California’s Mental Health System: Aligning California’s physical and mental health services to strengthen the state’s capacity for federal coverage expansion
This report will analyze the delivery of mental health services in California and will investigate the potential impacts of federal health reform legislation on the State and counties. California has operated successful mental health pilots where physical health has become more integrated with mental health. Results from these pilot programs will also be discussed, in addition to policy challenges and recommendations.
The World Health Organization defines mental health as a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community. Determinants of mental health include multiple social, psychological, and biological factors that influence the level of mental health of a person throughout his or her life.
The California Department of Mental Health reports approximately 2 million people in California suffer from severe mental illness or a severe emotional disorder, which comprises almost 7 percent of the population. The need for mental health care is very common in California, where 1 in 5 people report the need for such services. This means that more than four million Californians may be at risk for distress, pain, disability, and death associated with mental disorders. The unmet need for mental and behavioral health services is greatest among underserved groups, including elderly persons, racial/ethnic minorities, those with low incomes, those without health insurance, and residents of rural areas. As a result the health and wellness of the individual is jeopardized and the effects to society spread across communities, schools, businesses, prisons and jails, and healthcare delivery systems.
In the United States, and specifically in California, policy formation has been guided by the community’s perception and acceptance of those who suffer from mental illness. Expanding and improving mental health care and coverage is largely decided through public support and recognition that mental illness can be treatable and preventable. Studies continue to show that early identification and treatment can help prevent the onset of disease, decrease rates of chronic disease, and help people lead longer, healthier lives.
Policy provisions in the 2010 Patient Protection and Affordable Care Act (ACA) will require that health insurance plans offer equal physical and behavioral health coverage, including mental health and substance abuse services, starting 2014. Upon full implementation of healthcare reform, approximately 235,000 Californians with mental illness or addiction disorders will have new coverage through Medi-Cal or the Exchange. Building on ongoing State efforts to reform health care, the ACA and §1115 Waiver will provide California with new tools, flexibility, and resources to provide better mental health care coverage.
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