Mental Health Connections at APS Pilot Project: February 6 – June 30, 2012

1. Mental Health Connections at APSPilot Project: February 6 – June 30, 2012 Presentation to Mental Health Board January 14, 2013 Eva Lomeli, LCSW

2. Collaboration between Department of Mental Health and Department of Social Services at APS • Referral Process: APS • *Multiple consults • Linkage for Clients already in the system

3. 29 Clients Received Interventions • Some engagement efforts • Others regular contacts • And crisis interventions. • Some Clients had more than 15 face to face contacts and countless collateral contacts.

4. 29 Clients Received Interventions 8 Clients with SMI: • 5 with Bipolar I with Psychosis • 1 Anxiety DO and Hoarding • 1 Anxiety DO, Dependent Personality DO and to r/o Developmental delay • 1 diagnosed with Schizophrenia 7 OA caregivers living with Individuals with SMI who were refusing M.H. Treatment • 1 Care recipient with late Onset Psychosis • 1 OA family member caregiver with Bipolar II and caregiver burnout • 5 Care recipients with Bipolar • I DO with paranoia and psychosis or Schizoaffective Bipolar Type 3 Individuals in their 60’s with late onset Psychosis • All three educated professionals with long work history and no history of Mental Illness. All lacked insight about their psychosis and refused mental health treatment. • Theme: Electromagnetic fields and biosynthetic engineering

5. 29 Clients Received Interventions(continue) • 5 Clients with Dementia based Paranoia or psychosis: • 2 Clients with severe Axis II Borderline Personality Disorder • 2 Clients with housing and financial stressors • 1 Client with APS financial abuse • 1 Client with severe life losses related to medical condition

6. Client demographics: Insurance type: • 8 Medical • 7 Medicare only • 10 Kaiser or HMO • 1 Private pay • 1 uninsured • 2 unknown Housing: • 14 Home owners • 11 Renters • 3 in subsidized housing • 1 Homeless • 6 Clients at risk of losing, or lost housing: • 3 due to SMI, • 1 due to Dementia, • 1 due to financial abuse, • 1 due to financial stressors • (Cal fresh access barrier for SSI recipients) Age • 4 Clients under 50 • 8 Clients in their 60’s • 7 Clients in their 70’s • 8 Clients in their 80’s • 2 Clients in their 90’s Language: • 28 Primarily English speaking Clients Ethnicity: • 20 Caucasian Clients • 5 Hispanic Clients • 2 Middle Eastern Clients • 1 African American Client • 1 Greek Client

7. Treatment barriers and challenges • Clients with SMI refusing treatment: • Stigma about mental illness • Client’s right to self determination • Possible liability issues: Providing Crisis Intervention to Ct’s who are refusing services but need them • Medicare only Client’s and lack of access to needed resources: • 81 yo female Bed bound. No access to IHSS, as a result, with abusive caregiver. • 70 yo male legally blind and with hoarding problem. No access to IHSS • 83 yo female completely isolated with deteriorating health with no access to On Lok services. Also evicted due raise in housing cost. 400 sq ft studio rent $1,159.00, SDI income $1,158.00 mo.

8. Recommendations • Expand services to this underserved, unreached Client population • Create a service team or have APS M.H. provider working out of a service team