INTRODUCTION

In November 2004, California voters passed Proposition 63, also known as the Mental Health Services Act (MHSA). The intention was to expand and improve mental health services for Californians living with or at risk of serious mental illness. The MHSA applies a tax of 1% on incomes over $1 million to fund public mental health services and through this new funding stream, has provided services for priority populations identified as being unserved or underserved by the public mental health system. This includes highly vulnerable groups such as veterans, transitional-aged youth, individuals who are homeless, and underserved racial/ethnic minorities.

Consistent with prior efforts focused on reforming the delivery of mental health care in California, the MHSA provides broad policy guidance but relied on local mental health agencies to design and implement new programs. The Orange County Health Care Agency used MHSA funding to expand upon a multitude of services for children, teens, and adults. The decision of which services to provide in Orange County was the result of extensive planning efforts that started over a decade ago when MHSA became state law in 2005.

This report assesses the current state of mental health need and unmet need in Orange County since implementation of the MHSA, and is divided into three parts:

• Part 1 of this report provides estimates of the Prevalence of Mental Health Symptoms and Service Utilization in Orange County, with additional information presented for specific subgroups of interest, using data from the California Health Interview Survey.

• Part 2 examines Geographic Access to Behavioral Health Services using data from the

Orange County Health Care Agency Behavioral Health Services Directory and the online facility locator database maintained by the Substance Abuse and Mental Health Services

Administration. Part 2 also includes a supplemental analysis on the impact of the availability of psychiatric hospital beds on overnight emergency room stays using data from the Office of Statewide Planning and Development’s (OSHPD) Hospital Annual

Utilization Report.

• Part 3 identifies Barriers to Behavioral Health Care from Provider/Advocate and

Cultural/Linguistic Minority Community Members’ Perspectives using data from focus groups. A final section provides recommendations based on the findings from this report.

The final section of this report includes recommendations at the county and provider-level which may help address the needs and gaps identified in these analyses.