The following is a summary of some key MHSA topics addressed by NAMI California from January to June of this year. We will continue to focus on these issues and others that will inevitably be raised during the course of the next year. Thank you for your support and all you do to contribute to NAMI California's advocacy on MHSA.

NAMI CaliforniaMHSA Survey

Thank you to everyone who participated in NAMI California's Survey on the Impact of the Mental Health Services Act. NAMI California values our members' assessment of the quality and accessibility of mental health services as the MHSA continues to be implemented throughout our state. Though ours was not an attempt to scientifically evaluate implementation, with 87 respondents participating from 36 counties, the results are nonetheless informative and shed light on the perspectives of some of our most involved members. Some respondents have observed significant developments in program quality and access, while others report that the quality and access to mental health services in their counties still has a long way to go. The responses by survey participants draw attention to significant factors pointing to uneven implementation, such as geography, the economic downturn, and a multi-tiered system. This survey report should be viewed as a tool for discussion, as it highlights both areas of success and disappointment. The perspectives of our members are valid and they can be used as a framework for building a more thorough evaluation of the mental health system. While it is imperative for a systematic evaluation to scientifically obtain and analyze quantitative data, it is of equal value to integrate consumer and family member perspectives and quality of life outcomes throughout. NAMI California's Survey Report can be found here: http://www.namicalifornia.org/mhsa-surveys.aspx?tabb=surveys&lang=ENG

MHSA Evaluation

The MHSA evaluation committee has secured a contractor, Resource Development Associates (“RDA”), to begin the first phase of evaluation of the MHSA: defining the scope of work. RDA has completed the work of researching how the evaluation will be structured. After the first draft of the Request for Proposal was circulated, however, NAMI California and other statewide community partners determined that issues of importance such as consumer and family member involvement, cultural and ethnic inclusion, and the evaluation of MHSA values such as recovery and resiliency were not adequately represented. Instead, it was proposed that we choose only one of these three categories to evaluate. Due to the advocacy of statewide community partners, a revised draft is now being circulated, allowing time for further discussion on the Evaluation Request for Proposal before it goes to the Commission for approval in July.

Statewide Projects

At the state level, we are interacting with a new entity, a Joint Powers Authority acting on behalf of counties, called the California Mental Health Services Administration (“CalMHSA”). At this level, it is our responsibility to represent NAMI California consumers and family members to prioritize strategic actions for the statewide strategic plans addressing Stigma & Discrimination, Suicide Prevention, and Student Mental Health. We now attend monthly board meetings of CalMHSA and will be attending meetings of statewide stakeholders that we anticipate will be held in July. CalMHSA is not the sole entity authorized to administer these projects. The other two options are for counties to assign their funds to the state DMH or to engage in a multi-county collaborative. The county decision regarding the assignment of funds for these projects must be made with the input of community stakeholders. See the guidelines for the administration of statewide projects for further details: http://www.dmh.ca.gov/DMHDocs/docs/notices10/10-06_PEIGuidelines.pdf. CalMHSA has just released its plan for statewide stakeholder input for these projects. NAMI California values your input and looks forward to hearing from you. You can review CalMHSAs plan and instructions here: http://www.calmhsa.org/, and review the Strategic Plans for Stigma & Discrimination http://www.dmh.ca.gov/PEIStatewideProjects/docs/Reducing_Disparities/CDMH_MH_Stigma_Plan_09_V5.pdf, Suicide Prevention http://www.dmh.ca.gov/Prop_63/MHSA/Prevention_and_Early_Intervention/docs/SuicidePreventionCommittee/FINAL_CalSPSP_V9.pdf, and Student Mental Health http://www.dmh.ca.gov/MHSOAC/docs/StudentMentalHealth%20Initiative_091807.pdftby clicking on the appropriate links.

Training and Technical Assistance

The subject of training and technical assistance for community capacity building was raised in the May 2010 meeting of the MHSOAC Services Committee. Training and technical assistance had been originally slated as a statewide project, but in July 2008 the MHSOAC agreed to release the funds to the counties for local administration. The purpose of this training is to strengthen partnerships and capacity within local communities through, e.g., community organizations, education, social services and law enforcement. In addition, much of this training was intended to utilize the lived experience of consumers and family members. Since we were informed that the funding requests submitted to DMH by the counties for training and technical assistance are not regularly tracked by the MHSOAC, as to purpose and outcome, we brought up the subject of tracking these funding requests at the June Funding and Policy Committee meeting. At that meeting, the MHSOAC directed staff to begin this process. We hope this will help focus attention on ensuring that training and technical assistance funds are used to build capacity among local community partners. At the same time, we need to advocate at both the local and state levels for efforts to be made by counties to utilize the expertise of consumers and family members in community partner trainings.

MHSA Partners Forum

The MHSA Partners Forum is a collaborative communication venue between government and community stakeholders. NAMI California hosted this forum on May 5, 2010. Agenda items included the promotion of using MHSA funds for 1) consumer and family run services, including NAMI programs, 2) Working Well Together, the collaborative between NAMI California, UACF, The California Network of Mental Health Clients and CiMH which promotes consumer and family member employment in the system, 3) Peer Run Programs and Support; and 4) Crisis Residential Programs as recovery-oriented alternatives to hospitalization. As a result of the discussion between community and government partners at this meeting, it was decided that interested organizations would collaborate on a letter to the County Mental Health Directors Association (“CMHDA”) emphasizing the importance of increasing the use of consumer and family member driven services, like those outlined above, in challenging fiscal times. This letter was reported to be well received by the CMHDA governing board and the issue will be taken up in the July All Directors Meeting. A copy of the June 9, 2010 letter can be found here.

MHSA Partners Letter to County Mental Health Directors, June 9, 2010

Crisis Residential Programs List

MHSAOAC Fast Facts 2010

The Mental Health Services Oversight and Accountabillity Commission has released comprehensive updates on the implementation and status of the Mental Health Services Act. The report includes fast facts on outcomes, prevention and early intervention programs, projections of consequences if Prop. 63 funds are diverted by the Governor, cost-effectiveness of services, and new programs funded by the Act.

Click here to read the report.

Source: NAMI California

MHSA REPORT

January 2010 – February 2010

MHSOAC Involvement

The Mental Health Services Act (“MHSA”) is not intended to be a static document, but rather one that requires continuous action in order to fulfill its transformative goals for the public mental health system. As primary stakeholders in this outcome, it is our job to oversee this enactment and ensure that this living document becomes a permit for renewal – injecting hope into what has historically been a dysfunctional and disjointed system. Because of the high stakes involved, concerned consumers and family members should be kept informed of both the interpretation and administration of this Act. On the state level, oversight is carried out by the Mental Health Services Oversight and Accountability Commission (“MHSOAC”). The makeup of MHSOAC Commission membership, the schedule of monthly Commission meetings, and other relevant information, such as application for membership, can be found on this website: http://www.dmh.ca.gov/MHSOAC. In addition, the MHSOAC's 2010 Work Plan, adopted at the last meeting, can be found at: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_MHSOAC_2010_WorkPlan_01-27-2010.pdf.

Stakeholder Engagement

On January 29, a Stakeholder Workshop was held by the Chair and Vice-Chair of the MHSOAC. Over 30 statewide and community mental health stakeholders attended the meeting to give input on strengthening the stakeholder process on both local and statewide levels. Partial notes of the meeting were taken by the MHSOAC and recommendations were made by the Chair which reflect some, but not all, of the voices present: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_4_Stakeholder_Workshop_Notes.pdf.
http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_4_AP.pdf.

NAMI California wrote a letter to the MHSOAC about our recommendations for stakeholder improvement and, at the last Commission meeting, urged time for others to do so before the MHSOAC voted on official recommendations. Our letter was included as an exhibit to the agenda of February's Commission meeting: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_4_NAMI_Response.pdf.

Commission Vacancies

Unfortunately, two client and family member Commission positions have remained vacant for over two months. This means that important issues affecting clients and family members are being voted on without the client and family member representation provided for by law. Recommendations for appointments have been made to the governor, but these appointments have not yet been signed. Please send a letter or email to Governor Schwarzenegger today to let him know how important it is that these positions are filled:

Gov. Arnold Schwarzenegger

State Capitol, Sacramento, CA. 95814

http://www.govmail.ca.gov

MHSOAC Committees

MHSA policies and components are overseen and processed by committees of the MHSOAC and voted on by the Commission. Applications for membership on these committees can be made directly to the MHSOAC. http://www.dmh.ca.gov/MHSOAC/Contact.asp. The standing committees of the MHSOAC include: Client and Family Leadership, Cultural and Linguistic Competency, Services, Funding & Policy, and Evaluation. A brief description of activity in these committees over the past two months follows:

Client and Family Leadership Committee (“CFLC”)

This committee is engaged in representing the concerns of consumers and family members, not only as clients in the system but also in the protection of advocacy rights. The committee is composed of consumers and family members throughout the state, with at least one NAMI member and one NAMI Board member on the roster representing our concerns. The most recent undertaking of the CFLC in recent months has been their work on improving conditions for public comment at the monthly Commission meetings. Two of the recommendations of the CFLC, including protecting the three-minute per person time limit, and providing an additional period for public comment in the morning session, passed via narrow margins. Over the past two months, the CFLC has been tasked with developing their annual work plan and Charter. This is still in draft form, but can be reviewed here: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_CFLC_Charter_2010.pdf. In addition, committee membership is also listed on the MHSOAC website: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_CFLC_Membership_List.pdf.

Cultural and Linguistic Competency Committee (“CLCC”)

The CLCC is tasked with the responsibility of attending to the concerns of those belonging to groups with a history of being marginalized, including but not limited to racial and ethnic groups. Extensive evidence reveals that these groups have much less access to mental health services than most individuals with mental health conditions. Because of this, it is important to pay close attention to the work of this committee to represent the concerns of our constituents whenever possible. One focus of the work of this committee is the work that is being done on the Statewide Project on Reducing Disparities. The 2010 Charter of this committee, also in draft form, can be reviewed here: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_CLCC_Charter_2010.pdf, along with the CLCC membership list http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_CLCC_Membership_List.pdf.

Services Committee

In recent months, the focus of the Services Committee has been on writing the guidelines for administering the statewide projects of Suicide Prevention, Student Mental Health and Stigma & Discrimination. These guidelines were approved on January 28, 2010. They appear in draft form here: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Jan/Tab_5_Draft_Guidelines_for_PEI_Statewide_Project_Funds.pdf. NAMI California expressed concern with the fact that these guidelines do not specifically outline the processes for stakeholder involvement at state and local levels in our January 19, 2010 letter to the Services Committee.

Funding & Policy Committee

Discussion in this committee has necessarily been focused on the economic downturn and the decreasing revenues now available for the MHSA. The committee hired a consultant to assist them in the preparation of financial documents which were presented to the MHSOAC on January 28, 2010. These documents will be part of a regular financial analysis and update given by the Commission. The financial presentation given in January 2010 does not appear to be posted, but other financial documents and the MHSA Performance Dashboard can be found on the site for past meetings: http://www.dmh.ca.gov/MHSOAC/Prior_Meetings_2010_01.asp . In addition, the Charter for the Funding & Policy Committee: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_MH_Funding_Policy_Charter_2010.pdf and the committee membership list: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_MH_Funding_Policy_Members_2010.pdf are posted here for your review. Kathleen Derby applied for a position on this committee in February 2010 and that application has been accepted.

Evaluation Committee

This committee has secured a contractor, Resource Development Associates, to begin the first phase of evaluation of the MHSA: defining the scope of work. In this regard, the contractor contacted NAMI California, conducting a phone survey of Dede Ranahan and Kathleen Derby. While multiple topics were discussed, NAMI California input emphasized obtaining both quantitative and qualitative input from consumers and family members during the course of this evaluation. Kathleen Derby's application for membership on this committee was subsequently accepted. The 2010 Evaluation Committee Charter http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_Evaluation_Committee_Charter_2010.pdf and membership list: http://www.dmh.ca.gov/MHSOAC/docs/Meetings/2010/Feb/Tab_2_Evaluation_Committee_Membership_List.pdf are here for your review.

Other Areas of Statewide Involvement

Mental Health Planning Council

Though the Mental Health Planning Council is an oversight organization independent of the MHSOAC, they are working to inform the MHSOAC's Evaluation Committee, as they have been charged with developing performance indicators for the MHSA. Their Performance Indicator Proposal may be found at: http://www.dmh.ca.gov/Mental_Health_Planning_Council/docs/Meetings/2009/Oct/PerformanceIndicatorProposal909.pdf.

While their proposal is extensive, and includes a number of thoughtful factors, NAMI California's October 2009 letter urges a reexamination of some data sources in an attempt to include valid qualitative feedback from consumers and family members that focuses on quality of life concerns.

MHSA Partners Forum

NAMI California continues to be involved in coalitions with other members of the statewide advocacy community. The MHSA Partners Forum is a collaborative communication venue between government and community stakeholders.

CMHDA Social Justice Advisory Committee

This is a fairly new committee created to advise the California Mental Health Directors Association (“CMHDA”) on issues of social justice. Along with the Ethnic Services Committee, its purpose is to “support, and assist CMHDA in decision and policy making that aims to reduce disparities in service areas and care across diverse populations.” Further details that support this purpose may be found here: http://cmhda.org/go/Portals/0/CMHDA%20Files/Committees/SJAC/0907_SJAC%20Purpose%20Statement_Approved_070909.pdf.

MHSA Goes Into Wider Implementation

From The California Department of Mental Health by Staff Writer, July 25, 2008

Based on reports from counties during the third quarter of Fiscal Year 2007-08, a total of Mental Health Services Act programs provided services to 212,592 people, including:

•140,619 were served by System Development services, such as peer support, education and advocacy, and mobile crisis;

•54,042 were served by Outreach and Engagement services, which help reach out to people who need but are not receiving services and support; and

•17,931 participated in Full Service Partnerships, which provide a broad range of mental health and other supports to help consumers and family members achieve life and mental health recovery goals. See page 3 for more information about people participating in Full Service Partnerships.

For more information, read the latest Progess Report.

Source: The California Department of Mental Health

Dropping In - an MHSA Success

Behavioral health resources thrive at new Amador Country drop-in center funded by MHSA.

From The Ledger-Dispatch by Bethany Monk , July 4, 2008

Reaching out for help can be a "magical" thing.

That's how Michael Brown describes his continuing journey to heal and be healed, a journey that required him to call out to others for help in the midst of his darkest moments. The magical part, he said, is that he finally began the healing process.

Brown is like a quarter of American adults who suffered or currently endure some sort of diagnosable mental health disorder. Today, he is mining his personal struggles to help others, volunteering at a mental health drop-in center in Sutter Creek.

Brown and Michele Curran, a contract worker, are able to help staff the center once a week thanks to grant funds from the Mental Health Services Act. The drop-in center is open every Friday from 1 to 4 p.m. at the Behavioral Health Department in Sutter Creek. It's a casual, friendly environment for anybody who has at any time experienced mental health concerns, Curran said. People who visit the center, where Brown provides resources, information, support and a listening ear, can ask questions, share their stories or listen to others.

In other words: There's no pressure.

"It's a common social setting," Curran said. "People come and go (during the drop-in time) or stay the whole time."

Nationwide, about 26.2 percent of Americans 18 and older - about one in four adults - suffer from some sort of diagnosable mental disorder in a given year, according to the National Institute of Mental Health; this translates to about 57.7 million people when applied to 2004 U.S. Census data.

Mental disorders may include major depressive, bipolar, panic, anxiety and post-traumatic stress disorders, as well as schizophrenia and social phobia, among others. For more information, including a complete listing of mental disorders, their symptoms and treatment procedures, visit www.nimh.nih.gov.

The drop-in day at the Behavioral Health Department is not a therapy session, but rather a place where people can exchange information, find support and begin the healing process, Curran and Brown said. It's open to anyone 18 and over.

The service opened its doors to the public in the beginning of June and Brown said visitors have been trickling in. Some have even suggested activity ideas they'd like to see implemented in the future, such as the Wellness Recovery Action Planning program, currently in operation in Calaveras County. Curran said W.R.A.P., a program that helps participants organize wellness tools and turn them into action plans to deal with life issues and issues related to mental illness, will finds its way to Amador County in the near future.

The drop-in center and future W.R.A.P. program are both part of the grant's first phase, as other programs and resources will be implemented in the future.

"I'm happy with our block of time," Curran said. "We're moving forward."

Curran added that she has "this fantasy of a Taj Mahal respite place."

The Mental Health Services Act, or MHSA, was made possible by the passage of Proposition 63 in November 2004. With the act came the opportunity for the California Department of Mental Health to provide increased funding, personnel and other resources "to support county mental health programs and monitor progress toward statewide goals for children, transition age youths, adults, older adults and families," the department's Web site states.

Gov. Arnold Schwarzenegger's budget, thus far, includes $5 billion for the Department of Mental Health in 2008-09, which is an increase of $144.4 million from the revised 2007-08 budget and an increase of $159.4 million from the Budget Act of 2007, according to the governor's Web site.

Terri Daly, the county's administrative officer, said that it's possible the state's budget, which should be finalized sometime in the fall, may cut county social and mental health services.

Funds from MHSA will not be affected by the state's finalized budget, according to George Sonsel, director of the Amador County Department of Behavioral Health. The county is scheduled to receive $1.8 million from the act over the next couple of years, Sonsel said.

For more information on the Amador County Behavioral Health Department or the drop-in center, call 223-6412 or visit www.co.amador.ca.us/depts/mental/. The department is located at 10877 Conductor Boulevard in Sutter Creek and is open Monday through Friday from 8 a.m. to 5 p.m.

Source: The Ledger-Dispatch