Cohort Reflections

Michelle.Rogers

First-Aid for Mental Illness

Michelle Rogers

Community Outreach and Education Manager - Camarillo Health Care District

Last fall, a friend I had known since I moved to Ventura County in 2016 was displaying signs of what I thought might be early dementia. She was forgetful, confused at times, the stories and information she shared were inconsistent and oftentimes didn’t make sense, and she appeared disheveled, withdrawn and depressed.

When she lost her condo by the beach after her landlord sold it, she was homeless with no plan and no income, having lost her job years earlier. She jumped from hotel to motel with her dog, ending up in a Motel 6 in Ventura. It was out of character for her to not be able to solve her own problems. She seemed paralyzed by inertia. I found her in a dark motel room with the blinds closed, rotting food in the minifridge, and empty bottles of wine and beer everywhere.

First, I requested a welfare check, but the police were too busy. Then I called Adult Protective Services, but I couldn’t confirm whether she was receptive to help because of confidentiality. Desperate, I took her to the emergency room at a local hospital when she seemed extremely confused, malnourished and barely alert. She said she had fallen and hit her head but wasn’t sure when or how it happened.

Still, no answers because she was unwilling to wait another four hours in ER after initial screening and testing to find out what was wrong or get connected with resources

Later I learned from her family that it wasn’t early dementia. It was mental illness and prescription drug abuse.

After a series of presentations on April 14 during Social Safety Nets & Agriculture Day as part of my involvement in the Ventura County Leadership Academy, I now feel better equipped to help someone facing a crisis find the resources they need, or at least point them in the right direction.

Scott Gilman, director of Behavioral Health at Ventura County Health Care Services, presented an overview of his department, followed by Jillian Fleming, program manager, and Brandy Kosloy, program analyst, both with the Ventura County Human Services Agency, who talked about HSA’s Community Services Department and Homeless Services Program

What captured my attention in Gilman’s presentation was learning about an eight-hour mental health first-aid class. This should be mandatory for every human on the planet. Many people face mental health challenges and family, friends and colleagues feel ill-equipped to help.

“It should be as common as taking a first-aid class,” said Girl Scouts of California’s Central Coast CEO Tammie Helmuth, also a member of VCLA Cohort XXVIII, who attended the presentations with members of our group.

A skills-based training, mental health first aid teaches participants to identify, understand and respond to mental health and substance-use challenges.

Sign me up! This would have helped me correctly identify my friend’s problem and communicate it to agencies that could have offered her assistance.

I also learned about the Homeless Services Program. Its mission is to prevent and end homelessness in Ventura County. Its guiding principles are “housing first” and “trauma-informed care.” HSP receives an average of 1,530 referrals every month and enrolls about half. During fiscal year 2022-23, 508 people have been helped with permanent housing.

The Homeless Services Program offers both financial and supportive services. Examples of financial services include security deposits for rentals, rent arrears, short-term rental assistance, utility assistance, assistance making a home habitable and interim housing. Support services range from case management, housing navigation, landlord mediation and advocacy, to linkage to resources, outreach and collaboration with partner agencies.

To be eligible, one needs to be homeless or at risk of homelessness, a Ventura County resident within income and asset limits, have a valid lease agreement at a place with reasonable rent, the unit must pass habitability inspection and the landlord must be willing to work with HSP.

Had I known this at the time, I could have gotten my friend help with housing.

And then I learned about the Community Services Department, which administers CalWORKs, CalFresh, Medi-Cal, general relief and a cash assistance program for immigrants.

CalFresh has seen an increase in local clients, from 62,829 in 2019 to 69,048 in 2022. During the pandemic in 2020, that number peaked at 74,124, but came back down.

CalWORKs provided assistance to 9,125 people in 2019 and 7,745 in 2022.

Medi-Cal has added more than 35,000 people since 2019, with 254,645 enrolled in 2022.

If you’re not familiar with these programs, you’re not alone. I knew very little. I learned that CalFresh is a federally and state-funded nutritional assistance program designed to help low-income individuals and families buy food. It used to be known as food stamps. Benefits are issued on an EBT card, which is accepted at most grocery stories, as well as some farmers’ markets and restaurants.

CalWORKs is a time-limited program that provides financial assistance and services to qualified pregnant women and families with dependent children. Benefits are issued on the EBT card or can be direct deposited into a client’s bank account. While governed by federal and state laws and regulations, it’s administered by the county.

The General Relief program provides a loan to indigent adults in temporary need of assistance with housing and utility expenses. Grants are paid directly to the landlord for housing, and the program is funded and administered by Ventura County.

Medi-Cal is more widely known. It pays for health care for qualified residents of California. Public assistance recipients, such as those enrolled in CalWORKs, State Supplement Program and Supplemental Security Income, receive it automatically as a benefit. It’s supported by federal and state funding.

With offices located in seven cities – Ventura, Simi Valley, Santa Paula, Moorpark, Fillmore, Thousand Oaks and Oxnard – it shouldn’t be difficult to find help through the Community Services Department.

While I know the challenges around homelessness and poverty are huge, I have hope now they are not insurmountable. Gilman said a “millionaire’s tax” in California that brings in $40 million a year is being overhauled. He said prevention funding will be redirected toward homelessness and housing to the tune of $12-$13 million a year in the future.

Gilman also talked about a goal to get people in crisis “out of police cars, ambulances and jails,” and find alternative places where they can de-escalate. Ventura County Health Care Services is looking for nonprofits and community-based organizations to partner with to provide those alternative locations.

We also heard from Erik Sternad, executive director of Interface Children and Family Services, who talked about a proposed Community Information Exchange, a pilot program launching soon in Ventura County. It will provide an “ecosystem of multi-disciplinary network partners that use a shared language, a resource database and an integrated technology platform to deliver enhanced community care planning.”

Sternad said care planning tools will “enable partners to integrate data from multiple sources and make bi-directional referrals to create a longitudinal record,” which is a single, comprehensive patient record comprised of data from numerous data sources across the healthcare continuum.

It will enable communities to shift away from a reactive approach to providing care toward proactive, holistic, person-centered care. He called it “Social Services Health Care 2.0” as it will result in unified technology, agreements to work across sectors such as nonprofits, healthcare and government, and permission from clients to share personal information to provide that coordinated care.

The goal is to improve access to health services by addressing social needs of high-risk or high-need clients to reduce preventable emergency room and hospitable utilization.

Had this been in place during my friend’s crisis, maybe the situation would not have felt as overwhelming and hopeless. Maybe there would have been better communication, assistance, and a plan developed to get her the help and support she needed.

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