Youth Mental Health

The National Center for Mental Health Promotion and Youth Violence Prevention in EDC’s Health and Human Development Programs (HHD) is playing a key role in ensuring that California’s landmark mental health prevention initiatives will reach children and youth in schools. Without this guidance, the state’s youth may miss out on vital mental health programming.

Millions of dollars have been allocated to mental health through California’s 2004 Mental Health Services Act (MHSA), which collects a tax on incomes over $1 million. NCMHPYVP, along with local and state programs and federal officials are working to ensure that the state funds—expected to reach $175 million—have maximum impact on young people.

“These lessons and recommendations are expected to inform not only the state of California, but the entire country as mental health legislation becomes a hot button topic,” said Deborah Haber, HHD’s Director of NCMHPYVP.

Jack Campana, HHD senior scientist and technical assistance specialist for NCMHPYVP’s Safe School/Healthy Students (SS/HS) grantees, closely followed the legislation and noticed schools were not being invited to the table to help decide how MHSA money would be spent. As a result, along with the Alliance Healthcare Foundation and California Endowment, Campana worked to ensure that SS/HS grantees and schools meet with county mental health commissioners about allocating MHSA funding for schools.

SS/HS grantees’ focus on youth reflects the growing awareness that young people are at high risk for mental health problems. A recent study, conducted by Dr. Ron Kessler and colleagues at Harvard University, points out that half of all lifetime cases of mental illness begin by age 14, and early identification can avoid years of unnecessary suffering and the risk of illnesses becoming much more severe and treatment-resistant. “This is especially true when we have effective treatments for most early onset mental illnesses,” according to Campana. “The Mental Health Service Act provides an opportunity for schools, county mental health departments, and mental health providers to address needs through additional resources that were unavailable in the past.”

“Schools are an ideal place to reach youth with programming as most children and teens spend the majority of their days in school. However, despite research and a Surgeon General’s report outlining the importance of schools in preventing and addressing mental health problems among youth, MHSA does not specifically mention education or schools as venues for providing services,” says Haber. As a result, SS/HS grantees are engaging with dialogue with the state’s education and mental health sectors to show that schools provide a critical opportunity to integrate mental health promotion, prevention, and early intervention services for youth.

To further these policy-informing discussion, NCMHPYVP convened the MSHA Planning Meeting in Rancho Bernadino, California in October 2005, funded by the Alliance Healthcare Foundation and the California Endowment, and sponsored by Community Health Improvement Partners of San Diego. During the meeting, school officials, mental health workers, and government officials explored specific ways to integrate MHSA funding to maximize mental health promotion, prevention, and early intervention efforts for school-age children and youth and their families through schools and community organizations. This meeting also opened the door for collaborative work among SS/HS grantees and State and county officials.

Meeting participants confirmed their commitment to work together to address the state’s mental health needs, while they shared ideas and developed action steps.

Next Steps for States Planning Mental Health Programming for Youth: Lessons from MHSA:

• Formalize lessons learned about successful research-based practices in mental health promotion and prevention
• Formalize a memorandum of agreement between the State Departments of Mental Health and the Offices of the Chancellor of Education that will address the guidelines of the legislation
• Develop advocacy tools for schools to foster mental health promotion and implement prevention initiatives
• Establish evaluation and accountability guidelines to measure the success of interagency collaboration—between education, mental health services, and law enforcement—as evidenced at the school level

“The most positive outcome of the MHSA Planning Meeting was an enhanced relationship with mental health leadership,” says Dian Baker, Coordinator of SS/HS in Sacramento City Unified. “Having the state and federal government leaders at the meeting provide models on how we could work together to expand mental health services helped us sign a working agreement with local and county mental health officials, which we’d been unable to do previously.”

During the months since October 2005, participants have taken action to build on the connections initiated at the MHSA Planning Meeting, accomplishing the following:

• Developing guidelines for prevention funding
• Ensuring that SS/HS site representatives participate in discussions of mental health prevention and early intervention programming
• Convening a meeting in May 2006 to introduce five new SS/HS sites funded by SAMHSA to the possibilities of integrating SS/HS initiatives into the MHSA
• Developing strong working relationships and arranging collaborative work, such as cross-training for social workers and school-based personnel on how to recognize and handle the mental health issues of children and youth in school
• Funding a staff member to develop a plan for allocating prevention funds through the MHSA

Moreover, by convening the MHSA Planning Meeting, NCMHPYVP opened the door to potential ongoing collaborations that will benefit the mental health of California residents. The NCMHPYVP, which provides technical assistance to SS/HS sites, has expanded its own perspective on the basis of the discussion at the October meeting, leading NCMHPYVP to work with newly-funded SS/HS sites to evolve more integrated ways of bringing funds and staff together.

“Mental health professionals around the country are closely watching events unfold in California,” says Haber of HHD, “And we’re hoping that we can successfully keep the focus on youth and children.”