Transformational Change Report: July – December 2022

BIANNUAL REPORT July 2022 –December 2022 mhsoac.ca.gov MHSOAC —Commission Biannual Report Commission Biannual Report July 2022 –Dec 2022 LETTER FROM THE COMMISSION | JULY –DECEMBER 2022 Dedicated to the Wellbeing of All Californians This report covers six months of Commission activities to promote the mental wellbeing of all Californians and to reduce adverse mental health outcomes. Each day, the Commission works, along with state, county, and local partners, 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 61 hybrid and virtual and 31 in-person community events in the last six months. This section provides information on the various types of community engagements the Commission uses, including teleconferences, learning collaboratives, and statewide conversations. Sections 2 and 3 of this report provide an at-a-glance look at key activities surrounding each of our strategic initiatives and committees, showing how each is progressing. Section 2 offers more in-depth spotlights of select initiatives, their people, partners, and progress. In Section 4, we share the incredible reach and impact of the PBS documentary Hiding in Plain Sight: Youth Mental Illness, produced by Ken Burns. The Commission supported this film and hosted a special live screening, and as of this writing, the documentary has been viewed 4 million times. The film supports the Commission’s mission to confront stigma and advance a shift in the public perception of mental health issues today. 2 Commission Biannual Report July 2022 –Dec 2022 CONTENTS 01 Community Engagement 04 02 Strategic Initiatives: July -Dec 2022 Progress Report 08 Featured Initiative: Prevention and Early Intervention 15 Featured Program: Full ServicePartnerships 18 03 Committees 21 04 Foundational Work 24 Featured Foundational Effort: Community Screenings 25 Budget Update 29 05 Stay In Touch 30 Commission Biannual Report July 2022 –Dec 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 mental health peers, families, advocates, and community representatives as members of the Commission and in its deliberations and decision-making. 4 Commission Biannual Report July 2022 –Dec 2022 Commission and Committee Learning Public Meetings 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 and Family Leadership Committee, Anti-Bullying Learning Collaborative on Suicide Prevention.This Advisory Committee, Cultural and Linguistic Competency collaborative met twice in the second half of the year, Committee, and the inaugural meeting of the Impacts of advancing suicide prevention efforts through shared Firearm Violence Subcommittee. The second half of experiences and training. The Commission also hosted 2022 also saw more hybrid Commission meetings, two Mental Health Student Services Act learning with some Commissioners, presenters, and members of collaborative meetings, where county staff shared the public attending in person at the Commission’s office information about Wellness Centers, partnerships, and and some attending remotely. staffing strategies. Community Partner Engagements Statewide Conversations Communitypartnerengagementgrantshelpspecific The Commission's engagement in mental health policies and communitiesbuildanunderstandingofmentalhealth practices creates opportunities for statewide dialogue. In the needsandadvocateforsolutions. Thesegrantssupport second half of 2022, Commission staff presented at the communityevents, fromstatewidegatheringslikethe California County Boards of Education Conference, and as VeteransArt Project’sPop-Up Art Cafėonthestepsof part of a panel of experts on behavioral health at the California’scapitol, to localoneslikeUnited Parents’ Association of California Healthcare Districts Annual Meeting LunchtimeAdvocacyPanelsessions.TheCommission and on homelessness at the Nevada League of Cities also supportsvirtualdiscussionslikethosehostedbyArt Conference. Commission staff participated in conferences WithImpact, includingtheircollegeworkshops, which like the OneMindConference, NAMI California diveintofilm, poetry, andmentalhealthinguided Conference, and Words to Deeds Conference, making discussionswithcommunitycollegestudents. connections, expanding knowledge, and promoting solutions. 5 Commission Biannual Report July 2022 –Dec 2022 In-person Events Between July and December, the Commission participated in 31 in-person events and 61 hybrid and virtual events. As the Commission recommits to in-person engagements, events will expand beyond Sacramento, the Bay Area, and the Southern California coast. 6 Commission Biannual Report July 2022 –Dec 2022 Hybrid & Virtual Events NUMBER OF EVENT LOCATION OCCURENCES Commission meeting 3 Sacramento, CA* Children’s Committee meeting 1 Sacramento, CA* PEI Subcommittee meeting 1 San Diego, CA* Impacts of Firearm Violence Subcommittee meeting 1 Sacramento, CA* PEI Subcommittee meeting 1 Sacramento, CA* Research and Evaluation Committee meeting 1 Sacramento, CA* MHSSA Learning Collaborative meeting #1 2 Virtual Research and Evaluation Committee MHSSA 2 Virtual Workgroup teleconference ICCTM collaborative meeting #1 2 Virtual Suicide Risk Screening in Schools training 17 Virtual Older Adult Suicide prevention meeting 1 Virtual California Legislative Staff Education Institute: Health 1 Virtual Cohort Briefing Transform Mental and Behavioral Health Fund Committee 1 Virtual meeting Anti-Bullying Advisory Committee teleconference 2 Virtual Client and Family Leadership Committee teleconference 3 Virtual Cultural and Linguistic Competency 5 Virtual Committee teleconference Commission meeting 2 Virtual Art With Impact virtual events 15 Virtual * Indicates hybrid meeting 7 Commission Biannual Report July 2022 –Dec 2022 02 STRATEGIC INITIATIVES The Commission currently supports 11 strategic initiatives. These multifaceted, interrelated efforts together aim to improve mental wellbeing in California. 8 Commission Biannual Report July 2022 –Dec 2022 Strategic Initiatives: July – Dec Progress Report INITIATIVE PROGRESS WHAT’S NEXT allcove™Youth Drop-in Centers • Conducted site visits at the Santa Clara • CoveFesttakes place on January Half of all mental health conditions allcove™center and the San Mateo allcove™ 28, 2023in Redondo Beach to begin by age 14, and 75% develop by center on October 28. Youth leaders celebrate the opening of the newest the age of 25, making early detection presented on the needs of youth and on allcove™youth drop-in center. This and treatment urgent and critical. implementation and next steps in the center is operated by the Beach Based on a proven model from center development. The site visit included Cities Health Care District. Australia, allcove™youth drop-in staff from the Commission, Department of • Expand awareness of the model centers expand early access to Health Care Services, local elected officials, integrated mental health care for a state legislator, consultants from Stanford • Bolster technical assistance youth between 12 and 25 University, and members of the allcove™ strategy years of age. An allcove™center has youth advisory committees. • Develop data and evaluation opened in Santa Clara, and five more strategy communities have been awarded grants to open new centers. These • Recruit and fund additional centers provide a one-stop shop for partners mental health, physical health, • Engage all payors substance use counseling, and educational, vocational, and peer support services, all informed by a youth advisory group. COVID-19 & Emerging Issues • ICCTM Collaborative launched in October • There will be a total of 11 sessions The pandemic has tested the capacity 2022, with its first session featuring an for two cohorts of counties. The of the state’s mental health systems to overview of the Solano County ICCTM Commission anticipates proposed meet pre-existing and emerging needs Project. A second session in November innovation plans focused on of Californians. The Commission 2022 discussed the impact of COVID-19. A reducing disparities as an outcome. redirected funding to help county third session in December 2022 discussed • Fortify California’s behavioral partners and service providers support social determinants of health. health disaster planning their communities. The funds • Additional funding was redirected toward supported counties replicating a • Support the digital mental suicide prevention efforts; for further Solano County innovation project, the health strategy included in CYBHI details please see page 13. Interdisciplinary Collaboration and and CalHOPE Cultural Transformation Model and engaged county behavioral health leaders on opportunities to adapt, extend, and replicate the work of the California Reducing Disparities Project. Additional 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. 9 Commission Biannual Report July 2022 –Dec 2022 INITIATIVE PROGRESS WHAT’S NEXT Criminal Justice Prevention • Continued exploring dataset linking mental • The Commission will publish its Following the 2017 adoption of its health consumer data with criminal justice evaluation of the Innovation Together We Can report, the data, including arrest and incompetent to Incubator, which supported counties Commission is using an array of tools stand trial information. working on criminal justice –research, policy development, prevention projects. • Additional criminal justice prevention work is financial incentives, and technical being carried out by counties in Innovation • Community engagement assistance –to implement its Incubator multi-county collaboratives. Please recommendations to help counties • Strengthening data partnerships and see page 12 for more information. and their community partners build analysis proactive and effective service • Selecting key metrics for criminal systems that reduce criminal justice justice involvement system involvement for those living with unmet mental • Capacity building for FSPs health needs. • Documenting relationship between initial criminal justice involvement and state hospitalization Mental Health • The Crisis Now multi-county Incubator • Working with a contractor, the four Wellness (Formerly Triage) collaborative has currently recruited four counties in the Crisis Now Incubator California's Mental Health Wellness counties (Plumas, Santa Barbara, Santa Cruz collaborative will consider proposing Act grant program provides $20 and Ventura) to assess and determine the use the use of innovation funds to assess million each year to improve of innovation funds in developing/improving and potentially create a crisis system community response to people their local crisis systems of care. of care in their local communities. facing mental health crises. Grants • In July of 2022the Commission set priorities • Commission staff will hold discussion have supported the ability of crisis for the Mental Health Wellness Act funding with representatives of the California responders to connect those and allocated $20 million to support EmPATH Department of Aging in preparation having a mental health episode psychiatric Crisis Stabilization Units, older for the release of an RFA to expand with wellness, resiliency, and adults, 0-5 early intervention, peer respite the number of Age Wise and PEARLS recovery-oriented programs that programs, and Substance Use Disorder programs. offer the least restrictive settings programs. appropriate for their needs. • Coordinate with California Youth • In Septemberthe Commission approved a Behavioral Health Initiative on $20 million grant project to expand EmPATH. strategies to support families with In Novemberthe Commission approved a $20 young children ages 0-5 at risk of million grant project to support older adults. mental health crises. • In early December, Tom Orrockpresented • Award EmPATHgrants. information about the EmPATHmodel and Request for Applications at the California Hospital Association Annual Meeting. • The Commission released a Request for Applications (RFA) for the EmPATHprograms • The Commission worked with the Governor and Legislature to modify the parameters of the Mental Health Wellness Act to allow more upstream interventions to be supported with these funds. 10 Commission Biannual Report July 2022 –Dec 2022 INITIATIVE PROGRESS WHAT’S NEXT Early Psychosis • Engaged Sacramento County regarding • Commission staff are producing the Intervention Plus interest in expansion of their Early Psychosis contract documents and reviewing Nearly 100,000 adolescents and Intervention program after a former grantee county budgets. Contract will be young adults experience their first relinquished their grant due to critical executed in January 2023. psychotic episode each year in the staffing shortages. Sacramento County has • The Early Psychosis Intervention U.S. With half of all mental accepted the funding and will use the $2 Advisory Committee will meet disorders manifesting by the age of million grant to hire staff and expand in 2023. 14 and 75 percent by the age of 25, programs. the Commission is expanding the • Establish statewide goal for access to provision of high-quality best practices. Coordinated Specialty Care in • Document service delivery gap, seven grantee counties, focusing emphasis on disparities. on early detection and intervention to improve the lives of • Support research on improving adolescents and young adults, access to CSC in hard-to-reach significantly reducing the impact communities. of mental health challenges. This • Increase public awareness on the work is supported by the Early signs and symptoms of psychosis. Psychosis Intervention Plus Committee. • Build sustainable financing opportunities. Impacts of Firearm Violence • Subcommittee formed by Commission on • Subcommittee will meet virtually on More than 3,400 people die from August 25, 2022. January 24, 2023to hear from experts firearm violence in California each on prevention and early intervention • Published project framework. year; about half of these are opportunities homicides and just under half are • Held first meeting of the Impacts of Firearm in schools. suicides. In addition to the Violence Subcommittee on September 28, • Commission will hear a series of detrimental physical health 2022, with over 40 public members attending. presentations from experts during its problems that follow firearm • Visited the Watts neighborhood in Los February 23, 2023meeting. violence –including emergency Angeles to hear presentations from the department visits, • Commissioners have been invited to REACH TEAMproject, which aims to address hospitalizations, and death – visit a Sacramento gun range to learn trauma caused by community firearm violence also can cause about their efforts to prevent firearm firearm violence. trauma and lead to immediate and suicide and promote mental health ongoing mental health challenges • Conducted over 25 interviews with local and awareness among firearm owners for individuals, families, and national survivors, advocates, researchers, and their families. communities. This initiative administrators, and • Commission is exploring explores the mental health other experts. opportunities to visit a rural impacts of firearm violence and • Commission explored the use of its linked community to learn about local gun works to develop strategies to datasets to answer project questions. culture and impacts of firearm prevent firearm violence and violence in rural communities. respond to those impacts. 11 Commission Biannual Report July 2022 –Dec 2022 INITIATIVE PROGRESS WHAT’S NEXT Innovation & Innovation • In the past six months, the Commission • There are a total of 23 additional draft Incubator approved five innovation projects from five innovation projects in the The Mental Health Services Act counties totaling $13,138,081. These projects Commission's queue that are being (MHSA) includes a rare and explicit were focused on FSPs, Social Determinants of prepared for Commission review and commitment to fostering Health, and a multi-county collaborative total approximately $98 million in innovation in providing services focused on the infrastructure of the public innovation funding authority. If and support. The Commission mental health system. approved, these projects would be works to support counties creating focused on crisis services, • In October 2022, Commission staff presented and presenting innovation plans homelessness, criminal justice, older the Innovation Action Plan, which for approval. Additionally, the adults, youth, housing, transgender summarized the work that has been done to Commission supports the individuals, mobile services, reducing understand the strengths and challenges of Innovation Incubator. Created in disparities, and the public mental the innovation component, explore concerns 2018 with $5 million in one-time health infrastructure. and opportunities and present a plan to help funding, the Innovation Incubator counties develop transformative innovation • Implement Commission’s Innovation brings together county behavioral projects, strengthen the Commission’s review Action Plan. health agencies, subject matter process, and facilitate learning across and experts, and other partners to • Build out data strategy to inform within counties. drive innovations that improve innovation investments. mental health outcomes for • Engage new potential innovation. individuals and communities. partners and investigate opportunities to host an Innovation summit. Prevention & Early • Prevention and Early Intervention • The subcommittee will release a Intervention Subcommittee released the first draft of its revised draft of the report in January Everyone should have the final project report on August 24, 2022. 2023. opportunity to be well and thrive, • Subcommittee met to hear public comment • The subcommittee will meet in yet one in four people worldwide on its draft report on September 7, 2022in January 2023 to hear comments on will experience a significant San Diego and October 6, 2022in the revised draft. disruption to their mental Sacramento. wellbeing at some point in their • The Commission will consider lifetime. Guided by the Governor • The Commission’s Cultural and Linguistic adoption of the report in February or and Senate Bill 1004, the Competency Committee met on October 18 March of 2023. Commission launched a policy and November 10 and Client and Family research project to explore Leadership Committee met on October 25 opportunities for prevention and and November 15 to discuss the report. early intervention in mental health. 12 Commission Biannual Report July 2022 –Dec 2022 INITIATIVE PROGRESS WHAT’S NEXT School Mental Health • Commission staff, along with Commissioner • Site visits will be scheduled for The Schools and Mental Health Tamplen, conducted site visits to two Mental Calaveras and Sacramento counties Project is a multi-year effort to Health Student Services Act Wellness Center in January and March of 2023. guide funding and policy decisions programs in Marin County. • The next Learning Collaborative will supporting the provision of mental • Staff conducted a third site visit to Riverbank take place on March 1, 2023. health services to promote the Elementary School in Yolo County to hear academic and social success of • A plan for Technical Assistance will be about the implementation of their young people. The Commission implemented in the first quarter of partnership and workforce development has funded school-county 2023 and will include a focus on strategies. partnerships through grants to sustainability, partnership expand and better integrate • Commission staff held two Learning development, data collection, mental health services in schools. Collaborative meetings, September 7, 2022 and workforce development and December 7, 2022, which included and retention. information sharing on Wellness Center • Launch evaluation of school mental developments, partnership development, health investments. and staffing strategies. Both Learning Collaboratives included more than • Collaborate with state agencies on 150 participants. sustainable funding streams. Suicide Prevention Striving for Zero Suicide Suicide in California is a significant Prevention Strategic Planning Learning public health challenge. Guided by Collaborative data and community input, the • Four participating counties published local • Training module will be held in Commission developed a suicide prevention strategic plans: El Dorado, February 2023, and two collaborative statewide strategic plan for suicide Glenn, Kern, and Tulare Counties. meetings will be held, one in April prevention that incorporates the 2023 and one in June 2023 latest information and evidence to • Five counties advanced to drafting or guide state and local actions for finalizing their local county suicide saving lives. Following the prevention strategic plan. Commission’s 2019 adoption of • 91 check-in meetings with county teams the plan, the Commission is facilitated by the technical assistance team to working with governments and support counties. community partners to implement recommendations from the report • Up to 24 county teams participated in with the goal of reducing the rate learning modules on Older Adult Suicide and incidence of suicide in Prevention, Screening and Assessment, and California. Means Safety with a Focus on Suicide Prevention for Men. Suicide Risk Screening in Schools • 17 online, interactive • Trainings begin again in trainings hosted January 2023 • 1,299 participants trained • 50 counties participating • 287 school districts represented 13 Commission Biannual Report July 2022 –Dec 2022 INITIATIVE PROGRESS WHAT’S NEXT Suicide Prevention Suicide Fatality Review (SFR)Training (continued) • Five onsite and 92 virtual partners • After several requests from counties, participated in training for Lake County eight additional county teams will receive on site and ongoing training • 10 participants received additional virtual and technical assistance in 2023. training at the request of the Shasta County Sheriff/Coroner • 62 participants from 27 counties heard a virtual presentation on SFR and county presentations on implementation of SFR on November 8, 2022. Striving for Safety • Launch and continue to • Developed strivingforsafety.org, a website support strivingforsafety.orgto dedicated to placing lethal means safety support lethal means safety tools in the hands of every Californian. across California. Workplace Mental Health • Released draft of workplace mental health • The Workplace Mental Health Nearly one in five Americans live report. Advisory Committee met January 12, with a mental health condition, yet 2023to review a draft of the • Met with employers, federal leaders, and there are no well-established and workplace mental health report. others at One Mind At Work conference in agreed-upon standards in the U.S. Napa, CA. • Present report to the Commission for to guide public and private adoption and support employers about how to increase implementation after. mental health awareness in the workplace, support prevention, • Engage the Governor and the and respond to needs with Legislature as a large employer. recovery strategies. The Commission is developing a framework of voluntary standards to support mental health in the workplace for all Californians. Youth & Peer Empowerment • The Youth Innovation Project Planning • The Commission will discuss K-12 The Commission works through Committee is currently working with a advocacy funding strategies and a advocacy funding, sponsored contractor to develop a youth plan for funding allocation will be legislation, sponsored youth engagement toolkit. shared at its meeting in participation, and Committees to January 2023. • The Commission released the TAY Advocacy amplify the voices of youth and Request for Proposals in October 2022; • Host youth convening. peer leaders seeking to create awards were made at the very end of innovative solutions in the pursuit • Launch peer fellowship. December 2022. of emotional wellbeing and • Enhance engagement of youth prevention. • At the November meeting the Commission and peers. designated Commissioner Gordon to work with staff to create a strategy to use funds to • Expand technical support the involvement of K-12 students in assistance to support local conversations about school mental health community engagement. programs and policy; in early December • Expand partnership with Commissioner Gordon met with staff to Wellbeings/WETA project. outline the opportunities to allocate K-12 advocacy funding to amplify the voice of 14 students across California. Commission Biannual Report July 2022 –Dec 2022 FEATURED INITIATIVE: Prevention and Early Intervention Background: Guided by direction from the Governor and Legislature through Senate Bill 1004, in 2019 the Everyone should have the opportunity to be well Commission launched a policy research project to explore and thrive, yet 1 in 4 people opportunities for prevention and early intervention in worldwide will experience a mental health. significant disruption to their mental wellbeing at Prevention and early intervention (PEI) in mental health can be a difficult concept some point in their lifetime. for many to embrace. California's public mental health is focused on care and treatment. People traditionally have required a diagnosis to receive care. $210m Prevention and early intervention are foundational to protecting public health – not just mental health. It was not long ago that cancer was a life-ending diagnosis in almost every case. Public health departments, universities, hospitals, and other organizations united in a multi-pronged approach to prevent cancer. Researchers advanced and tested treatments to improve outcomes. Governments enforce safety standards for cancer-causing environmental factors. Hospitals adapted processes to ensure quicker intervention post-diagnosis. Patients receive routine screenings to allow for early intervention. Public health campaigns have helped communities see sunscreen as a powerful tool to reduce common forms of cancer. We have dramatically changed how we as a culture see cancer: something to be intercepted, treated, and for patients to thrive. This collaboration model across systems and companies has not been applied to mental health in the same way, but we are charged with changing this. Chances are, we will all be affected directly or through a friend or a loved one by a mental health challenge in our lives, and we must make prevention and early intervention a baseline to ensure the best outcomes possible. “Mental health is always a reflection of what is happening in our society broadly. And sowe need a framework, then that can evolve, as needs and concerns evolve. Prevention at its core, is recognizing the diversity of needs, and strengths in communities, and then creating response around that.” Kali Patterson Commission Research Scientist 15 Commission Biannual Report July 2022 –Dec 2022 But what does prevention and early intervention encompass? There are four main areas that are part of this continuum: 1 2 3 4 A statewide, multi- A plan must include strategies Addressing stigma and Recognizing that prevention partnered approach to to address shared risk factors misconceptions related to is also about preventing prevention at a macro level, that affect everyone mental health and negative consequences that with leadership support differently –i.e.addressing empowering people with occur when someone doesn’t basic socio economicneeds information that is credible, have adequate and to be well and ongoing accessible, and can help appropriate mental health traumas, and investing in them support their needs and support. People can live people’s resilience help them recognize happy and fulfilling lives with someone in crisis a diagnosis, and creating a system of care that is equitable and accessible can help them achieve wellness There are many opportunities to advance PEI and during this project through dozens of meetings and interviews, it became clear we needed a strategic framework. To create that, we needed to understand the needs of Californians –the threats to their mental health, the barriers to PEI, and the solutions they believe will be most valuable. Mental health threats will continue to change and evolve, and we need a framework that can evolve with them; a framework that is responsive to community needs instead of prescriptive. The first step is addressing basic needs. Ensuring people have enough resources to make sure they are fed well and housed and have opportunities to connect with people in their communities. Progress: July – December 2022 The Prevention and Early Subcommittee met to hear public The Commission’s Cultural and Intervention Subcommittee comment on its draft report on Linguistic Competency Committee released the first draft of its final September 7, 2022in San Diego and met on October 18and project report on August 24, 2022. October 6, 2022in Sacramento. November 10 and Client and Family Leadership Committee met on October 25 and November 15 to discuss the report. 16 Commission Biannual Report July 2022 –Dec 2022 Impact: Short Term Impact: Long Term One of the areas of opportunity that the Commission will The concepts of prevention and intervention in mental be focused on in the next six months is around health require a critical shift in thinking and acting. How prioritizing PEI investments. We have seen how critical it do you prevent a mental health crisis from happening in is for communities who continue to experience the first place? How do you prevent the escalation of a disparities to be heard and to respond, and going mental health challenge or the progression of a mental forward the Commission will be seeking input on health need? creating a process to identify programs to help disparities. • The subcommittee released the revised draft of the report January 3, 2023. • The subcommittee met January 17, 2023to hear comments on the revised draft. • The Commission will consider adoption of the report in 2023. I MPA CT IN AC TION Seeking Understanding $210m Since the project’s start in 2019, Californians have faced a pandemic, social, political and racial divisions, and more. It became clear that threats against mental health were global, cultural, and societal. Although we had to pivot our work during COVID-19, the Commission hosted virtual listening sessions to ensure voices representing as many communities as possible –both cultural and regional –were heard. Our approach was broad and open-ended, seeking to understand what communities found harmful and helpful, what it means to talk about mental health in their culture and language, and who in the community needs training and outreach. More than 800 people participated, helping us listen to voices that have never beforebeen at the table. We reached communities who were unfamiliar with the Commission or who wouldn’t have normally come to a government meeting. 17 Commission Biannual Report July 2022 –Dec 2022 FEATURED PROGRAM: Full Service Partnerships Background: Full ServicePartnership (FSP) programs support people with the most severe and persistent mental health needs. These programs, which are required under California's Mental Health Services Act, are designed to apply a “whatever it takes” approach to partnering with individuals on their path to wellness and recovery. FSPs were designed to serve people in the community rather than in locked facilities or hospitals. As they continue to be implemented across the state, FSPs can reduce costs, improve the quality and consistency of care, enhance outcomes, and most importantly, save lives. Currently, more than 70,000 individuals are enrolled in an FSP program across the state. Full ServicePartnerships represent a nearly $1 billion annual investment in public funds and have tremendous potential to reduce psychiatric hospitalizations, homelessness, incarceration, and prolonged suffering by Californians with severe mental health needs. Mental health is an extremely individual and However, the information sharing and collaboration emotional journey, requiring care that is responsive to between these nine counties has helped them learn from the needs of each person, and making it challenging to each other. They are sharing ideas on what is most standardize care. important to help FSP participants succeed and what information and data can help state and local leaders best In partnership with Third Sector, a non-profit consulting measure and report successes and challenges. agency, the Commission supported a project to strengthen FSP programs in nine counties. Through this work we FSPs support individuals with severe mental illness in an learned that the overarching challenge of scaling FSPs is intensive continuum of care in an outpatient setting, and the need for standardized data, and a common language are often tied closely to the individual’s community. The that is consistent across programs. Each of the counties ideal scenario that we are working toward in developing involved was made up of diverse communities, cultural and scaling FSPs throughout the state would see a person backgrounds, and target populations. And there is no follow a journey similar tothis: one-size-fits-all solution. 1 2 3 4 A person becomes a They are welcomed with a The person spends 1-2 The person graduates member of an FSP whole person care years in the FSP from the FSP, meaning program with 24/7 access they have learned to a care team –a strategies to live multidisciplinary team independently and that ensures they receive confidently, with a case management, basic resilient, healthy engagement strategies, connection to their and builds trust and community rapport with them 18 Commission Biannual Report July 2022 –Dec 2022 This project involved conducting more than 200 If we can intervene in mental health journeys and treat interviews with FSP participants and found that one of people earlier through FSPs, we can change their the most important measures of success is increased trajectories. Early data has shown us that FSPs are social connectedness. When asked what success looks successful, recidivism is low, and the outcomes we have like, participants said they felt like they had a seen thus far are promising. Success for an individual is community and felt supported and this helped them about them feeling well, stable, and independent, and feel that they were making progress. Community that they’ve arrived at a place where they can see their connectedness is a powerful metric highlighted by path forward. individuals in the program. Progress: July - December ‘22 Prior to the passage of the legislation directing the and recommendations around evidence-based practices Commission to evaluate FSPs, an Innovation Incubator from the project’s evaluator, RAND, the counties selected project on FSPs was in progress. This FSP project now and defined five measures to compare across counties has nine counties working together and aims to for adult FSP participants: implement a more uniform data-driven approach that provides counties with an increased ability to use data to • Increased Stable Housing improve FSP services and monitor outcomes. Counties • Reduced Justice Involvement are leveraging the collective power and shared learnings • Reduced Utilization of Psychiatric Services of a cohort to collaborate on how to provide the most • Increased Social Connectedness impactful FSP programs and ultimately drive • Frequency of Locations and Services transformational change in the delivery of mental health services. Building off this initial work, the Commission has prepared a report to the Leg$islat2ure o1n op0pormtunities to Participating counties worked together to identify strengthen FSPs moving forward. standardized measures for tracking what services individuals receive and how successful those services are. Guided by more than 70 FSP participant interviews 19 Commission Biannual Report July 2022 –Dec 2022 Impact: Short Term Impact: Long Term The initial FSP report and the efforts of the Multi-County The long termgoal for the statewide evaluation of FSPs is Innovation Project help shine a light on the current data to assess the extent to which programs are maintaining limitations and barriers to identifying best practices, clients in the community –helping them avoid cycling local, and statewide successes for FSP programs. The through hospitals and the criminal justice system, and recommendations generated by both projects provide living in stable housing environments. The evaluation direction for strengthening data quality, streamlining can establish best practices and provide implementation data reporting, and supporting consistency in FSP guidance to FSPs across the state so that clients are implementation. supported in their recovery. IMPACT IN ACTION Participants Involved in the Process During the Innovation Incubator project on FSPs, the team strove to listen to and elevate the voices of individuals receiving services, and to include them in decision making around services and programs. One county had a consumer engagement council made up of current and graduate participants, and others who met monthly to help the county think through program tools, success measurement, cultural responsiveness, inclusivity, and more. The power of including participants in their own journeys revealed extremely valuable insights. $210m “ “ Success would be for me, at least a semester of school, Slowly ease me into the transition process, rather than getting my own apartment. And feeling like less of a mental abruptly changing services. Not, oh we’re done with you. health case, and more of a, I guess, normal person.” Hope you have a good life.” —Fresno County FSP participant —Sacramento County FSP participant 20 Commission Biannual Report July 2022 –Dec 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. 21 Commission Biannual Report July 2022 –Dec 2022 Committees COMMITTEE PROGRESS UPDATE WHAT’S NEXT Anti-Bullying • Completed research and interviews with • Launch social media campaign to Advisory Committee youth, community members, and support youth –especially Asian subject matter experts into how a American, Pacific Islander, and other Chair:Commissioner ShuoChen social media response can meet the BIPOC youth –who have been bullied, Led by youth members, the Committee needs of youth who have been or are and share youth voices and resources. helps the Commission develop a social being bullied. • Monitor and support campaign into media strategy that will deliver trusted • Determined campaign direction and the summer. content designed to reduce the risks began work with youth advisors on associated with bullying and build resiliency among children and youth. campaign identity. The Committee will advise on the • Met on August 17 and strategy and how to make the November 17, 2022 content engaging and accessible to young audiences. Children’s Committee • The Children’s Committee met on • Clarify workplan November 8, 2022and continued the Chair:Commission Chair • Recruit members discussion on Committee goals and Mara Madrigal-Weiss membership, and heard a presentation • Develop staff resources California is on the brink of from a subject matter expert on the 0-5 unprecedented investment in year oldpopulation and related mental children’s mental health, and this health needs. The information presented presents exceptional opportunities. In its inaugural meeting, the Committee can guide Commission support through outlined two potential goals for its Mental Health Wellness Act funding. 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. Client and Family • The Committee reviewed a draft of the • Next steps on the Peer Certification Leadership Committee Peer Certification Resources Guide. Resources Guide will be determined in 2023. Chair:Commissioner KhateraTamplen • New Committee chairs and members will Made up of peer providers, consumers, be named in 2023. family members, and representatives from diverse populations, the Committee explores best practices in implementing Peer Support Specialist Certification and works with the Department of Health Care Services to support the creation of program standards that reflect 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. 22 Commission Biannual Report July 2022 –Dec 2022 COMMITTEE PROGRESS UPDATE WHAT’S NEXT Cultural and Linguistic • A report of the activities and • New Committee chairs and members will Competency Committee accomplishments of the CLCC over the be named in 2023. past 2 years was shared with the Chair:Commission Vice Chair Committee to document the public Mayra E. Alvarez engagement that has taken place. Vice Chair:Commissioner Gladys Mitchell • Committee met on July 14, August 23, September 8, October 18, and November The Committee focuses on 10, 2022. understanding inequities in California’s mental health system and identifying strategies to achieve equity. The Committee will identify ways to document and communicate inequities in California’s mental health system, model highly successful programs and other promising initiatives, and push for reforms to existing policies and practices. Fellowship Committee • Job listings were posted for the Peer • The Commission will hire and onboard a Fellow and Clinician Fellow in fall 2022 Peer Fellow and Clinician Fellow in 2023. Chair: Commissioner KhateraTamplen and the hiring process began. The Committee provides guidance on the goals, design, eligibility criteria, and application process for the Commission’s Mental Health Policy Fellowship for a mental health professional and a mental health consumer. Research and Evaluation • The Committee met on August 17, 2022. • The full Research and Evaluation Committee • Formed a workgroup to further look into Committee will continue to meet semi- annually to provide input and direction Mental Health Student Services Act Chair:Commissioner ItaiDanovitch on the innovation evaluation and projects; workgroup met on October 5, provide direction on the research Comprised of a diverse, interdisciplinary 2022and December 16, 2022. group of experts, the Committee priorities for the Commission. provides guidance and expertise that Additionally, a Full ServicePartnership reflects a broader understanding of the Workgroup will be formed to focus on opportunity for driving transformational the legislative mandate to report on change using research to improve prevention and innovation, as well as these programs. 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. 23 Commission Biannual Report July 2022 –Dec 2022 04 FOUNDATIONAL WORK 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. 24 Commission Biannual Report July 2022 –Dec 2022 FEATURED FOUNDATIONAL EFFORT Community Documentary Screenings Help Bring Awareness to Youth Mental Health Challenges Hiding In Plain Sightcommunity screening on September 22, 2022 Nearly 4 million video views to date. That is how many times since its June 2022 premiere on PBS stations across the nation that someone in the world has watched –and potentially been impacted by –Hiding in Plain Sight: Youth Mental Illness. A powerful documentary, produced in both English and Spanish by Ken Burns with support from the Commission, has not only been screened at the White House and in front of Congress with Commission representatives, First Lady Jill Biden, and other public and private sector decision makers in attendance, but has also been honored with the 53rd Annual Public Media Award for Excellence in Community Engagement, the 2022 Mental Health America Media Award, and most recently, the 2023 Research America Isadore Rosenfeld Award for Impact on Public Opinion. The incredible reach and impact of this film and its message not only supports the Commission’s legislative directive of distilling and disseminating knowledge on how mental health issues can be prevented, detected early, and addressed at population scale, it 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. It also supports the Commission’s strategic goal to better communicate the potential to prevent mental health issues to decision makers. Further impact from the Commission’s work on Hiding in Plain Sight: Youth Mental Illnesswas realized the second half of 2022 when the Commission hosted a special screening of the film and panel discussion at The Sofia in Sacramento, featuring the film’s director Christopher Ewers, youth film subject Morgan Brennan, and local youth mental health advocates. “Who would ever have imagined that youth mental health would one day be the subject of a Ken Burns documentary,” said Sacramento Mayor Darrell Steinberg, during his opening address to the event’s audience. 25 Commission Biannual Report July 2022 –Dec 2022 Following a reception and film screening, Ewers and Brennan were joined onstage by moderator and former Youth Innovation Committee member, Juan Acosta, as well as TrayzellWhite and Tanisha Lakanpal, local youth mental health advocates representing different regional groups. In addition to youth voices, the panel included California Deputy Director for Behavioral Health Stephanie Welch, and Commissioner Dave Gordon, also Sacramento County Superintendent of Schools since 2004, representing the Governor’s and the county’s perspectives respectively on the youth mental health crisis and how the state and local governments are responding. Together with partners at the Steinberg Institute, the Sacramento County Office of Education, The Children’s Partnership and PBS KVIE, the Commission is proud to not only have created the opportunity for more than 200 regional attendees to experience the film and hear live from its creators interacting with local youth, sitting side-by-side with government officials, but also to ask questions and interact with all the panelists, before, during and following the event. And the impact continues. As a result of attending the Commission’s Sacramento screening on September 22, an attendee from the Napa County Office of Education was inspired to host a screening in their region. Just over a month following the Commission’s event, Commission Director Toby Ewing sat on the discussion panel with youth and local education and behavioral health leaders during the Napa screening of Hiding in Plain Sight: Youth Mental Illness, on November 7, at the Napa Valley College Performing Arts Center. While more than 25 screenings of the film have been held throughout California, the Commission sees additional room for outreach on the opportunity for communities of all kinds to host a screening event. As a result, and in partnership with WETA, Commission staff have created a tool kit counties and community organizations can use to design and host their own screening events with panel discussions. In addition to supporting additional community engagement through screenings, the Commission worked with PBS KVIE, producers of the state- wide public affairs program Studio Sacramento, to sponsor an episode on the youth mental health crisis covered in the film. The Commission connected two individuals featured in the film, youth mental health advocate Makalynn Powell, and former leader of the National Institute of Mental Health, Dr. Tom Insel, with the show’s host Scott Syphax. The initial episode ran on November 18, 2022, with repeats throughout the following week, and it is available to watch anytime on the PBS KVIE website or on the free PBS Video app. 26 Commission Biannual Report July 2022 –Dec 2022 Foundational Work: July – Dec Progress Report EFFORT PROGRESS WHAT’S NEXT Administration • The Commission approved its Racial Equity • Working to create and implement a Work to prepare budgets and Plan at its November 2022 meeting. Commission Intranet to help contracts, support personnel and facilitate staff productivity and • Commission staff are updating fiscal hiring, and coordinate logistics to support capacity building. tracking tools to support public budget enable transformational change at presentations. • Strategic planning for 2024-2027. the Commission. • Commission staff are developing dynamic • Develop monthly progress organizational charts. reporting strategy on Commission initiatives. Advocacy Grants • Advocacy partners held six statewide • Release RFP for K-12 Student In approving the Mental Health events bringing the voice of mental health Advocacy project in early 2023. Services Act (MHSA) in 2004, California consumers, diverse racial and ethnic • Evaluate renewal of grants. voters mandated the use of communities, families, LGBTQ+ transparent and collaborative communities, parents and caregivers, and • Assess impact of existing grants. processes in determining the mental veterans to state legislators at the Capitol health needs, priorities, and services. • The Commission began partnerships with The Act aims to change the way people eight local advocacy organizations and one access mental health services and state-level organization to form a coalition participate in policy planning. It also to address the mental health needs of seeks to change public perception and immigrants and refugees reduce the stigma associated with mental health challenges. • Commission staff gathered information from over 80 Transition Age Youth (TAY) Through MHSA funding, the advocates and adult allies to inform the Commission awards grants to local next round of advocacy funds for TAY and state-level organizations to • VETART, the Commission’s advocacy provide advocacy, training, education, partner for veteran communities, brought and outreach on behalf of nine specific together 35 artists and 200 attendees to the populations: clients and consumers, Capitol West Steps in October to promote diverse racial and ethnic mental wellness through art, music, and communities, families, K-12 students, expression. Commission Chief of LGBTQ+, parents and caregivers, Community Engagement and Grants spoke transition age youth, veterans, and before veteran advocates on the immigrants and refugees. Commission’s partnership with the veteran community. 27 Commission Biannual Report July 2022 –Dec 2022 EFFORT PROGRESS WHAT’S NEXT Communication • Increased awareness of youth mental • Increase public awareness of lethal The Commission leverages health challenges by hosting public means safety in suicide prevention communication opportunities to screening of documentary Hiding In Plain by publicizing launch of improve public understanding of Sight: Youth Mental Illnessin Sacramento in forthcoming lethal means mental health needs, the potential for partnership with the Steinberg Institute, safety website. recovery, the value of services and the The Children’s Partnership, Sacramento • Improve public access to opportunity for transformational County Office of Education, and PBS KVIE. Commission information by change to significantly improve • Created and shared screening tool kit to updating website content to reflect results. The Commission publishes its empower counties and community more depth and detail. own communications in addition to organizations to host their own screenings leveraging strategic partnerships. of Hiding In Plain Sight: Youth Mental Illness • Supported release of PEI report drafts and engagement for community support. • Created additional partnership with WETA on its Wellbeingsproject, supporting continuing education around the documentary Hiding In Plain Sight: Youth Mental Illnessand supporting the creation of an upcoming documentary and accompanying educational materials, Hiding In Plain Sight: Adult Mental Illness. • Created series of fact sheets to help increase understanding of Commission strategic initiatives. Legislation • During the 2022-23 budget process, the • Launch of the 2023 Legislative year. Created and guided by legislation, the Legislature and Governor authorized Commission tracks legislation that changes to the Mental Health Wellness Act. impacts its work. Periodically, Statutory changes were made to allow consistent with the Commission's Mental Health Wellness Act funds to be policy projects and publicly adopted used to support crisis prevention and early priorities, the Commission will sponsor intervention, in addition to crisis response or support legislation. services and to allow use of these funds to work with partners other than county behavioral health departments, to support strategies other than supplemental staffing, to allow matching fund requirements and to allow competitive or non-competitive procurements when doing so is in the public interest. 28 Commission Biannual Report July 2022 –Dec 2022 Year-to-Date Budget Update The table below illustrates the budget for Fiscal Year 2022-2023, year-to-date expenses, committed funds, and funds that are potentially available for the Commission to use in the future. ADJUSTED YTD POTENTIALLY EXPENSE TYPE ITEM FY 22-23 COMMITTED EXPENSES AVAILABLE BUDGET Operations Personnel $7,380,000 $3,389,658 $3,700,000 $290,342 Core Operations $1,784,552 $460,086 $1,270,251 $54,215 Commission Priorities Communications $887,448 $264,100 $611,200 $12,148 Innovation $100,000 $100,000 Research $1,116,000 $64,034 $831,787 $220,180 Legislative Items California Behavioral $5,000,000 $5,000,000 Outcomes Fellowship Evaluation of FSP $400,000 $239,000 $161,000 Outcomes (SB 465) MHSSA Evaluation and $16,646,000 $63,163 $3,525,000 $13,057,837 Admin (avail over 5 years) Local Assistance Mental Health $20,000,000 $20,000,000 Wellness Act MHSSA $8,830,000 $179,937 $8,650,063 Community Advocacy $6,700,000 $732,550 $5,967,450 Children and Youth Behavioral $42,900,000 $42,900,000 Health Initiative Money Held For Reserve ($250,000) Total $111,744,000 $5,153,528 $77,368,907 $13,645,722 29 Commission Biannual Report July 2022 –Dec 2022 STAY IN TOUCH https://mhsoac.ca.gov/ https://www.facebook.com/mhsoac https://twitter.com/MHSOAC https://www.youtube.com/mhsoac https://www.instagram.com/mhsoac 30