Solano County Innovations Project
In 2016 Solano County Behavioral Health Division (SCBHD), partnered with UC Davis Center for Reducing Health Disparities (CRHD), to launch a multi-phase five-year community-initiated Mental Health Services Act Innovation project known as the Interdisciplinary Collaboration and Cultural Transformation Model (ICCTM). The project focuses on highlighting the experiences and mental health needs of the Filipino American, Latino and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning) communities of Solano County.
While significant disparities also exist for other ethnic/racial groups, these three populations were selected for this project because they have historically shown more severe patterns of disparities when accessing and utilizing County mental health services, compared to other populations in Solano County.
Traditional approaches used to engage and serve these three communities appropriately have focused mostly on the providers’ skill sets, and community engagement to improve utilization.
This project takes a decidedly collaborative and community-oriented approach to these challenges by creating a training curriculum based on the Culturally and Linguistically Appropriate Services (CLAS) standards - a set of nationally accepted standards for cultural proficiency in service organizations and information gathered directly from the three target communities.
This education, training, and problem-solving process brought together workgroups comprised of consumers, community and organizational leaders, advocates, and County and contract staff, to address identified barriers through CLAS-focused quality improvement interventions.
For ICCTM project detail, review the American Public Health Association roundtable presentation summary.
Take a look at the video created at the onset of the ICCTM project.
Project Goals and Outcomes
On an individual level, the intervention participants would increase their knowledge, experience, and self-confidence in using Culturally and Linguistically Appropriate Services (CLAS) standards.
On a community level, the following outcomes would be evident: (1) increase in community outreach and community engagement; (2) increase community partnerships across the county; (3) improve awareness of mental health services; and (4) proven innovative strategies that decrease stigma of mental health in their respective communities.
On a county (systemic) level, outcomes include: (1) improve access and utilization of mental health services for Filipino American, Latino and LGBTQ+ communities; (2) enhance collaborative partnerships between County, Community, and Community Based Organizations (CBOs); (3) increase workforce diversity; and (4)
improve organizational policies, programs and support systems to ensure and sustain culturally and linguistically competency in service delivery.
“Quadruple Aim” Framework
This project is grounded in the Quadruple Aim framework — to-date the most effective evaluation model in healthcare — to measure the impact that the ICCTM will have on Filipino American, Latino, and LGBTQ+ mental health consumers in Solano County. 2014-2016 baseline data was used to assess change in access and utilization over time.
Core Project Components
Community-Engaged Research (CEnR) – A framework that is used to increase our understanding of mental health disparities associated with race, ethnicity, gender, sexual orientation, current gender identity, and socio-economic status, and to increase community engagement to achieve mental health equity and increase access to care (Minkler & Wallerstein, 2008).
Culturally and Linguistically Appropriate Services (CLAS) standards – CLAS standards are designed to ensure that mental health consumers can access, utilize, and benefit from mental health services in the context of their language, race, ethnicity or other personal characteristics (Hollinger-Smith, 2016).
Quality Improvement (QI) and Sustainability – A focus on systematic and continuous actions that lead to measurable improvement in mental health services and the health status of targeted patient groups that sustain over time.
Providing Quality Care with CLAS Training Curriculum
The ICCTM is the first community-initiated project that combines CLAS with community-informed recommendations through a tailored curriculum.
Session 1: Overview/Health Disparities
Session 2: Community Needs/Gaps*
Session 3: CLAS Standards
Session 4: Quality Improvement Action Plan Development
*In Phase 1, CRHD collected hundreds of stories using qualitative research methods and spoke with a range of Filipino American, Latino, and LGBTQ+ individuals regarding the current state of mental health care and access in Solano County. Interviewees from SCBHD staff include both those, working regularly with community-based organizations providing services to each of the three priority communities and their consumers, and shared important insights into the larger context of mental health care service delivery in Solano County. The findings of these community needs/gaps guided the training and ultimately the quality improvement action plan development.
Inter-sectorial: Participants were selected from (1) SCBHD (2) Community Based Organizations (3) social services (4) schools (5) faith-based organizations (6) law enforcement (7) housing, (8) public health
Multi-stakeholders: Participants were selected from County, CBOs, and the Community. They included: (1) quality improvement staff members; (2) mental health providers; (3) community and county leaders; and (4) consumers and their family members.
Multi-Cohorts: Three cohorts were trained. Each cohort created 3-4 teams, each team created one quality improvement action plan, grounded in the community-defined challenges and community-defined solutions findings from Phase 1 efforts.
- Cultural Communication
- Culture and Community
- Workforce Education and Training
- Systemic/Societal Determinants of Health
Community Narrative Reports: Based on the qualitative data collected in 2016, a set of community specific narrative reports were created that summarized experiences shared by each of the three priority communities in describing their access and utilization of mental health care services in Solano County.
Each report gives an overview of the community, outlines their mental health priorities, highlights barriers to accessing and receiving quality services, identifies their particular strengths and assets, and showcases their community-defined strategies and solutions to improve mental health service delivery in Solano County.
Filipino American Narrative
Fighting Back Partnership created the Filipinx Mental Health Initiative (FMHI)-Solano. FMHI-Solano is a community-driven coalition which aspires to provide mental health access that is culturally responsive and meets the needs for the intergenerational Filipinx community. The mission of FMHI-Solano is to empower the Filipinx community by providing early intervention through education and access to resources leading to a resilient community. Their Facebook page https://www.facebook.com/fmhisolano/
Our three CBO partners joint efforts to create a Queer and Trans People of Color (QTPOC) initiative. This initiative is helping develop, promote, and coordinate a space specifically for people of color that identify in the LGBTQ+ spectrum where they can safely discuss issues affecting them and the impact those have on their wellness. This initiative will also help connect them to culturally and linguistically appreciate services.
Ten (10) quality improvement action plans were developed through this ICCTM project and fall into three areas of focus: