A decade-old comprehensive mental health program in California that has put about $4 billion into community-based programs improves the chances of people with serious mental illnesses being able to transition to independent living rather than end up homeless or in jail, according to a study released last week.
Adults who have an uninterrupted stay in California's Full Service Partnerships programs are 13.5% more likely to successfully transition into independent living, according to the study by Oregon State University's College of Public Health and Human Sciences. The study was published in October's American Journal of Public Health.
Full Service Partnerships were established as part of the Mental Health Services Act, Proposition 63, passed by voters in November 2004. The act, funded by a 1% tax on personal annual income in excess of $1 million, has provided about $1 billion a year to counties since 2005.
Full Service Partnerships are implemented by individual counties and provide intensive mental health services that include housing, employment, education, peer support and outreach. The average stay in the program is two years, according to program overseers.
It serves those with severe mental illnesses who are unserved or underserved, at risk for homelessness or incarceration, or frequently hospitalized for mental health problems.
Since the program's inception in 2005, California counties implementing the program have received about $4 billion. In the 2011-12 fiscal year, about 30,000 patients were served, a six-fold increase from 2006-07, according to the Mental Health Services Oversight and Accountability Commission, which was established to monitor the 2004 law.
According to the Oregon State study, which tracked 9,208 adults over four years, those who were continuously enrolled in the program were 13.5% more successful in moving into independent living,. The success rate is less for non-whites and those suffering from schizophrenia and bipolar disorders because of the severity of the illness.
The results of the study are not a surprise and are in line with what the program has been experiencing all along, said Rusty Selix, executive director and legislative advocate of the Mental Health Association in California and the California Council of Community Mental Health Agencies.
Selix said the key is how the program is structured, giving counties flexibility in how they spend the state funds, which can be in very non-traditional ways.
“Very often a person being served says I am about to be evicted, can you help me, or I have a place but need help moving my stuff,” Selix said. “If someone doesn't have stable housing, they are not going to stay in the program. They have to pay attention to a person's living situation and help with living skills and management of money, get employment, all these things.”
The Oregon State study calls the Mental Health Services Act and the partnerships “a bold experiment in addressing the comprehensive needs of an often marginalized population at high risk of homelessness, incarceration or exacerbation of mental disorders.”
It goes on to say that California's well-funded community mental health program and its results should be a guide to other states considering funding programs for people with severe mental illness.
The report was authored by Jangho Yoon, of Oregon State University, Tim Bruckner, University of California, Irvine, and Timothy Brown, University of California, Berkeley.
Selix said expansion is the next step for the California program.
“What's next is graduating people to less intense levels of care and at less cost,” Selix said. “The goal is to expand it because we feel there are many thousands more who need this care and are not getting it.”