Transformational Change Report: January – June 2022

SEMI-ANNUAL REPORT January 2022 –June 2022 mhsoac.ca.gov MHSOAC —Commission Semi-AnnualReport Commission Semi-Annual Report Jan 2022 –June 2022 LETTER FROM THE COMMISSION | JANUARY – JUNE 2022 Dedicated to the Wellbeing of All Californians This report covers six months of Commission activities designed to promote the mental wellbeing of all Californians and to reduce adverse mental health outcomes. Each quarter, the Commission, along with state, county, and local partners, work to make a difference in the lives of nearly 40 million people. The pages that follow provide a snapshot of our efforts and progress. It offers information and insights on interrelated initiatives, and priorities over the last six months. In Section 1 we focus on community engagement. The Commission sponsored or participated in over 128 community events in the last two quarters. This section provides information on the various types of community engagements the Commission uses, including teleconferences, learning collaboratives, and statewide conversations. In Section 2 this report provides an at-a-glance look at key activities surrounding each of our 11 strategic initiatives, showing how each is progressing. Sections 2 and 3 offer more in-depth spotlights of select initiatives and committees, their people, partners, and progress. In Section 4, we share how Commission staff are seeking to improve outcomes, promote prevention and intervention, and reduce disparities by analyzing data, consulting with experts, and engaging communities. 2 Commission Semi-Annual Report Jan 2022 –June 2022 01 Community Engagement 04 02 Strategic Initiatives: Jan -June 2022 Progress Report 07 Featured Initiative: Innovation Incubator 11 Featured Initiative: Suicide Prevention 13 Featured Initiative: Youth and Peer Empowerment 13 03 Committees 17 Featured Committee: Research and Evaluation 13 04 Advancing Transformational Change 21 05 What’s Next 27 Contents Commission Semi-Annual Report Jan 2022 –June 2022 01 COMMUNITY ENGAGEMENT Transformational change happens when the public – particularly those who access public services –are invited to shape those services, and local and state governments invest in that process. An essential commitment to community engagement is embedded in the Mental Health Services Act, which explicitly includes peers, families, advocates, and community representatives as members of the Commission and in its deliberations and decision-making. 4 Commission Semi-Annual Report Jan 2022 –June 2022 Commission and Committee Learning PublicMeetings Collaboratives COMMUNITY ENGAGEMENT How our meetings, conferences, and engagement efforts work. Community Partner Statewide Engagements Conversations Commission and Committee Public Meetings Learning Collaboratives Routine teleconference meetings for the Commission Commission initiatives happen statewide and at a local and committees allow Commissioners, committee level, and collaboration with counties is critical. Learning members, and members of the public to work together collaboratives are a way for counties to work together, on exploring goals, discussing future action, and learn from each other, and accomplish their goals, like 11 reviewing results. This included meetings of the Client counties are doing as part of the Striving for Zero Learning and Family Leadership Committee, Fellowship Advisory Collaborative on Suicide Prevention. This collaborative Committee, Cultural and Linguistic Competency met three times in the first half of the year, advancing Committee, and the inaugural meeting of the Children’s suicide prevention efforts through shared experiences and Committee. The first half of 2022 also saw the return of training. The Commission also hosted a technical hybrid Commission meetings, with some assistance webinar with SB-82 and SB-833 Adult/TAY and Commissioners, presenters, and members of the public Child/Youth grant programs to review data collection attending in person at the Commission’s office and some processes and share best practices, as well as conduct a attending remotely. Triage Summative Evaluation meeting with grantees. Community Partner Engagements Statewide Conversations Community partner engagement grants help specific Engagement in mental health also drives Commission staff communities build an understanding of mental health to participate in conversations outside the Commission. In needs and advocate for solutions. These grants support the first half of 2022, Commission staff presented and community events, from statewide gatherings like NAMI moderated a panel of experts on crisis services during the California’s Capitol Day, to local ones like United Parents’ Words to Deeds track at the 47th Annual Forensic Mental Lunchtime Advocacy Panel sessions. The Commission also Health Association of California Conference, presented at supports virtual discussions, like those hosted by Art With the Breaking Barriers Interagency Symposium, and Impact, including their virtual film festival, Voices With facilitated a breakout group at the Department of Social Impact, in July. Filmmakers with lived experiences shared Services, Office of Child Abuse Prevention’s statewide work around the themes of grief, resilience, substance use convening to support cross-sector prevention planning disorder, and recovery. Vice Chair Mayra Alvarez and teams formed to prevent child abuse in counties. Commissioner Itai Danovitch each introduced one of the Commission staff also presented at meetings of the featured films, speaking about the film as it relates to both California Behavioral Health Planning Council, the Advisory the Commission’s work and their own personal and Commission on Special Education and more. professional experiences. 5 Commission Semi-Annual Report Jan 2022 –June 2022 Community Engagement Much of the Commission’s most valuable (and often unseen) work is in intentionally and consistently constructing ways to convene community voices. We host, sponsor, and engage in conversations, workgroups, and collaboratives designed to elevate community voices and through those voices create change. Over the first half of 2022 we participated in 128 community events across 7 meeting platforms (webinars, conferences, teleconferences, site visits, presentations, virtual listening, and sponsored events). Organizations involved included: • Forensic Mental Health Association of California • NAMI California • Department of Social Services, Office of Child Abuse • The Veterans Art Project Prevention • California LGBTQ Health and Human Services • Fellowship Advisory Committee Network • Cultural and Linguistic Competency Committee • United Parents • Research and Evaluation Committee • California Youth Empowerment Network • Client and Family Leadership Committee • Boat People SOS Center for Community Advancement • CCESSA Learning Collaborative • The Cambodian Family • Children’s Committee • Center for Empowering Refugees and Immigrants • California Department of Public Health, School-Based • Level Up NorCal Health Center Statewide Collaboration Workgroup • Healthy House • California Behavioral Health Planning Council • Child Abuse Prevention Council of San Joaquin • Advisory Commission on Special Education County • Fellows at the University of California, San Francisco • African Communities Public Health Coalition • PhRMA California Task Force, Health Committee • Hmong Cultural Center of Butte County • Breaking Barriers Interagency Symposium • Healthy House Within a MATCH Coalition • California Pan-Ethnic Health Network • Vision y Compromiso • California Association of Mental Health Peer-Run Organizations 6 Commission Semi-Annual Report Jan 2022 –June 2022 02 INITIATIVES The Commission supports 11 strategic initiatives. These multifaceted, interrelated efforts together aim to improve mental wellbeing in California. 7 Commission Semi-Annual Report Jan 2022 –June 2022 Strategic Initiatives: Jan – June Progress Report INITIATIVE PROGRESS allcove™Youth Drop-in Centers • Presented to the California Department of Public Half of all mental health conditions begin by age 14, and Health’s School-Based Health Center Statewide 75 percent develop by the age of 25, making early Collaboration Workgroup to highlight how allcove™ detection and treatment urgent and critical. Based on a provides a continuum of care to youth outside of proven model from Australia, allcove™youth drop-in school centers expand early access to integrated mental health • Facilitated listening sessions with allcove™partners care for youth between 12 and 25 years of age and their and California Health Policy Strategies to explore the TM families. An allcove center has opened in Palo Alto, and challenges with providing services at no or low cost for five more communities have been awarded grants to all youth, regardless of insurance status open their new centers. These centers provide a one- stop-shop for mental health, physical health, substance use counseling, and educational, vocational, and peer support services, all informed by a youth advisory group. COVID-19 & Emerging Issues • Supported five mental health organizations at schools The pandemic has tested the capacity of the state’s across California doing on-campus education mental health systems to meet pre-existing and programs that elevate mental health and wellbeing, emerging needs of Californians. The Commission social-emotional learning, and peer support redirected $2.02 million to help county partners and service providers support their communities. The funds supported counties replicating a Solano County innovation project, the Interdisciplinary Collaboration and Cultural Transformation Model and engaged county behavioral health leaders on opportunities to adapt, extend, and replicate the work of the California Reducing Disparities Project. The remaining work in this project strengthens the Commission’s school mental health work through grants to on-campus organizations, with an emphasis on youth suicide risk and prevention. Criminal Justice Prevention • Continued exploring dataset linking mental health Following the 2017 adoption of its Together We Can report, consumer data with criminal justice data, including the Commission is using all tools –research, policy arrest and incompetent to stand trial information development, financial incentives, and technical assistance – • Moderated a panel at a statewide forensic mental to implement its recommendations to help counties and their health conference on opportunities to create an community partners build proactive and effective service integrated crisis care continuum that diverts people systems that reduce criminal justice system involvement for with mental health challenges from jail those living with unmet mental health needs. 8 Commission Semi-Annual Report Jan 2022 –June 2022 INITIATIVE PROGRESS Early Psychosis Intervention Plus • Implementing the first of its kind “Hub and Spoke” Nearly 100,000 adolescents and young adults experience model in Sacramento, Nevada, Colusa, and Mono their first psychotic episode each year in the U.S. With counties, allowing the counties to provide services half of all mental disorders manifesting by the age of 14 while receiving training and technical assistance from and 75 percent by the age of 24, the Commission is the “Hub” of UC Davis piloting the provision of high-quality Coordinated Specialty Care in seven grantee counties, focusing on early detection and intervention to improve the lives of adolescents and young adults, significantly reducing the impact of mental health challenges. Innovation Incubator • Supported six multi-county projects working to better The Mental Health Services Act (MHSA) includes a rare understand the mental health needs of people in the and explicit commitment to fostering innovation in criminal justice system and prevent and reduce providing services and support. Created in 2018 with $5 criminal justice involvement among those with unmet million in one-time funding, the Innovation Incubator mental health needs brings together county behavioral health agencies, • Concluded collecting information from surveys, subject matter experts, and other partners to drive interviews, and convenings and analyzed data for innovations that improve mental health outcomes for initiative evaluation. Lessons learned could help guide individuals and communities. improvements in the future uses of learning collaboratives by the Commission and other partners Prevention & Early Intervention • Advanced work on the Prevention and Early Everyone should have the opportunity to be well and Intervention draft report. The draft report was thrive, yet one in four people worldwide will experience a released for public comment in August 2022 significant disruption to their mental wellbeing at some • Partnered with state and local representatives to point in their lifetime. In 2019, the Commission launched explore tools and other supports to strengthen data a policy research project to explore opportunities for collection and reporting on programs funded by MHSA prevention and early intervention in mental health. Prevention and Early Intervention School Mental Health • Brought total number of MHSSA grantee programs to The Schools and Mental Health Project is a multi-year 54, supporting ties between education districts and effort to guide funding and policy decisions affecting the county behavioral health offices provision of mental health services to promote the • Released Request for Application to distribute $47 academic and social success of young people. The million to counties to enhance or expand current Commission has funded school-county partnerships programs or launch a new MHSSA program through grants to better integrate mental health services into schools. 9 Commission Semi-Annual Report Jan 2022 –June 2022 INITIATIVE PROGRESS Suicide Prevention • Brought Suicide Fatality Review training and technical Suicide in California is a significant public health challenge. assistance to three counties to train county staff and Guided by data and community input, the Commission community organizations to more effectively respond to developed a statewide strategic plan for suicide prevention suicide deaths that incorporates the latest information and evidence to guide • Linked mental health consumer data to suicide rates state and local actions for saving lives. Following the and incidence data Commission’s 2019 adoption of the plan, the Commission is working with governments and community partners to • Supported Suicide Prevention Learning Collaborative, implement recommendations from the report with the goal of helping counties develop and improve their suicide reducing the rate and incidence of suicide in California. prevention plans through learned and knowledge sharing Triage • Round 2 programs are concluding in 2022 Triage personnel or mobile crisis response teams may be • The Commission will identify priorities for crisis prevention the first mental health professionals in contact with and intervention for Round 3 of funding in 2023 someone requiring crisis intervention. This Mental Health Wellness Act grant program will help crisis responders • With recent changes to Senate Bill 82, the Commission connect those having a mental health episode with will explore opportunities to invest in programs that wellness, resiliency, and recovery-oriented programs expand crisis prevention and intervention services in that offer the least restrictive settings appropriate for hospitals, schools, community-based organizations, their needs. and county behavioral health departments Workplace Mental Health • Advanced work on Workplace Mental Health report Nearly one in five Americans live with a mental health • Presented on workplace mental health to California condition, yet there are no well-established and agreed-upon legislative staff to reduce stigma and increase standards in the U.S. to guide public and private employers awareness of the project about how to increase mental health awareness in the workplace, support prevention, and respond to needs with recovery strategies. The Commission is developing a framework of voluntary standards to support mental health in the workplace for all Californians. Youth & Peer Empowerment • Began research phase of Anti-Bullying Advisory Committee The Commission is working through advocacy funding, project. This project will create peer-to-peer support sponsored legislation, sponsored youth participation, through social media for youth who have been bullied and Committees to amplify the voices of youth and peer • Advanced work on Youth Innovation engagement leaders seeking to create innovative solutions in the playbook, a product of the Youth Innovation Project pursuit of emotional wellbeing and prevention. Planning Committee. This will be a resource for behavioral health departments to work with youth in planning • Convened Fellowship Advisory Committee twice (January 11 and April 5), which provided guidance on Peer Policy Fellowship and Clinician Policy Fellowship, their focus, and the Commission’s implementation plan 10 Commission Semi-Annual Report Jan 2022 –June 2022 FEATURED INITIATIVE: Innovation Incubator Background: The Mental Health Services Act (MHSA) provides dedicated funds to counties to innovate –to test and evaluate practices to improve the wellbeing of Californians. The Commission is working with counties to help them build the capacity to pursue innovations to improve outcomes. The Commission established the Innovation Incubator to Progress: January – June ’22 decrease the number of people with mental health Beginning in 2019, 26 counties participated in one or more challenges involved in the criminal justice system, and to multi-county collaboratives focused on reducing justice pilot a series of projects intended to support innovation, involvement of individuals with unmet mental health needs. capacity-building, and continuous improvement. This In 2021-22, the Commission evaluated the incubator by reconnaissance and technical assistance are essential to surveying and interviewing county officials who unlocking the potential of the Commission's innovation participated in the projects. The evaluation documented component. extraordinary value to the counties, particularly the technical assistance that was tailored to their precise needs The Incubator is comprised of five projects exploring and the chance to learn and share learnings with their peers ways to prevent or reduce justice involvement among in other counties. The lessons gleaned from the projects clients. A sixth project explores ways the Commission provide the Commission with a detailed understanding of can better support innovation in counties. These projects the management capacities that are required to design, cover a broad range of goals: linking criminal justice and execute, and evaluate innovation projects and insights into behavioral health data to better understand the mental the way technical assistance needs to be structured to be health needs of people in the criminal justice system, valued by counties. assessing Full Service Partnership programs and developing metrics for improvement efforts, exploring The innovation process review produced a shared options to deploy Psychiatric Advanced Directives to understanding among counties and the Commission on how improve the response from law enforcement to innovation planning can be improved and how counties and individuals who are in crisis, improving crisis response the Commission can work together to distill and share systems to better meet people's needs and reduce lessons to accelerate transformational change. The incarcerations and hospitalizations, and developing emphasis has shifted from reviewing county plans to policy options to improve performance and financial helping counties produce more effective plans and then sustainability for programs and strategies for preventing incorporate those learnings into ongoing operations. From and reducing criminal justice involvement among those the county perspective, this shifts the Commission’s role with mental health challenges. Additionally, through from a risk-filled regulatory process to a supporting partner. extensive involvement with clients, family members, The Commission is now implementing the improvements to providers, and county employees, the System Change its technical assistance and approval process with the Analysis project of the initiative detailed the barriers to expectation that counties will develop better innovation innovation projects and elevated the best options for projects with more potential to improve overall efficiency, facilitating improvement. effectiveness, and mental health outcomes for all. 11 Commission Semi-Annual Report Jan 2022 –June 2022 Impact: Short Term Impact: Long Term Every county that participated in the Innovation Through the implementation of the Innovation Incubator has a new understanding of the power of Improvement Plan, the Commission will help counties innovation and more capacity to pursue effective, build the capacity to improve outcomes, shape stronger creative and transformative projects. innovation investments, and facilitate learning across and within counties, resulting in scalable and sustainable improvements. IIMMPPAACCTT IN ACTION Shared Responsibility in Plumas County Shared Responsibility in Plumas County The Plumas County Behavioral Health Department custody team worked together to find the best solution shared the story of an individual with a history of for the client. These three teams helped him get a psychiatric hospitalization in another state who ended reevaluation, released him from jail, and sent him home. up in jail in Plumas County during a mental health crisis. Jail and behavioral health staff initially tried to The behavioral health department says this would not have place him in a psychiatric hospital, but the hospital been possible two years ago and historically might have led wouldn’t accept him. to disagreements between the jail and behavioral health staff. But due to the improved communication and sense of Without the option of the hospital, the other teams shared responsibility that resulted from participating in the $210m collaborated to find another solution. The jail medical Innovation Incubator, these teams banded together to find team, the behavioral health staff in the county, and the the best solution for a client. 12 Commission Semi-Annual Report Jan 2022 –June 2022 FEATURED INITIATIVE: Suicide Prevention Background: Suicide in California remains a significant public health challenge. In 2020, 4,075 Californians lost their lives to suicide. The continued loss of life to suicide despite so many linked death record data to demographic and service innovative advancements in the science of suicide and characteristics of public mental health consumers who its prevention is a tragedy. It also is a powerful call to died by suicide. People with mental health challenges action; one the Commission could not ignore. The are at increased risk for suicide compared to those Commission’s 2019 Striving for Zero: California’s without such challenges. Analyzing mental health Strategic Plan for Suicide Prevention lays the consumer data could illuminate opportunities to groundwork for several strategic steps –backed by prevent suicide among those receiving care in the science and supported by robust community input –the public mental health system. $210m state should take to save lives. Striving for Zero launched a legislative effort to create a state leader in suicide Here is a snapshot of findings from the preliminary prevention. In 2020, the Office of Suicide Prevention was descriptive analysis: established within the California Department of Public • 22,093 mental health consumers died by suicide Health. During this time, while the office was being between 2000 and 2022, accounting for .35%, or established, the Commission approved several initiatives roughly 355 per 100,000 of the total consumer to address critical statewide gaps in strategic planning, population. data, safety, training, and support. Below is an overview of the progress made on these initiatives during January • Superior counties had the greatest proportion of through June 2022. mental health consumers who died by suicide (.6%), followed by Bay Area Counties (.5%). PROGRESS: JANUARY –JUNE ’22 • Higher rates of death by suicide also occurred in Linked Data Highlights Opportunities to Infuse mental health consumers identified as white, male, Systems with Suicide Prevention between the ages of 20 and 29 years, and born Best Practices outside the U.S. Last year, the Commission published a dashboard • The most common diagnosis among mental health presenting suicide rates and incidence. During the first consumers who died by suicide was depression quarter of 2022, the Commission conducted exploratory (28.3%) followed closely by substance use disorder investigations regarding suicide data demographics and (24.2%). Bipolar disorder was the third most common calculating death rates using the death records from the diagnosis (17.6%). California Department of Public Health (CDPH) vital statistics records. • Firearms as a cause of death by suicide was lower in mental health consumers (21%) compared to the The Commission is working to advance data non-mental health consumer population (47%). opportunities articulated in the state’s strategic suicide The Commission also is exploring differences in service prevention plan. The team has been working with vital utilization among consumers who go on to die by suicide statistics data from CDPH to describe demographic compared to those who do not. These analyses could characteristics of Californians who died by suicide highlight opportunities to fortify existing services by between 2000 and 2020. The team has also successfully infusing them with best practices in suicide screening, 13 Commission Semi-Annual Report Jan 2022 –June 2022 assessment, and care. These analyses also could Virtual Training that included 262 registrations and 170 demonstrate the short window of time between service unique viewers from 49 counties. Following the online delivery and death by suicide, illustrated by scientific training, the Commission sponsored three SFR in-person studies using data outside California. Providers can save trainings with multidisciplinary teams in Del Norte, lives by delivering suicide prevention best practices at Shasta, and Glen Counites. This onsite Susan P. Baker the time a person at risk is seen for health, mental National Public Health Impact Award-winning training, health, and substance use disorder services. consisted of multiple parts: an introductory presentation on the goals of SFR, an interactive, complete, mock SFR The Commission is in the final stages of negotiating data with SFR participants invited by the county, a data use agreements for hospital data received by the collection/analysis meeting with the coroners and Department of Health Care Access and Information. In epidemiologists, and finally a discussion of the quarters to come, the Commission will link hospital recommended next steps for the group. These trainings data with its mental health consumer service data and help create clear partnerships between law death data. Analyses resulting from this linkage will enforcement, coroners, hospitals, mental health and broaden our understanding of opportunities to health representatives, and many others to strengthen strengthen different facets of our care delivery system so suicide prevention in real-time. After this training, that people at risk for suicide are identified as early as county partners recognize their unique role in suicide possible and quickly connected to effective high-quality prevention and are empowered to work together to care, preventing loss of life. deploy suicide prevention strategies based on data almost immediately following a death by suicide in the Strong Local Partnerships Use Data and community. Information to Save Lives Upon completion of each training, feedback was shared The Commission hosted aSuicide Fatality Review (SFR) with the contractor by participants. IIMMPPAACCTT IN ACTION Shared Responsibility in Plumas County Trainings Offer Empowerment and Hope The contractor noticed a theme of excitement, energy, and hope after each county session, with multiple agencies privately disclosing that they are excited to be working with certain partners, and that they had tried relationship building for years but had failed until this SFR effort. The contractor will continue technical assistance with site representatives, coroners, public health, and mental health professionals from participating counties as they implement the surveillance system and build their SFR. “ “ “ “ For the first time, You have given us literally I am going to use this “Your expertise and I think we actually can everything we need to tool to ensure my team workbook are incredible. stop suicides.” complete a Suicide Fatality performs better suicide Thank you so much for Review. This must have investigations, and I will use taking the time to drive down —Law Enforcement taken years of work. Thank this to evaluate our and share your knowledge you.” progress. with our county.” $210m —Health Official —Coroner —Behavioral health 14 Commission Semi-Annual Report Jan 2022 –June 2022 Counties Collaborate with the Support of Technical Experts to Create Strategic Plans The Striving for Zero Suicide Prevention Strategic Planning Learning Collaborative aims to advance local strategic planning and implementation in alignment with strategic aims, goals, and objectives set forth in Striving for Zero. Between January and March 2022: Between April and June 2022: • 2 participating counties published strategic plans • 47 check-in meetings with county teams facilitated by (Monterey and San Luis Obispo Counties) the technical assistance team to support counties • 1 new county coalition was established • 44 people representing 21 of the county teams attended learning module: Follow-Up After a Suicide Attempt • 64 check-in meetings with county teams facilitated by the technical assistance team to support counties • 50 people representing 25 of the county teams attended this quarter’s learning collaborative meeting • 46 people representing 24 of the county teams attended learning module: Crisis Response • 15 people representing 6 rural county teams participated in this quarter’s small county • 61 people representing 28 of the county teams collaborative attended this quarter’s learning collaborative meeting • 3 participating counties advanced from early planning to drafting or finalizing their strategic plan Training Boosts School Personnel’s Confidence in and Ability to Identify At-Risk Students and Connect Students with Care The Commission is providing a free training for designated school staff to learn about best practices in school-based screIMenPinAgC fTor suicide risk and how to respond effectively to keep students safe. The training incorporates content on Shared Responsibility in Plumas County Suicide Safety Planning Intervention, data collection and monitoring related to suicide risk screening, and cultural considerations. Attendees receive materials necessary for implementation. All online trainings feature interactive breakout groups. As one participant noted, “getting the opportunity to practice the questions and having a conversation with other school districts was eye opening. This training made me realize even more how much work we need to do and conversations we need to have regarding suicide.”Other participants find the training to be clear and concise for busy professionals. One participant noted “how simple it was to take in the information.” Interest in the Commission’s training is rising. Participation has been increasing with each quarter. Trainings in September and October 2022 already are at capacity, with 150 registrants for each training with their spots reserved. More trainings are being scheduled. Between January and March 2022: Between April and June 2022: • 6 online, interactive trainings hosted • 10 online, interaction trainings hosted • 181 participants trained • 426 participants trained • 14 counties participating • 22 counties participating • 24 school districts represented • 70 school districts represented 15 Commission Semi-Annual Report Jan 2022 –June 2022 FEATURED INITIATIVE: YOUTH AND PEER EMPOWERMENT Sponsorship of the Ken Burns documentary Hiding in Plain Sight: Youth Mental Illnessto support the demystification and destigmatization of mental health through storytelling. Through its partnership with the Well Beings Youth Mental Health Project, the Commission supported the creation of a powerful two-part documentary. Executive Produced by Ken Burns, the film presents an unvarnished window into daily life with mental health challenges, from seemingly insurmountable obstacles to stories of hope and resilience. Through the experiences of young people, the film confronts the issues of stigma, discrimination, awareness, and silence, and, in doing so, helps advance a shift in the public perception of mental health issues today. The four-hour film not only features the stories of youth 11-27, but also includes commentary from parents, teachers, friends, healthcare providers in their lives, and independent mental health experts. The film shows the stark reality that many people face and provides viewers the opportunity to find empathy and relatability in these real, everyday experiences. Words from First Lady How this documentary supports the Commission’s strategic goals: Jill Biden White House screening 1.1 Distilling and disseminating knowledge on how mental health issues can June 22, 2022. be prevented, detected early, and addressed at population scale is a major directive of the Commission, underlined by Senate Bill 1004. This “ documentary premiered on over 300 PBS stations nationwide and was “We want young people available for people to stream on the PBS website and free PBS video app. everywhere to know: We see you. 2.2 It was recently screened at the White House and Congress with We hear you. And we will work to Commission representatives, First Lady Jill Biden, and other public and make this better.” private sector decision makers in attendance. This supports the strategic ••• goal to communicate the potential to prevent mental health issues “[Mental health] isn’t a red or a to decision makers. blue issue. It’s an American issue – a global issue. And we must come About the Project: together to find better solutions.” Well Beings is a multiplatform, multi-year campaign from public media that ••• launched in July 2020 to address the critical health needs in America through “It takes incredible courage to tell original broadcast and digital content, engagement campaigns, and impactful your story. To be honest about the local events. Well Beings, created by PBS member station WETA, brings struggles you’ve faced and say, “I’m not OK.” And it’s on us to together partners from across the country, including people with lived meet that courage with action. To experience of mental health challenges, families, caregivers, educators, do everything in our power to give medical and mental health professionals, social service agencies, private you what you need to heal.” foundations, filmmakers, corporations and media sponsors, to create awareness and resources for better health and well-being. 16 Commission Semi-Annual Report Jan 2022 –June 2022 03 COMMITTEES The Mental Health Services Act charges the Commission with engaging the public. Committees allow Commissioners and the public to dive deep into questions and advise the full Commission. 17 Commission Semi-Annual Report Jan 2022 –June 2022 Committees COMMITTEE SUMMARY Anti-Bullying Advisory • Led by youth members, the Committee helps the Commission develop a social Committee media strategy that will deliver trusted content designed to reduce the risks associated with bullying and build resiliency among children and youth. The Chair: Commissioner ShuoChen committee will advise on the strategy and how to make the content engaging and accessible to young audiences. • The Committee did not meet between January and June of 2022, though work on the project progressed. Children’s Committee • California is on the brink of unprecedented investment in children's mental health, and this presents exceptional opportunities for the Commission. In its Chair: Commissioner Mara Madrigal-Weiss inaugural meeting, the Committee outlined two potential goals for its work: to enhance the integration of the Commission's work on children's mental health, and to inform the Governor's Children and Youth Behavioral Health Initiative. • The Committee met on May 26, 2022. Client and Family • Made up of peer providers, consumers, family members, and representatives Leadership Committee from diverse populations, the Committee explores best practices in implementing Peer Support Specialist Certification and works with the Chair: Commissioner KhateraTamplen Department of Health Care Services to support the creation of program standards that protect the unique work of peer providers in our mental health system and ensure that the skills of peer providers are appropriately included in local mental health plans. • The Committee met on February 14, 2022, March 28, 2022, and May 13, 2022. Cultural and Linguistic • The Committee focuses on understanding inequities in California’s mental Competency Committee health system and identifying strategies to achieve equity. The Committee will identify ways to document and communicate inequities in California’s mental Chair: Commissioner Mayra E. Alvarez Vice Chair: Commissioner Gladys Mitchell health system, highly model programs and other promising initiatives, and push for reforms to existing policies and practices. • The Committee met on February 10, 2022, April 20, 2022, and May 2, 2022. Early Psychosis • The Committee works to expand the provision of high-quality, evidence-based Intervention Plus (EPI Plus) early psychosis and mood disorder detection and intervention services by Advisory Committee advising the Early Psychosis Intervention Plus Program. Chair: Commissioner KhateraTamplen • The Committee did not meet between January and June of 2022, though work on the project progressed. 18 Commission Semi-Annual Report Jan 2022 –June 2022 COMMITTEE SUMMARY Fellowship Committee • The Committee provides guidance on the goals, design, eligibility criteria, and application process for the Commission’s Mental Health Policy Fellowship for a Chair: Commissioner KhateraTamplen mental health professional and a mental health consumer. • The Committee met on January 11, 2022 and April 5, 2022. Research and Evaluation • Comprised of a diverse, interdisciplinary group of experts, the Committee Committee provides guidance and expertise that reflects a broader understanding of the opportunity for driving transformational change using research to improve Chair: Commissioner ItaiDanovitch prevention and innovation, as well as mental health services and supports. The Committee supports the Commission in reaching its strategic goals and ensuring that information disseminated is timely, accurate, and useful to improving community wellness and client recovery. • The Committee met on February 4, 2022 and May 2, 2022. Workplace Mental Health • The Committee provides guidance on the Commission’s work to establish a Advisory Committee framework and voluntary standard for mental health in the workplace that serves to reduce mental health stigma, increase public, employee, and Chair: Commissioner KeyondriaBunch employer awareness of the recovery goals of the Mental Health Services Act, and provide guidance to California’s employer community to put in place strategies and programs to support the mental health and wellness of employees. • The Committee did not meet between January and June of 2022, though work on the project progressed. 19 Commission Semi-Annual Report Jan 2022 –June 2022 FEATURED COMMITTEE: RESEARCH AND EVALUATION Updated Fiscal Transparency Dashboard launches to allow clearer, more up-to-date information around county MHSA revenues The Commission’s Fiscal Transparency Dashboard allows To ensure the Dashboard’s improved usability and Californians to better advocate for their communities, by adoption, Commission staff performed extensive user displaying information on the fiscal status of county engagement on the new dashboard. In total, our staff Mental Health Service Act (MHSA) funding, including participated in over 20 engagement activities including: beginning/closing balances, revenue, expenditures, and other funding details. The dashboard is one of seven • Meetings with the California Department of Health dashboards in the Commission’s Transparency Suite, a Care Services tool built to help community members, advocates, • Data forums researchers, and others understand how people are • Personalized demos being served by MHSA programs, who is being served, • Partner and community member interviews and outcomes achieved. • Meetings with counties and the County Behavioral Health Directors Association of California More than two years ago, an initiative was set forth to update the Dashboard, with a goal of better supporting On March 24, 2022, the Commission reviewed an update public understanding of revenues from the Mental Health on the Commission’s Fiscal Transparency Dashboard, Services Act, and county MHSA expenditures and closing and in April 2022 the revised tool was released. balances. The initiative aimed to: 1 Help the Commission determine how to restructure data processing due to significant changes in the state mandated fiscal reporting. 2 Enhance its design to be more intuitive and engaging to the public. IIMMPPAACCTT IN ACTION Shared Responsibility in Plumas County 20+ Staff participated in more than 20 engagement activities to enhance the design and use of the Transparency Dashboard. Engagement Activities 20 Commission Semi-Annual Report Jan 2022 –June 2022 04 ADVANCING TRANSFORMATIONAL CHANGE In its effort to create transformational change for wellbeing in California, the Commission uses research, grants, innovation, and more to explore bold new ideas. These tools underpin Commission initiatives to create more robust evidence and exploration. 21 Commission Semi-Annual Report Jan 2022 –June 2022 Advancing Transformational Change Research and Evaluation The Commission’s Research and Evaluation work seeks 3 Recommending ways to improve mental health to improve outcomes, promote opportunities for strategies and outcomes. prevention and effective intervention, and reduce The Commission pursues public research and disparities by analyzing data, consulting with experts, analysis to improve outcomes. In the first half of and engaging communities to produce information and 2022, the Commission supported the Striving for recommendations that empower community members Zero Suicide Prevention Learning Collaborative and and inform policymakers and practitioners. This includes conducted six virtual trainings for educators on five primary activities strategically designed to increase suicide risk screening. public understanding and reduce stigma, document the impact of existing policies and programs, provide the 4 Linking consumer-level data across service systems information required for robust community involvement to understand the impact of mental health services. and continuous improvement in services and outcomes, The Commission links consumer-level data across and inform the Commission’s agenda. service systems to understand how mental health needs and services impact the health, safety, 1 Tracking community indicators to increase public education, and employment of Californians. In the understanding and awareness. first half of 2022, Commission staff worked with Vital The Commission reports population-level data on Statistics data from the California Department of significant outcomes associated with mental health, Health to describe demographic characteristics of including hospitalizations, criminal justice Californians who died by suicide between 2000 and involvement and suicide. As part of the 2020. Staff has also linked public death records to Commission’s transparency work, the Commission mental health data to describe demographic and released an updated version of the Fiscal service characteristics of public mental health Transparency dashboard, sharing information about consumers who died by suicide. The Commission funding and expenditures by county behavioral also is working to amend existing data use health departments. agreements to expand the scope of its request for birth and death records with the Department of 2 Curating an inventory of county plans and programs Public Health and incompetent to stand trial records to improve community planning. with the Department of Justice. The Commission The Commission gathers information on MHSA- preformed linkages of Client Services Information supported programs, including three-year plans and (CSI) and Full ServicePartnership (FSP) data to birth annual reports, data and outcomes reported for and death records and to California Department of Prevention and Early Intervention programs and Education data. Exploratory analyses to understand Innovation projects, program descriptions and the impact of mental health services on school- outcomes, revenue and expenditures. The based outcomes have begun. Also, exploratory Commission staff are working to update the analyses of a CSI and death record linked dataset are Commission’s fiscal transparency tool, which underway. visually displays information on MHSA funding and expenditures. 22 Commission Semi-Annual Report Jan 2022 –June 2022 5 Evaluating new initiatives to accelerate learning, outcomes. As part of this evaluation, program and adaptation, and scaling. evaluation staff worked together to conduct 24 key The Commission evaluates existing and pilot informant interviews with county behavioral health interventions to determine effectiveness and staff in counties who participated in one or more identifies opportunities for prevention, Innovation Incubator projects. This cross- improvement and replication. Evaluation of the departmental team also conducted two key Commission’s mental health crisis triage grant informant interviews with individuals with lived program is underway, with the team supporting experience who were involved in Innovation programs to deliver quality data that the Incubator projects. The evaluation team is also Commission can link to state agency databases. The working closely with Mental Health Student Services Commission has also made progress evaluating its Act (MHSSA) staff and grantees on a community investment in an Innovation Incubator to reduce engagement process to evaluate implementation of criminal justice involvement and as a model for the MHSSA grants. collaboration to accelerate learning and improve Community Engagement and Grants The Commission’s Community Engagement and Grants increase advocacy at all levels. The statewide team handles multiple external-facing programs that aim organization will work closely with local organizations to to directly serve community members through advocacy provide technical assistance, training, and data support. contracts, the Triage program, Early Psychosis Intervention Plus (EPI+), allcove™Youth Drop-In Centers, Early Psychosis Intervention Plus (EPI+) supports seven and COVID-19 response projects. counties developing early psychosis intervention programs based on the coordinated specialty care The Commission supports eight advocacy organizations model. Nevada, Colusa, and Mono counties are working that hold mental health advocacy events across in a hub-and-spoke grant in coordination with UC Davis California. The events bring mental health support and to bring early psychosis intervention programming to awareness to Clients and Consumers, Diverse Racial and underserved rural communities. The shortage of clinical Ethnic Communities, Families, LGBTQ+ communities, staff, limited resources, and geographical challenges Parents and Caregivers, Transition Age Youth, and have led these counties to pull together and partner with Veterans. In 2021 the Commission approved another UC Davis to provide clinical telehealth services for clients round of funding for Immigrant and Refugee advocacy in need of specialized early psychosis treatment. One contracts, totaling $2,010,000. In May 2022, the grantee county shared with the Commission the story of Commission awarded one state-level contract and four a client who was treated as part of the county’s new early local contracts. The local organizations will work directly psychosis efforts. This client’s severe symptoms of with the immigrant and refugee populations in their psychosis had caused extensive disruption to all aspects areas where the highest mental health needs are, of their life, but with specialized support from the providing opportunities for individuals and families who county, the client was able to stabilize and regain have been affected by war, torture, genocide, and employment. Additionally, by including family members generational trauma. The statewide organization will in their treatment and providing psychoeducation, the support the advocacy needs of immigrants and refugees client received support and understanding from their to increase the number of available mental health family members, and the client has improved their programs, create awareness of and access to culturally relationship with their family again. appropriate services, and provide opportunities to 23 Commission Semi-Annual Report Jan 2022 –June 2022 Grants were distributed in the summer of 2021 to five longer period to develop their individual program plans school-based contractors to support students in their with assistance from the Commission. The Commission return to campus after COVID-19 forced closures. During released a Request for Application in May of 2022 to the school year, these grants supported hundreds of distribute $47 million in MHSSA funds to counties campuses throughout California. Bring Change 2 Mind interested in enhancing or expanding current programs expanded to an additional 50 high school clubs, NAMI or launching a new MHSSA program. California’s NAMI on Campus High Schoolexpanded to include 31 additional high school clubs, the Genders and The Commission also supports youth mental health Sexuality Alliance Networkregistered over 500 clubs, and through its allcoveTMinitiative, which provides grants to MindUPprovided scholarships for faculty to receive counties to create youth drop-in centers. These centers social and emotional learning training and curriculum in provide access to affordable mental health and wellness over 30 districts and 80 schools. Directing Change services for Californians between the ages of 12 and 25. facilitated Suicide Prevention 101 trainings with 131 The Commission presented the program to the California participants and held a showcase in May 2022 to Department of Public Health’s School-Based Health celebrate 11 mini-grants for students participating in an Center Statewide Collaboration Workgroup to highlight annual art and film contest around mental health. how allcoveTMprovides a continuum of care to youth outside of school. The Commission also facilitated In addition to COVID-19 relief grants, the Commission listening sessions in March and April of 2022 with provides MHSSA grants to counties to help them develop representatives of counties, non-profit, and health closer, more productive relationships with school district partners participating in the allcoveTMnetwork to districts to increase student wellbeing. In early 2022, the explore the challenges with providing services at no or Commission funded additional MHSSA grants to 17 low cost for all youth, regardless of insurance status. counties that had not previously applied to receive These sessions augment the work already being done by funding, bringing the total of MHSSA programs to 54. The grantees to make allcoveTMsustainable and scalable. majority of these newest grantees were provided a Program Operations Program Operations is just one part of the Commission’s of these collaboratives and the Incubator model overall strategy to help it perform its fiduciary overall. Data-gathering activities have included a responsibility, identifying trends in mental health convening and a follow-up “Roundtable” with systems, and providing support through its review of contractors and other partners, a survey of county county submitted reports on the progress of the Mental behavioral health staff, engagement at a partner Health Services Act. collaboration meeting, interviews with individuals with lived experience, and interviews with county We detailed on page 12 how, as part of its third strategic behavioral health staff. This evaluation aims to goal to facilitate positive transformational change, the facilitate greater innovation and improve the way the Commission supports the Innovation Incubator Commission engages with counties and other partners Initiative. In the first half of 2022, the Program and will result in an innovation action plan that will Operations team continued to assist counties in several fortify the Commission’s support for innovation multi-county learning collaboratives funded by the projects in ways that improve overall efficiency, Innovation Incubator while also working in tandem with effectiveness, and mental health outcomes for all. the Research and Evaluation team to evaluate the work 24 Commission Semi-Annual Report Jan 2022 –June 2022 toolkit will include elements to better support interested Program Projects counties in understanding the mental health needs of As the Program Operations team supports the youth, understanding how to meaningfully engage youth Innovation Incubator, the Commission is learning how in designing services intended for youth, and supporting better to help counties create and execute compelling, youth to better engage counties in these efforts. In the aspirational, and achievable innovation projects. In first half of 2022, youth leaders completed a significant turn, this has led to an increase in county projects section of the draft toolkit and will soon seek feedback being approved, from just four projects in fiscal year from the community. 2012-2013 to 21 plans in fiscal year 2021-2022. The Commission was represented at a new mental 4 projects 21 projects health summit hosted in May 2022 by Washington-based nonprofit Chad’s Legacy Project, the University of 2012-2013 2021-2022 Washington Department of Psychiatry and Behavioral Fiscal year Fiscal Year Sciences, and the Harborview Behavioral Health Institute. The summit formed an inclusive forum of leaders, family members, consumers, caregivers, and As part of its work around innovation, the team also experts who developed, shared, and advanced new and supports the Youth Innovation Planning Project through promising ideas, opportunities, and collaborations that the contracted Youth Leadership Institute (YLI). are providing effective care for those with behavioral Transition age youth leaders, adult allies, and YLI are health challenges. Knowledge and experience sharing working on designing and creating a dynamic youth with innovation leaders from other states helps improve engagement toolkit to promote the meaningful inclusion the Commission’s ability to advance change. The of youth voice and engagement in input processes Commission is also doing advance planning for its own around mental health services. When completed, this mental health innovation summit in the future. Legislation The Commission supported two bills in the first half of 2022. Assembly Bill 748 (Carrillo) Assembly Bill 2281 (Lackey) Would direct the California Department of Education to Would create the Early Childhood Mental Health Services develop a model poster on student mental health Act, which would establish an incentive grant program to themes for local schools and require school sites in address mental health needs of young children, which grades 6-12 to display posters on their campuses. The would be administered by the Commission. The Commission voted to support AB 748 and to work with proposed program is modeled after the Mental Health the author to ensure that students are engaged in the Student Services Act and would target children ages 0-5. development of the model poster content. AB 748 The Commission voted to support AB 2281. This bill was passed out of the Assembly and is currently in the Fiscal passed by the Legislature but returned without signature committee in the Senate. This bill was passed and signed by the Governor in September 2022. by the Governor on September 19, 2022. 25 Commission Semi-Annual Report Jan 2022 –June 2022 Communications As part of its mandate to reduce stigma around mental D.C. The project reached a new milestone in June 2022 health, the Commission supported several efforts in the with the premiere of Hiding In Plain Sight: Youth Mental first half of 2022 to bring mental health messaging to the Illness, a feature-length documentary by the Ewers general public. brothers, executive produced by Ken Burns, and broadcast on PBS stations across the country. As Art With Impact’s annual film festival, Voices With detailed onpage 16 of this report, this is the first in a Impact, continued in a virtual format in June 2022. The planned three-part series on mental health. The festival features mental health stories told by filmmakers documentary was created to “shine a clear –and with lived experience. This year’s themes were “Grief and sometimes stark –light on what it is like for youth as well Resilience” and “Substance Use Disorder and Recovery.” as for the parents, teachers, friends and healthcare Through the Commission’s support, two filmmakers providers who try to help.” In addition to airing were provided grants to help make their short films. All nationally on PBS and being available for streaming after film screenings that were part of Voices With Impact its premiere, the two-part, four-hour documentary was were free to the public and featured a question and screened in advance, first at a White House screening answersession with the filmmakers. Commissioner Itai hosted by First Lady Jill Biden and next at a Danovitch and Vice Chair Mayra Alvarez each introduced Congressional screening hosted by Representative a film, discussing their thoughts on the film and how it Nancy Pelosi. Read the poignant quotes from Biden’s relates to the work of the Commission –as well as their speech at that screening on page 16. own work and life experience. Over the past three years, the Commission has also supported Well Beings, a mental health documentary initiative from PBS flagship station WETA in Washington, 26 Commission Semi-Annual Report Jan 2022 –June 2022 05 WHAT’S NEXT 27 Commission Semi-Annual Report Jan 2022 –June 2022 What’s Next OCTOBER 2022 10/18 Cultural and Linguistic Competency Committee Meeting o 3:00PM –5:00PM o Public 10/25 Client and Family Leadership Committee Meeting o 1:00PM –3:00PM o Public 10/27 October Commission Meeting o 9:00AM –1:00PM o Public NOVEMBER 2022 11/10 Cultural and Linguistic Competency Committee Meeting o 3:00PM –5:00PM o Public 11/15 Client and Family Leadership Committee Meeting o 1:00AM –3:00PM o Public 11/17 November Commission Meeting o 9:00AM –1:00PM o Public 28