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Mental Health Services Act (MHSA) Innovation Extension Request

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Mental Health Services Act (MHSA) Innovation Extension Request Mental Health Services Act (MHSA) Innovation Extension Request LGBTQ Behavioral Health Coordinated Services (The Pride Center) November 19, 2018 Table of Contents Background San Mateo County Pride Center………….…………………………....Page 3 Community Need …………………….……….………………………….Page 3 o High Risk of Mental Illness o Culturally Appropriate Services o Linkages to Comprehensive Services Accomplishments ………….…………………………………………...Page 4 o Pride Center’s Reach o Participant Demographics Learning Goals Evaluation Findings To-Date ………………………..........................Page 5 o Learning Goal #1 (Collaboration) o Learning Goal #2 (Access) Extension Request Why an Extension? ……………………………………………………...Page 7 Extension Goals …………………………………………………………Page 7 Extension Request ……………………………………………………...Page 9 o Added Value to an Extension Sustainability …………………………………….………………………Page 9 Community Input Community Program Planning………………….…………………...Page 10 Appendices A. Pride Center Services B. Evaluation Data Collection Plan C. Pride Center Budget D. Public Comments Received San Mateo County MHSA Innovation Extension Request San Mateo County Pride Center Community Need The Pride Center is an MHSA Innovation High Risk of Mental Illness project, approved by the Mental Health LGBTQ+ are considered one of the most Services Oversight and Accountability vulnerable and marginalized communities. Commission (MHSOAC) on July 28, 2016. Many experience multiple levels of stress There is no prior model of a coordinated and risk for Serious Mental Illness (SMI) approach across clinical services, psycho- due to constant subtle or covert acts of educational and community/social events homophobia, biphobia and transphobia. and resources for the LGBTQ+ community. LGBTQ+ individuals are at higher risk of mental illness compared to non-LGBTQ+.1 It is a formal collaboration of community- Nationally, suicide is second leading cause based organizations; StarVista as the lead of death for LGBTQ+ youth ages 10-24.2 agency, Daly City Partnership, Peninsula Family Service and Adolescent Counseling The LGBTQ Commission in San Mateo Services. The services include: County conducted a survey in 2018 of Clinical services for individuals at LGBTQ residents and employees. In San high risk of or with moderate to Mateo County, over half of LGBTQ+ adults surveyed responded that they needed severe mental health challenges. access to a mental health professional in the Psycho-educational and community past 12 months. Additionally, over three- activities to provide support through quarters of the LGBTQ+ youth surveyed peer-based models of wellness, reported that they considered harming recovery and stigma reduction. themselves in the past 12 months.3 Resource hub for local, county and 1King, M. et al., 2008; 2The Trevor Project; 3San Mateo national LGBTQ+ services. County LGBTQ Commission, 2017 Survey of LGBTQ Residents and Employees of San Mateo County JULY 2016 DEC. 2016 JUNE 2017 FEB. 2018 JUNE 2018 MHSOAC approves Pride Center site Grand opening Community One‐year funding secured Advisory Board anniversary SEPT. 2016 MARCH 2017 FALL 2017 APRIL 2018 Collaborating Soft opening Clinical services Receives Kaiser agencies selected operational grant San Mateo County MHSA Innovation Extension Request Page 3 of 15 Culturally Appropriate Services Participant Demographics There is often mistrust of behavioral health care in Demographic data shows a diverse participant LGBTQ+ communities due to historical trauma, base for the Pride Center: shame and stigma around seeking care. In San 85% are between age 16 and 59; 8% were Mateo County, surveyed residents reported limited 60+; 5% were 15 or younger access to LGBTQ-responsive behavioral health 52% were people of color or multiracial services.4 Over two-thirds identify as LGBTQ+ 3 in 5 adults cited lack of local health 62% are cisgender, 16% are transgender, professionals trained to serve LBGTQ+ clients gender queer, questioning, or other 2 in 5 felt their mental health care provider had 10% reported being unemployed the expertise to care for their needs 16% reported annual income < $25,000 2 in 3 youth did not know where to access LGBTQ-friendly healthcare Linkages to Comprehensive Services The LGBTQ Commission survey also indicated that there is a need for interagency coordination to connect under-served LGBTQ+ residents to social services and community resources.5 LGBTQ+ county residents are socially isolated 2 in 5 adults struggle to pay for basic needs like rent and food 3 in 5 youth reported lack of LGBTQ+ inclusive sex education in school Accomplishments The Pride Center provides an array of programs, events and clinical and supportive services for the LGBTQ+ community. Additionally, the Pride Center has collaborated with and trained service providers and community members across San Mateo County. See Appendix A for a comprehensive list of onsite programming, training and engagement efforts. Pride Center’s Reach (Fiscal Year 2017-18) 1,092 individuals dropped in or attended a peer group on site. o 15% accessed therapy services o 4% used case management services 2,045 people attended offsite trainings, workshops and events. 69% of participants who completed the satisfaction survey visited more than once o 41% visited at least six times 4-5San Mateo County LGBTQ Commission, 2017 Survey of LGBTQ Residents and Employees of San Mateo County San Mateo County MHSA Innovation Extension Request Page 4 of 15 Evaluation Findings To-Date An independent consultant, Resource Increased Capacity – the Pride Center Development and Associates (RDA), was has developed strong relationships that contracted to evaluate the Pride Center. facilitate referral pathways. RDA implemented a mixed methods The Pride Center is building approach to their evaluation, see capacity for LGBTQ+ appropriate Appendix B for an evaluation overview. care. More providers know the Focus groups, surveys, and interviews importance of asking sexual with participants and service providers orientation and gender identity informed the Learning Goals: (SOGI) questions. Educators, public agencies, and Learning Goal #1 (Collaboration): private businesses have actively sought the Pride Center. Does a coordinated approach improve service delivery for LGBTQ individuals at high risk for or with moderate to severe mental health challenges? Outcome Process Evaluation Evaluation Baseline Objective. Measures Examines how systems improved effectively collaborate behavioral currently to serve LGBTQ+ health indicators from Process Measures. pre/post Examines the increase in scales and communication, referrals, and client interaction between service satisfaction providers surveys Wide Range of Services –the Pride Center’s collaborative model has been instrumental in providing services for diverse participant needs. Each of the 4 partner organizations brings different specializations. High Quality Services – team cohesion and commitment to continuous learning have enabled high delivery of services. Coordination helps participants who benefit from multiple services get the support they need like job opportunities, applying for public assistance, searching for housing. 0% 20% 40% 60% 80% 100% It's easy to get connected to other services 88% 11% within the Pride Center. (n=152) It's easy to get connected to other services 69% 23% outside of the Pride Center. (n=142) Agree Somewhat Agree San Mateo County MHSA Innovation Extension Request Page 5 of 15 Learning Goal #2 (Access): Does the Pride Center improve access to behavioral health services for LGBTQ individuals at high risk for or with moderate to severe mental health challenges? Outcome Process Evaluation Evaluation Baseline Objective. Examines Measures clients extent staff are prepared to provide experience with culturally responsive services to the the Center LGBTQ+ community services as helpful and Process Measures. Examines culturally improvement in access to responsive behavioral health services for individuals that are high risk for or with moderate to severe mental health challenges Culturally Responsive Services – services offered by and for LGBTQ+ engages individuals who might not otherwise access or remain in clinical care. Participants feel more understood and supported compared to previous experiences. Participants begin treatment with a sense of trust, setting the foundation for a strong patient/provider relationship. 85% agreed and 15% somewhat agreed that the services they were receiving were improving their mental health. Reduced Stigma – having a physical location that is safe, inclusive space creates community, reduces stigma and isolation. Many participants said that the existence and prominent public location helps them feel welcome and proud. 80% 84% 88% 92% 96% 100% Staff understand & affirm my sexual orientation. (n=162) 99% 1% Staff understand & affirm my gender identity. (n=162) 99% 1% Staff are courteous and friendly. (n=172) 98% 2% Staff are responsive when I have requests. (n=165) 95% 5% Staff understand & affirm my culture/ethnicity. (n=160) 98% 1% Agree Somewhat Agree SanSan Mateo Mateo County County MHSA MHSA Innovation Innovation Extension Extension Request Request PagePage 6 of 615 of 15 Why an Extension? While the project was approved in July 2016, the Pride Center undertook several foundational activities related to planning and startup including identifying and securing a centrally located, accessible site, obtaining start-up items and systems and recruiting staff. Prior to the opening of the Pride Center there
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