Mental Health Association in California Activities in this County

Our efforts in this county began in earnest in February 2006. Steve Bischoff, Executive Director of MHA - Alameda County, consulted with his Board of Directors about how to effectively incorporate this project into other endeavors in Alameda County. As a result, we had a very important planning meeting in February 2006 that included Marye Thomas, Mental Health Director for Alameda County, representatives of the local provider organizations, and staff from the county Department of Behavioral Sciences. As an initial meeting, many ideas were discussed and target populations were considered. A proposed outreach plan was in development as of April 2006. In subsequent meetings we will be identifying initial target populations as well as looking at strategies that will be helpful in continuing the efforts of this project.

Fresno
Link to County Mental Health:
http://www.fresnomhsa.org

Mental Health Association in California Activities in this County

MHAC staff made the initial contact with Fresno County staff and the local MHA chapter in June 2005. The County Mental Health Director, Giang Nyguen, local TCE grantee Sergio Aguilar-Gaxiola. Vera Kennedy, Executive Director of the Fresno MHA, and representatives from other organizations were present. Discussions covered a wide range of topics that ultimately led to the decision to go forward with selection of the initial population we would begin to outreach to.

During three additional follow-up meetings, the decision was made to engage the Hmong population and to enlist the assistance of local community based organizations that were influential in the Hmong community. Hmong was selected due to size of the population, the level of unmet need and availability of meeting space for future events. 3 additional meetings were held with the Hmong community leaders, who were very reluctant in the beginning to work with us in outreach to their communities. This reluctance, as we have learned during our conversations with the community leaders, is based on a near lifelong experience of many different organizations coming and going and making many unfulfilled promises of assistance. These organizations are described as treating the community more as a 'research project' rather than a community with a vibrant background with true need. With our assurances that we were not conducting a research project, and with the assistance and direction of the local community leaders, an educational forum was identified as an appropriate first step.

The goals of the local community for this project include:

• Ensuring that the community was aware of the Mental Health Services Act and currently available mental health services.
• Assist in the process of getting people from their community involved in continued planning of a new system that would be accessible to many individuals in unique ways.
• Ensure that ALL services were provided in a 'culturally accessible' manner.

Contact was made throughout the local Asian community. Local COEC partners joined and were actively involved in meetings with the community leaders to discuss the logistics of the event and provide additional education about our individual organizations. The event was attended by 65-70 individuals. The initial 5 hour long forum was held at the McLane High School on November 12th, 2005. The true highlight of this event was not totally expected - it was the interaction that was created between the Mental Health Director and the local community. According to community leaders this was the first time that many of the community members felt comfortable discussing their issues regarding mental health and this forum gave them an opportunity to air issues in a safe environment. Additionally, the four advocacy groups gave individual presentations about their organizations and ways that the community could use their individual services.

Hmong translation services were offered to the community. This event also had a significant number of Cambodian participants and fortunately a Cambodian translator was available. Childcare was not offered at this event. Families had been contacted and their personal preference was to have children present with them throughout the event. Such was the case as there were 8 children in attendance throughout the day.

County participation has been excellent, with the county devoting personnel resources to the success of this event. Individual county employees - including the Mental Health Director - offered to provide transportation to community members that needed assistance in getting to the event.

We are awaiting surveys from the local community for input as to the effectiveness of this outreach forum and direction as to what our next steps should be in this community. A problem that we have encountered with the survey process is the inability of many of the participants to complete the survey without assistance from others in the community. As these are completed they will be forwarded to our office for review.

Los Angeles
Link to County Mental Health:
http://dmh.lacounty.info

Mental Health Association in California Activities in this County

The local MHA is serving as an active participant on this project. We have held meetings in October and December 2005 with former Endowment Grantees under the Mental Health Initiative funding in this county to get further input on our overall project. With further input from MHA-Los Angeles and the County Mental Health Director, we will initially be targeting the Latino Community with emphasis on Latino TAY and GLBT populations for our initial outreach forum. It will be held in proximity to Service Area 7 (Southeast LA County), which currently holds 27% of the county population but only receives 3% of direct mental health services. The local Mental Health Association has very strained resources but still is able to dedicate a staff person and an intern to this project. We have held three meetings with MHA staff and community leaders to develop a sense of what community outreach is essential and what the community needs are.

The community has identified the following goals as important ones to focus on during the implementation of this project:

• Increased availability of information about mental health and where services are provided.
• Determine what approach is best for most in the community about understanding how to eliminate problems before they become problems.
• Identification of individuals that would be willing to assist the community with voluntary therapeutic services that are not connected to any government entity, due to a common fear within the community of anything related to government which creates a barrier to accessing services.
• The beginning of dialog with those that would like to become more involved with ongoing planning for culturally appropriate services that would be based within their own community and would not require extensive and complicated travel. (Community members identified that to receive any appropriate mental health services, individuals that use public transportation are subjected to several bus transfers and up to 3 hours on local busses to reach their destinations.)

The local MHA Chapter has worked extensively with the Latino population in the identified region and has developed a series of weekly and bi-weekly meetings with the local community. During these meetings they have been able to identify several barriers to receiving services as well as segments of the population that have been resistant to participation in dialog about mental health due to stigma-related issues as well as the continued mistrust of government based services.

COEC will present information about the Mental Health Services Act as well as information relating directly to their individual organizations during the first educational forum to be held in the Los Angeles area. This event will be presented primarily in Spanish with English translation. The initial event is tentatively scheduled for June 2006.

San Diego
Link to County Mental Health:
http://www2.sdcounty.ca.gov/hhsa

Mental Health Association in California Activities in this County

Two initial meetings were held with the local MHA, MHAC and county officials in July 2005. The County Mental Health Director Alfredo Aguirre and the Cultural Competency Liaison Piadad Garcia met with MHAC representatives and the San Diego Mental Health Association Executive Director Karen Luton to discuss our outreach projects funded by The California Endowment and the California Department of Mental Health.

All individuals discussed the goals and objectives of this project and concluded throughout additional meetings that the Latino populations from both the North and the Southern portion of the county needed to be targeted during this initial phase of the project, as the need was clear and communities could be advised of our efforts within a very short time. Leaders and members of the Latino Community were contacted and met with representatives of the advocacy organizations of COEC, the MHA representatives and county officials during lunch to discuss the critical needs of this community and how an educational forum of this type could be better tailored to increase participation of the community.

Many issues were identified by the community leaders. Many potential goals were identified as representing the diverse and significant need in the region. This educational event became the catalyst for discussion. Goals were refined and ultimately identified as the following:

• Looking at the issues of both cultural and mental health related stigma and how they restrict many of those that need services from participating.
• Housing access - A continual lack of affordable housing for the community contributes to poor mental health
• Identifying ways that problems can be identified within the family environment - that will lead to early help and potentially avoid larger problems later in life.
• A general lack of awareness as to what 'mental health' actually is and what it can mean to the community.

Community involvement was crucial to the success of the planning for the overall project. In addition to the COEC advocacy groups and county and state government organizations, we had participation from the following organizations: 211- San Diego, Latinos y Latinas, Martin Del Campo, The Moses Project, La Maestra Family Clinic, UCSD Geriatric Psychiatry Research Center, Visions, PUH - Bayview, SYSTEMS Case Manager Mental Health, One Step Career Center Oceanside, Sharp Health Care, Family Health Centers of SD, Hospital Association of SD & Imperial Counties, Hemophilia Association, MHCWAR, SDYCS - Teen Choices, Welcome Back Program - Grossmont College, San Ysidro Health Care, and Protection and Advocacy, Inc.

A decision was made by this group that the first event would be structured in a manner that would be a learning experience about the MHSA as well as becoming a launching point for the general community to begin those important discussions about what the future will hold for those individual communities that are willing to discuss mental health among families and other participants.

As a result, the initial outreach event for this county was held December 20th at the Mission Valley Marriott Hotel in San Diego. The focus was building relationships between the mental health system and those that have never been directly involved in the system. Latino Communities from both the northern and southern portions of the county were involved in this initial forum. This population was selected as a result of discussions with the County Mental Health Department, community input and discussions with local COEC representatives. This event was held at the Marriott Hotel, which is central to the location of both areas of the population we were drawing from. COEC partners as well as local community organizations are assisted in direct outreach to this community. The community sees this event as yet another stepping stone to full inclusion of the community in ultimately reaching everyone and educating them about access to mental health, and involvement in the planning process. This event has been designed by the community to ensure that the spirit of planning continues throughout the event and that this does not become a 'dead end' in the community education aspect. This particular event was presented in Spanish, with English translation for those who needed it. Community leaders such as Isabel Vidales and Viviano Criazo were instrumental in facilitation and ensuring translation and focus on the identified needs of the community.

The local NAMI Affiliate, which has been conducting its 'Family to Family' workshops in Spanish during the past year, held an afternoon get-together for families and community members at the conclusion of the educational forum.