Amador County builds community college pipeline for mental health workers
In SummaryAmador is one of six California counties without a physical community college. It also struggles to recruit mental health providers. A small online learning program could offer a solution to both problems.
College pennants and framed certificates hang on the walls of the Amador Economic Prosperity Center. Computer stations fill the center of the room, and a shelf near the printer is stacked with used textbooks.
Since June, the building has offered a fresh start to Amador County residents who’ve historically struggled to access higher education. On a recent evening, more than a dozen people gathered over strawberries and scones to sign paperwork for their first online semester at Coastline Community College, which has a campus in Orange County serving more than 11,000 students.
During an icebreaker, some shared their fears about going back to school.
“I kind of feel like stopping and putting it on hold for a while, because it gets overwhelming,” said Jessica Hogue, a 24-year-old mom attending college for the first time.
Hogue is part of a small group receiving scholarships from the county to pursue a certificate or associate degree in human services, which can open doors to entry-level jobs in health and social work.
Using ‘lived experience’
The county gives preference to students who have a personal tie to mental illness, either as a patient or as a family member. The program aligns with broader state efforts to grow the mental health workforce using people with lived experience, and to increase access to higher education in areas where cost and transportation barriers can stop people from pursuing degrees.
Residents of Amador County have long struggled to access mental health professionals. Rural areas across the state have lower provider-to-patient ratios than their urban counterparts when it comes to psychiatrists, therapists, social workers and other positions.
Even though Amador’s psychiatrist-to-patient ratio is on the higher end compared to other counties, some of those providers may work just a few hours a week. And not all of them accept Medi-Cal, which is a source of insurance for about one fifth of Amador residents. For many in the county, seeing a psychiatrist means driving an hour to Sacramento or Folsom.
“To have people here who understand and are willing to work within the system to help people who are facing mental health issues, be they PhD’s or MD’s or certificated professionals, I think that is a gap-filler,” said Meg Newell, a volunteer with the nonprofit Amador Community College Foundation, which oversees the scholarship program.
Since it launched in 2014, the county has given scholarships to 44 students seeking careers in public mental health. The money covers the cost of tuition, fees and books, while the center offers students reliable wi-fi, enrollment help and academic tutoring.
Many of the students are working parents. Some were formerly incarcerated, have experienced homelessness, or are dealing with addiction. Most say college never seemed like an option.
Tammy Montgomery, 58, started online courses about two years ago. She moved to Amador in 2015, after the Butte Fire destroyed her Calaveras County home. A decade ago, three of her children died in a car accident, and losing their baby pictures and other childhood items in the blaze amplified her grief.
She says the scholarship pulled her out of a deep depression and gave her a purpose.
“If I hadn’t walked in the door, I don’t think I’d be in good shape, still,” she said. “It really got me out and started my life over again. It gave me something to do, a purpose, to help somebody.”
When Montgomery first showed up at the Amador learning center, she was barely computer literate, she said. She now tutors other residents pursuing human services certificates, and represents students on the Amador College Connect board while working toward her associate’s degree.
Filling workforce gaps
Community-based mental health workers, especially those with real-life experience, are a piece of solving the state’s provider shortage, said Janet Coffman, who studies the health care workforce at the University of California, San Francisco.
“Providers of behavioral health services in rural areas, in general, struggle more than in urban areas, either with turnover or just finding folks to fill vacant positions,” she said.
A group of experts looking at the problem recently recommended peer support workers in their list of solutions. But Coffman says more workforce support is needed at higher levels, too.
“The economic mobility of people who only have a certificate in human services is rather limited,” she said. “We need to make investments in the behavioral health workforce up and down the line.”
Eleven students have gained a certificate or associate degree in human services through the program, and another six, including Montgomery, will graduate this fall. Newell says at least seven of the program’s graduates are working or volunteering in human services locally.
Nadine Magana was one of the first students to become certified through the Amador program. She then got another county scholarship to pursue an associate degree, and now works as a program manager at Nexus Youth and Family Services, a local nonprofit.
“If tomorrow this agency didn’t exist, that degree is going to open a door for me that may not be there,” she said.
Some scholarship recipients, like Bobbie Harrison, go straight into employment without actually finishing their courses.
Harrison, 27, became interested in the human services certificate after her grandmother died. She was pregnant, and in need of direction.
“For a long time I would work Subway and Taco Bell, and just that continuous same routine over and over again,” she said.
She said taking the online courses gave her a way to speak about her depression and suicidal thoughts, which are often stigmatized in her Native American community.
She hasn’t finished her human services certificate yet, but an internship she completed through the scholarship program helped her find a job as a program supervisor at the Sierra Wind Wellness and Recovery Center.
“I’ve been here two years now, and it’s constantly pushing me to look at myself and to grow and to help other people,” Harrison said. “I don’t see myself working at another spot other than human services.”
And many more students are inching toward certificates or associate degrees at their own pace, taking time off from classes to work, take care of family, or handle a personal mental health issue. The scholarship program does not put time limits on graduation.
The future of peer support
Amador, along with a handful of other counties, is leveraging state funding to grow the ranks of peer mental health providers. The scholarship program relies on workforce development funds from California’s Mental Health Services Act, which established a millionaire’s tax for mental health prevention and intervention in 2004.
Monterey and San Bernardino counties also use the funds to train community members with real-life experience, with the goal of hiring them in county-run mental health clinics. They also provide financial assistance to residents pursuing bachelor’s and master’s degrees, in the hopes that those students will work in the area after becoming licensed.
“If we didn’t have MHSA, we really wouldn’t have the funding to have these peer-based services,” said Amie Miller, director of Monterey County Behavioral Health. “It’s unequivocally what’s built up our peer-based workforce. And those peers are doing really transformative things.”
She said the county hires peers for specific initiatives, such as working in inpatient behavioral health units, and training law enforcement on how to interact with people with mental illness.
Some advocates want to see the peer-based mental health workforce expand. A recent bill would have established a formal, standardized certification for peer providers across the state, potentially creating a clearer career path for community-based mental health workers and making their services Medi-Cal reimbursable.
But Gov. Gavin Newsom vetoed the proposal, stating that he’d rather have advocates make a budget ask for general fund dollars than sign a bill with “significant costs.” A legislative analysis found it would cost $2 million for the first year of implementation, plus several million in ongoing expenses, some of which could come from the Mental Health Services Act.
Reaching ‘stranded’ adults with online learning
For many in Amador County, becoming a peer mental health worker wouldn’t be possible without online education options. California is looking at digital learning more broadly as a way to make people more employable.
In a 2018 budget speech, then-Gov. Jerry Brown talked about the need to reach “stranded” adults who have high school diplomas but no college degrees. He allocated $120 million to an online-only community college, designed for the 2.5 million Californians ages 25 to 34 who struggle to participate in traditional classrooms. The school, called Calbright College, launched in early October.
Bailey DeWitt, a 22-year-old taking online classes through the Amador scholarship program, said she became interested in being a substance abuse counselor after watching her partner struggle with drug and alcohol addiction.
But she doesn’t have a driver’s license, which made going out of county for community college seem impossible.
Through the scholarship program, she’s been able to take classes from home while also caring for her 20-month-old son. She says her educational path doesn’t end when the scholarship runs out.
“I’m starting out with getting my certificate, then I get my AA, then I want to get my BA in either counseling or psychology, either one,” she said. “It all goes toward that goal, I’m just starting out with the baby steps.”
DeWitt will soon begin an internship with Amador County Behavioral Health Services. Human services students have the option to work at the food bank, the local rape crisis center and a variety of other safety net agencies as part of a 100-hour internship paid for by the county. Work or internship experience is also a requirement of graduating the Coastline program.
Tammy Montgomery, the 58-year-old student, says she isn’t sure if she wants to re-enter the workforce just yet. Right now, she’s finding meaning as a volunteer with a hospice group, working with children who’ve lost loved ones. She’s also interning with Amador College Connect.
She can’t break all of her old habits. Though she lives alone, she still tends to cook for a crowd — her teenagers always had friends around. And there are still days where she just wants to hole up from the grief.
But she says her coursework continues to help her find meaning.
“After being a mom for so long, and watching your children with milestones and succeeding and all of a sudden not having that, it’s been a real longing for me,” she said. “I know what I do helps. I’m not just out there peddling soap. I know I can give good information and good comfort to people. And that’s what it’s about. That’s my life.”
The California Dream series is a statewide media collaboration of CalMatters, KPBS, KPCC, KQED and Capital Public Radio with support from the Corporation for Public Broadcasting and the James Irvine Foundation.