 Revised: September 7, 2016 QQQQ 912A
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Everyone that has a mentally ill loved one that they have responsibility for should have their “Crisis Pac” printed and multiple copies ready at all times.
Later in the program the “Crisis Pac”
Will be described in detail.
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to contra costa’s
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4

The Crash Course
1. An Orientation to mental illness and the resources to manage a psychiatric case.
2. An introduction to the mental health programs and facilities in Contra Costa County.
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Mental Health Advocacy
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Education Support Advocacy
6
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Fact: No one ever joined NAMI that did not have a loved one that has a mental illness.
When you talk with a member that has been working with their love one’s case for awhile, you can see that they have acquired a wealth of information.
Information acquired by making mistakes and taking time.
The School of Hard Knocks has a very high tuition!
***********************************
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Four Sponsors
NAMI Contra Costa
September 7, 2016 QQQQ142P

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• First offered February 3, 2016
• Will be offered EVERY Wednesday of the year without exception.
• A 90 minute orientation to the mental health field
• You will be given printouts to take home that will give all the details, addresses phone numbers, etc.
• You can access the entire presentation on namicontracosta.org for review in the quiet of your own home.
9

The Crash Course:
Was created with the backing of the four sponsors by:
The Committee of 10
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Chair: David Kahler
Robert Thigpen
Peggy Harris
Lela Clark
Greg Beckner
Sharon Madison
Mark Cohen
Connie Steers
Peggy Luna
Sue Vanlandingham 10

Robert Thigpen
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Workgroup Partners
& Volunteers
Lela Clark
Dave Kahler & Peggy Harris
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Greg Beckner
Charles & Sharon Madison
11

Also One of the Principle Authors
Kimberly Krisch
George & Cynthia
Miller Wellness Center – Behavioral Health
Community Support Worker
Martinez, CA
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Where would you get the many case mangers that are so badly needed?
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Our Paramount Goal
Is to get one of the family members
To become

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The Family Case Manager
Would use the
Survival Guide’s five Points
The five points are:
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The Third Point Is
The
“One Page Summary”
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Release of Confidentiality
Authorization to Disclose Information
HIPAA Laws Protect Patients’ Privacy
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• Have your Loved One / Family Member sign
Consent Form when he/she is doing well
The psychiatrist or facility starting with
The One Page Summary.
• Sign a Form for each Healthcare Provider
• Psychiatrist
• Therapist
• Primary Care Physician (PCP)
• Sign Forms Annually
22
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1. Oversized envelop
2. File Jacket
3. One Page Summary
4. One paragraph cover letter
5. And any other documentation
Instructions: Seek out the decision maker in the
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Make multiple copies!

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You will have:
1.
2.
3.
Slide Printout
Information
Package
Slides on the
NAMI Website
27

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“here complete”
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Contra Costa Regional Medical Center- The County Hospital

Hospital
John Muir Behavioral Health-Concord
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Hope
House

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Being the Family Case Manager
You May Encounter . . .









The 911 Dispatcher
The Police
Martinez Detention Facility
Psychiatric Emergency Services (PES)
Miller Wellness Center
The Acute Care Ward-Out Patient Programs- AOD – Homeless
State Hospitals (Atascadero-Napa State Hospital)
Sub Acute facilities (Crestwood-Anka)
Criminal Justice System(DA- Public Defender-Probation-Jail)
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1.
ADD 1
3.
2.
Peace Officers
Police
Sheriffs
35

When an Incident
Occurs and 911 is called:
If the Incident involves
The breaking of a law,
The subject would be taken to the Martinez Detention
Facility (Jail)
If the Officer sees that the subject meets the LPS
Criteria: Danger to Self or
Others, the officer would call an ambulance and send the subject to the PES
The Police Officer
Has three choices
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When the patient does not meet thecriteria
But has a substance use related issue, refer to AOD 1-800-846 1652
If the decision is neither of the above, the subject would be free to go. The
Family Case Manager would have a strategy for that.
36
Here is where the WRITTEN
Strategy
Really Comes
In!

When you have done a 5150
And your loved one is being taken to PES
Psychiatric Emergency Services
E mail your One Page Summary
E mail address: crisisunit.com
Then call them and ask that they pull up the e mail and give it to the appropriate
Person. Tell the staff person the exact time the e mail was sent and what is on the
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Subject line!!
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:
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PES Discharge Form
10 Pages of information
Imperative to save!
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An enlarged view.
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The CCU – IMCU Waiting Room
• Has Restroom
• Water Fountain
• Pay Telephone
• House Phones
• TV Set
Problem: You can be forgotten there.
You are better off waiting on the “Bench”
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* M-Module is where persons with physical and/or mental health disabilities are held .
COULD Lead to 5250 Hold
-
* Lanterman
Petris
Short (LPS)
Patient NO LONGER Meets
5150 CRITERIA
Patient Released
5150 HOLD Lifted
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Adult Mental Health Service Map
Central County
Civil Court - Assisted Outpatient Tx IV
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The Los Angeles
County Jail is the
LARGEST
Mental health facility in the world
The Martinez Jail
The Martinez jail is the largest mental health facility in the county!
Trainin g 2015

Martinez Detention Facility
Opened in 1981
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The Jail is largest psychiatric facility in the county
Averages about around 200 mentally ill persons
“M” Module has 45 beds
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You will need to know how to work with:”
1. Public Defender
2. District Attorney
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3. The Courts
4. Probation Officer 49

is
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This is in your
Information packet
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Criminal Justice System I
Chief Public Defender
Robin Lipetzky robin.lipetzky@pd.cccounty.us
Contra Costa County
Office of the Public Defender
925-335 8000
Office of the Public Defender
800 Ferry Street
Martinez, CA 94553
Phone: (925) 335-8000
Fax: (925) 335-8010
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Criminal Justice System II
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Mark A. Peterson, District Attorney Greg Chiarella mpeterson@contracostada.org
Deputy District Attorney gchiarella@contracostada.org
Mental Health Litigation 900 Ward Street
.
4 th Floor
Martinez, CA 94553
Phone: 925-957-2200
Fax: (925) 646-4445
Hours
8:00 am - 5:00 pm
Monday - Friday
925-957 2200 53
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Potentially A Positive
Development
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925-313 4000
54
Todd Billeci
Chief Probation
Officer

1. 8 ½ x 11” Document suggesting psychiatric treatment program.
2. Subject will take Meds if prescribed
3. Will not stop taking without the express permission of the probation officer.
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
Psychiatric Emergency Services (PES)I
PES located at Contra Costa Regional Medical Center
 Next to CCRMC Medical Emergency Department
 NO Beds in PES – Patients Rest in Recliners
 Emergency Services for
.
P ersons Exhibiting Symptoms
. Due to a Severe Mental Illness
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 Patients are Discharged according to specific needs
Fax # 925-646 0112
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Psychiatric Emergency Services
 Clinical Team Determines weather Patient Meets 5150
Criteria
 Process Begins to Admit Patient to the Acute Care Facility
 If no beds available immediately – Patient is held at PES
** INSURANCE will determine which facility patient is admitted to
 Patient is Moved As soon as a Bed Becomes Available
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


Contra Costa Regional Medical Center – Psychiatric Unit - 4 C
John Muir Behavioral Health

HANDOUT
Summary of Lanterman-Petris Short ACT (LPS)
Summary o f
Lanterman-Petris Short ACT (LPS)
WIC 5150 – Up to 72-Hour Hold
WIC 5250 – Up to 14-Day Hold
WIC 5260 – Up to 30-Day Hold
Temporary Conservatorship (T-CON)
Permanent Conservatorship (Up to 1yr term)
.
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5150 Up To: 72 Hours
From the time the officer wrote the incident up.
5250 Up to 14 Days
5260 Up To 30 Days
T. Con. (Temporary Conservatorship)
Up to Six Months
Permanent Conservatorship
Up To One Year
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When a person as a result of a mental health disorder, is a danger to others or to himself or herself, or gravely disabled, a peace officer, . . . May upon probable cause take the person into custody for a period of up to 72 hours for assessment, evaluation and crisis intervention . . .
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This is an actual copy from the penal code.

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Strong Recommendation:
When doing a 5150, go directly to the
PES, ring that doorbell, and give them the “One Page summary. 62

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Tell them you will wait in case they have need for further information.
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This is the “Fishbowl” at PES
CIT Training
2015
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30
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CIT Training
2015
Nurse’s
Station
At PES
60% of the persons taken to the PES are out of there within 2 to 5 hours.
900 people a month pass through the
PES
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The Doctor arrives at a diagnosis based on subjective observations of the subject’s behavior.
And your reports.
The DSM may be used
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Example:
Lithium can do damage to the kidneys.
So there should be a periodic blood draw to determine the level in the blood. Many doctors, for their own reasons don’t call for the blood draw. The Family Case Manager should insist.
The desired level is approximately .09
If it is as low as .03 or lower, it is not likely to a therapeutic dose. If it is over .10 and up, it could be doing damage to the kidneys.
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Note:
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At this point it is important for you to understand the financial aspects of the system and how they drive decisions.
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Monthly Costs:
Acute Care Ward 4C: $44,880.
Sub Acute Facilities: 8,580. 19%
State Hospital: 15,210. 33%
Martinez Detention Facility 1,830 4%
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Total:
Behavioral Mental Health Budget
34 Million from MHSA
Plus money from Realignment and
Federal Reimbursement(Medi-Cal)
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A signed
Release of Confidentially
Is Required
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HEALTH INSURANCE PORTABILITY
AND ACCOUNTABILITY ACT OF 1996
If a caregiver or staffer can be shown to have violated the HPAA Law, they could be fined $10,000 and lose their job.
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Release of Confidentiality
Authorization to Disclose Information
HIPAA Laws Protect Patients’ Privacy
• Have your Loved One / Family Member sign
Consent Form when he/she is doing well
• Sign a Form for each Healthcare Provider
• Psychiatrist
• Therapist
• Primary Care Physician (PCP)
• Sign Forms Annually
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•
•
•
•
•
“I am not mentally ill”
“And I don’t appreciate you telling that I am”
“You are doing it because you don’t like me and never did”
“You have a hidden agenda”
“That’s why the CIA and the FBI are tapping my phone and tailing me all the time”
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A Classic Book.
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Pete Earley
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Available on You Tube
Dr. Amador has 10 films on
YouTube.com
You can watch FREE!
88

Think through just what your loved is thinking when his or her behavior is out of line.
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The capacity for participating in
Another’s feelings or
Ideas.
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1. Acute Care
2. Sub Acute Care
3. In-Patient Care
4. Out Patient Care 91

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• Acute Care-
• Ward 4C- at the CCRMC
• John Muir Concord-
• Napa State Hospital- Atascadero State
Hospital
• Sub Acute Care-
• Crisis Residential Facilities-
• Crestwood Healing Centers
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“Acute Care”
Psychiatric Facilities
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John Muir Behavioral Health
Concord Campus North
2740 Grant Street, CONCORD
Psychiatric Unit on 4C
Contra Costa Regional Medical Center
2500 Alhambra Ave., MARTINEZ
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INPATIENT TREATMENT
Acute Care Patients’ Rights
Patient is Admitted to Acute Care Psychiatric Facility - Meets 5150 Criteria (Grave Disability, DTS, DTO)
 Patient remains unstable and 72-Hour Hold is nearing end – Psychiatric Treatment Team
Files WIC 5250 14-Day Certification with Court
 Patient has right to challenge legitimacy of confinement or conditions of confinement by making request of any medical staff
 Possible violation of patient’s constitutional and statutory rights if denied
 Director of Acute Care Psychiatric Facility informs court of patient request of release
 Patients’ Rights Advocate available to support patient in completing forms, filing petition, supporting patient in any hearings
 Judicial Hearing takes place within 2 days of patient filing Writ of Habeas Corpus
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LPS Conservatorship – Guardianship I
 Process Starts in ACUTE CARE Facility with Psychiatrist
 Patient deemed “Gravely Disabled” –
 Patient considered highest level of vulnerability
 Patient is unwilling to accept psychiatric treatment voluntarily
 Referral made to CCBHS Public Guardian’s Office for
. Temporary Conservatorship (T-CON)
 Acute Care Facility Chief/Director signs
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 T-CON authorizes facility to make decisions for psychiatric care
. and treatment for 30-45 days (Can be up to 6 months)
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Conservatorship – Guardianship II
 Conservatorship / Guardian Program
 Agency conducts investigation, hearing is held
 Agency serves as Conservator for patient
 Agency makes decisions regarding psychiatric treatment/care
 Ensures “Conservatee’s” food, shelter and clothing needs are met


Conservatorship can last up to 1 year (1-year term)
Legal process must be initiated to get 2 nd year Conservatorship
 Family Member as Conservator involves Court Approval
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FAMILY ADVOCATE
Bob Thigpen
925-957 5139 robert.thigpen@hsd.cccounty.us,
Bob Thigpen is the County’s
Family Advocate. He is an employee of the county with a wealth of information.
You can talk with him at the
Crash Course which is every
Wednesday night
(925-676- 5771) crashcoursehelp2aol.com
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Bob’s Phone Number: 925 -957 5139
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Probate Conservatorship
NOT used in psychiatric Cases
LPS Conservatorship
Lanterman Petris Short
Authorizes psychiatric Care
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The Conservatorship /
Public Guardianship Program
Contra Costa Health Services
Conservatorship / Public Guardianship Office
1111 Ward Street
3 rd Floor
Martinez, CA 94553
Phone: (925) 646-2791
Fax: (925) 646-2853
Linda Arzio, Program Supervisor
* Located across from Martinez Detention Center - Jail
925-646 2791 101
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Inpatient Acute Care
Patient Challenges HOLD
Patient Meets with
Patients’ Rights Advocate
To File Petition
5250 Hold
“Gallinot Hearing”
Hearing Officer Determines
Need for Additional 14 Days
Hearing Officer
Denies 5250 HOLD
Patient is RELEASED
To the Community
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Hearing Officer
Grants 5250 HOLD
Patient Remains at
Acute Care Facility
4C or JMBH
104
Riese Hearing
Refusing
Medications
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www.telecarecorp.com
 Crisis Stabilization
 Where persons can stabilize mental
.
health symptoms and return to
.
their previous level of functioning
.
in the community.
 Referral of Medi-Cal CCHP patients from PES and Acute Care 4C to CCBHS
Transition Team
Crisis Residential Facility ( CRF ) I
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* Opened 2014
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Crisis Residential Facility ( CRF ) II
Telecare Corp.
Contra Costa Hope House
300 Ilene Street, MARTINEZ
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Anka Behavioral Health, Inc.
Nierika House
1959 Solano Way, CONCORD
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25 Allen Street
Martinez, CA 94553
Phone: (925) 313-7940
Fax : (925) 646-9997
Miller Wellness Center
Behavioral Health
Monday – Friday
* Doors lock at 8:15 p.m
.
Saturday
* Doors lock at 4:15 p.m
.
12:00 to 9:00 p.m.
8:00 a.m. to 5:00 p.m.
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Closed Sundays and all major holidays.
925-313 7940
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Miller Wellness Center –
Behavioral Health


A “ Walk-In” Transitional Outpatient Behavioral Health
Treatment Clinic “ Bridge Clinic ”
Persons not currently connected to mental health services



Medication refills for persons with appointments months out
Clients participating in other County Medi-Cal Treatment Programs
Short term services up to 60 days to address immediate issues
 Persons Meet with A Psychiatrist , LCSW, CSWs, and RN

Same day or short term appointments
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MILLER WELLNESS CENTER
Behavioral Health
Directly across the street from
Psychiatric Emergency
Services (PES)
Medical Emergency
Department (ED)
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Out-Patient Mental Health Treatment
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
Contra Costa County Behavorial Health Access Line
 Important: This is the door to County Service
 Access Line: (888) 678-7277
 Toll Free # - Link to Medi-Cal Mental Health Provider Network
 Collocated Behavioral Health Services AOD + MH + Homeless
 At each of the Clinics
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
Levels of Mental Health Treatment II
OUT-Patient Treatment –
For the Moderate to Severe patients.

Adult Mental Health Clinics – East, Central & West Co.
 Referrals from PES, Acute Care (4C), Mental Health Access Line,
Miller Wellness Center Behavioral Health
 Children & Adolescent Mental Health Clinics - East, Central & West Co.
 Referrals from PES, Acute Care (4C), Mental Health Access Line ,
Miller Wellness Center - Behavioral Health

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George & Cynthia Miller Wellness Center – Behavioral Health
 Walk-in Transitional Clinic for Adults, Children and Adolescents
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VOCATIONAL SERVICES 925-288 3973
115

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925-288 3973
118

Levels of Mental Health Treatment I
 OUT-Patient Treatment Medicare
 Partial Hospitalization Program (PHP)
 5-Day Intensive Therapeutic Services
 Psychiatric Evaluation / Assessment
 Individualized Treatment Plan
Program Objectives
 Prevent hospitalization
 In-patient hospitalization alternative
 Reduce symptoms and relapse
 Stabilize by reintegrating into the community
925-825 1793

Portia Bell Hume Behavioral Health
& Training Center
The Hume Center
1333 Willow Pass, CONCORD

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First Hope: Early Intervention
To prevent Psychosis
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An MHSA Funded Program
For ages 12 to 25 who are showing early signs of psychosis.
Must be a resident of Contra Costa County
Dr. Nancy Ebbert, Director
925-681 4450
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Toll Free
122 : 1-800-846 1652

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The Many
AOD Phone
Resources.
When you print this sheet out at home,
You will find the numbers legible.

Alcohol and Other Drug Services

Is the life of your loved one affected by the use of alcohol and other drugs?

Need to access outpatient counseling, residential treatment, detoxification, and support groups for men, women, families and youth.
 Addicted to prescription drugs?
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If you need to talk to a substance abuse counselor or need information about AOD
(Alcohol and Other Drugs)
Treatment Resources
Toll Free: 1-800-846 1652
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If your loved one is homeless or potentially homeless- You should call these numbers
Well in advance!

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The Nine Points
Started
February 1, 2016
This is the Front
Page of the NAMI
April Newsletter
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Mental Health Systems
Has been contracted with to manage the program.
For a Loved One to qualify
To be in the Laura’s Law program
There are nine points that will be considered.
They are shown on the front page of the April NAMI
Newsletter.
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The nine points the
Court will consider.
See the April, 2016
NAMI newsletter for more information.
131

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Mental Health
Systems, Inc.
925-483 2223
2280 Diamond Boulevard
Concord
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Criminal Justice System IV
 Behavioral Health Court (BHC)
 Clients Opt-Into Behavioral Health Court vs. serving jail or prison time
 2 year/4 Phase intensive clinical case management program (ACT Model)
 Treatment for chronic mental illness, substance abuse addiction & criminal behavior
 Clients remain on probation and receive caseworkers (hired by Sheriffs’ Department )
 BHC Clients receive coaching for:
 Mental illness symptom management
 Medication management

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Health management



Daily living skills
Problem solving
Accountability & responsibility
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Criminal Justice System V
 Behavioral Health Court (BHC)
 I ntensive clinical case management program
 Evidence Based Model – Launched in 2009
 20 to 25 Dual Diagnosis clients
 Clients transition to long term mental health treatment program post graduation
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Contra Costa County
Behavioral Health Court (BHC)
835 Castro Street
Martinez, CA 94553
Phone: (925) 646-1154
Fax: (925) 335-8010
E mail: mwilson@hsd.cccounty.us
Behavioral Health Court (BHC )
Martha “Marti” Wilson, PhD, Team Lead –
Forensic Mental Health (right ) with and Judge Mary O’Malley (Left)
137
925-646 1154

Suicide Prevention
 Facts About Mental Illness and Suicide
 According to NAMI National ( www.nami.org
)



American Foundation for Suicide Prevention (www.afsp.org)
Research Advocacy Education
It would be advisable to go in person to the
Contra Costa Crisis Center and talk with them about suicide.
They are located in the Shadelands Office Park in Walnut
Creek
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
Suicide Prevention II
Be Alert to Warning Signs – Notify a Mental Health Provider





Suicidal ideation can begin with seemingly harmless thoughts like a person saying, “I wish I wasn’t here.”
Increased alcohol and drug use
Aggressive behavior
Social withdrawal from friends, family and the community
Dramatic mood swings
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Suicide Prevention III
If you or someone you know is in an emergency, call . . .
911
Contra Costa Crisis Center – Suicide Hotline
(800) 833-2900
National Suicide Prevention Lifeline
(800) 273-8255
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“Suicide is a permanent solution . .
To a temporary problem.”
John Bateson
Author of:
The Final Leap
141

Knowing YOUR Insurance is
!
 DO YOU KNOW?
If your Loved One is . . .
 Transported to PES on a 5150 Hold, who pays for the ambulance?
 Transferred from PES to an Acute Care psychiatric hospital and has
.
private insurance, how much will services and transportation cost?
 Discharged from an Acute Care hospital, admitted to a Sub-Acute mental
.
program or Crisis Residential Facility (CRF), will it be in Contra Costa?
 Will hospital staff contact me when he/she is discharged?
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 Not stable enough to return to the community, but not appropriate to
.
remain in PES or in Acute Care – can he/she go to a CRF?
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ADVOCACY FOR THE FAMILY
Contra Costa County
Central County & West County Offices
MISSION Susan Kim, Executive Director
N
N
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ADVOCACY For The Family II
 Family Justice Center - Concord - “ One Stop Resource Center”
 Comprehensive and integrated wrap-around services in the pursuit of justice, hope, and healing
 For victims of domestic violence, sexual assault, child abuse, elder abuse, and human trafficking
 30+ agencies provide direct support & assistance to survivors of interpersonal and family violence
 Reduce trauma for victims having to retell story multiple times, file documents right away, to close cases quickly
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Advocacy - Veterans
Veterans Support Services – Benefit Support
U.S. Department of Veterans Affairs
Department of Defense
California Department of Veterans Affairs
Contra Costa County
Veterans Service Office
10 Douglas Drive, Suite # 100
Martinez, CA 94553
 Comprehensive benefit counseling
 Claim development, preparation & submission
 Case Management
 Networking with federal, state and local agencies
Phone: (925) 313-1481
Fax: (925) 313-1490
Nathan D. Johnson
Information & Referrals
Crisis Intervention Social Security
Public Assistance Homeless Services
145 925-313 1481 Nathan Johnson Crash Course

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Advocacy – Clubhouse Members
 Putnam Clubhouse
 Mental Health Social & Vocational Rehabilitation Program
 Program participants called “members” share ownership and responsibility for the success of the organization – called “The Clubhouse.”
Putnam Clubhouse
3024 Willow Pass Road
Suite 203
Concord, CA 94519
Phone: (925) 691-4276
Fax: (925) 691-5643
Tamara Hunter
 Recovery from serious mental illness is achieved at the
Clubhouse through restorative work and work-mediated relationships with fellow members and a small staff.
 Members spend the day in an accepting environment, performing valuable work to support running the organization, enjoy opportunities to socialize, learn and grow through wellness activities, expressive arts, education and paid employment assignments.
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Clubhouse
3024 Willow Pass Road
Greg
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Recovery Innovations
International
925-363 7290
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Advocacy – Mental Health Consumer
 Recovery Innovations International
 Mental Health Wellness & Recovery Program
 Program participants or “Citizens” embark or expand
. on their mental health recovery journeys in Wellness City communities
Recovery Innovations
2975 Treat Blvd., Suite C-8
Concord, CA 94518
Phone: (925) 363-7290
Fax: (925) 691-5643
 Those new to the journey learn to identify personal strengths and challenges
 Wellness coaches work alongside supporting citizens to develop personalized plans, learn new skills and set goals .
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Rainbow Community Center
 RCC is located at 2118 Willow Pass Road in
Concord CA
 Our founders wanted to develop programs to reduce isolation of LGBTQ people; provide a space for community development; and serve as an alternative to gay bars
 RCC is the only community center serving the
Lesbian, Gay, Bisexual, Transgender and Queer
(LGBTQ) community in Contra Costa County

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NAMI Monthly Newsletter
Distributed
The Early Part of Each Month
Mailed FREE
To Paid Members
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At the top of Each Newsletter
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Pleasant Hill
The Family to
Family classes
Started in
Lafayette
And Brentwood
In September 2016
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





NAMI Website www.namicontracosta.org
NAMI Monthly Newsletter
Top NAMI Affiliate Newsletter in CA
NAMI 24 x7 Phone: (925) 465-3864
Crisis Intervention Training (NAMI helps Fund)
NAMI In Our Own Voice – Speakers Bureau
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 NAMI Contra Costa – Support Groups


NAMI Family Member
–
Third Monday Monthly Support Group


John Muir Medical Center – Walnut Creek – 7:00 – 9:00 p.m
.
Facilitators: Sharon Madison & Robert Thigpen , CCC Family Advocate
NAMI Writer’s Group
 NAMI West County Support Group
 Bipolar Chill Community Support Groups
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 All are on page 2 of every NAMI Newsletter
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Page 2:
NAMI
Newsletter
159
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You will ALWAYS
Have the information
You need by simply
E Mailing:
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All this is so you won’t feel lost!
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Keep in Mind . . .
The people that have
Need this Orientation!
Tell them about it!
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