City of Philadelphia Department of Behavioral Health and Intellectual disability Services In partnership with The Thomas Scattergood Behavioral Health Foundation Proposed Mental Health First Aid Strategic Plan Executive Summary The Department of Behavioral Health and Intellectual disability Services (DBHIDS) believes the behavioral health field should shift orientation from one of responding to illness and diagnosis to one of supporting health and wellness. Philadelphia is using a public health approach to organize and implement Mental Health First Aid (MHFA) in a manner that will create change and impact at all levels of society. You are more likely to encounter a person in an emotional or mental crisis than someone having a heart attack. Behavioral Health challenges are more common than heart disease and cancer combined; an estimated 26% of people have a diagnosable behavioral health condition (Kessler et al., 2005). The stigma of mental illness is a significant barrier that precludes many individuals affected by behavioral conditions from seeking help. As such, many individuals with behavioral health diagnoses never seek treatment from mental health professionals. To confront this reality and strengthen the community s ability to identify and respond to behavioral health issues, DBHIDS has set the goal of being a national leader in providing MHFA city-wide. MHFA is a groundbreaking early intervention and public education program that teaches community members how to assist a person experiencing a behavioral health problem. MHFA teaches the skills needed to identify, understand and respond to signs and symptoms of behavioral health challenges or crises. First Aid is administered until appropriate treatment and support are received or until the crisis is resolved. 1
DBHIDS, under the direction of Commissioner Dr. Arthur C. Evans, has identified five potential target areas of impact that MHFA will have on a large city like Philadelphia and developed an implementation guide for addressing eight key logistical priority areas. Aligned with a larger public health approach, DBHIDS is utilizing the socio-ecological model for public health as the MHFA implementation framework. There are five target areas that MHFA will positively impact the City of Philadelphia: Increase the mental health awareness/literacy of the City of Philadelphia Increase early intervention and access to behavioral health services through the City of Philadelphia Support recovery and resilience Reduce the stigma surrounding behavioral health problems Strengthen the community and cross system capacity The public health approach that Philadelphia is taking to implement MHFA strives to be inclusive of all Philadelphians and focuses on all levels of society through the socio-ecological framework. 2
Figure 1. The socio-ecological model: the proposed fundamental public health framework for Philadelphia s MHFA initiative. The proposed MHFA Strategic Plan takes different environments, strategies, and components into consideration, with the intention that MHFA will result in a unique comprehensive, city wide initiative. MHFA will be targeting two groups: employerdriven and community-driven groups. These two groups will each be offered one of the three available modules: Public Safety, Adult Community, and/or Youth. The outreach strategies and sustainability of goals and objectives will vary for both groups. The employer-driven group will have additional variations, depending on whether the funding sources are public or private. There are eight logistic/priority areas that have been identified and developed to ensure that the proposed MHFA plan will be implementable. These areas directly impact each other, the sectors of the population being trained and all interaction strategies: Figure 2. Logistical Priority Areas Impacting Philadelphia s MHFA Initiative. 3
City of Philadelphia Department of Behavioral Health and Intellectual disability Services In partnership with The Thomas Scattergood Behavioral Health Foundation Proposed Mental Health First Aid Strategic Plan Tips For Getting Started Since January 2012 Philadelphia has taken a public health approach to organizing and implementing MHFA. Below are key factors and lessons learned to consider when developing, spreading and sustaining MHFA across a large city, like Philadelphia. Marketing and Technology o Have a large scale community-wide kickoff event to raise awareness and to build excitement and interest. o Seek out opportunities to have media coverage and positive attention. o Create a brand for MHFA in your geographic region. o Create brochures, flyers, Aider Cards and other materials. o Create a one stop shop website, with all of the information and functions needed to register for a training, become an instructor and to get involved. Human Capacity (Building a sustainable infrastructure) o Appoint/Hire a dedicated and influential leader with a clear vision. o Create a centralized team that will be responsible for the overall development, implementation, and sustainability. o Seek ideas from outside the organization. Create a Stakeholder Advisory Board that will assist with planning, marketing and outreach. o Train a pool of volunteer and community partner MHFA Instructors Ensure that there are instructor agreements and clear standardized expectations in place. (i.e. training costs, certifications, scheduling, training, registering for and reporting of trainings.) 4
Instructor agreements should be tailored for all types of instructors, including: internal, volunteer, community partners, etc. o Ie: internal instructors will need to work out training schedule with supervisor and discuss any opportunities for a flexible schedule/comp time. Offer professional development opportunities for instructors, as well as incentives and stipends. Develop a policy on engaging and maintaining instructors. o Hire fulltime instructors to conduct trainings and support/mentor community partners and volunteer instructors. o Create strategic partnerships with Memorandum Of Understanding or Agreements Examples of Philadelphia s MHFA Partnerships: American Red Cross o Plan to offer MHFA two times a month at the Red Cross. The hope is to provide MHFA in conjunction with Citizen CPR. These sessions will be open to all Philadelphians. o Include MHFA in existing curriculums for volunteers, staff and contracted agencies. School District of Philadelphia o Will train central office staff as instructors to train Teachers, Principals, Counselors, and Security Guards. National Constitution Center o Train their staff and the organizations affiliated with the Mall Partnership o Will offer quarterly trainings Community College of Philadelphia o To offer 1 training a month to the public, targeting CCP faculty and students. And many Grass Roots and Faith-based organizations that are part of the fabric of the communities in which they 5
reside. These organizations will also offer trainings to the public. Curriculum and Supplies o MHFA has the potential for great impact that will be a cost saver to the system. o Invest in the Training of Instructors and in the training supplies (manuals 15.00 pp). o Ensure that there is a process in place to meet the needs of the community instructors and to deliver the manuals to them. Sustainable Funding o Seek out grant opportunities, foundations and create strategic partnerships. o Having clear outcomes and data that MHFA is impacting the city as hoped, will be the best seller for long term investments. Evaluation o In Partnership with Drexel School of Public Health o To assess the impact of MHFA in the work, community and personal lives of Aiders including: Success referring friends, family, colleagues and others who experience a behavioral health challenge to the appropriate resources/services/behavioral health professionals. Increased knowledge, awareness, literacy and ability. Increased levels of self-confidence and perceived self-competence (self-efficacy) when responding to behavioral challenges and emergencies. Decreased stigma (experience of greater inclusion). More positive personal attitudes towards behavioral health conditions and treatments. Outreach Strategy o Seek Support from city officials (Mayor, Deputy Mayors and Commissioners). Align initiative with City Government goals and vision. Offer to train city employees. 6
Request a training plan from all City Commissioners (offer to help) o Create an Outreach Plan: clarify target audience and utilize natural connections. o Have staff dedicated to outreaching to targeted populations. o Seek partnerships outside of the behavioral health field (American Red Cross, Universities/Colleges, National Constitution Center, etc). These partners have a very large constituency base. Create opportunities to discuss partnership options that will be mutually beneficial. Draft an MOU or signed agreement that spells out expectations of all parties. For more information on the Philadelphia MHFA and other public health initiatives please visit the DBHIDS Public Health website: www.healthymindsphilly.org. For more information on the strategic plan, implementation status or opportunities to partner and share ideas, please contact Jennifer Sears, MHFA Director. Phone: 215 413 8591 Email: Jennifer.a.sears@phila.gov. 7