Summary of Prevention, Early Intervention PEI Data City of Berkeley Mental Health Department Community Meetings Foc

1. 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

2. 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

3. Who We Talked To

4. 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

5. 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

6. 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

7. 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

8. 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”

9. 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

10. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

21. 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

22. 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

23. 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

24. Psycho-Social Impact of Trauma Youth Advocates Under the umbrella of other diagnoses, trauma, is at the root of conditions and problems

25. 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

26. 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 Psycho-Social Impact of Trauma

28. 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

29. 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

30. 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

31. 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

32. 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

33. At Risk Children, Youth and Young Adult Populations

34. 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

35. 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

36. 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

37. 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

39. 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

40. 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?

41. 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.

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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.”

48. Stigma and Discrimination

49. 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

50. 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 Discrimination

51. 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”

52. 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

53. 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

54. 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

55. 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

56. 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”

57. Risk of Suicide

58. 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

59. 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

60. 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

61. 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

62. 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

63. Risk of Suicide Adults and Older Adults Elders are usually much more successful than other populations in carrying out a suicide

64. Recommendations

65. 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

66. 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)

67. Recommendations: Disparities in Access to Mental Health Services

68. 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

69. 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)

70. 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

71. 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

72. 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

73. 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

74. 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

75. 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

76. 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

77. Recommendations: Psycho-Social Impact of Trauma

78. 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

79. 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

80. 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

81. 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

82. 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

83. 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

84. 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

85. 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…”

86. Recommendations: At Risk Children, Youth & Young Adult Populations

87. 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.

88. 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”

89. 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

90. 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

91. 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

92. 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

93. 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

94. 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

95. 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

96. 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

97. 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

98. 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

99. 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

100. 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

101. 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

102. Recommendations: Stigma and Discrimination

103. 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.

104. 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

105. 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)

106. 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

107. 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

108. 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

109. 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.”

110. 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.

111. 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

112. 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.

113. 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

114. 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

115. 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

116. 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.

118. 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