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Racial, Health and Equity Training for Leadership Staff

In August of 2019, 80 Behavioral Health & Recovery Services (BHRS) managers and supervisors were trained on Race, Health and Equity. Throughout our San Mateo County Health department, 268 managers and supervisors were trained, as well as 91% of County Health divisions. The training covers historical context, current health inequities, levels of racism, as well as how important it is to connect with the subject of race personally, so we can be effective as public servants and members of our larger community. Years leading up the training included a cohort of County Health staff graduating from a learning year of the Government Alliance on Race and Equity (GARE). This GARE cohort implemented a department-wide survey to better understand what racial equity meant to staff, their experiences, and their challenges. Additional staff were recruited into the GARE effort to build capacity and strengthen equity and the way it is weaved across County Health, including our BHRS division. The training was received positively, and most staff members cited sharing their own individual experiences with race and racism to be the most impactful part of the training. Additionally, staff filled out commitment cards for how they would drive racial equity forward in their everyday work. This effort has served to normalize conversations about race and racism within BHRS and has been coupled with our BHRS’ Office of Diversity and Equity (ODE) Multi-Cultural Organizational Development (MCOD) work.

Coastside Needs Assessment

The coastal community, via the Mental Health Services Act (MHSA) Community Program Planning process, identified a need for mental health and substance use services in the coastside region of San Mateo County. The coastside community sees a scarcity of resources, as well as deep inequalities in wealth, health, and education, which are especially prominent in the Latinx community. Existing and new partnerships were leveraged for a needs assessment that included faith-based groups, residential apartment complexes, non-profit organizations, schools, and community events. This needs assessment was unique because it was developed through collaboration with community and county partners, and took a strength-based, community-centered approach to the creation of new services for this area. The team that worked on this assessment was fully bilingual and bicultural, and this reinforced rapport as well as response rates and participation. Through community “platicas” or dialogues, as well as key stakeholder interviews, over 200 community members provided input. Throughout this process, community members shared their stories of struggle and fears, as well as what brings them joy. Almost everyone we spoke to cited their family as the source of their motivation and the desire for a better life for their children. Using this needs assessment qualitative and quantitative data, a Request for Proposal was developed and led to the Cariño Project via ALAS grand opening in August 2020. The program will provide culturally responsive community-based mental health and substance use services, including peer support groups, art and cultural identity formation, capacity building, and linkages to behavioral health services for marginalized communities in the coastside region.
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First Behavioral Health Language Interpretation Video

San Mateo County Behavioral Health & Recovery Services’ (BHRS) Office of Diversity and Equity (ODE) developed the first nation-wide behavioral health language interpretation video as an additional resource for our behavioral health services staff. The videos reinforce a community-centered approach to ensure that everyone in our community receives the best quality of care available, whether they speak English or not. Interpretation services are a resource that, when used appropriately, can make an enormous difference in the experience clients have with BHRS, as well as their willingness to continue with services, build trust, and recommend our services. This effort was a necessary resource to abide by the National Culturally and Linguistically Appropriate Services standards. The actors in the production were BHRS staff, community, and providers. The videos showed a variety of topics including using an interpreter effectively vs. ineffectively, as well as familiar challenges a provider may face when working with an interpreter. Clinicians, community, and staff from all over the department were able to use their bi-cultural and bilingual skills to better inform this project. This resource compliments the BHRS mandatory trainings “Cultural Humility 101” and “Working Effectively With Interpreters” and has been requested as a resource for other counties.

Suicide Prevention Honors Pacific Islander Voices

In 2019, our Pacific Islander Health Equity Initiative completed a set of suicide prevention cards that honored the voice of our Pacific Islander community. These cards specifically uplifted the messages from Pacific Islander communities about what is needed to prevent suicide. Loss of a loved one by suicide is a painful experience that is often kept silent in the Pacific Islander community due to shame. According to the California Department of Public Health, from 2005 to 2010, the number of deaths by suicide among Pacific Islanders increased by 100%. Our Pacific Islander Health Equity Initiative took the lead in prioritizing the work to decrease this stigma and work towards preventing suicides. The work to create the suicide prevention cards began in 2018 when the initiative asked, “What can suicide prevention in the Pacific Islander community look like?” After hearing the community responses, they created messaging for a portrait series campaign about suicide prevention. This campaign now provides a voice for those who are suffering to find support, and works to decrease the stigma associated with suicide in our Pacific Islander community. Please go to the Behavioral Health & Recovery Services’ Office of Diversity and Equity webpage to see all the cards created (

Office of Diversity and Equity’s Community Response Team

In 2019, the Behavioral Health & Recovery Services’ (BHRS) Office of Diversity and Equity (ODE) received requests for support regarding unique and specific events that were impacting marginalized communities. This appeal and community feedback allowed us to gain a deeper understanding of current needs and to consider a system change in how we support communities. To provide prompt support and guidance, and assist in linking to resources, ODE created a Community Response Team. This team works to bring resources, information, and partners to address urgent matters that are impacting marginalized communities. The Community Response Team’s first effort was developing guidance for field-based workers to manage contact with ICE officials while collaborating with clients. With the support of the Latino Collaborative, key stakeholders, Legal Aid of San Mateo County, and San Mateo County Council, ODE created the Behavioral Health Field Based Staff Support and Guidance for Possible Contact with ICE Q & A document to provide guidance and ensure safety for our workforce, partnering agencies, and community.

Our Community Response Team has since provided resources, support, and a timely response to issues around employment in our coastal community, assisted BHRS and partnering agencies, with internal racial equity issues, and worked to assist our marginalized communities during Covid-19 response and recovery efforts.

Other key events in 2019:

With support from our Behavioral Health & Recovery Services (BHRS) leadership and staff, the Office of Diversity and Equity (ODE) finalized its BHRS Multicultural Organizational Development (MCOD) Action Plan; the Pacific Islander Initiative hosted a series of Heal and Paint events; through the ODE Storytelling Program the first San Mateo County Graphic Novel about Mental Health was published; and the ODE Parent Project® program graduated its 1,000th parent.