Campaign

Steering Committee

Friday, November 30, 2007

10-1 pm

Roseville

• Welcome & thank you• Consumer Voice• Public Comment• Campaign Steering

Roster– Updates to approve

• Prevention Updates– Where we are– Guiding Principles– Prevention reminders

Agenda

• Recommendations– Priority populations

identified• Recommendations

– Allocation framework by focus

– Workgroups

• Public comment review • Wrap-up/next steps

Agenda (continued)

.

VOICE

Public Comment

Comments Welcome

3-minutes per comment

Steering Committee Roster:Request for Approval

• Consumer youth – Sam Stodolski

• Need 1 more consumer– Latino, jail, Tahoe

• Latino, Youth advocate, Tahoe– Emilio Vaca

Prevention Planning Review

PEI Planning Elements for Discussion

• Review decision making process– Role of Steering

• Affirm guiding principles• Approve initial priority

populations and community needs– Review process first

• Formalize work groups• Approve allocation/funding

framework

Planning Process

SteeringCommunity

(Tahoe, Auburn, Lincoln,Roseville)

Needs &

Assets

SteeringEstablish work groups, approve initial criteria & plan

County staffFinalizes decisionsCreates work plans

Latino Leadership

NativeAmerican

Data collection/Risk & Protective Factors

Workgroup#1

Workgroup#2

Workgroup#3

LatinoWorkgroup

Native American

Target needs and priorities

Steering

Reviews workgroup recs,formalizes recs.

RecommendingBody

Decision-making

RecommendingBody

PEI Guiding Principles•Cultural competence•Collaboration•Client / Family centered •Recovery /strength-based wellness focus•Co-occurring competent•Early intervention•Evidence based outcome focus•Integrated services•Accessibility

Affirm

Prevention Refresher

• Definition of prevention• Trajectories• Upstream emphasis

“An ounce of prevention is worth of pound of service”

-Anonymous

Review handout

Prevention

• Interventions that occur before the onset of a problem

• Can also mean interventions that prevent relapse, disability and the consequences of severe mental illness

• The Institute of Medicine restricts the definition to processes that occur before there is a diagnosable mental illness.

Examples of Protective Factors

FamilyFamily

Health careHealth care

CultureCulture

ReligionReligion

FriendsFriends

Restricted access Restricted access to lethal means to lethal means (suicide)(suicide)

Self-help Self-help skillsskills

Anger Anger management skillsmanagement skills

Work/volunteeringWork/volunteering

Examples of Risk Factors

Job lossJob loss

Lack of health careLack of health care

TraumaTrauma

Physical illnessPhysical illness

Alcohol/substance abuseAlcohol/substance abuse

Gay youthGay youth

Native American Native American youthyouth

Previous suicide attemptPrevious suicide attempt

Grils & young womenGrils & young women

Isolated elderlyIsolated elderly

DiscriminationDiscrimination

Classification of Prevention Interventions

• A universal preventive intervention is applicable or useful for everyone in the general population.

• A selective preventive intervention is targeted at individuals or subgroups whose risk of developing mental health problems is significantly higher than average.

Classification of Prevention Interventions

• An indicated preventive intervention is aimed at individuals who have some symptoms of mental health problems but whose symptoms are not yet severe or prolonged enough to meet diagnostic criteria.

Why Intervene Early?

Step 1: Identifying NeedsWho is at risk & for what

Steering and

Community Input sessions

What did you tell us?

• Steering: Who is at risk & for what: – Children & youth at-risk

• Poverty, uninsured, abuse, depressed, disabled, poor school performers, substance abuse, incarcerated

– Adults• Trauma, depressed, single

(divorced,widowed,separated)

– Seniors• Depression, drug abuse

Community Input Summary (Kings Beach, Lincoln, Auburn))

• Children– Neglect, lack of care &

security– Those with mentally ill

parents and/or substance abuse

• Youth– Antisocial/isolation, inverted

family structure,drugs, neglect, gangs,aggressive

• LGBT

– Transitioning, lack of job skills

– Incarceration

Who is at risk & for what:

Community Input Summary(Kings Beach, Lincoln, Auburn))

• Adults- Women (depression,

poverty, transp.)– Men (money, jobless,

discrimination)• Families

– Drugs, abuse,early sex, bullying,domestic violence, divorce

• Seniors– Isolated, depressed– Elder abuse, substance

abuse– Health

Who is at risk & for what:

Latino Leadership Input

• Children– School failure,

domestic violence

• Women, men & family– Substance abuse,

isolation/depression, fear of immigration, lack of medical care, incarceration, job loss

Who is at risk & for what:

Native NetworkInput

• All ages/gender at-risk• Family-centered, community

approaches– Preservation of cultural

knowledge and traditional health practices is top priority.

• At-risk for:– Historical trauma,

discrimination, poverty, homelessness,low educational attainment, lack of access to care

“Culture is Prevention”

Who is at risk & for what:

Summary of Community Needs

• Depression across all ages groups– Children, youth, adults,

seniors, homeless

• At-risk children and youth– School failure

– Juvenile delinquency

– Stressed families

• Underserved cultures– Access to care

– Stigma/discrimination

What is the Data Telling Us?

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Refer to handout

The Good News:Protective Factors

• High educational levels– 68% some college or

higher

• Low violent crime• High graduation rates

– 91%

• High Quality Health Care– Low rate of uninsured

(3.5% kids)

• Low unemployment• Low poverty

Our Risk Factors

• Population growth 2nd highest in CA– Eldery

– Latino

• Above average suicide rates– 34 per 100,000 for (80-

84yrs.)

– 76% of all suicides are male

– 25% of all suicides ages 40-50

– Adolescents on par with State

Our Risk Factors

• Above average rate of child abuse calls– 20% Latino substantiated cases

• Above average alcohol and drug abuse– Hospital discharges

• 2nd to worst in State

– Juvenile arrests– Adult arrests (DUI, other

alcohol)– Accidents– 25% more liquor stores

• 100% youth in Tahoe request information on depression

Our Risk Factors

• Pockets of poverty– 8 schools have 65% or

more free/reduced lunch programs

– 6 areas identified:• North Auburn• Lincoln• Colfax• Central Roseville• Foresthill• Kings Beach

• Poverty increases risk of mental illness by 2x in Placer (see handout)

Most effective use of $

• The more upstream the more effective

• Shotgun approach will not work– Not a lot of $’s

• Need to focus

Most criticalareas to choose:

• Disparities in Access • Psycho-social impact of

trauma• At-risk children, youth

and young adult• Stigma & Discrimination• Suicide Risk

• Trauma exposed individuals

• First onset• Children, youth stressed

families• Children, youth school

failure• Children, youth juvenile

justice

Community Needs Priority Populations

Agreement/Approval

Proposed GeneralFunding Framework

• 0-25 yrs.• Disparities in Access

– Underserved cultures

• Depression/suicide

DiscussionAgreement/Approval

Recommended Workgroups

Children/Youth At- Risk

DepressionSuicide

Latino

NativeAmerican

Tahoe

Focus Areas

Disparities inAccess

DiscussionAgreement/Approval

Group Work by Jan 25Provide Recommendations

• Who is the target?• What are the outcomes?• Recommendation on prevention strategy:

–Universal, selective, etc.

Staff will assist

Public Comment Review

Recap of public comment process

Discussion

Public CommentProcess

Written:

Letter StaffResponds

SteeringReviews

2 weeks

Edits/ FinalResponse

Recommended Oral process:

PublicComment

Steering Listens

No formalResponse

DiscussionAgreement/Approval

Next Steps

• Complete community meetings

• Workgroups meet with staff assistance – Present targets and

outcomes

• Next Steering Meeting Jan. 25– 10-1pm CDRA, Auburn

• Happy New Year!

End