1993 Need Assessment Update & Fiscal Year 1994-95 Interim Priorities
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SAN MATEO COUNTY
FIELDS OF SERVICE CATEGORIES

• The area of physical health is vast and complex. At a very basic level there are diseases and injuries and those who suffer from them. Access to health care is limited by hate classic barriers of poverty, homelessness. Unemployment, language, and culture. Minorities, immigrants and refugees, women and the elderly are few of the population who are the most vulnerable to illness. Lack of nutrition, underemployment, family history can all contribute to certain populations medical frailty. In addition, it is frequently those who are most vulnerable to injury and illness who have the least access to medical care. Over one in five Americans are without health insurance and 80 percent of those are the working poor.

• Inadequate finical resources, lack of health insurance, poor access to health care and language barriers bar many Latinos in the county from good health care.

• Diabetes, as well as symptoms and risk factors for diabetes, constitute a serious and increasingly recognized health threat among Latinos.

CALIFORNIA:

• 23% of population lack health insurance. Of these 5 million, 3 million are employed. One in five children in the state has no health insurance and the percentages increase dramatically for low-income children.

• The leading cause of death in California are heart disease and cancer. Younger residents die most frequently from accidents, homicide, and AIDS. AIDS causes 25% of the deaths in the 35 to 44 age groups.

• Accessibility to mental health services is blocked by  physical barriers such as transportation and physical disability,  language and cultural barriers, and finical barriers (such as to few places accepting Medi-Cal and no sliding fee for people without insurance).

• San Mateo County Health Services expect to increase mental health outreach to children and youth and to older adults. Teens are special need of crisis counseling and prevention services (particularly high risk teens), to prevent pregnancy and to receive emotional support. In need of outreach are the 2,000 children of ex-offenders who need self esteem support, not to mention that ex-offenders themselves, of which there are some 1,000 men and women, need reentry planning counseling.

• Other populations needing counseling services are: abused children; abused elders; the deaf; elderly ethnic minorities; families in mental strife; single parents; and veterans, especially minority veterans. Abused children and elders need protective services that respond quickly. In this state, two out of three families reported for child abuse receive no service and no services system exists for generally neglected children. The deaf need service expansion since in this county there are only two professional mental health service providers experienced in giving service to hearing impaired people.

• Nationally. 32.3% of Americans had one or more serious mental disease during their lifetime.

• At anyone moment, major mental disorders effect almost 15% of the nations population.
  
  
  
  
  
  
  
  
  

• From 1979 to 1980, 315 persons were committed for 72 hour evaluation and treatment. From 1985 to 1986, the number increased 30% to 410. Of those patients committed for one year, rose from 66 in 1980 to 80 in 1986, a 29% increase.

• Over 50% of the county's board and care homes for mentally Ill are located in East Palo Alto.

• Geographically, the area reported to have the highest over utilization of residential mental illness services in East Palo Alto. The area has unemployment, high dropout rates, highest rates of crime, lowest income, largest household size, smallest housing units, highest rates of teenage pregnancy and households headed by single women, and high rates of alcohol and drug abuse. These economic/social stresses translate into a higher degree of mental problems

• Including all residential resources, there are estimated to be approximately 500 persons diagnosed as seriously mentally ill.

STATE (1990):

• Residential providers operating at 92% of licensed capacity, up from 85% long term care providers operating at 95% to 99% capacity.

• Nationally, 32.3% of Americans had one or more serious mental health disease during their lifetime.

• In the county there are estimated to be five to six hundred homeless mentally ill individuals. This may be a conservative estimate. There is an underlying problem with sex abuse in mentally disabled people. Nationally it is estimated that up to 50% of the seriously mentally ill population also abuse drugs and alcohol. Services are unavailable for non-English speaking populations who require the structured day treatment environment. The majority of mentally ill children are never diagnosed by parents, teachers or doctors according to the study Conditions of Children in California. Because poverty stresses play such a critical role in mental health, it is important to state the obvious: mental health programs could decrease if people could get adequate housing, food and clothing.

• 1/3 to 1/2 of all the mentally ill have duel diagnosis.

• Alcohol and drug abuse in seen as the number one problem facing the county and Bay Area today by respondents to two United Way of the Bay Area donor surveys and two San Mateo County surveys. The frequent association alcoholism beverages  with human service funding activist sends a mixed message to the community and substance abusers.

• In San Mateo County, cocaine is the most widely used illicit drug, but alcohol continues to be the biggest drug problem. Alcohol is implicated in convictions in violent crimes, fatal car accidents, in foster home placement of children, in alcohol and drug exposed infants and child abuse. Besides the human toll, alcohol and drug abuse have economic consequences for the county - theses problems cost San Mateo County almost one-half billion dollars in 1988. Population particularly effected by alcohol and drug abuse children of alcoholics, people with disabilities, elderly, and abusers of the elderly, ethnic minorities and mentally ill people who also have substance abuse problems, and gay men and lesbians.

• Until the AIDS epidemic, alcoholism was often considered the number one health problem among gay men and lesbians. Some experts the next wave of AIDS epidemic to come from the intravenous drug using population.

• Among young adults the greatest need in San Mateo County is in Coastside where use of alcohol and drugs by youth exceeds the national average. There's been little or no moderate or low cost treatment available locally.

• 16 to 20 people due of alcoholism for every one person who dies as a result of using illegal drugs.

• 26% of all hospitalized persons have alcohol related related health problems.

• 14% to 26% of the workforce age 18 to 40 comes to work everyday under the influence of alcohol and other drugs.

• By 1990 California will have 3.3 million people over 65 OR 36% increases over the number in 1980. It is estimated that at least 600 to 1,000 new licensed Adults Day Health Care Centers a needed statewide now. One person in Adult Day Health Care instead of a nursing facility saves the State $265 a month, or $3,000 a year.

• In San Mateo there are no Adult Day Health Care programs available in Northern or Southern San Mateo County and no center caters to the Black, Hispanic or Asian communities. Although it is not licensed as a day health care center, Fair Oaks Senior Center in Redwood City serves about 1,500 unduplicated seniors, 20% of them Hispanics, many frail and very ill.
  
  
  
  
  
  
  
  
  
  
  
  

• In San Mateo County there are no Adult Day Health Care programs available for residents in Northern or Southern San Mateo County and no Center caters to the Black, Hispanic, or Asian communities. Although it is not licensed as a day health care center,the Fair Oaks Senior Center in Redwood City serves about 1,500 unduplicated seniors, 20% of them Hispanics, many frail and very ill.

• The county has no affordable out-of-home, weekends or overnight respite programs for the elderly and their families. Although need is services for persons with moderate to sever dementia's. These people are Inadequately served by existing day care centers causing greater caregiver stress and premature institutionalize action.

• The need for senior services in Coastside is growing. The population 60 years and over in Coastside was 10% or 2,084 people. 22% was of ethnic or racial groups enumerated by the census. This percentage doesn't include large numbers of Portuguese and Italian speaking elders.

• 80% of care for frail elderly provided by family and friends.

• Of the 13,200 elderly people in South San Mateo County assumed to be living with family members, 6% or 600 receive special care requiring around-the-deck demand of the caregivers and their families.

• Meal service demands have increased 300% form FY 1982 FY 1989.

• In the County there are no health education and outreach programs aimed at immigrant and refugees population, in physical or mental health and substance abuse areas. In particular, efforts need to be directed to the attitudes of immigrants and refugees regarding the need for help and for substance abuse therapy.

• More health education efforts need to be directed to the following areas: public education is needed to help victims of sexual assault and rape so that victim-blaming does not occur; youth need education in three areas: education about family planning and family life education, including, life goal-setting and self esteem building, to be offered in more consistent and though was than is now available in the County; education that builds positive self-image and self-confidence to prevent drug experimentation/addiction, and awareness to mitigate teen suicides.

• Education on prevention of alcohol/drug abuse should be linked to AIDS prevention. School-based prevention efforts can be enhanced by peer support groups and parent support programs. Youth need more available alternative activities. Social and environmental alcohol policies need to be developed to deal with issues such as sale of alcohol at gasoline stations.

• Although most Americans know that fitness will improve their health and quality of life, 45% of American Adults still do not participate in any fitness activity.

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