IT TAKES A VILLAGE to meet the mental health needs of families in supportive housing

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1 IT TAKES A VILLAGE to meet the mental health needs of families in supportive housing Mary M. McKay, Ph.D. McSilver Professor of Poverty Studies New York University Silver School of Social Work New York, New York

2 Acknowledgements (Continued) Collaborators

3 Collaboration is a Necessary Foundation for Mental Health Programming and Service Delivery Our work is based on core assumptions : Collaboration with consumers (youth, parents, providers, and communities) lead to services and programs that potentially are: acceptable to consumers relevant to consumer s s context, specific needs and core values potentially effective when implemented in real world settings by naturally existing providers and resources (sustainable)

4 Why Do We Need to Embed Mental Health Services in Supportive Housing? Provides intensive support as families navigate transitions across the lifecycle and make the move from shelter to more permanent housing Reduce barriers and enhances receptivity to programs and services Potentially decreases stigma Applies to real life (where the family actually lives)

5 Collaboration is Necessary To Address the Serious Mental Health Issues of Vulnerable Families Head of Households (n = 25) Needs Adults Chronic Psychiatric Problems 15 Symptoms of Depression & Anxiety 23 Previous or Current Substance Use/Abuse 22 Trauma and Interpersonal Violence 23 Low Educational Attainment (less than high school) 23 Worked in last three years 0 5

6 Collaboration is Necessary To Address the Serious Gaps in Mental Health Service Delivery to Children and Families Two thirds of children in need of mental health care do not receive services Rates of service use are at their lowest in low income, urban communities No show rates can be as high as 50% Drop outs occurring after two or three sessions are common

7 Next: Highlights from New York City Mental Health Focused Partnership with Five Supportive Housing Programs MFG (multiple family groups for youth with disruptive behavioral difficulties) Wellness self management (WSM; for adults with serious mental health issues) Evidence-based engagement interventions

8 MFG (multiple family groups for youth with disruptive behavioral difficulties) New York Collaborators (Ervin Torres, Francis Lewis, Rita Lawrence)

9 Multiple family groups Multiple family group (MFG) is an evidence-informed informed service delivery strategy meant to address emerging conduct difficulties in children by supporting and strengthening their families MFG content and process was designed in collaboration with urban parents & providers

10 MFG service delivery model Strengthens parenting skills and family relationship processes child management skills family communication within family support parent/child interaction Addresses factors affecting service use and outcomes parental stress use of emotional and parenting support stigma associated with mental health care

11 In the words of families Multiple family groups should focus on: Rules Roles and Responsibilities Respectful communication Relationships Stress Social Support

12 MFG service delivery Sessions guided by a manual characterized by flexibility, choice of activities, discussion questions 16 week sessions (social networking, introduction of content, discussion and personalization of information, practice and take home exercises)

13 Wellness Self-Management Originally designed as an evidence-based practice for adults with serious mental illnesses Real world adaptation across New York State and set within a range of settings

14 What is wellness self- management? Curriculum based practice designed to assist adults to effectively manage serious mental health problems The topics covered include a number of research informed approaches that are organized into a comprehensive and coordinated set of practices The WSM program was based on Illness Management & Recovery, a nationally recognized Evidence Based Practice for adults with serious mental health problems 14

15 Eight goals of the program Learning about recovery and what it can mean for you Making the best use of your mental and physical health services Learning that mental health and physical wellness will help you to achieve your goals and support your personal recovery Staying well by decreasing symptoms of a mental health problem 15

16 Goals of the program (continued) Learning how to manage day to day stress and prevent relapse Staying well by connecting with others Staying well by living a healthy lifestyle Recognizing and building on your cultural values and experiences to support your personal recovery 16

17 Details about the WSM program Group or individual format Meets at least once a week Optimally closed group The length of time varies In addition to Orientation sessions at the beginning and Wrap-Up sessions at the end, three major chapters are covered: Recovery Mental health wellness and relapse prevention Living a healthy lifestyle and mental health recovery 17

18 More details about the program Emphasis on Action Steps,, which promote continued learning in real life outside the group Emphasis on involving family/significant others Practitioners use several approaches Motivational Educational Cognitive-behavioral These competencies are embedded within the workbook to guide and reinforce skills. 18

19 Evidence-based Engagement Interventions )

20 Empirically supported engagement strategies Goals: 1) Clarify the need; 2) Increase investment and efficacy 3) Identify attitudes and previous experiences; 4) PROBLEM SOLVE! 5) Information and clear expectations to increase comfort 6) Focus on practical and small wins 7) Collaboration is key 8) Respect choices to continue

21 Results # of families that came to 1st appt. No show Engage Compare

22 First Interview Results % for first interview (n=33) % for comparison (n=74) 20 0 Accepted 1st Appt. 2nd Appt. 3rd Appt.

23 Summary & Next Steps Important to consider building mental health intervention capacity within natural settings Collaboration is key to embedded mental health promoting process Evidence-based approaches can be reviewed and adapted to supportive housing context

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