Do not blame them but:

• Tell them they are responsible for their behaviors
• Work with a local mobile intervention team (short term solution)
• Recommend them for Assisted Outpatient Treatment (AOT)

It can be painful to see a loved one not reach their fullest potential as you might see it, or engage in harmful behaviors. Attempts to restore them to their previous level of functioning can be met with defensiveness, resentment, or hostility - leaving one feeling frustrated and even helpless. When an individual is not aware of their condition, it can be difficult to break through denial.

Many of these illnesses are insidious: slowly taking over thoughts, behaviors, and personality - ultimately masking their true self. It is best to intervene early when the first signs or symptoms appear in order to stop keep them from spiraling out control and to ensure a smooth treatment course.

When your loved one is in crisis, do not to blame them for their condition. First and foremost, the condition is not their fault. Moreover, accusations can be met with greater resistance and feelings of humiliation. Your loved one may not know why they are feeling this way, and it is important to educate them in a non-judgemental manner.

• Realize that the illness is strongly influencing them to say or do things that they would not normally.
• Even though the illness is not their fault, still communicate that they are responsible for their behavior and they may face consequences.
• Set and communicate reasonable expectations.
• Seek professional help early: see below for resources.

If your loved one is in crisis and it is an emergency, call 911 and tell the operator you are facing a behavioral emergency, and request a Crisis Intervention Training (CIT) trained officer.

San Mateo County has several early intervention and crisis intervention teams that can work with your family: http://namisanmateo.org/crisis-info/

You can recommend your loved one for AOT – assisted outpatient treatment, with the Behavioral Health and Recovery Services (BHRS) of San Mateo (a) if they have had a history of two or more hospitalizations or incarcerations in the past 3 years, or (b) if they have made threats or acts of violence towards themselves or others in the past 4 years.

AOT services include outreach, assessment, intensive case management, psychiatric interventions, community supports, housing assistance, and a 24/7 response capacity.

The process includes a comprehensive assessment to determine whether the individual meets criteria, and outreach/engagement if they meet AOT criteria. Collaboration is essential throughout the treatment phase, and if the individual does not accept treatment the services may be ordered by a judge.

To make a referral, call 650-372-6125 or email AOT@smcgov.org.

For more information, please visit:
http://www.smchealth.org/general-information/assisted-outpatient-treatment-san-mateo-county

Palo Alto Medical Foundation (PAMF)

www.pamf.org/teen
Provides information on topics including general health, risk taking, mental health, and sexual health.

www.pamf.org/preteen
Provides health information about topics of concern to preteens (age 9-12) and their parents such as "my body", "growing up", and "my feelings/interests".

StarVista

www.onyourmind.net
Teens can obtain live support by talking to trained peer mentors in a chat room or on the hotline.

HeadMeds UK

http://www.headmeds.org.uk/about
HeadMeds UK has a succinct guide on conditions, medications, and video stories on youth who have mental health conditions.

There are several local and national crisis phone lines, crisis text lines, and online confidential support:

Star Vista Crisis Hotline
(650) 579-0350

National Suicide Prevention Lifeline
Call or chat online.
1-800-SUICIDE (784-2433)

Crisis Text Line
Provides free confidential 24/7 emotional support and information to people in any type of crisis.Text "START" to 741741.
(Reference: http://www.smchealth.org/bhrs/crisis)

National Suicide Prevention Hotline
Provides a confidential crisis chat service in which you can talk to an accredited counselor if you are feeling stressed, depressed, going through a hard time, or if you are having suicidal thoughts. Online support.
Alternatively, you can call the Lifeline at 1-800-273 TALK (8255)

Drug & Alcohol Helpline (BHRS)
650-573-3950
A non-judgmental, confidential place to check in and get support and information about substance use.

There are three resources you can use to help you find appropriate services:

1. You can call the ACCESS line to help you find the appropriate service or clinic. ACCESS Call Center: Phone: (800) 686-0101, TDD: (800) 943-2833
2. You can also search the SMC Connect database organized by need – government assistance; children, teens, and families; emergency; and reporting.
3. If you are privately insured, you can contact your private insurance to find out what mental health services are available for you.

There are 2 types of benefits:

1. Supplemental Security Income (SSI) Benefits concern persons with limited resources/income. It also applies to individuals age 65 and older (with certain limitations for non-citizens).
2. Title II Benefits - 3 types:
   • Disabled workers who are insured under Social Security
   • Children of disabled workers who are insured under Social Security and who are either retired, disabled, or deceased. These benefits are sometime referred to as Title II benefits
   • Disabled Widow(er)'s Benefits (DWB) If something happens to a worker, benefits may be payable to their widow, widower or surviving divorced spouse with a disability if the following conditions are met: He or she is between ages 50 and 60, Their condition meets the definition of disability for adults, and The disability started before or within seven years of the worker's death. (ssa.gov)

You can qualify for SSDI if you have worked and paid social security long enough when you became disabled. After 24 months of SSDI benefits, you can start receiving Medicare

Start the benefit application process by calling 800-772-1213 and write down the name of the person you talk to and the date. CID is happy to assist you in this process!

The evaluation of disability based upon mental conditions depends on the following factors:

• The presence of a "medically determined impairment"
• The degree of limitation such an impairment(s) may impose on the ability to work
• Whether these impairments are expected to last continually for a period for at least 12 months

Disability Rights California provides a comprehensive booklet on benefits that can be located here.

Contact us for more information on how to apply for benefits and, if needed, how to contest a denial.

Community Information Handbook (2016)
(Page 38 begins the County's listings for mental health.)

There is a complete list of contacts on the BHRS website located here. Find the names, phone numbers, and emails of directors and managers of Various San Mateo County centers and clinics:

http://www.smchealth.org/bhrs-contacts

Stephen Kaplan, Director of Behavioral Health and Recovery Services
(650) 573-3609 | SKaplan@smcgov.org

Karen Krahn, Deputy Director of Mental Health Services - Adults/Older Adults
(650) 573-2038 | KKrahn@smcgov.org

Paul Sorbo, Deputy Director of Mental Health Services – Child/Youth
(650) 573-3926 | PSorbo@smcgov.org

San Mateo County has a program called the Office of Diversity and Equity which is committed to addressing health disparities, promoting cultural competence and humility, and developing advocacy and community capacity. This is a very strong and active program, and you are encouraged to get involved!

There are several Health Equity Initiatives that may be of interest to you, and they include:

• Diversity & Equity Council
• African American Community Initiative
• Chinese Health Initiative (CHI)
• Filipino Mental Health Initiative
• Latino Collaborative
• Native American Initiative
• Pacific Islander Initiative
• Pride Initiative
• Spirituality Initiative

You can visit their website: http://www.smchealth.org/bhrs/ode

Or contact Jei Africa, Director, Office of Diversity and Equity, at (650) 573-2714 or JAfrica@smcgov.org

SMC health provides an extensive list of attachments for staff forms and policies that can be viewed by consumers.

It can be accessed here:
http://www.smchealth.org/behavioral-health-staff-forms-policies

The BHRS Mental Health Documentation Manual is also very informative, though it is meant for professional use:
http://www.smchealth.org/sites/main/files/file-attachments/bhrsdocmanual.pdf

There are two types of conservatorships and we will be focusing on the first type:

1. Letterman, Petris, and Short (LPS) Conservatorship concerns individuals with mental disabilities and is handled through Mental Health Services.
2. Probate Coservatorship is for older persons, young persons, and those with cognitive impairments. It is handles through Aging and Adult Services and the Centralized Intake Unit.

A psychiatrist can make an LPS (mental health) evaluation to decide whether an individual is gravely disabled and can be legally conserved by a guardian. The court then appoints a legal guardian who will make medical, financial, and living arrangement decisions for the conserved person. Their rights are limited during this time. The conservatorship can last up to a year and can be renewed.

The deputy public guardian is responsible to the Superior Court for all actions taken on behalf of the conservatee. Accounting of assets happens after a year and every 2 years thereafter. An "investigator" interviews the person under conservatorship regularly to assess whether the conservator is acting properly.

The Conservatorship Investigation Office of San Mateo is open for consultations. Call them at 650-363-4117 if you need help establishing a conservatorship.

If you are a conservatee (you have been conserved), you have the right to (CANHR):

• Ask a judge to change conservators or to end the conservatorship.
• Vote, unless the judge says you're unable to do so.
• Marry.
• Control personal spending money if a judge says you can have an allowance.
• Make or change your will (unless the court grants this right to your conservator).
• Make your own healthcare decisions, unless a judge gives that right to a conservator (a judge will only give this right when a doctor has certified that the conservatee does not have capacity to consent to his or her own medical treatment).
• Exercise various personal rights including the right to receive visitors, telephone calls, and personal mail, unless specifically limited by court order.
• Be treated with understanding and respect.
• Have your wishes considered.
• Be well cared for.

http://www.canhr.org/factsheets/legal_fs/html/fs_ProbateConservatorship.htm
(Probate Conservatorships in California, Nurse Advocates)

• Find more information on the conservatorship legal proceedings here
• Find out conservatorship from Disability Rights California and how to avoid being conserved here
• Information from the Santa Clara County Superior Court conservatorship process can be found here with more info here
• Documents required when filing a conservatorship can be found here

The Mental Health & Substance Abuse Recovery Commission (MHSARC) is always looking for new board members.

You can apply by contacting BHRS administration, Chantae Rochester at (650) 573-2544 or email CRochester@smcgov.org to apply.

The California Clubhouse is a free and voluntary social/vocational program for adults 18 and older living in San Mateo County who have severe mental illnesses. The Clubhouse is an international, evidenced-based model of recovery that began in New York's Fountain House almost 70 years ago.

They are currently located at 210 Industrial Road Suite 102 San Carlos, CA 94070. For more information, their website is https://californiaclubhouse.org. You can contact them at 650-539-3345 or email info@californiaclubhouse.org.