Tell us about Partnership

Engaging Family & Youth Tell Us About Partnership Annually, Family & Youth Roundtable of San Diego County (FYRT) is entrusted with preparing a report for our partners; San Diego County Behavioral Health Children Youth and Families Services and their contracted providers on how to best identify and engage families and youth, including transition age youth (14 to 21 years of age), to participate in program, evaluation, policy, service-level development, and enhancement activities. Each year FYRT host a survey for families and youth to assist in informing this report. The survey focus ranges from engagement to partnership and forms the content upon which the annual report and recommendations are based. In the past two years, FYRT has focused our surveys and resulting reports on: •Family and Youth-identified barriers to partnering with providers and/or agencies •Family/Youth identification of what a meaningful partnership is to those receiving services. The following report and recommendations are informed by results from this year’s survey Tell us about Partnership, which examines the perspectives of families and youth on partnership at the service level.Funded by: County of San Diego, HHSA Children, Youth and Families Behavioral Health Services Authored by: Family & Youth Roundtable July 2012 San Diego, CA 92101. Telephone: 619-546-5852

Engaging Family & Family Youth Professional Partnership (FYPP):Youth Is family, youth and professional partners working together, by sharing information, resources, and responsibilities. Partners are responsive to the needs, cultures, and success ofTell Us About Partnership each partner. A successful FYPP utilizes a multi-stakeholder approach, where there is genuine intent to achieve their common purpose.Foundation Engaging Family & YouthOver twelve years ago, the County of San Diego,under Children’s Mental Health leadership, began 1building a foundation to improve outcomes forchildren youth and families. This effort becameknown as the Children System of Care. Rooted in aChildren’s System of Care is a rich array ofcollaboration between publicly-funded agencies,community-based organizations/service providers,educational systems, and the family1 youth2 sector.The family youth sector, as it is known in SanDiego’s Children’s System of Care, plays a criticalrole in improving services for children and youth.One might say this sector is the ultimatestakeholder. The growth of a successful Children’sSystem of Care requires behavioral changes forsystems, programs, practices and the people thatmake up a system of care. These systematicbehavioral changes necessitate inclusion of fullpartnerships that have the following elements:trauma informed, has a gained understanding ofenvironmental burdens and is one that fullysupports the overall health and wellbeing of thosethey serve. A fundamental component of achievingthe vision of a Children’s Systems of Care is therobust participation by families and youth whopossess lived experience with or as a child/youththat has experienced behavioral, social, emotional,trauma and/or health issues; that inhibit one to livewell and thrive in their community. The success ofSystems of Care is reliant on family/youthpartnering with practitioners in their own care, and1 Family: Parent/Caregiver of a child/youth that is or has received servicesfrom a public child-family serving system.2 Youth: Person under age 26 that has or is receiving services from a publicchild-family serving system.PWS: 5.5 County of San Diego Behavioral Health Children, Youth and Families Services

Engaging Family & Youthin using their experiences to inform evaluations, programs, policies, service-level developments and enhancement activities. Nourishing family and youth participation requires a culture shift at the systems, agency and direct-service levels. This behavior change nurtures partnership and involvement. It is noteworthy that partnership among family, youth and practitioners is a core component of the most effective (evidence-based) family therapies and treatment models. The evolution of our local Children’s System of Care can be linked to significant behavioral shifts, including:  County of San Diego’s Board of Supervisors adoption of a innovative and comprehensive ten-year plan aimed at improving the health and overall well- being of County residents called the “Health Strategy Agenda: Building Better Health.” The County’s Health and Human Services Agency (HHSA), along with other County departments, has embarked on an ambitious mission to engage the County workforce and the community, encouraging, children, and youth and families participation in the county’s efforts to “build better health.”  Systemic changes are displayed by way of policies and the institutionalized approach to coordinating authentic family and youth involvement in Children Youth and Families Behavioral Health Administration, as well as trainings and coaching services offered by this administration for contracted providers to enhance their practice of Family Youth Professional Partnership.  Program behavioral changes are measured by the number of authentic Family /Youth Support Partners employed within an agency, as well as the level of influence these partners and the families and youth sector have on programs, policies and practices with in a providing agency.  Behavioral changes at the practice level are measured by the amount of evidence-based practices that require family/youth involvement, which can be incorporated into the array of services offered by an agency.  The level of involvement families and youth feel they have contributed to their and/or their child’s treatment can also be measured. Furthermore, an indicator of successful Family Youth Professional Partnership is the level to which families and youth feel entry into services and the services received have been welcoming and responsive to their needs, customs and norms. Family and youth involvement is integral to the vision and mission of Children Youth and Families Behavioral Health Services in San Diego County (CYFBHS). The County’s vision statement notes that “... We work with a broad constituency of stakeholders to build a community of families, neighbors, schools and child serving agencies, which fosters physically and mentally healthy children and adolescents, maximizes their potential in school and in the home, and prepares them to be productive and responsible adults.”2 Family & Youth Roundtable, 345 15th Street, San Diego, CA 92101. Telephone: 619-546-5852 www.fyrt.org

CYFBHS promotes this vision by advancing “...a rich array of services delivered Engaging Family & Youththrough an integrated, community-based, mental health System of Care that enableschildren and adolescents to achieve positive outcomes.” 3Positioning for Meaningful Family Youth Professional PartnershipFamily/youth are first and foremost involved with the service delivery system inorder to resolve issues in their own or their family’s lives. This means that theextent to which family/youth will be interested and able to participate in agencydevelopment and enhancement activities will naturally vary.Family and youth have a variety of treatment experiences, favorable andunfavorable, which they may or may not be comfortable sharing. Additionally, theirinterest in sharing their lived experiences will vary, based on a number of conditions,including:  The degree to which they perceive stigma associated with their status  The degree to which they perceive that their input is valued  Their ability to provide input without undue burdenAt the service level, administrators must create varied and meaningful opportunitiesfor family and youth to share their perspectives in ways that are respectful,supportive, and lead to clear and observable impacts. It is important to note thatinauthentic or token efforts to engage families and youth are not only weak in theirimpact, but may stifle future family and youth interest. A service system’s culturethat truly values and supports authentic family/youth participation is critical forengaging and sustaining robust family youth interest. The goal of this report andsubsequent recommendations are to promote the development of agency andservice system culture that supports participation by and partnership with familiesand youth in their own treatment services. Families and youth who are valued andknow they are part of solution to their and/or their child’s health, safety andwellbeing are more apt to embrace treatment and partner to achieve shared goals.At the individual client level, it is incumbent upon provider organizations to makeuse of intervention models and approaches that value and deliberately build uponindividual and family culture, norms, and strengths, while taking into considerationthe environmental circumstance of the family and their surrounding community. Inaddition, provider organizations need to ensure that all of their practitioners arewell trained in and routinely utilizing family/youth engagement and partnership-building skills. Finally, outreach and education efforts to inform family and youth ofthe importance of their participation in directing their own care are vital inestablishing positive participation, thereby advancing authentic Family YouthProfessional Partnership within an agency.PWS: 5.5 County of San Diego Behavioral Health Children, Youth and Families Services

Engaging Family & YouthRecommended Strategies: 1. Provider organizations maintain clear and concrete Family Youth Professional Partnership policies and procedures as a foundation for guiding all of their treatment activities. 2. Provider organizations ensure that all practitioners are fully trained in and are routinely utilizing strategies to partner with family and youth, in the context of the family’s culture, values and beliefs, to develop and provide treatment services. These strategies should be evident throughout all stages of the treatment process from triage and assessment, to service plan development, therapeutic intervention, discharge planning and termination of services. 3. A high-level agency administrator is responsible for overseeing and ensuring adherence to Family Youth Professional Partnership practice, policies and procedures. This champion is also actively directing agency-sponsored family/youth participation activities. For example: PAG meetings/actions. 4. Provider organizations develop and implement an array of strategies for soliciting and accepting involvement from family/youth (i.e. quarterly focus groups, online and hardcopy surveys, etc.). 5. An education and engagement campaign is developed, consisting of posters and brochures that invite family/youth to share their lived experiences. The campaign materials explain to family/youth why the act of sharing their experiences is relevant and valued, and how their experiences will be used. In addition, the campaign materials will explain a variety of ways in which family and youth can share their experiences including: a. Talking with the agency’s Family/Youth Partner b. Responding to agency-specific surveys or joining agency-specific focus groups. c. Responding to online surveys conducted by the CYFBHS Family Youth Liaison (FYRT). 6. Provider organizations participate in FYRT’s Post Treatment Partnership Questionnaire. This questionnaire is available online or via hard copy. FYRT will deliver hard copies to your office upon request call: 619-546-5852 or email [email protected]. These questionnaires are summarized in an annual report (Survey Findings, page 5).4 Family & Youth Roundtable, 345 15th Street, San Diego, CA 92101. Telephone: 619-546-5852 www.fyrt.org

7. CYFBHS Family Youth Liaison’s annual Lived- Implementation Engaging Family & Youth Experience Report, summarizes results from the Post Treatment Partnership Well trained and Questionnaire and the impacts of supported Family/Youth participation-enhancing strategies that are Support Partners (former implemented across provider organizations. clients) provide This report, among other things, will be introduction to services used to demonstrate the impact of family and continually reminded youth partnership and in turn stimulate family and youth in the future family/youth participation. agency’s desire of their full involvement. Via faceSurvey Findings to face, telephone calls events, post cards, etc.During the 2011-12 fiscal year, Family & YouthRoundtable of San Diego County (FYRT) conducted Call FYRT for survey andthe Tell Us About Partnership survey, focusing on lobby postersfamily and youth’s view on partnership at theservice level. Call FYRT for assistance in establishing yourThis year a few service agencies collaborated with agency’s PAG/FamilyFYRT by providing hard copies of the survey and Youth Advisory GroupsFYRT collection boxes in their lobbies. FYRT alsoinvited families and youth to complete the surveyonline, and during FYRT trainings and events. 5PWS: 5.5 County of San Diego Behavioral Health Children, Youth and Families Services 619-546-5852

FYRT received 214 completed surveys. Demographic Data Ethnicity: African American Caucasian Latin Asian Pacific Islander Middle Eastern Multi Ethnic Unknown 40.0% 25.0% 30.2% 27.4% 20.0% Latin 8.5% 1.4% 0.5% 2.4% 0.5% 0.0% Asian Pacific Middle African Caucasian Islander Eastern Multi Ethnic Unknown American Area of residence within San Diego County:Engaging Family & Youth 40% 38% 26% 17% 17% Central East South North Central 20% 2% 0% North Inland Respondent type: 100% 69% 50% 24% Youth 18 to 25 0% 3% 1% 3% Birth Parent Foster Parent Youth under 18 Adoptive Parent Age while recieving services: 30.0% 22.6% 22.6% 26.5% 20.0% 7 to 11 0 to 5 12.9% 12.9% 10.0% 2.6% 11 to 14 5 to 7 0.0% 18 to 24 14 to 186 Family & Youth Roundtable, 345 15th Street, San Diego, CA 92101. Telephone: 619-546-5852 www.fyrt.org

Agency providing servicesAgency upon which answers are based:42.0% 38.0% 14.0% 5.0% 0.3% 0.5% 0.5%Children’s Child Welfare Juvenile Justice Alcohol and Physical health Regional Center EducationMental Health Services Drug services Outcome Achievement Respondents were asked the degree the outcome they hoped for were achievedOutcome was:40% Very good Helpful Not useful Very bad Engaging Family & Youth20% 0% Excellent VoiceRespondents were asked how much influence they felt they had on each of the components listed below1=None at all 2= Very Little 3=Some 4=Mostly 5=Very Much 2.4 Knew Expected 2.1 Outcomes Agency's Policies Program Design 2.5 2.8Understanding the Goals 2.7Changing the PlanEvaluating the Plan 2.6You/Your Child's Plan 2.4 7PWS: 5.5 County of San Diego Behavioral Health Children, Youth and Families Services

Respondens were asked if there were aspects of the services they received that made the their experience positive: 100% 33% 5% 62% 50% YES SOMEWHAT NO 0%Engaging Family & Youth Comments on Aspects: This question received 92 responses and 53 comments. Positive feedback:  Services have made it possible for our family to have a better quality of life.  Bus pass.  CWS made sure my son and I had everything we needed.  Yes bus pass! And therapy.  The Counselor at the program.  They’re very accommodating and considerate.  Incredible Families is a wonderful program.  Interactions between my baby and the facilitator.  The fact that I’ve been told I am a strong person.  I felt like I was very much a part of his treatment, they really valued my opinion and used my concerns to work with my foster son.  Yes helping me each day.  I like the services that I have. Negative feedback:  Don’t trust them. (This seemed to be a theme as 19% of the comments indicated a lack of trust.)  They need to be open-minded and get the full story before judging me.  They believe what my teenage says without asking me.  It’s the worst thing in the world to have a mental illness.  Caused me to miss my son’s birthday. Improving Family and Youth’s Experience When respondents were asked what would have improved their experience, 9 areas of improvement were contributed: 1. Accountability 2. Stop jumping to conclusions 3. Transportation 4. Be more open-minded 5. Give positive feedback 6. Stay in contact/don’t be so hard to reach8 7. Better structure and accountability 8. Work on what’s important to me 9. Family involvement! Verify everything rather than form opinions and treatments based on the reflections of the child/youth alone Family & Youth Roundtable, 345 15th Street, San Diego, CA 92101. Telephone: 619-546-5852 www.fyrt.org