The ‘Millionaires Tax’ And Mental Health Policy In California

Feldman, Saúl

doi:10.1377/hlthaff.28.3.809

Cited by 7 publications

(33 citation statements)

References 6 publications

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“…B The opposition of Governor Arnold Schwarzenegger turned out not to be a deterrent (Anke and Medlin, 2006); he disliked the proposition but did not campaign against it (Feldman, 2009). …”

Section: Why Proposition 63 Passedmentioning

confidence: 99%

“…This phased implementation resulted in multiple county planning processes and risked a ''silo'' mindset with potential threat to the integration of programs that must work together to be successful (Feldman, 2009). …”

Section: How It Workmentioning

confidence: 99%

“…MHSA funds are allocated directly to each county based on a formula that assesses several factors, including the number of people in a county with incomes below the federal poverty level and with severe mental illnesses. The prevalence of homeless people with mental disorders is not a factor (Feldman, 2009 In an era of limited and shrinking resources, the requirement that funds be spent only on new services is a conundrum for counties (Feldman, 2009). Critics of MHSA's implementation describe the result as a ''two-tiered system,'' with new MHSA-funded programs implemented while core services crumble (Yannello, 2011).…”

Section: How It Workmentioning

confidence: 99%

“…Proposition 63 provided for an Oversight and Accountability Commission (MHSOAC or Commission), the only new potential change agent created by the statute (Feldman, 2009). The first meeting of the Commission occurred on July 7, 2005.…”

Section: Mental Health Services Oversight and Accountability Commissionmentioning

confidence: 99%

“…Originally the Commission was located within the DMH, dependent on the department for its budget, staffing, contracts, and the selection of its executive director (Feldman, 2009 …”

Section: How the Mhsoac Operatesmentioning

confidence: 99%

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Mental health policy in California: the “millionaire's tax” and the Mental Health Services Oversight and Accountability Commission

Lee¹

2012

Mental Health Review Journal

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Purpose -This article's aim is to describe the history, purpose, challenges, strategies, and progress of California's Mental Health Oversight and Accountability Commission (MHSOAC), created by California's pioneering Proposition 63 (Mental Health Services Act). California voters passed this initiative in 2004 to expand and transform public mental health services.Design/methodology/approach -This case study is based on observations of the author, who has worked with the Commission since its inception, and the study is adapted from a 2009 article by one of the original Commissioners who served from 2005-2008. The article focuses on challenges and opportunities for oversight in an environment of stakeholders' high and diverse expectations, limited direct state authority, and significant and broad budget challenges.Findings -The Commission prioritizes evaluation as its principal strategy with a primary goal of using evaluation results for quality improvement. Implementing this strategy, with limited county reporting requirements, inadequate data systems, and insufficient funds designated for evaluation, is a continuing challenge. Other key challenges -and opportunities -include passionate stakeholders with high and divergent expectations, a de-centralized public mental health, and a statewide fiscal and budget crisis.Research limitations/implications -The paper relies on the observations of two key participants: a former Commissioner and the Commission's staff psychologist. Participant observation brings opportunities for bias as well as insight. Diverse stakeholders undoubtedly would provide different perspectives on the progress of Proposition 63 and on the MHSOAC.Practical implications -The Commission developed a logic model that defines strategies for oversight and accountability and links these strategies to Proposition 63's intended outcomes for California's public mental health services system and clients.Social implications -The success of California's Proposition 63 in transforming mental health delivery from a ''fail first'' crisis system to a ''help first'' proactive system has implications for integrated healthcare delivery that includes mental health.Originality/value -The California emphasis on recovery, resilience, and wellness for diverse people with and at risk of serious mental illness is consistent with national and world-wide recommendations and initiatives and is one of the largest efforts to transform a mental health system to reflect these values.

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“…B The opposition of Governor Arnold Schwarzenegger turned out not to be a deterrent (Anke and Medlin, 2006); he disliked the proposition but did not campaign against it (Feldman, 2009). …”

Section: Why Proposition 63 Passedmentioning

confidence: 99%

Section: How It Workmentioning

confidence: 99%

Section: How It Workmentioning

confidence: 99%

Section: Mental Health Services Oversight and Accountability Commissionmentioning

confidence: 99%

“…Originally the Commission was located within the DMH, dependent on the department for its budget, staffing, contracts, and the selection of its executive director (Feldman, 2009 …”

Section: How the Mhsoac Operatesmentioning

confidence: 99%

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Mental health policy in California: the “millionaire's tax” and the Mental Health Services Oversight and Accountability Commission

Lee¹

2012

Mental Health Review Journal

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Evidence-based psychological treatments for mental disorders: Modifiable barriers to access and possible solutions

Harvey

Gumport

2015

Behaviour Research and Therapy

177

126

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The prevalence of mental disorders is high and appears to be growing, yet the majority of individuals who meet diagnostic criteria for a mental disorder are not able to access an adequate treatment. While evidence-based psychological treatments (EBPTs) are effective single or adjunctive treatments for mental disorders, there is also evidence that access to these treatments is diminishing. We seek to highlight modifiable barriers to these problems at the patient, therapist, treatment, organization and government-levels of analysis. A range of solutions to each set of contributors is offered and domains for future research are highlighted. In particular, we focus on the need to continue to work toward innovation in treatment development while also solving the difficulties relating to the dissemination of EBPTs. Several relatively new concepts in the field will be discussed (implementation cliff, program drift, voltage drop and deployment treatment development) and we contrast America and England as examples of government-level processes that are in the process of major change with respect to EBPTs. We conclude that there is a need for people in our field to become more knowledgeable about, and get involved in, shaping public policy.

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Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives

Castillo

Chung

Bromley

et al. 2018

Harv Rev Psychiatry

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This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.

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The ‘Millionaires Tax’ And Mental Health Policy In California

Cited by 7 publications

References 6 publications

Mental health policy in California: the “millionaire's tax” and the Mental Health Services Oversight and Accountability Commission

Mental health policy in California: the “millionaire's tax” and the Mental Health Services Oversight and Accountability Commission

Evidence-based psychological treatments for mental disorders: Modifiable barriers to access and possible solutions

Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives

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