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Sonoma County, the chosen spot of all the earth as far as nature is concerned. According to the famed plant wizard Luther Burbank Diverse County, with 1,010,000 acres of land on 1574 miles of scenic roadways, Cinema County is rightfully famed for its agriculture did a culture, industry

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and recreation as well as for the amazingly successful ethnic and economic mixture of its more than 340,000 residents on for the forward looking philosophy of its local governing bodies. Now we invite you to take a closer look at Sonoma County in the eighties with your host,

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rich McGlinchy. Good evening, ladies and gentlemen. Welcome to another edition of cinema can. In the eighties. We're gonna be talking about a subject very, very important subject that has been dealt with all too little, certainly on our program. And we think elsewhere in the television media,

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we're gonna be talking about mental health problems as they affect youngsters, Children, youth. General, we're gonna be talking to two persons on this program. On the left of your screen is Steve Shaffer. He's head of the Children's Day treatment center and the Children's partial day treatment

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center. And on the right of your screen is Dorothy A Proctor. And she's a program coordinator for the use case management. We're going to talk to these two folks now about this aspect of mental health. Four Children, if you will for young people. And then we're

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going to do something we've never done before. We're going to next week, have another program follow up on the same subject because we feel that is important enough to want our treatment. Certainly in the accounting eighties program. At least twice. It's a pleasure to have you

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both here. Dorothy. Nice to be okay. I like to be here. Yeah, uh, how bounce these questions to do with you to begin with and then later to yourself. But if by any chance, either if you have something that you feel you'd like to add to

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the others remark by all means do so Ok, ok, that's that's That's hard game rules. Sort of speak. Um, your division, your case management. What? Services to Children and youth are available two years in a mental health services. Sonoma County mental health services have a wide

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continuum of services to Children and youth. They range from outpatient services at 18 hall, which is is in Santa Rosa, to our outreach is and then we have day treatment services for for Children and for adolescents at new directions. And then we have residential treatment and

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some short term hospitalization and a few youngsters at Napa State Hospital. That's the wide continuum of services that we do offer through ourselves and contract agencies. Courage? A lot. Yes, all right. You described the services who are eligible before the services and follow that with How

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can they be obtained? The, um, first, who's eligible? Okay, anyone would be eligible for the outpatient services, and Steve will be talking more about what those consist of. In terms of the more intensive services, day treatments and residential treatment. Those youngsters need to be labeled S

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E D, which is a school terminology. They need to be special education students who are seriously emotionally disturbed. All right, who are these SED Children and who decides what mental health services should be recommended for him? First of all, who are they, they those students on?

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There's a rather precise definition that my program has to assess these youngsters for for the school's. They're referred from the schools as being suspected of this or having on SED label. And these air youngsters who are have a longstanding, pervasive condition that adversely affects their education.

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And so these youngsters are referred to us through the schools, and then they're assessed by youth case managers. And then the case management program will will recommend and work together with schools in terms of what the suitable treatment for these kids is, Um, what is the

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residential treatment just mentioned and and why are people sent there? Residential treatment is the most restrictive off the treatments that that we offer. And we we need to buy, buy, buy law, look for the least restrictive setting. But there are some youngsters who, in order to

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benefit from their education, need the containment of a 24 hour facility where they are attending school, getting treatment during the daytime as well as being restricted at night. And, uh, those those youngsters who have not worked out in other settings are the ones that we recommend

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for residential treatment. You know, before I jump ahead or some other questions I got here for you. How about a little background on Dorothy. A proctor. Where you from? Where you go to school? How long have you been with? Oh, my goodness. I think I've been

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in Sonoma County forever, actually. I came here as a bride after graduating from Stanford, and I am originally from Southern California. And how have you been with the department? I've been with Sonoma County mental health for a little over seven years. And before then, I worked

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for Sonoma County Social Services on and before then, and during that time, I was a school board member. So I have had had quite a taste of of a number of facets of life in Sonoma County. Certainly. And also a lot of it with the school

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board with youth to yes. Especially okay. Back under these subjects here. Now, you said there were. I believe you said a moment ago. There are a few Soma County characters in Napa State Hospital. I believe you met. There were a couple or few cases like that

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where they sent their because they way actually have two youngsters. Um, and they're both young Children in Napa State Hospital. They they need that restrictive a setting, which means that they're locked and they need to. They're very, very disturbed kids, and they need to be restrained

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frequently, and there needs to be a very high staff ratio, and we feel it's much, much better that youngsters can be treated outside the hospital. But it's in a sense, it's our last resort. You know, one of the things we we talked, all of us before

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the program. We're talking about some of the things that we thought should be covered that would bring the public a better understanding of the mental health programs and one of the remarks I think I made or someone made his. What does a parent do when the

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youngster starts acting unusual? You know what I mean? When did they start determining whether or not this person has? A young person has just passing through a brief phase. It really has a deep seated problem. I don't know if this is the time we want to

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talk about that, that right at the moment or not, But it seems like that the audience out there should be aware of the fact that all the things we're talking about in the mental health programs and the various programs that these two folks coordinate are aimed

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at assisting young people who do have mental problems of one sort another or difficulties period of times. They're just not reacting in an acceptable, normal fashion, and they need some assistance. And I want the audience to be aware of the fact that that's what we're aiming

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at with our program this week and the Pro for little program next week. Uh, youth case minute, actually rich. Could I tag a little bit? I'd like to say I really support what you're saying, and I think what I wish more parents would be doing if

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they have some concerns about their youngster or something has happened in a youngster's life. For instance, a death, a divorce or or an accident. Some something traumatic, particularly has happened to the youngster. Or just if a parent has some concerns about their youngsters behavior that they

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would seek out individual help either through mental health or through one of the other community agencies or private practitioners. And there I think there's far too little of this. Oftentimes, parents hope that it'll go away, and usually what happens it gets worse, it does not go

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away. I'm not usually, but sometimes most cases it gets worse unless somebody capable of dealing with it helps that young person deals with. And I might say I think like with anything else. The sooner you identify and begin to treat the problem, the easier it is

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to get rid of it. Ah, lot of times people wait too long. Things have gotten very serious, and then they seek the help. And I know with Children, particularly if you get them quite young. You're much more likely to succeed than if you let the problem

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go on for quite a while when everyone is discouraged. This is good. This is what I wanted you to do when we have something of this nature. If I start to rush into a question, there's something that has not answered. Dio. Let's have it because more

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than anything else, ladies and gentlemen, we want you to understand the problems involved in mental health with youngsters and what these fine people are trying to do to correct or alleviate that problem. What I was going to say a moment ago, it is a youth case

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management. Your program coordinator. But I think maybe the people in the audience might want to know what's the function of a use case manager and and why are they needed? Yes, lots of things. Everything but the kitchen sink. I sometimes think it's It's like keeping house

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that the job is never done. But essentially what, what youth case management. What my my case managers do They? They look at the assess youngsters that are referred by the schools, um, to look at what their mental health needs are, and then they will make recommendations

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for what the's for meeting these needs. And then there they attempt to work as closely as they can with the other components of the program to get the youngsters into the slots that they need to be in. And they're also working closely with the parents with

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schools on. They monitor their treatment there, liaise owning to the other components of our program, and also to youngsters who replaced in in other residential treatments and Napa State Hospital and, uh, and they help with their exit planning and try and get the kids back into

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a normal situation. You know, nobody go. You mentioned SED students and something came to mind. RSCG students the only special education students that are eligible to receive mental health services. Actually, not any youngster who has been identified as as a special education student, and that could

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be anything from hearing impaired or other kinds of developmental disabilities. The key question is, if they need this in order to benefit from their education, those youngsters are are eligible to get the least restrictive of our mental health treatment, which is which is outpatient, as as

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part of the plan to help them benefit from their education. No, they need to be labeled SED in order to have the day treatments or residential placement. And a CD, by the way, stands for severely emotionally disturbed and is a category that is determined by the

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schools themselves through an I E D process right group and whatever condition it is at least to be longstanding and and impairing their education. All right, now, let's look at the cost for a minute. What is the cost of these programs to the parents? Actually, for

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over 10 years, there has been legislation and effect federal legislation, Public Law 94 1 42 which says that all services to special education students, which they need in order to benefit from their education, will be at no cost. Two parents. Wow, that's amazing. Who guys pay

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for these services? That's, uh, state locally, federally. And, um, it does put both schools in their provision of special education services and mental health in anticipating the provision of these services, Uh, the law further says that we are not allowed to provide these service A to

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to limit thes services in any way. Whatever the youngster needs, even though those services aren't there, they have to be made for. Um we're gonna have to pause right here for a moment so that we can bring our audience a public service announcement. But after we

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come back, Dorothy a. Proctor, Steve shaper and I will talk more about mental health for youngsters. I think you'll find it very interesting. So join us again. Your moment. Remember your lungs. I can understand why you forget them after all, is that song you gotta have

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heart? It wasn't. You gotta have bombs. Your lungs. A vital smoking really messes your lungs up until finally you can't breathe. Maybe they'll never right. I left Mile lungs in San Francisco, so take care of your lungs. They're only human. The American Lung Association signs are

00:16:16.380 - 00:16:35.160

often misunderstood based behavior, loss of awareness, aimless movements. You're on something hidden. Signs that may point to a common type of epilepsy. Early recognition and treatment of seizures can help keep kids like Evans on the team. Get the facts right. Epilepsy Foundation of America, Washington, D.

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C. To double 013 Welcome back, ladies and gentlemen to a very important, very special program on mental health for youngsters were talking with Dorothy a proctor on the right of your screen. We're not gonna talk with Steve Shaffer on the left. Ustream Steve is the head

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of the Children's Day treatment center and the Children's Partial Day Treatment Center at the Cinema County Mental Health Program. Your division? What? You refer to the sector over there while I am in charge of the Children's portion of day treatment, which is both partial and full

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day. So they're two separate. Your whole building is there is all aspect. Really? Yeah. It's called the Children's Day Tree. That center the title. I was looking for that all right, Steve. Now you're the head of the Children Day treatment center that depend the partial day

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treatment center. How about describing your program? Want you offering who you serve? Okay. The full day treatment program serves 24 emotionally disturbed Children ages five through 14 and this is both boys and girls, and they come to our program daily Monday through Friday from 8 30

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to 2 30 They spend approximately half of their day in our special education classrooms at the centre and the other half of their day in therapy. And when I say therapy, I'm speaking of individual therapy for the Children anywhere from once to three, possibly four times

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a week. They also receive group therapy, which might be talk therapy for some of the younger Children who don't talk so easily about their problems. We use play therapy, San Trey puppets, doll houses. We also do a lot of groups around socialization because most of the

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kids we work with find it very difficult to get along with their peers to cooperate. So a lot of our groups are geared toward helping these Children learn how to share, delay, gratification and generally become more able to fit in to their peer group. And then

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we also in our full day treatment program, offer family therapy for all of the families. In fact, the criteria for getting a child in today treatment is in part that the family participate in therapy. And by family, we mean anybody living in the home. So we

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might be working with aunts, uncles, grand parents. We feel at the age of the Children that we work with. It's very important to have families work with us. You have to programs you had two programs or coordinating. How does your regular day treatment program different from

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your partial day treatment program? Okay, well, some very basic differences. The regular day treatment program runs all day long, and the kids go to both school and therapy all at our center. We opened the partial day treatment about a month and 1/2 ago. That is an

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after school program, and the reason I'm really pleased toe have that program is in the past, we would occasionally get referrals for Children who were having a lot of problems in the community and at home and in their families. But maybe we're doing fairly well in

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their public school setting. And back when we didn't have partial day treatment, we either had to take those Children for the full day at our center and they would lose their public school placement because they would go to school at our center. Or we might have

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to turn them down because if they were doing well in school, we didn't wanna mess with that situation. With partial day treatment. They can go to their regular school all day, and then they are transported by the schools to the center, and they stay at the

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centre for partial day treatment from 3 to 6 p.m. Okay, mortar it Well, I was just going to say that we within the partial day treatment program offer a program for younger Children, which is kids aged five through nine. And that's a two day a week

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after school program. Three hours per day. The older Children, which is Children nine through about 13.5 for 14. They come to the partial day treatment program three days a week from 3 to 6 p.m. Right. I got the families. Are they involvement involved in your treatment

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program, But it's very important. Yeah, we offer family therapy. We also offer couples therapy. If there are some marital difficulties, we also see parents individually. We will occasionally see the brothers and sisters of the Children that are in our center. We will see their siblings also,

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and we also have a number of different types of involvement for parents. And as I say for both day treatment programs, the expectation is that the parents will be involved in some form of therapy with us. We find that with kids, theeighties is of our kids

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that it doesn't work to just have a child in our center. And then the parents picked them up. A year and 1/2 or two years later, they need to be involved in an ongoing this. You can't just send away you take this child treated and bring

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it back with chilling. Actually rich, I I would like to say that we find across the board that unless parents are involved in the treatment of their Children, like even in residential treatment, there needs to be some work with the families as well. So it it's

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a fast sure, sure, if the youngster really is to be helped. Everyone needs to learn how to get along on a different way. Ah, more successful kind of relating. I, uh, Steve your schools, your programs. Rather, I don't have a school component. Now. Can you talk

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about the therapist and the teachers and how they work together? Maybe. Sure. I think one of the things that makes day treatment unique is we do have two components to it, and that is the educational and the therapy component. The Children, as I mentioned, spend half

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their day when they're at the center in our special ed classrooms. And usually there are no more than five or six Children in the classroom at any one time with the teacher in UNAIDS. So the Children get a lot of individual attention. The classroom is run

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on a behavior modification system, so the Children are given points and work on levels and steps, and they are rewarded in some positive way for their behavior on and for their ability to get their class work done. And this is quite different than the therapy side

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of the program, where we do not use a great deal of behavior modification and reinforcement. We rely a great deal on, relating and having relationships and trusting relationships with the kids so that it's been very interesting to take these two different approaches and to combine them.

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And basically it's worked quite well. Yeah, it seems tohave from everything I understand. How long do Children stay in the data treatment programs And then, maybe more importantly, that where did they go when they're finished? You've done what you can, I guess. Okay, The Children who

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are in our full day treatment program. The average length of stay is from a year and 1/2 to 2 years. Occasionally we have Children that stay longer and some shorter than that. But on average year and 1/2 to 2 years in our partial day treatment program,

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the average stay is six months to a year. The reason that shorter is because if a child only needs partial day treatment than the assumption is there coming to us with fewer problems, Therefore we ought to be able to resolve them in a shorter period of

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time. Most of our Children and this is about 70% of them. As a result of having Bennett, our center are able to return to the public school setting that they came from, or possibly another one. They may go back in the special ed classes, but they

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are essentially going into a less restrictive setting than when they came to us. I would have to say about 30% of the kids that we take, we sort of bounce off of. And if we fail, the 30% we don't do well with are generally because we

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haven't been able to get the family to actively work with us or on occasion. The child may just have more problems than we have answers, and, in which case, they need a more restrictive setting, possibly residential. We're down to about four minutes, and we've got a

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couple other things will be sure to get here. How would someone find out about your programs, or perhaps refer a child or a family to you? Okay, The way Children get to day treatment is if a child's having problems, the referral must originate with that child's

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school. Someone at the school must originate the referral, and they do that by contacting Dorothy A at case management. Actually, so the referral goes from the child's school to case management and case management does an evaluation to see what would be best for the child. If

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it looks like they treatment is is the answer, then Dorothy A. Would send it down to us, and we would have a meeting with the child in the family to decide if we think we can help. I I should say at this point that if a

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school, if a parent wishes toe, have their child evaluated, if they have some concerns, they can request that the school make a referral for a couple of things here. We jotted down that we didn't have a regular flow questioning. But some youngsters, air left unserved may

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be disturbed, but their school performance, let's say, is not affected are Maybe we're talking about rebellious teenagers. Is your services for those folks? We'll be comin on that. Then maybe you can add to this I think is a problem, because to get for example, in today

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treatment, they must be identified by the school. And, as you say, there are some Children in school who may not be manifesting a lot of problems. As faras outpatient services parents can get outpatient services simply by calling the mental health department, but definitely is, is a

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problem in that there must be something showing at the school for them to get the heavier interventions. Yes, I would say I get at least one or two phone calls a week from parents of rebellious teenagers who may or may not be disturbed. And I think

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it speaks thes. Youngsters really are not able to be served from any of the agencies because of the fiscal constraints there. No laws saying that these youngsters need to be served. And it's it's a large concern. We have about a minute left to us, and one

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of the things I wanted to touch on briefly and has to be pretty brief. There's the mental health department been in the news quite a bit. Some unfavorable publicity now. And what effect that had on your staff. Well, a quick comment on that the publicity's that's

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been negative is focused on a very narrow aspect of mental health. The department includes many, many other elements have not been focused on that are very successful, and but basically obviously it doesn't help staff morale to have that going on we have run out of time,

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Dorothy, Thank you very, very much. This is the end of this particular addition of our program. Next week we're going to go into this subject even further with two other professionals from Mental Health Department. My name's rich. McClatchy the program to know mechanic metes back with

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you next week for the second half of our mental health program. Until that. So long. Good luck. Good health and good night to you all.