Sacramento County MHSA Steering Committee May 21, 2015 The California Mental Health Services Authority Ann Collentine, MPPA Program Director Update on PEI Statewide Projects • Impact to date in Sacramento County • RAND report on Statewide Prevention Compassion. Action. Change. 1
How did California Mental Health Services Authority (CalMHSA) Begin? A 2004 California Voter ‐ Approved Initiative (Prop 63) initiated an average of $1 billion in annual funds to support community ‐ based mental health services Nearly 15 years ago the US Seeks transformation from a system driven by crisis to surgeon general identified one that focuses on prevention, early intervention, wellness and recovery, and reducing disparities the stigma of mental illness as the formidable Suicide obstacle to progress in Prevention 20% of funds goes to Prevention and Early Intervention improving mental health. (PEI) Counties through CalMHSA implement statewide prevention programs Short Term and Long Term Outcomes SHORT TERM LONG TERM OUTCOMES OUTCOMES What are immediate targets of change? What negative outcomes are reduced? • S uicide • Knowledge • Discrimination • Attitudes • S ocial Isolation • Normative behavior • S tudent failure/ • Mental & emotional well-being • Disengagement • Help-seeking • Improved functioning • Early identification and intervention • R educed trauma impact • Peer-based support/ education 2
CA’s Public Health Approach: Targets Stigma, Improves Mental Health, Reduce Costs Statewide policies, practice standards, media-reporting (e.g. teacher credentialing & mental health parity) Communities 95% of counties engaged in Know the S igns 44,000 students attended Walk in Our S hoes Play 250,000 trained in PEI strategies Individual Over 50,000 educated through hearing personal stories Sacramento County Impact • School plays were held in 20 Nearly 8,000 visits from Sacramento County Schools. County residents to • 210 Presentations • 40,000 Students attended Walk EachMindMatters.org 6,100 individuals In Our Shoes. reached through • More than 3,700 website visits to various programs WalkInOurShoes.org. • 22 submissions were received in More than 3,700 Campaign 2014, 15 in 2013 individuals visited resulted in ReachOutHere. • The 2014 high school regional 55.9 million winner resided in Sacramento views County. 3
Eng Engaging aging Yo Youth Educational Campaign Fotonovelas ReahOut.com Directing Change • Target audience 9 ‐ 13 yr. old • Tool for mental health • Online forum • High school/college film students both English & Spanish dialogue in families in moderated by peers contest English & Spanish ” • Users compared to • Over past 3 years – non ‐ users have more than 3,000 • Over 44,000 students greater knowledge students have directed viewed performance. “ and positive attitudes change, resulting in • 81% expressed they got towards mental illness 1200 films from over more involved after seeing 112 campuses the presentation http://us.reachout.com/ http://us.reachout.com/bu http://www.sanamente.org/ http://walkinourshoes.org/ http://www.directingchange. scaapoyo org/ http://ponteenmiszapatos.org/ Primary Care: Integration & Parity 4
Suicide Prevention: My3 App and Training Resources, Contacts & Safety Plan Mental Health in the Workplace “Studies estimate the • Workplace mental health training economic cost of $105 program that seeks to increase the billion annually through capacity for employers to respond the impact on more appropriate ly when employees have mental health issues, and productivity from promote mental wellness in the untreated mental health workplace conditions” ‐ Wellness Works • 7 types of in ‐ person trainings, and 3 types of online education to fit the needs of each workplace www.mhwellnessworks.org 5
HEALTH Evaluating California’s Statewide Programs for Prevention of and Early Intervention with Mental Health Problems Statewide Suicide Prevention Programs Statewide Stigma and Discrimination Reduction Programs Dr. Audrey Burnam Prevention and early intervention programs seek to prevent mental health problems and reduce adverse outcomes for people already affected Goals of statewide programs: • Prevent suicide • Reduce stigma and discrimination • Improve student mental health Information Materials Websites Hotlines Training/Presentations Social Marketing 6
Statewide Suicide Prevention Programs Suicide causes over 4,000 deaths in California each year Number of Deaths 4,500 4,025 4,000 3,500 3,000 2,500 1,989 2,000 1,500 1,000 500 0 Suicide Homicide Based on 2013 data 7
Statewide suicide prevention programs included Social marketing Gatekeeper training 8
Californian adults exposed to the Know the Signs campaign in 2013 and 2014 35% 44% exposed 2013 unexposed 21% newly exposed 2014 Those newly exposed to Know the Signs showed increased confidence in intervening with people at risk for suicide Strongly 7 Agree 4.4* 4.0 Confidence to Intervene Strongly 1 Disagree Unexposed Newly Exposed *significant difference 9
Predicted effects of one year of CalMHSA investment in ASIST on averted suicide attempts and deaths in the future The 12,000 CalMHSA hired 79 ASIST On average, trainers will train Livingworks trainers each of 79 will others who avert at to train trained each Train 50 trainers least 3,600 suicide ASIST Trainers year per year, for 3 attempts (including ($0.4M per yr) years. 143 deaths) over 28 years Estimated monetary benefits of ASIST Category Value Spending on ASIST Training for Trainers (1 yr) $0.4 million Lifetime earnings gained by prevented suicide attempts and deaths $386 million Medical costs averted $9 million Societal Benefit : Cost Ratio $1,100 (Monetary value for every $1 spent) CA state income taxes gained $17 million Medi-Cal costs saved $1 million CA Government Benefit: Cost Ratio $50 (Monetary value for every $1 spent) 10
Conclusions: Suicide Prevention Mass Media Campaign Having Positive Effects Reaching a majority of the state’s adults Increasing their confidence about how to intervene with those at risk for suicide Suicide Prevention Training Saves Lives For each year of program investment, at least 3,600 future suicide attempts, including140 deaths, could be prevented Suicide Prevention Training is a Good Investment For each $1 invested, we estimate a return of • $1,100 to the people of California • $50 to the government of California Statewide Stigma and Discrimination Reduction Program Dr. Rebecca Collins 11
Mental illness stigma and discrimination have negative consequences Delays in Getting Appropriate Treatment Suffering Social Isolation Poorer Social Functioning CalMHSA stigma and discrimination reduction program influences those with mental health challenges both directly and indirectly Intervention Activities Information materials Websites Training/presentations Social marketing Individual change Institutional change Social change 12
We examined the state of stigma in California over 2 years Intervention Activities Information materials Websites Training/presentations Social marketing What is the reach of CalMHSA stigma and discrimination reduction activities over two years? Is there any change in stigma related attitudes, beliefs and behaviors among CA residents? What challenges to well-being are Californians with mental health problems still facing (as of 2014)? Exposure to CalMHSA stigma reduction programs over 2 years Percent of people reached 95 100 89 80 60 45 40 17 20 2013 or 2013 or 2013 2014 2013 2014 0 CalMHSA Reach Total Potential Reach 13
Awareness of stigma has increased in California Percent agreeing that . . . * 79 80 74 60 43 * 41 40 20 2013 2014 2013 2014 0 . . . people are generally caring and . . . people with mental illness sympathetic to those with mental illness experience high levels of prejudice and discrimination *Difference is statistically significant Social distance has decreased substantially Percent saying they were . . . 40 35 * * 30 30 28 30 23 * 19 20 10 2013 2014 2013 2014 2013 2014 0 Unwilling to move next door to Unwilling to spend an evening Unwilling to work closely on a job someone with a serious mental socializing with someone with a with someone with a serious illness serious mental illness mental illness *Difference is statistically significant 14
Reported experience of mental health problems has slightly increased Percent “yes” 60 53* 51 40 26* 24 20 2013 2014 2013 2014 0 Have you (yourself) ever had a mental Do you have a family member who has health problem? + had a mental health problem? * Difference is statistically significant Awareness of mental illness stigma is high Percentage strongly or moderately agreeing 100 * 81 80 CA Adults 73 in Distress 60 CA General Population 41 41 40 20 0 People are generally caring and People with mental illness experience sympathetic to people with mental high levels of prejudice and illness discrimination *Difference is statistically significant 15
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