History of Community Mental Health Services in San Diego
Planning and implementation of changes to San Diego County's public mental health services has been going on in phases since the summer of 1993. At that time, the state of California mandated that managed care principles be incorporated in the reorganization of public health and mental health services in all counties throughout the state. The state also mandated that each county take over the administration and delivery of services to Medi-Cal clients. The initial phase of change was focused on inpatient services. Later phases of change to the mental health system incorporated all non-hospital (outpatient) services and entailed a more massive shift of county mental health services and Medi-Cal services to a managed care model that privatizes more of the system of care.
In October 1997, an Administrative Service Organization (ASO) was created and United Behavioral Health was awarded the contract to serve as the ASO for San Diego County mental health services. UBH took over the administration of mental health services to Medi-Cal clients in San Diego County in July, 1998. They formed a provider network to serve the Medi-Cal population and offered contracts to psychologists and psychiatrists who had previously been serving that population. In addition, they set up a Crisis and Access Line for clients to access services and a utilization review process. They also increased provider fees to a more competitive level. The panel is open to new providers who wish to join and serve the Medi-Cal population.
San Diego County has chosen to maintain a separation between children's mental health services and the adult and older adult mental health system of care both administratively and in the delivery of services. The County has been planning and developing these separate systems through different planning processes and different time lines. The children's mental health system of care has been entitled Heartbeat. The Community Mental Health Committee is involved with both the children's system of care and the adult and older adult system.
As of July 1999 psychologists were members of the Interdisciplinary Advisory Group for Behavioral Health. This group began to meet in July of 1995. It was a collaborative effort by all mental health professional associations in San Diego county (San Diego Psychiatric Society, San Diego Psychological Association, Psychiatric Clinical Nurse Specialty Group, Marriage, Family and Child Therapist Association, National Association of Social Workers and Clinical Society of Social Workers). The group focused on the San Diego County's public mental health system, both the children's system of care, and the adult and older adult system of care. It provided a voice for private mental health practitioners who provide services through the above systems to the Medi-Cal and medically indigent populations of San Diego County.
In December 2006 the Mental Health Services Act (MHSA) was introduced. It was modeled after California Assembly Bill 2034, known as Proposition 63, which combined prevention strategies with treatment services. Using an innovative approach to improve the public mental health system, it thereby enhanced the quality of life for Californians living with serious mental illness. The MHSA services are anchored in community collaboration with cultural competency and emphasize prevention and early intervention as key strategies to transform California's mental health system.
Through the MHSA Community Services and Supports component it provides treatment funding to develop recovery oriented services and support for children, youth, adults and older adults living with serious mental illness. This component of the MHSA is referred to as Prevention and Early Intervention. It's focus is on interventions for individuals across the lifespan prior to the onset of a serious emotional or behavioral disorder.