Community partners work to end mental health stigma
“One out of four families will experience mental health challenges. My family is one,” narrates actress Glenn Close at the start of the documentary “A New State of Mind: Ending the Stigma of Mental Illness,” which was shown to residents at the El Dorado Hills Community Services District pavilion earlier this year in an effort to get more people to seek help when they or their loved ones are suffering with mental illness. Fifteen such forums were held throughout El Dorado County so far this year. “My sister Jessie wasn’t diagnosed with bipolar disorder until she was 51 and her son was diagnosed with schizophrenia at 19,” Close continued.
From Olympic diver Greg Louganis to retired congressman Patrick Kennedy, high-profile individuals spoke openly about their struggles with mental illness in the Mental Health Services Act sponsored film.
MHSA (Proposition 63) was passed by California voters in November 2004 and enacted into law Jan. 1, 2005. MHSA imposes a 1 percent tax on personal income in excess of $1,000,000. Funds are distributed to counties through the state and are intended to transform the public mental health system into one that is consumer and family driven, with services that are recovery oriented, accessible, culturally competent and appropriate for the population served.
Funds are pooled at the state level and distributed to counties based on a complex formula, including need for services, population and the number of individuals uninsured, explained MHSA program director for El Dorado County Ren Scammon.
“MHSA programs see serious mental illness patients such as bipolar and schizophrenia. Patients who qualify must be on Medi-Cal or uninsured,” Scammon explained. “If they can go through private insurance they are not eligible.
“MHSA requires us to provide services to people from zero to death,” she continued . “We look at not just what’s needed, but what’s causing it.”
El Dorado County receives $5 million annually, “which doesn’t go very far,” said Scammon. The county also gets an additional $1 million in Medi-Cal reimbursements.
Five components of MHSA services
- Prevention and early intervention — reaching individuals before mental illness gets debilitating and reduces stigma. “That’s not always possible, said Scammon. “Sometimes it is.” This represents 19 percent of the budget or $1 million in funding.
- Selective prevention — narrows focus on certain populations, like suicide prevention in youth or senior peer counseling. The program receives no new funding, but works off a fund balance from recent years.
- Community services and support — when an individual has been diagnosed with a serious mental illness this might help with transitional housing and independent living skills. Or funds can be used to transport seniors for care. This represents the bulk of the funding at $4 million or 76 percent.
- Innovation — thinking outside the box to find answers to problems that haven’t been solved. For example, could we train hairdressers to identify the signs of mental illness when they talk to clients? Innovation proposals have to be approved at the state level to be sure an idea hasn’t been done before. This category represents 5 percent of the county’s funds or $250,000.
- Work force education and training & capital facilities and technology needs — how to train others and implementing electronic health records. No new funding.
After the film a panel of professionals and one person living with bipolar disorder emphasized mental illness is more common than people think and talking about it reduces its stigma.
“Letting people know I have bipolar is worse than the diagnosis,” said a Sacramento attorney on the panel. He explained how he suffered between high school and his 20s because he couldn’t find medication that worked. “Today I’m living proof you can live your life in balance,” he said.
“In El Dorado County 4.6 percent of people need serious mental health help,” said Scammon. “Suicide is the huge issue in our country. Young people who commit suicide make the news, but the average age in our county is 45 to 65. Nationally the average is over 70.”
Sgt. Michael Seligsohn from the El Dorado County Sheriff’s Department talked about his work overseeing a crisis intervention team that facilitates early intervention from Tahoe to the West Slope.
He described how he makes home visits generally right out of crisis and how he’s seen success with the program. Seligsohn described a young man who’d been in and out of jail for battery and violent outbursts. “This had been a pattern since he was 17,” explained Seligsohn. “All along there’s been an underlying, untreated mental illness.”
Despite high-profile news stories, only 3 percent of people with mental illness are violent, explained Scammon.
While in jail, the young man Seligsohn mentioned took his meds and got counseling. “He’s affable. People like him,” he said. “He’s a great kid.”
Once released, a home check uncovered he’s close to continuing the cycle.
“He was down to two days of meds and hadn’t connected with any services,” said Seligsohn.
The deputies soon realized the man couldn’t read and once they personally drove him to mental health in Tahoe they helped get him back on the right track.
“He would’ve been back in jail in a couple weeks,” explained Seligsohn. “Without an intervention he cycles that way again and again. It’s an illness. You should focus on the illness and less on the mental. With most illnesses people are compassionate; we bring them soup and watch their kids, but not with mental illness.”
Though only 6 percent of the county’s Medi-Cal patients live in El Dorado Hills and 12 percent live in Cameron Park, 33 percent of the county’s MHSA budget goes to those highly populated areas. One county health partner is the El Dorado Hills Community Vision Coalition, a non-profit that supports youth programs, which educate young people about the dangers of drinking alcohol, smoking and bullying. The coalition also supports mental health programs that serve youth as well as nutrition education.
Vision Coalition Executive Director DJ Peterson is the spokesman and advocate for the community and works to make the youth programs happen. “The loss of a job, low income, child abuse, neglect, drug or alcohol abuse … any of these could trigger a mental health problem,” he said.
Peterson said he sees stigma as a huge problem, particularly in El Dorado Hills. “Some parents are in denial that their kids might have serious emotional problems,” he said.
Scammon also talked about unique challenges facing El Dorado Hills’ youth. “Some kids are feeling the effects of pressuring parents,” she said. “Recently a vice principal from El Dorado Hills said, ‘I can have a meeting about mental illness and 15 parents show up. I can have a meeting about AP classes and 300 parents show up.’ How can we get the mental health messages into those meetings? Perhaps it can take the form: How to deal with stress and expectations.”
“We had three suicides at the high school in the past few years,” said Peterson. “Five middle school kids were placed in lockdown between the start of school and Thanksgiving last year. It’s an issue and we need to do everything we can to make sure this doesn’t happen to another child.”
The county applied for a drug-free communities grant in 2000 to fund the coalition.
“They wanted to bring people together to do something about substance abuse. After three years they realized El Dorado Hills is the fastest growing population in the county,” said Peterson. “It was too hard to do county-wide, so they decided to focus on El Dorado Hills.
“Data showed young people in El Dorado Hills were doing substances and alcohol and drug use is proven to be related to emotional health,” explained Peterson. “When kids are having trouble they act out with drugs and/or alcohol or with violence. Half of people in LA County jails have a dual diagnosis of drug abuse and mental illness. That’s the end result. We want to catch them earlier, during middle school or high school when kids are acting out with drugs and alcohol.”
Previously Peterson worked at the State Department of Education and was in charge of drug, alcohol and tobacco abuse prevention programs. He has 40 years experience working in such programs.
The El Dorado Hills Vision Coalition makes assessments through community forums; analyzes data and trains people in effective strategies for dealing with young people ages 6-18; organizes community partners across 12 sectors, including business, parents, schools, youth organizations, civic organizations, faith communities and the media.
“We help pay for things like Safe & Sober Grad Night, Club Live, Friday Night Live — a whole variety of programs and services for kids,” Peterson said. “We fund proposals each year and 25 local groups do things on behalf of the Vision Coalition, including Hands4Hope.”
The Vision Coalition also uses Safe & Healthy Kids data to evaluate the success of their programs. “Since 2005, for instance, we’ve found drinking and binge drinking rates among teens in our community have reduced, as has drinking and driving and tobacco use,” said Peterson. “Marijuana use hasn’t changed much.”
Peterson would like to see more services in El Dorado Hills and Cameron Park. The two county mental health offices are located in Diamond Springs and South Lake Tahoe.
“Once kids are identified they need to get help,” he said. “We want prevention and early intervention where the need is. For kids it’s at the school sites.”
He’d like MHSA’s Primary Intervention Program expanded to include college students working toward their Marriage and Family Therapy licenses. These therapists in training could work in schools as interns, much like student teachers, to provide counseling services at low cost.
“We’d pay for the MFT supervisors for interns trying to get their hours,” said Peterson. “The interns have already done all their coursework, but they need 3,000 hours and they can get those hours in the schools. We’ve proposed the idea to the county.
“Half of long-term mental illness starts by 14. Two-thirds by 24,” Peterson continued. “That’s why we need real professionals. Sometimes we deal with kids with typical problems, maybe in their relationships. They can turn into long-term problems though.”
“We can’t fund everything,” Scammon said during a community forum at the El Dorado Hills Library. “There are 63 schools in the county. If we give $10,000 per school for extra counselors that’s $630,000. We pay for programs, but schools pay for counselors with their own funding. Last year we had 27 PEI (prevention and early intervention proposals) programs proposed that would cost $2.5 million. If we had unlimited funding, that would be wonderful.”
Peterson said the Vision Coalition is working to realize three goals:
- Prevention. “When kids are hurting emotionally and socially we need to recognize that’s a real problem that could end terribly,” he said. “Prevention should be happening. They could kill themselves or wait until the problem gets worse and treatment becomes more difficult.”
- Early intervention
When asked whether people are more aware of mental health or times really have gotten worse for kids, Peterson said, “Things have changed dramatically. Fifty years ago only one person worked and one person was home supervising. People used to look out for the kids down the street. Now people are afraid of getting sued and the extended family is all spread out.”
The county’s 2014-15 MHSA Plan Update has been posted at edcgov.us/MentalHealth/MHSA.aspx under “MHSA Plans and Updates.”