Mental Health Advocacy:A Team Approach

Leticia Perez, M.S.W. Candidate

Maire Mullaly, J.D., MPP

Kevin Jervik, Ph.D

Foster Youth Mental Health Initiative

• Background

• Proposal to the California Endowment

Foster Youth Mental Health Initiative

• Objective 1– Produce a mental health summit report to be

disseminated.• Participants of the Summit

• Local and State Key Stakeholders

– http://www.clcla.org/Mental_Health_Summit_Report_011707.pdf

Foster Youth Mental Health Initiative

• Objective 2– Develop a minimum of three workgroups to

implement policy recommendations.• Capacity Building Workgroup

• Psychotropic Medication Workgroup

• Systemic Reform Policy Workgroup

Foster Youth Mental Health Initiative

• Objective 3– Attorney support

• Develop a multi-disciplinary team to consult with CLC attorneys on mental health needs.

• Develop training materials that enhance staff’s ability to identify mental health problems.

• Advocate for evidence-based services to clients.

Original MHAT Model

• Program Director

• Clinician

• Mental Health Specialist

Expected Outcomes

• Improved coordination of mental health services for foster youth.

• Increased access to timely and appropriate mental health services.

• Improved training of staff to better identify needs.

Lessons Learned

• Introduction of Attorney Liaison

• Understanding attorney’s knowledge base and supporting their needs

• A team approach

Current MHAT Model

• Attorney Liaisons

• Psychologist

• Mental Health Specialist

Lessons Learned

• Myths regarding mental illness– Not a life sentence– Diagnosis in context of whole person– Axis II diagnosis– Process of change

Lessons Learned

• Privilege and Confidentiality– Secrecy surrounding mental illness– Balancing privacy with “need to know”

Lessons Learned

• Mental Health Services– Alternatives to residential care– Individual counseling is not the only effective

intervention.– Therapists are people too.– If residential care is used, view it as treatment,

not placement.

Lessons Learned

• Independent Assessments– Medi-care requires documentation of medical

necessity.– Request existing assessments and treatment

plans.– Expectations and Outcomes

Lessons Learned

• Legal Counsel and Advocacy– Attorneys have a duty to counsel their clients,

as well as advocate for them.– Don’t be afraid to talk about mental health

issues with clients.– Importance of client buy-in for own treatment

plan

Trends in mental health advocacy

• Evidence-based practice– What is evidence based practice?– Current state of evidence-based practice– Information about evidence-based practice

• http://www.nrepp.samhsa.gov/

• http://www.ffta.org/publications/EBPguideFinalWeb.pdf

Trends in mental-health advocacy

• Transitional-Age Youth with Mental Health Problems.– Development does not end at age 18.– Challenges faced by TAY youth with mental

health needs• Service Silos

• Service Chasms

Trends in mental health advocacy

• Special needs of TAY with mental health issues.– Continued mental health support/treatment– Vocational/Educational Development– Possible need of benefits (SSI, Medicaid)– Focus on strengths and individual needs– Integrated Care (e.g. ACT, SOC, TIP)

Trends in mental health advocacy

• Resources regarding TAY with mental health needs.– http://www.ncwd-youth.info/information-brief-

23– http://www.cimh.org/Services/Transition-Age-

Youth.aspx– http://cjjr.georgetown.edu/pdfs/

TransitionPaperFinal.pdf

Trends in Mental Health Advocacy

• Dual Diagnosis Clients (Developmental Delay/Mental Health Needs)– Tendency toward either/or view– “Diagnostic Overshadowing”– Service Silos

• Intervention Services

• Education/Training

– Evidence-based practice

Trends in Mental Health Advocacy

• Dual Diagnosis Clients– Resources

• http://www.thenadd.org/index.shtml

• http://www.bckidsmentalhealth.org/docs/Dual_Diagnosis_Guide.pdf

• http://www.nasddds.org/Resources/index.shtml

Overall trends in Mental Health Advocacy

• Early identification, prevention, and treatment

• Reducing risk factors and increasing protective factors

• Increasing client say and “buy-in”

• “Whole child” strength based attitude

Thank you for your time.

• Maire Mullaly, Attorney Liaison mulallym@clcla.org

• Leticia Perez, Mental Health Specialist, perezl@clcla.org

• Kevin Jervik, Mental Health Clinician, jervikk@clcla.org