Background Sheboygan County COMMUNITY CONVERSATION ABOUT MENTAL HEALTH AND

Transcription

Background Sheboygan County COMMUNITY CONVERSATION ABOUT MENTAL HEALTH AND
Sheboygan County
COMMUNITY CONVERSATION
ABOUT MENTAL HEALTH AND
ALCOHOL & DRUG ABUSE
MARCH 21, 2014
(Prepared by Lilly Irvine-Vitela, Facilitator
and edited by
The Planning Committee)
Background
On March 21, 2014 over 300 community stakeholders attended a Community Conversation
about Mental Health and Alcohol and Drug Abuse at the Blue Harbor Resort in Sheboygan
Wisconsin. The objectives of the day were as follows:
 To identify 3-5 community priorities to improve mental health and alcohol and drug
abuse systems in Sheboygan County.
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To encourage community involvement through recruitment of action team members to
move priorities forward.
Move in a direction to create good mental health in our community.
Educate the community regarding the services available in Sheboygan County.
The planning committee was made up of the following participants:
 Kate Baer, Mental Health America in Sheboygan County
 Kristin Blanchard, Lakeshore Community Health Center
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Amy Culver, Sheboygan County Health and Human Services Department
Abby Dahmer, The Salvation Army
Jon Doll, United Way of Sheboygan County
Jean McMurray, Aurora Health Care
Mary Paluchniak, St. Nicholas Hospital
Emily Rendall-Araujo, United Way of Sheboygan County
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Laura Roenitz, Safe Harbor
Shelley Saunders, Sheboygan County Detention Center
Norm Shanks, Aurora Health Care
Corrie Skubal, The Salvation Army
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James Veeser, Sheboygan County Service Providers
Ann Wondergem, United Way of Sheboygan County
The sponsors included: Aurora Health Care, Healthy Sheboygan County 2020, Lakeshore
Community Health Center, Mental Health America in Sheboygan County, Safe Harbor,
Sheboygan County Health and Human Services Department, Sheboygan County Service
Providers, St. Nicholas Hospital/Prevea Health, The Salvation Army, United Community for
Youth- Drug Free Community Grant, and United Way of Sheboygan County
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Special thanks to:
Blue Harbor Resort, Sargento Foods, Rhiannon Bakker – Volunteer
Coordinator at Aurora Health Care
Overview of the Day: Participants introduced themselves to others at their table, learned more
about the planning committee and the objectives for the day. Information about the prevalence of
adults with mental illness and substance use disorders with local data and resources were shared.
Kenya Bright, Section Chief of the Integrated Services Section, Wisconsin Department of Health
Services, provided updates about resources for mental health and alcohol and other drug abuse
(AODA) services, policy changes, and program options. Members of the community affected by
mental illness and the journey for well-being provided journeys. Once a common ground was
established, the groups broke into small group table discussions to address the following key
questions:
 Why is good mental health important to our community?
 What is currently working within our community for mental health and alcohol/drug
abuse support?
 What are the barriers that prevent people from accessing services?
 What is missing/gaps in the services available in our community?
 How do we build on what is working and the strengths?
After all of the questions were discussed, participants at each table were encouraged to identify
the top three priorities for action ranging from service development, policy change to systems
issues. The choices were then displayed and nominal group technique/dot voting was used to
poll participants for priorities. Each table of participants was then given an opportunity to create
preliminary action plans to address next steps for priority areas.
Next Steps: At the close of the day, participants were encouraged to complete a Call to Action
card to stay involved in addressing the top priorities identified. Information provided on
completed Call to Action cards will also be used to provide follow up information to participants.
Members of the Planning Committee committed to supporting the effort in moving the priorities
forward through community action teams (utilizing current committees with similar focuses on
priorities being addresses or creating new committees to focus on the identified concerns).
Furthermore, Aurora Health Care committed to providing a .5 FTE to support project
management for the planning committees.
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The following section provides the list of cumulative responses to the five key questions
discussed by the over 300 participants in their small group conversations. These lists were
categorized by the facilitator to make the summary more readable but are in no particular order
and some may be included under more than one category.
Why is good mental health important to our community?
Economic Development
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A focus on good mental health and prevention allows for cost savings and resources to be
reallocated
A proactive/preventative approach is an investment in the community
Allows resources for public housing needs
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Are able to access better insurance rates
Eases use of community resources
Employers are more satisfied and apt to hire
Good mental health improves employers’ ability to train and retain our workforce
Good mental health influences the business community and employment and productivity
in the workplace
Good mental health leads to more productive businesses because there are fewer days off
due to mental health
Greater response to crisis in business
Mental health impacts the cost of individual and community health care
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Promotes commerce
Promotes a healthier workplace
Stable mental health allows for more discretionary money for other priorities/programs
We prosper
When needs are met there are better educational and career outcomes
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Educational Achievement
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Children are our future leaders
Greater educational achievement and ability to use skills and training
Helps improve behaviors in schools and keep focus on learning
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Higher graduation rates
People can be more focused and driven to succeed
General
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Greater balance
Improves childhood outcomes
Less stress
Mental health impacts all systems, things are interconnected
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Mental health is part of and touches everyone in the population
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People are able to feel comfort seeking services
People who are mentally healthy are more productive at home and work
Prioritizing mental health now increases the stability of coming generations
Promotes the dignity of each person
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Relationships thrive
Unmet mental health needs are the root cause of other social/family issues
Until mental health is commonly promoted and mental illness is properly treated by
addressing the whole person, the individual, family, and community will suffer
There is a legal and moral obligation to meet mental health needs
There is more positive risk taking (creativity, innovation)
We’re more supportive to each other
We need to talk more honestly about mental health and reduce stigma and the idea of
people being “crazy”
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Health
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Affects all aspects of individual’s functioning (physical, emotional, spiritual, mental)
Children are less exposed to trauma and less likely to suffer the mental and physical
consequences of exposure
Good mental health helps community members connect and deal with each other
Coping skills are better and people have healthier lifestyles
Creates positive energy for self and others
Good mental health is contagious
Healthy relationships
If we support good mental health, we support the whole person.
Increases life span
Increases positive attitude
Increases trust
Less self-mediation
Less tragic deaths
Mental health touches every aspect of life - health, social, economic, education, family,
etc.
More happiness and contentment
More intensive and expensive levels of care are reduced
People are less likely to cope with illicit drugs and alcohol when their needs are met
Promotes well-being
Reduces stigma and increases well-being
There is better continuity of services when we focus on mental health and AODA issues
We need to increase access to treatment and medication
When mental health is strong, it is easier to identify and solve issues.
When needs are met there are less incidents of substance abuse
Where the mind goes, the body follows; we need a holistic approach to health and
wellness
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Livable Community
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Allows people to live up to their potential and this makes community stronger
A stronger sense of community - “better together”
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Current level of awareness and knowledge doesn’t match the number of people affected
Community involvement/more engaged
Fosters a greater community image - community has a good reputation
Good mental health is important to the future of the community
Good mental health is part of personal and community values
Good mental health makes the community more attractive
Improves quality of life
Increases creativity and fosters a solution focus
Increases the connectedness among people and relationships
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Increases the number of people who are able to participate in the electoral process
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because mental health is not criminalized
Less destructive conflict
Mental health impacts boundaries set by social norms and laws
More productive people means more positive growth in Sheboygan
People what to remain in a community that promotes good mental health
Reduces homelessness
The community is more stable and less reactionary
There is greater cohesion in neighborhoods, workplaces, and community-at-large
There is greater personal and community stability
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There’s less community distress
There is a greater willingness to support people with disabilities
Untreated mental health needs deteriorates the quality of life of the individual and
community
Public Safety
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Greater awareness decreases fear and safety
Increase safety and decrease crime and violence
If there is greater understanding the responses are less punitive and can lead to
rehabilitative services
Less victimization of people with mental illness
Prevents/reduces crime
Promotes security
Safety - work together in a better fashion
When healthcare needs are met, the crime rate decreases and there is less criminal justice
involvement and incarceration
Strong Families
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Better birth outcomes
Better outcomes for our children and our future
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Children can be raised in a more healthy environment
Can be a good role model for family
Children’s well-being is prioritized
Enhances family life and family well-being
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Families are more stable
Families can be more supported and remain intact
Improves healthy and effective parenting
Less dysfunction
Mental health affects families and all community systems
Poor mental health can lead to break-down of the family unit
Promotes connectedness
Reduces and prevents child abuse and violence
What is currently working within our community for mental
health and alcohol/drug abuse support?
Corporate Support and Partnership
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Awareness of wellness programs as a way to promote productivity and curb health care
costs
Corporate generosity
Corporate shift and focus on caring
Corporations taking ownership of mental health and substance abuse issues and
participating on boards of organizations focused on solutions
Incentives offered for positive and healthy behaviors within the corporate environment
Effective Providers/Service Delivery
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ACUITY support
Administered medication program
Adult Care Consultants
After Care
Aging and Disability Resource Center
Available mental health services at zero cost for those without insurance
Bilingual Services (but need more)
Birth to 3 Program
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Bridgeway Program
Comprehensive Community Services (CCS) is in the community- peer training classes
add credibility
Caring Clinicians
Celebrate Recovery
Cognitive Behavioral Therapy
Community Care (CC) - and CC Consultants
Coordinated Service Team approach
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County providing mentoring program
County Caregiver Coalition
Crisis Center/ Crisis Line-County Wide 24/7
Crisis Intervention Program
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Dialectical Behavior Therapy
Division of Vocational Rehabilitation
Early Childhood programs
Early Intervention and school involvement
Emergency Room (ER) doctors are more aware because of technology like EPIC
(electronic medical records)
Employee Assistance Programs
Family Care
Family Resource Center
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Genesis - inpatient services and voluntary AODA services
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Good success when people work together (example Corporation Counsel and social
workers)
Group homes
Healthy Sheboygan County 2020 Mental Health Priorities
Helping Hands
Hospice and Home Health Care
1-K unit
Inpatient Facility
Insurance coverage
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Intensive Outpatient Program
Kidship and Teenship within Sheboygan Area School District (SASD)
Lakeshore Community Health Center
Lakeshore Technical College Students asking for services and there is less stigma
Libertas - AODA outpatient for adolescents and adults
Local colleges- counseling staff
Lutheran Social Services: runaway and youth services in-school setting with mentoring
and family mediation (formerly Project Youth)
Medication Monitoring
Methadone Clinic
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Mindfulness-based Stress Reduction (mediation, yoga, martial arts, exercise, etc.)
Mobile Crisis Unit
Northshore- new therapist available for early childhood mental health
Open Door Center
Partial hospitalization with Aurora
Prevention Policy Board
Providing home-based treatment
Psychiatric unit at hospital
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Rainbow Kids/ Compassionate Parents
Recovery, Certified Peer Involvement)
Referrals
Residential Alcohol and Other Drug Program
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Respite
Rocky Knoll
Safe Harbor
Salvation Army Shelter
Seasonal Affective Disorder- awareness
Seeing the connection between AODA and mental health
Severe Mental Illness resources Suicide awareness and prevention walk
Shore Haven
Strengthening Families (10-14 year track record) Alcoholics Anonymous (AA), Narcotics
Anonymous (NA), Transitional Living, Celebrate
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Strong Start
Subsidized Housing
Suicide Hotline
Transitional Living Programs
Turning Point
Transportation
Veterans Counselor/Services/Supports
Volunteer Center
Wellness initiatives increasing
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Woodland and Vista
Workforce of trained professionals and good networking among professionals
Wrap-around models/relational models for care
Faith Community
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Churches
Family support
Holistic approach - Catholic Charities mental health and case management
Love Inc.
Pastoral counseling
Parish nurses
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Praise Fellowship
Recovery supports
Religious and spiritual support
Sheboygan County Interfaith Organization (SCIO)
Southside Alliance
Youth groups and youth pastors
General
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Access to care
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Affordable health care
Agencies working together
All levels of mental health care available in Sheboygan County including inpatient care
and services
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Anti-heroin groups pulling together TheFlyEffect.com
Awareness about how trauma impacts mental health and substance use disorders
Awareness building efforts, seminars, networking
Building One-on-One relationships with consumers in various areas (home health, social
work, mentoring, etc.)
Caring Community
Child-centered programs
Communication in health care with drug availability and manufacturers of drugs
Coordination with agencies (churches, county services, hospitals, police, non-profit,
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schools, funders)
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Data base compilation regarding mental health and policy
Education to health care providers
Flexible spending/Health Savings Accounts (HSA)
Good collaboration and communication across sectors
Good school system
Growing awareness of prescription drug misuse
Health and Human Services and hospitals collaborate
High levels of awareness about mental health and substance misuse and abuse in the
community
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Identifying problems
Improved education on mental health in schools
Medical community is aware of the issues
Neighborhood Associations
Options for services Outreach and education - educational resources available such as
directory and flyers and brochures
Passionate people who want change
People are mobilized to do something
Referrals
Resources
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Revitalized leadership in the community
Strong understanding in schools
This event - intentional community conversations about mental health and substance use
disorders that are inclusive of many ages, perspectives
Wisconsin Department of Health Services
Law Enforcement/Criminal Justice
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Alternatives to incarceration
Canine search crews
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Changing philosophy and focus on the root causes of behavior
Community Intervention Teams (CIT)- Sheboygan County Sheriff
Diverting people from criminal justice to treatment/care
Good Drugs Gone Bad Seminars
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Sheboygan Service Providers (Heroin initiative - knowledge and awareness rising and
done in partnership with community)
Improved connections between law enforcement and Human Services
Jail contracts mental health counselor 8 years ago and revamped approach
Law enforcement and court systems who care about people and mental health and
substance abuse issues
Neighborhood policing and neighborhood based solutions
Police awareness and involvement
Prescription/drug drop-off boxes at police station
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Probation and Parole know more about mental health and substance use disorders
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Schools - in the school setting families are more willing to accept support and work
toward solutions
School District - breakfast
Stronger penalties for drug dealers
Using resources other than jail
Training of law enforcement and corrections to understand mental health and substance
abuse disorders
Veterans Court
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Non-profit organizations/Initiatives
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Alzheimer’s Association
Big Brothers and Big Sisters
Emphasis on trauma informed care
Head Start - Sheboygan Human Rights
Mental Health America in Sheboygan County (MHA) - updated resources, supports,
awareness
Neighbors Against Drugs
Non-profits that provide free therapy
Samaritans Hands
Strengthening Families program
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Strong support United Way
Philanthropic Support
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Community Generosity
United Way
Schools
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School counselors
School social workers
School system monitoring students
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Support Groups
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Alcoholics Anonymous groups
Al-Anon/ Narcotic Anonymous
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Dementia Care
Family Support
Mental Health America in Sheboygan County (MHA)
NAMI, National Alliance on Mental Illness
Peer support
What are the barriers that prevent people from accessing
services?
Continuum of Care
 Ability to make appointments - big picture and next step thinking may be impaired
 Alternative treatment beyond medications
 Availability of support groups
 Broken systems that impact the county’s ability to deliver full-range of services
 Case management support
 Client-centered services
 Coordination of care and services
 Daily living support
 Disability associated with the disease itself as well as blind, deaf, and limited mobility
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Disconnected services
Difficult to get help unless in immediate danger to self and others
Eligibility
Evening services and resources
Facilities may not be accessible for physical disabilities
Fear of restriction
Fine line between team approach and feeling “passed around” to various providers
Free or low cost services (more)
Group homes and safe places to go (need more)
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Help navigating services-advocate for person in need
Lack of addictionologist in area
Lack of planning
Limited weekend and afternoon hours
Local treatment and support in home
No coordinated community-wide continuum of care
Peer support programs
Poor understanding of levels of care
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Psychiatric unit needed in the community
Relationships with schools and coordination of resources could improve
Referral steps are complicated
Referral system not consistently supportive-gaps in knowledge
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Residential beds (not enough)
Services in supportive culture and appropriate language
Timing - availability vs. need, group reports 4 month wait list
Waiting for appointments and local services if need specialty care
Cultural Norms
 Belief that medication will create a “quick fix”
 Culture of alcohol tolerance, social acceptance of alcohol miss-use
 Cultural attitudes
 Co-morbidity - recognize and treat
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Denial
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Entitlement attitude
Family dynamic- children’s mental health or substance use disorder may not be addressed
if a parents needs aren’t being met
Family dysfunction
Fear of
 Diagnosis
 embarrassment about the need for support
 feeling weak
 getting stuck
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 legal or employment repercussions for seeking help
 losing a coping mechanism (drugs)
 reporting to law enforcement
 use of restraints
Follow-up isn’t as comprehensive as it needs to be
Helping the mentally ill is less tangible than “feeding the hungry”
Individualism and belief that it can be handled alone
Intolerance
Lack of faith in ourselves and others
Lack of trust in government agencies
Low understanding of how to break a negative family cycle
Long-term care resources not adequate
Narrow interpretation of the bible related to sexual orientation and inadequate
supports
Older generations may not be as educated about AODA and mental health issues
People are aware of labels
Pride
Self-medication
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Shame, fear, myths to the individual and families with mental health issues or
substance abuse disorders
Stigma still exists, people feel judged
Technology may be misused and contribute to disconnectedness
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Terrible confusion
Under age drinking is common
Value privacy and appearances above wellness
Financing
 Barriers based on insurance provider
 Care expensive even with insurance
 Co-pays are costly
 Cost to employers high
 Economic opportunities impacted if substance abuse of mental health disorders
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Insurance-consider regulations and policies and restrictions
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Lack of resources for people that are not from Sheboygan
Low reimbursement rates for providers
Managed care and legal restrictions
Medicine is expensive
Resources are costly
Standard of living impacts outcomes
General
 Children are left on their own more and may not have enough boundaries and supervision
 Community has changed and people may not know each other or feel a sense of
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responsibility
Community is impacted by a ripple effect
Dislike and discomfort with side-effects make managing illness through medication
difficult
Face-to-face conversations and communication is limited
Improve how people are treated upon entrance into treatment
Lack of socialization
Low empathy
More mobile community
People are suffering
People feel judged
People feel pushed around
Perception that where you come from may impact the services you receive discrimination
Religion and culture may be a barrier for accessing services
Mental Health/Alcohol and Other Drug Abuse Workforce
 Correctly diagnosing people is time-consuming
 Inadequate training for the continuum of needs
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Issues seen as behavioral rather than mental health and minimized
Lacks of checks and balances
Lack of psychotherapy follow-up with the chronically mentally ill
Language competence for non-English speakers is low, not enough bilingual staff or
translators
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 Hmong and
 Spanish-speaking
 Sign-language
 Other
 Lack of cultural understanding
Low awareness in general public about resources other than the Emergency Room
Low use of evidence-based interventions
Medication compliance for school-age kids is poor
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Misunderstanding and miscommunication
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More training for teachers
Need more education and public awareness about services
Not enough physicians
Not enough providers that take Medicaid/BadgerCare
Prevention and early intervention require more focus
Promote continuity and continuation of services rather than waiting for crisis
Pushed to break laws because people need to be “sick enough” to receive care/ red tape
Qualifications may be limited to a specific program,
Secondary trauma
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Shortage of board certified psychiatrists in general and child psychiatrists in particular
Shortage of experienced mental health and AODA providers
Stigma
Transportation
Understanding of how to treat addiction and mental health at the same time is low
Volunteers need training and background checks
Wait list for low-income or underinsured people
Public Awareness
 Education about coping mechanisms
 First responder education to address problems early
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Greater education
Internet access low, access to information resources low
Judges need to be educated on mental health and medications
Knowledge of resources is insufficient
Medically side-effects poorly understood by professionals and general public
Misconceptions about the importance of issues related to mental health and substance
misuse/abuse
Parents may have limited knowledge about mental health or they hit a wall in the system
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Partner more with clergy to increase awareness of services
Volunteer opportunities for people who want to make a difference
Websites and information is hard to navigate
Willingness to speak out on issues
Public Policy
 Confidentiality
 Consequences of being arrested
 Crisis intervention for police department
 Fear of mandatory reporting
 Funding for programs is unstable and results in reduction in services
 Immigration status
 Improvements in health may result in lack of ability to re-qualify for services
 Legal restrictions may make it difficult to personalize/individualize services to meet the
specific needs of someone
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Medication distribution in jail is poor
Need policies
No minimal universal standards for MTL/ADOA services (insurance plans all vary)
Overemphasis on reacting to unmet needs rather than preventing growing unmet needs
People caught in the middle - making too much money to be eligible for services but
cannot afford additional supports
Policy makers that understand issues exist but aren’t the majority
Prior reauthorization can make intake difficult
Privacy and transparency needs are often at odds
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Qualifying for services
Requirements for forced treatment
Sufficient time to evaluate
Social Security Insurance is suspended while someone is in jail
Wisconsin law, 14 year-olds can refuse services
What is missing/gaps in the services available in our
community?
Advocacy
 24/7 answers!
 Consumer voice not heard
 Peer training
 Providers ombudsman
 Role models, celebrity role models
 Youth services rather than juvenile justice
Community
 Communication across service providers
15
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Directory - lack of information on the therapy skills, qualifications, and genders of
providers including professional bios and educational/training
Fund prevention
Mental health literacy of general public to know how to talk about needs with others
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Promote what good mental health is
Sober and dry activities
Translate the services provided for/ to target the new generations i.e. (google, IPad, etc.)
Financing
 Adequate reimbursement for mental health
 Enough providers who will take Medicare/Medicaid
 Funding - for those with no insurance/ under insured/ out of pocket expenses
 Medication funding
Health Care Capacity
 Behavioral health integration with primary care physicians
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Lack of communication between hospitals regarding ability to admit
Hospitals - “this person is dangerous we can't accept them”
Mental illness – training for help with aggression etc.
Lack of providers at hospital over extended especially when providers are on vacation
Methadone delivery system is questionable
No suboxone clinic/prescriber in the county
Missing/Insufficient Services
 Age-appropriate services not adequate
 Kids with ADHD
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 Infant mental health expertise is limited
 Child Psychiatrists and child psychologists
 Limited clinicians for very young children and adolescents
 Care for elders limited
AODA coordinator in the county
Bi-lingual services
Discharge services need to improve and follow-up care
Detox center
Drug court
Extended time to meet with health care providers (psychiatrist, therapists, etc.)
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Facility that providers mental support and medical detox monitoring for addiction
Family support groups limited
Gender specific outpatient
Lack of communication/ Collaboration between services
Lack of detox/inpatient facilities
Lack of marriage and family therapists
Lack of mental health services in schools
Lack of providers who will provide/ write prescriptions for psych meds.
16
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Lack of psychiatrists (no child psychiatrist in our DSS community)
Lesbian, Bi-sexual, Gay, Transgender, Questioning specific services (LBGTQ
community is disproportionately represented with poor mental health and AODA
outcomes)
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Life skill courses - resiliency, coping
Meditation and emotional coaching for younger kids
More supervision of court ordered treatment
More diversion programs for mental health instead of sending to jail
Nar-Anon - like Al-Anon but for opiate addiction
Peer services
Prescription drug monitoring and follow-up
Reduced school counselor/ therapists staffing in school
Services to match personal fit/needs
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Support groups with trained leaders for “CIC”
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Transitional living services
Warm line
Warm house
Professional Development/Workforce Issues
 Cultural competence needs of the providers
 Education
 Employee retention
 Networking opportunities for providers
 Salaries of mental health professionals, caseloads and working conditions

Training for care givers
Related Service
 Child care while receiving AODA and mental health services
 Diverse income levels are impacted by mental health and AODA issues but generational
poverty makes access to services more difficult
 Domestic Violence shelters
 Employment opportunities
 Family therapy
 Homeless services inadequate supports to mental health and AODA, hard to establish
residency
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Housing (affordable, safe, high quality)/long-term housing to stabilize on medication
Insufficient family supports
Mentorship
Natural supports over utilized when systems of care aren’t coordinated
Parenting Education
Pediatric psychiatric services
Positive activities - Open Door
Positive reinforcement for managing mental health and substance use
17
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Post crisis services
Residential Services
Resources to advertise services
Support systems fragmented or non-existent
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Teen pregnancy prevention resources
Transportation - distance and cost creates barriers for example the bus system doesn’t go
to Plymouth, especially hard in more rural communities
Treatment foster care
Services for young adults
School psychologists
Some are not connected to internet/web and other technology to find resources
Wrap around services
Treatment for domestic violence
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How do we build on what is working and the strengths?
Community Coalitions
 Communication - across stakeholders
 Continue connecting legal system to issues
 Develop coordination
 Develop system to document outcomes
 Forums like this with follow up
 Formal collaborative groups that focus on mental health – more focused (subcommittee)
 Getting non-medical, non-mental health provider services involved
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Improve community networking and expanding into the schools – psychiatrist, teacher
training, counselors, wraparound programs
Include more faith-based solutions
Increase parent involvement
Mental health provider fair
Organizational buy-in
Promote National Alliance for the Mentally Ill (NAMI)
Provider networking
Provide support and professional development to providers
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Public conversation & collaboration
Put collected suggestions into action
Raise awareness of community resources - “211”
“Resource mapping”
Spiritual health (mind-body-spirit)
Strengthen connections coordinators
Study other communities with successful programs
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Training for trainers
18
Comprehensive Mental Health and Alcohol and other Drug Abuse Services
 Add more to county services / medical Aging & Disability Resource Center
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(ADRC)/Aging/ACDA
ADDA inpatient not only connected to religious affiliation
Adolescent services in the summer support groups
Advocacy counseling fee
Affordable Care Act- increase understanding
Arts – enriching, therapeutic
Beds/facilities for patients
Build on successes of client-centered services
Build on social services
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Caseworker to help access services/ Caseworker for the working class to advocate &
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navigate like a hub – who do you call?/ (health care traditional med model) + support
staff
Centralized Intake
Children’s resources/family resource center
Continue medical care while people are incarcerated
Educating consumer about their disease – what is disease, what meds they are on, how to
deal with it
Educating providers more on available resources
Empower families
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Expand ability of parish
Expanding NAMI & ALANON
Grow nurse prescribers’ medication management
Heroin detox facility
Hire additional psychiatrist – child, adult, addition, public, private, Federally Qualified
Health Center (FQHC)
Home-based services
Improve coordination/communication, drug seeking behavior, diverting, pharmacies,
providers
Increased education in judicial system
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In-patient facility in the county/mental health/AODA separate
Jail system working with medical system
Managing medications better
More drug drop off opportunities (ER, etc.)
Nurse role – referrals, community involvement
One stop triage mental health
Parent/family support group by an agency facilitator
Peer consultation
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19
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Promote mental health services in addition to medication treatment
Recruit and retain skilled mental health providers/clinicians
Satellite offices out in county
School behavioral specialists
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Services for men in community/anger management/abuse
Support first time parents - provide parent education and role models—home visiting
Support groups in needed areas
Supportive Services - more access to transportation, child care, financial asst, other
enabling services, pet care
Tele-health counseling/psychiatry
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Funding
 Advocate for funding etc to continue and build and what is already working
 Better use of existing resources
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Continued fund raisers local collaborative
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Corporate funding partnerships
Expand mental health resources through ADRC
Grants - to support coordinated approach not just one agency or service
Increase funding for prevention (primary secondary)
Keep counselors/ school workers employed
Keep funding programs that work
More resources – specifically financial
Reach out to volunteers and philanthropic opportunities to build awareness & support of
mental health needs
Public Education
 Advocate for mental health and AODA careers in the schools – encourage vocation &
passion
 Community outreach/marketing resources
 Continue mock drunk driving modules
 Coordination between the obvious places people go to obtain information – coffee shops,
churches, law enforcement, taverns, non-profits, healthcare, schools, major employers,
governmental offices
 Create base level standard of communication
 Create the vehicle to which people can go to obtain info – book/ pamphlet, common
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website
Education about issues in workplace & community
Education of symptoms of illnesses
Education for young parents/families and children and parents together
Educate people on how to access services
Educate youth about drugs
First responder education about mental health, AODA issues, and trauma
Healthy Sheboygan Facebook page
20
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Information available in various media with all ages in mind
Improve websites - ACCESS (incompatibility with phones)
Marketing/awareness of current resources & issues
Neighborhood mental health fairs/forums
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Post training video clips, etc., on Facebook, Youtube to be accessible to all
Promote crisis services including all lines
Public awareness initiatives – billboards (We’ve started, let’s continue.
committee)
Raise awareness in church communities, bulletins
Required education (community)
 In schools – different topics
 In org issues
Statewide resource book
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Use media (local radio/billboards/web/tv/phonebook)
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Use the arts to raise awareness through creating endeavors – theater is a great resource
Utilize businesses to promote additional awareness
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Discuss in
Public Policy
 Address prevention vs reaction to mental health
 Better citizen to government reps communication
 Holding community decision-makers accountable for improving mental health delivery
system/addiction/prioritizing mental health/AODA issues
 Insurance reform, prior authorization, licensing & credentialing, MA
 Improve state legislation
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Listen to people who are using services
More function from state & fed
Measuring outcomes
Support from state legislators
Update legislators to make them informed on current issues
We have to all be part of the solution
Other
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Healthy food choices
Medicine – Research & science
Services in schools for more gifted children
21
Priorities
 Accessibility to Mental Health and AODA Services/Easier entry/Address language and
cultural barriers that affect access and quality (378)
 Community education - information available, understandable, & audience appropriate
to professionals & the consumers, marketing & awareness, use of social media, provider
information fair, business raise awareness and resources part of solution (203)
 Follow up services (160)
 Coordination & clearing house - create a community health liaison to help coordinate
services for people of all socio-economic classes to help navigate the mental health
system (156)
 Increase options for treatment/the amount of
therapists/counselors/psychiatrist/integrated care model (151)
 Prevention and early intervention (148)
 Changing societal perceptions, stigma reduction, cultural attitudes toward AODA
and mental health, increase empathy (127)
 One Stop Shop, collaboration between agencies, fix communication gap (113)
 Children-focused services (infant mental health, child, adolescent health) (86)
 Warm lines (62)
 Political advocacy/climate, revise current status, making decision makers accountable to
make mental health and drug treatment a priority, grassroots effort/align criminal justice
policies with approach that recognizes mental health and substance use disorders (49)
 Insurance, payment source (35)
 Increase in money & funding/Improve reimbursements (34)
 Support for those struggling with addiction (individuals, peers, families, parents) (28)
 Better conditions/money for providers (20)
Note: Using a nominal group process Community Conversation participants ranked the
overarching themes resulting from the small group discussions. The numbers in ( ) indicate the
result of the nominal group process.
22
Action Planning: Small group discussion tables were randomly assigned a priority area and
given about ½ hour to brainstorm and propose some ideas for further action plan development.
Participants struggled with the process of identifying tasks, steps, barriers, resources, and
responsible parties based on the limited information and time available. The participants did feel
the process was beneficial and that Community Action Teams may be able to incorporate some
ideas from the brainstorming plans. Below are the draft brainstorm plans.
Draft Action Plans
Goal: Community Education- Increase Awareness
Responsible Party : Board of Education, Head Start, Guidance Counselors, Boys& Girls Club, Family
Resource Centers, Mental Health America
Task/Step
Date
Barriers
Increase Parental Awareness
3-6 months
Coordination of those
responsible, Parent not
open to receive
information.
Closed mindedness,
language, cultural
differences clearing with
board of education
Increase Knowledge of Resources for
Families
3-6 months
Increase Professional Awareness
3-6 months Communication,
coordination, turn-over
Increase education about alcohol and
other drug use
Increase educational opportunities
identify target populations
make education available where
population is found
Clarify safe drinking limits
Concentrate message on
children and the
importance of modeling
Share consequences of
unhealthy use
Ongoing
Resources
Staff and families at
community-based
organizations
Re-set the image of
cool Substance free
events
Language, message, access People
to focused communication
method
23
Goal: Community Education-AODA Issues
Responsible Party : Schools, Tavern league, law enforcement, consumers/ community
Task/Step
Increase education about alcohol and
other drug use
Emphasize positive community norms
that don’t involve drug and alcohol
misuse/abuse
Date
Barriers
2 years
People like alcohol
money
social norm – it's okay
to be intoxicated,
funny
people use to selfmedicate don’t know
how to get help in other
areas
Too easy to access
drugs and alcohol
By Dec.
2014/January
2015
Resources
Re-set the image of cool
Substance free events
Clarify safe drinking limits
Concentrate message on
children and the
importance of modeling
Share consequences of
unhealthy use
Help people find their
passion
Goal: Community Education- Awareness of Resources
Responsible Party : Establish action team (Jennifer school system, Sara, Deb-bill board, Mental Health
America, United Way, Law Enforcement)
Task/Step
Date
Promote 211
Barriers
90 days
Resources
Agency Cooperation
Community, education on services- January
Assign people to develop media guide 2015
or template develop timeline, money to
find project, coordinate who will update
the guide
Get MHA community resource guide
6 months
out as many households as possible,
find sponsors/ funding/ grants to help
with costs of printing and distribution
company to print, find volunteers/
service groups/ individuals to help
distribute
make accessible at school registration
make accessible at various agencies and
business
Cost of resources
Staff time
Establishing lead
Agency
Use technology to
develop a media guide
to distribute all
community resources
Funding
Mental Health America
Doctors, teachers
promote services of each agency
Agency contacts
Advocacy from
experiences
peers/
real
life
24
Goal: Community Education- Reduce Stigma
Responsible Party : Everyone, yourself and your family
Task/Step
Date
Change the stigma of someone with
mental illness seeking help
Educating
people
about
within the
next 2 years –
everyone will
hear “how is
your mental
health?” in a
doctor visit
then ongoing
Barriers
Cultural differences
age differences
peer pressure
ingrained culture
Resources
Mental health
America
Job center
Signage
Facebook/ social
media
Public service
announcements
mental
illness, normalizing mental health
issues and acceptance
Goal: Community Education-Prevention and Early Intervention
Responsible Party: The committee of a various/ diverse members in the community i.e. (doctors,
counselors, therapists, etc.)
Task/Step
Date
Educate the public on the signs and
symptoms of mental illness and drug
abuse and addiction in the
community
1.Committee to write/ research signs
and symptoms on MH and AODA
2. Organize materials
3. Distribute information
Barriers
Funding, finding the
professional volunteers,
Marketing
Resources
Grants, Private
donations,
fundraising,
Community
organizations
1 month
3-6 months
Ongoing
25
Goal: Continuity of Care- Early Intervention/Prevention- Universal Access
Responsible Party: The committee of a various/ diverse members in the community i.e. (doctors,
counselors, therapists, etc.)
Task/Step
Address needs of
 children 0-4
 Parents
 Children
 Teens
Identify supports related to
 Education
 Parenting?
 Coping strategies?
 Healthy relationships
Date
2 years
3-6 months
Barriers
Funding, finding the
professional volunteers,
Marketing
Resources
Grants, Private
donations,
fundraising,
Community
organizations
May not have all skill
Have some
levels/specialization
components that
available in the community could be better
coordinated, Head
Start and Mental
Health America
Goal: Continuity of Care- Early Intervention/Prevention- First Time Parent Class
Responsible Party: The committee of a various/ diverse members in the community i.e. (doctors,
counselors, therapists, etc.)
Task/Step
Date
Barriers
Provide parent education on mental
health services
Fall 2014
transportation
financial
life skills limited
child care needed
timing day/ evening
Promote existing resources for adults
and children
Support basic parenting skills
Ongoing
See above
Ongoing
See above
Resources
1) form committee
2) include parents who
have already “been
there”
3) those already
working with parents
4) Sources of funding –
dept of social services
grant writing
Goal: Continuum of Care- Better structure continuum of care from prevention, early
intervention, and treatment
Responsible Party : Mental Health America, Sheboygan County, HSS, Community Stakeholders
Task/Step
Collaborative relationships between
agencies to refer to best services and
most appropriate provider
Date
Barriers
March 2015
Changing service levels
Resources
Participants from
community
conversation
26
Goal: Continuity of Care-Transitional Living
Responsible Party: The committee of a various/ diverse members in the community i.e. (doctors,
counselors, therapists, etc.)
Task/Step
Date
Educate the public on the signs and
symptoms of mental illness and drug
abuse and addiction in the community
1.Committee to write/ research signs
and symptoms on MH and AODA
2. Organize materials
3. Distribute information
Barriers
Funding, finding the
professional
volunteers,
Marketing
Resources
Grants, Private
donations, fundraising,
Community
organizations
1 month
3-6 months
Ongoing
Goal: Help Line or On-line Clearing House to Improve System Navigation
Responsible Party : Mental Health America, Sheboygan County, HSS, Community Stakeholders, Schools
Task/Step
Allocate/identify funding
Date
Barriers
12 months Funding
Develop/ define referral system to
12 months
create 24/7 Service
Create a “hub” for people with mental
health issues and families to go for
resources, direction, advocacy and a
plan of action, regardless of culture,
ability to pay, language and social
economic status
Focus on working class and middle class
who would not turn to a nonprofit for
help because they are not low income
stigma
Having tech personnel
Stigma associated with
using services
Coordinate Services
Lack of proximity
Ongoing
Resources
Consolidation
of
existing resources to
avoid duplication of
services and possibly
free up funds
Mental Health America
help people navigate
the “one-stop-shop”
Look for comparable
programs that may be
expanded
Existing directory
MHA good name
Area medical/ psych/
counselors –
underwriting
Physical space shared =
access easier services /
Lakeshore community
health care clinic
27
Goal: Increase Access to Services- Comprehensive
Responsible Party : Mental Health America, Sheboygan County, HSS, Community Stakeholders,
Lakeshore Community Health (consumers), Schools, Aging and Disability Resource Center
Task/Step
Date
Barriers
Resources
Increase access to providers
 Diverse language and cultural
knowledge Hmong and Spanish
 Specialized providers in infant
mental health
 Addictionologist
 Child Psychiatrist/Psychologist
Individuals who receive services at any
point based on mental health or AODA
services would have access to follow up
services - Identify what’s currently
available
increase options where there are gaps.
Include alternative choices, Base
options on client centered model, offer
more local options for long term
recovery
12 months Funding
Identify all access issues- review
feedback from session
April 2014 Time
Feedback from
community
conversation, surveys
Prioritize Issues
May 2014 Competing priorities
Community
involvement
Ongoing
Funding for staff and
administration of
additional services
Consolidation of
existing resources to
avoid duplication of
services and possibly
free up funds
Hospitals, non-profits
Involve providers in panning
June and July Time
2014
Involve a diverse range of consumers
June and July Time, transportation
2014
Complete and refine an action plan
August 2014
Provide transportation to services and
medication pick-up
Address educational barriers
3-6 months Funding
Child Care
3-6 months Funding/availability
Regulated child care
during service delivery do providers
family can focus on care
and children are in a
healthy environment,
flexible hours
Ongoing
Mental Health America
Research approaches
that are working
Community
Access to information
28
Goal: Increase Access to Services- Child and Adolescent Services
Responsible Party : Community, employer, provider, participant/ citizens/ family
and schools, child and adolescent committee w/ school counselor and counselor education
Task/Step
Date
Partnership among community, school
personnel and families to implement
early identification and treatment
Inventory of service providers that
specialize in children and adolescents
Intensive outpatient services and
continuum of services, increase and
coordinate service providers that
specialize with children and
adolescents and improve access to
these resources
Program structured with coordinated
services team
Workforce development - encourage
legislators to have incentives for
people to be trained to work with this
population and serve in high need
areas
Educate children / teens
early to encourage awareness of entry
in the field
Education - Form committee to design
a youth website linked to adult/ parent
website, all known resources available
support group availability, FAQ, Blog
Links to face books, twitter, etc.
Offer education mental illness,
substance abuse interpersonal
violence, peer pressure, bullying, safe
sex
PSA's at the schools
Parental Involvement- create Parent/
caregiver as teachers” mentor
program,
Increase awareness of this program
expand it to age 17
Barriers
Staffing
Funding
Locations
3 months:
Enough qualified
need
providers
identification
6 months:
Funding,
recruitment
w/ in 12
month: new
programs
ready
Resources
Tom Eggebrecht
Sheboygan County
Health & Human
Services
pupil services in
schools
parents
Training
school districts
Hospitals
Schools
County board –
government
Fundraising
local businesses
community clinics
family resource center
12 months
funding
Healthy Sheboygan
County 2020
mental health
committee
school counselors
college counselor
6 months
Funding/staff time
Mental Health America
and support from
United Way
1 month to
Not enough marketing
gather
and funding for
information
Strengthening Families
with assess
current status
UW-Extension
Strengthening Families
program/ Jane Jensen
family service
29
continuity of parents as teachers
program
(ages birth 9 years) into Strengthening
Program
Referral process – who knows about it
among other providers?
of
Strengthening
Families
Program
providers, schools,
juvenile justice as a
team
30