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The Mental Health Services Act (MHSA) passed by voters in California in 2004, has the goal of transforming the delivery of public mental health to a model of consumer wellness, recovery, and resilience. This paper presents results from the first study to evaluate how California’s public mental health delivery system has served older adults (60 years of age and over) since passage of the MHSA. The study used multi-methods including a secondary analyses of over 100 publications and evaluation reports, primary data collection through key informant interviews (59 county-level and 13 state-level), focus groups representing 33 consumers and 11 family members, and a county survey about the status of an older adult system of care (OASOC) for mental health. Findings indicate unmet needs and limited service penetration for older adults, deficits in the involvement of older adults in the required MHSA planning processes and in outreach and service delivery, workforce development, and outcomes measurement and reporting. However, services to older adults have increased, provider networks have expanded and counties have advanced promising programs and strategies to address current deficits. In addition, about 40% of California counties now have a distinct OASOC, up from the 25% that had this in 2004. Recommendations for improvement include designating a distinct administrative and leadership structure for older adult services in each county; enhancing older adult outreach and documentation of unmet need; promoting standardized geriatric training of providers; and increasing service integration efforts, especially between medical, behavioral health, aging, and substance use disorder services. |
