Features

On Jan. 22^nd, more than 100 people gathered in Berkeley for an all-day event to learn about innovative ways to provide care for adults and older adults with a mental health concern. The conference, presented by Alameda County Behavioral Health Care Services, featured speakers and workshops with a focus upon improving mental health outcomes for Alameda County residents – isolated adults (ages 18 – 59) and isolated older adults (age 60 and older). 

Berkeley residents T. Anne Richards, M.A., and Margot Dashiell, M.A., M.S., co-directed the Culture of Inclusion (COI) Project at the Lakehurst Hotel from July 2014 through July 2015. The aim of the COI Project, a project of the Public Health Institute, was to build community and create a sense of belonging among the residents of a 110-room hotel in Oakland. The hotel itself provides only a few small areas where residents can congregate and these areas are not conducive to socialization with the exception of an outdoor smoking area. COI provided a common area where residents could sit, relax, have coffee, read, and participated in an array of programs that were a meaningful shift from the isolation of being alone in their rooms. The programs included art, yoga and a song circle, where every person in the circle has an opportunity to lead, suggest or request at least one song.  

Richards and Dashiell found several effective approaches to reducing isolation. “Our idea was to go within a residency and deliver programs that were physically engaging, spiritually engaging and provided an environment where people could interact with each other in a positive way,” says Richards. The activities took place at the hotel and included serving congregate lunches, an art program, music activities, yoga and outings. “The outings were a big plus,” Richards says. “Going to the Oakland Art Museum, the Berkeley Botanical Garden and other places meant a great deal to them.” 

The COI project had two goals – 1) to determine how in-reach efforts reduce social isolation and improve quality of life for lonely and secluded adults and older adults with serious mental illness and 2) to connect participants with volunteer opportunities that are interest- and skill-level appropriate and that include peer coaching. One program participant went on to live independently and work. Although the program ended last summer, one volunteer continues to serve twice a month at a food program in Oakland. For each of these COI Program participants, these are big strides given where each of them were when they entered the program. 

In regards to the man who volunteers at the food program, Dashiell says “As a result of the praise he’s received for his contribution to the food pantry, we noticed a big lift in his self confidence.” Of note is the fact that lunch at the program and a stipend facilitated his acceptance of the assignment. People living on a below poverty SSI income have limited funds for necessities and transportation. 

Richards and Dashiell hope others will replicate the model in large residential complexes. “There is a profound human need served by meaningful activities and community building,” Dashiell says. “Well thought out in-reach programs are needed, not only because they improve quality of life, but also because they contribute to improvements in mental health.” 

More than 2 million adults – about 8% of the population – are affected by potentially disabling mental illnesses each year in California. (from http://prop63.org/about/prop-63-today) Thanks to the Mental Health Services Act, Alameda County programs have received funding to provide care to some of the hardest to reach men and women in the county. 

In 2004, voters approved Proposition 63, the Mental Health Services Act, and in 2005, it went into effect. The Innovation Grants fund learning projects. The Round Three Innovations Grants Program funded 18-month projects for two target populations, isolated adults and older adults; and LGBTQI2S with mental health concerns. The learning projects received funds through the Mental Health Services Act (MHSA), a 1 % tax on incomes over $1 million. The MHSA emphasizes transformation of the mental health system while improving the quality of life for people living with a mental illness. Innovation is an MHSA component that funds learning projects. Alameda County BHCS has implemented a grant program to implement 18-month pilot projects for community members to develop innovative mental health approaches. 

The Reaching In Project, designed and conducted by CJM Associates, has provided three 12-week workshops for family members and loved ones of someone who has a mental illness and is isolated, followed by six months of support from a peer or family wellness mentor. “Having a supportive community around the person with the illness and the family has proved to be invaluable,” says James Mensing, J.D., Ph.D., Vice President, CJM Associates. “We give family members an opportunity to work with their own feelings and experiences in a safe environment. Family members learn how to talk with their loved one about his/her symptoms in a non-judgmental way and try out different strategies for reducing isolation. 

Project Asian Outreach trained six individuals to be peer mentors and conduct home-based outreach. A bilingual clinician and peer team-up to reach Chinese and Korean-speaking older adults in their homes to build relationships, make connections to helpful community resources and mental health resources, as well as help seniors overcome cultural stigmas about mental health. The work with isolated seniors took place primarily in Oakland, with a few reaching to San Leandro, Union City and Fremont. The peer mentors would get to know the isolated older adults and engage them in culturally responsive activities, such as Chinese calligraphy, Cantonese opera and Mahjong. Through these pastimes, the peer mentor and person developed rapport and had conversations about emotional stressors, while breaking through social isolation. 

“There is an ongoing need to serve isolated adults and encourage them to be engaged in their interests and with people,” says Esther Chow, MSW, Project Director/Prevention Services Manager of API Connections, Asian Community Mental Health Services. “This is especially true for monolingual Chinese and Korean speaking older adults.” Studies of elderly people and isolation have shown that those without adequate social interaction were twice as likely to die prematurely. 

Karyn Tribble, the Deputy Director of Alameda County Behavioral Health Care Services and who holds Masters degrees in both Social Science and Science and a Doctorate degree in Clinical Psychology, spoke at the end of the day. “Our department staff wants to find ways for some of these innovation projects to continue,” she said. 

For information about the Innovation Grants, contact Linda Leung Flores at LLeungFlores@acbhcs.org