Federal and state laws mandating parity in coverage of mental and physical illness, together with expansion under the ACA of both Medi-Cal eligibility and scope of mental health services, have made more services available to more Californians. Public and private actors have devoted significant resources to expand access to care, better integrate physical and mental health care, and reduce stigma. Despite these efforts, the incidence of some mental illnesses continues to rise, many Californians still fail to receive treatment for their mental health needs, and many have poor overall health outcomes.
Using the most recent data available, Mental Health in California: For Too Many, Care Not There provides an overview of mental health in California: disease prevalence, suicide rates, supply and use of treatment providers, and mental health in the correctional system. The report also highlights available data on quality of care and mental health care spending.
Key findings include:
- The prevalence of serious mental illness varied by income, with much higher rates of mental illness at lower income levels for both children and adults.
- Compared to the US, California had a lower rate of suicide, although it varied considerably within the state by gender, age, race/ethnicity, and region.
- About two-thirds of adults with a mental illness and two-thirds of adolescents with major depressive episodes did not get treatment.
- Medi-Cal pays for a significant portion of mental health treatment in California. The number of adults receiving specialty mental health services through Medi-Cal has increased by nearly 50% from 2012 to 2015, coinciding with expansion of Medi-Cal eligibility.
- The supply of acute psychiatric beds may have stabilized after a long period of decline. However, emergency department visits resulting in an inpatient psychiatric admission increased by 30% between 2010 and 2015. More robust community services might decrease emergency department use.
- The incidence of mental illnesses in California’s jails and prisons is very high. In 2015, 38% of female prison inmates and 23% of the male prison population received mental health treatment while incarcerated.
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