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California Makes Strides in Mental Health, Slams Kaiser for Failures

California is taking mental healthcare seriously. The state's Department of Managed Health Care (DMHC) has criticized Kaiser Permanente for causing mental health patients to endure long delays for treatment and providing misleading information about the extent of their mental health coverage.

On the same day the DMHC released its report on Kaiser's behavioral health services, the RAND Corporation released a report on positive early results in California's effort to improve mental health prevention and early intervention.

In 2013, the state fined Kaiser $4 million for its handling of mental health patients and a DMHC report found 4 major deficiencies. According to the newest report, Kaiser has corrected 2 of the 4 areas, while the 2 uncorrected deficiencies have been referred to the Office of Enforcement for further investigation.

"Although Kaiser has taken substantial steps to identify and monitor issues related to timely access to behavioral health services, significant and serious concerns remain," DMHC Director Shelley Rouillard said in a statement. "Kaiser's actions have not been sufficient to ensure enrollees have consistent timely access to behavioral health services."

In particular, the DMHC found that measures taken by Kaiser to provide consistent timely access to behavioral healthcare services have been inadequate. The report also found that Kaiser's providers have been providing inaccurate and misleading health education information regarding the scope of enrollees' coverage for behavioral health services.

In a press release, Kaiser Permanente claimed it would continue to improve the mental healthcare it delivers to patients, but it also placed blame for its slow progress on the union representing mental healthcare workers. And the DMHC report does acknowledge that challenges with the National Union of Healthcare Workers (NUHW) has delayed action.

In January, 2600 mental healthcare workers went on strike against Kaiser to protest staffing levels and the long wait times mental health patients have to endure before being treated.

"The California Department of Managed Health Care has confirmed the severity of Kaiser's systemic understaffing and its serious, sometimes tragic consequences for Kaiser patients, yet Kaiser has no plan for improving access to care for some of its most vulnerable patients, those with mental health diagnoses such as depression, bipolar disorder, psychotic symptoms, and general anxiety," Marcy Reda, a Walnut Creek clinical social worker and bargaining team member for the NUHW, said in a statement in January just before the strike kicked off.

Meanwhile, California as a whole has successfully launched statewide prevention efforts that are making a difference toward reducing the stigma of mental health issues, according to Nicole Eberhart, co-leader of the report and a behavioral scientist at RAND.

"Often the most meaningful effects of prevention and early intervention programs cannot be detected immediately, so it will be important to continue to track public attitudes and knowledge regarding mental health, as well as impacts in reducing the negative consequences of mental health problems, over a longer period of time," M. Audrey Burnam, a RAND senior behavioral scientist and co-leader of the project, said in a statement.

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