue and Expenditure Budget Worksheet - Form No. 4

25. PEI Projects PEI Revenue and Expenditure Budget Worksheet - Form No. 4 • Expenditures • Personnel Expenditures • Operating Expenditures • Facility cost • Other operating expenses • Subcontracts/professional services • Proposed PEI Project budget • Revenues • Other revenue sources • Total funding requested • Total in-kind contributions

26. PEI ProjectsPEI Administration Budget Worksheet - Form No. 5

27. PEI Administration Budget Worksheet - Form No. 5 • Expenditures • Personnel Expenditures • Operating Expenditures • Facility cost • Other operating expenses • County Allocated Overhead • Revenue • Other Revenue Sources • Total Funding Requirements • Total In-kind Contributions

28. PEI ProjectsPEI Budget SummaryForm No. 6

29. PEI Projects Budget SummaryForm No. 6 • List all proposed county PEI projects • 51% of overall budget dedicated to programs for CY/TAY (birth-25) • Funds requested by fiscal year and age group

30. Local Evaluation of a PEI Project - Form No. 7

31. PEI ProjectLocal Evaluation of a PEI Project - Form No. 7 • PEI Project to be evaluated • Program outcomes • Demographics of individuals to be served • Outcomes to be measured • Data collection and analysis • Program/evaluation culturally competent • Fidelity in implementing the programs • Dissemination of evaluation report

32. Project Name: “School-Family Connections”(Example of a PEI Project) • Form No. 3 – PEI Project Summary • Form No. 7 – Local Evaluation of a PEI Project

33. Fund up to $12 million annually for four years to support specific PEI programs $6 million annually for four years directed to SMHI Preliminary plans for training/TA Training, Technical Assistance and Capacity Building

34. Next Steps • Upcoming PEI trainings

35. DMH Attn: Prevention and Early Intervention 1600 9th Street, Room 350 Sacramento, CA 95814 Phone: (916) 653-2358 Fax: (916) 654-2739 E-mail: Caitlin.Viscardi@dmh.ca.gov Website:http://www.dmh.ca.gov/mhsa Contact Information