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Summary of Prevention, Early Intervention (PEI) Data City of Berkeley Mental Health Department Community Meetings & Focus Group Discussions Prepared by Health & Human Resource Education Center. Introductions. Total Meetings Conducted – 8 Consumer Group 0-5 years Advocates Youth Advocates

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slide1

Summary of Prevention, Early Intervention (PEI) DataCity of Berkeley Mental Health Department Community Meetings& Focus Group DiscussionsPrepared by Health & Human Resource Education Center

introductions
Introductions
  • Total Meetings Conducted – 8
    • Consumer Group
    • 0-5 years Advocates
    • Youth Advocates
    • LGBT Advocate Group
    • African American Group
    • Elders and Adults
    • Asian Pacific Island Group
    • Youth
who we talked to
Who We Talked To

Berkeley Alliance, BUSD, School MH Planning Process, Pacific Center, Fred Finch Youth Center, BMH Adult Services (TAY Programs), Through the Looking Glass, Alameda County Child Counsel, Albany Project FYC, Berkeley Schools Homeless Educational Program, Rosa Parks Collaborative, Rosa Parks Elementary, Jones MH, The Better Way, Brothers Supporting Brothers, City Manager’s Office, Local 1021, Black Infant Health, Berkeley Drop-In Center, City Employment Coordinator, Progressive Baptist Church, MH Commission, Peer Counseling Collective, Radical MH Collective, Consumer Liaison City of Berkeley, AC Network of MH clients, BMH Mobile Crisis Team, Longfellow Middle School

pei state identified community mental health needs
PEI State Identified Community Mental Health 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

overall findings
Overall Findings

MH services are not culturally responsive regardless of age, gender, race, sexual orientation; socio-economic status; minimizing the potential impact on the mental well being of the citizens in the City of Berkeley.

The scope of existing PEI programs and funding for them is sorely inadequate for children, adolescents, and young adults; with limited accessibility for adults and older adults

common themes across focus groups
Common Themes Across Focus Groups

MH issues and services are isolated and not seen as community or system wide concerns

School-based climates are generating MH issues for teachers, students and families

There is fear and distrust of the MH system’s ability to meet the needs of the diverse cultures in Berkeley

Language and cultural barriers limit access

Physically accessing services is difficult (location, time, facilities, transportation)

Poverty presents a significant challenge to MH

common themes explored
Common Themes Explored

Reported Reasons for FEAR in Accessing Services

  • Potential consequences and recrimination from seeking treatment
    • Loss of children (single parents, elders caring for grandchildren, disabled)
    • Loss of job and or career
      • Teachers in particular fear seeking help in the mental health system; question confidentiality; fear loss of job/livelihood
    • Immigration Problems (deportation, loss of visa/student over-stays)
    • Elders fear losing independence
    • Being mis-understood and and mis-diagnosed

- Language and Cultural Barriers

- Impact of Historical Racism

    • Fear of forced treatment
  • Confidentiality
    • Loss of reputation, humiliation
    • Trust of clients, colleagues, family members and friends
    • Professional standing
    • LGBT issues
common themes explored8
Common Themes Explored

Reported Language and Cultural Barriers

  • Semantics of “Mental Health” terminology
    • Alienates people and keeps them from seeking services
    • Information presented in non accessible language and format
  • Diversity of Cultures and Languages in Berkeley
    • Impacts inability of system to provide information and services in timely manner
    • Impacts the general tone and attitude of feeling “welcomed” and “heard”
common themes explored9
Common Themes Explored

Physical Access is Difficult

  • Disabled
    • Lack of mobility and support to assist in transportation
  • Elders
    • Physical and mental challenges for negotiating transportation
    • Often housebound due to illness or lack of assistants
  • Single Working Parents
    • Lack of centralized or neighborhood services
  • Youth
    • Need for dedicated youth centered and friendly facilities
common themes explored10
Common Themes Explored

Poverty

Low income populations get less medical care

  • Especially pre-existing conditions that are not properly diagnosed
  • Working poor become isolated
  • Few mental health prevention services in general
  • Lack of awareness of what prevention services are available
  • Homelessness
    • Youth and all generations
    • MH waiting lists discriminate against homeless when restricted by residency requirements
  • Transitional Age Youth (TAY) lose support and services
    • No income to pay for services
    • No follow through with previous existing services and medications
slide11

Common Themes Explored

“What ever early intervention you put in place, psycho-social issues are under-girding everything: housing costs, pay, hunger, what we call low-income. It doesn’t matter what you do, if you don’t address these issues families will continue to be under tremendous stress.”

disparities in access to mental health services
Disparities in Access to Mental Health Services

Consumers

Unaddressed issue: MH Medications can cause weight gain; creating or exacerbating other life threatening conditions such as diabetes, hypertension and obesity

Low income populations get less medical care, limiting access to prevention information

Children are pulled into a mental health profile because parents couldn’t access mental health services

disparities in access to mental health services14
Disparities in Access to Mental Health Services

Age 0-5 Advocates

Berkeley’s early childhood facilities do not offer sufficient support for children from at risk homes

Most “at risk” families and the disabled have no medical coverage for pre-natal training or care; and lack awareness of services they can access for free.

There are limited services for teen parents

disparities in access to mental health services15
Disparities in Access to Mental Health Services

Youth Advocates (elementary through high school)

There is a disparity of access to services for youth depending on their medical coverage

There are gaps between City services and County services, and a lack of clarity regarding which are appropriate and available

Some youth and transitioning age youth aren’t in school and need community access to PEI services in places other than schools

disparities in access to mental health services16
Disparities in Access to Mental Health Services

LGBT

Problems getting to and paying for services are complicated by the need for confidentiality

Visibility of services is very low – they are hard to find

Staffing and funding is sorely inadequate

Latino and/or Spanish speakers have few services

Queer kids of color are marginalized even in LGBT community and lack specific services

Transgenders also marginalized and lacking services

disparities in access to mental health services17
Disparities in Access to Mental Health Services

African Americans

Many experience school sites as “white institutions” and not places of support for Black families

School systems fail to recognize the role of the extended family, particularly the grandmother, in the child’s life

The “attitude” and “tone” of many service providers shuts down communication

Family members experience staff who are culturally/linguistically insensitive

disparities in access to mental health services18
Disparities in Access to Mental Health Services

Adults and Older Adults

Information about MH is not in circulation

Many elders are isolated and not in communication with much of the outside world; they have no knowledge of services or transport options

Berkeley Adult School students lack MH access due to language difficulties, cultural barriers, and limited onsite MH staff

Many services require eligibility for Medi-Cal & Medicare

disparities in access to mental health services19
Disparities in Access to Mental Health Services

Asian Pacific Islanders

In Berkeley, many Asian students “don’t look like an immigrant”- primary issue is over staying visa expiration, creating stress and fear of deportation, and lessening likelihood of accessing MH services

Limited capacity of MH providers who understand MH issues for refugees and war-related trauma

psycho social impact of trauma
Psycho-Social Impact of Trauma

Consumers

Police play a part in on-going trauma (they symbolize force, or potential for force)

Vets returning from wars (present and past) with PTSD are in increasing numbers

There are no safe places for students to talk about witnessing traumatic events, problems, and fears for their safety

Trauma gets passed from parents to children

psycho social impact of trauma22
Psycho-Social Impact of Trauma

Age 0-5 Advocates

Young children with substance abusing parents, abused or very depressed moms are high risk

Low-income kids are starting school way behind kids who are more advantaged

Psycho-Social trauma increases issues of non-attachment for parent and child

psycho social impact of trauma23
Psycho-Social Impact of Trauma

Youth Advocates

Transitional age youth have lifetime of trauma and need multi-faceted PEI services, including safe housing and continuation of support

African American boys are not doing well in school and in society in general and need a systems-wide approach

Youth in group homes often get recruited for sex work

psycho social impact of trauma24
Psycho-Social Impact of Trauma

Youth Advocates

Under the umbrella of other diagnoses, trauma, is at the root of conditions and problems

psycho social impact of trauma25
Psycho-Social Impact of Trauma

LGBT

Youth are targeted and traumatized (especially in high school)

Safety is a constant concern; Local community center has to keep door locked

Youth stressed by coming out issues and lack of family acceptance

Schools are not well trained to give support to outand questioning youth

psycho social impact of trauma26
Psycho-Social Impact of Trauma

LGBT

There are no services and limited support in place for children with LGBT parents

Youth having two mommies or daddies are experiencing external homophobia resulting in gay bashing and fights

Internalized homophobia exists and goes unaddressed

slide27

Psycho-Social Impact of Trauma

“…coming out about having two mommies and daddies, it’s so strong and courageous but it takes a toll on these kids and the issue doesn’t get addressed. There’s no support.”

psycho social impact of trauma28
Psycho-Social Impact of Trauma

African Americans

Racism is a historical trauma that Black people live with today; impact of “bussing” in Berkeley still exists

Trauma is minimized in Black clients by attitudes that suggest a person should just “get over it”

Trauma is compounded by inadequate, insensitive, unaffordable MH services

Many African Americans inappropriately served within the current MH system

psycho social impact of trauma29
Psycho-Social Impact of Trauma

Adults and Older Adults

Elders suffer daily trauma from “invisibility” and grief that comes with the loss of independence

Many Berkeley Adult School students have trauma related to immigration and language; home situations are often abusive

There is a growing veteran population in need of MH services

Chronically homeless have physical problems in addition to MH

psycho social impact of trauma30
Psycho-Social Impact of Trauma

Asian Pacific Islander

Many immigrant women face domestic violence issues

Recent immigrants have a difficult time adapting and fitting in, causing a great deal of stress

Immigrant parents expect children to be happy aboutbeing in America, when it’s likely their children are suffering from confusion and anxiety

psycho social impact of trauma31
Psycho-Social Impact of Trauma

Asian Pacific Islander (con’t)

Asian populations tend to somaticize their MH issues and aren’t comfortable “talking out” the problem. MH services that include bodywork are very limited or non-existent

Most first generation immigrants do not identify as API, instead identifying with their specific country of origin

Class issues must be considered; traditional socio-economic class distinctions play a part in MH

psycho social impact of trauma32
Psycho-Social Impact of Trauma

Youth

  • Children can experience something at a very young age that was never dealt with. This can affect their behavior and attitudes (fears) growing up
  • “Abusive contact” wears on the personality
  • Many youth are forced to contribute to their family income that pushes them into adulthood before their time, causing great stress
  • Many youth use sports as an outlet for their emotions
at risk children youth and young adult populations34
At Risk Children, Youth and Young Adult Populations

Consumers

Childhood behaviors may be related to side affects of medication for physical conditions (ex: asthma)

“At-risk” children are more often put into treatment prematurely

Early diagnoses ‘type-cast’ students causing them to be tracked unfairly during school years

College age youth are at high risk of first onset during exam time

at risk children youth and young adult populations35
At Risk Children, Youth and Young Adult Populations

Age 0 – 5 Children’s Advocates

Studies show state-subsidized pre-K programs have expulsion rates 3 times of all K-12

Expectant mothers suffering from abuse, medical trauma, or disabilities need information and support in baby care and relationship building with their child

Some children are identified with learning disabilities when the root of their issues may be problems at home

at risk children youth and young adult populations36
At Risk Children, Youth and Young Adult Populations

Youth Advocates(elementary through high school)

Continuum of school based MH services is limited and fragmented

Lack of PEI services is contributing to mental health issues in the school system

Teachers need more MH consultants to support PEI classroom activities

Schools need to be more welcoming to parents in a culturally competent manner

at risk children youth and young adult populations37
At Risk Children, Youth and Young Adult Populations

Youth Advocates-(con’t)

Parents need schools to take better measures to ensure their children’s safety

Transitional age Youth (TAY) lose MH services when housing ends with no immediate carry-over for support

TAY is a high risk time for first breaks; often MH crisis demands high end adult services

slide38

At Risk Children, Youth and Young Adult Populations

  • Youth Advocates-(con’t)
  • Transitional Age Youth (TAY) life-skills building services are not billable
  • Billing doesn’t support social integration activities that are crucial for the MH of all youth, especially those returning from jail or hospital
at risk children youth and young adult populations39
At Risk Children, Youth and Young Adult Populations

LGBT

LGBT youth are targeted and traumatized (especially in high school)

Youth experience internalized homophobia

Children and youth with gay/lesbian parents feel stigma early and need support for the challenges of alternative family structures

Tolerated derogatory language (ex: “that’s so gay”) contributes to unsafe environments

at risk children youth and young adult populations40
At Risk Children, Youth and Young Adult Populations

African Americans

Black children singled out for unjust disciplinary action causes MH issues at an early age

It is reported that 70% of Black youth in BUSD are in Special Ed, or said to have serious emotional problems – and there appears to be no alarm?

at risk children youth and young adult populations41
At Risk Children, Youth and Young Adult Populations

African Americans

Incidences of racial discrimination contribute to MH problems

Black youth ages 16-18 have deep despair regarding their future prospects

Black children are discouraged from free play and self-expression;

Black children are overrepresented in MH diagnoses.

at risk children youth and young adult populations42
At Risk Children, Youth and Young Adult Populations

African American

Pain and anger in Black clients is addressed negatively and not therapeutically

Poverty impacts the MH of Black families, especially women who are single heads of households

Youth (and adults) are overrepresented and inappropriately served in existing MH services

at risk children youth and young adult populations43
At Risk Children, Youth and Young Adult Populations

Asian Pacific Islanders

MH is a westernized concept and psychology is very new to API youth and their families

API ages 15-25 have the highest depression rates of all people of color

Immigration issues can look different; often related to “overstays”

Young adults who “get MH” and want group services cannot find API counselors

at risk children youth and young adult populations44
At Risk Children, Youth and Young Adult Populations

Asian Pacific Islanders (con’t)

Many Asian students do well academically so MH issues go unaddressed; only acting out students are identified

Expectations of parents causes a great deal of stress along with transition and acculturation issues of immigrant youth

Extreme difficulty in matching dialect language services to client needs

at risk children youth and young adult populations45
At Risk Children, Youth and Young Adult Populations

Youth

  • Youth first turn to each other
  • Turn only to adults, counselors if friends won’t talk or not helpful
  • Usually go first to a school adult (counselor)
  • Some youth believe that just going out to party will overcome their depression or worries
  • Romantic relationship problems can deeply affect teens
at risk children youth and young adults populations
At Risk Children, Youth and Young Adults Populations

Youth (cont’d)

  • Many youth put off going home after school
  • Teens feel not listened to, like they are not trusted
  • Feel they don’t get to spend enough time with their parents
at risk children youth and young adults populations47
At Risk Children, Youth and Young Adults Populations

“I think part of understanding youth culture is understanding that there is new culture everyday. Youth define themselves different everyday, and we need to incorporate that and ask them what is your culture.”

stigma and discrimination49
Stigma and Discrimination

Consumers

Mental health diagnoses create discrimination within medical healthcare system; the “at risk” term is used in only certain ethnic and/or socio-economic areas

“At risk” labeled youth may be put into treatment before necessary and/or un-warranted

Family members feel stigmatized when one of them is diagnosed or treated

stigma and discrimination50
Stigma and Discrimination

Consumers (con’t)

Internalized stigma works on children and adults: marginalization and isolation

Media attention on people with mental illness makes the general public afraid of individuals with MH issues

Media attitudes discourage fostering of community, but rather encourage stigma and alienation

stigma and discrimination51
Stigma and Discrimination

Age 0-5 Advocates

Disabled parents do not trust seeking MH help for fear of losing their children

There is a tendency to over identify children as having disabilities, particularly African Americans

Students in Special Ed are not included when school system attempts to support the “whole child”

stigma and discrimination52
Stigma and Discrimination

PEI Youth Advocates

Important consideration:

Entry point for MH services plays an important role in whether youth will go for help regarding an experienced trauma or risk of suicide

stigma and discrimination53
Stigma and Discrimination

LGBT

Kids learn early discrimination in elementary school with language and derogatory phrases

Kids with gay/lesbian parents feel stigma early and need support

Age, race, and sexual orientation contribute to different types of stigma and discrimination

Transgender people suffer terribly from stigma in society, family, and within the LGBT community

stigma and discrimination54
Stigma and Discrimination

African Americans

Heavy use of behavior modifying medications in black children is considered discriminatory

Family members often feel intimidated walking into a room full of white MH professionals

Non-biological parents/caregivers are not eligible for resources/services as much as biological kin who are not taking care of the child

stigma and discrimination55
Stigma and Discrimination

Adults and Older Adults

Older adults can also experience first breaks, similar to young people, in depression, anxiety, and phobias

A MH diagnosis is feared because it can mean the loss of a home and/or independence

Stigma against the elderly transcends race, gender, and socio-economic status

Age stigma adds to mental illness stigma

stigma and discrimination56
Stigma and Discrimination

Youth

  • Fear of humiliation, and or fear of a lack of confidentiality keeps youth from seeking help from friends and/or professionals
  • Admitting anger or depression to others allows people to “look at you like you’re crazy”
risk of suicide58
Risk of Suicide

Not all groups provided information on issues related to the risk of suicide. However, this is not to say that risk of suicide is not an issue for any particular population.

Those groups that spoke specifically to the issues of suicide are presented

risk of suicide59
Risk of Suicide

PEI Youth Advocates

Entry points play an important role in whether youth go for help regarding trauma or risk of suicide

The MH system is perceived to be inadequately coordinated to effectively identify youth at risk of suicide

risk of suicide60
Risk of Suicide

LGBT

Suicide is highest amongst teens

Elder LGBT community is also at high risk

There is an ongoing suicide risk with transgender people due to stigma

risk of suicide61
Risk of Suicide

African Americans

Suicidal behavior among black youth includes “hanging out” in high risk situations

Black youth’s lack of being able to see forward (their future) leads to a loss of reverence for life

Alcohol, drugs and homicide have become fashionable forms of suicide among youth

Staying in domestically abusive relationships is a form of suicide

risk of suicide62
Risk of Suicide

African Americans

Due to the normalizing of sexual abuse of Black women through slavery, many Black women remain silent about their current sexual abuse which can lead to substance abuse and/or suicidal behavior

risk of suicide63
Risk of Suicide

Adults and Older Adults

Elders are usually much more successful than other populations in carrying out a suicide

frequently talked about recommendations
Frequently Talked About Recommendations
  • Promote resiliency, wellness and MH health across the City of Berkeley; emphasize Mind, Body and Spirit
  • Provide people, youth, parents someplace to go for MH support and feel safe. Don’t have it flash “I’m here for a mental health problem”
  • Raise cultural competency levels across the board; Build on strengths of cultural groups
  • Create school and community based MH services
frequently talked about recommendations66
Frequently Talked About Recommendations
  • Carry out a broad public education campaign introducing new MH language and attitudes; Include nutrition and the self empowerment that comes from making healthy choices
  • Increase access for PEI Mental Health services by partnering with existing clinics and medical services
  • Provide safe housing and support for Transitional Age Youth (TAY)
recommendations disparities in access to mental health services68
Recommendations: Disparities in Access to Mental Health Services

Consumers

  • Offer free or affordable interactive workshops on nutrition, exercise, stress reduction with mind, body, and spirit philosophies
  • Stress wellness and health in low-income populations
  • Make 24 hour places available to foster networks of support (coffee shop atmosphere)
  • Make resources available with up to date contact information (E.G., The Blue Book)
  • Consider things that can be done for free
recommendations disparities in access to mental health services69
Recommendations: Disparities in Access to Mental Health Services

Age 0-5 Advocates

  • Provide MH PEI information and training to home visiting healthcare workers
  • Make sure PEI campaigns reach into every part of the community (workforce and schools)
  • More parenting support across the board; offer services around the city, have multiple entry points; include MH outreach and support activities in big community events
  • Ensure teachers are trained to work with all types of children (socio-economics; culture and ethnicity)
recommendations disparities in access to mental health services70
Recommendations: Disparities in Access to Mental Health Services

Age 0-5 Advocates

  • Increase focus on parents with disabilities or parents of children with disabilities and offer PEI services
  • Strengthen support to existing multi-agency integrated approaches working with schools and parents
  • Develop services that are not time or deadline focused in order to meet the needs of the homeless, who often can not meet time requirements
recommendations disparities in access to mental health services71
Recommendations: Disparities in Access to Mental Health Services

PEI Youth Advocates

  • Develop school based infrastructure to support PEI. Place MH counselors at every school
  • Increase communication between parents and schools. Provide more parent liaisons
  • Bridge the gap existing between families, schools and neighborhood environments; Create PEI opportunities that support parents to help their children to succeed in school and life
recommendations disparities in access to mental health services72
Recommendations: Disparities in Access to Mental Health Services

PEI Youth Advocates

  • Develop Transitional Age Youth run activity centers. Provide opportunities to expose them to adults successfully overcoming life challenges.
  • Increase access to family support activities including family therapy.
  • More assertive outreach to youth regardless of age, in school and out of school, to engage them in PEI activities
  • Provide training to understand how providers may bill forservices that fall into the early intervention category that are now considered un-billable
recommendations disparities in access to mental health services73
Recommendations: Disparities in Access to Mental Health Services

LGBT

  • There should be a fully funded center for LGBT clients in an accessible location
  • Create greater public visibility of LGBT services in print and other forms of media
  • Increase the LGBT communities capacity to offer alternative support groups (people of color; women over 40; etc.). Hold cultural competency trainings within the LGBT community.
  • Create capacity for immediate interventions for LGBT related MH crises
recommendations disparities in access to mental health services74
Recommendations: Disparities in Access to Mental Health Services

African Americans

  • Recognize that cultural competency is an access issue and that issue is a barrier for African Americans adults, youth and children in accessing mental heath services.
  • Hire professionals to reflect the cultural make up of the Black community
  • Increase family oriented services House family services in schools and make school sites more inviting for families
  • Expand afterschool programs and socializing events
  • Develop system to track utilization rates for Berkeley MH services
recommendations disparities in access to mental health services75
Recommendations: Disparities in Access to Mental Health Services

Adults and Older Adults

  • Create “behavioral health” roving teams to hang out with people and provide PEI information and referrals
  • Develop and integrative approach and bring PEI monies to partner with existing health facilities and services
  • Create awareness campaign for family members and elderly
  • Enlist in-home service providers to provide some basic assessments for early interventions
recommendations disparities in access to mental health services76
Recommendations: Disparities in Access to Mental Health Services

Asian Pacific Islanders

  • Create a focus on family therapy and the betterment for the entire family, not just an individual
  • Link MH services and job related services
  • Link PEI services with churches and temples; recruit leaders from Asian communities
  • Hire more Asian therapist to support Asian women who do want to go to therapy
recommendations psycho social impact of trauma78
Recommendations: Psycho-Social Impact of Trauma

Consumers

  • Create drop-in peer counseling
  • Foster communication and networking among like minded groups (ex: seniors, students, single parents, parents with incarcerated children)
  • Distribute the Blue Book; a reliable and widely available guide to resources
recommendations psycho social impact of trauma79
Recommendations: Psycho-Social Impact of Trauma

Age 0-5 Advocates

  • Address “secondary trauma” in children who witness violence and other traumatic events
  • Offer services around the city with multiple entry points
  • Provide screenings not just for the child but include the parent and vice a versa
  • Strengthen infant caregiver relationships
  • Develop PEI materials that do not profile the differences of low-income children; target all children
recommendations psycho social impact of trauma80
Recommendations: Psycho-Social Impact of Trauma

PEI Youth Advocates

  • Develop a true system of intensive preventative care for youth
  • Provide early interventions for victims of trauma so they develop skills earlier in life
  • Add tolerance and anti-bullying curricula to the everyday school routine and classes
  • Address the everyday accumulation of trauma just as you would PTSD
recommendations psycho social impact of trauma81
Recommendations: Psycho-Social Impact of Trauma

LGBT

  • Provide ongoing counseling support with cultural sensitivity for HIV/AIDS clients
  • Start tolerance education at elementary levels
  • Make schools a safer place for LGBT youth who live with the fear of violence everyday
  • Train a panel of queer youth who can be available as peer to peer leaders and provide presentations
recommendations psycho social impact of trauma82
Recommendations: Psycho-Social Impact of Trauma

African Americans

  • Provide trainings on how to create welcoming and comfortable environments that are respectful and “do not talk down” to adults attempting to help their child; extended family members as strong advocates
  • The historical school related related trauma requires alternative settings for many Black families to want to receive services
  • Host a conference on what it means to be white
  • Offer workshops on dealing with stress resulting from daily discrimination
recommendations psycho social impact of trauma83
Recommendations: Psycho-Social Impact of Trauma

African Americans

  • Address the factors contributing to poverty
  • Change focus from therapy-centered MH to a community approach with paid para-professionals
  • Create a mechanism to educate people about African Americans that validates positive attributes and not stereotypes
recommendations psycho social impact of trauma84
Recommendations: Psycho-Social Impact of Trauma

Adults and Older Adults

  • Create environments that help elders relax their defenses from living in a youth oriented culture
  • Provide increased crisis counseling at Berkeley Adult School
  • Increase cultural competency in matching elders to service providers
  • Create more intergenerational events
recommendations psycho social impact of trauma85
Recommendations: Psycho-Social Impact of Trauma

Asian Pacific Islanders

  • Increase competency in working with PTSD as a large percentage of people come from places with war
  • Provide support to parents and family members to address issues of acculturation
  • Create district wide PEI workshops for Asians under the umbrella “this is to help your students do better in school…”
recommendations at risk children youth young adult populations87
Recommendations: At Risk Children, Youth & Young Adult Populations

Consumers

  • Educate teachers (and parents) on the side effects of medication in children E.g.: Asthma medication can cause children to be hyperactive
  • Provide support services young people relate to, such as relationships, sex, issues at school. Include PEI information
  • Offer Challenge Days, a youth oriented program focused on tolerance, and creating a healthy school environment.
recommendations at risk children youth young adult populations88
Recommendations: At Risk Children, Youth & Young Adult Populations

“If we took the money and built up some type of industry, meaning vocational training; maybe something in the high school so kids who feel hopeless have an alternative … (for) having a job and feeling worthwhile”

recommendations at risk children youth young adult populations89
Recommendations: At Risk Children, Youth & Young Adult Populations

Age 0-5 Advocates

  • Provide community based interventions that include playgroups, parent support, parent classes, etc
  • Put prevention dollars to support their care, development and connection to the school system
  • Provide home visits and follow up care for at risk families
  • Assist parents and childcare workers in understanding normal childhood behaviors and development phases
recommendations at risk children youth young adult populations90
Recommendations: At Risk Children, Youth & Young Adult Populations

Age 0-5 Advocates

  • Identify children impacted by smoking, alcohol and drug abuse in their early years and provide PEI services to families to avoid future health and behavioral problems
  • Establish Child Wellness Centers where anyone can come for help, training and information
  • Provide additional training to K-teachers on how to appropriately respond when they identify a MH problem
  • Connect MH assessments with Pediatric care
recommendations at risk children youth young adult populations91
Recommendations: At Risk Children, Youth & Young Adult Populations

Age 0-5 Advocates

  • Provide pregnancy support for both men and women
  • Ensure services and outreach are provided to pregnant women with disabilities; provide depression screenings
  • Build on information gathered from the comprehensive needs assessment “addressing the whole child” building a system of universal learning supports
recommendations at risk children youth young adult populations92
Recommendations: At Risk Children, Youth & Young Adult Populations
  • Support low income immigrant and working poor families to re-engage; often they are dealing with grief, loss and overwhelming circumstances
recommendations at risk children youth young adult populations93
Recommendations: At Risk Children, Youth & Young Adult Populations

PEI Youth Advocates

  • Implement a comprehensive plan to provide integrated prevention services on school sites
  • Change the climates at school sites to become safe and welcoming environments for students and their families
  • Create services that immediately support transitional age youth once their housing has ended
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Recommendations: At Risk Children, Youth & Young Adult Populations

PEI Youth Advocates (con’t)

  • Have safe places where homeless youth can go for MH support that doesn’t look like MH services (interest groups, parks, centers, etc.)
  • Limit the exposure Transitional Age Youth have to mentally ill adults who are not in recovery. Provide young adult alternative locations to receive services
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Recommendations: At Risk Children, Youth & Young Adult Populations

PEI Youth Advocates (con’t)

  • For early childhood support systems use “Building Effective Schools Together” program, a nationally proven model
  • Develop best practices for a variety of support groups offered to youth
  • Develop a system of payment for MH professional seeing youth outside of MH facilities
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Recommendations: At Risk Children, Youth & Young Adult Populations

LGBT

  • More conflict facilitation and counseling services.
  • Start LGBT awareness at the elementary school level
  • Provide parenting classes for LGBT parents
  • Develop activities, camps or events where low-income LGBT families can do recreational activities with their children
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Recommendations: At Risk Children, Youth & Young Adult Populations

African Americans

  • Consider using the Family Independence Initiative as a model in working with Black youth
  • Create training models for teachers in working with Black families that addresses methods to ease tensions; how to be attentive; and conveying appropriate attitudes and respect
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Recommendations: At Risk Children, Youth & Young Adult Populations

African Americans

  • Make schools welcoming environments for family members; recognize the “digital divide” and disseminate information in multiple ways
  • Increase PEI funds for youth from 51% to a minimum of 95%
  • Put PEI monies into vocational training programs for high school level youth
youth offered recommendations
Youth-Offered Recommendations
  • Youth are most responsive to peer to peer counseling and mentoring – “someone who can relate to me”
  • Youth relate better to counselors who use language and have techniques that are more appropriate to young people
  • Off-school-site after school programs are badly needed
  • Offer speakers on varied topics 
  • Offer day long workshops with people from different professions, letting kids see the inside of policing, for example
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Youth-Offered Recommendations
  • Offer dance classes (hip hop, salsa, etc.)
  • Therapy “Boot camps” for families
  • Offer an experience where the parent is the kid for a day, and the kid the parent
  • Have childcare for teen mothers
  • Offer arts/crafts, connecting to ethnic or cultural traditions
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Youth-Offered Recommendations
  • “Professional” adults (school, therapists, etc.) should have common respect for teens
  • Offer workshops on nutritious eating, and healthy nutrition for babies for teen girls.
  • Don’t restrict physical activities by grade requirements
  • Anger management programs, but with space respect and respect for some privacy
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Recommendations: Stigma and Discrimination

Consumer

  • Service providers need to meet clients “where they are” rather than profiling them from a diagnosis
  • Create SAFE places where people know they can be free to express their greatest fears, or frustrations without recriminations and meet like-minded peers
  • The “ideal” safe community place would be a well-staffed 24 hour multi-ethnic, multi-generational space where people can go for a good listener, a referral to the correct resource, and/or the company of kind strangers.
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Recommendations: Stigma and Discrimination

Consumers (continued)

  • Focus should be put on wellness instead of disease
  • Hold peer counseling gatherings or hours in each neighborhood using the schools as gathering, healing places, and hubs of communication
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Recommendations: Stigma and Discrimination

Age 0-5 Advocates

  • Hold community meetings or workshops where ‘dialectical therapy’ can be taught to teachers, parents, families (for example: “self-soothing” activities that encourage reflection)
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Recommendations: Stigma and Discrimination

PEI Youth Advocates

  • Create a PEI campaign that supports wellness; begin with young children as the anti-tobacco campaign did; partner with the State; start small and grow into a bigger campaign
  • Create environments where children and youth feel good and supported
  • Invest in aligning the system for better client access and reception
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Recommendations: Stigma and Discrimination

LGBT

  • Better outreach and marketing to LGBT families for family support services that are therapeutic, social and recreational
  • Direct more services and outreach to the LGBT Latino community
  • Provide workshops on internalized homophobia
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Recommendations: Stigma and Discrimination

African Americans

  • Schools must go the “extra distance” to recruit and hire professional staff of color
  • Place services in the neighborhoods where there is a great need for PEI activities
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Recommendations: Stigma and Discrimination

African Americans

“I’ve got several school parents voicing concerns about their kids’ mental health because they’re Black, they’re getting discriminated against in all kinds of ways. Kids acting out as young as third grade. I had one principal admit after observing a kid’s case, say, “I watched the teacher single him out”. Kids are young but they have a sense of injustice. Several parents and coordinators have expressed a need for MH workshops for Black communities in Berkeley; everyone’s going through depression and stress, there are a lot of issues to be depressed about.”

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Recommendations: Stigma and Discrimination

Adults and Older Adults

  • MH services should be available within existing clinics and medical services so that elders do not fail to get seen or treated because they are afraid to go to a mental health facility.
  • Develop universal MH screenings
  • Changing the MH semantics/language would make a big step toward community acceptance of MH issues and services.
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Recommendations: Stigma and Discrimination

Asian Pacific Islanders

  • Normalize the focus on getting help for mental health issues in Asian communities
  • Work with community leaders to talk with their communities about mental health
  • Create a campaign targeting Asian Pacific Islanders with API voices, culturally appropriate language and images
recommendations suicide risk
Recommendations: Suicide Risk

It should be noted that the risk of suicide as a community mental health need received the least amount of discussion across all groups.

recommendation suicide risk
Recommendation: Suicide Risk

PEI Youth Advocates

  • Entry points play an important role in whether youth go for help regarding trauma or risk of suicide
  • The current system is not aligned or easily coordinated to easily catch potential suicidal youth
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Recommendation: Suicide Risk

LGBT

  • Create services that address the highest risk groups – teens, transgenders and elders
  • Adequate services to the LGBT community will positively effect a reduction in suicide risk
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Recommendation: Suicide Risk

African American

  • Self-esteem, despair, hopelessness and drugs must be looked at in connection to reducing the risk of suicide
  • Address “hanging out” behaviors in high risk situations by developing vocational programs to get Black youth out of parks late at night, liquor stores and other places where youth hopelessly hang out
  • Counter the mass media messages that glorify reckless and (self) destructive behavior
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Recommendation: Suicide Risk

Adults and Older Adults

  • Recognize that early intervention does not only benefit young people
  • Healthcare and other service providers must be watchful in recognizing depression and early signs of when an individual is contemplating suicide.
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A roadmap for holistic PEI services;

as created by a Berkeley MH consumer

contact information
Contact Information

City of Berkeley Mental Health Administration

1947 Center Street, 3rd Floor

Berkeley, CA

Karen Klatt, MHSA Coordinator

510-981-5222 - kklatt@ci.berkeley.ca.us

Kathy Cramer, MH Program Supervisor

510-981-5229 - kcramer@ci.berkeley.ca.us

Health & Human Resource Education Center

2288 Fulton Street, Suite 103

Berkeley, CA 94704

510- 549-5990; fax 510-549-5990;

admin@hhrec.org www.hhrec.org

Facilitation Team:

Anne Bacon, Adriana Diaz, Tisha Kenny, Colette Winlock