New report by UC Berkeley Petris Center
outlines status of California's county mental health programs

Tuesday, November 6, 2007
Contact: Mistique Felton (510) 643-4104

Berkeley — California's county mental health departments spent most of their budgets on outpatient services, with low overhead and low spending on hospitalization, according to a new report released today (Tuesday, Nov. 6) by the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at the University of California, Berkeley.

The survey covers the structure, organization, and financing of county mental health departments in the 2004 fiscal year, providing baseline data on each county before voters passed the Mental Health Services Act (MHSA) later that same year.

"The report provides a clear starting point for future measurements of how effectively the new funds and services resulting from the MHSA will improve the lives of mentally ill people in California," said Richard Scheffler, UC Berkeley professor of health economics and public policy, director of the Petris Center, based at UC Berkeley's School of Public Health and co-author of the report.

California has already had some success in improving the health and quality of life of people with a serious mentally illness with programs funded through California Assembly Bill 2034 (AB 2034), passed in 2000 to address the mental health needs of homeless adults.

The Mental Health Services Act expands on AB 2034 by supplying the public community mental health system with additional resources to provide consumer directed, recovery-based services to people with mental illness, including housing and employment opportunities, reduced incarceration and the reduced need for hospitalization. Funds for the legislation, supplied by a 1 percent tax on incomes over $1 million, go to county mental health departments for new or expanded innovative programs based on the recovery model, while maintaining the 2004 funding level for mental health.

However, there has been a major concern about implementing the MHSA-how to determine if the new funding would spark the intended transformation since there was no baseline measurement in many of the areas expected to change.

Part of this problem has been solved with the publication of the new report "California on the Eve of Mental Health Reform," by the Petris Center.

"The data generated by this study will help us be more accountable to the voters and will help to insure that recovery based community mental health services are expanded across all of California," said Mark Refowitz, immediate past president of the California Mental Health Director's Association and mental health director for the County of Orange. "These services will assist people to live a full and meaningful life in their community."

Forty-four counties representing 98 percent of California's population responded to the survey. Counties spent an average of $5,011 per client per year on services, and services represented an average of 90 percent of budgets. An average of 2 percent of budgets was spent on state hospital beds, and 4 percent on Institute for Mental Disease (IMD) beds. One-third of the budgets were spent on child and family services. More than one-third of mental health department employees were bilingual. Most counties had experience with at least one program to provide innovative models of care such as AB 2034.

"MHSA is very outcomes focused, and this report will help provide a baseline of information for assessing progress made in each county across several dimensions," said Tracy Finlayson, assistant professor at San Diego State University, former Agency for Healthcare Research & Quality Post-Doctoral Scholar at the Petris Center and lead author of this report. "This is the first time key organizational information about the county mental health departments has been systemically compiled. The results can help inform the counties about their strengths and potentially facilitate sharing of successful strategies across like counties."

The survey also looked at the amount of consumer involvement in county mental health departments prior to the passage of MHSA. Sixteen percent of counties had a consumer as part of the management team and one-third had a program for hiring consumers as county employees. The average spending on peer and family services was $34 per client for adults and $54 per client for children and families.

"As one of the goals of MHSA is to improve consumer participation in the system, these measures will help document counties' improvement during MHSA implementation," said Mistique Felton, senior research associate at the Petris Center and co-author of the report.

The survey is part of a three-year study by the Petris Center to evaluate the impact of the MHSA funded by the California HealthCare Foundation. Timothy Brown, associate director of research at the Petris Center, is another report co-author.

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