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Extracted from Consolidated Report
This investigation was originally published as part of a larger consolidated report containing multiple investigations. View the consolidated PDF for the complete document.
Alameda County Grand Jury
• 2021-2022
Alameda County Mental Health System Too Complex to Navigate
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 8 findings
F1
Page 26
A county-wide needs/gaps assessment (broader than what the Mental Health Services Act mandates) has not been completed since 2015. A current strategic plan for Alameda County Behavioral Health is missing. 26 2021-2022 Alameda County Civil Grand Jury Final Report _______________________________________________________________________________________
F2
Page 27
Alameda County mental health data is not well developed, organized, shared, or distributed by Alameda County Behavioral Health Care Services. Outside of mandatory Mental Health Services Act annual and three-year plans required by the state, integrated data is unavailable to the general public and local advocates. Because of this lack of transparency, Alameda County Behavioral Health outsiders suspect that funds are not properly directed to community service gaps and needs.
F3
Page 27
Alameda County Behavioral Health service contracts are inflexible. Alameda County Behavioral Health’s switch to fee-for-service contracts from performance-based contracts has likely resulted in reduced services available to Alameda County residents.
F4
Page 27
The mental health record systems of county mental health service providers cannot connect with each other. Lack of interoperability of medical records for Mental Health Services Act providers limits needed communication and consistent information capacity between service providers.
F5
Page 27
Most Alameda County residents have limited knowledge of the ACCESS phone line and its role.
F6
Page 27
Although there is a phone line answered by a volunteer from a local mental health provider during hours when ACCESS is not staffed, emergency mental health services for low-income seriously mentally ill individuals are not offered 24-7. There is no crisis referral line or alternative to jail or 5150 for immediate care for the seriously mentally ill when ACCESS is closed.
F7
Page 27
Behavioral Health Court works. That’s the unanimous verdict of the Grand Jury’s witnesses. But it’s not adequately supported and funded. Alameda County Behavioral Health and the courts have not provided adequate data to determine that the well-regarded Behavioral Health Court is effective and is racially and geographically equitable so it can attract more funding.
F8
Page 27
The Mental Health Advisory Board, which has strong, knowledgeable, and experienced members and generates excellent ideas, is not used effectively by the Board of Supervisors. 27 2021-2022 Alameda County Civil Grand Jury Final Report _______________________________________________________________________________________
Recommendations 14
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R1Page 28Alameda County Behavioral Health should develop a community-wide needs/gaps assessment, beyond the scope of what the Mental Health Services Act requires, to guide funding and ensure equity in service delivery. This can help Alameda County Behavioral Health develop a strategic plan to ensure that Alameda County’s current approach to mental health services and funding is fully in sync with “Care First, Jail Last” and Alameda County’s current needs.
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R2Page 28Alameda County Behavioral Health should invest in and improve its data development, organization, sharing, and distribution capabilities. Accurate and complete data-driven analysis and evaluation should direct Alameda County mental health service and funding choices.
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R3Page 28Alameda County Behavioral Health should lift contract caps for providers who are over- serving their contracts, or at least provide clear protocols for how and when to lift those caps during contract negotiations with service providers.
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R4Page 28Alameda County Behavioral Health must develop technology that allows uniform interoperability between multiple provider agencies for sharing of medical records.
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R5Page 28Alameda County Behavioral Health should add outreach in multiple ways, languages, and venues, including directing materials to law enforcement, health care, social services, and to the general public to instruct them appropriately about ACCESS as both a resource line and a referral line.
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R6Page 28The ACCESS number should be more widely distributed by Alameda County Behavioral Health to the professional and consumer communities. If the ACCESS line is an information and referral line, there should be corresponding easily accessible resource information about mental health programs on ACBH’s website and outside of the website, available to the public.
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R7Page 28Alameda County Behavioral Health should provide a mental health support/crisis line that is staffed 24-7 as a referral alternative to jail or psychiatric holds. 28 2021-2022 Alameda County Civil Grand Jury Final Report _______________________________________________________________________________________
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R8Page 29Alameda County Behavioral Health must develop enough program slots to meet current needs.
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R9Page 29Alameda County Behavioral Health must improve/expand upon its coordination between service providers and ACCESS staff regarding available slots for service by developing appropriate technology to assess available program slots in real time.
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R10Page 29Alameda County Behavioral Health must provide more transparency in its reporting on Behavioral Health Court and make results of Behavioral Health Court available, including graduation rates, recidivism, and reasons for lack of completion.
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R11Page 29Alameda County Behavioral Health, in collaboration with the courts, should increase the capacity of Behavioral Health Court, based on findings above, to support the “Care First, Jails Last” Board of Supervisors resolution.
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R12Page 29Alameda County Behavioral Health, in collaboration with the courts, needs to provide data that ensures that Behavioral Health Court is racially and geographically equitable.
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R13Page 29The Alameda County Board of Supervisors should better utilize the expertise and skills of the Mental Health Advisory Board. Regular, scheduled Advisory Board presentations to the Board of Supervisors would be useful.
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R14Page 29The Alameda County Board of Supervisors should fill the vacant Mental Health Advisory Board positions that the Board of Supervisors is supposed to appoint. 29 2021-2022 Alameda County Civil Grand Jury Final Report _______________________________________________________________________________________