Mental Health Data Mental Health Data Workbook and Workbook and TrainingTraining

Ann Arneill-Py, PhD, Executive OfficerAnn Arneill-Py, PhD, Executive OfficerCA Mental Health Planning CouncilCA Mental Health Planning Council

Stephanie Oprendek, PhD, Senior AssociateStephanie Oprendek, PhD, Senior AssociateCalifornia Institute for Mental HealthCalifornia Institute for Mental Health

All Directors Meeting - December 10, 2009All Directors Meeting - December 10, 2009

CA Mental Health Planning CA Mental Health Planning CouncilCouncil

Oversight of the public mental health systemOversight of the public mental health system Advocate for adults and older adults with Advocate for adults and older adults with

SMI and children and youth with SED and SMI and children and youth with SED and their familiestheir families

Advise DMH, the Legislature, and local Advise DMH, the Legislature, and local boards on mental health policies and boards on mental health policies and prioritiespriorities

Evaluate the performance of local mental Evaluate the performance of local mental health programs health programs

Oversight of education and training Oversight of education and training component of MHSAcomponent of MHSA

Mental Health Board Mental Health Board RequirementRequirement Section 5604.2, Welfare and Section 5604.2, Welfare and

Institutions CodeInstitutions Code– Review and comment on the Review and comment on the

county’s performance outcome data county’s performance outcome data and communicate its findings to the and communicate its findings to the California Mental Health Planning California Mental Health Planning CouncilCouncil

WorkbookWorkbook

Developed workbook to provide information to Developed workbook to provide information to MHB/Cs on continuous quality improvement. MHB/Cs on continuous quality improvement. Uses data on mental health servicesUses data on mental health services– Penetration rates (identifies potential unmet need)Penetration rates (identifies potential unmet need)– Retention ratesRetention rates

(analyzed by gender, age, and race/ethnicity)(analyzed by gender, age, and race/ethnicity) Data were provided to all Mental Health Data were provided to all Mental Health

Directors to review in June 2009 to review for Directors to review in June 2009 to review for accuracyaccuracy

Mandatory for MHB/Cs to complete workbook Mandatory for MHB/Cs to complete workbook due to statutory mandatedue to statutory mandate

Workbooks to be developed on an on-going 2-Workbooks to be developed on an on-going 2-3 year cycle3 year cycle

Workbook Table of ContentsWorkbook Table of Contents CHAPTER 1 CHAPTER 1 BACKGROUNDBACKGROUND Engaging in Continuous Quality Improvement…………………………............….......5Engaging in Continuous Quality Improvement…………………………............….......5 The Continuous Quality Improvement Process…………………………..................... 6The Continuous Quality Improvement Process…………………………..................... 6 Access to Services (Penetration): Definition and Measurement……....................…8Access to Services (Penetration): Definition and Measurement……....................…8 Service Retention: Definition and Measurement……………………............….....…11Service Retention: Definition and Measurement……………………............….....…11 Using This Workbook to Examine Access (Penetration) and Using This Workbook to Examine Access (Penetration) and Retention Information...............................................................................................12Retention Information...............................................................................................12 CHAPTER 2CHAPTER 2 RACE/ETHNICITY: Access (Penetration) and Retention Information Analyzed by RACE/ETHNICITY: Access (Penetration) and Retention Information Analyzed by

Race/EthnicityRace/Ethnicity Examining and Interpreting the Access (Penetration) Charts…….............……...…15Examining and Interpreting the Access (Penetration) Charts…….............……...…15 Examining and Interpreting the Retention Charts………………...........…….…...….19Examining and Interpreting the Retention Charts………………...........…….…...….19

Potential Factors Associated with Access and Retention Differences Potential Factors Associated with Access and Retention Differences by Race/Ethnicity………………………………………………..…………......…….......22by Race/Ethnicity………………………………………………..…………......…….......22 Questions to Guide the Continuous Quality Improvement Process…...........…...…25Questions to Guide the Continuous Quality Improvement Process…...........…...…25 CHAPTER 3CHAPTER 3 AGE: Access (Penetration) and Retention Information Analyzed by AgeAGE: Access (Penetration) and Retention Information Analyzed by Age Examining and Interpreting the Access (Penetration) Charts…………............…....28Examining and Interpreting the Access (Penetration) Charts…………............…....28 Examining and Interpreting the Retention Charts………………………...............….31Examining and Interpreting the Retention Charts………………………...............….31

Potential Factors Associated with Access and Retention Differences Potential Factors Associated with Access and Retention Differences by Age………………………………………………………………………..........…...…34by Age………………………………………………………………………..........…...…34 Questions to Guide the Continuous Quality Improvement Process…...........…...…37Questions to Guide the Continuous Quality Improvement Process…...........…...…37 CHAPTER 4CHAPTER 4 GENDER: Access (Penetration) and Retention Information Analyzed by GenderGENDER: Access (Penetration) and Retention Information Analyzed by Gender Examining and Interpreting the Access (Penetration) Charts…………................…40Examining and Interpreting the Access (Penetration) Charts…………................…40 Examining and Interpreting the Retention Charts………………………............…....43Examining and Interpreting the Retention Charts………………………............…....43

Potential Factors Associated with Access and Retention Differences Potential Factors Associated with Access and Retention Differences by Gender……………………………………………………………………….....……...46by Gender……………………………………………………………………….....……...46 Questions to Guide the Continuous Quality Improvement Process…..........…....…49Questions to Guide the Continuous Quality Improvement Process…..........…....…49 APPENDIX AAPPENDIX A: Statewide Access (Penetration) and Retention Charts…………............50: Statewide Access (Penetration) and Retention Charts…………............50 APPENDIX BAPPENDIX B: Access (Penetration) and Retention Data Tables……………............….63: Access (Penetration) and Retention Data Tables……………............….63 ENDNOTES / REFERENCESENDNOTES / REFERENCES.........................................................................................64.........................................................................................64

One-Day TrainingOne-Day Training

CiMH will provide one-day trainings to CiMH will provide one-day trainings to MHB/Cs.MHB/Cs.

Uses an inter-county gathering format: 2-4 Uses an inter-county gathering format: 2-4 neighboring counties.neighboring counties.

Each county will receive the training within Each county will receive the training within the next 18 months. the next 18 months.

Focus is on understanding CQI, data concepts, Focus is on understanding CQI, data concepts, limitations of data, data interpretation.limitations of data, data interpretation.

Counties will explore their local penetration Counties will explore their local penetration and retention data.and retention data.

During the training, CiMH will assist MHB/Cs in During the training, CiMH will assist MHB/Cs in responding to questions posed by the CMHPC responding to questions posed by the CMHPC contained in the workbooks.contained in the workbooks.

County Groupings for MHB/C Data Trainings

Monterey*, San Benito, Santa CruzShasta*, Siskiyou, TehamaSan Diego*, ImperialDel Norte, Humboldt, TrinityMadera, Merced, StanislausButte, Colusa, Glenn, SutterFresno, Kings, TulareLassen, ModocKern, San Luis Obispo, Santa Barbara, VenturaNevada, Plumas, Sierra, YubaLos Angeles, Orange, Riverside, San BernardinoLake, Mendocino, SonomaAmador, El Dorado, PlacerSacramento, San Joaquin, YoloSolano, Napa, MarinSan Francisco, San Mateo, Santa ClaraAlameda, Contra CostaAlpine, Inyo, MonoCalaveras, Tuolumne, Mariposa* Pilot County

Data Workbook Questions: Data Workbook Questions: Access/PenetrationAccess/Penetration by by RACE/ETHNICITYRACE/ETHNICITY

1.1. What are your findings regarding access/penetration for What are your findings regarding access/penetration for mental health services by race/ethnicity? What mental health services by race/ethnicity? What racial/ethnic groups have higher access (penetration)?racial/ethnic groups have higher access (penetration)?

2.2. What factors in your county account for differences in What factors in your county account for differences in access (penetration) by race/ethnicity; e.g., transportation, access (penetration) by race/ethnicity; e.g., transportation, geography, mental health literacy, stigma?geography, mental health literacy, stigma?

3.3. What barriers exist in your county to increasing the access What barriers exist in your county to increasing the access (penetration) for mental health services for the identified (penetration) for mental health services for the identified underserved race/ethnic groups?underserved race/ethnic groups?

4.4. What is your understanding of what your county is doing What is your understanding of what your county is doing to increase access (penetration) for mental health services to increase access (penetration) for mental health services by race/ethnicity; e.g., implementing the Mental Health by race/ethnicity; e.g., implementing the Mental Health Services Act and your county’s Cultural Competence Plan?Services Act and your county’s Cultural Competence Plan?

5.5. What recommendations do you have for increasing the What recommendations do you have for increasing the access/penetration for mental health services for the access/penetration for mental health services for the identified underserved racial/ethnic groups in your county?identified underserved racial/ethnic groups in your county?

Data Workbook Questions: Data Workbook Questions: Service Service RetentionRetention by by RACE/ETHNICITYRACE/ETHNICITY

1.1. What are your findings regarding retention in mental health What are your findings regarding retention in mental health services by race/ethnicity? What racial/ethnic groups have services by race/ethnicity? What racial/ethnic groups have higher retention in mental health services?higher retention in mental health services?

2.2. What factors in your county account for differences in What factors in your county account for differences in retention by race/ethnicity; e.g., transportation, geography, retention by race/ethnicity; e.g., transportation, geography, mental health literacy, stigma?mental health literacy, stigma?

3.3. What barriers exist in your county to increasing the retention What barriers exist in your county to increasing the retention in mental health services for the identified underserved in mental health services for the identified underserved racial/ethnic groups?racial/ethnic groups?

4.4. What is your understanding of what your county is doing to What is your understanding of what your county is doing to increase retention in mental health services by increase retention in mental health services by race/ethnicity; e.g., implementing the Mental Health Services race/ethnicity; e.g., implementing the Mental Health Services Act and your county’s Cultural Competence Plan?Act and your county’s Cultural Competence Plan?

5.5. What recommendations do you have for increasing retention What recommendations do you have for increasing retention in mental health services for the identified underserved in mental health services for the identified underserved racial/ethnic groups in your county?racial/ethnic groups in your county?

Contact InformationContact Information

Ann Arneill-Py, PhD, Executive OfficerAnn Arneill-Py, PhD, Executive Officer

CA Mental Health Planning CouncilCA Mental Health Planning Council

1600 91600 9thth Street, Room 420 Street, Room 420

Sacramento, CA 95814Sacramento, CA 95814

(916) 651-3803(916) 651-3803

Ann.Arneill-Py@dmh.ca.govAnn.Arneill-Py@dmh.ca.gov

Stephanie Oprendek, PhD, Senior AssociateCalifornia Institute for Mental Health2125 19th Street, 2nd FloorSacramento, CA  95818(916) 556-3480 ext. 155 (916) 284-8146 (cell)soprendek@cimh.org