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Published on: July 4, 2007
Population targeting amid complex mental health programming: Are California's Full Service Partnerships reaching
Katharan D Cordell1, Lonnie R Snowden2
1Department of Social Welfare, University of California, Berkeley.
Insights
California's Full Service Partnership (FSP) programs effectively reach vulnerable children with mental illness who are underserved by public systems. These specialized programs identify and serve a distinct group needing targeted mental health care.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Public Mental Health Policy
Background:
- California's Mental Health Services Act (MHSA) established Full Service Partnership (FSP) programs.
- FSPs aim to serve socially and economically vulnerable children with mental illness.
- These children are often underserved by existing public mental health systems.
Purpose of the Study:
- To determine if FSPs serve a unique population of underserved children.
- To compare FSP entrants with children in broader public mental health systems.
- To compare FSP entrants with those in intensive Medicaid programs (Therapeutic Behavioral Services - TBS).
Main Methods:
- Comparative analysis of FSP entrants (n=15,598) against all public mental health clients (n=282,178) and TBS clients (n=11,993).
- Examination of indicators of underservice, treatment history, clinical severity, and service needs.
- Statistical comparison controlling for clinical severity and service need indicators.
Main Results:
- FSP clients encountered mental health services earlier but had less overall treatment duration.
- FSP clients were less likely to have received prior treatment (except crisis care) compared to other groups.
- FSP entrants presented with higher rates of substance abuse and trauma-related issues, indicating significant underservice.
Conclusions:
- Specialized programs like FSPs can successfully identify and serve distinct, underserved populations within public mental health systems.
- FSPs augment a system's capacity to reach vulnerable children with unmet mental health needs.
- Despite policy overlaps, targeted interventions demonstrate practical effectiveness in addressing service gaps.
Abstract:
California's Mental Health Services Act (MHSA) created Full Service Partnership programs (FSPs) targeting socially and economically vulnerable children with mental illness who are underserved by counties' public mental health treatment system. To determine whether FSPs reach a distinctive group of children, this study compares indicators of FSP-targeted underservice for FSP entrants (n = 15,598) versus everyone treated in the counties' public mental health systems (n = 282,178) and for FSP entrants versus entrants in the most intensive Medicaid delivered program in California, Therapeutic Behavioral Services (TBS, n = 11,993). Results identify that, despite first encountering mental health services systems at earlier ages, FSP clients had fewer months of treatment and were less likely to have been treated in the prior 6 months, except for crisis care, as compared to all other children served, after considering clinical severity and indicators of service need. FSP entrants also had more substance abuse and trauma-related problems. Although less seriously ill than TBS served children, FSP served children were significantly underserved. The results indicate that, amid overlapping policies and programs, carving out and reaching a distinctly underserved population can be achieved in practice, and that specialized programs, such as the FSP program, which target underserved children, have the potential to augment a system's ability to reach the underserved. (PsycINFO Database Record
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