Mental Health Data Workbook and Training

1. Mental Health Data Workbook and Training Ann Arneill-Py, PhD, Executive Officer CA Mental Health Planning Council Stephanie Oprendek, PhD, Senior Associate California Institute for Mental Health All Directors Meeting - December 10, 2009

2. CA Mental Health Planning Council • Oversight of the public mental health system • Advocate for adults and older adults with SMI and children and youth with SED and their families • Advise DMH, the Legislature, and local boards on mental health policies and priorities • Evaluate the performance of local mental health programs • Oversight of education and training component of MHSA

3. Mental Health Board Requirement • Section 5604.2, Welfare and Institutions Code • Review and comment on the county’s performance outcome data and communicate its findings to the California Mental Health Planning Council

4. Workbook • Developed workbook to provide information to MHB/Cs on continuous quality improvement. Uses data on mental health services • Penetration rates (identifies potential unmet need) • Retention rates • (analyzed by gender, age, and race/ethnicity) • Data were provided to all Mental Health Directors to review in June 2009 to review for accuracy • Mandatory for MHB/Cs to complete workbook due to statutory mandate • Workbooks to be developed on an on-going 2-3 year cycle

5. Workbook Table of Contents • CHAPTER 1 • BACKGROUND • Engaging in Continuous Quality Improvement…………………………............….......5 • The Continuous Quality Improvement Process…………………………..................... 6 • Access to Services (Penetration): Definition and Measurement……....................…8 • Service Retention: Definition and Measurement……………………............….....…11 • Using This Workbook to Examine Access (Penetration) and • Retention Information...............................................................................................12 • CHAPTER 2 • RACE/ETHNICITY: Access (Penetration) and Retention Information Analyzed by Race/Ethnicity • Examining and Interpreting the Access (Penetration) Charts…….............……...…15 • Examining and Interpreting the Retention Charts………………...........…….…...….19Potential Factors Associated with Access and Retention Differences • by Race/Ethnicity………………………………………………..…………......…….......22 • Questions to Guide the Continuous Quality Improvement Process…...........…...…25 • CHAPTER 3 • AGE: Access (Penetration) and Retention Information Analyzed by Age • Examining and Interpreting the Access (Penetration) Charts…………............…....28 • Examining and Interpreting the Retention Charts………………………...............….31Potential Factors Associated with Access and Retention Differences • by Age………………………………………………………………………..........…...…34 • Questions to Guide the Continuous Quality Improvement Process…...........…...…37 • CHAPTER 4 • GENDER: Access (Penetration) and Retention Information Analyzed by Gender • Examining and Interpreting the Access (Penetration) Charts…………................…40 • Examining and Interpreting the Retention Charts………………………............…....43Potential Factors Associated with Access and Retention Differences • by Gender……………………………………………………………………….....……...46 • Questions to Guide the Continuous Quality Improvement Process…..........…....…49 • APPENDIX A: Statewide Access (Penetration) and Retention Charts…………............50 • APPENDIX B: Access (Penetration) and Retention Data Tables……………............….63 • ENDNOTES / REFERENCES.........................................................................................64

6. One-Day Training • CiMH will provide one-day trainings to MHB/Cs. • Uses an inter-county gathering format: 2-4 neighboring counties. • Each county will receive the training within the next 18 months. • Focus is on understanding CQI, data concepts, limitations of data, data interpretation. • Counties will explore their local penetration and retention data. • During the training, CiMH will assist MHB/Cs in responding to questions posed by the CMHPC contained in the workbooks.

7. County Groupings for MHB/C Data Trainings • Monterey*, San Benito, Santa Cruz • Shasta*, Siskiyou, Tehama • San Diego*, Imperial • Del Norte, Humboldt, Trinity • Madera, Merced, Stanislaus • Butte, Colusa, Glenn, Sutter • Fresno, Kings, Tulare • Lassen, Modoc • Kern, San Luis Obispo, Santa Barbara, Ventura • Nevada, Plumas, Sierra, Yuba • Los Angeles, Orange, Riverside, San Bernardino • Lake, Mendocino, Sonoma • Amador, El Dorado, Placer • Sacramento, San Joaquin, Yolo • Solano, Napa, Marin • San Francisco, San Mateo, Santa Clara • Alameda, Contra Costa • Alpine, Inyo, Mono • Calaveras, Tuolumne, Mariposa * Pilot County

8. Data Workbook Questions: Access/Penetration by RACE/ETHNICITY • What are your findings regarding access/penetration for mental health services by race/ethnicity? What racial/ethnic groups have higher access (penetration)? • What factors in your county account for differences in access (penetration) by race/ethnicity; e.g., transportation, geography, mental health literacy, stigma? • What barriers exist in your county to increasing the access (penetration) for mental health services for the identified underserved race/ethnic groups? • What is your understanding of what your county is doing to increase access (penetration) for mental health services by race/ethnicity; e.g., implementing the Mental Health Services Act and your county’s Cultural Competence Plan? • What recommendations do you have for increasing the access/penetration for mental health services for the identified underserved racial/ethnic groups in your county?

9. Data Workbook Questions: Service Retention by RACE/ETHNICITY • What are your findings regarding retention in mental health services by race/ethnicity? What racial/ethnic groups have higher retention in mental health services? • What factors in your county account for differences in retention by race/ethnicity; e.g., transportation, geography, mental health literacy, stigma? • What barriers exist in your county to increasing the retention in mental health services for the identified underserved racial/ethnic groups? • What is your understanding of what your county is doing to increase retention in mental health services by race/ethnicity; e.g., implementing the Mental Health Services Act and your county’s Cultural Competence Plan? • What recommendations do you have for increasing retention in mental health services for the identified underserved racial/ethnic groups in your county?

10. Contact Information Ann Arneill-Py, PhD, Executive Officer CA Mental Health Planning Council 1600 9th Street, Room 420 Sacramento, CA 95814 (916) 651-3803 Ann.Arneill-Py@dmh.ca.gov Stephanie Oprendek, PhD, Senior Associate California Institute for Mental Health 2125 19th Street, 2nd Floor Sacramento, CA  95818 (916) 556-3480 ext. 155 (916) 284-8146 (cell) soprendek@cimh.org