Campaign Steering Committee Friday, November 30, 2007 10-1 pm Roseville

1. Campaign Steering Committee Friday, November 30, 2007 10-1 pm Roseville

2. Agenda • Welcome & thank you • Consumer Voice • Public Comment • Campaign Steering Roster • Updates to approve • Prevention Updates • Where we are • Guiding Principles • Prevention reminders

3. Agenda (continued) • Recommendations • Priority populations identified • Recommendations • Allocation framework by focus • Workgroups • Public comment review • Wrap-up/next steps

4. . VOICE

5. Public Comment Comments Welcome 3-minutes per comment

6. Steering Committee Roster:Request for Approval • Consumer youth • Sam Stodolski • Need 1 more consumer • Latino, jail, Tahoe • Latino, Youth advocate, Tahoe • Emilio Vaca

7. Prevention Planning Review

8. PEI Planning Elements for Discussion • Review decision making process • Role of Steering • Affirm guiding principles • Approve initial priority populations and community needs • Review process first • Formalize work groups • Approve allocation/funding framework

9. Planning Process County staff Finalizes decisions Creates work plans Decision-making Steering Reviews workgroup recs,formalizes recs. Recommending Body Workgroup #1 Workgroup #2 Workgroup #3 Latino Workgroup Native American Target needs and priorities Recommending Body Steering Establish work groups, approve initial criteria & plan Data collection/Risk & Protective Factors Steering Community (Tahoe, Auburn, Lincoln, Roseville) Latino Leadership Native American Needs & Assets

10. PEI Guiding Principles • Cultural competence • Collaboration • Client / Family centered • Recovery /strength-based wellness focus • Co-occurring competent • Early intervention • Evidence based outcome focus • Integrated services • Accessibility Affirm

11. Prevention Refresher • Definition of prevention • Trajectories • Upstream emphasis “An ounce of prevention is worth of pound of service” -Anonymous Review handout

12. Interventions that occur before the onset of a problem Can also mean interventions that prevent relapse, disability and the consequences of severe mental illness The Institute of Medicine restricts the definition to processes that occur before there is a diagnosable mental illness. Prevention

13. Examples of Protective Factors Friends Family Work/volunteering Self-help skills Health care Anger management skills Culture Restricted access to lethal means (suicide) Religion

14. Examples of Risk Factors Alcohol/substance abuse Job loss Previous suicide attempt Discrimination Gay youth Lack of health care Native American youth Trauma Grils & young women Physical illness Isolated elderly

15. A universal preventive intervention is applicable or useful for everyone in the general population. A selective preventive intervention is targeted at individuals or subgroups whose risk of developing mental health problems is significantly higher than average. Classification of Prevention Interventions

16. An indicated preventive intervention is aimed at individuals who have some symptoms of mental health problems but whose symptoms are not yet severe or prolonged enough to meet diagnostic criteria. Classification of Prevention Interventions

18. Why Intervene Early?

19. Step 1: Identifying NeedsWho is at risk & for what Steering and Community Input sessions

20. What did you tell us? • Steering: Who is at risk & for what: • Children & youth at-risk • Poverty, uninsured, abuse, depressed, disabled, poor school performers, substance abuse, incarcerated • Adults • Trauma, depressed, single (divorced,widowed,separated) • Seniors • Depression, drug abuse

21. Community Input Summary (Kings Beach, Lincoln, Auburn)) • Children • Neglect, lack of care & security • Those with mentally ill parents and/or substance abuse • Youth • Antisocial/isolation, inverted family structure,drugs, neglect, gangs,aggressive • LGBT • Transitioning, lack of job skills • Incarceration Who is at risk & for what:

22. Community Input Summary(Kings Beach, Lincoln, Auburn)) • Adults - Women (depression, poverty, transp.) • Men (money, jobless, discrimination) • Families • Drugs, abuse,early sex, bullying,domestic violence, divorce • Seniors • Isolated, depressed • Elder abuse, substance abuse • Health Who is at risk & for what:

23. Latino Leadership Input Who is at risk & for what: • Children • School failure, domestic violence • Women, men & family • Substance abuse, isolation/depression, fear of immigration, lack of medical care, incarceration, job loss

24. Native NetworkInput • All ages/gender at-risk • Family-centered, community approaches • Preservation of cultural knowledge and traditional health practices is top priority. • At-risk for: • Historical trauma, discrimination, poverty, homelessness,low educational attainment, lack of access to care Who is at risk & for what: “Culture is Prevention”

25. Summary of Community Needs • Depression across all ages groups • Children, youth, adults, seniors, homeless • At-risk children and youth • School failure • Juvenile delinquency • Stressed families • Underserved cultures • Access to care • Stigma/discrimination

26. What is the Data Telling Us? Refer to handout

27. The Good News:Protective Factors • High educational levels • 68% some college or higher • Low violent crime • High graduation rates • 91% • High Quality Health Care • Low rate of uninsured (3.5% kids) • Low unemployment • Low poverty

28. Our Risk Factors • Population growth 2nd highest in CA • Eldery • Latino • Above average suicide rates • 34 per 100,000 for (80-84yrs.) • 76% of all suicides are male • 25% of all suicides ages 40-50 • Adolescents on par with State

29. Our Risk Factors • Above average rate of child abuse calls • 20% Latino substantiated cases • Above average alcohol and drug abuse • Hospital discharges • 2nd to worst in State • Juvenile arrests • Adult arrests (DUI, other alcohol) • Accidents • 25% more liquor stores • 100% youth in Tahoe request information on depression

30. Our Risk Factors • Pockets of poverty • 8 schools have 65% or more free/reduced lunch programs • 6 areas identified: • North Auburn • Lincoln • Colfax • Central Roseville • Foresthill • Kings Beach • Poverty increases risk of mental illness by 2x in Placer (see handout)

31. Most effective use of $ • The more upstream the more effective • Shotgun approach will not work • Not a lot of $’s • Need to focus

32. Disparities in Access Psycho-social impact of trauma At-risk children, youth and young adult Stigma & Discrimination Suicide Risk Trauma exposed individuals First onset Children, youth stressed families Children, youth school failure Children, youth juvenile justice Most criticalareas to choose: Community Needs Priority Populations Agreement/Approval

33. Proposed GeneralFunding Framework • 0-25 yrs. • Disparities in Access • Underserved cultures • Depression/suicide Discussion Agreement/Approval

34. Recommended Workgroups Focus Areas Tahoe Depression Suicide Native American Children/ Youth At- Risk Latino Disparities in Access Discussion Agreement/Approval

35. Group Work by Jan 25Provide Recommendations Who is the target? What are the outcomes? Recommendation on prevention strategy: Universal, selective, etc. Staff will assist

36. Public Comment Review Recap of public comment process Discussion

37. Public CommentProcess Written: Steering Reviews Letter Staff Responds Edits/ Final Response 2 weeks Recommended Oral process: Public Comment Steering Listens No formal Response Discussion Agreement/Approval

38. Next Steps • Complete community meetings • Workgroups meet with staff assistance • Present targets and outcomes • Next Steering Meeting Jan. 25 • 10-1pm CDRA, Auburn • Happy New Year!

39. End