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City of Berkeley Mental Health Department

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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
  –   LGBT Advocate Group
  –   African American Group
  –   Elders and Adults
  –   Asian Pacific Island Group
  –   Youth
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
•   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
• 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
• 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
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 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 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 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
 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 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 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 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 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 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 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 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 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 Trauma
       Youth Advocates

       • Under the umbrella of other
         diagnoses, trauma, is at the root of
         conditions and problems
     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 out
  and questioning youth
     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
  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 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 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 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 about
  being in America, when it’s likely their children are
  suffering from confusion and anxiety
     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 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 Populations
         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 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 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 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
         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 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 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 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 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 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 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 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
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 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 Discrimination
         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 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 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 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 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 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 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 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 Suicide
                  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 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 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 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 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 Suicide
Adults and Older Adults

• Elders are usually much more successful than other
  populations in carrying out a suicide
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
              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 Services
       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 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 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 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 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 for
  services that fall into the early intervention category
  that are now considered un-billable
    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 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 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 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 Trauma
         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 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 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 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 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 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 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 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 Populations
 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 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 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 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 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 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 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
 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
 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
 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
  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
 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 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
    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
   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
    Recommendations:
Stigma and Discrimination
             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.
             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
            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)
             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
            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
            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
             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.”
             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.
              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
 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
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
       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
      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
     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.
A roadmap for
holistic PEI
services;
as created by a
Berkeley MH
consumer
                  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

				
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