J. SCOTT ASHWOOD, NICOLE K. EBERHART, STEPHANIE WILLIAMSON, AMY L. SHEARER
Evaluation of Outcomes
of Fresno County’s
Mental Health
Prevention Programs
C
alifornia’s Proposition 63, which was signed into law as the Mental Health Services Act
(MHSA), levied a 1-percent tax on personal income in excess of $1 million, with the funds
intended to be used for mental health services and supports. The MHSA specifically indi-
cated that 20 percent of this funding should be dedicated to prevention and early inter-
vention (PEI) services. California’s PEI programs have various aims, with the following program
categories: (1) prevention, (2) early intervention, (3) outreach for increasing recognition of early
signs of mental illness, (4) stigma and discrimination reduction, (5) access and linkage to treatment
for individuals with serious mental illness, (6) improving timely access to services for underserved
populations, and (7) suicide prevention.
The state’s PEI regulations state that county departments of behavioral health should measure
appropriate outcomes and indicators for these PEI program types (California Code of Regulations,
Title 9), but they do not provide specific guidance on which outcomes to measure and how to mea-
sure them. Many counties have struggled to measure PEI outcomes, in part because prevention
programs often do not use electronic health records to capture participant data.
To address this challenge, the Fresno County Department of Behavioral Health (DBH) engaged
our RAND research team to design
a web-based data collection tool for
its prevention programs. We began
by interviewing staff from Fresno
County DBH’s PEI programs to
gather data on what the staff saw as
the key outcomes they were trying
to affect and the methods they were
using to evaluate their programs. We
used this information to identify core
domains to measure in the prevention
KEY FINDINGS
■ The participating county prevention programs serve a diverse
population that experiences serious challenges with mental health
and life functioning.
■ Youth and adults alike experienced challenges in various domains:
They had low self-efficacy, high perceived stress, low social sup-
port, and low overall life satisfaction.
■ Adults served also reported low mental health knowledge and
difficulty functioning in their day-to-day lives because of emo-
tional issues.
Evaluation Report
