Youth Mental Health April 9, 2013

Overview History Current Youth Mental Health Resources – Wraparound Orange Youth Mental Health Proposal Action item – Health Services

History Asylums: 19 th and early 20 th century – Notorious for poor conditions, lack of hygiene, overcrowding, and ill treatment Community Mental Health Act (1963) – Widespread Deinstitutionalization – Many communities not able to deal with complex needs of mental health patients Mental Health Treatment in the US

History Inadequate resources led to: – Frustration and limited access – Use of law enforcement and jails as methods to gain access to treatment – Increase in homelessness and criminal history for those with mental disorders

Overview History Current Youth Mental Health Resources – Wraparound Orange Expanded Youth Mental Health Proposal Action item – Health Services

Existing System Emergency Rooms Emergency Rooms Foster Care/ Dependency Foster Care/ Dependency SA/MH Juvenile Justice JAC Juvenile Justice JAC Public Schools Primary Care Clinics – PCAN Primary Care Clinics – PCAN Child Mental Health Substance Abuse Juvenile Justice

SAMHSA Grant (federal) awarded to Orange County in 2009 – $9M over 6 Years – Purpose: Create a comprehensive & coordinated system of care – Family-Driven and Youth-Guided Wraparound Orange

Service Intensity Matches Needs Natural Supports Community Based Early Prevention Intervention Individualized Services Team Based Culturally Competent Seamless Coordinated Wraparound Orange

High-fidelity wraparound from Portland State University, Oregon To date, services provided to over 244 families; over 1,000 children impacted Navigation services provided to EVERY family that calls Reduction in service gaps and barriers Referrals received from school, child welfare, juvenile justice, state attorney, public defender, court administration, and families Wraparound Orange

School performance – 67% remained stable or improved Arrests rates at 6 months - decreased from 64% to 16% Youth coping - 70% of youth feel they can make positive changes in their life Significant reductions in youth reporting symptoms of anxiety, depression, aggression and thought disturbances

Overview History Current Youth Mental Health Resources – Wraparound Orange Expanded Youth Mental Health Proposal Action item – Health Services

Youth Mental Health Proposal Build on the Success of Wraparound Orange  Wraparound Orange Teams (5)  Mobile Crisis Unit  Mental Health Navigators (6)  Crisis Intervention Team – Youth  Mental Health 1 st Aid Training  PCAN Mental Health Screening Program  Management Information System  Social Assistance Funds  Anti-Stigma Social Marketing Campaign

Wraparound Orange Teams (5) 2 person teams that provide services to high-risk children and youth Goals: – Assure youth with signs of mental illness get referred to treatment – Provide evidence based services to children and their families $498,129 Youth Mental Health Proposal

Mobile Crisis Unit Provides immediate response to a mental health crisis in the field to divert from criminal justice and dependency Goals: – Earlier and more efficient access to treatment – Reduce likelihood of criminal stigmatization $900,000 Youth Mental Health Proposal

Mental Health Navigators (6) Accept referrals, and assist in connecting individuals with appropriate resources Assist in benefit eligibility processes Goals: – Better access to treatment services – Ties families to appropriate resources $302,400 Youth Mental Health Proposal

Provide CIT-Youth Training for law enforcement officers/school resource officers and first responders Enhances current CIT training focused on adults Goals: – Reduce violence in schools – Offer diversion from Juvenile Justice $10,000 Youth Mental Health Proposal

Mental Health 1 st Aid Training Education program designed for the general public – Distribute the Mental Health First Aid Curriculum across the community – Uses a “Train the Trainer” method Goal: – Identify and respond to signs of mental illnesses earlier $30,000 Youth Mental Health Proposal

Provide Mental Health Screening through PCAN – Implement/use a common, evidence- based, mental health screening tool Goals: – Earlier detection of unrecognized or unmanaged mental health disorders – Connects patients and providers via a navigator $50,000 Youth Mental Health Proposal

Management Information System Expansion of the current system being used by Wraparound Orange Web-based electronic medical record Goal: – Enhanced data management – More fluid electronic referrals and reporting of available services $150,000 Youth Mental Health Proposal

Social Assistance Funds Allocation of emergency funds for children/young adults needing treatment, medication, etc. Provides the safety net until other resources can be obtained These funds are often used to assist a family in the short-term to avoid homelessness $300,000 Youth Mental Health Proposal

Anti-Stigma Social Marketing Educational awareness campaign, that includes distribution of information, use of PSA’s, billboards, etc. Goal: – Increase likelihood of seeking treatment by decreasing stigma – Improved understanding of mental illness as a public health issue $100,000 Youth Mental Health Proposal

 Wraparound Orange Teams (5)  Mobile Crisis Unit  Mental Health Navigators (6)  Crisis Intervention Team - Youth  Mental Health 1 st Aid Training  PCAN Mental Health Screening Program  Management Information System  Social Assistance Funds  Anti-Stigma Social Marketing Campaign Youth Mental Health Proposal Estimated Annual Operating Costs: $ 2.3 Million

Funding: – In-kind contributions – Partner match – Strategic shifts of money to mental health services – Social Marketing plan – Corporate Sponsorship Youth Mental Health Proposal

Overview History Current Youth Mental Health Resources – Wraparound Orange Youth Mental Health Proposal Action item – Health Services

Health Services Department Request to provide funds for SAMHSA Grant Local Match April 9, 2013

SAMHSA Grant – Year 4 Wraparound Orange is funded by a SAMHSA Grant over 6 years – Currently in Year 4 – Dollar-for-Dollar match of local funds Total Federal share available this year is $2 Million if local match is met – $ 1M short after vigorous efforts

Health Services received a $963,091 refund from AHCA – These dollars were committed to community health in the budget Applying these funds to the local match for the SAMHSA grant brings an additional $963,091 in federal funds – All current Wraparound Orange activities can be preserved SAMHSA Grant – Year 4

Action Requested: Approval to apply $963,091 from the Health Services budget as local match for year 4 of the Wraparound Orange grant.

Health Services Department Request to provide funds for SAMHSA Grant Local Match April 9, 2013

SAMHSA Grant Grant Year Federal Orange County Match Community Match 1 (Actual) $958,664$336,0930 2$1,500,000$336,093$163,907 3$2,000,000$336,093$330,574 4$2,000,000$336,093$1,663,907 5$1,500,000$336,093$2,663,907 6$1,000,000$336,093$1,663,907 70$336,093$1,500,000