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County Spotlight - Mono

Sex, Drugs, Rock and Roll—Collaborative efforts to address high risk behaviors in our youth
The SDRR group meets bi-monthly to address an increase in risky behaviors amongst the youth who live in Mammoth Lakes, the “hub” of Mono County.  Through the California Healthy Kids Survey (CHKS) we learned that our 11th grade students make a sudden decline in their perception of harm when it comes to drinking alcohol.  Additionally, they report an alarming level of “access” to obtaining alcohol once they get into high school.  This, in addition to a surge in positive tests for Sexually Transmitted Diseases (STD’s) and a bump in Transitional Age Girls pregnancy rates, caught the attention of a variety of county and community members.  The group, made up of members from our schools, law enforcement, our health clinic, County Public Health, County Behavioral Health,  County Child Welfare, the District Attorney, Wild Iris (local Domestic Violence and Sexual Assault treatment center), and Mono County Behavioral Health.  With the assistance and guidance of 14 Transitional Age Youth we developed a survey for high school students in an attempt to determine how to provide an innovative response to these risky behaviors.  The survey will be administered in the fall.

Bertha Jimenez, Case Manager and Remote Site Coordinator for our Tele-Psych services
In December 2014 Mono County Behavioral Health partnered with Kings View for psychiatric services.  Bertha was selected to use her excellent organizational skills to become the point person for MCBH and Kingsview.  She created our delivery system, formed the structure through which all of our consumers needing medication (in Mammoth Lakes and remote areas of the county) get served, and developed exceptional relations with the consumers and providers.  Our medication services have increased by more than 100% since Bertha took this on and we couldn’t be more pleased!

Dinner and a Movie
Benton, California, population 282, was one of Mono County’s underserved outlying areas.  Over an hour drive from our home base in Mammoth Lakes, Benton  Distrust of “government agencies” is the norm by most of the inhabitants of this community.   And in 2013, when we arranged a gathering to see how we might best provide better service and care to the people who live there, we were told by many that, “no one will show up.”  In May, we set out on a Saturday, with barbeque and other food, activities for kids, and three large poster sized “sticky notes” for people to use to write thoughts and feedback.  52 people came to the event and the resounding response to our question:  “what does Benton need to be an even better place to live?”  “Something to do that is safe, regular and does not involved alcohol.” 

Trainings and Education Opportunities
Mono County is a Frontier County; population just about 14,000.  We are the smaller of the small when it comes to people, and larger than most areas with a very large land mass and peaks in the Sierra Nevada ranging from 10,000-14,000 feet.  We, like any county behavioral health agency, need training and educational opportunities for all of our staff members.  Travel is expensive and, with winter, sometimes impossible.  While we do continue to go elsewhere for our educational opportunities, we also have developed a training program here in Mono.    We invite anyone who may be interested—other county departments, community members, medical staff from our one clinic, members from the Health and Human Services agency from our neighboring Inyo County—and we attempt to tailor the event to what will encourage not just individual learning, but collaboration between entities as well.  Thus far, we’ve produced a quarterly series on Psychiatry with Dr. Kristen Ochoa, MD, Assistant Clinical Professor, at the David Geffen School of Medicine at UCLA. Dr. Ochoa has provided assistance in our crisis response and service delivery, understanding of the harm reduction model of care when working with persons with severe mental illness, and has promoted partnerships between our agencies and medical establishment to enhance services to all consumers/patients in Mono County. 
During the Fiscal Year 2015-2016 we will be promoting “Trauma Informed Care” training throughout the year.  We will be hosting leaders in the field to talk with us not only about best practice from a clinical perspective, but help us create a foundation of knowledge and common vocabulary for all agencies who may be dealing with persons in the legal, Child Welfare, and medical systems. 
This year we will also be offering Cultural Humility trainings on working with Latino families, and working with the LGBT consumer. 

The effects of Climate Change and Drought on Rural Communities
Within Mono County you will find the headwaters of many large water ways that feed the California aquifers.  In the Sierra Nevada winter and spring snow pack is measured so that scientists can predict how much water runoff will feed the Delta, the Los Angeles Basin and the Central Valley.  In other words, we live where your water comes from.  While the “record California Drought” has made the news, we began to notice an increase in our consumers talking about feeling anxious about the drought and climate change.  Mammoth Lakes is a resort community, with Mammoth Mountain being one of the premiere skiing/snowboarding locations in the county.  When we don’t get the snow fall and subsequent snow pack, residents become concerned about our economy; it directly affects local businesses and the employment of many in our county. 
In an effort to help shape a positive, healthy community and individual response to these very scary times, we have begun to discuss, as a staff, ways we can capture data that is specific to the psychological response/effects of living in a place that has been altered by drought and climate change.  We are tracking how often and in what ways our consumers are talking about their feelings/reactions to the drought.  We have staff members dedicated to finding research on the psychological effects of climate change and drought as it relates to the Psychology of Place. As we move forward, we will work with other agencies who are dealing with the effects of the drought on the land to incorporate a new narrative regarding psychological health in this new era of environmental change.   Once we have a framework to discuss this, we will ask for stakeholder feedback to find the best way to promote this new narrative.