1. Behavioral Health Needs of Women and Girls of Color in San Francisco By Maru Salazar For San Francisco Mental Health Board July 8, 2011 By Maru Salazar For San Francisco Mental Health Board July 8, 2011

2. Introduction  SF MHB  GABHS for Gals  Needs Assessments  SF MHB  GABHS for Gals  Needs Assessments

3. Participating Agencies & Programs

6. Needs Assessments  Whom does your program serve?  How are you funded?  What are your best practices in working with women and girls?  What are the needs of the women and girls you serve?  How do you address safety issues? And in particular, client-to-client sexual harassment policy?  Whom does your program serve?  How are you funded?  What are your best practices in working with women and girls?  What are the needs of the women and girls you serve?  How do you address safety issues? And in particular, client-to-client sexual harassment policy?

7. San Francisco Population San Francisco Total Population:815,358 Three Populations of Focus San Francisco Total Population:815,358 Three Populations of Focus Racial / Ethnic GroupTotal Population Percentage Asian and Pacific Islander (API) 260,09931.9% Latina / Hispanic117,41214.4% African American54,6296.7%  Source, U.S. Census, 2009.

8. Women in San Francisco Total Population of Women: 392,184 or 49.2% Largest Age Groups of Women Total Population of Women: 392,184 or 49.2% Largest Age Groups of Women Age groupTotal PopulationPercentage Under 1855,69014.2% 25 to 2942,74810.9% 30 to 3442,35610.8% 35 to 3933,3368.5% Source: U.S. Census, 2009

9. Women and girls of color  3 populations of focus  African American  Latina  Asian and Pacific Islander  Demographics  Women  Girls  3 populations of focus  African American  Latina  Asian and Pacific Islander  Demographics  Women  Girls

10. Common Themes  Shame and stigma  High incidence of trauma  Relationship issues  Shame and stigma  High incidence of trauma  Relationship issues

11. Common Themes  Treatment barriers  System issues  Treatment barriers  System issues

12. What makes a difference?  Safe environment  Listening to her story  Empathy  Work on multiple levels  Continuing care  Safe environment  Listening to her story  Empathy  Work on multiple levels  Continuing care

13. Highlights of SF Programs  Hunter’s Point Family: Girls 2000  Instituto Familiar de la Raza, Inc.  The Family Acceptance Project  Horizons Unlimited: YWAP, FAV  Filipino Community Center  Community Youth Center: YAWAV,  Asian American Recovery Services, Inc.,: LWCC  Hunter’s Point Family: Girls 2000  Instituto Familiar de la Raza, Inc.  The Family Acceptance Project  Horizons Unlimited: YWAP, FAV  Filipino Community Center  Community Youth Center: YAWAV,  Asian American Recovery Services, Inc.,: LWCC

14. Evolving Treatment Approaches

15. Gender-responsive Services “creating an environment through site selection, staff selection, program development, content and material that reflects an understanding of the realities of women's lives, and that addresses and responds to their strengths and challenges”. Source: Covington and Bloom, 2004 “creating an environment through site selection, staff selection, program development, content and material that reflects an understanding of the realities of women's lives, and that addresses and responds to their strengths and challenges”. Source: Covington and Bloom, 2004

16. Best Practices in the Field  Outreach and Engagement  Gender-responsive  Trauma-informed  Culturally competent  Recovery-oriented  Outreach and Engagement  Gender-responsive  Trauma-informed  Culturally competent  Recovery-oriented

17. Recommendations  Improving quality of service delivery  Increase outreach and engagement strategies that are culturally relevant.  Incorporate recovery-oriented systems of care in continuum of care.  develop minimum standards of practice for programs.  Improving quality of service delivery  Increase outreach and engagement strategies that are culturally relevant.  Incorporate recovery-oriented systems of care in continuum of care.  develop minimum standards of practice for programs.

18. Recommendations  Increasing system capacity  Dedication of gender-specific funding streams.  Increase capacity of support service programs.  System-wide education and training.  Increasing system capacity  Dedication of gender-specific funding streams.  Increase capacity of support service programs.  System-wide education and training.

19. What can we do now?  What actions can be implemented or integrated into existing programs, agencies now?  How can we encourage programs, agencies and CBHS to take action based on these recommendations?  What actions can be implemented or integrated into existing programs, agencies now?  How can we encourage programs, agencies and CBHS to take action based on these recommendations?

20. Behavioral Health Needs of Women and Girls of Color in San Francisco  By Maru Salazar For San Francisco Mental Health Board July 8, 2011