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Older Californians and the Mental Health Services Act: Is an Older Adult System of Care Supported?

January 25, 2018

Policy Brief

Authors: Kathryn G. Kietzman, PhD, MSW, Danielle Dupuy, MPH, Jo Ann Damron-Rodriguez, LCSW, PhD, Alina Palimaru, Homero E. del Pino, Janet C. Frank, DrPH, MS

This policy brief summarizes findings from the first study to evaluate how California’s public mental health delivery system has served older adults (60 years of age and over) since the passage of the Mental Health Services Act (MHSA) in 2004. Study findings indicate that there are unmet needs among older adults with mental illness in the public mental health delivery system. There are deficits in the involvement of older adults in the required MHSA planning processes and in outreach and service delivery, workforce development, and outcomes measurement and reporting. There is also evidence of promising programs and strategies that counties have advanced to address these deficits. Recommendations for improving mental health services for older adults include designating

a distinct administrative and leadership structure for older adult services in each county; enhancing older adult outreach and documentation of unmet need; promoting standardized geriatric training of providers; instituting standardized data-reporting requirements; and increasing service integration efforts, especially between medical, behavioral health, aging, and substance use disorder services.


This policy brief is part of a six-county study of public mental health services for older adults funded by the MHSA.  This is the first study to assess whether MHSA-funded services meet the complex needs and address the recovery goals of older adults with mental illness by supporting an Older Adult System of Care (OASOC). For more information on this evaluation, and to see all related publications, please visit:


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