Skip to main content
Full access
Other Articles
Published Online: 1 August 2012

Voluntary Psychiatric Emergencies in Los Angeles County After Funding of California's Mental Health Services Act

Abstract

Objective:

Since 2006, California's Mental Health Services Act (MHSA) has distributed an estimated $6 billion in new tax revenues to county mental health systems. Although evaluations of MHSA's effectiveness find favorable outcomes among high-risk individuals that represent 6% of all mental health clients, scant research has tested whether MHSA funds improve the overall functioning of the public mental health system. The authors analyzed whether the incidence of voluntary emergency psychiatric visits, a key gauge of the functioning of the mental health system, fell below expected levels after the disbursement of MHSA funds. Los Angeles County, the most populous county in California, was examined.

Methods:

The authors obtained the monthly incidence of emergency psychiatric visits among Medi-Cal patients for 96 months spanning July 2000 to June 2008 (5.9 million overall admissions, of which 47,328 were emergency visits). Time-series methods controlled for temporal patterns in emergency visits as well as other potential confounders (unemployment, for example) that could induce spurious associations.

Results:

The incidence of voluntary psychiatric emergencies fell below expected levels eight to 12 months after the disbursement of MHSA funds. After one year, emergency visits returned to their long-term mean level. Results remained robust after analyses controlled for outliers and potential confounders.

Conclusions:

In the short term, an infusion of public funds devoted to mental health services appeared to reduce psychiatric emergency visits. Explanations for the transient nature of the decline in emergency visits in Los Angeles County are discussed. (Psychiatric Services 63:808–814, 2012; doi: 10.1176/appi.ps.201100372)

Formats available

You can view the full content in the following formats:

Figures and Tables

Figure 1 Number of mental health-related emergency visits by Medi-Cal clients seeking care in Los Angeles County, July 2000 to June 2008
Figure 2 Odds of mental health-related emergency department visits among Medi-Cal clients seeking care in Los Angeles County, July 2000 to June 2008
Table 1 Time-series results predicting the log-odds of voluntary psychiatric emergency visits in Los Angeles County, July 2000 to June 2008

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: Girl With Ball, by Roy Lichtenstein, 1961. Oil on canvas. Gift of Philip Johnson. The Museum of Modern Art, New York. Digital image © The Museum of Modern Art/Licensed by SCALA/Art Resource, New York.
Psychiatric Services
Pages: 808 - 814
PubMed: 22660697

History

Published online: 1 August 2012
Published in print: August 2012

Authors

Details

Tim A. Bruckner, Ph.D., M.P.H.
Dr. Bruckner and Mr. Kim are affiliated with the Department of Planning, Policy, and Design, University of California, Irvine, 202 Social Ecology I, Irvine, CA 92697-7075 (e-mail: [email protected]). Dr. Bruckner is also with the Program in Public Health, University of California, Irvine. Dr. Chakravarthy is with the Department of Emergency Medicine, University of California, Irvine. Dr. Brown is with the Berkeley Center for Health Technology, University of California, Berkeley.
Kim Yonsu, M.A.
Dr. Bruckner and Mr. Kim are affiliated with the Department of Planning, Policy, and Design, University of California, Irvine, 202 Social Ecology I, Irvine, CA 92697-7075 (e-mail: [email protected]). Dr. Bruckner is also with the Program in Public Health, University of California, Irvine. Dr. Chakravarthy is with the Department of Emergency Medicine, University of California, Irvine. Dr. Brown is with the Berkeley Center for Health Technology, University of California, Berkeley.
Bharath Chakravarthy, M.D., M.P.H.
Dr. Bruckner and Mr. Kim are affiliated with the Department of Planning, Policy, and Design, University of California, Irvine, 202 Social Ecology I, Irvine, CA 92697-7075 (e-mail: [email protected]). Dr. Bruckner is also with the Program in Public Health, University of California, Irvine. Dr. Chakravarthy is with the Department of Emergency Medicine, University of California, Irvine. Dr. Brown is with the Berkeley Center for Health Technology, University of California, Berkeley.
Timothy Tyler Brown, Ph.D.
Dr. Bruckner and Mr. Kim are affiliated with the Department of Planning, Policy, and Design, University of California, Irvine, 202 Social Ecology I, Irvine, CA 92697-7075 (e-mail: [email protected]). Dr. Bruckner is also with the Program in Public Health, University of California, Irvine. Dr. Chakravarthy is with the Department of Emergency Medicine, University of California, Irvine. Dr. Brown is with the Berkeley Center for Health Technology, University of California, Berkeley.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share