Santa Clara County commits $600K to youth mental-health center

Stanford leads fundraising efforts for new clinic

The Santa Clara County Board of Supervisors unanimously approved on Tuesday $600,000 over three years to support two "critical" staff positions at a yet-to-open youth mental-health center currently being developed by Stanford Medicine's Center for Youth Mental Health and Wellbeing.

The funding, which is contingent on the opening of at least one center within Santa Clara County, is an "important first step" toward providing critical early intervention and support services for youth and adolescents in the area, said Steven Adelsheim, director of the Center for Youth Mental Health and Wellbeing.

Adelsheim has been spearheading a growing, yearslong effort to open a clinic based on a national youth mental-health initiative in Australia called headspace, which provides early-intervention services — from physical and mental health to alcohol and other drugs, work and academic issues — to 12- to 25-year-olds at either a low cost or for free. The clinics are also founded upon a "by youth, for youth" sentiment: They are designed and operated with strong youth input, including from established youth advisory boards.

The goal of the headspace model, which was created and funded by the Australian government in 2006, is to increase young people's access to mental-health support by providing a physical, stand-alone space they feel comfortable going to for help with anything, from a bad breakup to diagnosed depression. headspace also provides confidential online and telephone support services, as well as school-based programs and training for health professionals and research efforts.

The "essence" of the model is getting young people early help for mild to moderate mental-health issues, but strong relationships with outside providers also ensure that anyone in need of more serious psychiatric support or intervention receives it, according to a description of the initiative on the Center for Youth Mental Health and Wellbeing website.

"Given the fact we have quite a bit of data that says early identification makes a huge difference for young people — whether we're talking about early treatment for anxiety or depression or treatment for psychosis, it's really clear that early treatment is important," Adelsheim said in an interview Thursday. "This is really a first step in developing that first public mental-health part of the process that we really don't have, not only in our system for this county but I think really in the United States."

The Board of Supervisors voted unanimously to provide $200,000 annually to fund two positions at the clinic: a youth support specialist and supported employment and education specialist. A total of $170,000 will be allocated each year to cover their salaries and benefits. The remaining $30,000 will support "youth-led marketing" efforts "to combat stigma and reach youth in need," reads a report from Supervisor Joe Simitian, who brought the funding recommendation.

The youth support specialist will work with a youth advisory board to develop the initial messaging and marketing campaign for headspace, run focus groups to solicit youth and family input and develop a peer-support model, according to Simitian's report. The supported employment and education specialist will serve as a conduit between headspace and schools and help young people coordinate their treatment plans with their educational and employment goals.

Funding these two positions is particularly critical because unlike a therapist or primary care provider position, they are not reimbursable through Medicaid.

The positions "are in my view important — I dare say essential — to the success of the effort, yet they're the kinds of positions that might not ordinarily be funded by conventional insurance or even grantmakers," Simitian told the Weekly Thursday.

"In talking with Dr. Adelsheim, what excited me about the headspace model was that it really does seek to meet teens where they are, to engage them in a way typical service providers cannot," he said.

Simitian's recommendation notes that one in five adolescents has a diagnosable mental disorder, yet less than half of adolescents with these disorders received any kind of treatment in the last year, according to the U.S. Department of Health and Human Services' Office of Adolescent Health.

The same is true in Santa Clara County. Out of the county's 168,420 children between the ages of 11 and 17, only 8,122 youth ages 0 to 25 are using mental-health services in the county, according to a National Center for Children in Poverty report.

Simitian said headspace's early-intervention model will make a difference in a county where the system is currently "geared toward crisis management."

"Time after time, the saddest part of the story is that a kid didn't reach out earlier, didn't have the opportunity to get help when it might have mattered and really made a difference or saved a life. Again, one of the appeals of headspace is that it is designed to engage youngsters who are struggling at an earlier time, before the crisis arrives on their doorstep," Simitian said.

Several local community organizations that provide youth mental-health services expressed support for the headspace funding in letters sent to the Board of Supervisors, including Momentum for Mental Health, Counseling and Support Services for Youth (CASSY), Asian Americans for Community Involvement (AACI) and EMQ FamiliesFirst.

"The headspace model provides that first step in a public mental health system to allow young people to come in on their own to obtain mental health support for mild to moderate mental health issues in a site that also integrates primary care, early addiction intervention, and school/employment support," wrote David Mineta, CEO of Momentum for Mental Health.

"The non-clinical appearance and nature of these spaces are critical to providing a safe, welcoming, and easily accessible space for these youth to share their issues with supportive staff," wrote AACI Executive Vice President Sarita Kohli. "Often times, it is the availability of someone to listen and support them that makes all the difference in saving a life."

Stanford hopes the new center (or centers) would provide services to 1,000 adolescents and young adults annually over the first few years, according to Simitian.

Meanwhile, both public and private fundraising efforts continue. The Center for Youth Mental Health and Wellbeing has applied for Mental Health Services Act (MHSA) Innovation funds through the county, Adelsheim said. The funds support programs that have the "potential to transform the behavioral health system" with "new approaches that can inform current and future practices," a county description reads.

The Lucile Packard Foundation for Children's Health, Lucile Packard Children's Hospital Stanford and Stanford Medicine's Department of Psychiatry and Behavioral Sciences have all committed to contributing staff time and resources for program development and fundraising, according to Vicki Harrison, manager of community partnership for the Center for Youth Mental Health and Wellbeing.

Stanford Medicine also previously received funding from the Robert Wood Johnson Foundation to conduct a feasibility study of opening a headspace-like center in the U.S.

Simitian wrote in his report that Stanford plans to open one or two pilot centers over the course of the coming year. Adelsheim said this timeline will depend on fundraising efforts.

"Our hope is this initial support from the county and the board will help move that much more quickly," he said.

"We're hopeful we can be an active partner with both the county and the other community mental-health partners in building this whole continuum of mental-health support for our young people, which is just so badly needed," he added.

Process for inpatient unit also moves forward

Running parallel to the headspace effort is one to open a youth inpatient psychiatric unit in Santa Clara County. The county has not had such a unit for more than 20 years, so an average of 20 adolescents each day are receiving inpatient psychiatric care outside of the county, from San Mateo to Sacramento, according to Simitian.

Simitian brought to the Board of Supervisors last May a request to have staff analyze the feasibility of opening such a unit within the county's borders, kickstarting a serious effort to close what many parents and youth have described as a serious gap in local mental-health services.

In April, the county issued a Request for Information (RFI) to solicit ideas and suggestions for a local child and adolescent inpatient unit, then a more full Request for Proposal (RFP). Palo Alto's Lucile Packard Children's Hospital, Mountain View's El Camino Hospital and Kaiser Permanente submitted a joint response to the earlier Request for Information.

The county also received RFI responses from Fremont Hospital, which currently operates a youth inpatient facility but would open a new additional unit in Santa Clara County; EMQ Families First, a statewide nonprofit that offers mobile crisis services in Santa Clara County and also operates a small short-term crisis stabilization unit in Campbell for suicidal children and teens; and Bay Area Children's Association (BACA), a San Jose nonprofit that provides child and adolescent psychiatric services. BACA jointly responded to the RFI with PrairieCare Medical Group, a Minnesota-based psychiatric healthcare system.

Final responses to the Request for Proposal are due Wednesday, June 22. The county will review them in July, Simitian said.


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19 people like this
Posted by Sarah1000
a resident of Los Altos
on Jun 16, 2016 at 10:04 pm

I applaud Supervisor Simitian, the entire Board of Supervisors, and Dr. Adelsheim for coming together to bring this proactive treatment model to the youth of Santa Clara County. And thanks to the other providers who are supporting this effort. It's wonderful to see everyone uniting to improve our community. By providing early indentification and treatment for our teens and young adults who have illnesses of the mind, we will have fewer seriously ill individuals on our streets, in our justice system and on our train tracks.

16 people like this
Posted by good start
a resident of Barron Park
on Jun 16, 2016 at 10:10 pm

I think this is an excellent step in the right direction. However, it seems that if they can find tens of millions of dollars to keep a rundown trailer park, there should be more funds available to support vulnerable youths in the community.

12 people like this
Posted by Sense
a resident of Another Palo Alto neighborhood
on Jun 17, 2016 at 12:51 am

@good start,
This is indeed good news.

And you make a good point about general priorities, but you have the wrong impression about the funding sources. Buena Vista funds come from money paid by developers to an affordable housing fund, and the money cannot be used for anything but affordable housing. In that case, it makes far more sense to help existing long-time Palo Altans to keep their homes.

I agree with you that we should be spendng more on vulnerable youth. One thing the community can do - you personally can do to help - is put real energy into ensuring the money we already spend is put to good use. The school district is as major an economic concern as the City, but with arguably far fewer checks and balances. We just had an election for a tax in which we were promised that the money was in part necessary for children's mental health services, but that appears not to be how it will be spent. All of the many administrators will get big raises. When the community fails to be proactive in ensuring the funds are spent to benefit the children in the most effective way possible, it's no better than failing to fund the schools.

13 people like this
Posted by Donna
a resident of Los Altos
on Jun 17, 2016 at 7:54 am

Thank you Joe Simitian and the SCC Board of Supervisors for recognizing the need to support our local adolescents and provide funding to this all important step Dr. Adelsheim is taking on with Headspace. Also, thank you to paloaltoonline for keeping the dialogue open to your readers about the ongoing process to provide acute care to our local youth. People continue to be surprised that no youth inpatient psychiatric unit exists in Santa Clara County where suicide and mental health crises continue to be an issue. Thank you Dr. Adelsheim on the work you have done to bring Headspace to our community.

7 people like this
Posted by Bette
a resident of Los Altos
on Jun 17, 2016 at 10:13 am

Fantastic news. Thanks to everyone involved. It's all small steps, but moving in a good direction. Let's keep on keeping on.

7 people like this
Posted by Dr. Philippe Rey
a resident of Old Palo Alto
on Jun 17, 2016 at 10:33 am

ACS applauds the decision for this new funding and we are excited for the community! It is important to prioritize more resources for youth mental health, especially during these critical times in our community and the nation. The ability to serve more adolescents in crisis will help towards reducing the stigma of mental health issues locally.

Thank you to Supervisor Simitian and Dr. Adelsheim for their unwavering support of youth and mental health. ACS is proud to be partners with such dedicated local leaders!

In Community,
Dr. Philippe Rey
Executive Director, Adolescent Counseling Services

9 people like this
Posted by Phillip
a resident of Gunn High School
on Jun 17, 2016 at 4:41 pm

Thank you Supervisor Simitian and all of you on the Board for your commitment to supporting the mental health needs of our youth. Mental health service options are woefully inadequate; it is phenomenal that you have recognized this and are working to rectify the situation.

8 people like this
Posted by Courtney
a resident of Midtown
on Jun 18, 2016 at 6:15 pm

This is incredible news! Thank you Sarah Gentile for your persistent efforts at this much, much needed place for young kids who suffer with mental illness.

5 people like this
Posted by Linda
a resident of Mountain View
on Jun 20, 2016 at 8:23 am

Thanks Joe for your continued efforts for the physical and mental well being of our youth. Your efforts go way back to when you were on the School Board. You continue to be one of the biggest advocates for our youth, a special thank you. Dr Adelsheim although new to our community your clear commitment for the physical and mental health well being of our youth is clear. Thank you for spearheading getting beds in Santa Clara County for our youth. This will enable our youth to be close to home so they can have the needed support of family and friends while going through a very difficult time.
After visiting a Headspace Clinic in Australia the idea of primary care and mental health services in one space seems to have decreased the stigma to reach out for help for both the youth and their family. The fact that the youth have some control over the space, programs needed, work programs and social events undoubtedly leads to their feelings of having an accessible and safe place to go to. Thanks again for all of your efforts. We as a community need to continue our support to make sure Headspace becomes a reality! linda

Like this comment
Posted by Caroline V.
a resident of Portola Valley
on Jun 25, 2016 at 2:02 pm

I applaud the efforts of Stanford, Dr. Adelsheim, and the Santa Clara Board of Supervisors for allocating funding for a new approach to address the increasing rate of mental health issues. However, again none of the reports listed in this article address the causes of our mental health crisis.
The Mental Health Services Act was implemented 2004 and according to the Department of Healthcare Services (DHCS MHSD) regulated pursuant the California Welfare and Institution Codes, see link below.  
Web Link
The Bronzan-McCorquodale Act was put in place to organize and finance community mental health services. This act requires quality of services ((welfare code 5600.2 (f) and expects available funds (welfare code 5600.2 ).
This media report: Web Link as well as this government report Web Link confirm the innovative ways our administration and politicians are using to expand and fund our mental health industry, confirm its lucrative business, confirm the lack of transparency and accountability, and raise very important questions. Do we really have the funds? Can we afford more trial based efforts? Will government demand another tax increase? Or is it time we listen to the experts who advocate with no conflict of interest and/or no financial gain.
Despite the increased funding California’s education system remains at the bottom of all 50 states. Despite the increased funding California has increased rates of depression, suicidal ideation and suicides. Despite the increased spending the quality of our US healthcare has drastically diminished: Web Link
The American Academy of Pediatrics recommended to limit “screen time” for a variety of reasons: Web Link. The current administration controlling education decided to pursue “digital learning “, despite the warning of pediatricians and child development experts. The tech industry is now financing a large part of our public education and healthcare systems and seems to be benefitting from this lucrative business.
May I remind our politicians, the healthcare providers, and the administration controlling our healthcare and education systems that mental health services are well defined and regulated under the Welfare and Institutions codes section 5600-5623 and that these services were intended to prevent mental health disorders. I believe it is time we see data that confirms the effectiveness of our mental health services.

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