California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.org

September 2013

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Table of Contents (Scroll down to read all articles or click on a title and/or calendar to read that article)

California Mental Health and Substance Use Policy Forum - “Improving Access, Reducing Disparities for Underserved Populations” (September 11-13, 2013)

DSM-5™: When Can We Use IT? (September 20, 2013)

Workforce Development: "!e Bridge to Health Care Reform” is the theme for the upcoming Regional Mental Health Cultural Competence Summit (October 2-3, 2013)

Fiscal Leadership Institute Series Puts Focus on Integration (November 5-6, 2013)

Peer Support in Congregations

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Policy'Forum!

Sept.&11"13!

DSM"5™!

Sept.&20!

Regional)Mental)Health'CC'Summit'

Oct.%2"3!

Fiscal"Leadership"Ins$tute(Series(

Nov.%5"6!

California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.org

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California Mental Health and Substance Use Policy Forum “Improving Access, Reducing Disparities for Underserved Populations”

By Sandra Naylor Goodwin, PhD, MSW, President and CEO, CiMH and Alice J. Washington, Associate, CiMH

!e next California Mental Health and Substance Use Disorders Policy Forum is on September 12, 2013 in San Diego. !e Policy Forum is held two times a year, in February and September. !e event is conducted by the California Institute for Mental Health. !e sponsors of the event are the following: California Mental Health Directors Association (CMHDA), the County Alcohol and Drug Program Administrators of California (CADPAAC), the California Council of Community Mental Health Agencies (CCCMHA), and the California Association of Alcohol and Drug Program Executives (CAADPE).

Most policy forums highlight important mental health and substance use disorder policy initiatives in California. !is Policy Forum is focused on increasing access and reducing disparities for underserved or inappropriately served populations. We will be highlighting outcomes from Los Angeles County that examine access issues for these populations. We will also highlight the California Reducing Disparities Project (CRDP) and the !ve reports from this work. !e CRDP strategic plan will be the focus of one presentation. Each of the !ve population reports will be the focus of break-out sessions. Each of these sessions will be conducted by one of the authors of the !ve reports, along with a county or CBO program addressing the need of the speci!c population. !e last panel of the day will include “next step” responses from the presidents of CMHDA, CCCMHA, CADPAAC, and CAADPE.

Links to the CRDP Reports

Please register for the policy forum using this link: http://cimh.networkofcare4elearning.org/EventDetail.aspx?pId=177&OrgId=223

Preview all handouts at: http://www.cimh.org/Learning/Conferences-Training/Handouts.aspx

California Reducing Disparities Project reports http://www.cdph.ca.gov/programs/Pages/CaliforniaReducingDisparitiesProject(CRDP).aspx

African American Population Report http://www.aahi-sbc.org/Afi-Am_Population_Report_.php

Asian/Pacific Islander Population Report http://crdp.pacificclinics.org/resources

Latino Population Report http://www.ucdmc.ucdavis.edu/crhd/images/pdf/Latino_SPW_3_8.PDF

LGBTQ Population Report http://www.eqcai.org/atf/cf/%7B8cca0e2f-faec-46c1-8727-cb02a7d1b3cc%7D/FIRST_DO_NO_HARM-LGBTQ_REPORT.PDF

Native American Population Report http://issuu.com/nativeamericanhealthcenter/docs/native_vision_report !

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DSM-5™: When Can We Use IT?

Since the release of DSM-5™in May 2013, it seems that the most frequently asked question is “When can we start using the DSM-5™?” The short answer is “it depends”.

On one hand, clinicians may use it immediately given that DSM-5™is compatible with the HIPAA-approved ICD-9-CM and ICD-10-CM coding system now in use by insurance companies and Medi-Cal (information about its approval for use in the U.S. by CMS can be found at https://questions.cms.gov/faq.php?id=5005&faqId=1817).

On the other hand, there are changes in format and the elimination of the multi-axial system that was the hallmark of DSM-III and DSM-IV, as well as significant changes in some diagnoses in DSM-5™. This has resulted in delaying full implementation of DSM-5™ by insurance companies, DHCS/Medi-Cal, and compliance agencies that need to update their claim forms and reporting procedures to accommodate these changes. Consequently, the roll out of DSM-5™implementation is contingent upon guidelines set forth by one’s payer source. For now, clinicians should use DSM-IV-TR diagnoses and codes when required by a specific payer or governmental agency.

Aside from the insurance delays, DSM-5™continues to be the only up-to-date manual that contains pertinent clinical information and criteria needed for mental health professionals to base their diagnostic and treatment decisions. This new edition has made some major changes and improvements to how clinicians think through and make diagnoses and quality assessments. Some of the changes include adding developmental and spectrum approach, cultural formulation, and cross-cutting measures.

To learn more about these changes, the new diagnoses and clinical utility in DSM-5™, CiMH has offered open enrollment trainings to the public as well as individualized trainings to counties and agencies. The next full-day training, which includes CEU credits will be on Sept 20, 2013 at the CiMH offices in Sacramento, CA and is open to anyone interested in attending.

Registration and further details are available at http://cimh.networkofcare4elearning.org/EventDetail.aspx?pId=188&OrgId=223

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California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.org

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DSM-5™: When Can We Use IT?

Since the release of DSM-5™in May 2013, it seems that the most frequently asked question is “When can we start using the DSM-5™?” The short answer is “it depends”.

On one hand, clinicians may use it immediately given that DSM-5™is compatible with the HIPAA-approved ICD-9-CM and ICD-10-CM coding system now in use by insurance companies and Medi-Cal (information about its approval for use in the U.S. by CMS can be found at https://questions.cms.gov/faq.php?id=5005&faqId=1817).

On the other hand, there are changes in format and the elimination of the multi-axial system that was the hallmark of DSM-III and DSM-IV, as well as significant changes in some diagnoses in DSM-5™. This has resulted in delaying full implementation of DSM-5™ by insurance companies, DHCS/Medi-Cal, and compliance agencies that need to update their claim forms and reporting procedures to accommodate these changes. Consequently, the roll out of DSM-5™implementation is contingent upon guidelines set forth by one’s payer source. For now, clinicians should use DSM-IV-TR diagnoses and codes when required by a specific payer or governmental agency.

Aside from the insurance delays, DSM-5™continues to be the only up-to-date manual that contains pertinent clinical information and criteria needed for mental health professionals to base their diagnostic and treatment decisions. This new edition has made some major changes and improvements to how clinicians think through and make diagnoses and quality assessments. Some of the changes include adding developmental and spectrum approach, cultural formulation, and cross-cutting measures.

To learn more about these changes, the new diagnoses and clinical utility in DSM-5™, CiMH has offered open enrollment trainings to the public as well as individualized trainings to counties and agencies. The next full-day training, which includes CEU credits will be on Sept 20, 2013 at the CiMH offices in Sacramento, CA and is open to anyone interested in attending.

Registration and further details are available at http://cimh.networkofcare4elearning.org/EventDetail.aspx?pId=188&OrgId=223

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Workforce Development: “The Bridge to Health Care Reform”

WORKFORCE DEVELOPMENT: “The Bridge to Health Care Reform” is the theme for the upcoming Regional Mental Health Cultural Competence Summit which will convene October 2-3, 2013 at the Doubletree Hotel in Modesto, California. The Regional Summit is co-hosted by Stanislaus, Merced, Sacramento, and San Joaquin counties. The Regional Summit will feature a range of cultural competence skill building workshops, vendor fair and nationally renowned speakers. The enriching two-day event will provide a forum for promoting and advancing cultural competence throughout organizations and systems in order to more effectively meet the needs of individuals and families from diverse communities. Featured keynote presenters include Dr. Daniel E. Dawes Esq. and Sergio Aguilar-Gaxiola, MD, PhD of UC Davis Center for Reducing Health Disparities, Professor of Clinical Internal Medicine.

The commitment to ensure culturally competent care in the advancement of wellness and recovery is shared across mental health, substance abuse, and primary care organizations and extends to communities, including individuals with lived experience and their families. Healthcare professionals from diverse backgrounds, managers, decision makers in leadership roles, representatives from community based organizations, physicians (including family physicians, pediatricians and psychiatrists), faculty and staff from academic departments, representatives from faith based communities, as well as researchers and collaborators from different sectors (e.g., emergency social services, law enforcement officers, or employers) are all invited to attend.

For more information about registration and hotel accommodations, please visit our website http://cimh.networkofcare4elearning.org/EventDetail.aspx?pId=162&OrgId=223 or contact conferences@cimh.org !

California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.orgPage 4

Fiscal Leadership Institute Series Puts Focus on Integration

CiMH's next Fiscal Leadership Institute will equip finance managers in county behavioral health departments to address new challenges in a post-Affordable Care Act (ACA) environment. Taking place on November 5-6, 2013 in Sacramento, CA the two-day conference is the fifth in a training series focused on equipping fiscal leaders with the knowledge, skills, and tools needed to manage the complex fiscal environment of county behavioral health services financing. Registration information will be available soon.

The Institute enables fiscal experts to hear from leading experts including Dale Jarvis, Mike Geiss, Tom Renfree, Don Kingdon, The Kiely Group, and many others who provide in-depth information and opportunities for dialogue on critical topics. Critical to building a cohort of fiscal leaders who will guide the mental health system through complex challenges, the Institute also includes a component on leadership development and bridge-building across counties.

Institute participants have noted the Institute provides rare opportunities for established and emerging county leaders to focus, problem-solve, and bring together the best working knowledge on finance and leadership in county behavioral healthcare systems.

For more information, please contact Adrienne Shilton of the California Institute for Mental Health at 916-556-3480, ext. 148 or email ashilton@cimh.org.

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California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.orgPage 5

Fiscal Leadership Institute Series Puts Focus on Integration

CiMH's next Fiscal Leadership Institute will equip finance managers in county behavioral health departments to address new challenges in a post-Affordable Care Act (ACA) environment. Taking place on November 5-6, 2013 in Sacramento, CA the two-day conference is the fifth in a training series focused on equipping fiscal leaders with the knowledge, skills, and tools needed to manage the complex fiscal environment of county behavioral health services financing. Registration information will be available soon.

The Institute enables fiscal experts to hear from leading experts including Dale Jarvis, Mike Geiss, Tom Renfree, Don Kingdon, The Kiely Group, and many others who provide in-depth information and opportunities for dialogue on critical topics. Critical to building a cohort of fiscal leaders who will guide the mental health system through complex challenges, the Institute also includes a component on leadership development and bridge-building across counties.

Institute participants have noted the Institute provides rare opportunities for established and emerging county leaders to focus, problem-solve, and bring together the best working knowledge on finance and leadership in county behavioral healthcare systems.

For more information, please contact Adrienne Shilton of the California Institute for Mental Health at 916-556-3480, ext. 148 or email ashilton@cimh.org.

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California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.orgPage 6

Peer Support in Congregations !

The Center for Multicultural Development, a division of the California Institute for Mental Health (CiMH), launched the Peer Support in Congregation pilot project during 2012-13. Pastors traditionally serve as the first line of support to congregants in crisis and in under resourced communities such as the Lesbian, Gay, Bisexual, Transgender, Questioning (LGBTQ) community where the need is high and service providers are few. The church is often assessing, referring, and sometimes providing limited forms of treatment when access to services is unavailable. This project sought to expand the number of trained individuals available to support the Pastor’s efforts to serve individuals in crisis in the LGBTQ community. The overall purpose was to implement peer-based mental health prevention and early intervention services to un-served/underserved LGBTQ populations in open, same gender loving, affirming faith-based organizations that provided targeted outreach to LGBTQ communities. The project sought to empower the community to create strategies for identifying and managing mental illness and to engage faith-based organizations as a conduit for services to the LGBTQ community.

A key component of the Peer Support in Congregations project included the training of individuals within the congregations with ” lived experience”; those who have successfully navigated and managed the mental illness of themselves, their family members or friends. “Peers” were selected by their pastor to participate in the project to provide social support, education, resources, and facilitation of access to care and community support to individuals at-risk of or those living with mental illness, who seek support from faith based organizations to manage their mental health. Peers were asked to provide community-based services and social support that complemented, but did not substitute, the more specialized services of mental health care providers.

We believe by being able to use their unique position, skills, and expanded knowledge base, Peers may help reduce health care and personal costs as they identify locally-driven, culturally and ethnically appropriate services, while also integrating essential spiritual and social support. We also assert that engaging the leadership and members of faith-based organizations who are consumers and family members helped to reduce stigma related to mental illness and psychological distress.

During the course of the pilot year, over 75 Pastors and Peers from eleven churches across the state participated in the project. CiMH supported these churches and their local community by helping to build their capacity to appropriately and adequately address the mental health needs of their community. This was accomplished through individualized meetings and technical assistance provided to each participating church, in addition to general trainings offered to all of the Pastors and Peers. Each church designed their own Mental Health Wellness Ministry according to their unique needs, location, and make-up. Congregations developed innovative strategies for implementation of this ministry or expanded upon current programs that were culturally relevant and appropriate to meet their needs. Some examples include: use of social media to provide mental health information; development of homeless and food ministries; celebration of Mental Health Awareness Month in May through invited speakers. A number of churches also collaborated to write

a grant for county innovation funds in order to further develop their Mental Health Wellness Ministries.

Pastors and Peers were trained in Mental Health First Aid (MHFA), Wellness and Recovery Action Planning (WRAP), and Healing from the INSIDE OUT. In addition to participating in the formalcurriculum for these trainings, discussions relevant to the impact of the mental health information for the LGBTQ population and faith-based community were integrated throughout. Participating churches also received Peer Support in Congregations Newsletters, which highlighted relevant mental health information, resources, and project related details.

Participants appreciated the training received as well as the opportunity to connect with and learn from other Peers and Pastors. They provided numerous testimonies regarding how the information provided and tools gained helped to create a positive impact and change in own lives, within their families, in their congregations and communities.

Comments from participants included: • This should be required training for any ministry or pastor! Thank you. • I believe this program is quintessential to the people of God – those affected by mental

health. • Very enlightening, learned a lot about myself. Now I have tools to help others. • Validation that God has me on the right path to do the work I was called and destined to do

– provide support, help and healing to those experiencing and living through mental illness to wholeness.

Peers and Pastors in the project agreed to uphold the following “Mental Health Wellness Ministry Pledge.” Imagine what a different experience people living with mental illness could have if we all lived by this pledge.

As the Peer Support Wellness Ministry of _______Church, we embrace the thought that individuals living with mental illness can lead fulfilling and happy lives. Our intention is to create a caring and compassionate congregation by providing emotional support, practical referrals, and spiritual counseling. We agree to continue to educating ourselves and our community about mental illness. We strive to create a culture that is understanding, loving and supportive of people who are living with mental illness and their families, a culture that normalizes seeking emotional support and refrains from using negative mental illness language. We pledge to begin our efforts of Wellness by taking active steps to take care of ourselves. Our goal is to improve the lives of those living with Mental Illness and support them in a life of wellness and recovery.

For more information contact: Kristee Haggins, PhD at khaggins@cimh.org!

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California Institute for Mental Health 2125 19th Street, 2nd Floor (916) 556-3480 www.cimh.orgPage 7

a grant for county innovation funds in order to further develop their Mental Health Wellness Ministries.

Pastors and Peers were trained in Mental Health First Aid (MHFA), Wellness and Recovery Action Planning (WRAP), and Healing from the INSIDE OUT. In addition to participating in the formal curriculum for these trainings, discussions relevant to the impact of the mental health information for the LGBTQ population and faith-based community were integrated throughout. Participating churches also received Peer Support in Congregations Newsletters, which highlighted relevant mental health information, resources, and project related details.

Participants appreciated the training received as well as the opportunity to connect with and learn from other Peers and Pastors. They provided numerous testimonies regarding how the information provided and tools gained helped to create a positive impact and change in own lives, within their families, in their congregations and communities.

Comments from participants included: • This should be required training for any ministry or pastor! Thank you.• I believe this program is quintessential to the people of God – those affected by mental

health.• Very enlightening, learned a lot about myself. Now I have tools to help others.• Validation that God has me on the right path to do the work I was called and destined to do

– provide support, help and healing to those experiencing and living through mental illnessto wholeness.

Peers and Pastors in the project agreed to uphold the following “Mental Health Wellness Ministry Pledge.” Imagine what a different experience people living with mental illness could have if we all lived by this pledge.

As the Peer Support Wellness Ministry of _______Church, we embrace the thought that individuals living with mental illness can lead fulfilling and happy lives. Our intention is to create a caring and compassionate congregation by providing emotional support, practical referrals, and spiritual counseling. We agree to continue to educating ourselves and our community about mental illness. We strive to create a culture that is understanding, loving and supportive of people who are living with mental illness and their families, a culture that normalizes seeking emotional support and refrains from using negative mental illness language. We pledge to begin our efforts of Wellness by taking active steps to take care of ourselves. Our goal is to improve the lives of those living with Mental Illness and support them in a life of wellness and recovery.

For more information contact: Kristee Haggins, PhD at khaggins@cimh.org !

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