1. Mental Health Division’s Mental Illness Prevalence Study Briefing Memorandum January 7, 2004 Joint Legislative Audit and Review Committee Robert Krell, JLARC Staff

2. JLARC Mental Illness Prevalence Briefing Memo 1/07/04 Overview Mental Health Division has just completed a legislatively mandated study on the prevalence of serious mental illness within the state –Mandate resulted from recommendation in JLARC’s performance audit of the public mental health system Issue is significant because of implications related to allocation of $800 million to the state’s fourteen Regional Support Networks (RSNs) for community mental health services –Other state funding for MH services not impacted 2

3. JLARC Mental Illness Prevalence Briefing Memo 1/07/04 Background Pertinent findings from 2000 audit: –Funding system inequitable –New estimate of the prevalence of serious mental illness had recently become available (PEMINS study) Generally well regarded, but some groups excluded –Proportion of Medicaid eligible persons a good proxy for proportion needing publicly funded MH services In 2001-03 Budget, Legislature: –Authorized DSHS to implement new funding formula, to be phased in over six years –Appropriated $500,000 for another prevalence study 3

4. JLARC Mental Illness Prevalence Briefing Memo 1/07/04 Study Highlights Methodology: –Updated original study to reflect 2000 census –Developed estimates for groups excluded from original study Some key findings: –Adding in figures for new groups (especially children) nearly doubled number estimated to have serious mental illness –Prevalence among those estimated to be in need of publicly funded MH services only about one-half of total estimate –Statistical relationship between Medicaid eligibles, and those in need of publicly funded services, has lessened 4

5. JLARC Mental Illness Prevalence Briefing Memo 1/07/04 Overall Assessment…and Implications Current study is a good faith and commendable attempt to estimate prevalence of mental illness –Some minor concerns, but don’t detract from overall assessment In light of findings, may be calls to modify current funding structure. Prior to taking action, Legislature should consider: –Substantial difference between estimated prevalence of mental illness in total, and mental illness among those in need of publicly funded services –Funding allocation should reflect cost of all mental health services, including both community outpatient services and inpatient hospitalizations 5