Health Services Act
Transforming the Public
Mental Health System
In November of 2004, California voters passed Proposition 63, the Mental Health Services Act (MHSA), to transform the pubic mental health system. MHSA envisions a mental health system that is driven by consumers and families; focuses on wellness, recovery, and resiliency; and results in an integrated and culturally competent service delivery experience that demonstrates positive outcomes for individuals served.
MHSA funding is separated into different funding components to ensure that funding is not only available for those with the most serious need, but also to provide prevention and early intervention services to reduce the life-long impact of a mental health condition, for infrastructure development and technology, and for workforce education and training. Funding was also made available to try new and innovative practices targeted towards specific community needs.
Implementation of the Act is now in its eighth year. Given the high levels of stigma associated with mental health and the growing demand for services, there is a continued opportunity to promote the values of MHSA and realize a transformative impact on the public mental health system.
- Counties will need to update their plans for MHSA. MHSA requires that counties engage in inclusive community planning processes to decide at the local level how to best respond to the needs of the un-served, underserved, and inappropriately served. Previously, counties developed plans for each component of MHSA. Starting in 2013, counties are being asked to integrate the components into one unified plan informed by key stakeholders and the community planning process.
- A consumer- and family-driven service system is only possible when there is meaningful involvement throughout the system. “Benevolent stigma” continues to present a pervasive threat to the full realization of a consumer and family driven system, and provides continued opportunity for us to challenge ourselves and each other to address our own well-intentioned beliefs and assumptions.
- MHSA evaluation should measure the level of transformation of the public mental health system and the degree to which the lives of individuals served have improved. MHSA is one of the most widely evaluated programs in the history of California’s public mental health system. MHSA evaluation, however, has focused mostly on individual-level outcomes, like homelessness and incarceration.