Health System: Mental Health Adult Services (6140P)

Program Outcome Statement

Increase the percentage of consumers attaining wellness/recovery goals.

Program Services

  • Outreach
  • Assessment
  • Treatment
  • Linkages to Health Care Services
  • Case Management
  • Medication and Medication Support
  • Supported Employment
  • Education
  • Socialization


Behavioral Health and Recovery Services (BHRS) for Adults and Older Adults provides outreach, assessment, treatment, linkage to healthcare services, case management, medication and medication support, supported employment, education, and socialization. The program also works with consumer and family groups to support the development of self-help resources.
Mental health and co-occurring substance use disorder services are provided to almost 10,000 adults and older adults annually. Additionally, psychiatric emergency and inpatient services are provided for people in crisis, intensive case management, residential and supported housing alternatives are provided for the most vulnerable BHRS population, and services are provided to people discharged from jail. Services are co-located with primary care and are offered through specialty mental health teams for those who have greater needs. BHRS works closely with community partners to provide opportunities for individuals and families to improve their wellness and recovery.
BHRS for Adults and Older Adults promotes individual recovery, improved well-being and quality of life, and independent living in the community for adults who suffer from serious mental illness. Evidence-based mental health services improve functioning and stability and avoid unnecessary hospitalization, arrests and other negative outcomes such as homelessness. The Mental Health Services Act funded Full Service Partnerships (FSP) that “do whatever it takes” to keep their clients living safely in the community have contributed to these results. All programs serving adults and older adults focus on fostering healthy outcomes, reducing isolation and keeping clients engaged in meaningful activities and promoting their safety and well-being. By implementing Community Service Areas (CSA) models, which focus on aligning service delivery to the needs of the community, it is expected that BHRS and its community partners will improve access to mental health and drug and alcohol services.
The provision of services for clients on probation with Criminal Justice Realignment eligibility will continue to be provided through Service Connect. This collaborative program with the Human Services Agency and Probation works to reduce recidivism and maintain public safety by engaging with clients upon release from prison/jail and helping them integrate successfully into the community. BHRS provides mental health and alcohol and substance use services for these clients and helps connect them to medical care.

Percent of Clients Stating they have Benefited from Services Remains High

Percent of Adults who Attend a Follow-Up Visit with a Clinical Provider within 7 Days of Being Discharged from a Psychiatric Hospital Below Target

Percent of Adult Clients Receiving Full Service Partnership Services who Experience a Reduction in Hospitalizations Below Target

FY 2017-18 Mid-Year Story Behind Performance

Percent of Clients Stating they have Benefited from Services

The percent of clients stating they have benefited from services remains high. This is primarily due to staff that is embedded in other service delivery systems, such as San Mateo Medical Center, where key individuals are present to assist our partners in a way that results in the right care at the right time. Examples include the Primary Care Interface, where BHRS staff work directly with physicians in support of persons maintaining the right level of care, and the maintenance of direct relationships with Psychiatric Emergency Services (PES) working pre-discharge to achieve the appropriate levels of care when patients do go into inpatient psychiatric care. BHRS has consistently improved customer satisfaction over time by paying attention to what matters for the residents we serve. For example, the BHRS Access Call Center is one of the few in the state where a caller will most likely get authorized to a treatment service and referral during their first call to us; or the Same Day Assistance Program, where individuals in need of a service can be served when they walk into a clinic, or our Community Service Areas where local neighborhoods plan for the services provided at the local clinic.

Percent of Adults who Attend a Follow-Up Visit with a Clinical Provider within Seven Days

BHRS has concentrated follow-up services after hospitalization for young adults so that most of the services are now being provided before discharge reducing the need for follow-up visits. However, for adults and older adults, the percent who do see a provider within seven days is under target at 65 percent. Work with the Health Plan of San Mateo and the BHRS contract evaluator, brought to light deficiencies in the data collection instruments used to measure performance in follow up to hospitalizations. Changes to the instrument will be reflected in the year end data. Nonetheless, BHRS continues to employ strategies to improve performance, including: the recent opening of the Geriatric Behavioral Health Unit at Seton Medical Center, which provides 20 beds for the acute care of patients 65 years of age and older; the recent acquisition of four inpatient beds nearby that are available 24/7 in a facility with enhanced services that are easily accessible to BHRS staff, as opposed to placing patients in facilities located across the Bay area making it difficult to engage and transition patients; and, the development of a new contract template with significant performance expectations that is in the process of being executed with all acute inpatient hospitals where BHRS patients are placed.

Percent of Adult Clients Receiving Full Service Partnership Services who Experience a Reduction in Hospitalizations

The Full Service Partnership Program (FSP) continues to produce positive outcomes for BHRS clients in the areas of hospitalization, housing, incarceration, and employment. The reduction in performance is the result of the length of time that clients have remained in the FSP program. As the program matures, the number of years to evaluate has increased, which dilutes the noticeable results of the performance of year one participants.

Future Priorities

  • Implement a Utilization Management Program across all adult programs that accounts for service decisions that afford the greatest level of beneficiary protection.
  • Manage placements into acute psychiatric inpatient hospitals and improve client flow from acute inpatient services to lower and less restrictive levels of care.
  • Expand Medication Assisted Treatment into primary care.
  • Develop and implement a strategic plan to guide the continuing evolution of program services.
  • In cooperation with HPSM, work toward the full integration of mild and moderate services with medical care services.

Author: Gina Wilson; Chief Financial Officer, Health System     Contact Email:     Last Updated: 02-08-2018