Berkeley City Council
July 26, 2022

7 Gender demographics are as follows:

Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersexed, Agender, Plus (LBGTQIA+) Population
Per a brief by the Williams Institute, UCLA, entitled “LGBT Adults in Large US Metropolitan Areas” the LGBT population is 6.7% in the San Francisco Bay Area. According to the Brief, the estimated percentages of adults age 18 and older who identify as LGBT was derived from the Gallup Daily Tracking Survey which is an annual list-assisted random digit dial (70% cell phone, 30% landline) survey, conducted in English and Spanish, of approximately 350,000 U.S. adults ages 18 and up who reside in the 50 states and the District of Columbia. LGBT identity is Females
Males
51%
49%
City of Berkeley
Gender
12%
88%
Under 18 18 & Over
City of Berkeley
Age

8 based on response to the question, “Do you, personally, identify as lesbian, gay, bisexual, or transgender?” Respondents who answered “yes” were classified as LGBT. Respondents who answered “no” were classified as non-LGBT. Estimates derived from other measures of sexual orientation and gender identity may yield different results. (Conron,K.J, Luhur.W., Goldberg, S.K. Estimated Number of US LGBT Adults in Large Metropolitan Statistical Areas (MSA), (December 2020). The Williams Institute, UCLA. Los Angeles, CA.) Income/Housing
With some of the highest housing costs in the Bay Area, the Berkeley median household income is $91,259. Nearly 18% of Berkeley residents live below the poverty line and approximately 42% of Berkeley children qualify for free and reduced lunches. While 43% of Berkeley residents own their own homes, there are many homeless individuals including women, TAY, and Older Adults. In Berkeley, approximately 46% of the homeless population meets the federal definition for chronic homelessness (adults unaccompanied by children, who have at least one disability and have been homeless for over a year, or four or more times in the last year). This is a disproportionately high percentage compared to other municipalities, and a sub-group with higher rates of both mental illness and substance abuse.

Education
Berkeley has a highly educated population: 97% of individuals aged 25 or older are high school graduates; and approximately 73% possess a bachelor’s degree or higher.

System Organization
Berkeley Mental Health (BMH), one of two city-based public mental health programs in the state, provides services for residents in Berkeley. It is a Division of the City of Berkeley Health, Housing & Community Services (HHCS) Department. Services are provided at multiple clinic sites and in the field. BMH has several units providing services: Access; Family, Youth & Children; and Adult Services. Services include: assessment, assertive community treatment, individual and group therapy, case management, and crisis intervention. In addition to offering homeless outreach and support, some services are provided through a variety of community- based agencies and at school sites. As part of the Access unit, a Mobile Crisis Response Team operates seven days a week. The majority of mental health services provided by BMH are aimed towards the Medi-Cal and uninsured population; as such it is important to note the ways in which the Medi-Cal population demographics differ from the overall demographics in Berkeley. Using data available from Alameda County, the Medi-Cal population in Berkeley in 2021 was as follows:

9 White
42%
African American
42%
Other/Unknown
4%
Asian Pacific
Islander (API)
7%
Latino/a/x
4%
Alaska Native/Am. Ind.
1%
White African American Other/Unknown API Latino/Latina/Latinx (Latino/a/x)

10 Community Program Planning Process

The Community Program Planning (CPP) process for this City of Berkeley MHSA FY23 Annual Update was conducted while a global pandemic was still occurring. During this time one MHSA Advisory Committee meeting was held on Tuesday, May 3rd and six Community Input Meetings were held on the following dates/times:
• Monday, May 2nd: 3:00-4:30pm
• Thursday May 5th: 11:00am-12:30pm
• Tuesday May 10th: 1:00-2:30pm
• Wednesday May 11th: 6:00-7:30pm
• Thursday, May 12th: 6:00-7:30pm
• Monday, May 16th: 6:00-7:30pm
Announcements of the meetings were sent to MHSA Advisory Committee members, consumers, family members, representatives from community-based organizations, individuals from unserved, underserved and inappropriately served populations, HHCS Staff, City Commissioners, and other MHSA stakeholders. Additional outreach regarding opportunities on how to inform the MHSA FY23 Annual Update was conducted with the Mental Health Commission through email and presentations at the April 28th and May 26th Commission meetings.

During the MHSA Advisory and Community Input Meetings which were conducted through the Zoom platform, a presentation was conducted to provide information on MHSA background, funding, program requirements, and the CPP process. The presentation also covered detailed information on the proposed MHSA FY23 Annual Update and provided opportunities for input from the community. An anonymous voluntary online survey through Survey Monkey, was administered during each meeting to obtain demographic information on meeting participants.

Individuals who joined the meetings by phone were contacted following the meeting to have the opportunity to voluntarily participate in the survey. The results of 19 individuals who voluntarily participated in the survey while attending either a Community Input Meeting, or the Public Hearing, or by phone were as follows:

DEMOGRAPHICS N=19
Gender Identity Participant Number % of total
Male 5 26%
Female 10 53%
Gender Queer 1 5%
Declined to Answer (or Unknown) 3 16%
Race/Ethnicity
Race/Ethnicity Participant Number % of total
African American 4 21%
Asian Pacific Islander 1 5%
White 9 48%
Latino/a/x 1 5%
Other 1 5%
Declined to Answer (or Unknown) 3 16%
Age Category
Age Category Participant Number % of total
Adult (Ages 26-59) 11 58%

11 Older Adult (Ages 60+) 5 26%
Declined to Answer (or Unknown) 3 16%
Sexual Orientation
Sexual Orientation Participant Number % of total
Heterosexual 11 58%
Gay or Lesbian 1 5%
Queer 1 5%
Declined to Answer (or Unknown) 6 32%
Veteran
Veteran Status Participant Number % of total
Veteran 1 5%
Non-Veteran 15 79%
Declined to Answer (or Unknown) 3 16%
Disability Status
Disability Status Participant Number % of total
Disabled 4 21%
Not Disabled 10 53%
Declined to Answer (or Unknown) 5 26%
Representative Categories*
Representative Status Participant Number % of total
Consumer 4 27%
Family Member of Consumer 3 13%
Community Member or MHSA
Stakeholder
3 Parent, Student or Representative
of Berkeley Unified School District
1 7%
Representative of Community
Based Organization
8 20%
City of Berkeley Staff 3 20%
Other 3 13%
Declined to Answer (or Unknown) 3 20%
*Some participants were in more than one category.

As a method to continue to gather input from the community on this Annual Update, additional Community Input meetings were scheduled during the 30-Day Public Review. As with previous MHSA Plans and Annual Updates, a methodology utilized for conducting CPP for this Annual Update was implemented to enable a collaborative process to occur between BMH staff, MHSA Advisory Committee members and other MHSA stakeholders. Development of the MHSA FY23 Annual Update began with an internal examination of existing programs, unaddressed needs, and available funding which included a review of input received over the prior year and during previous MHSA planning processes. Following an internal review, proposed ideas and potential programs were vetted through the MHSA Advisory Committee prior to engaging other stakeholders.

Proposed additions considered in this process include:
• Increase staffing on the Homeless Full Services Partnership and the Adult Full Services Partnership to build capacity and supports for each program; • An additional position for the Adult Services programs to support quality assurance and program outcomes;
• An additional position to build the internal capacity for program evaluation and to support the Division-wide Results Based Accountability evaluation;

12 • Allocate funding for short-term housing for individuals served on the Homeless Full Services Partnership;
• Increase funding for the Bay Area Hearing Voices Network for outreach, technology, and program administration;
• Provide funding for on-site program management at the Martin Luther King House; • Allocate a small amount of additional funds to participate in the Greater Bay Area Regional Partnership Student Loan Repayment program.

During the CPP process questions were answered regarding various MHSA programs and funding. Input received during this process was as follows:
• A nutritionist should be hired or a collaboration with Public Health should be initiated to support the wellness recovery of individuals receiving services at BMH with healthy weight weight management.
• Suggest changing the term, or redefining the language, of “Mental Health Illness”. • We need to see more information to help make meaningful contributions and recommendations. There is not enough information on how to add funding to a large complex component.
• We need to come up with a plan to get the community invested in participating in the community program planning process and on the MHSA Advisory Committee . It could be that there is stigma around mental health but we have a lack of success in attracting the community in participating in these community meetings.
• Individuals need long term treatment, not services (blankets, toothbrushes, etc.). I don’t hear that individuals are receiving treatment and I don’t hear any succ ess stories. Individuals are wandering the streets and dying on the streets in my neighborhood and they aren’t getting the treatment that they need. It’s miserable for them and for the residents living around it to witness. Treatment should be mandatory for individuals who are living in these conditions as they are unable to help themselves.
• Utilize unspent PEI funds to provide Dynamic Mindfulness (DMind) training, coaching, and supports to Head Start staff. (Dmind is an evidence-based trauma-informed program. validated by independent researchers as a transformative strategy for teaching skills for optimal stress resilience and healing from trauma, through mindful action, centering and breathing).
• Utilize unspent PEI funds to add the InPower mobile App into the Supportive Schools project, the High School Prevention Project , and the Community Education and Supports project. (InPower is a mobile App that provides two minute mindful movement practices using video animation and audio narration, that can help guide the user to regulate powerful emotions by changing how they feel in stressful moments and/or at times of anger, sadness, anxiety, worry, and/or tiredness. InPower ensures physical, emotional, and social well-being for youth, adults and older adults).
• Utilize unspent INN funds to add the InPower App to the Mental Health Apps that are available to the community through the Help@Hand project.
• Implement the Mental and Emotional Education Team (MEET) program in the High School in FY23. (MHSA has provided PEI funding to implement MEET in the Berkeley High School.

MEET implements a peer -to-peer mental health education curriculum to 9 th graders and an internship program for a cohort of high school students to serve as peers to their fellow

13 students. The goals of the program are to incre ase student awareness of common mental health difficulties, resources and healthy coping and intervention skills. In the past several years by the choice of the Berkeley High School, the MEET program has not been implemented).

A 30-Day Public Review was held from Wednesday, May 25 th through Thursday, June 2 3rd to invite input on this MHSA Annual Update. A copy of the Annual Update was posted on the BMH MHSA website. A hard copy of the Annual Update was accessible for reviewing at the reference section of the Berkeley Public Library on 2090 Kittredge Street. Four additional Community Input Meetings were held during the 30-Day Public Review on the following dates and times:

Monday, June 13: 6:00-7:30pm
Tuesday, June 14: 1:00-2:30pm
Thursday, June 16: 6:00-7:30pm
Wednesday, June 22: 3:00-4:30pm

Information on the Community Input Meetings was posted on the MHSA webpage and on the City of Berkeley Event Calendar. Announcements of the 30-Day Public Review and Community Input Meetings were mailed and/or emailed to community stakeholders and City staff. A Press Release was also issued on the 30 Day Public Review and Community Input Meetings . Following the 30 Day Public Review, a Public Hearing was held on Thursday June 23rd, during the Mental Health Commission meeting which was conducted on the Zoom platform. Public Input received during the 30-Day Public Review and/or the Public Hearing was as follows:
• I didn’t realize Berkeley had a Mental Health Division. Maybe some of the funds could be used to increase visibility and outreach. When I was looking for a psychiatrist and a therapist awhile back, no one mentioned the City as an option for services. Maybe there needs to be more outreach to practitioners, agencies, social workers and clinics as well. • Need more public awareness for MHSA Community Input Meetings. • It would be a good idea to use some of the funding for education: webinars, in-person lectures, literature, etc. As someone with a mental health disability, I confront a lot of prejudice. Reducing the stigma through education would also help those with mental illness, seek treatment.
• Berkeley needs a Drop-In Crisis Center with skilled professionals (not interns and volunteers) who are trained to help people with complex PTSD and other mental illnesses.

We need help when we are triggered but before we have psychotic episodes and hurt others or ourselves. We do not belong in jail or psych wards. Help us help ourselves!! Most of us have incredible difficulty navigating the horrendous “pathway” needed to get a regular therapist or psychiatrist. The system is so screwed up and none of it makes any sense.

Consider even a place that offers classes on “How to deal with our triggers, tapping, other helpful tools”. Look to Santa Cruz who I think have such places. • The Adult Clinic should have designated staff who have had Neurodiversity Training and are trained to work with individuals who are dyslexic. There is a big co-morbidity of neurodiversity and mental health issues. Being dyslexic can create a significant issue in communicating and can lead to underlying shame.
• Students, parents and adults all need to be able to have access to Peer Counseling programs as individuals are more likely to share and open up to others that are similar to them and whom they trust.

14 • How can MHSA funds be utilized to provide more blended services, and braided teams, where someone receiving housing services for instance can also receive clinical services? • Results Based Accountability (RBA) is good, it addresses the what and the how, but it doesn’t address the “why”. We need to understand the root causes of why we are doing what we are doing.
• You should consider the credentials of who you are hiring for the evaluation position and have a set aside of funds for evaluation and consider the resources that will be needed, such as the use of Data Analytics.
• Consider building a webpage with a dashboard that shows which demographic groups are accessing services so community members or partners can have a way of referencing how they and the Division are doing, and how well they are serving underserved populations, etc. • Please reserve some funds for local mental health organizations. The Berkeley Chapter of Depression and Bipolar Support Alliance (DBSA) provides support for those with mood disorders. They are chronically underfunded, relying solely on donations from members, many of whom are on SSI or SSDI.
• There has been improvement in the gathering of required demographic and related statistics in the MHSA Annual Update, but I still think for some groups, I think the LGBTQ groups, there are certain providers who still haven’t come around to really giving some thought on how they should be collecting that data. There should potentially be some kind of training for these providers on how to do that because not only are they not collecting it, but are they actually tailoring the services to these individuals in a way that is culturally responsive? It may be true for other populations as well.

All input received will be utilized to inform this MHSA Annual Update and/or future MHSA Three Year Plans and Updates. Following the Public Hearing the Mental Health Commission passed the following motion:

M/S/C (Fine, Jones) Recommend that the City Council approve this funding and submit the MHSA Plan to the State.

Ayes: Fine, Jones, Opton, Pritchett Noes: None; Abstentions: None; Absent: Escarcega; Taplin.

MHSA FY22/23 Annual Update

This City of Berkeley’s MHSA FY22/23 (FY23) Annual Update is a stakeholder informed plan that provides an update to the previously approved MHSA FY20/21 – 22/23 Three Year Program and Expenditure Plan (Three Year Plan). The Annual Update summarizes proposed program changes and additions, includes descriptions and updates of currently funded MHSA services that are proposed to be continued in the next year, and a reporting on FY21 program data. Additionally, per state regulations, this Annual Update includes the Prevention and Early Intervention (PE) Fiscal Year (FY) 2018/2019 – 2020/2021 Three Year Evaluation Report (Appendix A), and the Innovations (INN) FY2022/2021 Annual Evaluation Report (Appendix B).

While some MHSA programs collected outcome and client self-report measures, the majority of the data that was collected in FY21 was still more process related. However, as reported in previous MHSA Plans and Updates, a few initiatives that are currently underway to evaluate the outcomes of several MHSA programs are as follows:

15 • Impact Berkeley : In FY18, the City of Berkeley introduced a new initiative in the Health Housing and Community Services (HHCS) Department called “Impact Berkeley”. Central to this effort is using a highly regarded framework called Results Based Accountability (RBA) to account for the work of the Department. RBA provides a new way of understanding the quality and impact of services provided by collecting data that answer three basic questions:

1. How much did you do?

2. How well did you do it?

3. Is anyone better off?
RBA has been incorporated into selected programs within the Department. This has included community agency programs funded through the MHSA Prevention & Early Intervention (PEI) Community Education & Supports program. Through this initiative the Department worked with each contractor to envision, clarify and develop measures on the outcomes and results each program is seeking to achieve, and used a rigorous framework to begin measuring and enhancing progress towards these results. Page 54 of this Three Year Plan provides an aggregated summary of some of the results of this initiative. • Results Based Accountability Evaluation for all BMH Programs: Through the approved FY19 Annual Update the Division executed a Request for Proposal (RFP) process to hire a consultant who will implement a Results Based Accountability Evaluation for all programs across the Division, and Resource Development Associates (RDA) was the chosen vendor .

In FY21 RDA began working with the Division to implement the RBA research methodology.

An update of the work on this evaluation is included on pages 40-41 of this Annual Update.

• PEI Data Outcomes : Per MHSA PEI regulations, all PEI funded programs have to collect additional state identified outcome measures (specific to the category of serv ices provided) as well as detailed demographic information. Beginn ing in FY19, PEI Evaluations were required to be included in each MHSA Annual Update or Three Year Plan. See Appendix A for the Prevention & Early Intervention Fiscal Years (FY) 2018/2019 - 2020/2021 Three Year Evaluation Report.

• INN Data Outcomes: Per MHSA INN regulations, all INN funded programs have to collect additional state identified outcome measures and detailed demographic information.

Beginning in FY19, INN Evaluations were required to be included in each MHSA Annual Update or Three Year Plan. See Appendix B for the Innovations (INN) Fiscal Year (FY) 2020/2021 Annual Evaluation Report.

Future MHSA Plans and Updates will continue to include reporting on the progress of these initiatives.

PROPOSED NEW FUNDING ADDITIONS

The Division is proposing to add several new positions, and supportive services through this Annual Update, and will be discontinuing one program. Proposed new additions are a result of community needs that have arisen since the Three Year Plan was approved. Funding amounts for the proposed additional staffing outlined below are calculated based on staff being hired by mid FY23 with 30% of the costs of the positions offset by Medi-Cal reimbursement. The

16 proposed staffing and services to be added or discontinued through this MHSA Annual Update, are as follows:

Increase Program Capacity on the Homeless Full Services Partnership (FSP) The Homeless Full Service Partnership (FSP) provides services and supports for homeless individuals who are experiencing mental health needs. As this FSP is rapidly reaching program capacity, the Division is proposing to utilize MHSA Community Services and Supports (CSS) FSP Funds to expand this program through the addition of the following positions:
• 2 Social Service Specialists - $107,491
• 1 Behavioral Health Clinician II - $63,082
Increase Program Capacity on the Adult Full Services Partnership (FSP) The Adult Full Services Partnership (FSP) is the largest program in the MHSA Community Services and Supports funding component. This FSP provides intensive support services to TAY, Adults and Older Adults with severe mental illness using an Assertive Community Treatment (ACT) approach. The program focuses on serving individuals who have had difficulty with obtaining or maintaining housing; frequent and/or lengthy psychiatric hospitalizations; and/or frequent or lengthy incarcerations. Priority populations also include individuals from un- served, underserved and inappropriately served cultural communities. In order to increase the program capacity and organization of this FSP, the Division is proposing to add the following positions through MHSA CSS FSP Funds:
• 1 Social Service Specialist - $53,745
• 1 Senior Behavioral Health Clinician II - $68,741
Increase Administrative Support for Adult Programs
Berkeley Mental Health (BMH) Adult Services is comprised of the following three large programs: Adult FSP, Comprehensive Community Treatment, and Focus on Independence. The programs provide a continuum of services and supports for individuals in need. In order to provide administrative support for each program in meeting Quality Assurance and performance outcomes, the Division is proposing to add the following position through MHSA CSS System Development Funds and MHSA FSP Funds:
• 1 Assistant Management Analyst - $53,738
Create internal capacity for Program Evaluation
Feedback received over previous years focused on implementing evaluation measures that help BMH, MHSA Stakeholders, and community members more fully understand and determine how well programs are meeting participant and community needs. Integral to this type of outcome measure is to engage the voice of the program participant around the services they received. As a result of this feedback in the previously approved MHSA FY19 Annual Update, BMH allocated funds to hire a Consultant to conduct an evaluation on all BMH programs across the system utilizing the “Results Based Accountability” (RBA) framework. The RBA framew ork measures how much was done, how well it was done, and whether individuals are better off as a result of the services they received. In FY19 a competitive RFP process was executed, and Resource Development Associates (RDA) was the chosen consultant. RDA is currently in the process of working with the Division on this evaluation.

17 In order to create the internal capacity to collect and report on the RBA outcomes as well as future evaluations, the Division is proposing to utilize MHSA CSS System Developme nt Funds to hire the following administrative position to support this work:
• 1 Community Services Specialist III - $74,686
Add funding to support on-site management at Martin Luther King House The Martin Luther King Jr. House is a 12-unit single room occupancy (SRO) complex with shared living spaces that serves the disabled community in Berkeley. This SRO is currently experiencing a need for increased property management. Through this Annual Update the Division is proposing to allocate $107,890 of CSS System Development Funds to support the Martin Luther King Jr. House in acquiring on-site property management Increase short-term housing for individuals on the Homeless FSP Through this Annual Update the Division is proposing to allocate $120,000 of MHSA FSP Funds to support short-term housing for individuals receiving services on the Homeless FSP. The funding will be utilized to provide housing, three meals a day, utilities, 24/7 security, housing navigation and the maintenance of Trailers for four individuals at 701 Harrison Street.

Increase funding for Bay Area Hearing Voices Network
The Division currently provides MHSA funding to the Bay Area Hearing Voices Network to implement free support groups for individuals in Berkeley who experience voices, visions, special messages, unusual beliefs or extreme states of consciousness. The support groups are co-facilitated by trained group leaders whom have lived experiences in the mental health system. Through this Annual Update, the Division is proposing to increase the funding amount by $12,205 to support program outreach, technology costs and administrative services. With the proposed increase the new annual project amount will be $46,941 which will be funded through CSS System Development Funds.

Provide additional funding for the Greater Bay Area Workforce, Education & Training Regional Partnership
The Office of Statewide Health Planning and Development (OSHPD) allocated $40 million in Workforce, Education and Training funds through FY25 for Regional Partnerships across the state for various mental health workforce strategies. A total of 2.6 million of OSHPD was allocated to the Greater Bay Area (GBA) Workforce, Education & Training Regional Partnership.

In order to participate in the GBA Regional Partnership, mental health jurisdictions were required to contribute a portion of local funds towards this initiative. For the Berkeley contribution the amount was $40,127, which the Division allocated through the previously approved Three Year Plan.

Since the approval of the Three Year Plan, the Division has participated in meetings with representatives from other counties in the GBA Regional Partnership. All participating counties decided to allocate these funds to implement the Loan Repayment program. This program will enable funds to be made available to repay a portion of student loans for a given number of staff who are in hard-to-fill positions, in exchange for a number of years of service in the Public Mental Health system.

18 Since the approval of the Three Year Plan some local counties decided not to participate in this initiative. As a result, the GBA Regional Partnership was notified that each participating mental health jurisdiction will need to increase the amount of funds they are contributing to this initiative. The additional amount for Berkeley is $1,361. Per this Annual Update, the Division is proposing to transfer $1,361 of CSS System Development Funds to the Workforce, Education and Training (WET) funding component, through the following process:

Per MHSA Statute, (Welfare and Institutions Code, Section 5892 (b)): “In any year after 2007 -08, programs for services pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) of this division may include funds for technological needs and capital facilities, human resource needs, and a prudent reserve to ensure services do not have to be significantly reduced in years in which revenues are below average of previous years.

The total allocation for purposes authorized by this subdivision shall not exceed 20 percent of the average amount of funds allocated to that county for the previous five years pursuant to this section.”
Funds will be utilized to participate in this initiative, which is being administered through a joint powers authority, the California Mental Health Services Authority (CalMHSA). Through this Annual Update the Division is requesting to enter into a Participation Agreement with CalMHSA to allocate the designated funds to participate in this initiative.

Adult Clinic Repair and Renovation Study on Adjacent Property Construction on the Adult Clinic began in FY19, and in June 2021, the renovation was completed, staff moved back into the building, and the clinic was re-opened for services. There is approximately $199,572 in remaining CFTN Funds. It is anticipated that approximately $35,000 of these funds will be utilized in FY23 to alleviate water damage at the Adult Clinic and $75,000 will be utilized to conduct a Renovation Study on the adjacent property to the Adult Clinic (2636 Martin Luther King Jr. Way) where some Adult Clinic staff offices are located.

Discontinue Community-Based Child & Youth Risk Prevention Program The Community-Based Child & Youth Risk Prevention Program is funded through the MHSA PEI component that targets children (aged 0-5) who are impacted by multiple risk factors including trauma, family or community violence, familial distress, and/or family substance abuse, (among other issues). A BMH clinician has served as the Mental Health Consultant on this project providing information, services and supports to teachers and parents at the YMCA Head Start program in South Berkeley. Services have included individual case consultation for teachers and parents, group consultations, classroom observations and interventions, assessments, brief treatment, and referrals to other resources as needed. The main goals of the program have been to reduce risk factors or other stressors, and promote positive cognitive, social, and emotional well-being. In FY23 this program will be discontinued, as the YMCA Head Start program has hired an internal staff to fill this role.

PROGRAM DESCRIPTIONS AND FY21 DATA

BY FUNDING COMPONENT
Outlined in this section per each funding component are descriptions of current City of Berkeley MHSA services along with FY21 program data. Across all MHSA funded programs, in FY21, approximately 3,805 individuals participated in some level of services and supports.

19 Additionally, a total of 561 individuals attended BMH Diversity and Multi-cultural trainings and/or events. As with FY20, among the largest of accomplishments in FY21 is that almost all MHSA funded services were able to continue providing services in some capacity during the pandemic.

Some of the FY21 MHSA funded program highlights included: A reduction in psychiatric inpatient hospital and/or incarceration days for severely mentally ill clients; a decrease in the number of days severely mentally ill clients spent homeless; step down to a lower level of care for some clients; services and supports for homeless or marginally housed TAY, who are suffering from mental illness; services and supports for family members; multicultural trainings, projects and events; Wellness Center services; consumer driven wellness recovery activities; housing, and benefits advocacy services and supports for clients; augmented prevention and intervention services for children and youth in the schools and community; increased outreach, and support services for homeless TAY, Adults and Older Adults and individuals in unserved, underserved and inappropriately served cultural and ethnic populations.

COMMUNITY SERVICES & SUPPORTS (CSS)
Following a year-long community planning and plan development process, the initial City of Berkeley Community Services & Supports (CSS) Plan was approved in September 2006. Since the approval of the original plan, Three Year Plans or Annual Updates outlining proposed CSS funding and programming have been been developed and approved on an annual basis. From the original CSS Plan and/or through subsequent plan updates, some of the many services the City of Berkeley has provided through CSS funding are as follows:
• Wrap-around Services for Children and their families; • TAY, Adult and Older Adult Intensive Treatment Services; • Homeless Services;
• Multi-cultural Outreach & Engagement;
• TAY Case Management and Support Services;
• Consumer Advocacy;
• Wellness and Recovery Services;
• Family Advocacy;
• Transitional Outreach Team;
• Support Groups for individuals;
• A Wellness Recovery Center; and
• Benefits Advocacy.

Descriptions and updates for each CSS funded program and FY21 data are outlined below:

FULL SERVICE PARTNERSHIPS (FSP)

Children/Youth Intensive Support Services Full Service Partnership

20 The Intensive Support Services Full Service Partnership (FSP) is for children ages 0-21 and their families. This program is for children, youth and their families who would benefit from, and are interested in participating in a program designed to address the total needs of a family whose child (and possibly other family members) is experiencing significant emotional, psychological or behavioral problems that are interfering with their wellbeing.

Priority populations include children and youth who:
• have substantial impairment in self-care, school functioning, family relationships, the ability to function in the community, and are at risk of or have already been removed from the home and have a mental health disorder and/or impairments that have presented for more than six months or are likely to continue for more than one year without treatment; OR
• display psychotic features, or a history of hospitalization due to Danger to Self, Danger to Others, Grave Disability or a recent suicide attempt within the last six months from the date of referral.

The Children/Youth FSP program utilizes wraparound as the treatment model. Wraparound differs from many service delivery strategies, in that it provides a comprehensive, holistic, youth and family-driven way of responding when children or youth experience serious mental health or behavioral health challenges. The model puts the child or youth and family at the center. With the help of the FSP team, the family and young person take the lead in deciding their vision and goals. Team member’s work together to put the goals into an action plan, monitor how well it is working, and make changes to it as needed. The projected number of individuals to be served in FY23 by each age category is as follows: 9 individuals aged 6-12; 9 individuals aged 13-17; and 2 individuals aged 18-21.

In FY21, a total of 17 children/youth and their families were served through this program.

Demographics on those served were as follows:

DEMOGRAPHICS N=17
Age Number Served % of total
6-12 years 5 29%
13-17 years 9 53%
18-21 years 3 18%
Gender Identity Number Served % of total
Male 11 65%
Female 6 35%
Race/Ethnicity
Race/Ethnicity Number Served % of total
African American 10 59%
Asian Pacific Islander 1 6%
White 4 23%
Latino/a/x 2 12%
Sexual Orientation
Heterosexual or Straight 12 71%
Declined to State or Unknown* 5 29%

Flex funds are used to provide various supports for FSP program participants and/or the families of program participants. In FY21, flex funds were utilized as follows: 8

21 individuals/families received funding for food/groceries; 3 individuals/families received funds for clothing/hygiene; 1 individual/family received funds for furniture/household items; and 6 individuals/family members received funding for other various needs.

Program Successes:
• Seven individuals met and/or exceeded the stated objectives in their treatment plan. • Successfully transitioned client care to Zoom at the beginning of the Pandemic. Staff were able to successfully support their clients/families to utilize the platform and to regularly have scheduled appointments.
• Increased linkages to psychiatric medication services, and individual/family therapy. Three individuals who were over 18 years of age were referred to BMH Adult Services for medication support.
• Reduced psychiatric hospitalizations and usage of crisis services. • Services were provided by clinicians who mirrored the racial/ethnic identity of the populations served.
• The FSP Team was able to provide flex funds to support the felt needs of clients during the pandemic. This supported the purchase of food, household items, clothing/hygiene, and other various needs.
• As the shelter in place was eliminated for Berkeley residents, staff were able to engage individuals safely in public settings which improved engagement and the quality of care provided.

Program Challenges:
• Providing FSP level care to clients and families via Zoom during the Pandemic was extremely difficult as staff and families implemented safety protocols to reduce the risk of exposure to COVID-19. Families also reported high levels of Zoom fatigue since all services and academics were provided on line, which impacted consistent engagement in services. • Reduction in referrals to the program due to the fact that families were sheltered in place at home. This reality made it difficult for natural supports (i.e. school staff) to see the students who could benefit from services and make the subsequent referrals. • Staff were only able to provide services in English due to the resignation of the Spanish speaking clinician. Other BMH Family & Children’s Services behavioral health clinicians were able to fill in to support these individuals and families.

TAY, Adult and Older Adult Full Service Partnership
This FSP program provides intensive support services to TAY, Adults and Older Adults with severe mental illness using an Assertive Community Treatment (ACT) approach. The program focuses on serving individuals who have had difficulty with obtaining or maintaining housing; frequent and/or lengthy psychiatric hospitalizations; and/or frequent or lengthy incarcerations.

Priority populations also include individuals from un-served, underserved and inappropriately served cultural communities.

The team utilizes an ACT approach which maintains a low staff-to-client ratio (12:1) that allows for frequent and intensive support services. Individuals are provided assistance with finding appropriate housing and in some cases may qualify for temporary financial assistance. The primary goals of the program are to engage clients in their treatment and to reduce days spent

22 homeless, hospitalized and/or incarcerated. Goals also include increasing, employment and educational readiness; self-sufficiency; and wellness and recovery. The projected number of individuals to be served in each age category in FY23 is as follows: 5 Transition Age Youth; 55 Adults; and 15 Older Adults.

In FY21 a total of 79 TAY, Adults, and Older Adults participated in the program for all or part of the fiscal year. Demographics on those served include the following:

DEMOGRAPHICS N=79
Gender Identity Number Served % of total
Male 47 59%
Female 25 32%
Pangender 1 1%
Declined to Answer (or Unknown) 6 8%
Race/Ethnicity
Race/Ethnicity Number Served % of total
African American 35 44%
Asian Pacific Islander 1 1%
White 36 46%
Latino/a/x 4 5%
Declined to Answer (or Unknown) 3 4%
Age Category
Age Category Number Served % of total
Transition Age Youth 4 5%
Adult 56 71%
Older Adult 19 24%
Sexual Orientation
Heterosexual 52 66%
Bisexual 3 4%
Gay 2 2.5%
Pansexual 2 2.5%
Declined to Answer (or Unknown) 20 25%

Flex funds are used to provide supports for FSP program participants. In FY21, 20 partners received rental and housing assistance; 28 received food and groceries and 25 partners were provided with miscellaneous assistance with cleaning, clothing, bus passes, furniture, etc. FSP outcomes included the following: 11 partners were dis-enrolled from the program during FY21, 4 partners met treatment goals and graduated to lower levels of care (36%), 4 partners were transferred to a new Full Service Partnership team specializing in individuals who are chronically homeless (36%), 1 partner moved out of the county (9%), 1 partner died (9%), 1 partner could not be located (9%). 7 new partners were enrolled and completed services.

There were 71 FSP program participants in FY21 who completed at least 1 full year of service in the program and are included in the program outcome report data. There were positive outcomes with regard to reductions in days spent homeless, in hospital settings and/or incarcerated. There was a 42% reduction in days spent homeless. Partners spent 7,565 days homeless (on the street, couch surfing and in shelters) the year before program enrollment and 4,374 days homeless during the first year of program participation. There was a 68.5% reduction in days spent in hospital settings (Psychiatric Emergency, acute psychiatric inpatient, IMDs, MHRCs, state psychiatric hospitals and medical hospitals, SNF) during the first year of

23 program participation. Partners spent 4,221 days in hospital settings the year before program enrollment and 1,328 days in these settings during the first year of program participation. There was a 56% reduction of days spent incarcerated during the first year of program participation.

Partners spent 1,533 days incarcerated (jail and prison) the year prior to program enrollment as compared with 670 days incarcerated during the first year of program participation.

Outcomes are outlined in the chart below:

Overall, as with previous years, the program continued to have strong outcomes with regard to reducing days spent in hospital settings (68.5%) and days spent incarcerated (56%). The program continues to have more modest success with reducing the number of days spent homeless for participants (42%). Program challenges included the ongoing housing crisis in the Bay Area, staff vacancies, and the ongoing COVID-19 pandemic.

Program Challenges:
• Bay Area Housing Crisis: As the Bay Area housing crisis has continued, finding safe and affordable housing is extremely difficult as housing prices continue to rise and are among the most expensive in the country. Licensed Board & Cares that provide clients 24/7 support and monitor medication adherence have also been closing down. Single Room Occupancy Hotels have been raising their monthly rates such that clients are not able to afford staying there without housing subsidies.
• Coordinated Entry System: The Coordinated Entry System in Alameda County is intended to address homelessness more efficiently and equitably. The system standardizes the assessment process and prioritizes resources for individuals who are assessed to have the highest need. Helping the highest need homeless individuals get through the assessment process can be challenging given the need for clients to participate in an assessment appointment. Also, some individuals served in the FSP were reluctant to acknowledge their mental health and substance use issues which in turn lowered their “needs” assessment score and chances of obtaining permanent supported housing resources. 7,565
4,221
1,533
4,374
1,328
670
0 1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
42% decrease days
homeless

68.5% decrease days
hospital settings
56% decrease days
incarcerated
FSP Outcomes During First Year of Service

24 • COVID-19 Pandemic: The COVID-19 pandemic continued to present challenges in FY21 in providing services to clients. In-person visits continued to occur at somewhat reduced levels to minimize unnecessary risks to clients and staff. Hospitals, Board and Cares and various other programs closed sites to visitors during periods of outbreak. • Staffing: Retaining and hiring staff was difficult. Several staff left the team and it has been very difficult to fill those vacancies. There have been significantly fewer applicants over the past year than in years past. Staff that applied for and were offered positions reported receiving multiple job offers from other organizations. The pandemic has likely played a role in the hiring crisis. The FSP requires working in the community with individuals who are considered the highest need within the service system. The work can be challenging.

Current employees also had to manage their concerns about possible exposure to COVID- 19 while doing front line services as well as managing their burnout as staffing levels decreased. It is anticipated that the current vacancies will be filled in the coming fiscal year.

Going forward the FSP will continue to develop staff expertise in treating co-occurring substance use disorders by providing ongoing training in Motivational Interviewing. The team will also continue to work on increasing fidelity to the Assertive Community Treatment model.

Homeless Full Service Partnership
Through the previously approved MHSA FY20 Annual Update, and as a result of the need to ensure ongoing services and supports for homeless individuals following the ending of the Homeless Outreach and Treatment Team (HOTT) Pilot Program, a Homeless Full Services Partnership was developed. This program provides services and supports for homeless individuals who are experiencing mental health needs. It was implemented in the last quarter of FY21. During that timeframe one individual was served. The projected number of individuals to be served through this program in FY23 by age category is as follows: 5 Transition Age Youth; 35 Adults; and 10 Older Adults.

MULTI-CULTURAL OUTREACH AND ENGAGEMENT
Diversity & Multicultural Services
The Diversity & Multicultural Coordinator (DMC) provides leadership in identifying, developing, implementing, monitoring, and evaluating services and strategies that lead to continuous cultural, ethnic, and linguistic improvements within the organization’s system of care, with a special emphasis on unserved, underserved, inappropriately served, and emerging populations.

The DMC also collaborates with the state, regional counties, other city divisions, local agencies, and community groups in order to address mental health inequities and disparities for targeted populations and communities, and the community-at-large in Berkeley.

The Diversity & Multicultural Coordinator accomplishes these goals by:
• Providing cultural competency training to all behavioral health, community partners, and all stakeholders in Berkeley and other geographic locations in the region as a collaborative partner;
• Performing outreach and engagement to unserved, underserved, inappropriately served and emerging communities and populations;

25 • Developing long and short-term goals and objectives to promote cultural/ethnic and linguistic competency within the system of care;
• Developing an annual training plan and budget;
• Chairing the agency’s Diversity and Multicultural Committee; • Attending continuous trainings in the areas of cultural competency; • Monitoring Interpreter and Translation Services for the agency; • Collaborating with State, Regional, County, and local groups and organizations, and • Developing and updating BMH’s Cultural Competency Plan as needed.

Program services, events and activities conducted in FY21, are summarized below:

Activity Update
Participants involved in Berkeley Mental Health’s trainings, committees, groups, cultural/ethnic community events and activities are city staff, service providers, consumers/peers, family members, and residents from diverse groups and populations. There is a focus on improving services for unserved, underserved, inappropriately served, and emerging populations and communities throughout the cities of Berkeley and other areas within the region.

Diversity & Multicultural Trainings & Events: (Culturally Diverse Participants) • Latino/Latinx Conference 2020 – Latino Intercambio: Together We Are Stronger!/Juntos Somos Fuertes! Friday, October 23, 2020.
(Zoom Event - 110 individuals attended this event) - Attendees included staff, consumers, family members, community partners, students, and residents. This training was a collaboration with the City of Berkeley Public Health and Aging Services Divisions; BAHIA, Inc.; and RISE.
• BMH Event - Black Expressions of the Soul in All Forms – Celebrating Black Joy – Thursday, February 18, 2021- (Zoom Event - 62 individuals attended this event) - Attendees included staff, consumers, and residents.
• Black History Month Youth Celebration - Thursday, February 20, 2021 - (Zoom Event - 46 individuals attended this event) - Attendees included youth, family members, teachers, staff, and residents. This event was a collaboration with BUSD. • Berkeley in Solidarity with Asian Americans and Pacific Islanders – May 10, 2021 – A collaboration with the University of California at Berkeley (Zoom Event – 73 individuals attended this event) – Attendees included students, professors, staff and residents.
• May Is Mental Health Month – COVID-19: Challenges, Hope, and Resiliency - Increasing Community Mental Health and Wellness – May 26, 2021 - (Zoom Event - 52 individuals attended this event) - Attendees included staff, consumers, and residents. • PRIDE Month 2021 - Transgender Tay: Finding Self and Love in Transition – Thursday, June 17, 2021 (Zoom Event - 15 individuals attended this event) - Attendees included staff, consumers, and residents.

Staff Training Coordinator
The Staff Training Coordinator prepares, facilitates, presents, monitors, evaluates and documents training activities for BMH’s system of care. The position also collaborates with staff

26 from state, counties, local agencies and community groups in order to enhance staff development of employees in the cities of Berkeley, and other areas in the region.

The Training Coordinator accomplishes these goals by:
• Providing staff training in the area of behavioral health to all stakeholders in Berkeley and other geographic locations in the region as a collaborative partner; • Developing long and short term goals and objectives to promote staff development and competencies within our system of care;
• Developing an annual budget;
• Chairing the agency’s Staff Training Committee;
• Attending continuous trainings in the areas of behavioral health services and other trainings as needed;
• Collaborating with State, Regional, County, and local groups and organizations; and • Developing a two-year staff training work plan.

Workforce, Education, and Training (WET) Services: (Culturally Diverse Participants) • "Motivational Interviewing: Introductory & Continuing the Journey - Wednesday, September 2, 2020, and Thursday, September 3, 2020 - (Zoom Event - 56 individuals attended this training) - Attendees included staff and community partners. • Berkeley Mental Health - Dr. Hardy - Staff Cultural Humility 2 - Day Training – 2020 (September 14th & 21st; September 15th & 22nd; September 16th & 23rd; September 17th & 24th) – Zoom Event - BMH Staff Attended
• Suicide Prevention and Intervention Skills Building Workshop - Friday, November 13, 2020 - (Zoom Event - 48 individuals attended this training) - Attendees included staff and community partners.
• City of Berkeley - Law & Ethics for County Healthcare Providers - Wednesday, March 10, 2021 - (Zoom Event - 43 individuals attended this training) Attendees included staff and community partners.

Committees/Groups:
• BMH Diversity & Multicultural Committee, Chair
• BMH Staff Training Committee, Chair
• Alameda County BHCS PRIDE Committee Member
• BHS Community Resource Committee
• Statewide Spirituality Liaison, Spirituality Initiative Committee Member • State and County Ethnic Services Managers/Cultural Competency Coordinators, Committee Member
• Alameda County BHCS African American Steering Committee for Health and Wellness, Committee Member
• BMH Health Equity Committee – Co-Chair
• African American Holistic Resource Center, Community Leadership Committee, Co-Chair Outreach and Engagement:
• Native American Health Center – Indigenous Community
• Black Infant Health –Women & Children
• Berkeley Drop-In – Homeless Population
• McGee Baptist Church – African Americans

27 • The Way Christian Center – African Americans
• Village Connect, Inc., African American & Latino/a/x populations • Pacific Center – LGBTQI2-S Community
• BAHIA, Inc. – Latino/a/x population
• Healthy Black Families – African American Women & Children Population • BUSD – Staff, Students, and Families
Due to the COVID-19 pandemic all trainings went virtual and online from May 2020-present.

Transition Age Youth (TAY) Support Services
The Transition Age Youth (TAY) Support Services program provides outreach, services, supports, and/or referrals to TAY with serious mental health issues who are homeless or marginally housed and not currently receiving services. Priority is given to youth coming out of foster care and/or the juvenile justice system and particular outreach strategies are utilized to engage youth from various ethnic communities, including African Americans, Asian and Latino/a/x populations, among others. Program services include: Culturally appropriate outreach and engagement; peer counseling and support; assessment; individual and group therapy; family education; case management, coaching, ancillary program referrals and linkages. Also provided are services in housing attainment and retention, financial management, employment, schooling, and community involvement. Services are designed to be culturally relevant, tailored to each individual’s needs, and delivered in multiple, flexible environments. The main goals of the program are to increase outreach, treatment services, and supports for mentally ill TAY in need, and to promote self-sufficiency, resiliency and wellness. This program serves 15-20 youth at a time.

In FY21, a total of 129 TAY individuals were served. Demographics on individuals served were as follows:

DEMOGRAPHICS N=129
Gender Identity Number Served % of Total
Male 82 64%
Female 47 36%
Race/Ethnicity
Race/Ethnicity Number Served % of Total
African American 71 55%
American Indian or Alaska Native 4 3%
Asian Pacific Islander 5 4%
White 19 15%
Latino/a/x 34 26%
More than one Race 15 12 %
Other 11 8%
Declined to Answer (or Unknown) 4 3%
Age Category
Age Number Served % of Total
16-25 years 129 100%
Sexual Orientation
Sexual Orientation Number Served % of Total
Gay or Lesbian 13 10%

28 During FY21, 345 outreach activities were conducted with a total of 126 duplicated contacts. A total of 129 individuals participated in ongoing mental health program services. There were 476 referrals to the following services and supports: 112 Mental Health; 104 Physical Health; 87 Social Services; 76 Housing; and 97 other unspecified services. Per a Satisfaction Survey that was administered, youth participants reported the following: 96% indicated satisfaction with the treatment services they received; 22% exited the program into stable housing; and 39% became employed or entered into school.

In FY21 there were both changes in leadership and a move of the program to a new location.

These changes were challenging but ultimately fruitful and provided immeasurable benefits for youth who participated in the program.

SYSTEM DEVELOPMENT

System Development includes Wellness Recovery Support Services that are intended to expand collaboration with stakeholders, promote the values of wellness, recovery and resilience, and move the Division towards a more consumer and family member driven system.

Services are comprised of the following main components: Wellness/Recovery System Integration and Family Advocacy Services. Together, both ensures that consumers and family members are informed of, and able to be involved in, opportunities to provide input and direction in the service delivery system and/or to participate in recovery-oriented or other supportive services of their choosing. Strategies designed to reach program goals include: developing policies that facilitate the Division in becoming more Wellness & Recovery oriented and consumer/family member driven; outreach to, and inclusion of, consumers and family members on Division committees; provision of family support & education; supported employment and vocational services; wellness activities; peer supportive services; and client advocacy. Some of the additional services and supports that CSS System Development provides funding for are as follows: Housing Services and Supports; Benefits Advocacy; Employment/Educational Services; Wellness Recovery Center; Counseling Services for Senior Citizens; Youth Case Management Services; Hearing Voices Groups; Transitional Outreach Team; Flex Funds and Sub- Representative Payee Services for clients, etc.

Wellness Recovery System Integration
The BMH Wellness Recovery Team works with staff, stakeholders, community members and clients to advance the goals of Wellness and Recovery on a system wide level. In order to accomplish these goals, some of the various tasks include: recruiting consumers for Division committees; convening committees around Wellness Recovery system initiatives; oversight/administration of peer stipends; convening and conducting meetings for the Berkeley “Pool of Consumer Champions (POCC)”; working with staff to develop various Wellness and Recovery related policy and procedures; and oversight of the Division’s “Wellness Recovery Activities”. The Consumer Liaison is also a resource person around “Mental Health Advance Heterosexual or Straight 80 62%
Bisexual 16 12%
Questioning or unsure 4 3%
Other 1 1%
Declined to Answer (or Unknown) 15 12%

29 Directives” for consumers desiring to express their treatment preferences in advance of a crisis; and is a participant on a number of local MHSA initiatives. The combination of individual services and system-level initiatives impact all clients and their family members across the system in a given year. In FY21, there were a total of 418 clients in the BMH system.

During the reporting timeframe, some of the various activities of the Wellness Recovery Team that were conducted under the direction of the Consumer Liaison included:

Berkeley Pool of Consumer Champions (POCC)
In FY21, the Berkeley Pool of Consumer Champions (POCC) met seven times, as meetings were paused for awhile due to the pandemic. During the meetings the POCC primarily focused on creating a position for new members, reviewing the mission statement, and having members apply for roles and responsibilities within the POCC. The Alameda County POCC has 2 identified positions, a Chair and Note-Taker for their meetings, so the Berkeley POCC decided to make all 6 stipend positions, roles for members who have to apply to hold a position. The following six positions were created along with job descriptions: Chair, Note-Taker, Outreach, Ambassador to the City, MHSA/MHC representative, and Event’s Organizer. The Berkeley POCC also has a member who is a representative of the Alameda County POCC Steering Committee. Other activities the POCC focused on were: presenting about their work at the Alameda County POCC Steering Committee; attending the cultural holiday event online; helping out with food giveaways in person; making executive decisions for the entire POCC, reviewing polices; and organizing the POCC conference. A total of 14 unduplicated individuals participated in the POCC meetings and activities.

Wellness Recovery Activities
Designed with, and building on the talents of consumers, wellness recovery activities is a group that highlights consumer facilitation and creativity skills. In FY21, due to the COVID-19 pandemic and shelter in place protocol, this group was not held.

Walking Groups
In FY21 the Wellness Recovery Team began walking groups to help with isolation and the restrictions of having groups indoors. This group is a new addition to the Wellness Recovery Activities/groups. The walks took place at local parks and neighborhoods in Berkeley and they varied in physical intensity. People were required to wear masks and socially distance. The walks were advertised in the Wellness Recovery monthly newsletter. There were 43 walks scheduled throughout the year. During the colder months in January and February walks were not scheduled due to the increase of COVID-19 cases and weather. The parks visited were Ohlone, Grove, Strawberry Creek, Codornices, Aquatic, and San Pablo Park and the University of California at Berkeley campus and Rose Garden. A total of 11 unduplicated individuals participated in the Walking Groups.

Field Trips
In FY21 all field trips were canceled due to shelter-in-place and COVID-19 restrictions.

Card Party Groups
In FY21 a total of 40 Card Party groups were offered to inspire consumers to create inspirational cards for individuals in psychiatric hospitals. This program is modeled after the Do-Send-A-Card program created by the San Francisco Mental Health Association. BMH Wellness Recovery

30 staff partnered with the Alameda Network of Mental Health Clients’ Reach-Out Program to distribute the cards that were created from the Card Party groups when they visit the hospitals throughout the County. Patients can choose the card they want to receive. Through this program 184 cards were created and given to the Reach-Out Program. This program has been operating on the zoom platform and the participants used their personal craft materials to make cards for others. A total of 13 unduplicated individuals participated in the Card Party Groups.

Mood Groups
The Mood group is designed for people to share their thoughts and feelings in a safe place where support is also offered. In FY21 the weekly support group focused on reviewing moods scales to help people identify where they are and then share whatever they wanted among non- judgmental peers. This group was impacted in the attendance by the COVID-19 pandemic and began again in February 2021. A total of 8 unduplicated individuals participated in 9 groups.

Mental Health Advance Directives
One-on-One Consultations on Mental Health Advance Directives are available through Wellness Recovery Staff. Although consultations were advertised in the Wellness Recovery Newsletter, in FY21 there weren’t any individuals who requested this service.

The Wellness Recovery Team also conducted and participated in the following activities during the reporting timeframe: Developed a monthly Newsletter in April 2020 and the newsletter has been written, edited and prepare by the Wellness Staff every month of the FY 20-21. The team began to published a 6-page newsletter highlighting wellness tool, community resources, food recipes, fun activities, information about diagnosis, and interviews with community members.

These mailings were sent to approximately 150 individuals via mail and another 130 individuals via email; Worked on the development of a Mission Statement for the Wellness Recovery Team:
hosted a special we small group for the “We move for health” event for Berkeley residents, Participated in the planning and implementation of the May is Mental Health Month event in Berkeley, Health and Human Resource and Education Center-10x10 8 Dimensions of Wellness, “We move for Health 10x10 campaign, POCC listen sessions and Alameda County Peer Support Specialist certification forums; Conducted Consumer Perception surveying in June 2021 by mail, during the State survey period as well as submitting completed surveys to the state; The following conferences were attended– CAMHPRO LEAD Conference in Sacramento and many put on by the Mental Health Division.

Hearing Voices Support Groups
The Hearing Voices Support Groups are offered through a contract with the Bay Area Hearing Voices Network. A weekly free drop-in Support Group is for adults who experience voices, visions, special messages, unusual beliefs or extreme states of consciousness. The support group is co-facilitated by trained group leaders both of whom have lived experience in the mental health system. Per the approved MHSA FY20 Annual Update, two additional new support groups were implemented through this program in December 2019, one for Transition Age Youth and one for Family Members of individual participants.

In FY21, 590 individuals were served through weekly online support groups. A survey questionnaire was sent to group participants in January 2021 with a total of 25 individuals responding to the survey. The survey results were as follows:

31 DEMOGRAPHIC SURVEY RESPONSES N=25
Gender Identity Number Served % of total
Male 7 28%
Female 15 60%
Declined to Answer (or Unknown) 3 12%
Race/Ethnicity
Race/Ethnicity Number Served % of total
African American 1 4%
Asian Pacific Islander 3 12%
White 15 60%
Latino/a/x 5 20%
More than one Race 1 4%
Age Category
Age Category Number Served % of total
Adult 14 56%
Older Adult 11 44%
Sexual Orientation
Heterosexual or Straight 14 56%
Bi-Sexual 2 8%
Gay 4 16%
Declined to Answer (or Unknown) 5 20%
Responses to some of the survey questions on the impact of the group were as follows:

How has the group helped you?
• Knowing that we are not alone. Getting others people opinions on different situations.

I
appreciate hearing about other people's experiences, especially when they resonate with mine. It's so freeing to share experiences in such a nonjudgmental space. Even though I've only gone a couple of times so far, I've been able to share and get advice about issues that were really troubling me.
has given me tips and insights on communicating with my loved one. Let me know I'm not alone with this issue.

• support group
fellowship with others who hear voices
It helps me find the strength to go out
into the world after being with people who understand what I'm going through.

• Validation to understand my own experiences and provide support to others who have different challenges but equally significant ones. To have a community.

• It helped me normalize myself

• To feel not so alone with these problems

• I get ideas for how to manage life with my loved one. • Normalized the situation

• Allowed me to talk to folks about my voices.

• it is an open forum where I can let loose and say what I need to say about my voices

• By a lot it helps me understand others and myself

• Really supportive

• This group has helped me understand how to support and handle people who hear voices. • I feel less alone knowing other people hear voices, too.

32 • Given me a safe haven to talk about our situation here with our son.

• Group has offered me support and new perspectives on my family relationships and myself.

• Its nice to talk to other people who hear voices.

• Showing me that I am not alone.

• Place to talk about hearing voices
How have you seen your life improve since you started coming to the group? • My life has changed knowing that I have the support.
• Knowing that I can turn to the group at difficult times.

• Continues being a challenge

• I have more hope for the future.

• I have community. I also have the support to advocate for the alternative senses if reality community in my work life and personal life as well.

• I have more self respect and I respect my limits more and have a better relationship with myself

• not yet except for feeling better about the future

• When I was participating regularly I had improved relationships

• Less depression and anxiety during the time I am talking to the group. • Been able to talk to people a lot more compared to less social activity

• more aware of my voices

• It's an outlet and hope. It is something I look forward to. • I don't need to filter as much in this group as I do in other groups.

• Our son respects that both of his parents are spending time each week in an effort to better understand him. And we parents are doing a better job talking to the other about our different ways of being with our son.

• It gives me a place to talk for support for 2 hours.

• Better understanding of my voices
Family Support Services
The Family Service Specialist works with family members, staff, community-based organizations etc. to improve services and supports for BMH clients and their family members on a system- wide level. Services provide both individual family services and supports, and system–wide change initiatives. This family/caregiver-centered program provides information, education, advocacy and support for family/caregivers of children, adolescents, TAY, adults and older adults with serious emotional disturbance or severe mental illness. Services are provided in a culturally responsive manner providing outreach to people of various ethnicities and language groups.

The Family Services Specialist serves as a point of contact for family members who are currently accessing or attempting to access services and/or who have questions and concerns about the mental health system, providing them with supports, and as needed, referrals to additional community resources. Outreach is provided to families through existing BMH family support groups, NAMI of the East Bay, community clinics and the Alameda County Family

33 Education Resource Center (FERC). Additionally, the Family Services Specialist coordinates forums for family members to share their experiences with the system; recruit’s family members to serve on BMH committees; supports family members through a “Warm line”; conducts a Family Support Group; and creates training opportunities to educate mental health staff on how to effectively work with families. The combination of individual services and system-level initiatives impact all clients and their family members across the system in a given year. In FY21, there were a total of 438 clients in the BMH system.

During the reporting timeframe, the following individual or group services and supports were conducted through this program:

Warm Line Phone Support: A phone Warm Line provided a sympathetic resource for family members needing information, referrals, supports, and assistance in navigating the complex mental health system. Through the Warm Line, the Family Services Specialist helped families find services and resources as needed.

Family Support Group: Provides supports for parents, children, siblings, spouses, significant others or caregivers. The group met once a month for two hours.

As the Family Services Specialist position has been vacant since April 2019, the previous position holder has continued the Family Support Group and occasional Warm Line Phone support. In addition, the global COVID-19 pandemic resulted in a pause of the Family Support Group which is reflected in the low number of individuals served.

During FY21 a total of 15 family members were served. Demographics of individuals served are outlined below:

DEMOGRAPHICS N=15
Gender Identity Number Served Percent of Total Number
Served
Male 5 33%
Female 10 67%
Race/Ethnicity
Race/Ethnicity Number Served Percent of Total Number
Served
African American 1 7%
Asian Pacific Islander 2 13%
White 7 47%
Declined to answer (or
unknown)
5 33%
Age Category
Age in Years Number Served Percent of Total Number
Served
25-44 years 1 7%
45-64 years 10 67%
65+ years 4 26%
Sexual Orientation
Declined to answer (or
unknown)
15 100%

34 Employment Services
Previously, a BMH Employment Specialist provided services to support consumers in job readiness and accessing employment opportunities. It was envisioned that these services would at a minimum, create and nurture supported vocational, educational and volunteer “try- out” opportunities in the community; build employment and educational readiness; and increase the numbers of consumers who are gainfully employed and/or engaging in other meaningful activities such as school or volunteer work. Different strategies were implemented along the way including utilizing the Dartmouth model of supported employment. The Dartmouth model helps to promote wellness and recovery by enabling clients to work alongside other non- mentally ill workers in a competitive environment in their community. In this model, employment supports were provided to clients from multiple sources including the following: Employment Specialist; Case Manager; Psychiatrist; and any involved Family Members. The Employment Specialist also: provided supports to clients who were interested in starting their own business by guiding them through the necessary steps of getting a license, advertising, etc.; assisted clients who weren’t quite ready to obtain employment, in becoming involved in volunteer opportunities; connected clients with the Department of Rehabilitation for computer skills training; worked with staff to ensure clients were adhering to their medication regimen; and supported clients in filling out job applications and or practicing their interview skills.

Although various strategies were implemented over the years, client participation and employment outcomes remained low through FY12, followed in FY13, with an unexpected vacancy in the Employment Specialist position. Low client outcomes coupled with a vacancy in the position prompted BMH to evaluate current best practices for mental health client employment. Additionally, input received during various MHSA Community Program Planning processes, provided recommendations on strategies to better support clients in reaching their employment goals, such as: assisting clients on interviews and on what to share with an employer regarding reasonable accommodations; providing mentoring and job shadowing; implementing technology training for clients; having services be integrated and supported, and implementing evidence based practices.

A new Employment Specialist position was proposed through a previously approved Three Year Plan. It was envisioned that once hired, the Employment Specialist would be focused on utilizing an evidenced based model for supporting individuals with serious mental illness in obtaining and retaining competitive employment. The hiring process for this position has not occurred yet, as the City of Berkeley has been evaluating whether the best use of funds would be to hire the full- time position, or to contract the services out to a local organization that focuses on employment services and supports for mental health consumers. As a decision on the best approach had not been finalized yet, in the previously approved MHSA FY19 Annual Update, the Division requested to have flexibility on how to best utilize funds allocated for the Employment Services Specialist position.

Housing Services and Supports
The Housing Specialist provides housing resource services for clients; working with landlords to increase housing opportunities; collaborating with case management staff, landlords, and Board & Care Managers to provide additional supports for clients who are already housed; and working in tandem with the City of Berkeley HHCS Department Hub (which serves as a single

35 entry point into emergency shelter and transitional housing, where clients are triaged based on their housing and service needs). Some of the various places where clients with subsidies are housed are the Berkeley Food and Housing Project Russell Street Residence Board and Care, McKinley House, and Lakehurst Hall.

Benefits Advocacy Services
Through this project a community-based organization, the Homeless Action Center (HAC), assists clients in obtaining public benefits. Services are provided for approximately 10 BMH clients a year. In FY21, 9 clients were served through this agency. Demographics on those served were as follows:

Pandemic related challenges of connecting with disabled and homeless or indigent clients made it more difficult to keep cases moving along, and harder to get cases started or finished.

Additionally, the Social Security Administration’s challenges for these clients were magnified by the pandemic as the administration was harder to contact and slower to process every aspect of a claim. All case processes took a longer period of time. Among It all, there was a 100% success rate of clients who won their claim, as each time a case was closed in FY21, it was due to the client successfully being awarded public benefits.

Flexible Funds for Level One Clients
A contract with the community-based organization, Berkeley Food & Housing Project, enables flexible funds to be used with clients across the system for supports such as housing, clothing assistance, food, transportation, etc. This use of flexible funds aids individuals in achieving better stability in areas where they are less capable of addressing their daily living needs. This program is set up to aid any clients in need across the system in a given year. In FY21, there were a total of 418 clients in the BMH system.

DEMOGRAPHICS N=9
Gender Identity Number Served Percent of Total Number Served Male 5 56%
Female 4 44%
Race/Ethnicity
Race/Ethnicity Number Served Percent of Total Number Served African American 3 34%
White 4 44%
Latino/a/x 1 11%
Other 1 11%
Age Category
Age Number Served Percent of Total Number Served
18-24 years 2 22%
25-44 years 5 56%
45-64 years 2 22%
Sexual Orientation
Declined to Answer (or
Unknown)
9 100%

36 Mobile Crisis Team (MCT) Expansion
Through the previously approved MHSA FY14/15 - 16/17 Three Year Plan, and as a result of staff and community input on increasing and improving services for those experiencing a mental health crisis, the following additions to BMH have been or are in the process of being implemented through CSS System Development funds:
• Increase in staff to expand the Mobile Crisis Team (MCT) capacity and hours of operation; • Mental Health First Aid Trainings to teach community members how to assist individuals who are in crisis or are showing signs and symptoms of a mental illness; • A Consumer/Family Member Satisfaction Survey for Crisis services.

Transitional Outreach Team (TOT)
The Transitional Outreach Team (TOT) was added thru the previously approved FY16 MHSA Annual Update to support Crisis Services, through interventions that address issues individuals experience either immediately prior to, or following a mental health crisis. This team, follows up with individuals and families that have had a recent crisis. The goal of the team is brief outreach and engagement to assist the individual and/or family in getting connected to the resources they may need.

In FY21, 306 individuals were served through this project. Demographics on those served were as follows:

DEMOGRAPHICS N=306
Gender Identity Number Served Percent of Total Number Served Male 151 49%
Female 143 47%
Transgender 3 1%
Declined to Answer (or Unknown) 9 3%
Race/Ethnicity
Race/Ethnicity Number Served Percent of Total Number Served African American 65 21%
Asian 24 8%
White 94 31%
Latino/a/x 18 6%
Other 105 34%
Age Category
Age in Years Number Served Percent of Total Number Served 0-18 22 8%
18-25 34 11%
25-44 90 29%
45-64 59 19%
65+ 28 9%
Declined to Answer (or Unknown) 73 24%
Sexual Orientation
Declined to Answer (or Unknown) 306 100%

Services provided by this team are subject to the number of referrals that are generated by the Mobile Crisis Team crisis calls. Clients served by TOT often enter the crisis system with fewer

37 resources such as collateral supports, lack of insurance, etc. As a result of the pandemic many services were switched from in-person to telephone supports and tele-health.

Outcomes of the program during the reporting timeframe:
• Continuation of successful follow up with residents who have had contact with Mobile Crisis by phone and/or in person.
• Connection of individuals and families to needed and wanted mental health, housing, literacy, family, and emergency medication services.
• Offered intensive short term support to individuals and families who experienced a mental health crisis, including referrals, linkage, psycho-education, and active support in connecting with needed services in Berkeley or elsewhere in the Alameda County system of care. • Provided in person outreach and engagement to individuals in inpatient settings who needed assistance connecting to treatment and were unlikely to make it to the clinic for an intake.

Settings included John George Psychiatric Facility, Villa Fairmont, Herrick Hospital, Woodrow House, and other sites. TOT staff worked with facility staff in addition to mental health consumers.
• Provided in person outreach and engagement to individuals receiving homeless services and staff at homeless service provider agencies, including MASC, BOSS, BFHP, and others.

Also conducted in person outreach at homeless encampments throughout the City. • Coordinated with other programs within the City’s Mental Health Division, including the Crisis/Assessment/Triage (CAT) On Duty staff, field based services such as Mobile Crisis (MCT) and the Homeless Outreach and Treatment Team (HOTT), and with the case management teams at the Adult and Children’s clinics.

Program Successes:
• The TOT provided numerous individuals and families with follow up services. These services continued as the newer staff gained more skill and facility with the program and working with the population.
• Responses from service recipients have been generally positive and conveyed an appreciation of services received.
• Started regular discussions and integration of cultural humility training, and practices into both teams and client care.
• Continued to link individuals who may have had barriers, ambivalence, or difficulty engaging with the mental health system to appropriate and desired services through persistent outreach and engagement at inpatient facilities and in the community.

Program Challenges:
• Facility and system issues affecting the BMH Adult Services Program as a whole continue to affect consistency.
• Outreach efforts are hampered by system issues outside of BMH, for example, the County psychiatric facility’s decisions regarding patient admission/length of stay over which TOT Staff have no control.
• TOT as a program has continued to struggle with the best way to coordinate care with other units within the City system. Staff continue to work on improving procedures and protocols that support the program mission and clarify roles.

38 • The data collection system does not capture all necessary information that would support accurate outcome reporting.
• The COVID-19 pandemic changed many service procedures and availability of services to the public, including with the TOT. Facilities that normally would have accepted in person services and visits were no longer open; many resources changed their operating hours/availability; many services closed or were no longer accessible; and many residents refocused their efforts on basic needs rather than mental health service linkages which changed the interface and usage of the TOT services.

Sub-Representative Payee Program
In the previously approved MHSA FY2014/15 – 2016/17 Three Year Plan the Division proposed to use a portion of CSS System Development funds to outsource Sub-Representative Payee services, as the practice for many years at the BMH Adult Clinic was for clinicians to act as representative payees, managing client’s money. While on some levels this practice improved clients’ attendance at regular appointments, it also presented an array of other challenges around the dual role of clinician/money manager.

In FY20, Sub-Representative Payee services was contracted out to Building Opportunities for Self Sufficiency (BOSS) who were chosen through a competitive RFP process. BOSS began these services in April 2019. Approximately 79 individuals receive services a year. In FY21, 78 individuals were served. Demographics on individuals served were as follows:

DEMOGRAPHICS N=78
Gender Identity Number Served % of total
Male 56 72%
Female 22 28%
Race/Ethnicity
Race/Ethnicity Number Served % of total
African American 46 59%
Asian Pacific Islander 3 4%
Latino/a/x 6 8%
Native American 1 1%
White 25 32%
More than one Race 3 4%
Age Category
Age In Years Number Served % of total
18-24 4 5%
25-44 14 18%
45-64 26 33%
65 years or older 34 44%
Sexual Orientation
Declined to Answer (or Unknown) 78 100%

Berkeley Wellness Center
The Berkeley Wellness Center is an MHSA funded collaboration between the City of Berkeley, Mental Health Division and Alameda County BHCS. This program implemented through the community-based organization, Bonita House, provides: mental health and substance abuse

39 counseling; living skills training; community integration and educational activities and opportunities; pre-vocational training; wellness recovery programming; support groups; referrals to community resources; computer training; Art Therapy and other activities.

The main goals of the program are to assist individuals in functioning as highly as possible so they can become integrated into the community. The Berkeley Wellness Center opened in November 2019 and was open for in-person services up until the closure of offices in March 2020 due to the pandemic. Beginning in March 2020 and through FY21, services were provided via phone or tele-health. Group services, Crisis support and other mental health services were also provided via the Zoom platform.

In FY21, 78 individuals participated in this program. Demographics on individuals served were as follows:

DEMOGRAPHICS N=78
Gender Identity Number Served % of total
Male 27 35%
Female 51 65%
Race/Ethnicity
Race/Ethnicity Number Served % of total
African American 8 10%
White 53 69%
Latino/a/x 5 6%
Other 12 15%
Age Category
Age in Years Number Served % of total
25-44 years 19 24%
45-64 years 59 76%
Sexual Orientation
Declined to State (or Unknown) 100 100%
Program Successes:

The Berkeley Wellness Center pivoted their services to attempt to continue to address needs during the shelter-in-place environment. This included running virtual groups and meeting with individuals over the phone and via zoom. For the average 3-4 clients that were regularly participating, the continuation of these groups in a virtual platform was very useful. Though everyone has been encouraged to return to the physical space, the addition of a virtual option in addition to in-person services is something that will continue to expand access and going forward a hybrid services approach will continue to be maintained so that individuals who are not able or ready to participate in person can continue to be apart of program activities.

Program Challenges:

During the COVID-19 shelter-in-place many Wellness Center participants were unable to access the technology that would have enabled them to connect to the virtual platforms; be it due to lacking devices or skills to use the devices. They either did not own the technology or their underlying mental health symptoms factored into their lack of desire to use the technology to connect with services. Some individuals preferred to wait until the Wellness Center was open again for in-person services.

40 BMH Peer and Family Member Positions
Since the first MHSA Plan, BMH has included positions for peers and family members with lived experience to be added to various programs throughout the Division. The BMH Division utilizes existing City job classifications to create an employment track for peer or family member providers. The entry level position is Community Health Worker, the mid-level is Assistant Mental Health Clinician, and the top-level is Social Services Specialist. All of these classifications are used broadly for differing purposes throughout the City. For the specific positions where the MHSA Plan envisioned utilizing peer or family providers, BMH has had success in establishing employment lists where there are applicants who describe themselves as peer providers or family member providers. In 2018, a Peer Specialist was hired to support the Wellness Recovery services work. This position became vacant in December 2021 and the Division is currently seeking to fill the vacancy.

Two additional positions were added through the FY22 Annual Update, to increase the Wellness Recovery work. The addition of peer staff will enable a greater ability to provide a variety of peer led services, and the provision of activities and supports to individuals in the waiting room. It is envisioned that this service addition will create a more welcoming environment for individuals waiting for their appointments.

Case Management for Youth and Transition Age Youth

In response to a high need for additional services and supports for youth and TAY who are suffering from mental health issues and may be homeless or marginally housed, case management services for TAY are provided through a local community partner, Youth Spirit Artworks (YSA). This project serves approximately 50 youth a year.

In March 2020, due to the pandemic, YSA was forced to close its facilities in Berkeley. Staff and youth participants quickly transitioned to online services. During the pandemic, staff social workers communicated with youth primarily through phone calls and tele-conferencing via the Zoom platform. As YSA transitioned back to in-person service provision, remote services remained as an option.

In FY21, a total of 30 youth were served through this project. Demographic data on youth participants is outlined below:

DEMOGRAPHICS N=30
Gender Identity Number Served % of total
Male 11 37%
Female 11 37%
Gender Queer 1 3%
Transgender 4 13%
Gender Non-Conforming 2 7%
Declined to Answer (or Unknown) 1 3%
Race/Ethnicity
Race/Ethnicity Number Served % of total
African American 13 44%
Asian Pacific Islander 4 13%
White 2 7%
Latino/a/x 6 20%

41 Other 4 13%
More than one race 7 23%
Declined to Answer (or Unknown) 1 3%
Age Category
Age Category Number Served % of total
0-18 years 14 47%
18-24 years 16 53%
Sexual Orientation
Heterosexual or Straight 12 40%
Bisexual 10 33%
Gay 3 10%
Lesbian 4 13%
Queer 1 4%

Program Successes: Successes included getting staff and youth trained in the use of Zoom for remote conferencing for meetings and workshops and laying the groundwork for a larger referral system. Outreach and collaborations were expanded with the County’s Department of Juvenile Probation and with agencies who work with youth in the Berkeley Schools and individuals involved with Juvenile Justice.

Program Challenges: Service delivery the entire year was a challenge, due to the pandemic.

Program services were delivered remotely, via phone or Zoom meetings. This made it much more difficult to reach and engage new youth Outreach work to engage disenfranchised youth and provide case management is much more effective if there is face-to-face interaction and peer support. During the year, many of the agencies YSA receives referrals from, were not in operation.

The pandemic also made it more difficult to hire new staff that YSA needed to provide case management and mental health services, and new staff had a more difficult time engaging youth, as there were fewer opportunities, due to the physical distancing requirements, to develop a trusting relationship.

Additional Services for Asian Pacific Islanders
The Asian Pacific Islander (API) population is significantly underserved in the mental health system. In an effort to better meet the needs of this underser ved population, BMH proposed through the previously approved MHSA FY19 Annual Update to allocate CSS System Development funds to contract with a local community-based organization or to partner with Alameda County BHCS to increase funding for a contractor selected for similar purposes. It was envisioned that the contractor would provide access to additional services and supports for this population. In FY20 and in FY22 three separate RFP processes were executed to find a community partner that the Division could contract with who would provide these services, however the Division was unable to secure a Contractor . As a result, the Division will re-assess the best way to provide additional services and supports for the API population.

Results Based Accountability Evaluation
Feedback received over recent years focused on implementing evaluation measures that help BMH, MHSA Stakeholders and community members more fully understand and determine how well programs are meeting participant and community needs. Integral to this type of outcome

42 measure is to engage the voice of the program participant around the services they received.

Despite best intentions of staff there is simply not the time or expertise to effectively accomplish this objective and the specialized skills of a con sultant would ensure the most successful outcome.

As a result, in the previously approved MHSA FY19 Annual Update, BMH allocated CSS System Development funds for a Consultant who would conduct an evaluation on all BMH programs across the system utilizing t he “Results Based Accountability” (RBA) framework. The RBA framework will measure how much was done, how well it was done, and whether individuals are better off as a result of the services they received. In FY19 a competitive RFP process was executed, and Resource Development Associates (RDA) was the chosen consultant.

In FY21, the following activities occurred for the RBA evaluation project:
• A contract was executed with Resource Development Associates (RDA), to conduct a comprehensive process to develop RBA outcomes measures for all internal Mental Health Division programs.
• A Work Plan for the full RBA project was developed
• A Community Advisory Group (CAG), consisting of key stakeholders for the project (community members, Alameda County BHCS, MH Division staff), was created to provide input and guidance throughout the life of the project.
• A data dictionary of existing data measures available for mental health division programs was developed.
• Monthly meetings for mental health program teams were initiated. These meeting were focused on developing understanding of the RBA methodology, and supporting program teams in developing RBA outcome measures.

Updates on this evaluation will be reported in future MHSA Plans and Updates.

Counseling Services for Older Adults
Older Adults who only have Medicare insurance currently have great difficulty accessing mental health services, despite consistent input on the need for mental health services for this population. In an effort to increase mental health services and supports for older adults, the Division allocated additional funding in the approved FY20 MHSA Annual Update to support this population. MHSA funds are transferred to the Aging Services Division of HHCS, to implement various counseling services for Older Adults. The Aging Services Division issued a Request For Proposal (RFP), and in FY22 services began to be provided through the chosen contractor, the Wright Institute.

Substance Use Disorder Services
A large portion of individuals who currently receive services at BMH are also suffering from co- occurring disorders, having both mental health issues and substance use disorders (SUD). In an effort to increase the capacity to serve individuals with SUD, funds were previously allocated through the MHSA FY22 Annual Update for the Division to work with a local SUD provider to co- locate SUD services at the Mental Health Adult clinic. This will increase the provision of SUD services for BMH clients, provide an opportunity for staff to obtain consultations on SUD services, and will make referrals into SUD services outside of the Mental Health Adult clinic

43 easier for consumers. The contract with a local provider for these increased SUD services is currently in the process of being executed.

Specialized Care Unit
On July 14, 2020 City Council passed Resolution No, 69,501-N.S.; a package of items providing direction for the development of a new paradigm of public safety in Berkeley. One of the items adopted by City Council directed the City Manager to analyze and develop a pilot program to re- assign non-criminal police service calls to a Specialized Care Unit (SCU). The SCU will consist of trained crisis-response field workers who will respond to behavioral health occurrences that do not pose an imminent threat to safety without the involvement of law enforcement. The SCU will be implemented as a pilot model and lessons-learned will inform the long-term implementation. Through the approved FY22 Annual Update, the Division proposed to allocate a small portion of CSS and PEI funds to be leveraged with other City funds for this pilot program. This allocation was a one-time MHSA funding amount, while the City determines how to best fund this initiative.

In FY22, Resource Development Associates (RDA), chosen through a competitive Request for Proposal (RFP) process to evaluate the current crisis system in Berkeley, received an expanded scope of work to provide recommendations on the implementation of the SCU. To oversee and advise RDA in their work, the City formed an SCU Steering Committee consisting of Health, Housing and Community Services Department and Fire Department staff, and community representatives from the Mental Health Commission and the Berkeley Community Safety Commission. The Steering Committee met from January 2021 through January 2022 and advised on RDA’s completion of three critical reports. The first two reports summarized crisis response programs in the United States and internationally as well as gathered perspectives from community and City stakeholders regarding the crisis response system. This included gathering input from City of Berkeley and Alameda County agencies, local community-based organizations (CBOs), local community leaders, and utilizers of Berkeley’s crisis response services. These reports laid the foundation for the twenty-five recommendations that were the subject of the third and final report to inform the SCU model. Each recommendation put forth in the final report is deeply rooted in the stakeholder feedback included in the two previous reports.

The work of the SCU Steering Committee has now transitioned from planning to implementation. It is envisioned that the SCU will begin operations in late FY22 or early FY23 through a community partner that will be chosen through a competitive Request for Proposal process.

PREVENTION & EARLY INTERVENTION (PEI)

The original City of Berkeley Prevention & Early Intervention (PEI) Plan was approved in April 2009. Since the approval of the original plan, Three Year Plans or Annual Updates outlining proposed PEI funding and programming have been approved on an annual basis. From the original PEI Plan and/or through subsequent plan updates, some of the many services the City of Berkeley has provided through the PEI funding component are as follows:
• An early identification, assessment, treatment and referral program for children (0-5 years old) and their families;

44 • Prevention and short-term intervention services in the Berkeley school system; • Trauma support services for youth, adults and older adults in unserved, underserved and inappropriately served populations;
• An anti-stigma support program for mental health consumers and family members; and • Intervention services for at-risk children.

PEI Reporting Requirements
Per MHSA PEI regulations, all PEI funded programs must collect specified state identified outcome measures and detailed demographic information. MHSA als o requires Evaluation Reports for PEI funded programs. Beginning in FY19, PEI Evaluations were required to be included in each MHSA Annual Update or Three Year Plan. Included in Appendix A of this Annual Update is the Prevention & Early Intervention (PEI) Fiscal Year (FY) 2018/2019 – 2020/2021 Three Year Evaluation Report.

Impact Berkeley

In FY18, the City of Berkeley introduced a new initiative in the HHCS Department called “Impact Berkeley”. Central to this effort is using a highly regarded framework called Results Based Accountability (RBA) to account for the work of the Department. RBA provides a new way of understanding the quality and impact of services provided by collecting data that an swer three basic questions:
• How much did you do?
• How well did you do it?
• Is anyone better off?
RBA has been incorporated into selected programs within the D epartment. This has included community agency programs funded through the MHSA Prevention & Earl y Intervention Community Education & Supports program. Through this initiative the Department worked with each contractor to envision, clarify and develop measures on the outcomes and results each program is seeking to achieve, and used a rigorous framework to begin measuring and enhancing progress towards these results. Page 54 of this Annual Update provides an aggregated summary of some of the results of this initiative.

PEI Regulations
Per PEI State Regulations, Mental Health jurisdictions are to utilize PEI funds to implement the following programs: Prevention, Early Intervention, Access and Linkage to Treatment, Stigma and Discrimination Reduction, and Outreach for Increasing Recognition of Early Signs of Mental Illness. Programs and/or strategies within programs can also be combined. Jurisdictions may also opt to utilize some PEI funds to implement a Suicide Prevention program. The definitions of each program are outlined below along with the City of Berkeley corresponding program:

45 PEI Program
Type
Program Definition City of Berkeley PEI
Program(s)
Prevention A set of related activities to reduce risk
factors for developing a potentially serious
mental illness and to build protective factors.
• Mental Health Promotion
Campaign
• High School Prevention
• DMIND
• MEET
• African American Succes
Early Intervention Treatment and other services and
interventions, including relapse prevention, to
address and promote recovery and related
functional outcomes for a mental illness early
in its emergence, including the applicable
negative outcomes that may result from
untreated mental illness.
• High School Prevention
• Be A Star
• DMIND
• MEET
• African American Success
• Supportive Schools
• Child & Youth At Risk
• Community Education and
Supports
• Specialized Care Unit
Outreach for
Increasing
Recognition of Early
Signs of Mental
Illness

A process of engaging, encouraging,
educating, and/or training, and learning from
potential responders about ways to recognize
and respond effectively to early signs of
potentially severe and disabling mental
illness.

• Mental Health First Aid
(non-PEI funded program)

Stigma and
Discrimination
Direct activities to reduce negative feelings,
attitudes, beliefs, perceptions, stereotypes
and/or discrimination related to being
diagnosed with a mental illness, having a
mental illness, or to seeking mental health
services and to increase acceptance, dignity,
inclusion, and equity for individuals with
mental illness, and members of their families.

• Social Inclusion
Access and Linkage
to Treatment
Connecting children who are seriously
emotionally disturbed, and adults and seniors
with severe mental illness as early in the
onset of these conditions as practicable, to
medically necessary care and treatment,
including but not limited to care provided by
county mental health programs.

• Homeless Outreach and
Treatment*
• High School Prevention
• Specialized Care Unit

OPTIONAL
Suicide Prevention

Activities to prevent suicide as a
consequence of mental illness.
• CalMHSA PEI Statewide
Project
*Prior project that was in operation during FY21, the reporting timeframe of this annual update) Beginning January 1, 2020, p er Senate Bill (SB) 1004, Welfare and Institutio ns Code (WIC) 5840.7 (a) directed the Mental Health Oversight and Accountability Commission (MH SOAC) to establish priorities for the use of MHSA PEI funds. Section 5840.7 (d)(1) states that mental health jurisdictions shall, through their MHSA Three Year Program and Expenditure Plans and Annual

46 Updates, focus use of their PEI funds on the Commission-established priorities or other priorities as determined through their respective, local stakeholder processes. If a mental health jurisdiction chooses to focus on priorities other than or in addition to those established by the Commission, “the plan shall include a description of why those programs are included and metrics by which the effectiveness of those programs is to be measured” (WIC Section 5840.7 (d)(1)).

At the time of the writing of this Annual Update, the MHSOAC had not established additional priorities to the following specifically enumerated required priorities in WIC Section 5840.7 (a) for the use of PEI funding:
• Childhood trauma prevention and early intervention to deal with the early origins of mental health needs;
• Early psychosis and mood disorder detection and intervention, and mood disorder and suicide prevention programming that occurs across the lifespan; • Youth outreach and engagement strategies that target secondary school and transition age youth, with a priority on partnership with college mental health programs; • Culturally competent and linguistically appropriate prevention and intervention; • Strategies targeting the mental health needs of older adults; • Early identification programming of mental health symptoms and disorder, including but not limited to, anxiety, depression, and psychosis.

In order to meet the requirements, each mental health jurisdiction is required to show in the PEI Component of the Three Year Plan or Annual Update the following:
• Which specific PEI priorities the mental health jurisdictions plan addresses, an estimate of the share of PEI funding allocated to each priority, and an explanation of how stakeholder input contributed to those allocations;
• If the mental health jurisdiction has determined to pursue alternative or additional priorities to those listed in Section 5840.7(a), how the determinations were made through its stakeholder process;
• For any alternative or additional priority identified by the mental health jurisdiction, what metric or metrics relating to assessment of the effectiveness of programs intended to address that priority the county will measure, collect, analyze, and report to the Commission, in order to support statewide learning.

All MHSA programs and projected funding amounts were vetted through the Community Program Planning process for this Annual Update. Many PEI projects meet multiple established priorities. Per PEI regulations, outlined below are the City of Berkeley PEI programs, priorities, and FY23 projected funding amounts:

CITY OF BERKELEY PEI

PROGRAMS
PEI

PRIORITIES
FY23
Projected Funding
Per Priority
• Be A Star
• Supportive Schools
Childhood trauma prevention and early
intervention to deal with the early origins of
mental health needs.

$144,658

47 CITY OF BERKELEY PEI

PROGRAMS
PEI

PRIORITIES
FY23
Projected Funding
Per Priority
• High School Youth
Prevention Project
• Mental Health Peer
Mentor Program
• Dynamic Mindfulness
Program
• African American
Success Project
• Specialized Care Unit

Youth Engagement and Outreach Strategies that
target secondary school and transition age youth,
Early identification programming of mental health
symptoms and disorders, including but not
limited to, anxiety, depression, and psychosis

Culturally competent and linguistically
appropriate prevention and intervention

$308,663

$376,663

$100,000

• Mental Health
Promotion Campaign
• Social Inclusion
• Community Education
& Supports

Culturally competent and linguistically
appropriate prevention and intervention

Youth Engagement and Outreach Strategies that
target secondary school and transition age youth,
with a priority on partnership with college mental
health programs

Strategies targeting the mental health needs of
older adults.

$409,000

$32,046

$32,046

PEI Funded Children and Youth and TAY Services

Per MHSA regulations 51% of PEI funds are to be used on servic es and supports for Children, Youth, and TAY. Small counties, of which the City of Berkeley is considered, may elect to forego this regulation as long as a community vetted, locally approved justification is provided as to why children and youth serv ices are funded at a lower level . Since the init ial PEI Plan , the City of Berkeley has allocated more than 51% of PEI funds to services and supports for children, youth and TAY as the majority of PEI funds has been utilized to serving these populations.

Currently, seven out of ten local PEI programs provide services for children and youth, 6 of which are in the Berkeley Unified School District (BUSD). Programs are as follows: Behavioral - Emotional Assessment, Screening, Treatment and Referral (BE A STAR); Supportive Schools Project; Mental Emotional Education Team (MEET); Dynamic Mindfulness (DMIND); African American Success Project; High School Youth Prevention Project, and the TAY Trauma Support Project. Additionally, from FY11 through FY20, the City of Berkeley utilized a portion of PEI funds to provide services for children, youth and TAY in the Albany Unified School District, through the Albany Trauma Project.

Programs and services funded with PEI funds, and FY21 data are outlined below by PEI Program type.

PREVENTION PROGRAMS

Prevention Program – Includes a set of related activities to reduce risk factors for developing a potentially serious mental illness and to build protective factors.

48 Through the FY22 Annual Update the City of Berkeley funded the following Prevention initiative that will be implemented in FY23:

Mental Health Promotion Campaign
As a result of the impact of the pandemic, and public input around the overwhelming need for mental health supports in the community, the Division proposed through the FY22 Annual Update to allocate PEI funds for a community Mental Health Promotion Campaign to support the wellness and self-care of Berkeley residents. The Division will partner with the community and consider using a social marketing firm to develop and implement the campaign.

PEI Goals: The goal of this campaign is to increase prevention efforts and response to early signs of emotional and behavioral health problems.

PEI Priority: Culturally competent and linguistically appropriate prevention and intervention.

It is envisioned that this campaign will get implemented in FY23 and the Division will continue to work with the community to determine how to best promote mental health and wellness in Berkeley.

EARLY INTERVENTION PROGRAMS
Early Intervention Program – Provides treatment and other services and interventions, including relapse prevention, to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the applicable negative outcomes that may result from untreated mental illness.

The City of Berkeley Early Intervention programs are as follows:

Behavioral-Emotional Assessment, Screening, Treatment, and Referral (BE A STAR) The Be A Star program is a collaboration with the City of Berkeley’s Public Health Department providing a coordinated system in Berkeley and Albany that identifies children birth to age five and their parents, who are at risk of childhood development challenges including developmental, social, emotional, and/or behavioral concerns. The program specifically targets low income families, including those with teen parents, who are homeless, substance abusing, or in danger of foster care. Services include triage, assessment, treatment and referrals to appropriate community-based or specialist services as needed. Children and families are accessed through targeted efforts at the following: Black Infant Health; Vera Casey Teenage Parenting programs; Child Health and Disability Prevention programs, Pediatric providers, and through state-subsidized Early Childhood Development Centers. The goals of the program are to identify, screen and assess families early, and connect them with services and supports as needed. The program uses the “Ages and Stages Questionnaires” (ASQ) screening tool to assess children in need. The ASQ consists of a series of 20 questionnaires that correspond to age intervals from birth to 6 years designed to help parents check their child’s development.

Each questionnaire contains simple questions for parents to answer that reflect developmental milestones for each age group. Answers are scored and help to determine whether the child's development is on schedule or whether the child should be referred for a developmental checkup with a professional. Over 400 children are assessed each year.

49 PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure and the removal of children from their homes.

PEI Priority: Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.

In FY21, a total of 2,203 children were screened through this program however data was not collected on all individuals screened. Only Race/Ethnicity data was collected on a subset of 141 children as follows:

DEMOGRAPHICS N=2,203
Age Groups
0-15 (Children/Youth) 100%
Race N=141
Asian 30%
Black or African American 32%
White 8%
More than one Race 1%
Other 29%
Ethnicity: Hispanic or Latino/Latina/Latinx N=141
Unspecified Hispanic or Latino/Latina/Latinx 29%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
Declined to Answer (or Unknown) 100%
Primary Language
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Gender: Assigned Sex at Birth
Declined to Answer (or Unknown) 100%

Program Successes:
• A total of 154 referrals to resources/services were made as a result of the developmental screens conducted at BUSD preschools and pediatric sites. • Overall, there was an increase in developmental screenings in pediatric settings. For example, when compared to data in FY20, two Berkeley pediatric sites increased their number of screenings by 211% and 76%.
• Sites demonstrated great adaptability due to the challenges that COVID-19 caused. Several sites were able to transition to doing developmental screenings online. Be A Star was able to provide training and Technical Assistance to help ensure a smooth transition.

50 Program Challenges:
• Although many pediatric sites and BUSD preschools were able to provide more services this year, there were still challenges caused by COVID-19, including delayed trainings for pediatric sites and decreases in available referral services. • Be A Star staffing was impacted by the City of Berkeley’s COVID-19 response. All Public Health nursing positions supported the emergency response in some capacity. A new Be A Star Public Health Nurse started in January 2021 and there has been a transition as this nurse has settled into the role.
• There were program challenges in being able to collect an accurate full data set as some of the Berkeley pediatric sites do not collect and report out on various demographic information and other screening sites only captured general demographic information.

Supportive Schools Program
Through this program leveraged MHSA PEI funds support the provision of mental health prevention and early intervention services at each of the Elementary Schools in Berkeley.

Services include: outreach; mental health programming; classroom, group, and one-on-one psycho-social education and support; and consultation with parents and/or teachers.

PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure and the removal of children from their homes.

PEI Priority: Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.

In FY21 Early Intervention Services were provided at each of the BUSD elementary schools.

BUSD sub-contracted with local agencies to provide early intervention services based upon the standard of evidence-based practices. Bay Area Community Resources (BACR), Child Therapy Institute (CTI), and Lifelong Medical (Lifelong) were subcontracted to provide services at BUSD elementary schools. Additionally, a counselor provided support at two elementary schools. As a result of the pandemic, schools began the year in distance learning. BUSD then transitioned to small cohorts at each elementary school, before moving to in-person learning in the spring of 2021. During the academic year, supports were provided both virtually, and in-person.

BACR provided services to improve emotional functioning and success in school and life, including individual and group therapy, family consultation, conflict resolution/restorative justice, suicide prevention, check-in/check-out, crisis intervention, and classroom presentations.

Additionally, BACR participated in weekly Coordination of Services (COST), Student Success Team (SST), and Individualized Education Program (IEP) meetings for students, providing mental health and trauma informed perspectives. BACR consults with staff on many issues and provides trauma informed coaching for teachers, and referrals to outside providers, parenting classes/support groups, crisis hotlines, and other programs.

In addition, other agency and district staff providers led social skills groups, early intervention social and emotional support, playground social skills, “check in/check out,” individual counseling, and support for parents and guardians from diverse backgrounds. As aligned with priority and focus on equity, providers participated in COST team meetings, and linked parents and guardians with resources within the school district, and in the community.

51 Supports for each school per each service provider, and numbers served in FY21 were as follows:

Elementary School Agency/Provider Number of Students Served • Cragmont
• Emerson
• Malcolm X
• Oxford
• Ruth Acty
• Thousand Oaks

Bay Area Community Resources
(BACR)

115
• Bay Area Arts Magnet (BAM)
• Washington
Child Therapy Institute 39
• John Muir
• Sylvia Mendez
School Site Counselor 25
• Rosa Parks Lifelong Medical Care No Data Available
Total 179

Demographic data provided by BUSD on 179 students that were served through this project in FY21, is outlined below:

DEMOGRAPHICS N= 179
Age Group
0-15 (Children/Youth) 100%
Race
American Indian or Alaska Native 1%
Asian 6%
Black or African American 25%
Native Hawaiian/Pacific Islander 1%
White 33%
More than one Race 19%
Declined to Answer (or Unknown) 11%
Ethnicity: Hispanic or Latino/Latina/Latinx
Central American 1%
Mexican/Mexican-American/Chicano 1%
South American 1%
Declined to Answer (or Unknown) 20%
Ethnicity: Non-Hispanic or Non- Latino/Latina/Latinx
American Indian 1%

52 Asian Indian/South Asian 1%
Chinese 1%
Eastern European 1%
Filipino 1%
Korean 1%
More than one Ethnicity 3%
Declined to Answer (or Unknown) 68%
Primary Language Used
English 30%
Spanish 4%
Other 1%
Declined to Answer (or Unknown) 65%
Sexual Orientation
Declined to Answer (or Unknown) 100%
Disability
Communication Domain 1%
Mental domain not including a mental illness
(including but not limited to a learning disability,
developmental disability, dementia)
11%
Declined to Answer (or Unknown) 88%
Veteran Status
No 100%
Gender: Assigned sex at birth
Male 53%
Female 43%
Declined to Answer (or Unknown) 4%
Current Gender Identity
Male 52%
Female 43%
Non-binary 1%
Other Gender Identity 4%
Community-Based Child & Youth Risk Prevention Program
This program targets children (aged 0-5) who are impacted by multiple risk factors including trauma, family or community violence, familial distress, and/or family substance abuse, (among other issues). A BMH clinician has served as the Mental Health Consultant on this project

53 providing information, services and supports to teachers and parents at the YMCA Head Start program in South Berkeley. Services include individual case consultation for teachers and parents, group consultations, classroom observations and interventions, assessments, brief treatment, and referrals to other resources as needed. The main goals are to reduce risk factors or other stressors, and promote positive cognitive, social, and emotional well-being.

This program serves approximately 50 Children & Youth a year.

PEI Goals: The goal of this program is to bring about mental health including the reduction of school failure and the removal of children from their homes.

PEI Priority: Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.

In FY21, 49 children were served through this program. Demographics on those served is as follows:

DEMOGRAPHICS N=49
Age Groups
0-15 (Children/Youth) 100%
Race
American Indian 2%
Asian 12%
Black or African American 45%
White 14%
More than one Race 5%
Declined to Answer (or Unknown) 22%
Ethnicity: Hispanic or Latino/Latina/Latinx
Declined to Answer or Unknown 100%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
Declined to Answer (or Unknown) 100%
Primary Language
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Gender: Assigned Sex at Birth
Declined to Answer (or Unlknown) 100%

54 Program Successes:

All of the general mental health consultation duties outlined below continued to be provided remotely via Tele-Care/Zoom until they were transitioned to in-person services in early FY22:
• Facilitated weekly Early Childhood Mental Health Reflective Case Consultation group/meetings to five classrooms. Case consultation meetings allowed teachers to develop clear plans and interventions for individual children and families in their classroom that present with high risk factors including but not limited to: complicated family dynamics; trauma; mental health concerns; social-emotional needs; and/or overall developmental needs.
• Provided general classroom observation to five infant care, toddler care and pre-school classrooms, serving a total of 49 children.
• Provided individual and group consultation to the Center Program Supervisor, 15-20 Early Childhood Teachers, and two family advocates
• Coordinated with the Inclusion Program which includes Inclusion Specialists and a Speech Pathologist to help observation and assessment efforts that facilitate early intervention screenings and referrals to BUSD and the Regional Center. • Provided planning and assistance with implementation of behavior plans for children with behavioral and social-emotional needs.
• Provided direct interventions around classroom interventions including providing visuals and classroom tools to help teach children self-regulation skills, social skills, and skills to help with transitions, and to improve the overall functioning of individual children in the classroom setting.
• Provided individual mental health consultations to parents, and provided direct psycho- education around developmental concerns, social-emotional issues/behavioral concerns, parenting issues, and information regarding mental health services as well as information regarding community services including First 5 Alameda, Help Me Grow, the Regional Center, primary care Doctors, and BUSD services.

Program Challenges:
• The downside of continuing services and not being on site was not having access to families. This posed some difficulties in being able to build relationships with children and families directly.
• There was an increased need to provide crisis interventions during the pandemic as staff managed the stress of returning to their work as essential workers in the middle of a pandemic.
• There was an increase of collective stress as a result of the pandemic. • As the pandemic continued into FY21 the center continued to experience disruptions to care with staff and children being quarantined at times.
• It was a challenge to work off-site during the COVID-19 pandemic to observe the child and teacher interactions. With not being onsite in-person there were no continuous conversations, spontaneous consultations, nor in-vivo modeling interactions. The ability to demonstrate for staff by working with the children and practicing certain interventions with children in-person along with observing staff implementing the techniques was limited. • There was no ability to model in-person for the teachers, as these elements were a part of the challenge in working remotely via telehealth (Zoom).

55 In FY23, this program will be discontinued as the YMCA Head Start program has created a staff position for an internal Mental Health Specialist.

Community Education & Supports
The Community Education & Supports program implements culturally-responsive psycho- educational trauma support services for individuals (18 and above) in various cultural, ethnic and age specific populations that are unserved, underserved and inappropriately served in Berkeley including: African Americans; Latino/a/x; LGBTQIA+; TAY; and Senior Citizens. All services are conducted through area community-based organizations. In FY21, three of the five projects were in operation as indicated in the data below. In order to ensure fair contracting opportunities in the City, in FY21 the Community Education & Supports services were put out for a re-bid through a Request for Proposal Process for the FY22 services. Updates on those services will be reported in the next Three Year Plan.

In FY21 the Community Education & Supports projects participated in the HHCS Results-Based Accountability (RBA) Evaluation. RBA evaluation results are presented in an aggregated format across all programs as follows:

How Much Did We Do? How Well Did We Do It? Is Anyone Better Off? • 578 Support
Groups/Workshops
• 1,247 Support
Groups/Workshop
Encounters
• 118 Individual Contacts (2 of
3 programs reporting)
• 2,524 Outreach Activities
• 225 Outreach Contacts
• 1,179 Referrals

• 9 Support groups or
workshop sessions
attended on average per
person
• 85% Survey respondents
reported satisfaction with
services
• Referrals by type:
223 Mental Health
200 Social Services
213 Physical Health
124 Housing
419 Other Services
• 86% of program participants
reported an increase in
social supports or trusted
people they can turn to for
help (2 of 3 programs
reporting)
• 90% of program participants
reported positive changes in
terms of coping strategies,
feeling anxious or
overwhelmed (2 of 3
programs reporting)
Descriptions for each project within the Community Education & Supports program and FY21 data are outlined below:
• Transition Age Youth Trauma Support Project
In FY21 this project was implemented through the Covenant House, Youth Engagement Advocacy Housing (YEAH!) program. This project provides supportive services for Transition Age Youth (TAY) who are suffering from the impact of trauma and/or other life stressors and are homeless, marginally housed, or housed but in need of supports. The project serves a wide range of youth from various cultural and ethnic backgrounds who share the common goal of living lives less impacted by trauma and more impacted by wellness. The project consists of the following four components: One-on-one sessions that assess individuals needs around trauma supports and support group readiness; psycho-educational support groups; youth social outings that provide TAY with exposure to healthy settings designed to enhance life skills and choices; and youth celebratory events that are held monthly to convene youth around a positive occasion to acknowledge the various small and large accomplishments of TAY participants, and build trust and community. Approximately 30-35 TAY receive services through this project a year.

56 PEI Goals: The goal of this project is to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the prevention of suicide.

PEI Priorities:
• Culturally competent and linguistically appropriate prevention and intervention; • Youth engagement and outreach strategies that target secondary school and transition age youth.

In FY21, 150 TAY participated in one or more project services. Services were continued during the pandemic through tele-health and tele-conferencing platforms. Support Group sessions included: Harm Reduction and Substance Use; Mindfulness; Coping Skills; Creative Expression, among others. There was a total of 9 Youth Social Outings with 37 unduplicated TAY participants, and 68 unduplicated TAY, participated in 18 Youth Celebratory Events.

Demographics on youth served were as follows:

DEMOGRAPHICS N = 150
Age Group
16-25 (Transition Age Youth) 100% Race
American Indian or Alaska Native 3%
Asian 3%
Black or African American 57%
Native Hawaiian or Other Pacific Islander 1%
White 15%
More than one Race 15%
Other 3%
Decline to Answer (or Unknown) 3% Ethnicity: Latino/Latina/Latinx
Central American 14%
Mexican/Mexican-American 9%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
African 19%
Asian Indian/South Asian 1%
European 4%
Filipino 1%
Japanese 1%
More than one Ethnicity 21%
Other 29%

57 Declined to Answer (or Unknown) 1% Primary Language Used
English 89%
Spanish 11%
Sexual Orientation
Gay or Lesbian 6% Heterosexual or Straight 47% Bisexual 12%
Questioning or unsure 4% Other 20%
Declined to Answer (or Unknown) 11% Disability Status
Mental (not mental health) 15% Physical/Mobility Disability 4% Chronic Health Condition 3% Other Disability 31% No Disability 35%
Declined to Answer (or Unknown) 12% Veteran Status
No 100%
Gender: Assigned sex at birth
Male 61%
Female 39%
Current Gender Identity
Male 60%
Female 37%
Transgender 3%

During the reporting timeframe 2,510 outreach activities were conducted. There were 493 referrals for additional services and supports. The number and type of referrals was as follows:
112 Mental Health; 104 Physical Health; 87 Social Services; 76 Housing; 114 other unspecified services. A total of 25% of project participants received individual counseling; 24% exited the project into stable housing; 53% obtained employment or entered school during the project.

Per participant feedback, 79% reported being satisfied with project services.

58 • Trauma Support Project for LGBTQIA+ Population
Implemented through the Pacific Center for Human Growth, this project provides outreach, engagement and support group services for individuals (18 and above) in the LGBTQIA+ community who are suffering from the impact of oppression, trauma and other life stressors.

Particular emphasis is on outreaching and providing supportive services to identified underserved populations within the local LGBTQIA+ community. Approximately 12-15 weekly or bi-weekly support groups are held throughout the year targeting various populations and needs within the LBGTQIA+ community. Support groups are led by Peer Facilitator community volunteers who are trained in Group Facilitation/Conflict Resolution and who have opportunities to participate in additional Skill Building workshops in order to share methods used to address group challenges and to learn new facilitator techniques. Approximately 250 individuals a year are served through this project.

PEI Goals: The goal of this project is to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the prevention of suicide.

PEI Priorities:
• Culturally competent and linguistically appropriate prevention and intervention; • Youth Engagement and Outreach Strategies that target secondary school and transition age youth.
• Strategies targeting the mental health needs of older adults.

In FY21, 12 outreach activities reached approximately 155 duplicated individuals. A total of 480 support groups were conducted. Through 20 Peer Support groups, weekly or bi-weekly sessions were conducted which were all led by a trained facilitator on Zoom. All of the long time running peer groups were offered and one new group was added. A total of 69 individuals participated in support groups throughout the year. Demographics on individuals served include the following:

DEMOGRAPHICS N=69

Age Groups
16-25 (Transitional Age Youth) 26%
26-59 (Adult) 46%
Ages 60+ (Older Adult) 20% Declined to Answer (or Unknown) 8%

Race
American Indian or Alaska Native 4%
Asian 13%
Black or African American 6%
Native Hawaiian or Pacific Islander 1%
White 41%

59 More than one Race 14%

Declined to Answer (or Unknown) 21%

Ethnicity: Hispanic or Latino/Latina/Latinx
Caribbean 1%
Central American 1%
Mexican/Mexican-American/Chicano 1%
South American 1%
Declined to Answer (or Unknown) 4%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
African 4%
Asian Indian/South Asian 3%
Chinese 7%

Eastern European 6%

European 43%

Filipino 1%

Korean 1%

Vietnamese 1%

More than one Ethnicity 16%

Other 1%

Declined to Answer (or Unknown) 9%

Primary Language Used
English 100%

Sexual Orientation
Gay or Lesbian 25%

Heterosexual or Straight 6%

Bisexual 12%

Questioning or Unsure 3%

Queer 22%

60 Other 29%

Declined to Answer (or Unknown) 3%

Disability
Difficulty Seeing 1%

Difficulty Hearing or Having Speech Understood 3%

Mental (not Mental Health) 4%

Physical/Mobility Disability 6%

Chronic Health Condition 14%

No Disability 36%

Declined to Answer (or Unknown) 36%

Veteran Status
Yes 1%

No 99%

Gender: Assigned Sex at Birth
Male 30%

Female 36%

Declined to Answer (or Unknown) 34%

Current Gender Identity
Male 6%

Female 23%

Transgender 33%

Genderqueer 9%

Questioning or Unsure 4%
Other 23%

Declined to Answer (or Unknown) 2%

During the reporting timeframe 38 Peer Facilitators were trained. The offering of Skills Building Workshops that included trainings on Intersectionality; Disability, Justice and Accessibility; and Micro-aggressions were provided to 38 Peer Facilitator participants. Services were adjusted to accommodate for the pandemic, and Support Group and other services were able to continue virtually on the Zoom platform. There were 91 referrals for additional services and supports.

61 The number and type of referrals was as follows: 51 Mental Health; 7 Physical Health; 7 Social Services; 26 other unspecified services. To assess the project services, a self-administered Peer Support Group Survey was distributed to all peer group members. Survey results were as follows:
• 93% indicated they would recommend the organization to a friend or family member; • 79% felt like staff and facilitators were sensitive to their cultural background; • 93% reported they deal more effectively with daily problems; • 71% indicated they have trusted people they can turn to for help; • 86% felt like they belong in their community.

Project Successes:
• Of the 20 peer support groups that were running prior to Shelter-In-Place (SIP), 19 groups successfully transitioned to Zoom and flourished on the virtual platform and 1 new group was launched.

• Staff increased consultation meeting frequency to support the facilitators for a portion of the fiscal year.

• Peer groups gained returning attendees who had moved out of town and who, for a variety of reasons, ie, disability, transportation barriers and child-care and other caregiving needs, were able to attend due to online access.

• Three 6-hour Facilitator Orientation and Trainings were provided to community members welcoming them as trained peer group facilitators.

• Three Diversity, Equity and Inclusion trainings were offered: Intersectionality; Disability, Justice and Accessibility; and Micro-aggressions.

• A Social Work student provided case management and wellness checks to older adults.

• A handful of peer groups requested to hold their meetings throughout the winter break when the agency is typically closed for all services.

• Peer group facilitators were invited to join the white accountability group or the Black, Indigenous and People of Color (BIPOC) affinity group (spaces to discuss various challenges, explore and examine topics relating to privilege and oppression, dynamics of power, etc.) to explore how they show up in relationships for added accountability and support.

• The virtual/online outreach started to pick up by the end of the fiscal year. To make up for the reduction in outreach opportunities, email lists were utilized with community partners and networks and social media platforms, such as Meet-up, Instagram, and Facebook to inform and engage the community.
• A new pilot clinical consultation ‘on-call’ system was offered for facilitators to access a clinician to be invited to their virtual group space as needed should a group member bring mental health concerns and/or behaviors outside of the peer group scope of service.

Project Challenges:

• Continual adjustment to being in the virtual space. There was a learning curve for peer group facilitators in navigating the virtual space, for which program staff and fellow peer group facilitators provided support and guidance. Zoom safety tips and guidelines were

62 created to assist the facilitators.
• Some community members, including a few peer group facilitators, were no longer able to attend their peer group when it moved to a virtual space due to a lack of privacy in their home, anxiety when in virtual spaces, or the lack of the necessary equipment and/or sufficient internet connection.
• Since paper forms were adapted to be received digitally, many group members had challenges completing and submitting the demographic forms.

• Due to the Shelter In Place, the typical in-person outreach opportunities drastically declined. • Peer group facilitators expressed concern for their group members’ stress level in regards to the anxiety producing November Presidential election, and the aftermath of the January 6th violent events in Washington DC.

• Living Well Project
Implemented through Center for Independent Living, this project provides services for Senior Citizens (aged 50 and over) who are coping with trauma and/or mental health issues associated with acquired disabilities. Senior Citizens with acquired disabilities are one of the most difficult groups to reach with disability services. It is similarly difficult to intervene with this group’s developing mental health issues related to aging and the traumatic impact of acquiring one or more disabilities (such as loss of mobility, vision, hearing, et al). The core of the project is a wellness workshop series entitled “Living Well with a Disability”. Through a combination of education, goal setting, group and peer counseling, the workshop series is designed to promote positive attitudinal shifts in a population who, despite the tremendous need for care, are often typically not responsive to mental health intervention. The workshop series includes a 10 week, one to two-hour class conducted by Peer Facilitators, and an optional 30-minute counseling session. Counseling sessions are designed to monitor curriculum impact and continually assess individual goals and resource needs. This project serves up to 150 Older Adults a year.

PEI Goals: The goal of this project is to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the prevention of suicide.

PEI Priorities:
• Culturally competent and linguistically appropriate prevention and intervention; • Strategies targeting the mental health needs of older adults.

In FY21, 49 Living Well Workshop sessions were conducted. Each Living Well Workshop series included the following sessions: Orientation; Goal Setting; Problem Solving; Healthy Reactions; Beating the Blues (Depression and Moods); Healthy Communication; Seeking Information; Physical Activity; Eating Well (Nutrition); Advocacy (Self and Systems Change); and Maintenance. Topics of Grief and Loss, Depression, Retirement, and Senior Invisibility were also incorporated into the project. In all 25 Senior Citizens participated in the Living Well Workshops. Demographics of Workshop participants are outlined below:

DEMOGRAPHICS N=25
Age Groups
26-59 (Adult) 16%

63 Age 60+ (Older Adult) 84%

Race
Asian 4%
Black or African American 56%
White 28%
Other 12%
Ethnicity: Hispanic or Latino/Latina/Latinx
Caribbean 4%
South American 4%
Other 8%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
African 36%
Eastern European 8%
European 20%
Filipino 4%
More than one Ethnicity 4%
Other 12%
Primary Language Used
English 96%
Spanish 4%
Sexual Orientation
Gay or Lesbian 4%
Heterosexual or Straight 76%
Bisexual 8%
Other 4%
Declined to Answer (or Unknown) 8%

Disability
Physical/mobility disability 24%
Chronic health condition 24%

Other Disability 16%
No Disability 28%

64 Declined to Answer (or
Unknown)
8%
Veteran Status
Yes 4%
No 96%
Gender: Assigned Sex at birth
Male 16%
Female 84%
Current Gender Identity
Male 16%
Female 80%
Other 4%

During the reporting timeframe 2 outreach and informational events were conducted reaching 12 individuals, with 93 unduplicated individuals receiving further engagement services. Services were moved to virtual format providing tele-workshops and tele-support services to accommodate the pandemic. There were 595 referrals for additional services and supports.

The number and type of referrals were as follows: 60 Mental Health; 102 Physical Health; 106 Social Services; 48 Housing; 279 other unspecified services. A total of 88% of project participants completed a Living Well Workshop Series. Feedback per participant self-report was as follows:
• 91% reported they felt satisfied with the workshops;
• 91% indicated an improvement in feeling satisfied in general; • 91% had increased feelings of social supports;
• 91% felt prepared to make positive changes; and
• 88% reported they felt less overwhelmed and helpless.

Project Successes:

To help seniors stay connected 96 tele-support group sessions were held. Living Well Program virtual/tele-workshops were offered every Monday and tele-support groups every Tuesday. In December laptops and technical training were provided to previous participants and also in May to participants who completed The Living Well Workshop Series.

Project Challenges:

The workshops were well attended with lively engagement. Some Living Well seniors gave painful testimonies of isolation, sadness and fear and others of loneliness. Many missed their families, their grandchildren, and friends. Some needed to travel out of state to support adult children with life-threatening illnesses and two struggled with potentially life-threatening diagnoses themselves. There was a lot of uncertainty revolving around the COVID-19 pandemic. Many seniors had difficulties connecting with others due to the technological gap.

The Workshop Series facilitator also had to learn systems she never had to use before.

65 SoulSpace Project
In FY22, following a competitive Request For Proposal (RFP) process, OnTrack Program Resources began implementing the SoulSpace Project for African Americans in Berkeley. The project assists African Americans in Berkeley to access culturally, ethnically, and linguistically responsive and trauma-informed prevention and early intervention services. Project services include: community education; outreach and engagement; assessment; coaching; referrals; navigation supports; support groups; and life skills training.

PEI Goals: The goal of this project is to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the prevention of suicide.

PEI Priorities:
• Culturally competent and linguistically appropriate prevention and intervention; • Youth Engagement and Outreach Strategies that target secondary school and transition age youth.
• Strategies targeting the mental health needs of older adults.

This project was not in operation in FY21. Future MHSA Three Year Plans and Annual Updates will include a reporting on the data and activities of this project.

• Latinx Trauma Support Project
In FY22, following a competitive Request For Proposal (RFP) process, East Bay Sanctuary Covenant began implementing the Latinx Trauma Support Project. This project assists low- income, Latinx families in Berkeley to access culturally, ethnically, and linguistically responsive and trauma-informed prevention and intervention services. Project services are in direct response to, and in collaboration with, Latinx community members, and are largely facilitated by individuals from within the targeted community and conducted in Spanish or an indigenous language. Services include: One-on-one outreach and support; support groups; staff and partner training and warm referrals.

PEI Goals: The goal of this project is to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the prevention of suicide.

PEI Priorities:
• Culturally competent and linguistically appropriate prevention and intervention. • Youth Engagement and Outreach Strategies that target secondary school and transition age youth.
• Strategies targeting the mental health needs of older adults.

This project was not in operation in FY21. Future MHSA Three Year Plans and Annual Updates will include a reporting on the data and activities of this project.

PREVENTION & EARLY INTERVENTION COMBINED PROGRAMS
Prevention Program – Includes a set of related activities to reduce risk factors for developing a potentially serious mental illness and to build protective factors.

66 Early Intervention Program – Provides treatment and other services and interventions, including relapse prevention, to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the applicable negative outcomes that may result from untreated mental illness.

The City of Berkeley Prevention & Early Intervention combined programs are as follows:

Dynamic Mindfulness Program (DMind)
Through the previously approved MHSA FY19 Annual Update BMH allocated PEI funds to support the BUSD Dynamic Mindfulness (DMind) Program. BUSD partners with the Niroga Institute to provide DMind for students and staff at Berkeley High, Berkeley Technology Academy, Berkeley Independent Study, MLK Jr., Willard, and Longfellow. DMind is an evidence-based trauma-informed program implemented in BUSD middle and high schools.

Validated by independent researchers as a transformative program for teaching children and youth, skills for optimal stress resilience and healing from trauma, the DMind program integrates mindful action, breathing, and centering into an intervention that is implemented in the classroom in 5-15 minute sessions, 3 to 5 times a week. This program has proven to be successful with vulnerable students who are exhibiting signs of chronic stress/trauma/PTSD from Adverse Childhood Experiences (ACEs), and/or disengagement from school, chronic absences, and significant behavioral challenges, including emotion regulation, impulse control, anger management, and/or getting frequent referrals/suspensions and at high risk of school failure. DMind also enables teacher and staff well-being, which has been shown to enhance student learning. Program components include in-class and after-school DMind sessions for students, student peer leadership development, training and coaching of school staff, and program evaluation.

PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure and the removal of children from their homes.

PEI Priorities:
• Youth Engagement and Outreach Strategies that target secondary school and transition age youth, with a priority on partnership with college mental health programs. • Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis.

Due to the pandemic, in FY21 all supports were shifted to online in the second half of the school year. Data on individuals served were not provided by BUSD. Per anecdotal evidence from site leadership, the program presents positive use.

Mental and Emotional Education Team (MEET)
Through the previously approved MHSA FY19 Annual Update BMH provides PEI funds to support the BUSD MEET Program. This program implements a peer-to-peer mental health education curriculum to 9th graders and an internship program for a cohort of high school students to serve as peers to their fellow students. The goals of the program are to increase student awareness of common mental health difficulties, resources, and healthy coping and intervention skills. Through this program, students are trained by a licensed BUSD clinician to

67 conduct class presentations covering common mental health disorders, on and off campus resources, and basic coping and intervention skills.

PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure and the removal of children from their homes.

PEI Priorities:
• Youth Engagement and Outreach Strategies that target secondary school and transition age youth, with a priority on partnership with college mental health programs. • Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis.

In FY21 and FY22, this program was not in operation.

African American Success Project
The African American Success Project (AASP) implements “Umoja” - a daily elective class offered at Longfellow Middle School. Umoja provides African American students a safe affinity space to explore their cultural heritage and identity, while building positive peer relationships and establishing relational trust with adults. Umoja provides an ongoing focus on social and emotional development, including building skills, habits and mindsets that enable self-regulation, interpersonal skills, perseverance and resilience.

Umoja provides a unique chance to expose learners to content traditionally overlooked by educational institutions. Umoja course lessons are rooted in African and African American cultural precepts, and are composed to guide African American learners through:
• An exploration of their identities;
• An interrogation (questioning or query) of their ancestral history. • Development of a positive sense of purpose and cultural pride. • Envisioning their futures and outlining a path for fulfillment. • Developing an awareness of their communal role.

Direct services for parents and guardians:

Umoja seeks to increase entry points for caregivers to be informed and involved in their child’s learning.

Highlights in this area include:
• Community meetings/engagements (monthly typically).

• Coordinating and hosting Parent teacher conferences.
•
Individual parent meetings/contacts, including advising, problem-solving, and updates regarding student progress.

• Coordinating and hosting community events: Kwanzaa Celebration, Black History Month event and activities.

Direct services for students (academic, social, behavioral):

• School-day cultural enrichment designed to uplift and empower African American learners using African centered pedagogical approaches.

• Equity centered support sessions (weekly).

• Structured class check-in sessions.

68 PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure and the removal of children from their homes.

PEI Prioritiy:
• Culturally competent and linguistically appropriate prevention and intervention. • Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis.

In FY21, 63 students participated in this project. Outlined below are demographics on individuals served through this project:

DEMOGRAPHICS N=63
Age Groups
Children/Youth (0-15) 100%
Race
Black or African American 68%
More than one Race 11%
Ethnicity: Hispanic or Latino/Latina/Latinx
Hispanic/Latino/Latina/Latinx 21%
Primary Language
English 98%
Other 2%
Sexual Orientation
Declined to Answer (or Unknown) 100%
Disability
Other 8%
Veteran Status
No 100%
Gender: Assigned sex at birth
Male 56%
Female 44%
Current Gender Identity
Male 56%
Female 44%

ACCESS AND LINKAGE TO TREATMENT PROGRAM
Access and Linkage to Treatment Program - Connects children who are seriously emotionally disturbed, and adults and seniors with severe mental illness as early in the onset of these

69 conditions as practicable, to medically necessary care and treatment, including but not limited to care provided by county mental health programs.

The City of Berkeley had one Access and Linkage to Treatment Program from April 2017-March 2021:

Homeless Outreach and Treatment Team (HOTT)
The Homeless Outreach and Treatment Team (H OTT) program was established out of an effort to address the homeless crisis, and as a result of input received through various MHSA community program planning processes. Utilizing a portion of PEI and CSS funds, blended with realignment and general funds HOTT is a pilot program to support homeless mentally ill individuals in Berkeley and to connect them into the web of services that currently exist within the system of care. Key program components include the following: Persistent and Consistent Outreach; Supportive Case Management; Linkage to Care; and Treatment. HOTT was in operation until March 2021 when the Homeless FSP began.

PEI Goals: The goal of this program is to connect individuals who have severe mental illnesses as early in the onset of these conditions as practicable, to medically necessary care and treatment, including but not limited to, care provided by county mental health programs.

PEI Priority: Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis.

The HOTT program was a three-year pilot project that was originally intended to run from May 2017 through April 2020. Due to the COVID-19 pandemic, the program was extended through February 2021 with a redirected focus mainly towards encampment outreach, in addition to the original purpose of serving unhoused Berkeley residents with linkage, resource, housing, and short-term treatment services.

A local consultant, Resource Development Associates (RDA), was hired to conduct a dedicated independent evaluation to assess the program accomplishments and to ascertain whether HOTT should continue past the initial funding period.

The RDA Homeless Outreach and Treatment Team Final Evaluation Report which covered the timeframe from January 2018 – February 2020, showed the following program outcomes:
• A total of 4,435 total encounters were conducted with individuals who were either enrolled or non-enrolled in the program, averaging 171 encounters per month; • The number of contacts provided in-person in the field was 73%, while 26% were provided by phone;
• A total of 81% of HOTT encounters were with clients who were enrolled in the program; • Enrolled clients had an average of 20 total encounters with HOTT staff, with an average of 4 encounters per month;
• During encounters, HOTT staff provided at least 1,845 material supports and services (including food, transportation or BART or bus passes, Hygiene Kits, Emergency Housing Vouchers, Blankets, etc.); to respond to clients’ immediate and longer-term needs; • During 488 encounters, HOTT provided emergency or temporary housing vouchers (e.g., for a motel) to individuals who required immediate shelter;

70 • Approximately three-quarters of enrolled clients (75%) and over a third of non-enrolled individuals (38%) were referred or connected to housing support services; • In addition to connecting individuals to housing services, HOTT also connected individuals to other supportive services to help reduce or address initial barriers to obtaining housing; • Approximately 27% of HOTT clients and 6% of non-enrolled individuals successfully enrolled in social service benefits. In comparison, only 9% of HOTT clients and 1% of non- enrolled clients ultimately enrolled in mental health services; • Over 58% of all HOTT clients, and 9% of non-enrolled individuals obtained emergency or temporary housing (e.g., motel or shelter) at some point during their engagement with HOTT. In comparison, 12% of HOTT clients and 1% of non-enrolled individuals obtained permanent housing;
• To assess changes in self-sufficiency, HOTT staff completed a Client Self-Sufficiency Matrix (SSM) on enrolled clients at program intake, on a quarterly basis after program enrollment, and/or at program discharge. Overall, HOTT clients’ SSM scores remained relatively unchanged from baseline to follow-up.

During interviews that were conducted with several HOTT existing and previous clients regarding their experience with the program, interviewees reported the following:
• “They help people, not just me. I introduce people on the street to them, and I say you can talk to the HOTT team and they will help you.”
• “I really didn’t expect anything, but when I called the City, they said someone [from HOTT] would meet me right then. They got me a hotel room that day. I wasn’t expecting the City to help.”
• “They were so helpful. I felt like if I didn’t get the hotel room, they would have let me stay at their personal house.”
In addition to these interviews, RDA conducted focus groups with HOTT clients during a previous year of the evaluation, and developed brief client impact stories based on clients’ experiences. In one of the impact stories, client self-report was as follows:
“I would still be on the streets and probably dead if it wasn’t for HOTT. I could have died and no one would have cared. Doctors told me I had months to live and I gave up on living. I gave up on everything for help. No one cared but the HOTT team did care. I’m the type of person that never asks for help, and here they were offering to help and they never gave up on me. I lived on the same spot for six years and never got medical care. They checked up on me and came back multiple times, even though I was turning them away in the beginning. I figured HOTT team was just like the other programs where they would just disappear after the first meeting.

But I know the HOTT team is there. And everything the HOTT team said they would do came true. Now I am in hospice care getting the care that I need. I don’t know how much longer I have to live, but it’s a hell of a lot longer than a couple months which is what the doctors said. This gives me the opportunity to live my life with dignity. The HOTT team provided me with the positive energy just like hospice care that is so needed for people like me.” The program continued into FY21 which was past the original end -date and the evaluat ion timeline. Data, and successes and challenges in FY21 are outlined below. In FY21, 91 individuals were served. Demographics on individuals served were as follows:

71 DEMOGRAPHICS N= 91
Age Groups
25-44 years 21%
45-64 25%
65 years and older 8%
Declined to Answer (or Unknown) 46%
Race
Black or African American 37%
Latino/a/x 5%
White 43%
Other 15%
Ethnicity: Hispanic or Latino/Latina/Latinx
Declined to State (or Unknown) 100%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Veteran Status
Declined to Answer (or Unknown) 100%
Gender: Assigned Sex at Birth
Declined to Answer (or Unknown) 100%
Current Gender Identity
Male 58%
Female 40%
Transgender 2%
Sexual Orientation
Declined to Answer (or Unknown) 100%

In FY21 Flex funds were used to provide various supports for HOTT program participants including: Hotel stays/rental or housing assistance for 42 participants; Food/groceries for 26 participants; Bus passes or transportation for 3 participants; and on Pharmacy needs for 1 participant.

Due to the nature of the many brief interactions attempting to engage with clients, as well as trying to avoid barriers to bringing clients into services, some data wasn’t able to be collected in order to best support effective service provision. Additionally, some limitations to the current

72 data collection system prevented certain data from being gathered and provided for this project and report.

Program Successes:

The HOTT pilot demonstrated that a dedicated team of workers could effectively engage and work with a large number of unhoused residents providing short term services and connections to longer term treatment and care. It also demonstrated that the team could be flexible in redirecting its efforts to support the needs of the unhoused community during the pandemic:
• HOTT was responsive to both enrolled and unenrolled clients when providing outreach and engagement: responding to community referrals, providing direct in-person outreach, and responding to immediate service calls and needs.
• The project provided an array of material supports, including but not limited to basic necessities, transportation (direct and voucher), hygiene kits, emergency housing/respite support, COVID-related supplies (masks, testing, resource information, sanitizer, etc). • HOTT facilitated linkages and referrals to treatment, housing, primary care, material support, and other community resources.
• Community needs were supported by encampment outreach by the HOTT, including outreach, material support, and other COVID related needs.

Program Challenges:

With the change in HOTT’s mission and staffing, it became increasingly difficult to effectively serve the community. The needs and resources in the community, especially due to COVID-19, drastically changed:
• Staff left the team steadily over this time period from a supervisor and 4 staff until only one staff was left, and then the program ended.
• With the pandemic, many of the resources to which the HOTT team would normally link clients had either: changed their hours, gone to only remote service, changed their services available, or closed their doors.
• The directions from the Emergency Operations Center (EOC) during the pandemic were not consistent due to the changing nature of the COVID-19 response. This also made consistent services difficult to maintain.
• Since most of the services HOTT was directed to perform during this time period were COVID-19/encampment outreach related, the previous linkage services were no longer the focus of the team and its work.

HOTT continued to be in operation until March 2021, when the Homeless FSP was fully implemented.

ACCESS AND LINKAGE TO TREATMENT AND

PREVENTION & EARLY INTERVENTION COMBINED PROGRAM
Access and Linkage to Treatment Program – Connects children who are seriously emotionally disturbed, and adults and seniors with severe mental illness as early in the onset of these conditions as practicable, to medically necessary care and treatment, including but not limited to care provided by county mental health programs.

Prevention Program – Includes a set of related activities to reduce risk factors for developing a potentially serious mental illness and to build protective factors.

73 Early Intervention Program – Provides treatment and other services and interventions, including relapse prevention, to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the applicable negative outcomes that may result from untreated mental illness.

The City of Berkeley has one combined Access and Linkage to Treatment and Prevention & Early Intervention combined program:

High School Youth Prevention Program
This program operates in conjunction with other health related services offered at Berkeley High School (BHS) and Berkeley Technology Academy (BTA) and has become a successful partnership between BUSD and the Public Health and Mental Health Divisions of Berkeley’s HHCS Department. The program provides young people with the information and individual support they need to make positive and healthy decisions in their lives. The program includes:
outreach activities designed to provide students with basic information around the risks of certain behaviors, and ways to protect themselves and make positive and safer decisions; classroom presentations to enable students to receive more in-depth information around a variety of health topics and available resources, and provide the opportunity for students to do a personal assessment of risk and current lifestyle choices; drop-in crisis, counseling services; individual appointments to identify young people who may need more intensive intervention; and short-term treatment. The individual appointments, held at the school-based health center, provide young people with the opportunity to hold very in-depth discussions around the choices they are making and the risks that are involved in their choices. They receive guidance about changes they can make to reduce or eliminate their risks, and are given the opportunity to identify barriers that might exist for them that prevent them from making healthier choices. In addition, they complete a 40 question, in-depth HEADSSS (Home, Education, Activities, Drugs/Alcohol, Sexuality, Safety, and Suicidality) assessment. Based on the outcome of the individual appointment and/or assessment, a young person may be referred to either a medical or mental health professional for follow-up care and intervention and/or treatment.

PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure or dropout.

PEI Priorities:
• Youth engagement and outreach strategies that target secondary school and transition age youth.
• Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis.

In FY21, approximately 101 students received services through this project. Demographics on youth served are outlined below:

DEMOGRAPHICS N=101
Age Groups
0-15 Years 27%
16-25 Years 73%

74 Race
Asian 16%
Black or African American 15%
White 32%
More than one Race 19%
Other 10%
Declined to Answer (or Unknown) 8%
Ethnicity: Hispanic or Latino/Latina/Latinx
Other 32%
Declined to Answer (or Unknown) 9%
Primary Language
English 87%
Spanish 13%
Sexual Orientation
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Veteran Status
No 100%
Gender: Assigned sex at birth
Male 40%
Female 60%
Current Gender Identity
Male 37%
Female 52%
Transgender 3%
Genderqueer 8%

Program Successes:
• In spite of the numerous and multi-faceted challenges associated with COVID-19 and distance learning, the Health Center was still able to provide mental health counseling services to over 100 students and was able to provide longer-term support to more students due to the lower than typical number of unduplicated clients. The Health Center was able to host a small, diverse, and talented graduate-level MFT trainee cohort. • Adapted care provision to utilize these new platforms and was able to flexibly provide services while also mitigating potential safety risks associated with COVID-19.

75 • During the course of the school year, the Health Center’s mental health team was able to develop and implement use of a JotForm application in order to digitize referral processes, make referrals accessible online, and thereby improve overall accessibility. Transition to this HIPAA-compliant online referral process has been maintained into the FY22 school year and is now being more broadly used by all Health Center programs. • The online referral process was implemented in January 2021 and promoted across student/parent bulletins, emails to the school community from BHS and BTA principals, and presentations to teacher leads and other school staff. Upon successfully implementing this new method for referrals, the Health Center phased out use of its phone-based Mental Health Warm Line, which was initially utilized in Spring 2020 shortly after the COVID-19 pandemic began. The Warm Line was phased out in order to simplify the referral pathway for accessing mental health services from the Health Center. • Throughout the COVID-19 pandemic and for the duration of the FY21 school year, the Health Center’s mental health team maintained a positive and collaborative relationship with school administration, the BHS and BTA COST teams, and the school-based Intervention and IEP counselors. Collaboration and coordination with school-based stakeholders enabled program staff to effectively triage and refer students/families to EPSDT/ERMHS services in addition to short-term Health Center services.

Program Challenges:
• During the FY21 school year, BUSD provided all educational instruction via remote “distance learning” using platforms like Zoom and Google Meet due to COVID-19-related safety concerns. Students were not present on campus from the start of the school year in August 2020 through spring break in April 2021. From mid-April through early June of 2021, a small percentage of the student body was on campus two hours per day, 2-3 days per week. Health Center counseling rooms were not usable for in-person services due to spatial limitations, inadequate social distancing, and inadequate ventilation. An alternative physical space on the BHS campus was identified for crisis-only use during this timeframe. • For the duration of the FY21 school year, one Health Center clinician was on parental leave.

The Health Center’s graduate-level trainee cohort was also downsized by 50%, from four to two, due to COVID-19-related constraints.
• Up until COVID-19, the Health Center relied upon a paper-based referral process where referrals needed to be submitted in person to staff. Accessing services remotely was not feasible until workflow adjustments were made, which required technological advancements and collaboration with the City’s IT department. The planning and implementation of a digital, online, HIPAA-compliant referral portal took approximately five months.

ACCESS AND LINKAGE TO TREATMENT AND EARLY INTERVENTION

COMBINED PROGRAM
Access and Linkage to Treatment Program – Connects children who are seriously emotionally disturbed, and adults and seniors with severe mental illness as early in the onset of these conditions as practicable, to medically necessary care and treatment, including but not limited to care provided by county mental health programs.

Early Intervention Program – Provides treatment and other services and interventions, including relapse prevention, to address and promote recovery and related functional outcomes for a

76 mental illness early in its emergence, including the applicable negative outcomes that may result from untreated mental illness.

Through the FY22 Annual Update the City of Berkeley provided a one-time amount of CSS and PEI funding to support a pilot program. Per PEI program type definitions, this program would be considered as an Access to Treatment and Early Intervention combined program. The program is as follows:

Specialized Care Unit
As outlined in the CSS section of this Annual Update, on July 14, 2020 City Council passed Resolution No, 69,501-N.S; a package of items providing direction for the development of a new paradigm of public safety in Berkeley. One of the items adopted by City Council directed the City Manager to analyze and develop a pilot program to re-assign non-criminal police service calls to a Specialized Care Unit (SCU). The SCU will consist of trained crisis-response field workers who will respond to behavioral health occurrences that do not pose an imminent threat to safety without the involvement of law enforcement. The SCU will be a pilot model that will inform the long-term implementation of the program. Through the approved FY22 Annual Update, the Division proposed to allocate a small portion of CSS and PEI funds to be leveraged with other City funds for this pilot program. This allocation was a one-time MHSA funding amount, while the City determines how to best fund this initiative.

PEI Goals: The goal of this program is to connect individuals who have severe mental illnesses as early in the onset of these conditions as practicable, to medically necessary care and treatment, including but not limited to, care provided by county mental health programs.

PEI Priority: Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis.

In FY22, Resource Development Associates (RDA), who was chosen through a competitive Request For Proposal (RFP) process to evaluate the current crisis system in Berkeley, received an expanded scope of work to provide recommendations on the implementation of the SCU. To oversee and advise RDA in their work, the City formed an SCU Steering Committee consisting of Health, Housing and Community Services Department and Fire Department staff, and community representatives from the Mental Health Commission and the Berkeley Community Safety Commission. The Steering Committee met from January 2021 through January 2022 and advised on RDA’s completion of three critical reports. The first two reports summarized crisis response programs in the United States and internationally as well as gathered perspectives from community and City stakeholders regarding the crisis response system. This included gathering input from City of Berkeley and Alameda County agencies, local community-based organizations (CBOs), local community leaders, and utilizers of Berkeley’s crisis response services. These reports laid the foundation for the twenty-five recommendations that were the subject of the third and final report to inform the SCU model. Each recommendation put forth in the final report is deeply rooted in the stakeholder feedback included in the two previous reports.

The work of the SCU Steering Committee has now transitioned from planning to implementation. It is envisioned that the SCU will begin operations in late FY22 or early FY23 through a community partner that will be chosen through a competitive Request for Proposal process.

77 STIGMA AND DISCRIMINATION PROGRAM
Stigma and Discrimination Program - Directs activities to reduce negative feelings, attitudes, beliefs, perceptions, stereotypes and/or discrimination related to being diagnosed with a mental illness, having a mental illness, or to seeking mental health services and to increase acceptance, dignity, inclusion, and equity for individuals with mental illness, and members of their families.

The City of Berkeley Stigma and Discrimination program is as follows:

Social Inclusion Program
PEI Goals: To reduce negative feelings, attitudes, beliefs, perceptions, stereotypes and/or discrimination related to being diagnosed with a mental illness, having a mental illness, or to seeking mental health services and to increase acceptance, dignity, inclusion, and equity for individuals with mental illness, and members of their families. To create changes in attitude, knowledge and/or behaviors related to seeking mental health services or related to mental illness.
• PEI Priority: Culturally competent and linguistically appropriate prevention and intervention.

The Social Inclusion program was created to combat stigma, attitudes and discrimination around individuals with mental health issues. Through this program, a “Telling Your Story” group provides mental health consumers with opportunities to be trained, compensated and empowered to share their stories of healing in a supportive peer environment. When they feel ready, consumers can elect to be community presenters, sharing their inspirational stories at pre-arranged local public venues to dispel myths and educate others. This program serves approximately 10-20 individuals a year.

In FY21, the “Telling Your Story” group held 25 meetings with 21 unduplicated persons attending for a total of 168 visits. This group has met through the virtual platform “zoom”. On average there were 6.72% attendees. Program participants spent time discussing and practicing what makes a good story based on the topics given by the instructors.

Demographics on individuals served were as follows:

DEMOGRAPHICS N= 21
Age Groups
26-59 (Adult) 52%
Ages 60+ (Older Adult) 48%
Race
Asian 5%
Black or African American 9%
Native Hawaiian or other Pacific Islander 5%

78 White 71%
Other 5%
More than one Race 5%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
African 14%
Asian Indian/South Asian 5%
European 14%
Filipino 9%
Japanese 5%
Middle Eastern 5%
Declined to Answer (or Unknown) 48%
Primary Language Used
English 100%
Sexual Orientation
Gay or Lesbian 5%
Heterosexual or Straight 52%
Bisexual 9%
Another Sexual Orientation 5%
Declined to Answer (or Unknown) 29%
Disability
Difficulty Hearing 14%
Mental Domain not including a mental illness 14%
Physical Mobility domain 14%
Chronic Health Condition 14%
Other (Specify): PTSD 10%
Declined to Answer (or Unknown) 34%
Veteran Status
No 48%
Declined to Answer (or Unknown) 52%
Gender: Assigned sex at birth
Declined to Answer (or Unknown) 100%
Current Gender Identity

79 Male 14%
Female 67%
Declined to Answer (or Unknown) 19%
Program Successes:

The Telling Your Story group has grown to having more consistent attendees who better able prepared to share based on the topics provided. Some participants enjoy having the group virtually in the comfort of their home, they feel safer and the hassle of commuting has been eliminated. People have felt more prepared during their shares and they enjoy the support they receive from their peers.

Program Challenges:

The Telling Your Story group challenges have been a lack of in-person connection and some people not having zoom are unable to see others on the screen.

SUICIDE PREVENTION PROGRAM

Suicide Prevention Program – An optional program that provides activities to prevent suicide as a consequence of mental illness.

The City of Berkeley partners with the California Mental Health Services Authority to locally provide Suicide Prevention resources through the PEI Statewide Projects initiative:

California Mental Health Services Authority (CalMHSA) - PEI Statewide Projects In 2009, California’s counties formed the California Mental Health Services Authority (CalMHSA) as a Joint Powers Authority to implement PEI statewide program initiatives. With an approved combined funding level of $40 million per year for four years during the timeframe of 2011 through 2015, CalMHSA implemented statewide initiatives in the following areas: Suicide Prevention, Stigma and Discrimination Reduction, and Student Mental Health. Following 2015, funding for PEI Statewide projects was generated through pooled contributions from individual counties. Contributing counties are members of a CalMHSA board that provides direction into the types of initiatives that are implemented. In order to continue to sustain programming, CalMHSA previously asked counties to allocate 4% of their annual local PEI allocation each year to these statewide initiatives. In the City of Berkeley, this has varied from year to year between $42,000 - $66,000 depending on the amount of PEI revenue received. Through the previously approved Three Year Plan the City of Berkeley allocated PEI funds for one year towards this statewide initiative, and for the remaining two years, elected to assess on an annual basis whether or not to continue to allocate funds to this initiative. The Division allocated funding for services in FY22, and was required to execute a Participation Agreement with CalMHSA in order to provide the funding to participate in this initiative. In FY23 the Division is recommending to continue funding this initiative as in previous years at 4% of the projected PEI funding amount (approximately $70,907) and to amend the Participation Agreement with CalMHSA to allocate funds to participate in this project.

80 In FY21, through this initiative resources on Suicide Prevention, Student Mental Health and Stigma and Discrimination reached approximately 1,620 individuals. Additionally, resources were distributed via email to local schools, community agencies and community members.

INNOVATIONS (INN)

The City of Berkeley’s initial INN Plan was approved in February 2012. Subsequent updates to the initial plan were approved in May 2013, January 2014, June 2014 and January 2015. Per the initial INN Plan and/or through Plan Updates the following seven pilot projects were implemented from June 2012 – June 2015 through this funding component:
• A Community Empowerment project for African Americans; • Services and supports for Ex-offenders re-entering the community, Veterans returning home from being deployed or at war, and their families;
• Cultural Wellness strategies for Asian Pacific Islanders; • A Holistic Health care project for TAY;
• Technology Support Groups for senior citizens;
• Nutrition, Healthy Meal Preparation, and Exercise classes for Board and Care residents; • Mental Health services and supports for LGBTQI located in community agencies.

Since the initial plan was approved, INN requirements were changed to require approvals from the State Mental Health Services Oversight and Accountability Commission (MHSOAC) in addition to local approval.

In May 2016, the second MHSA INN Plan was approved by the MHSOAC. This plan implemented a Trauma Informed Care project in BUSD for students, educators, and school staff. An update to this plan was subsequently approved by the MHSOAC in December 2018 which added funds to the project and switched the initial target population from BUSD students and staff to children, teachers and parents at YMCA Head Start sites in Berkeley.

In September 2018, the Division received approval from the MHSOAC for a third INN project to allocate funds to join the Technology Suite Multi-County Collaborative (later re-named Help@Hand Project) and in April 2022, the Division received approval for a fourth INN Project to allocate funds for an Encampment Based Mobile Wellness Center Project.

INN Reporting Requirements
Per MHSA INN regulations, all INN funded programs have to collect additional state identified outcome measures and detailed demographic information. Beginning in FY19, INN Evaluations were required to be included in each MHSA Annual Update or Three Year Plan. The Innovations (INN) Fiscal Year (FY) 2020/2021 Annual Evaluation Report is located in Appendix B of this Annual Update.

A description of current INN programs, and INN programs funded during the reporting timeframe as well as FY21 data are outlined below:

81 Early Childhood Trauma Resiliency (ECTR) - Trauma Informed Care Project In May 2016, the City of Berkeley received approval from the MHSOAC to implement a Trauma Informed Care (TIC ) for Educators project (which is posted on the MHSA Plans and Updates webpage) into several BUSD schools to assess whether educators who are trained to become aware of their own trauma and trauma triggers (and how to address them), are better equipped to recognize and make appropriate decisions on how to help students who are exhibiting trauma symptoms, and assist them in accessing the mental health services and supports they may need.

The project was implemented through the 20/20 Vision Program which is operated out of the City of Berkeley, City Manager’s Office. After a year of the TIC Project being executed, there were two vacancies in the 20/20 Vision Program which impacted the ability to continue the implementation of the TIC Project. The project was only able to be implemented for one year in FY17 and during that timeframe an evaluation was conducted by Hatchuel Tabernik & Associates (HTA) on the project outcomes. The HTA Training Informed Systems Training Program 2016-17 Pilot Year Evaluation Report is located on the City of Berkeley MHSA Plans and Updates webpage.

In FY18, due to staffing vacancies the TIC project was not able to be implemented. When staffing vacancies were filled in mid FY18, meetings were held with several BUSD principals who indicated that although their schools received a lot of positive benefits out of the TIC project, additional training requirements within the school system had been added for teachers and administrators that needed to be fulfilled over the next couple of years. As a result, the TIC Project would not be able to be prioritized within the school system at that time. In light of the changes in the school system, staff conducted outreach and found that area YMCA Head Start Centers were interested in executing the same TIC Project for their early childhood educators and staff, to impact the children and families who are served at the centers. As such, proposed changes to the population and funding amount of the original TIC Plan were vetted through community program planning, and an update to the TIC Plan underwent a 30 Day Public Review and Public Hearing process. The City of Berkeley Trauma Informed Care Plan Update (which is posted on the MHSA Plans and Updates webpage) was approved through City Council in October 2018 and by the MHSOAC in December 2018. The modified project implements TIC Training for Educators and interested parents in four local Head Start sites.

The TIC modified project, “Early Childhood Trauma and Resiliency” (ECTR) was implemented from January 2019 through June 2021 at four YMCA Head Start sites located in Berkeley:

Ocean View. South YMCA, Vera Casey, and West YMCA. The project provided training and supports to enable Head Start staff to recognize trauma and its effects on themselves and the children and families they serve, and to integrate trauma and resiliency informed approaches into their work. The project provided training, coaching and peer support to staff and parents who have children enrolled in Head Start and advanced Berkeley’s 2020 Vision priority, that all Berkeley children enter kindergarten ready to learn.

The learning objectives of this project were as follows:
• To create a change in the way Head Start educators and staff view and handle challenging student and parent behaviors (which often mask trauma); • To create an increase in access to mental health services and supports for children/families in need;

82 • To promote better mental health outcomes by increasing child/family referrals to “appropriate’ mental health services.

In FY21, 178 children received services through this program. For all program outcomes refer to the ECTR Final Three Year Evaluation Report which was developed by HTA during the reporting timeframe and is located on the MHSA webpage and in Appendix B of this Annual Update. Below are demographics of individuals impacted by this program:

DEMOGRAPHICS N=178
Age Groups
0-15 (Children) 100%
Race
Asian 9%
Black or African American 29%
White 9%
Other 28%
More than one Race 17%
Declined to Answer (or Unknown) 8%
Ethnicity: Hispanic or Latino/Latina/Latinx
Central American 2%
Mexican/Mexican-American/Chicano 32%
Puerto Rican 1%
South American 2%
Other 2%
More than one ethnicity 7% Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
African 6%
Cambodian <1%
Chinese 3%
Middle Eastern <1% Vietnamese 1%
Other 9%
More than one Ethnicity 2%
Declined to Answer (or Unknown) 20%
Primary Language
English 67%
Spanish 23%
Urdu <1%

83 Arabic 2%
French 1%
Berber 1%
Mongolian <1%
Amharic <1%
Tigrina 1%
Chinese/Mandarin 1%
Nepalese <1%
Declined to Answer (or Unknown) <1%
Disability
Communication: other, speech/language
impairment
39%
Physical domain 7%
Other 7%
No Disability 47%
Gender
Female 41%
Male 59%
Help@Hand Project
In September 2018, following a four -month community planning process and approval from City Council, the City of Berkeley Technology Suite Project (which has since been renamed “Help@Hand) was approved by the MHSOAC. This project allocates a total of $462,916 to participate in a Statewide Collaborative with other California counties to pilot a Mental Health Technology Project that makes various technology -based mental health services and support s applications (Apps) locally available in Berkeley. The Help@Hand project seeks to learn whether the use of the Apps will increase access to mental health services and supports; and whether it will increase the quality of mental health services, including leading to better outcomes.

Since plan approval and through FY21, the City of Berkeley worked both internally and with the California Mental Health Services Authority (CalMHSA), the fiscal intermediary for this project to prepare for citywide implementa tion. Due to a need for additional community mental health supports as a result of the pandemic, the priority population f or accessing Apps was changed from the original primary focus on TAY and Older Adults, to include anyone who lives, works and goes to school in Berkeley.

Per a competitive recruitment process, the Division contracted with Resource Development Associates (RDA), who conducted Project Coordination work through early FY22 on this project.

Additionally, on behalf of the City and with locally designa ted Help@Hand project funds, CalMHSA executed a contract with Uptown Studios, a local Marketing company in early FY22 to conduct a marketing and social media campaign for this project. In November 2021, as a result

84 of this project, free access to the HeadSpace and MyStrength Apps became locally available for a limited timeframe to anyone who lives, works or goes to school in Berkeley.

The City is currently participating in a State Evaluation with other counties in this project. The evaluation is being conducted by the University of California at Irvine (UCI). Additionally, following a competitive recruitment process, the Cit y of Berkeley entered into a contract with Hatchuel, Tabernik & Associates to conduct a local evaluation of this project.

Encampment-Based Mobile Wellness Center
In FY20, the community program planning process for the next round of INN funded Projects was provided by Resource Development Associates (RDA), who was chosen through a competitive recruitment process to conduct this work. Based on community input received around the need for additional services and supports for individuals who are experiencing homelessness and mental health needs, including direct feedback from individuals who reside in homeless encampments, an Encampment-Based Mobile Wellness Center project was developed.

In April 2022, the Division received approval to implement the Encampment-Based Mobile Wellness Center Project from the Berkeley City Council and the State Mental Health Oversight and Accountability Commission (MHSOAC. This new project will pilot a five year, 2.8 million dollar Mobile Wellness Center at Homeless encampments in Berkeley that will provide an on- site, customizable menu of services that are chosen by individuals who reside at the encampments. The project will be led by peers with lived experience of homelessness, and include partners from encampment communities to encourage participation, help define service needs, and support service provision at the site. The project will be implemented through a community partner who will be chosen through a competitive Request For Propoosal (RFP) process.

The project will seek to learn whether on-site wellness center services have a positive impact on mental health outcomes including an increase in the uptake of mental health services. The project will also assess the impact of how having individuals from the community help to provide services, shapes service delivery, and the participant satisfaction with services.

WORKFORCE, EDUCATION & TRAINING (WET)
The City of Berkeley WET Plan was approved in July 2010. A subsequent update was approved in May 2013. Specific programs in the approved WET Plan include:
• Peer Leadership Coordination;
• Staff Development and MHSA Training;
• High School Career Pathways Program;
• Graduate Level Training Stipend Program;
• Peer Leader Stipend Program.

WET programs were funded for an initial period through FY18 and FY19, and per the local MHSA AB114 Reversion Expenditure Plan (which is posted on the City of Berkeley MHSA

85 Plans and Updates Webpage) the Graduate Level Training Stipend Program was extended through FY20.

Greater Bay Area Workforce, Education & Training Regional Partnership The Office of Statewide Health Planning and Development (OSHPD) allocated $40 million in Workforce, Education and Training funds through FY25 for Regional Partnerships across the state for various mental health workforce strategies. A total of 2.6 million of OSHPD was allocated to the Greater Bay Area (GBA) Workforce, Education & Training Regional Partnership.

In order to participate in the GBA Regional Partnership, mental health jurisdictions were required to contribute a portion of local funds towards this initiative. For the Berkeley contribution the amount was $40,127, which the Division allocated through the previously approved Three Year Plan.

Since the approval of the Three Year Plan, the Division has participated in meetings with representatives from other counties in the GBA Regional Partnership. All participating counties decided to allocate these funds for the Loan Repayment program. This program will enable funds to be made available to repay a portion of student loans for a given number of staff who are in hard-o-fill positions, in exchange for a number of years of service in the Public Mental Health system.

As some local counties have decided not to participate in this initiative, the GBA Regional Partnership was notified that each participating mental health jurisdiction will need to increase the amount of funds they are contributing to this initiative. The additional amount for Berkeley is $1,361. Per this Annual Update, the Division is proposing to transfer $1,361 of CSS System Development Funds to the Workforce, Education and Training (WET) funding component, through the following process:

Per MHSA Statute, (Welfare and Institutions Code, Section 5892 (b)): “In any year after 2007 -08, programs for services pursuant to Part 3 (commencing with Section 5800), and Part 4 (commencing with Section 5850) of this division may include funds for technological needs and capital facilities, human resource needs, and a prudent reserve to ensure services do not have to be significantly reduced in years in which revenues are below average of previous years.

The total allocation for purposes authorized by this subdivision shall not exceed 20 percent of the average amount of funds allocated to that county for the previous five years pursuant to this section.”
Funds will be utilized to participate in this initiative, which is being administered through a joint powers authority, the California Mental Health Services Authority (CalMHSA). Through this Annual Update the Division is requesting to enter into a Participation Agreement with CalMHSA to allocate the designated funds through FY25 to participate in this initiative.

CAPITAL FACILITIES AND TECHNOLOGICAL NEEDS (CFTN)

The original City of Berkeley CFTN Plan was approved in April 2011, with updates to the plan in May 2015, June 2016, January 2017. Through previously approved MHSA Plans and/or Annual Updates, BMH allocated a total of $3,773,811 towards the renovation of the Adult Mental Health Clinic.

86 The Adult Clinic serves Berkeley’s most at-risk and fragile population through crisis intervention, case management, individual/or group supports, psychiatric medication support, Full Services Partnership Intensive Case Management Teams, Clinical services, Mobile Crisis, and Transitional Outreach Services. In its previous condition, use of the Adult Clinic space was inefficient and inadequately aligned with MHSA goals, including not having welcoming spaces for client and family centered wellness and recovery programs and services. In addition to electrical, HVAC and other environmental upgrades, CFTN funds were used to re-configure shared work spaces to increase safety; improve clinical, wellness/recovery, support services, and administrative functions; and to support the implementation of electronic health records and other emerging technologies.

Construction on the Adult Clinic began in FY19, and in June 2021, the renovation was completed, staff moved back into the building, and the clinic was re-opened for services. There is approximately $199,572 in remaining CFTN funds. It is anticipated that approximately $35,000 of these funds will be utilized in FY23 to alleviate water damage at the Adult Clinic and $75,000 will be utilized to conduct a Renovation Study on the adjacent property to the Adult Clinic (2636 Martin Luther King Jr. Way) where some Adult Clinic staff offices are located.

87 FY21 AVERAGE COST PER CLIENT
*(Includes FY21 expenditures attributed to the MHSA Funding component)

COMMUNITY SERVICES & SUPPORTS
Program Name Approx. #
of Clients
Cost Average Cost
Per Client
Children and Youth Intensive Support Services FSP 16 $119,135 $7,446 TAY, Adult & Older Adult FSP 79 $550,410.07 $6,967
Homeless FSP 1 $292,767 $292,767
TAY Support Services 129 $122,856 $952
System Development (includes: Wellness Recovery
Services; Family Support Services; Benefits Advocacy;
Employment/Educational Services; Housing Services
and Supports; Crisis Services; TOT; FIT; TAY Case
Management Services; Hearing Voices; Berkeley
Wellness Center)

1,232

$2,742,199

$2,226

PREVENTION & EARLY INTERVENTION
Be A Star 2,203 $61,154 $28
Supportive Schools Program 179 $55,000 $307
Living Well Project 25 $32,046 $1,282
LGBTQI Trauma Project 69 $32,046 $464
TAY Trauma Project 150 $32,046 $214
High School Youth Prevention Program 101 $339,900 $3,365 Homeless Outreach and Treatment Team 91 $52,416 $576 Child And Youth at Risk Project 49 $35,924 $733
Dynamic Mindfulness Unknown $95,000 Unknown
African American Success Project 63 $150,000 $2,381

INNOVATION
Trauma Informed Care Project 178 $233,059.22 1,309

88 BUDGET NARRATIVE

The enclosed budget provides an update to the estimated revenue and expenditures that were projected for FY23 in the approved Three Year Plan. As with all MHSA Plans and Annual Updates, revenue and expenditures in this Annual Update are estimates.

The Division obtains financial projections from the state on the amount of MHSA revenue to be allocated in a given year. Previous FY23 projections received, which were utilized to calculate MHSA revenue the City would receive in the three-year timeframe, were included in the approved Three Year Plan. Financial projections for the Three Year Plan were provided at a time of great uncertainty of the amount of revenue that would be generated during the pandemic, and were based on a projected downturn of revenue in the MHSA Fund. As has been reflected nationally regarding the wealth divide, there was an increase of MHSA revenue in FY22, and funds are projected to increase in FY23 in the MHSA Fund. Additionally, the expenditure projections for FY22 in the approved Three Year Plan reflected the total costs of each program if it was fully operable. The actual expenditures in FY22 were less than what was projected, due to several factors including staff attrition and vacancies, and slower start-ups with new programs.

The savings from the FY22 expenditures, and the projected additional revenue in FY23, will provide increased monies to support MHSA programs and services over the next couple of years. Additionally, the budgets in this MHSA Annual Update reflect the following: a movement of some staff from being fully funded on the MHSA Fund, to being partially funded on Medi-Cal and partial MHSA; a 10% vacancy across all programs; and funding amounts for the proposed additional positions based on staff being hired by mid FY23 with 30% of the costs of the positions offset by Medi-Cal reimbursement. This funding projection more fully reflects the realities of spending amid vacancies, delays in hiring positions, and the movement of staff to blended funding streams.

The Division will continue to closely monitor the City of Berkeley MHSA allotments and expenditures to assess whether program changes are needed in the future. Any proposed program changes will be vetted for community input and reflected in the next Three Year Plan.

PROGRAM BUDGETS
1A

County: City of Berkeley Date: 6/24/22

A B C D E F
Community
Services and
Supports
Prevention and
Early
Intervention
Innovation
Workforce
Education and
Training
Capital Facilities
and
Technological
Needs
Prudent Reserve
A. Estimated FY 2018/19 Fundingated FY2022/23 Funding

1. Estimated Unspent Funds from Prior Fiscal Years 5,002,253 1,897,440 1,730,975 41,248 199,572

2. Estimated New FY2022/23 Funding 7,088,391 1,772,679 482,230

3. Transfer in FY 2022/23a/ 1,361

4. Transfer Local Prudent Reserve in FY 2022/23

5. Estimated Available Funding for FY 2022/23 12,090,644 3,670,119 2,213,205 42,609 199,572 B. Estimated FY18/19 Expendituresated FY22/23 Expenditures 8,514,903 1,805,605 548,650 42,609 110,000 G. Estimated FY18/19 Unspent Fund Balanceated FY22/23 Fund Balance 3,575,741 1,864,514 1,664,555 0 89,572 H. Estimated Local Prudent Reserve Balance

1. Estimated Unspent Local Prudent Reserve on June 30, 2022 1,237,629

2. Contributions to the Local Prudent Reserve in FY2022/23 0

3. Distributions from the Local Prudent Reserve in FY2022/23 0

4. Estimated Local Prudent Reserve balance on June 30, 2023 1,237,629 FY 2022/23 Mental Health Services Act Annual Update
Funding Summary
a/ Pursuant to Welfare and Institutions Code Section 5892(b), Counties may use a portion of their CSS funds for WET, CFTN, and the Local Prudent Reserve. The total amount of CSS funding used for this purpose shall not exceed 20% of the total average amount of funds allocated to that County for the previous five years.

MHSA Funding

County: City of Berkeley Date: 6/24/22

A B C D E F
Estimated Total
Mental Health
Expenditures
Estimated CSS
Funding
Estimated Medi-
Cal FFP
Estimated 1991
Realignment
Estimated
Behavioral
Health
Subaccount
Estimated Other
Funding
FSP Programs

1. TAY, Adult & Older Adult FSP 1,997,481 1,997,481

2. Children's FSP 427,313 427,313

3. Homeless FSP 1,542,847 1,542,847

4. 0

5. 0

6. 0

7. 0

8. 0

9. 0

10. 0

11. 0

12. 0

13. 0

14. 0

15. 0

16. 0

17. 0

18. 0

19. 0
Non-FSP Programs

1. Multicultural Outreach & Engagement 337,592 337,592

2. System Development, Wellness & Recovery 3,564,591 3,564,591

3. Crisis Services 261,794 261,794

4. 5.

6. 7. 0

8. 0

9. 0

10. 0

11. 0

12. 0

13. 0

14. 0

15. 0

16. 0

17. 0

18. 0

19. 0
CSS Administration 383,285 383,285
CSS MHSA Housing Program Assigned Funds
Total CSS Program Estimated Expenditures 8,514,903 8,514,903 0 0 0 0 FSP Programs as Percent of Total 46.6%
FY 2022/23 Mental Health Services Act Annual Update
Community Services and Supports (CSS) Funding
Fiscal Year 2022/23

County: City of Berkeley Date: 6/24/22

A B C D E F
Estimated Total
Mental Health
Expenditures
Estimated PEI
Funding
Estimated Medi-
Cal FFP
Estimated 1991
Realignment
Estimated
Behavioral
Health
Subaccount
Estimated Other
Funding
PEI Programs - Prevention

1. High School Prevention Program 188,930 188,930

2. African American Success Project 37,500 37,500

3. CalMHSA 70,907 70,907

4. Dynamic Mindfulness 71,250 71,250

5. Mental Health Promotion Campaign 100,000 100,000

6. Mental and Emotional Education Team 23,194 23,194

7. 8.

9. 0 0

10. 0 0
PEI Programs - Early Intervention

11. High School Prevention Program 236,163 236,163

12. African American Success Project 112,500 112,500

13. BE A STAR 34,658 34,658

14. Community Education & Supports 364,092 364,092

15. Dynamic Mindfulness 23,750 23,750

16. Supportive Schools 110,000 110,000

17. Specialized Care Unit 68,000 68,000

18. Mental and Emotional Education Team 23,195 23,195

19. PEI Programs - Stigma & Discrimination

20. Social Inclusion 9,000 9,000
PEI Programs - Outreach for Incr. Recog. Of Mental Illness

21. High School Prevention Program 47,233 47,233
PEI Administration 285,233 285,233
PEI Assigned Funds
Total PEI Program Estimated Expenditures 1,805,605 1,805,605 0 0 0 0 FY 2022/23 Mental Health Services Act Annual Update
Prevention and Early Intervention (PEI) Funding
Fiscal Year 2022/23

County: City of Berkeley Date: 6/24/22

A B C D E F
Estimated Total
Mental Health
Expenditures
Estimated INN
Funding
Estimated Medi-
Cal FFP
Estimated 1991
Realignment
Estimated
Behavioral
Health
Subaccount
Estimated Other
Funding
INN Programs

1. Help@Hand - Technology Suite Project 21,900 21,900

2. New INN Homeless Encampment Project 526,750 526,750

3. 4. 0

5. 0

6. 0

7. 0

8. 0

9. 0

10. 0

11. 0

12. 0

13. 0

14. 0

15. 0

16. 0

17. 0

18. 0

19. 0

20. 0
INN Administration
Total INN Program Estimated Expenditures 548,650 548,650 0 0 0 0 FY 2022/23 Mental Health Services Act Annual Update
Innovations (INN) Funding
Fiscal Year 2022/23

County: City of Berkeley Date: 6/24/22

A B C D E F
Estimated Total
Mental Health
Expenditures
Estimated WET
Funding
Estimated Medi-
Cal FFP
Estimated 1991
Realignment
Estimated
Behavioral
Health
Subaccount
Estimated Other
Funding
WET Programs

1. Greater Bay Area Regional Partnership 42,609

2. 0

3. 0

4. 0

5. 0

6. 0

7. 0

8. 0

9. 0

10. 0

11. 0

12. 0

13. 0

14. 0

15. 0

16. 0

17. 0

18. 0

19. 0

20. 0
WET Administration 0
Total WET Program Estimated Expenditures 42,609 0 0 0 0 0 FY 2022/23 Mental Health Services Act Annual Update
Workforce, Education and Training (WET) Funding
Fiscal Year 2022/23

County: City of Berkeley Date: 6/24/22

A B C D E F
Estimated Total
Mental Health
Expenditures
Estimated CFTN
Funding
Estimated Medi-
Cal FFP
Estimated 1991
Realignment
Estimated
Behavioral
Health
Subaccount
Estimated Other
Funding
CFTN Programs - Capital Facilities Projects

1. Renovation Study of 2636 MLK 75,000 75,000

2. Water Damage Repairs 2640 MLK 35,000 35,000

3. 4.

5. 6.

7. 8.

9. 10.

CFTN Programs - Technological Needs Projects

11. 12.

13. 14.

15. 16.

17. 18.

19. 20.

CFTN Administration
Total CFTN Program Estimated Expenditures 75,000 75,000 FY 2022/23 Mental Health Services Act Annual Update
Capital Facilities/Technological Needs (CFTN) Funding
Fiscal Year 2022/23

APPENDIX
A

Prevention
and
Early

Intervention

Fiscal
Years
2019
–
2021

Three
Year
Evaluation
Report

1B

City of Berkeley
Mental Health Services Act

Prevention and Early
Intervention
Fiscal Years 2019 - 2021
Three Year Evaluation Report

1 INTRODUCTION
Mental Health Services Act (MHSA) Prevention and Early Intervention ( PEI) funds are used to prevent mental illnesses f rom becoming severe and disabling. Programs funded under the MHSA PEI component are focused on ind ividuals across the life sp an and should emphasize improving timely access to services for underserved populations. Programs shall also include the following :
•   Outreach to increase knowledge and recognition of the early signs of mental health challenges or potentially severe and di sabling mental illnesses.
•   Reduction in stigma associated with either having or being diagnosed with a mental illness or seeking mental health services.
•   Reduction in discrimination against individuals with mental health challenges or mental illness. •   Access and linkages to n ecessary medical care for individuals in need of additional services. •   Emphasis on strategies to reduce the following negative outcomes that may result from untreated mental health challenges and mental illness : Suicide; Incarcerations; School failure or dropout ; Unemployment; Prolonged suffering; Homelessness; Removal of children from their homes.

Beginning in 2017, per MHSA State requirements, Men tal Health jurisdictions are required to submit a PEI Evaluation Report to the Mental Healt h Services Oversight and Accountability Commission (MHSOAC) on an annual basis. Additionally, beginning December 2018, a Three Year PEI Evaluation Report is due to the MHSOAC every three years. Regulations also require mental health jurisdictions to submit either a Three Year Evaluation Report or an Annual Evaluation Report to the State Depart ment of Healthcare Services (DHC S). The PEI Evaluation Report is to be included with the MHSA Annual Update or Three Year Program and Expenditure Plan and undergo a 30 Day Public Review period and approval from the local go verning board. In FY22, the Prevention and Early Intervention (PEI) Fiscal Years 2018/2019 – 2020/2021 (FY18/19 –20/21) Three Year Evaluation Report is due.

This PEI FY18/19 – 2/021 Three Year Evaluation Report provides descriptions of currently funded MHSA services, and reports on program and demographic data during the reporting timeframe, to the extent possible. The main obstacles in collecting data for this PEI Three Year Evaluation Report continue be with limited staffing and resources both within the City and at Contractor sites to implement and oversee all the necessary data collection requirements. While, it may be a multi -year process before the City of Berkeley will be able to present a comp lete data set for each PEI Program on an Annual basis, ongoing efforts will continue towards accomplishing this goal.

Impact Berkeley Initiative
In FY18, the City of Berkeley introduced a new initiative in the Health Housing and Community Services (HHCS) Department called “Impact Berkeley”. Central to this effort is using a highly regarded framework called Results Based Accountability (RBA) to account for the work of the Department. RBA provides a new way of understanding the quality and impact of servic es provided by collecting data that answer three basic questions:

1. How much did you do?

2. How well did you do it?

3. Is anyone better off?

2 RBA has been incorporated into selected programs within the Department . Since FY18 this has included community agency programs funded through the MHSA Prevention & Early Intervention Community Education & Supports program. Through this initiative the Department worked with each contractor to envision, clarify and develop measures on the outcomes and results each p rogram is seeking to achieve, and used a rigorous framework to begin measuring and enhancing progress towards these results. Results of the RBA Evaluation are captured in this report and will continue to be reported in future PEI Evaluation Reports.

BACKGROUND
In 2007, the California Department of Mental Health (DMH) issued State Requirements (thro ugh DMH Information Notice 07 -17) outlining how Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) funds were to be used for local programs. Through these requirements, PEI Programs were to be utilized on the following Key Community Mental Health Needs and Priority Populations:

Key Community Mental Health Needs:
•   Disparities in Access to Mental Health Services – Reduce disparities in access to early mental health interventions due to stigma, lack of knowledge about mental health services or lack of suitability (i.e., cultural competency) of traditional mainstream services. •   Psycho-Social Impact of Trauma – Reduce the negative psycho -social impact of trauma on all ages. •   At-Risk Children, Youth and Young Adult Populations – Increase prevention efforts and response to early signs of emotional and behavioral health problems among specific at -risk populations. •   Stigma and Discrimination – Reduce stigma and discrimination affecting individuals with mental illness and mental health problems.
•   Suicide Risk – Increase public knowledge of the signs of sui cide risk and appropriate actions to prevent suicide.

PEI Priority Populations:
•   Underserved Cultural Pop ulations – Projects that address individuals who are unlikely to seek help from any traditional mental health services whether because of stigma, lack of knowledge, or other barriers (such as members of ethnically/racially diverse communities, members of g ay, lesbian, bisexual, transgender communities, etc.) and would benefit from PEI programs and interventions. •   Individuals Experiencing Onset of Serious Psychiatric Illness – Individuals identified by providers, including but not limited to primary health ca re, as presenting signs of mental illness first break, including individuals who are unlikely to seek help from any traditional mental health service. •   Children and Youth in Stressed Families – Children and youth placed out -of-home or individuals in families where there is substance abuse or violence, depression or other mental illnesses or lack of caregiving adults (e.g., as a result of a serious health condition or incarceration), rendering the children and youth at high risk of behavioral and emotional pr oblems. •   Trauma-Exposed – Individuals who are exposed to traumatic events or prolonged traumatic conditions including grief, loss and isolation, including individuals who are unlikely to seek help from any traditional mental health service.
•   Children and Youth at Risk for School Failure – Due to unaddressed emotional and behavioral problems.
•   Children and Youth at Risk of or Experiencing Juvenile Justice Involvement – Individuals with signs of behavioral/emotional problems who are at risk of or have had any c ontact with any part of the

3 juvenile justice system, and who cannot be appropriately served through MHSA Community services and Supports funded services.

In April 2009, following a nine-month long Community Planning Process, the original City of Berkeley Prevention and Early Intervention plan was approved. Since the approval of the original plan, Thr ee Year Plans or Annual Updates outlining proposed PEI funding and programming have been developed and approved on an annual basis.  Based on the DMH Regulation s, through the original PEI Plan (or subsequent updates) programs were created to address Key Community Mental Health Needs and PEI Priority Populations as follows:

PEI Programs Key Community Mental
Health Needs
PEI Priority Populations
Behavioral-Emotional
Assessment, Screening,
Treatment and Referral –
(BE A STAR) Program

Supportive Schools Program

Community Based Child &
Youth Risk Prevention Program
Ø   At-Risk Children, Youth and
Young Adult Populations
•   Children and Youth in
Stressed Families
•   Children and Youth at Risk
for School Failure
•   Underserved Cultural
Populations
High School Youth Prevention
Project

Mental Health Peer Mentor
Program

Dynamic Mindfulness Program

African American Success
Project

Ø   At-Risk Children, Youth and
Young Adult Populati ons
Ø   Disparities in Access to
Mental Health services
Ø   Psycho-social Impact of
Trauma

•   Trauma Exposed
•   Children and Youth in
Stressed Families
•   Children and Youth at Risk
for School Failure
•   Underserved Cultural
Populations
Community Education &
Supports
Ø   Psycho-social Impact of
Trauma
Ø   At-Risk Children, Youth and
Young Adult Populations
•   Trauma Exposed
•   Underserved Cultural
Populations
•   Children/Youth in Stressed
Families
•   Children and Youth at Risk
for School Failure
•
Homeless Outreach &
Treatment Team (HOTT)

Ø   Psycho-social Impact of
Trauma
Ø   Disparities in Access to
Mental Health services
At-Risk Children, Youth and
Young Adult Populations
•   Underserved Cultural
Populations
•   Trauma Exposed

Social Inclusion Ø   Stigma and Discrimination
Psycho-social Impact of Trauma
•   Trauma Exposed
Underserved Cultural
Populations

4 On October 6, 2015, updated PEI regulations designed by the Menta l Health Services Oversight and Accountability Commission (MHSOAC) became effective. The updated regulations changed the PEI requirements. Per new PEI State Regulations, Mental Health jurisdictions are to utilize PEI funds to implement the following programs: Prevention, Early Intervention, Access and Linkage to Treatment, Stigma and Discrimination Reduction, and Outreach for Increasing Recogn ition of Early Signs of Mental Illness. Programs or strategies within programs can also be combined. Jurisdictions may also opt to utilize some PEI funds to implement a Suicide Prevention program. Th e definitions of each program are outlined below:

5 PREVENTION
Activities
to
reduce
risk
factors
for
developing
a

potentially
serious
mental
illness
and
to
build

protective
factors.

EARLY INTERVENTION
Treatment
and
other
services
and
interventions,

to
address
and
promote
recovery
and
related

functional
outcomes
for
a
mental
illness
early
in

its
emergence,
including
the
applicable
negative

outcomes
that
may
result
from
untreated
mental

illness.

ACCESS
and

LINKAGE
to

TREATMENT

Connecting
children
who
are
seriously

emotionally
disturbed,
and
adults
and
seniors

with
severe
mental
illness
as
early
in
the
onset
of

these
conditions
as
practicable,to
medically

necessary
care
and
treatment,including
but
not

limited
to
care
provided
by
county
mental
health

programs.

6 STIGMA and

DISCRIMINATION

REDUCTION
Activities
to
reduce
negative
feelings,
attitudes,

beliefs,
perceptions,
stereotypes
and/or

discrimination
related
to
being
diagnosed
with
a

mental
illness,
having
a
mental
illness,
or
to
seeking

mental
health
servicesand
to
increase
acceptance,

dignity,
inclusion,
and
equity
for
individuals
with

mental
illness,
and
members
of
their
families.

OUTREACH FOR

INCREASING

RECOGNITION

OF

EARLY

SIGNS
OF
MENTAL

ILLNESS
Engaging,
encouraging,
educating,
and/or
training,

and
learning
from
potential
responders
about
ways

to
recognize

and
respond
effectively
to
early
signs
of

potentially
severe
and
disabling
mental
illness.

OPTIONAL -­‐SUICIDE

PREVENTION
Activities
to
prevent
suicide
as
a
consequence
of

mental
illness.

7 Within each PEI program the following strategies should also be implemented: Access and Linkage, Improve Timely Access, and Reduce and Circumvent Stigma. The definitions of each strategy are outlined below:

PEI Regulations, also include program and demographic data requirements that are to be reported to the MHSOAC through Annual and Triennial PEI Evaluation Reports.

The following pages outline the PEI Program and D emographic reporting requirements.

Access
and
Linkage
• Activities
that
engage
and

connect
youth,
adults,
and

seniors
with
severe

mental
illness,
as
early
in

the
onset
of
the
condition

as
practicable,
to

medically
necessary
care

and
treatment.

Improve
Timely
Access
• Improve
timely
access
to

mental
health
services
for

underserved
populations

through
accessibility,

cultural
and
language

appropriateness,

transportation,
family

focus,
hours
available,
and

cost
of
services
Reduce
and
Circumvent

Stigma
• Reduce
and
circumvent

stigma,
including
self-­‐
stigma,
and
discrimination

related
to
being
diagnosed

with
a
mental
illness,
or

seeking
mental
health

services.

Make
services

accessible,
welcoming,

and
positive.

8 PEI PROGRAM REQUIREMENTS

PROGRAM
TYPE

PROGRAM

DEFINITION

PROGRAM AND DATA COLLECTION

REQUIREMENTS
Prevention A set of related activities to reduce
risk factors for developing a
potentially serious mental illness
and to build protective factors.

Ø   Describe the target popu lation- type of risk(s)
and the criteria used for establishing/identifying
those at risk
Ø   Measure the impact of one or more of the
negative outcomes listed in the MHSA (suicide,
incarcerations, school failure or dropout,
unemployment, homelessness, and rem oval of
children from their homes)
Ø   Demonstrate the use of an evidence -based or
promising practice or a community or practice -
based evidence standard*
Ø   Collect all PEI demographic variables
Early Intervention

Treatment and other services and
interventions, including relapse
prevention, to address and promote
recovery and related functional
outcomes for a mental illness early
in its emergence, including the
applicable negative outcomes that
may result from untreated mental
illness.

Ø   Provide services that d o not exceed 18 months
Ø   Program may include services to parents,
caregivers, and other family members of the
person with early onset of a mental illness.

Ø   Program may be combined with a Prevention
program
Ø   Measure the impact of one or more of the
negative outcomes listed in the MHSA (suicide,
incarcerations, school failure or dropout,
unemployment, homelessness, removal of
children from their homes).

Ø   Demonstrate the use of an evidence -based or
promising practice or a community or practice -
based evidence sta ndard*
Ø   Collect all PEI demographic variables
Access and Linkage
to Treatment
Connecting children who are
seriously emotionally disturbed, and
adults and seniors with severe
mental illness as early in the onset
of these conditions as practicable, to
medically necessary care and
treatment, including but not limited
to care provided by county mental
health programs.

Ø   Collect # of unduplicated individuals served
Ø   Collect # of unduplicated referrals made to a
Treatment program (and type of program)
Ø   Collect # of individuals who followed through
(participated at least once in Treatment)
Ø   Measure average time between referral and
engagement in services per each individual
Ø   Measure duration of untreated mental illness
(interval between onset of symptoms and start of
treatment)per each individual
Ø   Collect all PEI demographic variables
Stigma and
Discrimination
Reduction
Direct activities to reduce negative
feelings, attitudes, beliefs,
perceptions, stereotypes and/or
discrimination related to being
Ø   Collect the number of individuals reached by
activity (e.g., # who participated in each service
or activity)

9 PROGRAM
TYPE

PROGRAM

DEFINITION

PROGRAM AND DATA COLLECTION

REQUIREMENTS
diagnosed with a me ntal illness,
having a mental illness, or to
seeking mental health services and
to increase acceptance, dignity,
inclusion, and equity for individuals
with mental illness, and members of
their families.

Ø   Measure changes in attitude, knowledge, and/or
behavioral related to seeking mental health
services or related to mental illness
Ø   Collect all PEI demographic variables
Outreach for
Increasing
Recognition of Early
Signs of Mental
Illness

A process of engaging,
encouraging, educating, and/or
training, and learning from potential
responders about ways to recognize
and respond effectively to early
signs of potentially severe and
disabling mental illness.

Ø   May include reaching out to individuals with
signs and symptoms of a mental illness, so they
can recognize and respond to their own
symptoms.

Ø   May be a stand-alone program, a strategy within
a Prevention program, a strategy within an Early
Intervention program, a strategy within another
program funded by PEI funds, or a combination
thereof.

Ø   Unduplicated # of individual potential responders
Ø   The types of potential responders engaged in
each setting (e.g., nurses, principals, parents,
etc.)
Ø   The # and kind of settings in which the potential
responders were engaged
Ø   Measure impact to 1 or more of the negative
outcomes listed in the Act (suicide,
incarcerations, school failure or dropout,
unemployment, homelessness, and removal of
children from their homes)
Ø   Collect all demographic variables for all
unduplicated individual potential responders

OPTIONAL
Suicide Prevention

Activities to prevent suicide as a
consequence of mental illness.

Ø   Collect available #of individuals reached
Ø   Collect # of individuals reac hed be activity (ex. # trained, # who accessed website)
Ø   Select and use a validated method to measure
changes I attitudes, knowledge and/or behavior
regarding suicide related mental illness
Ø   Collect all PEI demographic variables for all
individuals reached
* Evidence-based practice standard: Activities for which there is scientific evidence consistently showing improved mental health outcomes for the intended population, including, but not limited to, scientific peer -reviewed research using randomized clinica l trials.

Promising practice standard: Programs and activities for which there is research showing positive outcomes, but the research does not meet the standards used to establish evidence -based practices and does not have enough research or r eplication to support generalizable positive public health outcomes.

Community and/or practice -based evidence standard : A set of practices that communities have used and determined to yield positive results by community consensus over time, which may or may not have been measured empirically. Takes a number of factors into consideration, including worldview, historical, and social contexts of a given population or community, which are culturally rooted.

10 PEI Demographic Reporting Requirements

For the information reported under the various program categories, each program will need to report disaggregate numbers served, number of potential responders engaged, and number of referrals for treatment and other services by:

(A) The following Age groups:
•   0-15 (children/youth)
•   16-25 (transition age youth)
•   26-59 (adult)
•   ages 60+ (older adults)
•   Number of respondents who declined to answer the question

(B) Race by the following categories:
•   American Indian or Alaska Native
•   Asian
•   Black or African American
•   Native Hawaiian or other Pacific Islander
•   White
•   Other
•   More than one race
•   Number of respondents who declined to answer the question

(C) Ethnicity by the following categories:
(i) Hispanic or Latino as follows
•   Caribbean
•   Central American
•   Mexican/Mexican-American/Chicano
•   Puerto Rican
•   South American
•   Other
•   Number of respondents who declined to answer the question

(ii) Non-Hispanic or Non -Latino as follows
•   African
•   Asian Indian/South Asian
•   Cambodian
•   Chinese
•   Eastern European
•   European
•   Filipino
•   Japanese
•   Korean
•   Middle Eastern
•   Vietnamese
•   Other
•   Number of respondents who declined to
answer the question
•   More than one ethnicity

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(D) Primary language used listed by threshold languages for the individual county •   English
•   Spanish
•   Number of respondents who declined to answer the question

(E) Sexual orientation
•   Gay or Lesbian
•   Heterosexual or Straight
•   Bisexual
•   Questioning or unsure of sexual orientation
•   Queer
•   Another sexual orientation
•   Number of respondents who declined to ans wer the question

(F) Disability, defined as a physical or mental impairment or medical condition lasting at least six months that substantially limits a major life activity, which is not the result of a severe mental illness •   If Yes, report the number th at apply in each domain of disability(ies) o   Communication domain separately by each of the following:
§   difficulty seeing,
§   difficulty hearing, or having speech understood)
§   other, please specify
o   Mental domain not including a mental illness (including but no t limited to a learning disability, developmental disability, dementia)
o   Physical/mobility domain
o   Chronic health condition (including but not limited to chronic pain) o   Other (specify)
•   No
•   Number of respondents who declined to answer the question

(G) Veteran Status,
•   Yes
•   No
•   Number of respondents who declined to answer the question

(H) Gender
(i) Assigned sex at birth:
(a) Male
(b) Female
(c) Number of respondents who declined to answer the question

(ii) Current gender identity:
(a) Male
(b) Female
(c) Transgender
(d) Genderqueer
(e) Questioning or unsure of gender identity
(f) Another gender identity
(g) Number of respondents who declined to answer the question

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Effective July 2018 amended PEI regulations specif ied the following:
•   For projects/programs serving children or youth younger than 18 years of age, the demographic information collected and reported should only be done so to the exte nt permissible by privacy laws. •   For projects/programs serving minors younger than 12 years of age, demographic information shall be collected and reported, except for sexual orientation, current gender identity, and veteran status. •   Information that cannot be obtained directly from the minor ma y be obtained from the minor’s parent, legal guardian, or other authorized source.

CITY OF BERKELEY PEI PROGRAMS
Since the release of the 2018 PEI Regulations, the City of Berkeley has regularly reviewed PEI programs to ensure they fit within the required program definitions . As a result, local PEI funded programs have been re- classified from the previous construct. Outlined below is a listing of the PEI program type, definition and the City of Berkeley programs that were funded during t he timeframe of this report:

PEI Program Type Program Definition City of Berkeley PEI Program(s)
Prevention A set of related activities to reduce risk
factors for developing a potentially serious
mental illness and to build protectiv e factors.
•   Mental Health Promotion
Campaign
•   High School Prevention
•   DMIND
•   MEET
•   African American Success
Early Intervention Treatment and other services and
interventions, including relapse prevention, to
address and promote recovery and related
functional outcomes for a mental illness early
in its emergence, including the applicable
negative outcomes that may result from
untreated mental illness.
•   High School Prevention
•   Be A Star
•   DMIND
•   MEET
•   African American Success
•   Supportive Schools
•   Child & Youth At Risk
•   Community Education and
Supports
•   Specialized Care Unit
Outreach for
Increasing
Recognition of Early
Signs of Mental
Illness

A process of engaging, encouraging,
educating, and/or training, and learning from
potential responders about ways to recognize
and respond effectively to early signs of
potentially severe and disabling mental
illness.

•   Mental Health First Aid
(non-MHSA funded
program)

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Stigma and
Discrimination
Direct activities to reduce negative feelings,
attitudes, beliefs, perceptions, stereotyp es
and/or discrimination related to being
diagnosed with a mental illness, having a
mental illness, or to seeking mental health
services and to increase acceptance, dignity,
inclusion, and equity for individuals with
mental illness, and members of their fa milies.

•   Social Inclusion
Access and Linkage
to Treatment
Connecting children who are seriously
emotionally disturbed, and adults and seniors
with severe mental illness as early in the onset
of these conditions as practicable, to
medically necessary car e and treatment,
including but not limited to care provided by
county mental health programs.
•   Homeless Outreach and
Treatment*
•   High School Prevention
•   Specialized Care Unit

OPTIONAL
Suicide Prevention

Activities to prevent suicide as a consequence
of mental illness.
•   CalMHSA PEI Statewide
Project
*Prior project that was in operation during FY21, the reporting timeframe of this annual update)

Beginning January 1, 2020, per Senate Bill (SB) 1004, Welfare and Institutions Code (WIC) 5840.7 (a) directed the Mental Health Oversight and Accountability Commission (MHSOAC) to establish priorities for the use of MHSA PEI funds. Section 5840.7 (d)(1) states that mental health jurisdictions shall, through their MHSA Three Year Program and Expenditure Plans and A nnual Updates, focus use of their PEI funds on the MHSOAC established priorities or other priorities as determined through their respective, local stakeholder processes. If a mental health jurisdiction chooses to focus on priorities other than , or in addi tion to, those established by the MHSOAC , “the plan shall include a description of why those programs are included and metrics by which the effectiveness of those programs is to be measured” (WIC Section 5840.7 (d)(1)).

At the time of the writing of this Annual Update, the MHSOAC had not established additional priorities to the following specifically enumerated required priorities in WIC Section 5840.7 (a) for the use of PEI funding:
•   Childhood trauma prevention and early intervention to deal with the earl y origins of mental health needs;
•   Early psychosis and mood disorder detection and intervention, and mood disorder and suicide prevention programming that occurs across the lifespan; •   Youth outreach and engagement strategies that target secondary school and transition age youth, with a priority on partnership with college mental health programs; •   Culturally competent and linguistically appropriate prevention and intervention; •   Strategies targeting the mental health needs of older adults; •   Early identification p rogramming of mental health symptoms and disorder s, including but not limited to, anxiety, depression, and psychosis.

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In order to meet the requirements, each mental health jurisdiction is required to show in the PEI Component of the Three Year Plan or Annu al Update the following:
•   Which specific PEI priorities the mental health jurisdictions plan addresses, an estimate of the share of PEI funding allocated to each priority, and an explanation of how stakeholder input contributed to those allocations;
•   If the mental health jurisdiction has determined to pursue alternative or additional priorities to those listed in Section 5840.7(a), how the determinations were made through its stakeholder process; •   For any alternative or additional priority identified by the me ntal health jurisdiction, what metric or metrics relating to assessment of the effectiveness of programs intended to address that priority the county will measure, collect, analy ze, and report to the MHSOAC , in order to support statewide learning.

Many PEI projects meet multiple established priorities. Per PEI regulations, o utlined below is a crosswalk of the City of Berkeley PEI Program s with the MHSOAC PEI Priorities:

CITY OF BERKELEY

PEI PROGRAMS

PEI PRIORITIES
•   Be A Star
•   Supportive Schools
Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.
•   High School Youth
Prevention Project
•   Mental Health Peer
Mentor Program
•   Dynamic Mindfulness
Program
•   African American
Success Project
•   Specialized Care Unit

Youth Engagement and Outreach Strategies that target secondary school and transition age youth,
Culturally competent and linguistically appropriate prevention and intervention
Early identification programming of mental health symptoms and disorders, including but not limited to, anxiety, depression, and psychosis
•   Mental Health
Promotion Campaign
•   Social Inclusion
•   Community Education
& Supports

Culturally competent and linguistically appropriate prevention and intervention
Youth Engagement and Outreach Strate gies that target secondary school and transition age youth, with a priority on partnership with college mental health programs
Strategies targeting the mental health needs of older adults.

This PEI FY18/19 – 20/21 Three Year Evaluation Report documents program measures and demographic elements to the extent data was available. While, it may be a multi -year process before the City of Berkeley will be able to present a complete data set for each PEI Program on an Annual basis, ongoing efforts will continue towards accomplishing this goal.

5 15

PEI Funded Children and Youth and TAY Services
Per MHSA regulations 51% of PEI funds are to be used on services and supports for Children, Youth, and TAY. Small counties, of which the City of Berkeley is considered, may elect to forego this regulation as long as a community vetted, locally approved justification is provided as to why children and youth services are funded at a lower level. Since the initial PEI Plan, the City of Berkeley has allocated more than 51% of PE I funds to services and supports for children, youth and TAY as the majority of PEI funds has been utilized to serving these populations.

Currently, seven out of ten local PEI programs provide services for children and youth, 6 of which are in the Berkeley Unified School District (BUSD). Programs are as follows: Behavioral -Emotional Assessment, Screening, Treatment and Referral (BE A STAR); Supportive Schools Project; Mental Emotional Education Team (MEET); Dynamic Mindfulness (DMIND); African American S uccess Project; High School Youth Prevention Project, and the TAY Trauma Support Project. Additionally, from FY11 through FY20, the City of Berkeley utilized a portion of PEI funds to provide services for children, youth and TAY in the Albany Unified School District, through the Albany Trauma Project.

Programs and services funded with PEI funds, and FY18/19 – 20/21 data are outlined below by PEI Program type.

6 16

PREVENTION PROGRAM
Prevention Program - A set of related activities to reduce risk f actors for developing a potentially serious mental illness and to build protective factors.

Through the FY22 Annual Update the City of Berkeley funded the following Prevention initiative that will be implemented in FY23:

Mental Health Promotion Campaign

As a result of the impact of the pandemic, and public input around the overwhelming need for mental health supports in the community, a community Mental Health Promotion Campaign will be implemented to support the wellness and self -care of Berkeley residents. The Division will partner with the community and may consider using a social marketing firm to develop and implement the campaign.

PEI Goals: The goal of this campaign is to increase prevention efforts and response to early signs of emotional and behavioral health problems.

PEI Priority: Culturally competent and linguistically appropriate prevention and intervention.

It is envisioned that this campaign will be implemented in FY23 and the Division will continue to work with the community to determin e how to best promote menta l health and wellness in Berkele y.

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EARLY INTERVENTION AND PREVENTION & EARLY

INTERVENTION COMBINED PROGRAMS

8 18

EARLY INTERVENTION PROGRAMS

Early Intervention P rogram - Provides treatment and other services and in terventions, including relapse prevention, to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the applicable negative outcomes that may result from untreated mental illness.

The City of Berkeley Early Intervention programs are as follows:

Behavioral-Emotional Assessment, Screening, Treatment, and Referral (BE A STAR) The Be A Star program is a collaboration with the City of Berkeley’s Public Health Department providing a coordinated system in Berkeley and Albany that identifies children birth to age five and their parents, who are at risk of childhood development challenges including developmental, social, emotional, and/or behavioral concerns. The program specifically targets low income fa milies, including those with teen parents, who are homeless, substance abusing, or in danger of foster care. Services include triage, assessment, treatment and referrals to appropriate community -based or specialist services as needed.

Children and familie s are accessed through targeted efforts at the following: Black Infant Health; Vera Casey Teenage Parenting programs; Child Health and Disability Prevention programs, Pediatric providers, and through state -subsidized Early Childhood Development Centers. Th e goals of the program are to identify, screen and assess families early, and connect them with services and supports as needed. The program uses the “Ages and Stages Questionnaires” (ASQ) screening tool to assess children in need. The ASQ consists of a series of 20 questionnaires that correspond to age intervals from birth to 6 years designed to help parents check their child’s development. Each questionnaire contains simple questions for parents to answer that reflect developmental milestones for each ag e group. Answers are scored and help to determine whether the child's development is on schedule or whether the child should be referred for a developmental checkup with a professional. Over 400 children are assessed each year.

PEI Goals: The goal of this program is to bring about mental health, including the reduction of school failure and the removal of children from their homes.

PEI Priority: Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.

In FY19, there were vacancies in staff, as such program data for the reporting timeframe is unavailable.

In FY20, there were vacancies in staff, and shortly after a staff person was hired, they were deployed to work in the City’s Emergency Operations Center as a result of the pandemic. A total of 1,538 children were able to be screened through community partners .

In FY21, a total of 2,203 children were screened through this program however data was not collected on all individuals screened. Only Race/Ethnicity data was collected on a subset of 141 children as follows:

DEMOGRAPHICS N=2,203
Age Groups
0-15 (Children/Youth) 100%

9 19

Race N=141
Asian 30%
Black or African American 32%
White 8%
More than one Race 1%
Other 29%
Ethnicity: Hispanic or La tino/Latina/Latinx N=141
Unspecified Hispanic or Latino/Latina/Latinx 29%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
Declined to Answer (or Unknown) 100%
Primary Language
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (o r Unknown) 100%
Gender: Assigned Sex at Birth
Declined to Answer (or Unknown) 100%
Program Successes:
•   A total of 154 referrals to resources/services were made as a res ult of the developmental screenings conducted at BUSD preschools and pediatric sites .
•   Overall, there was an increase in developmental screenings in pediatric settings. For example, when compared to data in FY20, two Berkeley pediatric sites increased their number of screenings by 211% and 76%.
•   Sites demonstrated great adaptability due to the challenges that COVID -19 caused. Several sites were able to transition to doing developmental screenings online. Be A Star was able to provide training and Technical Assistance to help ensure a smooth transition.

Program Challenges:
•   Although many ped iatric sites and BUSD preschools were able to provide more services this year, there were still challenges caused by COVID -19, including delayed trainings for pediatric sites and decreases in available referral services.
•   Be A Star staffing was impacted by the City of Berkeley’s COVID -19 response. All Public Health nursing positions supported the emergency response in some capacity. A new Be A Star Public Health Nurse started in January 2021 and there has been a transition as this nurse has settled into the role. •   There were program challenges in being able to collect an accurate full data set as some of the Berkeley pediatric sites do not collect and report out on various demographic information and other screening sites only captured general demographic in formation.

0 20

Community-Based Child & Youth At Risk Prevention
This program targets children (aged 0 -5) who are impacted by multiple risk factors including trauma, family or community violence, familial distress, and/or family substance abuse, (among other issues). A BMH clinician serves as the Mental Health Consultant on this project providing information, services and supports to teachers and parents at the YMCA Head Start program in South Berkeley. Services have included individual case consultation fo r teachers and parents, group consultations, classroom observations and interventions, assessments, brief treatment, and referrals to other resources as needed. The main goals are to reduce risk factors or other stressors, and promote positive cognitive, social, and emotional well -being. This program serves approximately 50 Children & Youth a year.

PEI Goals: The goal of this program is to bring about mental health including the reduction of school failure and the removal of children from their homes.

PEI Priorities: Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.

In FY19, 54 children were served through this program. Demographics on those served is as follows:

DEMOGRAPHICS N=54
Age Groups
0-15 (Children/Youth) 100%
Race
Asian 6%
Black or African American 55%
White 4%
Other 33%
More than one Race 2%
Ethnicity: Hispanic or Latino
Mexican/Mexican-American/Chicano 33%
Ethnicity: Non-Hispanic or Non-Latino
Declined to Answer (or Unknown) 67%
Primary Language
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Gender: Assigned Sex at B irth
Declined to Answer (or Unknown) 100%

1 21

In FY19, the following services were provided:
•   Fifteen Early Childhood Mental Health Reflective Case Consultation groups for five classrooms; •   General Classroom Consultations in five classrooms; •   Individual and group consultations to the Center Program Supervisor, 15 -18 Childhood Teachers, and two Family Advocates;
•   Coordination with the “Inclusion Program” which includes Inclusion Specialists and a Speech Pathologist to help observation and assessment efforts that facilitate early intervention screenings and referrals to BUSD and Regional Center;
•   Planning and assistance with implement ation of behavior plans for children with behavioral and social - emotional needs;
•   Direct interventions including providing visuals and classroom tools to help teach children self - regulation skills, social skills, and skills to help with transitions and to i mprove the overall functioning of individual children in the classroom setting;
•   Mental Health consultations to 15 parents which included a variety of direct psycho -education around developmental concerns, social -emotional issues/behavioral concerns, parent ing issues, providing information regarding mental health services as well as information regarding community services such as: First 5 Alameda, Help Me Grow, Regional Center, BUSD, and Primary Care physicians; and •   Co-facilitation of monthly Resiliency Cir cles to promote self -care and trauma informed care principles with teaching staff.

According to the HeadStart Center Supervisor, the consistency with the curre nt Mental Health Consultant allowed for relationship building and establishing rapport with teach ers and their families, which are essential to providing successful and effective mental hea lth consultations.

In FY20, 54 children were served through this program. Demographics on those served is as follows:

DEMOGRAPHICS N=54
Age Groups
0-15 (Children/Youth) 100%
Race
Asian 5%
Black or African American 56%
White 4%
Other 19%
More than one Race 2%
Ethnicity: Hispanic or Latino/Latina/Latinx
Mexican/Mexican-American/Chicano 33%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
Declined to Answer (or Unknown) 67%

2 22

Primary Language
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Gender: Assigned Sex at B irth
Declined to Answer (or Unknown) 100%
FY20 services were as follows:
•   Consultation meetings allow ed teachers to develop clear plans and interventions in the classroom for individual children (and families) who had high risk factors including but not limited to complicated family dynamics, trauma, mental health and social -emotional needs as well as ove rall developmental needs of individual children
•   General classroom c onsultations were held in five classrooms; •   Individual and group consultations to the Center Program Supervisor, 15 -18 Childhood Teachers, and two Family Advocates;
•   Coordination with the “Inclusion Program” which includes Inclusion Specialists and a Speech Pathologist to help observation and assessment efforts that facilitate early intervention screenings and referrals to BUSD and Regional Center;
•   Planning and assistance with implementation o f behavior plans for children with behavioral and social - emotional needs;
•   Direct interventions including providing visuals and classroom tools to help teach children self - regulation skills, social skills, and skills to help with transitions and to improve the overall functioning of individual children in the classroom setting;
•   Mental Health consultations to over 15 parents which included a variety of direct psycho -education around developmental concerns, social -emotional issues/behavioral concerns, parentin g issues, providing information regarding mental health services as well as information regarding community services as as: First 5 Alameda, Help Me Grow, Regional Center, BUSD, and Primary Care physicians; •   Co-facilitation of monthly Resiliency Circles to promote self-care and trauma informed care pri nciples with teaching staff; and
•   Over 15 Early Childhood Mental Health Reflective Case Consultation gr oups for five classrooms. Case maintenance despite the impact of the pandemic.

In FY21, 49 children were s erved through this program. Demogra phics on those served were as follows:

DEMOGRAPHICS N=49
Age Groups
0-15 (Children/Youth) 100%
Race
American Indian 2%
Asian 12%
Black or African American 45%

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White 14%
More than one Race 5%
Declined to Answer (or Unknown) 22%
Ethnicity: Hispanic or Latino/Latina/Latinx
Declined to Answer or Unknown 100%
Ethnicity: Non-Hispanic or Non-Latino/Latina/Latinx
Declined to Answer (or Unknown) 100%
Primary Language
Declined to Answer (or Unknown) 100%
Disability
Declined to Answer (or Unknown) 100%
Gender: Assigned Sex at Birth
Declined to Answer (or Unlknown) 100%

Program Successes :

All of the general mental health consultation duties outlined below continued to be p rovided remotely via tele-care/Zoom until they were transitioned to in -person services in early FY22:
•   Facilitated weekly Early Childhood Mental Health Reflective Case Consultation group/meetings to five classrooms. Case consultation meetings allowed teachers to develop clear plans and in terventions for individual children and families in their classroom that present with high risk factors including but not limited to: complicated family dynamics; trauma; mental  health concerns; social -emotional needs; and/or overall developmental needs.
•   Provided general classroom observation to five infant care, toddler care and pre -school classrooms, serving a total of 49 children.
•   Provided individual and group consultation to the Center Program Supervisor, 15 -20 Early Childhood Teachers, and two family a dvocates
•   Coordinated with the Inclusion Program which includes Inclusion Specialists and a Speech Pathologist to help observation and assessment efforts that facilitate early intervention screenings and referrals to BUSD and the Regional Center.
•   Provided planning and assistance with implementation of behavior plans for children with behavioral and social-emotional needs.
•   Provided direct interventions around classroom interventions including providing visuals and classroom tools to help teach children self -regulation skills, social skills, and skills to help with transitions, and to improve the overall functioning of individual children in the classroom setting. •   Provided individual mental health consultations to parents, and provided direct psycho -education around developmental concerns, social -emotional issues/behavioral concerns, parenting issues, and information regarding mental health services as well as information regarding community services including First 5 Alameda, Help Me Grow, the Regional Cent er, primary care Doctors, and BUSD services.

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Program Challenges :
•   The downside of continuing services and not being on site was not having access to families. This posed some difficulties in being able to build relationships with children and families d irectly. •   There was an increased need to provide crisis interventions during the pandemic as staff managed the stress of returning to their work as essential workers in the middle of a pandemic. •   There was an increase of collective stress as a result of the pandemic. •   As the pandemic continued into FY21 the center continued to experience disruptions to care with staff and children being quarantined at times.
•   It was a challenge to work off -site during the COVID -19 pandemic to observe the child and teacher interactions. With not being onsite in -person there were no continuous conversations,  spontaneous consultations, nor in -vivo modeling interactions. The ability to demonstrate for staff by working with the children and practicing certain interventions with ch ildren in-person along with observing staff implementing the techniques was also limited.
•   There was no ability to model in -person for the teachers, as these elements were a part of the challenge in working remotely via telehealth (Zoom).

In FY23, MHSA funding for this program will be discontinued as the YMCA Head Start program has created a staff position for an internal Mental Health Specialist.

Supportive Schools Program
Through this program leveraged MHSA PEI funds provide resources to support mental health prevention and intervention services in the Berkeley Elementary schools. Services include: outreach; mental health programming; classroom, group, and one -on-one psycho-social education and support; and consultation with parents and/or teachers.

PEI Goals: The goal of this program is to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the reduction of school failure and the removal of children from their homes.

PEI Priority: Childhood trauma prevention and early intervention to deal with the early origins of mental health needs.

In FY19, BUSD sub -contracted with the following local agencies to provide services: Bay Area Community Resources (BACR), Child Therapy Institute (CTI), and LifeLong Medical Care. Agency and district staff providers led social skills groups, provided early intervention social and emotional support services, playground social skills, “check in/check out,” individual counseling, and support for parents and guard ians from diverse backgrounds. As aligned with priority and focus on equity, providers participated in Coordination of Services Team (COST) meetings, and linked parents and guardians with resources at the school, within the school district, and in the comm unity. A total of 1,065 elementary age students were served through this program.

Note: data provided by BUSD in FY19 combined the demographics for the Supportive Schools Project, the MEET Program, and DMind. Program data for all three projects is outline d below:

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DEMOGRAPHICS N= 3,065
Age Group
0-15 (Children/Youth) 81%
16-25 (Transition Age Youth) 13%
26-59 (Adult) 6%
Ages 60+ (Older Adult) <1%
Race
American Indian or Alaska Native 1%
Asian 11%
Black or African American 19%
Native Hawaiian/Pacific Islander <1%
White 41%
Other 1%
More than one race 4%
Declined to Answer (or Unknown) 9%
Ethnicity: Hispanic or Latino
Mexican/Mexican-American/Chicano 14%
Primary Language Used
English 86%
Spanish 7%
Mandarin 1%
Declined to Answer (or U nknown) 6%
Sexual Orientation
Gay or Lesbian 7%
Heterosexual or Straight 49%
Bisexual 2%
Questioning or unsure of sexual orientation <1%
Queer <1%
Declined to Answer (or Unknown) 41%
Disability
Mental domain not including a mental illness
(including but not limited to a learning disability,
developmental disability, dementia)
9%

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Physical/mobility domain <1%
Veteran Status
Declined to Answer (or Unknown) 100%
Gender: Assigned sex at birth
Male 58%
Female 42%
Current Gender Identity
Male 54%
Female 39%
Transgender <1%
Questioning or unsure of gender identity <1%
Another gender identity (Non- Binary) <1%
Declined to Answer (or Unknown) 6%
In FY20, Early Intervention Services were provided at all eleven BUSD elementary schools. Funding was allocated at each elementary school to prov ide early intervention services. BUSD sub-contracted with local agencies to provide early intervention services based upon the standard of evidence -based practices. Bay Area Community Resources (BACR), Child Therapy Institute (CTI), and Lifelong Medical (Lifelong) were subcontracted to provide services at BUSD elementary schools. Additionally, a counselor was provided to support two elementary schools. As a result of the pandemic, schools finished the year in distance learning.

During the academic year, supports were initially provided in -person, before shifting to o nline. It was reported that providing remote therapy sessions had its challenges. Supports for each school, per service provider, and numbers serv ed in FY20 were as follows:

Elementary School Agency/Provider Number of Students Served Cragmont
Emerson
Malcolm X
Oxford
Ruth Acty
Thousand Oaks

Bay Area Community Resources
BACR

229
Bay Area Arts Magnet (BAM)
Washington
Child Therapy Institute 39
John Muir
Sylvia Mendez
School Site Counselor No Data Available
Rosa Parks Child Therapy Institute No Data Available
Total 268

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BACR provides services to improve emotional functioning and success in school and life, including individual and group t herapy, family consultation, conflict resolution/restorative justice, suicide prevention, check-in/check-out, crisis intervention, and classroom presentations. Additionally, BACR participated on the weekly Coordination of Services (COST) team, Student Success Team (SST), and Individualized Education Program (IEP) meetings for students, providing mental health and trauma informed perspectives. BACR consults with staff on many issues and provides trauma informed coaching for teachers, referrals and care coordination to outside providers, parenting classes/support groups, crisis hotlines, and other programs.

In addition, other agency and district staff providers led social skills groups, early intervention social and emotional supports, playground social skill s, “check in / check out,” individual counseling, and supports for parents and guardians from diverse backgrounds. As aligned with the priority and focus on equity, providers participated in the COST team meetings, and linked parents and guardians with res ources within the school district, and in the community.

Data provided by BUSD, on 248 students that were served from this project in FY20, is outlined below:

DEMOGRAPHICS N= 248
Age Group
0-15 (Children/Youth) 100%
Race
American Indian or Alaska Nat ive 7%
Asian 4%
Black or African American 34%
Native Hawaiian/Pacific Islander 1%
White 24%
More than one Race 19%
Declined to Answer (or Unknown) 11%
Ethnicity: Hispanic or Latino/Latina/Latinx
Mexican/Mexican-American/Chicano 22%
Declined to Answer (or Unknown) 5%
Ethnicity: Non-Hispanic or Non- Latino/Latina/Latinx
Asian Indian/South Asian 1%
Filipino <1%
More than one Ethnicity 10%
Declined to Answer (or Unknown) 62%
Primary Language Used
English 13%

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Spanish 3%
Other <1%
Declined to Answer (or Unknown) 84%
Sexual Orientation
Declined to Answer (or Unknown) 100%
Disability
Mental domain not including a mental illness
(including but not limited to a learning disability,
developmental disability, dementia)
6%
No Disability 11%
Declined to Answer (or Unknown) 83%
Veteran Status
No 100%
Gender: Assigned sex at birth
Male 55%
Female 45%
Current Gender Identity
Male 55%
Female 45%
In FY21 Early Intervention Services were provided at each of the BUSD elemen tary schools. BUSD sub - contracted with local agencies to provide early intervention services based upon the standard of evidence - based practices. Bay Area Community Resources (BACR), Child Therapy Institute (CTI), and Lifelong Medical (Lifelong) were subco ntracted to provide services at BUSD elementary schools. Additionally, a counselor provided support at two elementary schools. As a result of the pandemic, schools began the year in distance learning. BUSD then transitioned to small cohorts at each element ary school, before moving to in-person learning in the spring of 2021. During the academic year, supports were provided both virtually, and in-person.

BACR provided services to improve emotional functioning and success in school and life, including individual and group therapy, family consultation, conflict resolution/restorative justice, suicide prevention, check-in/check-out, crisis intervention, and classroom presentations. Additionally, BACR participated in weekly Coordination of Services (COST), Stude nt Success Team (SST), and Individualized Education Program (IEP) meetings for students, providing mental health and trauma informed perspectives. BACR consults with staff on many issues and provides trauma informed coaching for teachers, and referrals to outside providers, parenting classes/support groups, crisis hotlines, and other programs.

In addition, other agency and district staff providers led social skills groups, early intervention social and emotional support, playground social skills, “check in / check out,” individual counseling, and support for parents and guardians from diverse backgrounds. As aligned with priority and focus on equity, providers

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participated in COST team meetings, and linked parents and guardians with resources within the sch ool district, and in the community.

Supports for each school per each service provider, and numbers served in FY21 were as follows:

Elementary School Agency/Provider Number of Students Served •   Cragmont
•   Emerson
•   Malcolm X
•   Oxford
•   Ruth Acty
•   Thousand Oaks

Bay Area Community Resources
(BACR)

115
•   Bay Area Arts Magnet (BAM)
•   Washington
Child Therapy Institute 39
•   John Muir
•   Sylvia Mendez
School Site Counselor 25
•   Rosa Parks Lifelong Medical Care No Data Available Total 179
Data provided by BUSD, on 179 s tudents that were served through this project in FY21, is outlined below:

DEMOGRAPHICS N= 179
Age Group
0-15 (Children/Youth) 100%
Race
American Indian or Alaska Native 1%
Asian 6%
Black or African American 25%
Native Hawaiian/Pacific Islander 1%
White 33%
More than one Race 19%
Declined to Answer (or Unknown) 11%
Ethnicity: Hispanic or Latino/Latina/Latinx
Central American 1%
Mexican/Mexican-American/Chicano 1%
South American 1%
Declined to Answer (or Unknown) 20%

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Ethnicity: Non-Hispanic or Non- Latino/Latina/Latinx
American Indian 1%
Asian Indian/South Asian 1%
Chinese 1%
Eastern European 1%
Filipino 1%
Korean 1%
More than one Ethnicity 3%
Declined to Answer (or Unknown) 68%
Primary Language Used
English 30%
Spanish 4%
Other 1%
Declined to Answer (or Unknown) 65%
Sexual Orientation
Declined to Answer (or Unknown) 100%
Disability
Communication Domain 1%
Mental domain not including a mental illness
(including but not limited to a learning disability,
developmental disability, dementia)
11%
Declined to Answer (or Unknown) 88%
Veteran Status
No 100%
Gender: Assigned sex at birth
Male 53%
Female 43%
Declined to Answer (or Unknown) 4%
Current Gender Identity
Male 52%
Female 43%
Non-binary 1%
Other Gender Identity 4%

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Community Education & Supports Program
The Community Education & Supports program implements culturally -responsive psycho -educational trauma support services for individuals (18 and above) in various cultural, ethnic and age specific populations that are unserved, underserved and inappropriately served in Berkeley and Albany including:

African Americans; Asian Pacific Islanders; Latinos /Latinas/Latinx; LGBTQIA+; TAY; and Senior Citizens. All services are conducted through area community -based organizations.

Since 2019 the Community Services & Supports projects have participated in the Health, Housing and Community Services Department “Impact Berkeley” Results Based Ac countability (RBA) Evaluation. RBA seeks to answer the quantity of servic es provided, how well the program is providing services, and whether participants are better off as a result of participating in the services.

In FY19, RBA aggregated results across all Community Education & Supports projects were as follows:

How Much Did We Do? How Well Did We Do It? Is Anyone Better Off? •   651 Support Groups/Workshops
•   3,524 Support
Groups/Workshop Encounters
•   419 Outreach Activities
•   6,938 Outreach Contacts
•   1,308 Referrals
•   7 Support groups or workshop
sessions attended on average
per person
•   96% Survey respondents were
satisfied with services
•   Referrals by type:
251 Mental Health
240 Social Services
227 Physical Health
156 Housing
434 Other Services
•   92% of program participants
reported an increase in social
supports or trusted people they
can turn to for help (3 of 5
projects reported in this
measure).
•   88% of program participants
reported positive changes in
terms of coping strategies,
feeling anxious or overwhelmed
(4 out of 5 programs reported on
this measure).

In FY20 the aggregated results across all Community Education & Supports projects were as follows:

How Much Did We Do? How Well Did We Do It? Is Anyone Better Off? •   555 Support Groups/Workshops
•   5,183 Support
Groups/Workshop Encounters
•   188 Individual
Contacts/Individuals
•   3,342 Outreach Contacts
•   1,245 Referrals

•   13 Support groups or workshop
sessions attended on average
per person (5 out of 7 programs
reporting).
•   98% Survey respondents were
satisfied with services
(4 out of 7 programs reporting)
•   Referrals by type:
277 Mental Health
252 Social Services
230 Physical Health
125 Housing
361 Other Services
(6 out of 7 programs reporting)
•   90% of program participants
reported an increase in social
supports or trusted people they
can turn to for help (2 out of 7
programs reporting).
•   88% of program participants
reported positive changes in
terms of coping strategies,
feeling anxious or overwhelmed
(3 out of 7 programs reporting).

In FY21, the aggregated results across all Community Education & Supports projects were as follows:

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How Much Did We Do? How Well Did We Do It? Is Anyone Better Off? •   578 Support Groups/Workshops
•   1,247 Support
Groups/Workshop Encounters
•   118 Individual Contacts (2 of 3
programs reporting)
•   2,524 Outreach Activities
•   225 Outreach Contacts
•   1,179 Referrals

•   9 Support groups or workshop
sessions attended on average
per person
•   85% Survey respondents
reported satisfaction with
services
•   Referrals by type:
223 Mental Health
200 Social Services
213 Physical Health
124 Housing
419 Other Services
•   86% of program participants
reported an increase in social
supports or trusted people they
can turn to for help (2 of 3
programs reporting)
•   90% of program participants
reported positive changes in
terms of coping strategies,
feeling anxious or overwhelmed
(2 of 3 programs reporting)
To ensure fair contracting practices in the City, the Division proposed in the approved FY20 MHSA Annual Update, to execute a new Request for Proposal (RFP) process for the Community Education & Supports Project contracts that have been in place for five or more years. It was anticipated that the RFP process would be executed in the Spring of FY20. Due to Covid -19 the Division decided it would be best to delay this RFP Process, and RFP’s for each project were executed in the Spring of FY21. All Community Education & Supports contracts were continued through June 30, 2021. In FY22, the chosen bidders fro m the RFP processes, began providing services to each population.

Per the previously approved Three Year Plan, in an effort to ensure each unserved, unde rserved and inappropriately served population has an equitable amount of dedicated MHSA funds for programs and services, the Division made the following changes to this program, which began in FY22: Increased the amount up to $100,000 per each of the foll owing populations, African Americans, Latinos/Latinas/Latinx and LGBTQIA+; and no longer funded the API population in this program, as the Division is providing $100,000 of dedicated CSS funds for services and supports for this community.

Outlined below ar e descriptions of services provided and num bers served through this program during the reporting timeframe :

Albany Trauma Project
Implemented through Albany Unified School District this project provides trauma support services to Latinx, Asian Pacific Is landers and African American TAY, and Adults. Through various supports the project: provides helpful information and coping strategies around the effects of trauma; offers interventions to keep at-risk individuals and families from developing serious ment al health symptoms and behaviors; provides a forum for clinicians to monitor trauma -exposed individuals and families who may need more intensive mental health services; and creates a venue to explore trauma and stress management through symbols of healing, artwork, and alternative coping strategies. Services include one-on-one outreach and engagement for adults, and support groups in the Elementary and High School in Albany. Additional one time cultural activities to promote healing through reflection gro ups and art projects are also conducted throughout the year. This project annually serves approximately 40 -55 children/youth and 25 -45 adults.

Descriptions of services provided and numbers served through this project are outlined below:

Adult Support G roups: This project used to implement outreach and engagement activit ies and support groups to Latino/Latina/Latinx immigrant adults dealing with trauma issues, who live and work the backstretch of Golden Gate Field’s race track as groomers; exercise jock eys and caretakers of the horses.

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Over the years this project has migrated to more of a one -on-one engagement project to support individuals in need, with occasional cultural and strength building group activities.

PEI Goals: The goal of this project was to address and promote recovery and related functional outcomes for a mental illness early in its emergence, including the prevention of suicide.

PEI Priority: MHSOAC priorities were not required during the timeframe that this project was implemented.

In FY19, 24 individuals received supports through one -on-one engagement sessions. Eleven referrals were provided, 1 to Physical Health services, 3 for Legal services, 1 for Tax Preparation, and 6 to other unspecified supports.

Children/Youth Support Groups : Young children and high school youth experiencing trauma are unlikely to seek services at traditional mental health clinics. Schools are an essential vehicle of treatment for trauma exposed individuals and their families. By aiming psycho -educational interventions for elementary age children and high school youth, it is possible to introduce youth and their families to information about trauma, coping mechanisms, and to combat the isolation that trauma brings.

The purpose of the groups was to reduce at-risk behaviors, reduce a sense of alienation, and increase a sense of belonging among group members. Various psycho-educational techniques were used to achieve these goals, such as improving communication skills, using role modeling and feedback, increas ing empathy by encouraging self-disclosure and emotional engagement in the group, and developing trust via positive interactions in the group. The support group program provided information about the effects of trauma, and helpful coping strategies; serve d a preventive function by offering interventions that will keep at -risk individuals and families from developing serious symptoms and behaviors; provide d a forum for clinicians to monitor trauma -exposed individuals and families who may need more intensive mental health services; and created a venue to explore trauma and stress management through symbols of healing, artwork, and alternative coping strategies.

PEI Goals: The goal of this project was to address and promote recovery and related functional out comes for a mental illness early in its emergence, including the reduction of school failure or drop out.

Elementary School Support Groups : Through this project, Support Groups were p rovided to Elementary aged students to reduce children’s negative respon ses to trauma, correct maladaptive beliefs and attributions, and build resilience and reduce an xiety. Student participants were referred from parents, teachers or school staff. Students with experiences of community violence, physical assault, significan t separations, witness to domestic or sexual violence, and lack of food, clothing, or shelter were invited to attend groups. As these experiences can lead to the child's regulatory capacity being overwhelmed, his or her daily life behaviors, school performance, attention, self -perception and emotional regulation may all be affected. Support Groups provided psycho-education, coping skills, and a safe environment in which to address and process traumatic experiences.

In FY19, 18 support groups were provid ed to a total of 10 participants. Each group met for 1 -2 hours in duration. There were two referrals for additional mental health services. Fifty -one outreach activities were also conducted. From teacher, school staff, and parental report, outcomes for st udents participating in support groups were as follows: 60% took a more active role in learning; 90% received increased positive attention from peers; and 80% exhibited less anxiety in the classroom.