Meeting the Needs of Californians

1. Meeting the Needsof Californians County Behavioral Health Departments: Transforming Mental Health Services to Improve Lives, Save Money, and Reach Underserved Communities

2. Behavioral Health Funding Wellness Federal MHSA Prop. 63 1991 & 2011 Realignment

3. MOQAMeasurementsOutcomes &Quality Assessment “Not everything that counts can be counted, and not everything that can be counted counts” from "Informal Sociology: A Casual Introduction to Sociological Thinking" by William Bruce Cameron

4. Statewide Snapshot of County Behavioral HealthSystem Outcomes • 47 of 58 Counties Reporting • Over 90% of the State's Population • Data Sources: Community-Based, Counties, Experiential, EQRO/DHCS, FSP/MHSOAC, CalMHSA

5. Recovery Full Service Partnerships have served over 27,000 adults since '05, focusing on those with severe mental health issues, and doing Whatever It Takes. Reduction in people HomelessHospitalized Jailed

6. Resiliency Reduction in days Homeless Hospitalized Jailed

7. Improving Lives & Lowering Costs TAY 147.2% (16-25) Adults 100.0% (26-19) Older - Aduts 72.4% (60+) Including: Inpatient Psychiatric hospitalizations, skilled nursing facilities, long-term psychiatric care; emergency room use; juvenile hall placement; and jail incarceration Not including: law enforcement contacts; court administration; homelessness; code enforcement, parks/public space maintenance

8. M is a middle-aged woman with a history of emergency psychiatric hospitalizations - 77 of them. Since beginning participation in an FSP, she has not been hospitalized once (in over a year)

9. Improving the lives of Children Trauma-Focused Behavioral Therapy seeks to help children who have experienced traumatic events at home or in their community

10. J is an 18 year old Latino male who found himself in juvenile hall in his early teens. A daily pot smoker, his grades and school attendance were awful.After getting involved with Youth in Mind, J gave up pot, improved his grades, and graduated high school. Today he attends college, recently began his first job, and plans to earn a degree in counseling to help other youth.

12. It isAll AboutThree "Somes"

13. SomewheretoLive

14. SomethingtoDo

15. Someone toLove…and to love us back

16. S is a Long Beach native who was homeless for over 4-years. Working with Mental Health America LA, she received the financial and health benefits to stabilize her life, including community connections. Now she lives in her own apartment, decorates for the holidays, and has a new puppy to love

17. Robert E. Oakes, JD, MBA Executive Director CMHDA (California Mental Health Directors Association) www.CMHDA.org 916-556-3477 ROakes@cmhda.org

18. Demographic Profiles

19. ALAMEDA COUNTY Clients Servedthrough MHSA Programs 2010 Census Demographics

20. LOS ANGELES COUNTY Clients Servedthrough MHSA Programs 2010 Census Demographics

21. TULARE COUNTY Clients Servedthrough MHSA Programs 2010 Census Demographics

22. BUTTE COUNTY Clients Servedthrough MHSA Programs 2010 Census Demographics

23. Integrated Care: Under-Represented Ethnic PopulationsLos Angeles County Department of Mental Health

24. Integrated Services Management (ISM) Goals • Create an integrated community network combining formal & non-traditional community-based natural supports for: • African / African Americans • American Indians • Asians / Pacific Islanders • Middle Eastern / Eastern Europeans • Latinos • Increase access and quality of care • Integrate peers into treatment (peer and family advocates, parent partners, and community members)

25. ISM Core Services • Community-designed • Peer/Community-based outreach, engagement, and education • Integrated mental health, physical health and substance abuse services • Include “non-traditional” community services

26. Integrating Non-Traditional Approaches • Outreach & Engagement strategies: • Community Coffee Clubs (Armenian ISM) • Use of Promotoras as Outreach Workers (Latino ISM) • Linguistically appropriate poetry and reading classes • Integration into a mental health treatment plan service strategies: • Monks partner with mental health provider to perform Blessing Ceremonies for consumers (Cambodian ISM) • Drumming included as part of treatment plan to promote healing (Native American ISM) • Accupuncture • Yoga

27. Evaluating ISM: Key Indicators • Service Integration Level • The Integrated Treatment Tool - Case Western Reserve University • Domains: organizational, treatment, care coordination • Social Network Analysis - To better understand care coordination approaches -frequency and mode of communications about client care and quality of communication • Health status improvement • PROMIS System- Global Health, Milestones of Recovery Scale • Mental Health status improvement • PROMIS System • Illness Management and Recovery Scale • Substance use • PROMIS System • Client satisfaction • Community Satisfaction • Self-Stigma • Cost effectiveness

28. Outcomes Overview

29. Illness Management & Recovery Scale (IMR) ISM clients with IMR ratings at baseline, 3, and 6 mos. follow-ups. Significant decrease in overall IMR scores between baseline and 3 mos. & baseline to 6 mos. assessments. A decrease in IMR score indicates progress toward recovery.

30. Milestones of Recovery Scale (MORS) MORS ratings at baseline, 3, & 6 mos. follow-up. Significant change in MORS scores between baseline and 3 mos. & baseline to 6 mos. assessments. A MORS increase indicates progress toward recovery

31. Latino ISM - IMR Scale Significant decreases in IMR Total scores from baseline and 3 mos. & baseline to 6 mos. assessments Significant decreases in 2 of the 3 IMR subscales (Recovery & Management) No significant change in Substance Use subscale scores

32. Latino ISM IMR Scale Significant decreases in IMR Total scores from between baseline and 3 mos. & baseline to 6 mos. assessments Significant decreases in 2 of 3 three IMR subscales (Recovery & Management) No significant change in Substance Use subscale scores