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There's a shortage of youth mental health services in East Palo Alto. A new community collaborative hopes to change that.

Children's Health Council leading effort to fill gaps in care

A group of local nonprofits, health care providers and schools are coming together to address what one participant called a "big problem" in East Palo Alto and Belle Haven: the lack of mental health services for children and teens.

Led by the Palo Alto-based Children's Health Council, the collaborative plans to apply for funding to specifically target a gap in services for youth with mild to moderate mental health needs, such as depression, anxiety and environmental stressors such as homelessness and poverty. The group includes the Ravenswood City School District (and its education foundation), the Boys & Girls Clubs of the Peninsula, Counseling And Support Services for Youth (CASSY), Community Collaboration for Children's Success initiative, One East Palo Alto, Ravenswood Family Health Center, San Mateo County Behavioral Health and Recovery Services, Stanford Children's Health and The Primary School.

"As community providers who have worked in community for a long time, we hope to disrupt the mental health system of care for kids that's currently not meeting a need," said Ramsey Khasho, chief clinical officer for Children's Health Council. "I don't think ever before in the history of the community have these longstanding partners come together in this way to really shake up the system and say, 'This must happen and we're going to work together to make it happen.'"

Over the last few years of working in East Palo Alto and Belle Haven, Children's Health Council staff started noticing that there were few local resources to which they could refer families for additional support, Khasho said, or there would be long wait times for appointments. Other entities that work on mental health in East Palo Alto and east Menlo Park, including the Ravenswood Health Center and San Mateo County, made the same observation.

Through a grant from the Sand Hill Foundation, Children's Health Council conducted a needs assessment to determine gaps in care in East Palo Alto and families' perceptions of mental health. They interviewed mental health providers, families, young adults and kids.

One of two "core" findings, Khasho said, was that there are not enough clinicians in the community to provide ongoing treatment to young people with mild to moderate mental health challenges. Children and teens are often referred outside of East Palo Alto for that care, "which is very upsetting to us," Khasho said. There are also few options for family therapy in East Palo Alto, they found. The shortage in providers has led to long wait times, according to the Children's Health Council.

The East Palo Alto Community Counseling Center on University Avenue, a San Mateo County-run clinic, is limited to severe cases. HealthRight 360, also on University Avenue, provides individual and group therapy, substance abuse treatment and crisis intervention services to underserved youth but only assists children over 12 years old.

Youth in East Palo Alto and east Menlo Park are struggling with depression and anxiety as well as issues such as vaping, homelessness and food insecurity, Khasho said.

The second finding was that many families are reluctant or unable to seek mental health support, whether it's due to cultural stigma, affordability or logistical issues such as traffic or child care. For families "struggling to get their basic needs met" such as housing, food or work, mental health is often not a priority, the needs assessment found. Other barriers include language, parents not knowing where to go for help and inconvenient appointment times.

In response, Khasho said the collaborative hopes to secure funding to train non-professionals such as parents, grandparents, pastors and community leaders to provide mental health support to families who are unlikely to seek care. The training would be akin to Mental Health First Aid, a national program that teaches people how to identify, understand and respond to signs of mental illnesses and substance use disorders, Khasho said.

The collaborative also hopes to increase access by having therapists go into homes or using teletherapy and providing free transportation to appointments.

And while every Ravenswood City School District campus now has a counselor, the collaborative also hopes to increase the number of therapists at the schools providing individual, family and group therapy — and to do so year-round. Therapists could also work with after-school programs and support parent education programs.

As a collaborative, the organizations aim to "be better able to ensure that mental health provider capacity is allocated efficiently and effectively, proper referrals are made, services are coordinated, and navigation is seamless," reads a memorandum of understanding approved by the Ravenswood school board on Thursday. "In addition, there is the potential for valuable resources — ranging from local knowledge and community relationships to office space and training materials — to be shared across entities."

"A lot of us are seeing the same issues," said Alison Kjeldgaard, manager of communications and external relations for The Primary School. "Being able to share knowledge and potentially share funding that could come in from a new grant could be a really big win for the community."

Next, the group will have to secure funding to execute on its ambitious goals. They plan to apply for grants from local foundations that already support the East Palo Alto and east Menlo Park communities. They're also working with the California Children's Trust, a statewide initiative seeking to improve youth emotional well-being through policy and systems reform, on identifying alternative funding sources for their work, Khasho said.

"We want it to be sustainable and not foundation-dependent," he said.

Long-term, if the collaborative is successful, it could offer a model that could be replicated in other similar communities, Khasho said.

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