Impact to date in Sacramento County RAND report on Statewide - - PDF document
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
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Sacramento County MHSA Steering Committee
May 21, 2015
The California Mental Health Services Authority Ann Collentine, MPPA
Program Director
Update on PEI Statewide Projects
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A 2004 California Voter‐Approved Initiative (Prop 63) initiated an average of $1 billion in annual funds to support community‐based mental health services
Suicide Prevention
How did California Mental Health Services Authority (CalMHSA) Begin?
20% of funds goes to Prevention and Early Intervention (PEI) Counties through CalMHSA implement statewide prevention programs Seeks transformation from a system driven by crisis to
wellness and recovery, and reducing disparities
Nearly 15 years ago the US surgeon general identified the stigma of mental illness as the formidable
improving mental health.
SHORT TERM OUTCOMES What are immediate targets of change?
LONG TERM OUTCOMES What negative outcomes are reduced?
uicide
tudent failure/
educed trauma impact
Short Term and Long Term Outcomes
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Communities
Over 50,000 educated through hearing personal stories 95%
igns 44,000 students attended Walk in Our S hoes Play 250,000 trained in PEI strategies
Individual
policies, practice standards, media-reporting
(e.g. teacher credentialing & mental health parity)
Statewide
CA’s Public Health Approach:
Targets Stigma, Improves Mental Health, Reduce Costs
Sacramento County Impact
Sacramento County Schools.
In Our Shoes.
WalkInOurShoes.org.
2014, 15 in 2013
winner resided in Sacramento County.
More than 3,700 individuals visited ReachOutHere.
Campaign resulted in 55.9 million views
Nearly 8,000 visits from County residents to EachMindMatters.org
6,100 individuals reached through various programs
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Educational Campaign
students both English & Spanish
Eng Engaging aging Yo Youth
viewed performance.
more involved after seeing the presentation
http://walkinourshoes.org/ http://ponteenmiszapatos.org/
Fotonovelas
dialogue in families in English & Spanish
Directing Change
contest
ReahOut.com
moderated by peers
non‐users have greater knowledge and positive attitudes towards mental illness
http://us.reachout.com/ http://us.reachout.com/bu scaapoyo
more than 3,000 students have directed change, resulting in 1200 films from over 112 campuses
http://www.directingchange.
http://www.sanamente.org/
Primary Care: Integration & Parity
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Suicide Prevention: My3 App and Training
Resources, Contacts & Safety Plan
program that seeks to increase the capacity for employers to respond more appropriately when employees have mental health issues, and promote mental wellness in the workplace
types of online education to fit the needs of each workplace
www.mhwellnessworks.org
Mental Health in the Workplace
“Studies estimate the economic cost of $105 billion annually through the impact on productivity from untreated mental health conditions” ‐ Wellness Works
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HEALTH
Statewide Stigma and Discrimination Reduction Programs Statewide Suicide Prevention Programs
Evaluating California’s Statewide Programs for Prevention of and Early Intervention with Mental Health Problems
Information Materials Websites Hotlines Training/Presentations Social Marketing Prevention and early intervention programs seek to prevent mental health problems and reduce adverse outcomes for people already affected Goals of statewide programs:
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Statewide Suicide Prevention Programs Suicide causes over 4,000 deaths in California each year
500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 Suicide Homicide 1,989
Based on 2013 data
Number of Deaths 4,025
8 Statewide suicide prevention programs included
Social marketing Gatekeeper training
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21% newly exposed 2014 35% exposed 2013 44% unexposed
Those newly exposed to Know the Signs showed increased confidence in intervening with people at risk for suicide
1 7 Unexposed Newly Exposed 4.0 4.4*
Strongly Disagree Strongly Agree
Confidence to Intervene *significant difference
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Predicted effects of one year of CalMHSA investment in ASIST on averted suicide attempts and deaths in the future
79 ASIST trainers trained each year On average, each of 79 will Train 50 trainers per year, for 3 years. The 12,000 trainers will train
least 3,600 suicide attempts (including 143 deaths) over 28 years CalMHSA hired Livingworks to train ASIST Trainers ($0.4M per yr)
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 (Monetary value for every $1 spent) $1,100
CA state income taxes gained $17 million Medi-Cal costs saved $1 million
CA Government Benefit: Cost Ratio (Monetary value for every $1 spent) $50
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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
Statewide Stigma and Discrimination Reduction Program
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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
Information materials Websites Training/presentations Social marketing Intervention Activities
Social change Individual change Institutional change
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We examined the state of stigma in California over 2 years
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)?
Information materials Websites Training/presentations Social marketing Intervention Activities 17 89 45 95
20 40 60 80 100
CalMHSA Reach Total Potential Reach 2013 2013 or 2014 2013 2013 or 2014 Percent of people reached
Exposure to CalMHSA stigma reduction programs over 2 years
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43 74 41 79
20 40 60 80
. . . people are generally caring and sympathetic to those with mental illness . . . people with mental illness experience high levels of prejudice and discrimination
*
Percent agreeing that . . .
*
*Difference is statistically significant
2013 2014 2013 2014
35 23 30 30 19 28
10 20 30 40
Unwilling to move next door to someone with a serious mental illness Unwilling to spend an evening socializing with someone with a serious mental illness Unwilling to work closely on a job with someone with a serious mental illness
* * * 2013 2014 2013 2014 2013 2014
Percent saying they were . . .
*Difference is statistically significant
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24 51 26* 53*
20 40 60
Have you (yourself) ever had a mental health problem? + Do you have a family member who has had a mental health problem?
Percent “yes”
*Difference is statistically significant
2013 2014 2013 2014
41 81 41 73
20 40 60 80 100
People are generally caring and sympathetic to people with mental illness People with mental illness experience high levels of prejudice and discrimination
*
Percentage strongly or moderately agreeing
CA Adults in Distress CA General Population
*Difference is statistically significant
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Discrimination is common ‐ in various relationships and settings
20 40 60 80
Family Dating/intimate relationships Marriage/partner/divorce Making/keeping friends School/on-the-job training Employer Social activities Potential employer Police Mental health staff Physical health staff People in neighborhood Finding/keeping housing Percent treated unfairly within past 12 months
66 63 35 60 57 36 44 35 44 35 41 36 24
Only a subset of those seriously distressed sought treatment
59% 59% Sought treatment 41% did not seek treatment
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Conclusions
Conclusions: Stigma and Discrimination
Stigma reduction efforts have already reached large numbers of Californians and reach is growing Stigma has decreased over the course of these efforts
Reaching Californians, Reducing Stigma Discrimination and Unmet Need for Treatment are High
9 in10 experienced discrimination in the past 12 months 1 in 3 Californians with mental health concerns still feel inferiority, shame, and disappointment in
themselves 41% who probably needed mental health treatment didn’t seek it
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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
Ann Collentine, MPPA
Program Director Ann.Collentine@CalMHSA.org