Student Mental Health April 2017

Transcription

1 Student Mental Health April 2017 An Initial Plan to Implement Mental Health Services in the Los Rios Community Colleges This report contains recommendations developed by a cross-functional workgroup, the Mental Health Workgroup (Spring 2014 Spring 2017). The workgroup s charge was to develop a comprehensive plan that responds to the increasing demand for students needing mental health services. Last Updated: March 6,

2 Los Rios Community College District Chancellor Brian King Los Rios Board of Trustees Deborah Ortiz, President Ruth Scribner, Vice President Tami Nelson Pamela Haynes Dustin Johnson Robert Jones John Knight Marianna Sousa (Student Trustee) Los Rios Community College District 1919 Spanos Court Sacramento, CA (916) April, 2017 Last Updated: March 6,

3 Student Mental Health Workgroup Members American River College Jennifer Scalzi, Faculty/Counselor Lydia Delgado, Faculty/Counselor Manuel Pérez, Administrator Michele Arnott, Faculty/Nurse Pamela Whipple, Faculty/Nurse Reyna Moore, Faculty/Counselor Scott Crow, Classified Cosumnes River College Estella Hoskins, Faculty/Counselor Eva Rhodes, Classified Michelle Barkley, Faculty/Nurse Rhonda Calloway, Classified Shannon Dickson Cooper, Administrator Folsom Lake College Jeffrey Dillon, Adjunct Faculty/Counselor Jill Morrison, Faculty/Counselor Julie Rodriguez, Faculty, Psychology Libby Cook, EOPS Coordinator Mary Hansen, Faculty/Nurse Michelle Madden, Faculty/Counselor Tim McHargue, Faculty/DSPS Coordinator Vanessa Acosta, Student Sacramento City College Jeffery Christian, Faculty/Nurse Kris Janssen, Faculty/Counselor Melody Jimenez, Student Shannon Gilley, Faculty/Transfer Center Director Shelby Gauthier-Owensby, Student Victor Vargas, Student Wendy Gomez, Faculty/Nurse District Office Betty Glyer-Culver, Director of Institutional Research Dr. Victoria C. Rosario, Associate Vice Chancellor, Student Services Mayra Villarreal, Student Personnel Assistant, Student Services Last Updated: March 6,

4 Table of Contents I. Executive Summary... X II. Background & Project Summary... X III. Planning Documents & Literature Review...X IV. Program Plan... X 1. Mental Health Prevention Model... X 2. Stakeholder Engagement... X 3. Community Partnerships... X 4. Professional Development... X 5. Resources for Mental Health... X 6. Communication Plan... X V. Budget Plan... X VI. Summary & Recommendations... X VII. Appendices Appendix A: Mental Health Needs & Perceptions Survey Results Appendix B: Focus Group Questions & Results Appendix C: References Last Updated: March 6,

5 I. Executive Summary This report presents a comprehensive plan for the four Los Rios colleges to better serve students whose learning is impacted, in part, by mental health issues. It is informed by data, aligns with the District s Strategic Plan, and is the result of the work of a broad base of key stakeholders including staff, faculty, administrative leaders and students. In 2014, the Board of Trustees requested a review of services to students with disabilities, including mental health services. The initiative was overseen by a senior administrator, the Associate Vice Chancellor of Student Services. A work group was established to mobilize those with an interest to participate in a strategic planning process and outline program elements. Members reflected various perspectives and reinforced the idea that promoting student mental health is a responsibility shared by many different campus administrators, staff and faculty. A key first step identified was the need for data collection. As such, for the first time in the District s history, a survey was developed that was designed to gather the perceptions of students and employees about mental health resources and services. The Mental Health Needs Perception Survey was administered by the District s Office of Institutional Research. The highlights of the survey results for both students and employees were discussed at a subsequent focus group meeting. Participants represented the college s Behavioral Intervention/Response and Crisis Intervention Teams. The interactions resulted in rich dialogue about best practices from their and other colleges that support mental health services, the intersection of student mental health needs with the college s Student Equity Plans, and interand intra-campus collaborations. The results of the surveys and focus group informed the work of the project work group which met regularly throughout the fall 2016 semester. Their collaborations resulted in a framework and action plan for implementing mental health services throughout the four Los Rios colleges. The Work Plan outlines the following 6 goals: While it is recognized that the changes proposed in this plan will be a long-term process, and that there are many more questions and answers that will need to be addressed, the work to date and that yet to be determined is based on the following planning assumptions: a. The Los Rios Colleges provide a vibrant learning environment that empowers all students to achieve their educational and career goals. b. The unique and diverse needs of our student body require a broad rand of mental health promotion and prevention strategies that are culturally relevant and accessible to all. Last Updated: March 6,

6 c. College s capacity to address student mental health in a comprehensive way is limited. d. An improved system of support will call upon all members of the college community to ensure that students in need of mental health services receive the assistance they need to accomplish their educational goals. e. A communication plan that effectively and efficiently disseminates information regarding mental health services (campus and community based), policies and initiatives to all invested stakeholders. Recommendation 1: Phase Two Workgroup Recommendation 2: Student Health Fee Recommendation 3: Minimum program standards This report is divided into seven (7) sections: (1) Executive Summary, (2) Background and Project Summary, (3) Planning Documents and Literature Review, (4) Program Plan, (5) Budget Plan, (6) Summary and Recommendations, and (7) Appendices. Last Updated: March 6,

7 II. Background and Project Summary A. Introduction The Los Rios Community College District is one of the nation s most respected learning institutions and the second largest community college district in California, serving the greater Sacramento region. The four colleges, American River, Cosumnes River, Folsom Lake and Sacramento City offer AA/AS degrees, certificates and transfer education in more than 70 career fields. The District s 2,400 square mile service area includes all of Sacramento and El Dorado counties and parts of Yolo, Placer and Solano counties. About 75,000 students are enrolled in the four Los Rios colleges. The District recognizes that the colleges programs and services are continually evolving in an effort to meet the changing needs of students from such a broad and expansive service area. As a result, one such review of health center activities and services was undertaken in The effort resulted in a menu of services that aligned with the provisions of Regulation As it relates to the provision of mental health services, the model was one that was based on identification and prevention of short term concerns and subsequent referral for long term or crisis situations. In recent years, college students mental health has become a greater issue on campuses across the country as more and more students of all ages and backgrounds have experienced mental health challenges that are qualitatively different and significantly more complex than in previous generations. Increasingly, faculty and staff are reporting that students are presenting mental health issues with greater frequency and complexity. Additionally, this concern is heightened when also considering the broad range of emotional and behavioral issues affecting our students and classrooms. Nationally it has been observed that there is a lack of appropriate support for students who are faced with significant developmental challenges, emotional stressors and mental health risks. At higher education institutions, for example, student risk of suicide has risen. According to the National College Health Assessment Survey (2000), over 9% of students have considered suicide, yet 80% of those students who were thinking of suicide received no mental health services at all. While regular contact with students at our colleges is typically pleasant and productive, on occasion some behaviors cause concern about a student s well-being or safety in the workplace. Various campus services are available to provide support to faculty, staff and students as situations of concern arise. However, the range of services varies across campuses compelling the District to explore how the colleges can respond to the rising challenge of student mental, emotional and behavioral health issues. In 2014, the Board of Trustees requested a review of services for students with disabilities, including the provision of mental health services. It is the interest of the District to assist students to be proactive about their mental health by making smart lifestyle choices, developing good coping skills and practicing stress management. But for students dealing with mental health challenges like depression, bipolar disorder or anxiety disorders, college can be a trying and even dangerous time. Although mental health illnesses can cover a broad Last Updated: March 6,

8 spectrum, some are medical conditions that can dramatically impact a person's thoughts, feelings, judgment and ability to function. These conditions can affect people of any age, but often first appear between the ages of 18 and 24. If unaddressed, these illnesses can lead to distress, dangerous behaviors like substance abuse and thoughts of suicide. The District, like many colleges across the nation, recognizes that mental health challenges are treatable and, with the proper medical attention, students dealing with these challenges can be successful throughout their college years and beyond (The Jed Foundation, 2015). B. Student Demographics Current data on the student population of the District reflects the diversity of the region in terms of age, gender, income, enrollment status, and race/ethnicity. The District also services growing populations of first generation students, students eligible for the BOG Fee Waiver, veterans, students with disabilities (DSPS) and foster youth. The following tables highlight this diversity (Source except as noted: LRCCD, Office of Institutional Research, Fall 2016). Age 40 and Over % 20% 40% 60% 80% 100% Gender Male Female 0% 20% 40% 60% 80% 100% Student Income Levels Enrollment Status Unable to Determine Middle and Above Low-Income Below Poverty 0% 20% 40% 60% 80% 100% Light Load (Up to 5.9) Mid-Load ( ) Full-Time and Over 0% 20% 40% 60% 80% 100% Race and Ethnic Distribution Multi Race White Native American Hispanic/Latino Asian/Pacific Islander African American 0% 20% 40% 60% 80% 100% Last Updated: March 6,

9 Foster Youth/DSPS Students/BOG Recipients/First Generation Students/Veterans or Dependents of Veterans Foster Youth DSPS Students BOG Recipients 1st Gen. Students Veterans or Dependents of Veterans 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Source: California Community Colleges Chancellor s Office, Data Mart, Fall 2016 A notable observation for our District is the rise in the number of students who are receiving services for psychological disabilities through the colleges' DSPS programs. The chart below depicts the overall growth rate for this category (394%); and for African American (397%) and Hispanic (1,342%) students in particular over the course of 15 years. DSPS Students with Psychological Disabilities Student % Student % Student % Student % Count Count Count Count Total % % % African Am % % % Hispanic % % % % Source: CCCC Data Mart The current student profile for Los Rios reflects the overall changing landscape of higher education throughout California. Changing demographics throughout the colleges indicate the need for policies and strategies that are culturally relevant and accessible to assist students in meeting their educational, professional, and personal goals. C. Project Summary The project spanned two years which began in earnest in April 2015, when a cross functional work group was established. To ensure that the members of the project were diverse and represented all stakeholders, the work group consisted of personnel from various departments throughout the four colleges: nurses, counselors, classified staff, administrators, DSPS Coordinators and students. The work group set out to accomplish the following outcomes: Identify the mental health needs of students. As an initial first step the District developed and administered two districtwide surveys (Appendix A). The first survey was sent to over 8,000 students and gathered their perceptions about mental health resources and services. The second survey was sent to all Los Rios employees (n=5,400) to gather employee perceptions about the mental health needs of our students. For the purposes of the survey, Last Updated: March 6,

10 mental health was defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. We received input from nearly 500 students (6% response rate) and over 780 employees (14% response rate). The data indicate that perceptions of mental health services by students and employees are often parallel to one another. Areas of relative agreement included: a) Areas that cause stress and/or increase stress levels for students (e.g. trouble sleeping, college coursework, anxiety, and an unhealthy diet). b) Agreement that there are adequate levels of mental health resources in the greater Sacramento area and at Los Rios. c) Knowledge of whom to contact for professional mental health services. d) Agreement that mental health counseling is helpful for students. Three areas of the survey demonstrated disconnect between the student s expressed experiences and employee s perceptions of those experiences. These areas included: a) Who students connect with when they are stressed 32% of students stated they would turn to their family, only 9.3% of employees believed the same. b) The level of comfort students have in seeking mental health services 71% of students agreed that they felt comfortable seeking counseling, while only 19.6% of employees believed the same for students. c) The perceived barriers to seeking services 82% of employees felt that cost was one of the greatest barriers in seeking mental health services, 54% of students expressed that cost was a barrier. The survey concluded by providing space for students and employees to write-in ways to increase services and awareness of mental health services. These comments included: a) Adding a mental health professional on campuses. b) Creating a wellness center or dedicated space with access to mental health resources and information on each Los Rios campus. c) Promotion of help-seeking behavior. d) Peer and mentor support groups. e) Acknowledge the unique needs of the diverse student population. f) Increase faculty and staff training. Examine data relating to student mental health and wellness. The Mental Health Needs Perception Survey Summary Findings of Employee and Student Respondents District-wide (August 2016) was shared with a structured focus group comprised of twenty one (21) members from each of the colleges Behavioral Intervention/ Response and Crisis Intervention Teams (Appendix B). The goals of the focus group were to: a) identify the goals of mental health services on our college campuses; b) identify strategies and interventions; and c) identify next steps. The interactions resulted in rich dialogue about best practices from their and other colleges that support mental health services, the intersection of student mental health needs with the college s Student Equity Plans, and inter- and intra-campus collaborations. The major themes that emerged were: Last Updated: March 6,

11 1. Need for district-wide mental health prevention model. A district-wide model to provide a clear direction for the district and clear role definitions and expectations for all district staff and faculty. 2. Targeted resource development for mental health. Concerns over lack of staffing, funds, and physical space to offer comprehensive mental health services emerged. 3. Training for faculty and staff on mental health issues. Greater availability of training around mental health issues and that this training is adapted to fit the various needs of different district constituencies. 4. Improved Communication. Need for improved communication regarding information on students of concern between campus stakeholders. 5. Faculty involvement. Participants would like to see more faculty involved in training on how best to identify students in distress and how to refer students to mental health services. 6. Community partnerships. Participants expressed a need to develop the new position of mental health campus coordinator that can be a liaison between each college and community based organizations. The discussions also yielded a broader understanding of efforts currently underway to support the growing mental health needs of our students. They include: Suicide prevention Counseling services Program outreach and awareness Peer to peer resources Faculty, staff and student training Crisis intervention Services to support veterans Define infrastructure and elements. The results of the surveys and focus group informed the work of the project work group which met regularly throughout the spring 2017 semester. Their work resulted in a framework for implementing mental health services throughout the four Los Rios colleges. The framework is based on a thorough literature review and reflects the interest of the colleges to focus on prevention while still being responsive to students with issues ranging from adjustment to severe mental health challenges. A diagram of the model is provided here and will be described in detail in Section IV of this report. Prepare final report. This Board Report is prepared for the Los Rios Board of Trustees for its April 5, 2017 meeting. Last Updated: March 6,

12 III. Planning Documents and Literature Review A. Introduction The mental health issues experienced by the general population, and in particular college going adults, characterize a substantial public health dilemma within the United States. Approximately one-third of the disease burden in the United States is that of mental disorders, which most commonly first surface in individuals by their early 20 s (Mental Health Atlas, 2011; Kessler et al., 2005). Untreated mental health challenges coupled with stresses associated with transitioning into adulthood can manifest into distress that is seen within the college setting. Due to the increase in campus violence and increased rates of suicide on college campuses, a renewed focus at the national and State level has resulted in a number of policies intended to support those needing mental health services. These policies include among others the Community Mental Health Act of 1963 and Section 504. Given the onset at which most individuals experience mental health challenges, institutions of higher education are in a unique position to assist students holistically. Staff and faculty are readily able to identify students at risk for mental health challenges and are usually called upon to intervene when problems arise both in and out of the classroom. For college personnel to be successful, a deeper understanding of student mental health needs, supports, and service utilization is essential (Sontag-Padilla et al., 2014). {Add summary of Approaches and brief summary of framework} Last Updated: March 6,

13 B. The Problem While many college students experience varying levels of mental distress, few seek formal assistance. This may be due to a lack of awareness of the services offered within their college or community but also because of the heavy stigma, or shame, attached to mental health challenges. Because of this, students may often conceal these challenges from those able to provide assistance. For those students who come from diverse racial and ethnic backgrounds, the stigma may be even more pronounced (Mock, n.d.). Left undiagnosed, untreated, or questioned, students may feel isolated in their circumstance leading them to opt for selfmedication rather than formal treatment (Jue, n.d.). Overall rates of incidence. According to the Mental Health Association of Maryland (2013), authors of Mental Health First Aid, approximately 5.8% of adults nationally suffer from serious mental health challenges. Eighty percent (80%) of those who experience mental challenges have their first experience between years old (McCarty et al. 2016). Of those with formally diagnosed mental health challenges, only 41% use mental health services. Rates in California and in Sacramento County are similar. Approximately 5% of adults in California and 4.5% of adults in Sacramento County suffer from serious mental health challenges (Ca DHCS et al., 2012; Ca Health Care Foundation, 2013). However, if the definition is expanded to encompass more commonly underdiagnosed and untreated mental health issues such as depression and anxiety, these numbers increase to 15.8% and 13.8%, respectively (Ca DHCS et al., 2012). Rate of incidence for ethnic minorities and veterans. Individuals from special populations, such as racial/ethnic minorities and veterans, have elevated risk for mental health disorders due to inadequate housing, limited financial resources, or limited transportation to access to quality mental health services (Mock, n.d.). In California, increasing numbers of racial and ethnic minority groups pose an even greater challenge as these populations have higher levels of serious mental health challenges than the overall population: Latino (9%); African American (9.6%); American Indian/Alaskan Native (16.7%); and Native Hawaiian/Pacific Islander (13%) (Grant et al., 2011). And for Sacramento County, these rates are slightly higher for these same groups when looking at those with serious mental health challenges: Latino (5%); African American (6%); American Indian (7.3%); and Pacific Islander (3%) (Ca DHCS et al., 2012). Veterans are also particularly vulnerable. Approximately 20% of veterans suffer from Post- Traumatic Stress Disorder (PTSD); another 20% have experienced a traumatic brain injury; and still many more continue to experience high levels of stress as they transition from military to civilian life (CCCSMHP, n.d.). [Check data] Rates of incidence for college students. These statistics become more worrisome when examining the experiences of college going adults. Nationally, college students experience higher levels of mental health challenges than the general population (American College Health Association, 2012). Much of this can be attributed to high levels of stress and trauma they experience as they juggle a myriad of responsibilities (Duncan-Andrade, 2009; HEMHA and JED 2013). According to a National College Health Assessment conducted by the American College Health Association (2012), a number of areas can lead to high levels of trauma, including: academics, finances, intimate relationships, and family problems. For California s public college Last Updated: March 6,

14 and university students, 19% meet or exceed the threshold for psychological distress (Sontag- Padilla et al., 2014). While many students may show indication of mental health challenges, few are referred to or utilize mental health services when referred. This is particularly true for community college students. Of the nearly 16,000 community college students surveyed for the CalMHSA Student Mental Health Campus-Wide Survey (2013) only 10% stated they reported using mental health services in general (compared to 23% of UC and 20% of CSU students); and only 40% reported using mental health services on their college campus (compared to 77% of UC and 71% of CSU students) (Sontag-Padilla et al., 2014). Given the increasing incidence of mental health issues experienced by the general population, and in particular college students, a growing body of federal, state, and local policies and resources have been enacted. These policies are intended to provide students affected by mental health challenges the resources they need to achieve their own academic and personal success. C. What Has Been Done to Address the Issue As the number of tragic acts of violence and rates of suicide on college campuses nationwide has risen in recent years, the study of student mental health has been thrust to the forefront of the country s national agenda and has brought college student mental health issues to public consciousness. National and State Policies. Efforts to ensure access and services to individuals with mental health challenges have been taking shape for more than forty years. At the federal and state level, several policies have ensured that individuals at all levels are protected from discrimination and receive accommodations to reach their full potential and lead complete lives. The following table represents seminal national and state policies that have been enacted or proposed in support of this interest. Relevant LRCCD policy and regulation are also provided. Policy Level Policy Description National The Community Mental Health Act (1963) Established comprehensive community mental health centers throughout the country. First piece of legislation that focused on community-based support for individuals with mental health challenges. Section 504 of the Rehabilitation Act (1973) Americans with Disabilities Act (1990) First U.S. federal civil rights laws offering protection for people with disabilities. Any college receiving federal dollars shall provide a free and appropriate public education to each qualified handicapped person. Prohibits discrimination and ensures equal opportunity for persons with disabilities. Reaffirms protections for individuals that have physical or mental impairments that significantly limit one or more major life activities. Last Updated: March 6,

15 California LRCCD Mental Health on Campus Improvements Act (MHCIA) (2016) Section of the California Education Code (1976) Section of the California Code of Regulations (1997) Mental Health Services Act (2004) Section of the Education Code (2006) AB 2017, College Mental Health Services Program (2016) Counseling and Health Services, Student Health Services, Policy-2523 Counseling and Health Services, Student Health Services, Regulation-2523 Counseling and Health Services, Counseling Services, Policy-2511 Bill did not make it out of the House of Representatives. Grant funds to improve college mental & behavioral health services: increase outreach/access to mental health & behavioral services; improve prevention of disorders & promotion of mental health; improve identification & treatment for students at risk; improve collaboration; reduce stigma. Provides for counseling programs that include assistance with academic planning, career counseling, and personal counseling. Funds collected by the health supervision and services fee can only be expended on: clinical care services, mental health services, support services, and special services such as health education & promotion. Additional tax on high wage individuals earning to fund county programs for individuals with mental health challenges. Provides prevention & early intervention services; medical & supportive care; reduce financial stress for such services to individuals, families and state budgets; culturally and linguistically competent approaches for underserved communities; services that prevent suicide, incarceration, school failure, unemployment, and homelessness. Provided a means of garnering funds for health services. Mandatory or optional student fee for community college health services. Vetoed by Governor Brown in Grant program for colleges to improve access to mental health services on campuses; foster stronger county partnerships. Each College shall maintain a health service program that reflects the overall philosophy of the college and is responsive to the needs of its students, within the confines of available funding. Contribute toward the educational aims of students by promoting their physical emotional well-being, as per Title V, Section mandate. Each health center will provide: o Emergency first aid o Primary medical care o Health appraisals and evaluations o Health education and health counseling o Environmental health and safety o Assistance to students with disabilities o Information regarding health/accident insurance plans o Health education and consultation Each College shall provide a comprehensive, systematic counseling program that will further student goals of academic achievement, vocational direction, and personal-social development. National and State Resources. While national and state level legislation provided certain protections for individuals with mental disabilities and established funding for mental health services, these efforts often fell short to meet the needs of this growing population. To fill this gap, various organizations and coalitions at the national, state and local levels have been developed to further assist communities with providing adequate services for individuals with Last Updated: March 6,

16 mental health challenges. The following table represents seminal national and state resources that provide support to those experiencing mental health issues, their families, educators, and other providers so they may lead fully productive lives. Resource Level National Resource Description Recommendations Council for the Advancement of Standards in Higher Education (CAS) Higher Education Mental Health Alliance (HEMHA) The Jed Foundation (JED) Mental Health America (MHA) NASPA Student Affairs Administrators in Higher Education (NASPA) An association of professional associations in higher education, which promotes the use of its professional standards for the development, assessment, and improvement of quality student learning, programs, and services. Partnership of organizations dedicated to advancing college mental health. Developed a document outlining the issues, procedures and protocols that should be kept at the forefront of campus crisis intervention teams. Partners with high school & colleges to strengthen mental health, substance abuse and suicide prevention programs & systems. Developed documents for colleges and universities to further understand and consider issues and laws when drafting or revising protocols related to students in distress. Leading community-based nonprofit addressing those with mental health challenges and promoting overall mental health for all Americans annual conference focus: destigmatizing mental health and addiction. Leading student affairs association conference focus: tools to effectively address college student mental health through accessing resources, effective programming, and how developed appropriate prevention & intervention. Provide the following directly, through referral, or in collaboration: o Individual counseling o Group interventions o Psychological testing/assessment o Outreach and counseling for students from diverse backgrounds o Counseling support for addictions and substance abuse o Educational preparation counseling o Services for students utilizing psychotropic medications o Crisis and violence assessment, intervention and response o Disaster preparedness and response o Staff and faculty professional development Placing special attention on available resources. Federal policies. Community engagement. Evidence-based practices. Life skills development. Social network and marketing promotion. Educational programs. Crisis management. Laws around privacy and confidentiality, disability and liability. Provide access to data. Utilize current and promising best practices. Honor needs of consumers. Patient centered research. Cultural and linguistic competency. Last Updated: March 6,

17 National Alliance on Mental Illness (NAMI) National Council for Behavioral Health (NCBH) Student Health 101 Nation s largest non-profit mental health organization dedicated to educating, advocating, and developing programs to assist those affected by mental health challenges. Works to raise awareness and provide support and education. Works with mental health and addiction treatment organizations. Provider of Mental Health First Aid in the U.S., a training program that introduces participants to risk factors and warning signs of mental health challenges, provides understanding of their consequences, and overviews common treatments. Emphasizes the development of online resources for college health issues including stress, sleep, nutrition, alcohol, sexual behaviors, and mental health. Provides information via text message, social media, and print. Shift to a culture that embraces engagement, or the active participation of those who deliver and seek services, as a new standard of care. Require culturally sensitive and competent training for mental health professionals. Invest in research. Provide trauma-informed care. Crisis services. Educational training to constituencies. Develop programs with a social justice focus. California California Community Colleges Student Mental Health Program (CCC SMHP) California Department of Mental Health (CDMH) Developed to assist California s community colleges to better address student mental health needs. Coordinates training and provides technical assistance on building sustainable community based partnerships. Toolkit to locate contacts, facilitate partnerships, and best practices. Publications that focus on engaging unserved and underserved populations such as racial/ethnic diverse students, transition-aged foster youth, student veterans, and LBGTQ students. Developed various training documents such as PowerPoint presentations, videos, and threat assessment training. Initiates, administers, supports and enhances an integrated, comprehensive system of public mental health services. Strategic outreach venues. Information in languages other than English. Material to families. Stigma reducing language. Culturally relevant professional development. Locate year-round housing. Train on life skills and socio-economic support. Link to knowledgeable staff. Peer-to-peer support groups. Online suicide prevention training from Kognito. Use of video Public Services Announcements (PSAs). Ensure safety of patients and personnel. Promotion of mental health care services that focus on an individual recovery model. Enhanced disaster preparedness. Reduction of stigma and discrimination. Utilization of technology to improve efficiency. Continuous assessment of protocols, facilities, policies. Services to meet the need of changing demographics. Last Updated: March 6,

18 California Mental Health Services Authority (CalMHSA) Cultural Competence Mental Health Southern Region Summit XVIII (2013) Evidence-Based Practices Symposium: Outreach to Outcome: Continuum of Prevention and Early Intervention Services (2017) Health Services Association of California Community Colleges (HSACCC) Provides counties a platform to work jointly to develop, fund, and implement mental health services & educational programs at state, regional, local levels. Available programs include: Prevention and Early Intervention (PEI) Statewide Project, Student Mental Health Initiative (SMHI), Stigma and Discrimination Reduction (SDR), and Suicide Prevention, and the Cultural Responsiveness Project. Organized by the County of San Diego Behavioral Health Services. Presented information on reducing mental health disparities in the African-American, Latino, Asian Pacific Islander, Native American, and LGBTQ communities via prevention & early intervention strategies. Toolkit to assist practitioners to become more culturally competent and sensitive to address cultural gaps that facilitate mental health disparities. Organized by California Institute for Behavioral Health Solutions (CIBHS) and the Los Angeles County Department of Mental Health (LACDMH). Will provide strategies that are culturally relevant, enhance outreach efforts, address disparities, manage more effectively the implementation of evidence based practices (EBP), and improve evaluation. Provides support and encourages student access to health service programs in the California Community Colleges. Outlines minimum staffing for health centers, recommends specific mental health services, and provides demographic data on services offered in health service departments throughout the system via surveys. Effective and efficient coordination with community organizations. Professional development opportunities for personnel. Social marketing campaigns for stigma and discrimination reduction, and suicide prevention. Evidence-based intervention training for faculty, staff, & students. Comprehensive, accessible websites. Collaboration/networking. Increase cultural competence of educators & mental health providers. Media advocacy to reduce stigma and increase mental health literacy. Strengthen community collaboration. Staffing for Centers: o FT Master s prepared licensed RN Director o 1 FT clerical support o 1 physician consultant/medical director o 1 licensed RN o 1 mental health professional (FT, PR, or contracted) Mental Health Services: o Clinical care services o Mental health services o Support services o Special services Last Updated: March 6,

19 University of California Mental Health Cultural Competency Summit (2016) Provided knowledge, skills and abilities in culturally aware mental health treatment to diverse students. Presented information on engaging with ethnically and culturally diverse, LGBTQ, foster youth, immigrant population; utilize technology effectively. Technology: o On-line therapy programs o Crisis text hotlines o Social Media D. Major Mental Health and Preventive Healthcare Models The manner by which mental health challenges are diagnosed and how mental health resources are allocated are greatly dependent on the model that an organization follows. Major models concerning mental health, prevention, and intervention include the Biomedical Model, the Biopsychosocial Model, and Levels of Preventive Healthcare (Institute for Work and Health, 2015; Yates, n.d.). Additionally, many colleges are adopting a public health approach to mental health and suicide prevention which provides for care on a continuum from promotion and prevention to treatment and maintenance. Biomedical Model. Established in the early 20th century and posits that all diseases are explainable through some sort of cellular abnormality. Also, this particular framework views health as the complete absence of disease, pain or defect. Represents the historical context of the model s establishment, as the largest threats to a healthy life were purely bacterial and viral ailments, such as tuberculosis, pneumonia, influenza and diarrhea. The treatment of this model works to remove illnesses by analyzing the pathology of the disease. This model seeks to find a solution that fits the respective problem (Yates, n.d.). Biopsychosocial Model. Comprised of three essential components: biology, psychology and social ideologies. The concept of health is viewed as a balance between these three sectors. Includes the wide spectrum of psychological conditions and variety of social elements like cultural and economic backgrounds. Emphasis is given to a person s thoughts, emotions and behaviors and promotes the idea of the mind-body connection. This model has become the new standard of viewing illness (Yates, n.d.). Public Health Approach. According to The Jed Foundation (2011), in its Guide to Campus Mental Health Action Planning document, many colleges are going beyond simply providing treatment services by expanding efforts to prevent mental health challenges from arising and promote the mental health of all students. This public health approach addresses the social and environmental risk factors that influence student mental health. In this model there are three levels of prevention: primary, secondary, and tertiary. Primary level. Effort is made to prevent injury or illness from occurring. This is done via health promotion activities and specific protection. Health promotion refers to the engagement of activities that are non-clinical and promote general well-being. Specific protection refers to efforts toward particular illnesses that also promote overall health promotion. Last Updated: March 6,

20 Secondary level. Aims to reduce the effect of illness that has already occurred. It consists of early diagnosis and prompt treatment to stop or slow down the progress of the illness. Tertiary level. Aims to reduce the negative effects of the illness by focusing on rehabilitation. Individuals are helped to manage long-term and complex health problems (Institute for Work and Health, 2015; Preventive Healthcare, 2017). E. Theoretical Framework [Too theoretical. Bring in relevance to community college students] For students that experience mental health issues, this reality is buttressed by the challenges faced within their immediate social context: financial insecurity, difficulties within their families, violence that is experienced in their romantic relationships and/or neighborhoods, uncertainties because of their immigration status, ethnic or racial identity and sexuality. This trauma is not only lived once but is experienced daily. Thus there is a need for students to have resources and allies available that assist them to manage these realities and recurring traumas. While existing national and state legislation and resources have provided a foundation for establishing mental health services on college campuses, there is still a need for mental health models and services that are developed within a culturally competent lens that meet the increasingly complex needs of our diverse students. Students must be seen as individuals situated within various communities and identities, all of which will affect their mental health in various ways. It is in this structure that students can be provided the agency to more holistically plan for their personal and academic success. Jeffery Duncan-Andrade s (2009) idea of critical hope provides a lens by which to formulate a culturally competent mental health model. Critical hope is the commitment to actively engage in the issues that are affecting students, in particular those from unserved and underserved communities, and work to change the conditions that create barriers for success. Duncan-Andrade explains this type of hope being comprised of three synergistic elements: material, Socratic, and audacious. Material Hope. Educators alleviate the reality of the various social stressors that students face via material resources. Though providing resources does not create an ideal social environment in and of its self, it does begin to provide students a sense of stability and hope that the circumstances they face are surmountable. It is in this element of critical hope that we can examine the type and quality of resources that are provided to students. It is critical to then examine the accessibility of resources on and off campus and the level of knowledge that staff and faculty hold of these resources. Data from the CalMHSA Student Mental Health Campus-Wide Survey speak to the work of educators to identify and access resources. While approximately two-thirds (63%) of faculty and staff surveyed across the higher education systems can identify resources for students, less than 40% of faculty and staff felt they had the adequate skills to guide students to actually receive the individualized services students needed (Lisa Sontag-Padilla et al. 2014). Socratic Hope. The determination of educator and student to exam the social location of students and to use a student s righteous indignation as a source of strength (Duncan- Andrade, 2009). Socratic hope prompts educators to work with students to demonstrate that the challenges students have and may continue to face are not deficits but sources of strength Last Updated: March 6,

21 that can be utilized toward social justice. This lens becomes useful in examining the existing policies as well as the mission and goals within existing and new student services. Are policies and services simply existing as a means to comply with federal/state mandates or do they also provide the space and mechanisms by which students can see themselves as valuable because of their tenacity to continue forward? Audacious Hope. Educators are moved to be allies to students in their struggle with mental health issues. While we may not have control over the social contexts that students are situated within, there is the opportunity to provide mechanisms by which students can control how they react to their contexts. It behooves educators to not be added stressors on the lives of students as a result of the policies, services and programs that are put in place. This lens assists students to develop help-seeking skills that will serve them not only within the context of their academics but will serve them in their personal and professional lives. This is particularly critical given the extent to which students experience trauma. Nearly 59% of men and women experience at least one adverse childhood experience (ACE) in their life and 9% experience five or more ACE s (National Council for Behavioral Health, 2015). This issue has been studied by Jeffery Duncan-Andrade (2009) who focused on the trauma experienced by urban youth. Duncan-Andrade (2009) explains that one in three urban youth experience Post- Traumatic Stress Disorder (PTSD), a rate that is twice as much as veterans of war. The trauma they experience from financial instability, homelessness, and/or violent relationships or environments is one that is not only lived once, but is experienced daily. Without adequate coping mechanisms, this trauma can enact barriers to students academic success. Duncan- Andrade (2009) thus calls educational institutions to enact critical hope, or the commitment to empower students to enact their own agency and change the difficult situations they may find themselves in. Critical hope pushes educators to understand the historical, social, and political context of students, in particular those of unserved or underserved communities, to provide appropriate material resources, empowerment, and space for healing. F. LRCCD Plan for Action The social, environmental and contextual stressors experienced by students can critically affect their educational readiness for post-secondary education and adulthood (Mock, n.d.). Untreated and unaddressed mental health challenges can impact all areas of a student s life, including personal relationships, participation in campus activities, health and wellness, and academic success (National Mental Health Association and the Jed Foundation, 2002). Student academic success is thus predicated upon students having their basic needs met. It is through this lens that the Los Rios Community College District has developed a mental health prevention model that is culturally competent and serves to promote a culture of caring. This is based on the three levels of care described in the Public Health Model. As the District considers expanded mental health services for students, these efforts will be coupled with developing programs and policies that will bring about changes to the culture and environment within the four colleges to create safety nets for student who may or may not directly seek services. These changes will reassure that everyone within the district has a role in assisting students with mental health issues become academic successful. When people care about Last Updated: March 6,

22 each other and feel their institution cares about them, the odds of detecting someone who is emotionally disturbed and intervening before a tragedy occurs become much better (HEMHA and JED, 2013). It thus becomes critical for the District to purposefully engage with all of the various stakeholders of the college community, establish strong partnerships with community organizations that impart mental health resources, provide culturally competent and accessible training to staff and faculty of the District, identify and promote mental health resources for students, and develop a communication plan that is purposeful and effective in informing students, staff and faculty, and the community of the various mental health resources and campaigns available through the District and on each of the colleges. The following sections outline in detail how each of the above mentioned components will be executed. Last Updated: March 6,

23 IV. Program Plan A. Mental Health Model [DO lead: Victoria Rosario with Manuel Perez] Introduction. The mental health model will address how to support the needs of students with mental health needs. The model was informed by data that reflected the current climate and needs of students within the Los Rios Community College District. Additionally, this model will identify culturally-relevant and holistic resources to prevent and intervene in moments of crisis and urgency related to mental health. Mental health is framed within a narrative of wellness in which a person moves through stages that are cyclical in nature. This model depicts the various stages that a person can move through in their wellness along with critical areas for prevention and intervention. Within this model, a student s mental health is largely impacted by these stages of wellness. Prevention and intervention are critical resources within these stages and are introduced in the cycle through targeted support services and holistic case management. This model centers on the need to provide help and support to students in order to address moments of crisis and provide follow-up services. This model is designed to frame how to minimize the frequency or intensity of moments of feeling unwell that negatively impact mental health and create moments of crisis. Stages of Wellness. This model illustrates mental health as a cycle in which students move through stages of wellness at different times which, in turn, necessitate varying levels of prevention and intervention. These stages are identified as 1) well, 2) becoming unwell, 3) unwell, and 4) recovering. Each stage requires tailored strategies to address a student s mental health needs. Each of these stages is addressed within the context of three distinct levels of care. These levels of care are identified as primary, secondary and tertiary. Each of these levels frames how to provide resources for the campus, training for faculty and staff, and prevention and intervention related to student mental health needs. Primary Secondary Tertiary Individuals can move through these stages of wellness as a result of a variety of factors. Most importantly, the intensity of each of these stages varies greatly and is largely influenced by the environment (i.e., social, cultural, political) and a person s access to resources (health care, culturally-relevant support services, support groups, diet and exercise). These aforementioned factors provide holistic support for supporting student mental health needs. Last Updated: March 6,

24 Level 3: Individual students; Assessment-based; high intensity Recovering Well Level 2: Some students (at-risk); high efficiency; rapid response; small gropu interventions; some individualizing Unwell Becoming Unwell Level 1: All students; preventive and proactive; all settings Prevention & Intervention: Inclusive and Culturally Relevant. This Mental Health Model is a framework from which to offer support for student mental health needs and engage the campus community in varying levels of prevention and intervention. More importantly, this form suggests that this support and resources must be offered through a lens of equity, inclusion and culturally-relevant practice. This model is rooted in Duncan-Andrade s (2009) critical hope pedagogy. Critical hope rejects hopelessness in naming the trauma that student s face in the community, calling out that this trauma impacts student mindfulness. More importantly, this framework anchors prevention and intervention resources to a practice of hope that is critical and holistic in meeting student needs at varying levels. Last Updated: March 6,

25 B. Stakeholder Engagement [CRC lead: Eva Rhodes] Introduction. A fundamental shift in how we engage in dialog and interact with surrounding communities, including the County, must occur to build stronger alliances and partnerships as a way to provide the best and most up-to-date resources and information for students in need of mental health services. Instituting mental health programs on the Los Rios Community College District campuses will require acceptance from the various constituencies on campus and in the community at large. Strategies will be employed to bring together groups and campus members who might not normally be part of the conversation. Objectives and Strategies for Implementation. The level of engagement that is provided to a given constituency group is dependent on the level of participation that sought by the District. Stakeholders are then engaged within a three tier model: primary, secondary, and tertiary level of engagement. Advisory Group Targeted Messaging Primary Level. Currently, there are no established campus mental health programs or stable community mental health partnerships in the District. Students who are in distress and/or exhibit behavioral concerns are directed to crisis counseling and student discipline. While each Los Rios College has formed a Behavior Intervention Team (BIT), these teams are not equipped to address student mental health issues. They serve as a centralized point of contact or clearinghouse for faculty, staff, and students who may be concerned about the behavior of students on campus, but can only provide referrals to local community resources and no consistent follow up. Secondary Level. The formation of an advisory group is recommended to coordinate the implementation of strategies to provide both direct and indirect mental and behavioral health services. The advisory group, housed either on each campus or at the District level would consolidate both internal and external groups. Each advisory group would have representation from its campus communities (e.g. managers, faculty, staff, students, and law enforcement) as well external partners which include local mental health agencies, and surrounding universities (e.g., CSUS or UCD). It would also be beneficial to partner with other colleges that have more developed services or trainings and sign up for the Mental Health & Wellness Association (MHWA) listservs as a way to connect with colleagues at other colleges. How often the advisory group(s) meets can be left to each campus or the District to determine based on their needs. Tertiary Level. Anecdotal evidence suggests that there are serious gaps in the efforts needed to reach specific campus constituencies on the importance of mental health, and the resources and services available both on campus and in the surrounding communities. There are, however, various ways in which buy-in can be Last Updated: March 6,

26 achieved, such as faculty and staff workshops, managerial, faculty, and staff meetings, students clubs and student government meetings, and student focus groups. The formation of peer groups may also be a highly effective way to connect students with the resources and services available on campus. The primary objective of stakeholder engagement will be met when there is an increase in awareness levels pertaining to the importance of mental health education, and a greater number of individuals understand the processes set up on their campuses. Challenges. While we have to meet students needs within the scope of an educational mandate never losing sight of the goal of assisting students to be successful faculty and staff must also look beyond the classroom to paint a holistic picture of the student. Some challenges that may become barriers to this end include: Bringing various constituent groups together for a common vision surrounding the formulation and implementation of a mental health plan for each college and local community. Community agencies oftentimes are limited in resource capacity making it difficult to partner with colleges on a consistent basis. The potential of increased workload for faculty and staff may prevent their participation in stakeholder meetings and gatherings. Students may not be interested in participating as a stakeholder due to their personal struggles with mental health issues and other concerns. Recommendations. As a means to curb potential challenges and for stakeholder engagement to be successful, the following recommendations have been made: Employ a Mental Health Coordinator or other designated person to assist in building campus and community partnerships around a singular vision of mental health service delivery. Offer incentives to community agencies such as LRCCD participation in agency fundraiser events. Institute a College Hour and and/or release time for faculty and staff so that they can attend various workshops or presentations throughout the academic year. Many mental health educational events can be filmed and uploaded to the college websites, to be viewed at later times and when convenient for employees. Develop student focus groups as a way to engage them as active participants as well as provide connection with other students who may be experiencing similar struggles. Budget. Providing a broader spectrum of services for students would require more funding than is currently available to the Los Rios colleges. However, the institution of a health fee would ensure that the previously mentioned Coordinator position could be employed and having more resources would guarantee more choices in engagement activities and events for the colleges. Mental Health Coordinator annual salary approximately $100,00 FTE cost unknown if College Hour is instituted Cost of incentives for community agencies unknown Last Updated: March 6,

27 Materials and incentives for student focus groups unknown C. COMMUNITY PARTNERSHIPS [ARC lead: Pam Whipple with nurses] Introduction. Community partnering allows organizations who share a common mission to effectively provide outreach and service while decreasing duplication of services available in the community. Partnerships can streamline access and are convenient and cost effective, especially when factoring in travel, wait time and mental energy of their clients. Relationships between partnering organizations can more fully demonstrate the challenges and successes of both systems and provide a more holistic approach by providing services in the context of the clients natural social environment. Objectives and Strategies for Implementation. Certain levels of the public health prevention model may be more amenable to partnering in community colleges than others, based on local resources and capacity of the partners. It may be noted that LRCCD does not currently use this model for health related service in general. Primary Level Campus based activities to help reduce stigma, promote help seeking, improve coping and maintain a supportive environment. Community partners may participate in campus events and activities. Secondary Level Campus based group and individual service through assigned gatekeepers, such as counselors and nurses, who assess and refer. Community partners or campus employees may facilitate support groups and provide peer support and education. Individual therapy, social work, and health enrollment services may be best provided by appropriately licensed and skilled campus employees to provide consistency and accountability for quality and outcomes. Tertiary Level-Campus Behavior Intervention Teams (BITs) with a campus employed case manager who can provide time-intensive follow- up services to students with more severe and/or chronic concerns. May refer to campus based support groups and individual services through assigned gate keepers, or establish pathways to more intensive services through community partnering. Challenges. After telephonic, electronic and face to face interviews regarding the pros and cons of community partnering with LRCCD Health Centers and other Student Services departments, the following challenges were reported: District bureaucracies that delay the process of establishing Memorandums of Understanding (MOUs) and contracts. Lack of clarity related to service goals and points of contact Last Updated: March 6,

28 Lack of clear definition as to what constitutes a community partnership. Sustainability of partnerships/services due to lack of funding, staffing and turnover, space, quality of service and maintaining an appropriate client load. Unclear business models from community partner and undefined expectations from the host college. Lack of data sharing that provides a better understanding of how many students are currently presenting to various departments with mental health concerns. Recommendations. In order for community partnering to be successful, it is important to: Build institutional capacity and have clear expectations regarding roles and outcomes. Defining what constitutes a community partner relationship in the LRCCD would be an important first step, as well as gathering data regarding students currently presenting with mental health support concerns on LRCCD campuses. Increase staff and other resources to provide service and increase institutional capacity to partner. Budget Items Personnel Campus MH Coordinator Campus level-case managers Campus level practitioners Software and Programs Student Health 101 Kognito Student Scheduling/Tracking Equipment Space, tables, chairs, computers, phones, desks, Other Sustainable funding Last Updated: March 6,

29 D. PROFESSIONAL DEVELOPMENT [CRC lead: Shannon Dickson] Introduction. The rise in students with mental health challenges continues to increase (Jed Foundation, 2015). Staff and faculty often have frequent contact with students and are in a position to intervene early in assisting students in finding appropriate campus and community resources. However, most faculty and staff have little or no training in identifying students who may be in distress and in need of assistance which can leave them feeling unproductive, demoralized and fearful of students. It is important to ensure that faculty and staff are properly trained to appropriately assist students in finding the help and resources they need. The primary level of training and professional development will focus on general staff and faculty awareness of mental health issues; the secondary level will focus on targeted mental health strategies that can be employed by faculty and staff; and the tertiary level will focus on counseling faculty and crisis teams (e.g., BIT and campus police). Objectives and Strategies for Implementation [Insert introduction] Primary Level. Focus will be placed on establishing a mental health advisory group; campus professional development with mental health specific topics and utilizing student scenarios; and safety training for faculty and staff. Secondary Level. At this level, it will be the aim to make available trainings such as Mental Health First Aid training by bringing them on the District campuses; provide flex and convocation workshops; provide Red Folder list of resources and crises intervention flowchart for front counters and department/division offices; renew the Kognito license so that faculty and staff and experience situational models and scenarios; and institute a College Hour so that faculty and staff are better able to attend mental health educational workshops and events. Tertiary Level. At this level, specific members of the staff and faculty will be provided access to national training and professional development opportunities; NaBITA training; off-campus training at community centers; crisis response training; and BIT and CIT training to counseling faculty. Challenges. Particular challenges that may arise include: The potential of increased workload for faculty and staff may prevent their participation in trainings and professional development The adequate number of trainings and professional development may be cost prohibitive Last Updated: March 6,

30 Instituting a College Hour across the district may be difficult to implement Obtaining buy-in from the campus community (e.g., faculty, staff, and administrators) Consistent and timely updates of Red Folder materials Recommendations. Faculty and staff interact with students on a daily basis in their classrooms and offices, and oftentimes have better knowledge of changes in students behavior. Because of these interactions, students more readily identify with faculty and staff and form relationships. Providing more comprehensive mental health education and training will empower faculty and staff to assist students in finding appropriate resources and services on and off campus. Recommendations to adequately equip staff and faculty with the tool necessary to attend to the needs of students include: Incorporate faculty and staff training and professional development into District and campus strategic plans Develop a yearly training and professional development plan and budget Develop a training and professional development campaign emphasizing the importance of mental education and training Budget FTE cost unknown if College Hour is instituted Potential costs involved for mental health trainers could start at $150.00/hour Renewal of Kognito license estimated at $25, Duplicating costs of $200-$1,000 for mental health materials (e.g., posters and flyers, etc.) NaBITA and other national trainings cost on average $500.00/person for registration Last Updated: March 6,

31 E. RESOURCES FOR MENTAL HEALTH [FLC lead: Tim McHargue] Introduction. Effective and culturally relevant and competent mental health resources provide students the opportunity for tangible materials that can establish a sense of control when trying to work with existing mental health challenges or related issues. It is thus necessary to take inventory of the existing mental health services available for students and any gaps that may exist. Objectives and Strategies for Implementation. [Provide explanation for objectives] Primary Level. The first level of service focuses on preventative measure. This includes the assurance that all students needs are being met and the organization is working diligently to combat stigmatization regarding mental health. This requires that faculty, staff, and students engage in ongoing basic training and education regarding mental health challenges, how to handle them in a classroom setting, and to whom students can go to when dealing with mental health challenges. Currently, Los Rios Student Services fulfills some of these roles, including departments such as DSPS, EOPS, Counseling, Campus Police and the Nurse/Wellness Services. Each of these entities provides pertinent seminars and workshops. Additional resources needed include webinars and video training, material such as Kognito on-line and interactive mental health training. Secondary Level. When students become at-risk and intervention becomes necessary, a secondary level of service is required. This necessitates ongoing training of faculty and staff on how to recognize when a student becomes at-risk (e.g., exhibiting signs of severe depression that could lead to suicidal ideation, exhibiting signs of aggressions, etc.). Currently this is occurring on a limited basis by DSPS, EOPS, Counseling and the Nurse/Wellness Services. Resources needed to augment the limited services available for addressing students mental health challenges included internal and external services. It is suggested that a coterie of trained Los Rios counselors (General, DSPS, EOPS, Nurse & Campus Police) be available to respond to mental health emergencies and crises. Also, available community partnerships would augment these efforts for referrals for longer-term counseling and therapeutic assistance. Tertiary Level. The third level of mental health services to students is the availability of a licensed psychologist/psychotherapist when mental health challenges escalate (e.g. crisis or emergency situations) and a student becomes a potential threat to him/her self or others. The licensed therapist would assess the situation and provide Last Updated: March 6,

32 needed counseling and therapy in an effort to remediate the presenting problem. Referrals to outside agencies, hospitalization and other alternatives (e.g. Campus Police) would be invoked in the event of an ongoing or longer-term crisis. Challenges. The challenges presented in implementing this project include the following: Stigma reduction: Changing the culture to embrace mental health issues and develop greater tolerance. Consistent funding: Allocating money through shifting availability of funds. Space allocation: Finding space on-campus when little exists. Central and college organization: An implementation and administration structure that allows for a centralized approach as well as individualized differences at each campus. Coordinated training: Ensuring each campus has adequate services and training available. Recommendations. Proposed services and needs were identified by students in surveys (see Attachment A) as well as best practices from community colleges in California. These suggestions include: 1. Mental Health Department/Center: This would be a space that could include a relaxation room, student lounge or safe area for students who are struggling with mental health issues to decompress. The space might have therapy dogs, stuffed animals and pillows to hug when enduring a panic attack, literature designed to help calm people and peers to speak with during when mental health issues surface. 2. Peer to Peer counseling: The duty of a peer counselor is to mediate problems students are experiencing by helping them to find solutions. Peer Counselors would undergo extensive training to develop skills and techniques for problem-solving and peer mediating. 3. Licensed Mental Health Specialist(s): At least 1 full-time licensed psychiatrist (M.D.) and 1 full-time licensed psychologist or psychotherapist who will provide short-term counseling/therapy to students at each campus. The psychotherapy would focus on identifying issues or major concerns, problem-solving, and providing support to help students develop strategies to address their personal goals. Length and time-frame of counseling will be at the discretion of the mental health professional but will not exceed 1 semester. Additional onsite therapists might be Master s level interns accumulating hours towards licensure. 4. Workshops for students relative to Mental Health awareness and information (e.g., coping skills, stress management, education). 5. Dedicated section on campus websites to Mental Health where you would find resources to crisis hotlines for not only suicide but stress, domestic abuse, sexual Last Updated: March 6,

33 assault, drug/alcohol abuse, etc.; list of self-help apps designed for mental health purposes; and links to self-help websites and self-assessments. 6. Referral program for students who have completed the allotted short-term counseling times to outside therapists, therapy groups, county mental health services, etc. so students are not left out in the cold and to their own devices. 7. At least one district-wide Coordinator for Mental Health Services. The Coordinator(s) would oversee District mental health services and ensure equitable distribution between all four colleges. They would ensure that delivery of mental health services are being carried out properly while maintaining efficient communication and common goals and objectives. Budget. The following are expected services that will need funding: Onsite Clinician(s): 80,000 X 4 Coordinator(s): o District Office: 60,000 o College half-time: 30,000 Office space: 200,000 X 4 Workshops: 50,00 X 4 Special Events: 10,000 X 4 Training: 5,000 X 4 Webinars/video production: 5,000 X 4 Safe area/decompression lounge: 50,000 X 4 Therapy animals: 1,000 X 4 Last Updated: March 6,

34 F. Communication Strategy [SCC lead: Shannon Gilley with Scott Crow] Introduction. Communication is vital to the success and resilience of a mental health program. All stakeholders students, faculty, staff, administration, and Los Rios Police need to know the existing services and how to access them. In addition, communication is service itself in the form of dissemination of valuable mental health education. In order to accomplish these communication goals, three things need to be identified: who to communicate to, what to communicate and how to communicate. Who Audience What Messages How Channels Students (traditional students, online students, disabled students, English language learners, etc.) Messages must include sensitivity to cultural differences and mental health stigmas. What services are offered and how to access them. Decreasing the stigma of mental health issues. Education on various mental health issues such as stress, anxiety, depression and suicide. Faculty, staff, administrators Information on how to help a student directly and where to send them for additional help if needed. Reminder that they are an integral part of preventing mental health concerns and disseminating mental health education. Communication to faculty, staff, and administrators should create a feeling of shared responsibility for the mental health and wellness of our students by making the connection between mental health and academic success, student retention. Administrators need to provide the resources needed to develop and run mental health services on campus as well as encouraging departments to include mental health in their programs. Web resources Videos Social media Signage Posters/flyers Newsletter Syllabi Student organizations such as the Student Associated Counsel, student clubs Specific student services programs such as DSPS, EOPS, CARE, Veterans Centers, and Foster Youth Grad Guru Gmail MyLosRios Division meetings Flex offerings and convocation Academic and classified senates Specific trainings for their areas of work Executive councils and senior leadership teams Web resources Videos Social media Posters/flyers newsletter Last Updated: March 6,

35 General community (including alumni, Foundation, community partners, etc.) Demonstrate that Los Rios cares; that this issue is a priority to us. Information about the services we are providing. Los Rios Police Department (LRPD) Information on the services available and how LRPD fits in to those services. Include in mental health trainings. [Add details] A member of LRPD needs to be involved in the process of creating and running a wellness center Objectives and Strategies for Implementation. Primary Level. Create a district wide communication plan that emphasizes the goal of informing and educating the Los Rios Community College District on the issues and information on Mental Health, including creating a theme around Mental Health that will be recognized by all those in the district. Strategies for implementation include: o District-wide website that includes pages for each stakeholder group to visit to receive information and answers on resources, quick links to information and videos, introduction to services video, information on any applied student fees, and the provision of translated materials. o Signage and informational material to be displayed throughout campuses and in classrooms that provides information on programming and services on topics, including, but not limited to: nutrition, health, financial stability, academic progress, and day-to-day stressors. o Informational document on frequently asked questions that could be posted on colleges, website, and social media o Posting resources on course syllabi o Engaging in Prevention/Awareness months o Provide tour of facilities, with invitation, to all Faculty and staff Secondary Level. Create campus specific communications that targets the diverse and different student populations on each campus and create communication that attends to the carious concerns and questions of Faculty, Staff and Administrators on each campus. Strategies for the secondary level include: o Establishing district-wide slogans for campaigns (e.g. A Well Mind is a Well Heart, One Click to Wellness ) o Student created Public Service Announcement videos to demystify mental health and to provide education and information o Conducting outreach through social media outlets including Instagram, Face Book, and Twitter o Development of a Student Health Newsletter o Conducting in-class presentations to further promote resources or specific campaigns o Include an icon for self-referral on the main page of the District website Tertiary Goal. Directly communicate to students the importance of understanding Mental Health, identifying various levels of mental health, providing resources inside Last Updated: March 6,

36 and outside of the LRCCD, and creating mental health resources on each specific campus. Strategies for the tertiary level include: o Dedicate a semester of Flex activities to providing education to faculty and staff; also provide webinars thereafter for faculty and staff o Desktop icons for staff and faculty o Mental health specific push notifications o Monthly district office crisis intervention team meetings o Education and information to staff and faculty during department meetings o A mobile phone application that provides students with a crisis hotline, selfassessment and self-help Challenges. Reaching students must occur through the different avenues. Because of the different communication pathways it is important to address with students, in a focus group, how they would like to receive the information, messages and education on Mental Health. Having this insight will allow our communications district and campus wide to be more targeted and effective. Recommendations. Communication to each stakeholder will be critical in creating a culture supporting mental health programs (which may include a Wellness Center). Before serving students and providing them with information, we should first do focus groups and surveys to find out how the information and education may best be received. Here are ideas that will be beneficial in reaching various stakeholders. The communication should come from both the District and colleges to all stakeholders. Each campus should use the same general messages, but with adjustments based on local and community needs. A kick-off/roll-out date should be set for the district in which all four colleges participate in a campus-wide event/initiative to provide education and information and a welcome for the mental health services program (which may include a Wellness Center). A campaign potentially including a logo (suggested colors by students: red, orange, yellow) and slogan may be created and used at each of the colleges to brand the mental health program, but also to communicate unity on this issue, and to increase comfort amongst students who travel from campus to campus. If a Wellness Center is part of the program, the campaign should identify why students should use the center. The campaign should focus on self-education, highlighting various issues through education/ information on various topics, referring students to services through graphics and messages. Multi-lingual resources should be offered in all materials. Cultural competency must be addressed in messages. A coordinator should be hired to organize, create, and disseminate the communication plan to each campus. Regular collection of student input/data Budget A. Printing costs will vary depending upon size of materials as well as color vs black & white Last Updated: March 6,

37 1. 11x17 color posters are $.26 each through ARC Printing Services for example; 8.5x11 color flyers are $.13 each 2. An annual budget of $4,000-5,000 for printing would be ideal for the first year, with the hope that future years would be less (materials should be designed to be used for more than one year) 3. Budget for banners might be considered, as these items are large and have high visibility. Banners can cost a couple hundred to short of a thousand, depending on size, material, etc. B. Social media ads 1. Ads on Facebook can get targeted, efficient results for as little as $ An annual budget of $250 would help the program accomplish its goals. C. Staff time 1. While this is not a direct cost item, we need to be mindful of the time of staff who take time away from their regular duties to work on mental health program communications 2. One solution would be devote a temporary classified budget to communications support for the program; Student Personnel Assistant (SPA) is one position, with an hourly wage of $ days, 8 hours a day would be a total of $13,050. Last Updated: March 6,

38 Los Rios Community College District 2016 Plan ANNUAL WORK PLAN GOAL 1: STAKEHOLDER ENGAGEMENT-DESCRIPTION: BROAD REACHING INITIATIVES THAT WILL INCREASE CAMPUS COMMUNITY AWARENESS OF RESOURCES AND SERVICES FOR STUDENTS AND CREATE BENEFICIAL PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS Objective Key Strategies & Major Initiatives Performance Outcomes Timelines Responsible Person(s) 1. Create partnerships with Form an Advisory Group that will Advisory Groups will set To begin Fall Mental Health campus-based meet twice an academic year. goals, publish agendas and 2018 Coordinator and constituents and Use targeted messaging to meeting minutes. support staff community-based students, faculty, and staff Increased level of awareness organizations through social media and other of available resources and innovative methods services by constituent More messaging during faculty, groups staff, and student club meetings Increased constituency buyin Hold Flex and Convocation due to communication workshops make them strategies available by video Resource Needs Coordinator salary Facilities Campus Operations 2. Strengthen engagement efforts on campus constituents Hold student focus groups to gauge their knowledge and interest Institute College hour or release time for faculty and staff Utilize student peer groups to engage student participation Update website with culturally relevant and student friendly information on campus and community mental health resources and services Reduced stigma for students regarding mental health Increased participation in workshops, presentations, campus activities or events Increased cultural competency Increased improvement in campus climate Students will be able to identify mental health resources both on and off campus Ongoing, but will begin Fall 2017 Mental Health Coordinator and support staff IT support Necessary hardware and software upgrades Facilities Campus Operations Graphic Design office Last Updated: March 6,

39 Make available suicide awareness and prevention information and materials Conduct campus climate survey Organize and present mental health activities and events (e.g., MH Awareness month in May; Active Minds national campaign) Develop peer to peer network utilizing student ambassadors/student clubs Increase students sense of selfefficacy and self-help skills Update Online Orientation to include information on campus and community mental health resources and services There will be an increase in student involvement/participation Students will be able to be more proactive, earlier, in seeking help Students will be better able to demonstrate self-help strategies to emotionally self-regulate Last Updated: March 6,

40 Los Rios Community College District 2016 Plan ANNUAL WORK PLAN GOAL 2: COMMUNITY PARTNERSHIPS- DESCRIPTION: ESTABLISH OUTREACH TO COMMUNITY PARTNERS TO PROMOTE THE IMPORTANCE OF HEALTH AND WELLNESS AS A VITAL ELEMENT OF STUDENT SUCCESS. Objective Key Strategies & Major Initiatives Performance Outcomes Timelines Responsible Person(s) Primary Events, activities, clubs-student Track Mental Health Prevention/Intervention Life and other campus # events/activities Coordinator 1. Reduce stigma departments # participants Participating 2. Promote help seeking Establish community partnerships # club membership departments 3. Provide stress reduction to support primary level # online access-student Health Student Senate activities objectives 101 and Kognito Student Clubs Online resources-student Health PIO 101 and Kognito Student Secondary Prevention/Intervention 1. Faculty and staff referral to campus gatekeepers 2. Campus gatekeepers refer to campus employed practitioners or community based services 3. Students participate in campus based support groups 4. Students participate peer support/educator relationships Kognito for faculty/staff (see Professional Development section) Gatekeeper processes and training (see Professional Development section) Campus-employed licensed practitioners (LMFT s, LCSW s) Campus based support groupsidentify potential partners Peer support/educators-identify potential partners Track # students presenting campus gatekeepers # students referred to campus-employed practitioners # students participating in support groups # students seeking peer support (eventual linkage to educational outcomes through persistence and completion data) Campus MH Coordinator Campus gatekeepers Campus-employed practitioners Campus based support groups Peer support/ educators Student Services Administration Resource Needs Campus MH Coordinator Scheduling/ Tracking Space, tables, chairs Sustainable funding Student Health 101 and Kognito Student Campus MH Coordinator Scheduling/ Tracking Space Equipment (computers, phones, desks, tables, chairs) Sustainable funding Last Updated: March 6,

41 Tertiary Prevention/Intervention 1. Support students in severe distress or with chronic conditions 2. Pathways for community care 3. Address campus safety needs if applicable BIT or Student Conduct- which may result in Secondary or Tertiary level intervention Campus-employed Case Manager for follow up beyond the initial referrals Campus MH coordinator, case manager and campus employed practitioners establish pathway to community based care if student not already established in care (identify partners) Track # students referred to BIT # students referred to secondary level intervention from BIT # students referred to discipline process # students referred to/reconnected with community based tertiary services (all above linked to educational outcomes through persistence and completion data) Campus BIT s Campus level case managers Campus level MH coordinators District Office Liaison Student Services, Legal, Risk Management Community Based Organization(s)- sustainable and accessible DO Liaison Campus level- Case managers Campus level MH coordinators Campus level practitioners MOU s/ Contracts Tracking Space Equipment Sustainable funding Last Updated: March 6,

42 Los Rios Community College District 2016 Plan ANNUAL WORK PLAN GOAL 3: PROFESSIONAL DEVELOPMENT- DESCRIPTION: ESTABLISH A PROFESSIONAL DEVELOPMENT PROGRAM FOR STUDENTS, FACULTY, STAFF & ADMINISTRATION THAT FOCUSES ON PREVENTION AND THE REDUCTION OF MENTAL HEALTH STIGMA FOR OUR COLLEGE YOUTH. Objective Key Strategies & Major Initiatives Performance Outcomes Timelines Responsible Person(s) 1. Level I Primary Mental Health Advisory Group Faculty/staff will be able to Spring 2018 Mental Health Campus professional readily identify campus and Coordinator development w/ mental health community resources Supervisors and specific topics Faculty/staff will be better Managers Student scenarios able to refer students in Safety training for faculty/staff crises to appropriate campus and community resources 2. Level II Secondary Bring Mental Health First Aid training to campus Bring mental health training on campus Provide Flex and Convocation workshops Provide Red Folder list of resources and crises intervention flowchart for front counters and department/division offices Renew Kognito license Institute College Hour for training and workshops 3. Level III Tertiary Access to national training & professional development opportunities NaBITA training Off-campus mental health training at community agencies BIT & CIT led trainings Resource Needs Coordinator position Mental health budget/funding Technical/IT support Last Updated: March 6,

43 Los Rios Community College District 2016 Plan ANNUAL WORK PLAN GOAL 4: RESOURCES FOR MENTAL HEALTH- DESCRIPTION: IDENTIFY INTERNAL AND EXTERNAL RESOURCES TO CONNECT STUDENTS TO COMMUNITY RESOURCES AND PROVIDES OPPORTUNITIES FOR ENGAGEMENT WITH SUPPORT SERVICES. Objective Key Strategies & Major Initiatives Performance Outcomes Timelines Responsible Person(s) 1. Provide continuous, current, updated training for students on mental health and wellness topics. Bring outside agencies for training and workshops, e.g. WEAVE and suicide prevention Prevention workshops for students (anxiety, stress, and depression) Kognito Training in person and online Training on safety related topics by campus police, e.g. dating violence, and providing a list of these workshops on web site Wellness and health workshops and activities for students including: meditation; book club with wellness topics such as mindful living and time management; nutrition; exercise; and the importance of sleep Workshops on personal responsibility, self-motivation, interdependence, self-awareness, lifelong learning, emotional intelligence, and believing in yourself. Track number of students who attend workshop and training sessions. Disbursement of survey each semester Reduced stigmatization from education and awareness Mental health coordinator District nurses Faculty Crisis intervention teams Volunteers Students Outside agencies Resource Needs Funding for mental health coordinator Funding for student employees Last Updated: March 6,

44 Dedicated Mental Health section on college websites Webinars and video training Mental Health Services: Crisis management Short-term mental health assessment/counseling from licensed (or interning) mental health specialist. Assessment/referrals to longterm counseling Peer to peer counseling Safe area or relaxation/decompression lounge 2. Provide LRCCD mental health and wellness services at least in part by charging a student health fee that meet the minimum requirements as stated in the Health Services Association of California Community College (HSACCC) Position Statement (2010). Other: Integration of services of all kinds to support student wellness. Mental health and wellness education, promotion and prevention Teaching and research Student insurance assistance Crisis hotlines, online selfassessments, list of mental health related apps, etc. on website LRCCD Board of Trustees LRCCD Chancellor s Office Dean of Student Services Outside Agencies Students District nurses Volunteers Full-time LRCCD Health Services Coordinator Full-time College Master s Prepared RN Director (can be NP) Full-time College Nurse Full-time Mental Health Professional (psychotherapist) Contracted Parttime Medical Director or Consultant Psychiatrist 3. Develop community partnerships in an effort to provide mental health & wellness services to students that are not met through district funding EXTERNAL Partnership in place with WEAVE Partner with other outside agencies, such as Turning Pt., Planned Parenthood, Wind Youth Services, etc. to provide services/referrals Partner with local churches for community resources Sacramento and El Dorado county mental health for resources Successfully establish community partnerships with both external (outside of LRCCD) agencies and internal (inside LRCCD) departments that will provide mental health and wellness services not met through district funding Mental Health Coordinator Outside agencies College nurses LRCCD police LRCCD faculty and staff Student government (ASG) Campus BIT teams Campus counseling Mental Health Coordinator Impose student health fee Last Updated: March 6,

45 4. Hire a coordinator to oversee district mental health and wellness services and ensure equitable distribution between all four colleges. Partner with CSUS and the Center for Counseling and Diagnostic Services (CCDS) for low-cost counseling services Partner with CA Dept. of Veterans Affairs to provide referrals/support for our veterans on campus Establish MOUs with local drug stores, such as Walgreens, for discounted medications INTERNAL LRCCD police Qualified mental health provider on campus (MHP) College nurses Counseling departments Behavioral Intervention Team (BIT) for community service referrals Student Government (ASG) for peer support group LRCD Librarians for mental health education topics/presentations Ensure adequate funding via student health fee. Hire district wide coordinator(s) with background in mental health. Establish communication strategies that publicize services and educate students about best practices in mental health & wellness prevention, intervention, and education Successfully establish MOUs with outside retail drug stores for discounted medications Maintain strong relationships with our established community partners, so as not to disrupt the continuity of mental health and wellness services Review all established community partnerships on a regular (annual?) basis, to ensure continuity and appropriateness of mental health and wellness services being provided Coordinator(s) will successfully bridge the gap between the four colleges and ensure proper communication. Coordinator(s) will successfully ensure that operations to spread awareness, workshops, education, etc. are properly carried out. departments Campus librarians Students Available funds to pay coordinator(s). Last Updated: March 6,

46 Los Rios Community College District 2016 Plan ANNUAL WORK PLAN GOAL 5: COMMUNICATION STRATEGY- DESCRIPTION: EFFECTIVE AND CLEAR COMMUNICATION OF PERTINENT INFORMATION ON MENTAL HEALTH SERVICES, RESOURCES, PROTOCOLS AND CAMPAIGNS DISSEMINATED TO STUDENTS AND PERSONNEL. Objective Key Strategies & Major Initiatives Performance Outcomes Timelines Responsible Person(s) 1. Find out how target Focus groups and surveys Qualitative and quantitative Spring, audiences (students, data summer 2017 others) prefer to receive information 2. Develop campaign messages and look/feel; implement campaign Potentially create a logo and slogan to be used at each of the colleges to brand the mental health program (to communicate unity on this issue and increase comfort amongst students who travel from campus to campus) If a Wellness Center is part of the program, the campaign should identify why students should use the center. The campaign should focus on self-education, highlighting various issues through education/ information on various topics, referring students to services through graphics and messages. Multi-lingual resources should be offered in all materials. Cultural competency must be addressed in messages. Campaign messages and materials Ideally in time for start of Fall 2017 Resource Needs Staff time Potential incentives for focus group, survey participants See budget for specifics Last Updated: March 6,

47 3. Assess effectiveness of campaign; make changes as needed Monitor data of services used Monitor communication data (numbers of clicks on social media, for example) Survey target audiences Qualitative and quantitative data Ongoing, but starting in Spring 2018 Staff time Potential incentives for focus group, survey participants Last Updated: March 6,

48 V. Budget Plan Program Year: Object of Cost College District Total Costs - - Last Modified: March 6,

49 VI. Summary and Recommendations Last Modified: March 6,

50 VII. Appendices Appendix A: Mental Health Needs & Perceptions Survey Results Appendix B: Focus Group Questions & Results Appendix C: References Last Modified: March 6,

51 APPENDIX A: MENTAL HEALTH NEEDS & PERCEPTIONS SURVEY RESULTS Last Modified: March 6,

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