Millions of Americans are affected by mental health conditions every year. In fact,

• One in five adults − approximately 43.8 million − experience mental illness in a given year.
• Nearly one in 25 − about 10 million − live with a serious mental illness such as schizophrenia, major depression, or bipolar disorder.
• One-half of all chronic mental illness begins by the age of 14; three-quarters by the age of 24.

Increasing and improving mental and behavioral health resources for Coachella Valley residents has long been a priority for the Desert Healthcare District and Foundation Board. In 2018, the District and Foundation launched a Behavioral Health Initiative. The Board allocated $3 million to support behavioral health services and programs. To further understand the community and target funding, the District Board of Directors commissioned two needs assessments to better understand the population it serves: a behavioral health needs assessment (BHNA) and a community health needs assessment (CHNA).

In 2019, the Board of Directors approved EVALCORP Research and Consulting to conduct a comprehensive, community based behavioral health needs assessment. EVALCORP worked with the community to identify four key recommendations to address the gaps in behavioral healthcare for the Coachella Valley. The recommendations included: improving access to behavioral health resources, education and stigma reduction, professional development, and workforce expansion. In addition to the BHNA, the District worked to develop a CHNA in which the BHNA narrative and data was utilized to inform the behavioral health sections of the larger scale CHNA. Through extensive community engagement, the CHNA uplifted five community health priorities: access to healthcare, economic stability, education access and quality, environment, and mental health. Following the finalization of the CHNA, the Desert Healthcare District and Foundation Board of Directors utilized the CHNA and BHNA to create an informed 2021-2026 Strategic Plan. The Strategic Plan outlines seven goals with specific strategies designed to target efforts in order to make the greatest health impact and help create equitable access to health and wellness resources and services. One of the highest priority goals in the 2021-2026 Desert Healthcare Strategic Plan is to proactively expand community access to behavioral/mental health services.

With Behavioral Health being a top priority for the District, a Coachella Valley Behavioral Health Collective was created in response to the data and narrative contained in the CHNA and BHNA. The initiative utilizes a collective impact approach by means of interactive working group convenings of over 60 collaborative partners. Currently, the 60 community partners make up three working groups: workforce development, improving access, and policy development. One behavioral health area of concern that came out of the Coachella Valley Behavioral Health Collective was finding a way to address child and family related behavioral health needs and gaps. Following discussions, an aligned strategy was identified to target access to behavioral health education and preventative services for children (0-18 years) and their families. With the collaborative approach to target this need in behavioral health services, the Desert Healthcare District released a request for proposals in May 2022 seeking applicants to focus on behavioral health access, awareness, availability, and education for children and families. Ultimately, five organizations were awarded nearly $1.2 million in August 2022.

Local data continues to reveal how adults and children are struggling with behavioral and mental health challenges. In the last year, according to the Palm Desert-Health Assessment and Research Communities (HARC), nearly 40% of Coachella Valley adults struggle with an emotional, mental, or behavioral health problem and nearly 25% of children ages three to 17 identified challenges with their emotions, attentiveness, behavioral, and/or getting along with others.

Behavioral and mental health conditions are a community problem that touches every socioeconomic status, race, and identity. The Desert Healthcare District and Foundation continues to fund programs with mental and behavioral health initiatives in an effort to see improvement in the effectiveness and coordination of programs and services in the Coachella Valley. 

Contributing Factors-The factors below help move the curve in the desired direction:

• Coping and problem-solving skills
• Connections to friends, family, and community support
• Supportive relationships with care providers and family
• Availability of physical and behavioral health care
• Increase number of behavioral health professionals in the region
• Reducing the stigma of mental and behavioral health issues
• More safe spaces for those struggling with their mental and behavioral health
• Raised awareness of alcohol and substance abuse
• Increased effectiveness in having people use Telehealth
• Addressing barriers to access to care
• Programs that provide tools for resiliency

Restricting Factors-The factors below prevent the curve from moving in the desired direction:

• Barriers to health care
• Cultural and religious stigma associated with mental and behavioral illness or help-seeking
• Easy access to lethal means among people at risk (e.g. firearms, medications)
• Previous suicide attempt
• Mental and behavioral health illnesses, such as depression, schizophrenia, bipolar disorder, and anxiety disorders
• Online Forums
• Social isolation
• Criminal problems
• Financial problems
• Job problems or loss
• Legal problems
• Physical ailment or disability
• Substance use disorder
• Bullying
• Family history of mental health issues
• Relationship problems such as a breakup, violence, or loss
• Sexual violence

Anticipated Factors

• Approximately a third or more of adults in several Coachella Valley communities have a mental health disorder
• Mental and behavioral health is also a major issue for the LGBTQIA+ community
• 15% of Coachella Valley adults 19 to 64 are uninsured, and that impacts seeking behavioral health assistance
• Limited insurance coverage
• Lack of equity
• Discriminatory behaviors

Additional Research

• Understand the impacts of mental and behavioral health factors at an earlier age
• Environmental factors
• Social inclusion and connection
• Access to health and social support services and resources
• Impacts of COVID, civic and political unrest

The following five organizations were approved by the Desert Healthcare District Board of Directors to receive a total funding award of $1,175,817, over two years, under the request for proposals focused on improving Access to Behavioral Health Education and Prevention Services to Children (0-18yrs) and their Families:

• Regents Of The University Of California At Riverside (funds awarded: $500,000)
• Martha’s Village And Kitchen (funds awarded: $99,853)
• Clinicas De Salud Del Pueblo dba Innercare (funds awarded: $150,000)
• Desert Sands Unified School District Educational Foundation (funds awarded: $296,193)
• Transgender Health and Wellness Center (funds awarded: $129,771)

Through this Request for Proposals, the Desert Healthcare District awarded grant funding to promote and improve the behavioral health of all Coachella Valley children (0-18) and their families. Specifically, DHCD provided funding to expert nonprofit organizations so that they can put their expertise to work to ensure that the target population has increased behavioral health access, awareness, availability, and education. 

When Desert Healthcare District awarded a grant to an organization, it enters into a grant agreement with the grantee that includes a scope of work, deliverables, evaluation, and performance measures organized within the RBA framework. This grant agreement is legally binding and governs the relationship between the District and its grantees.

When the grantee reports back to the Desert Healthcare District (usually twice per year), these performance measures become central organizing categories for their reports. They report to DHCD, in essence, by explaining what they have done, how well they have done it, and what difference it has made in terms of impact. Grantees report other accomplishments, products, anecdotes about individuals who benefit from their services, etc.  The RBA framework is the guiding system for reporting. 

What Works:

1. Community Interventions

• Parenting skill and family relationship programs
• Community engagement activities
• Postvention
• Recreational programs
• Support groups
• Breaking down barriers and uniting the community

2. Clinical Interventions

• Treatment for people at risk of mental health issues
• Prevention & Intervention programs
• Cultural and language
• Non-traditional service delivery

3. School-based Interventions

• Peer norm programs
• Social-emotional learning programs
• Anti bullying support programs

4. Organizational Interventions

• Organizational Policies and Culture
• Culturally competent trained professionals
• Organizational communication pathways