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January - March 2006 Quarterly Report

California Network of Mental Health Clients
Contract # 05-75352-000
Quarterly Report
January 1 - March 31, 2006

KEY ADMINISTRATIVE/MANAGEMENT ACTIVITIES:

• For the first few weeks of January, staff time was exclusively focused on preparing for Client Forum 2006 held January 13 -15, in San Mateo. (See brief description of Client Forum 2006.) For the remainder of the quarter, staff worked on assessing and billing outstanding Conference fees, reviewing the hotel's banquet and lodging bills, allocating expenses to the appropriate cost center, and, generally, analyzing the costs versus receipts balance. In addition, staff reviewed the program evaluations, including the Demographic Spotlight survey.
• Staff continued to provide administrative and program support for all of the CNMHC Projects.
• Staff continued to work collaboratively with other mental health constituency groups, policy makers, and legislators.
• The Executive Director continues to be the chief participant in the Recovery Consortium, a project of the National Empowerment Center (NEC.) She continued to work collaboratively with other consortium members to develop a manual on statewide consumer run advocacy groups, specifically describing the CNMHC, that will be published by NEC with SAMHSA support. She met with the other consortium members in monthly teleconferences.
• Staff continued to work with Trilogy Integrated Resources (the company that manages the Network of Care) to redesign the CNMHC Web Site. Trilogy is going to manage the CNMHC Web Site, and staff actively worked with Trilogy in designing the Site map, and providing old and new documents for the new Site.
• The CNMHC developed an e-mail list serve for CNMHC members and potential members, through the assistance of a Board Member who is its owner and manager.

KEY BOARD ACTIVITIES:

• The Personnel/Executive Committee met to discus and approve a job change among two employees. The newly revised and nearly finalized Personnel Policies were discussed.
• A joint Public Education and Policy Project (PEPP)/Executive Committees to review and approve a plan for local action groups.
• There was a Board Meeting following the Client Forum 2006.

PROGRAM ACTIVITIES:

Client Forum 2006

Client Forum 2006 was held at the San Mateo Marriott Hotel on January 13 - 15. The theme of the Conference was: Esperanza y Lucha (Hope and Struggle): California Clients Leading the Way. From theme: "We remain forever hopeful that the principles we have advanced for so long will be implemented. On the other hand; we are forever in struggle against entrenched attitudes and systems that aggressively resist change. We must keep this balance of esperanza for a service system that is based on recovery values of choice and freedom and respect, and la lucha in our on-going advocacy for change."

The Forum was 1 ½ days of workshops/Institutes/caucuses, with the final day devoted to membership meetings.

Client Forum 2006 had the following goals:

• to provide knowledge and skills to mental health clients;
• to enhance statewide and regional networking of client;
• to work on organizational issues and other common issues at membership meetings.

All the goals of the Conference were met:

Goal 1: to provide knowledge and skills to mental health

Twenty (20) workshops, four(4) institutes and nine (9) caucuses were intertwined in the 1 ½ days. All of the workshops and institutes advanced the work of the CNMHC, training clients on the current policy and practice issues and activities of the CNMHC and the mental health community. Most workshops/institutes fell into five (5) tracks: self-help; public policy; cultural competency, and anti-stigma and discrimination, and employment.

• Public Policy:
  An Institute on Public Policy provided an overview of the year since the passage of Proposition 63, the Mental Health Services Act (MHSA), as well as unveiling three (3) CNMHC draft policy papers on MHSA components to be addressed in the year to come. The MHSA was featured throughout the Forum, including a plenary of County client representatives describing the MHSA experience in their respective counties, a membership meeting which highlighted the draft policy papers and the initial results of the MHSA client involvement survey, and Regional Meetings, which continued the discussion of county MHSA plans and planning and the draft policy papers. Other public policy issues covered by workshops at the Forum included: Board and Cares Need Reform; Collaborations and Partnerships, which described the CNMHC's collaborations with many statewide mental health and disability organizations; the Power to Decide which explored the concept of informed consent; and the History of the Consumer/Survivor Movement. A special Institute on Advocacy for Empowerment and Recovery, presented by national consumer leaders Judi Chamberlin and Dan Fisher, summarized the steps toward becoming a powerful advocate.
• Cultural Competency:
  An Institute on Cultural Competency was presented, which gave attendees a summary overview of cultural competency issues. The DMH Office of Multi-Cultural Affairs assisted in the presentation of this Institute. Later in the Forum, workshops explored specific issues of cultural competency in more detail. These included: Understanding Barriers for Latinos in recovery and Working with GLBTI & Friends Community. In addition, three (3) caucuses explored issues of special populations from the perspective of the persons from the special population. In addition, a plenary panel discussed the MHSA promise and the reality of diversity outreach and inclusion.
• Self Help:
  An Institute "Self-help, Mutual Support Groups and Consumer-Run Options" was followed by workshops covering specific issues of self-help and mutual support groups/programs. These included: Recovering Meaning, Dignity, and Hope: An alternative approach to day programs; The Language of Peer Support: How semantics and linguistics can enhance peer-to-peer relationships; Trauma Informed Peer Support/Boundaries vs. Limits: creating an equal-power, safe environment through a pure peer support model; How Do We Know if We're Consumer Driven? Looking at self-help/client-run principles and philosophies and the reality of how client groups are often operated; Building Peer-Support in IMD: Creating peer-run support clubs in locked facilities.
• Stigma and Discrimination:
  Anti-stigma and discrimination was highlighted in three (3) workshops: one workshop described a consumer speakers' bureau, another described the emerging themes from a series of Bay area focus groups in which clients shared their experiences and opinions about stigma and discrimination, the another promoted personal story telling to self heal and to educate the public at large.
• Employment:
  This marks the first year that employment was a Forum focus. Workshops included: Using WRAP to handle work and other stress; and describing mental health client employment opportunities through state, county and non profit providers and challenges that accompany employment.
• Of course, there were workshops that did not "fit" into tracks. These included the very successful workshop for artists with disabilities and a demonstration workshop displaying the information website Network of Care.

This Client Forum was enriched by a pre-Conference two-day Empowerment Training done by National Empowerment Center (NEC), Judi Chamberlin and Dan Fisher (funded by the California Wellness Foundation.)

The CNMHC utilizes the Forums to provide its membership with informational materials, from CNMHC organizational information to public policy position papers. This year the CNMHC provided disks of public policy positions and other information, which proved to be a popular format for attendees.

Throughout the Forum, passionate keynoters imparted special messages, primarily about a year of MHSA development. These included Darrrell Steinberg, considered a prime architect of the MHSA, and Senator Wesley Chesbro, a longtime friend of consumer interests. Two plenary panels highlighted local consumer leaders and their perspective of the MHSA as it related to their respective county or the issues of diversity and inclusion. Judi Chamberlin and Dan Fisher, both recognized national consumer/survivor leaders, talked about advocacy and leadership. Clients were welcomed to the Forum by Steve Mayberg, the Director of DMH, and latter, Gale Bataille, the Director of Mental Health Department in San Mateo County, the host county of the Forum, and Linford Gaile, Consumer Affairs Coordinator of the county.

As in the past years Client Forum, a series of five surveys/evaluations were collected asking participants to rate their level of knowledge of the subject before and after attending topic-specific workshops at the Client Forum. Knowledge exchange was broadly measured at the Forum because experience had shown that many participants do not attend entire workshops, but rather "sample" several topic-related workshops. The topic-specific workshops were: Stigma and Discrimination; Employment; Public policy; Self-help and Mutual Support; and Cultural Competency.

The evaluation methods for 2006 yield one hundred ninety eight (198) "completed" surveys with no incomplete surveys returned. The overall attendance was approximately 318 participants; so the evaluations were returned by almost two thirds of the participants. Nevertheless, this is a smaller number than the 2005 Client Forum. Post conference review of the method of evaluation determined that pre-conference preparations did not take into account the logistics involved in disseminating and collecting evaluation forms at each workshop in a consistent manner. This proved to be a significant problem and resulted in missing data. This will be included in pre-conference planning next year. However, the evaluations returned provided important information.

Specific results from the Client Forum 2006 Tracts are summarized below: (a decrease in score indicates a change in knowledge. The score of one (1) was the score indicating "very good" knowledge of the topic.

1. Stigma and Discrimination-a total of 18 surveys completed with an average change in knowledge from a score of 2.11.to 1.5.
   
   
2. Employment-a total of 24 surveys completed with an average change in knowledge from a score of 2.5 to 1.7.
   
   
3. Public Policy-a total of 44 surveys completed with an average change from 1.93 to 1.31.
   
   
4. Self-Help and Recovery-a total of 112 surveys completed with an average change in knowledge of the topic from 2.02 to 1.3.
   
   

Statistical tests (two tailed T-test) indicate the change score from before and after trainings were significant at the .05 level for all four tracts. Thus, there was a clear increase in self-reported learning documented.

An additional survey assessed demographics of the participants. There were 69 responses to this measure. The ethnic/cultural breakdown of participants was as follows: 39% European Americans/Caucasian, 20% African Americans, 1% Middle Easterners, 15% Native Americans, 6% Latinos, 6% other, 2% Asian, 9% Multicultural.

Corresponding gender and sexual orientation reported by participants was as follows: 68% Female, 26% Male, 1% Transgendered, and 1% Multi-gendered. Survey respondents reported sexual orientation as follows: 49% Heterosexual, 3% Bisexual, 1% Lesbian, and 4% Gay.

Demographic age show none were under age 23, 55% were under 54, and 45% were over 55. There were 54% living independently, 4% reported being Homeless, 4% were residents of a Board & Care, 1% living independently in Room & Board home.

In addition, 6% reported Veterans status and 1% from the Criminal Justice population. Finally, 45% reported having a physical disability.

Review of the data from this year's Client Forum details some interesting trends. Special outreach was conducted subsequent to the forum in order to solicit data from Latino consumers who attended after it was observed there were very few surveys collected from the Latino attendees. In fact, there was a significant Latino presence and a Latino workshop that was well attended. Special consideration is being given to understanding why there was so little feedback from the Latino attendees. There were no evaluations collected from the Cultural Competency workshops. This was a function of miscommunication by staff members. Secondly, data collected indicates a high incidence of co-occurring physical illness and disabilities among participants.

Goal 2: to enhance statewide and regional networking of clients.

Approximately 320 people attended and 33 counties were represented. Some small counties, such as Amador, were represented for the first time.

Networking characterized the whole Conference. Group meals encourage statewide networking. The San Mateo Consumer Center ran an on-site hospitality room with snacks. Evenings were filled with music, dancing, karaoke, talent show, statewide awards, and caucuses.

Representatives of the various counties met in Regional Meetings, where they networked with each other and addressed regional and statewide issues. A minimum generic Agenda for all of the meetings was:

• Update on Regional Project
• MHSA - What are the next steps for clients' to influence the implementation of the Community Services and Supports in their respective counties? Input from members on the Draft Concept papers/issues on the new MHSA components
• Other business based on regional needs and wants

Judi Chamberlin and Dan Fisher visited each of the Regional Meetings to provide any technical support that was desired.

There was a wrap-up session for reports from the regional sessions and an open mike.

Goal 3: to work on organizational issues and other common issues at a membership meeting.

The last day of the Conference was devoted to Membership issues. Nancy Thomas, the CNMHC President, addressed the membership, providing her perspective of the state of the CNMHC. There was a MHSA training, including a summary of the last years' successes and challenges and a brief presentation of the Draft Concept papers on the MHSA components to be developed in the next year. This was followed by an open mic - designed to hear members views of the newly developed Concept papers as well as their local experiences with the MHSA, especially the involvement of consumers in the MHSA planning process.

Cultural Competency Project

Background: The CNMHC has joined with 3 statewide advocacy organizations to form the collaborative California Outreach & Education Collaborative (COEC) offering MHSA Educational Forums to select counties for identified underserved community populations. The organizations are the Mental Health Associations of CA, National alliance of Mental Illness-CA, and the United Advocates for Children of CA. The CNMHC component of the COEC is called, CA. Client Diversity Outreach and Inclusion Team (CA Clients DO-IT)

The San Francisco Educational Forum was held Jan.19, 2006

The CNMHC Coordinator

• Participated in two (2) teleconferences to finalize plans for the event in San Francisco.
• Attended one (1) strategy meeting in person with community leaders and had representation at an additional one (1).
• Held four (4) conference calls with CA Clients Diversity Outreach and Inclusion Team (CA Clients DO-IT) members, with particular emphasis on smooth, fluent translation of all written and spoken materials. The Team members represented the CNMHC at the Educational Forum.
• Held de-briefing conference call after event for future improvement.

Discussions about a Gold Country Regional Educational Forum

The CNMHC Coordinator

• Attended one (1) COEC planning meeting.
• Participated in one (1) COEC teleconference.

A new CNMHC Coordinator for COEC began work in February.

The new Coordinator held meetings with all of the COEC partners to introduce herself.

The CNMHC Coordinator:
Attended strategy/planning meetings for COEC in Calaveras Co. The County participants selected the older adult population for outreach for MHSA involvement.

Attended strategy/planning meetings for COEC in Sacramento. The County participants chose the TAY population for outreach for MHSA involvement.

Attended on going interagency planning meetings via teleconference.

The CNMHC COEC Coordinator was appointed to be a liaison to the cross disability community, specifically participating in the planning for Capitol Action Day.

Public Education and Policy Project (PEPP)

• The PEPP held three (3) teleconferences of its sub Committee, the Client MHSA Implementation Team.
• The Client MHSA Implementation Team produced 3 Draft Concept Papers on MHSA components to be developed by work groups: Training and Education; Prevention and Early Intervention, especially Stigma and Discrimination; and Innovations.
• The Client MHSA Implementation Team coordinated a presence at MHSA Oversight and Accountability Commission (OAC) meetings this quarter to provide clients with maximum and meaningful involvement in MHSA processes and decision-making. Clients had a visible presence through identifying shirts, buttons and at the Public Mike. Staff communicated individually with OAC personnel and members for the purposes of education and promoting client inclusion. Particularly, the CNMHC was invited to and formally presented on the issue of PERCs in relation to MHSA funding at the February OAC meeting. The CNMHC developed a draft policy paper for this presentation.
• The PEPP Committee held five (5) teleconferences dealing with various public policy issues, including involuntary outpatient commitment and board and care reform.
• The PEPP Committee addressed a legislative initiative - AB 2357 - that extends the sunset deadline of AB 1421,an involuntary outpatient commitment law. The PEPP invigorated its participation in CARES, an organization of 4 advocacy organizations that promote voluntary community services and oppose any move to increase involuntary treatment. The CNMHC wrote a letter to the Assembly Health Committee describing its opposition position to the bill. CNMHC also, as part of public comment, responded to Nevada County's CSS plan which includes involuntary outpatient commitment.
• PEPP produced and distributed to an advocacy mailing list of over 200 individuals as well as self-help groups throughout the State a News Alert focusing on the issue of the involuntary outpatient commitment initiative.
• The PEPP held a teleconference and met with legislative staff to discus our on going concern about the need for board and care reform.
• A PEPP sub committee, inclusive of different viewpoints, explored the issue of Cal MEND, a medication algorithm project in California. This group developed basic concerns about Cal MEND, and met with CiMH representatives to discus our agreements and disagreements about the project.
• In accordance with our goal to aggressively assure that clients are represented at all levels of the mental health system, the CNMHC has provided the client perspective in many venues. Following are a selected few:
• Sharon Kuehn is serving on MHSA Workforce, Education and Training and Education Advisory Committee to the MH/
• Kathy Trevino continues to serve on Napa State Hospital's Advisory Committee and is now President.
• Sally Zinman presented at:
  Gave the Key note address at Sonoma County's consumer Conference.
  Spirit class in Contra Costa County, a consumer developed employment training program for consumers to work in the mental health system and self help programs, on the History of the Consumer Movement. Carole Ford and Dave Hosseini also presented at the Spirit class.
  Did an interview for Mental Health Matters, a Sacramento based Access TV program, that is produced by mental health clients.
• Nancy Thomas serves on the MHSA's Performance Measurement and Outcomes Advisory Committee of the DMH.
• Sally Zinman, Jay Mahler, Joyce Ott, Joe Mortz, and Rob Chittenham were appointed to different sub-committees of the Oversight and Accountability Commission.
• The PEPP continued its collaboration with Protection and Advocacy, Inc (PAI) and People First of California on the California Memorial Project. The Coordinator left his position, Key activities of the CMP Coordinator follow:

Continued to discuss plans for restoration of the Napa Cemetery with the Department of Mental Health

1. Met with DMH all through the planning process to include a meeting to discuss the development plans and the cost of the project.
2. Participated in teleconferences with the other California Memorial Project agencies to discuss the Restoration prior to meeting with DMH. CMP believes that DMH's ruling that the names of the dead cannot be displayed because of confidentiality undercuts the very concept of the restoration legislation and project - to give an identity and thus value and dignity to the thousands who are anonymously buried in California's State Hospital's grave sites.

Participated in many discussions regarding the disposition of the remains found at Stockton State Hospital.

1. Gave testimony to the Stockton City Council regarding the CMP's position of wanting to leave the remains where they were found. The final decision handed down by the Council was to move the remains to a rural cemetery and provide a memorial/plaque in both locations.
2. Participated in many teleconferences regarding this issue prior to testifying in front of the council.

Continued work on the recording of the Client Movement.

1. Continued to edit and re-edit the live footage video and had it on display at Client Forum 2006.

Participated in this year's Client Forum.

1. Displayed an informational board along with the life footage video.
2. Was available for any questions by guests at the forum.
3. Recorded a workshop about the Client Movement which will be integrated into the live footage video.

Self-Help and Regional Project

• A Project Coordinator for the Central Valley was hired. The Central Valley Directors and new staff met face to face to develop the Project's Action Plan.
• The Bay Area completed the following Project activities:
1. The Project Coordinator presented a 90 minute workshop at the CNMHC Client Forum, with an electronic overview of the Bay Area Region's report on stigma and discrimination, followed by a panel presentation and Q & A from attendees.
2. The Project Coordinator facilitated a 3 ½ hour Bay Area Regional Meeting at a self-help center in Santa Cruz.
3. The Project Coordinator wrote, edited, uploaded and published a new website for the CNMHC Bay Area Regional Project: Strategies for Transformation - Rethinking Stigma, Ending Discrimination.
4. The Project Coordinator co-presented a workshop with Dr. Steven Segal and Andrew Phelps, "Mental Health: Getting Transformation Right" at San Jose/Evergreen Community College District's Instructional Improvement Day: "Courageous Conversations: From Crisis to Constructive Action."
5. The Project Coordinator co-presented a 90 minute Spirit workshop in Concord on stigma and discrimination, focusing on the Bay Area Region's qualitative research study on stigma and discrimination and emerging themes from the report.
• The South Region developed Focus questions to understand "Barriers to Access Mental Health Services for Language and Ethnic Groups" and began implementing the Focus Groups for ethnic groups.
1. Did a Latino focus group in Antelope Valley with 12 people attending.
2. Did two focus groups in Los Angeles for Korean people with mental disabilities. There were 8 participants at each group.
3. Did a focus group in Compton for African Americans at which 10 people participated.
• In the Far North, a CNMHC Board Member actively participated in a county-wide Consumer Networking Conference at TEAM House in San Bernadino County.
• Far North Board members and staff met via teleconference and e-mail to plan the Region's peer counseling training events.
• The Office of Self Help key activities include the following:
  (This Project is funded by a SAMHSA grant along with a smaller grant from the California Wellness Foundation. However, DMH provides much in-kind support for this Project and DMH contracted activities interrelate with it. For example, the Director of the Office of Self Help supervises the Regional Project Coordinators.) In February 1,through an internal transfer of job responsibilities, a new Director of the Office of Self Help began work.

The following activities were completed within the Office of Self Help, with some overlapping responsibilities between the outgoing and incoming Directors of the OSH:

January, 2006

• Planned and facilitated a Client Leadership Training with Judi Chamberlin & Dan Fisher of the National Empowerment Center (NEC) immediately preceding Client Forum 2006.
• Planned and facilitated the Self-Help Institute (panel) at Client Forum 2006.
• Planned and presented with a Southern California client, Trauma Informed Peer Support workshop at Client Forum 2006.

February, 2006

• Held many meetings with Executive Director and former OSH staff to transfer responsibilities.
• Met with OS-H/TASC office assistant to assess job responsibilities and short-term work plan
• Offered technical assistance by phone and electronically on nineteen (19) occasions
• Provided a two-day training to Placer County Mental Health staff and clients on the importance of self-help and how to develop client-run programs
• Held two (2) meetings with the CIMH evaluation staff
• Hosted a statewide teleconference for self-help specialists with sixteen (16) participants
• Held a follow-up training teleconference with those emerging client leaders that had attended the Jan. Empowerment (preceding Client Forum 2006) training in conjunction with NEC
• Prepared a Power Point on Trauma Informed Peer Support for the CIMH Peer Support webcast on 3/01/06.

March, 2006

• Produced first drafts of SAMHSA Continuation grant application for review and edit
• Designed Self-Help Specialists' Consultant Program Brochure and arranged for printing
• Reviewed all applications for S-H Specialist, made selections and wrote letters to all applicants
• Contacted all Regional Coordinators to review status of Regional projects and offer assistance as needed
• Held two (2) meetings with the CIMH evaluation staff, did analysis of returned surveys, and discussed possible revisions in measurement tools
• Offered technical assistance by phone and electronically on twenty two (22) occasions
• Hosted a meeting for Workforce Development client leaders with CA DMH staff Warren Hayes to discuss Education and Training Component of MHSA
• Participated in statewide Values-drive, Evidence Based Practice Advisory Board teleconference hosted by CIMH
• Participated in national teleconference hosted by SAMHSA for all state grantees
• Presented two (2) trainings for Amador County, 1.) Client Culture presentation for all Behavioral Health staff 2.) Awareness training for Social Service Eligibility staff