In 2004, California voters passed the Mental Health Services Act, which was intended to transform California's community mental health system from a crisis-driven system to one that included a focus on prevention and wellness. The vision was that prevention and early intervention (PEI) services comprised the first step in a continuum of services designed to identify early symptoms and prevent mental illness from becoming severe and disabling. Twenty percent of the act's funding was dedicated to PEI services. The act identified seven negative outcomes that PEI programs were intended to reduce: suicide, mental health-related incarcerations, school failure, unemployment, prolonged suffering, homelessness, and removal of children from the home. The Mental Health Services Oversight and Accountability Commission (MHSOAC) coordinated with the California Mental Health Services Authority (CalMHSA), an independent administrative and fiscal intergovernmental agency, to seek development of a statewide framework for evaluating and monitoring the short- and long-term impact of PEI funding on the population. CalMHSA selected the RAND Corporation to develop a framework for the statewide evaluation. This report describes the approach, the data sources, and the frameworks developed: an overall approach framework and outcome-specific frameworks.

The California Mental Health Services Authority (CalMHSA) has implemented an ambitious, first-of-its-kind set of statewide prevention and early intervention (PEI) initiatives with the broad goals of reducing mental illness stigma and discrimination, preventing suicide, and improving student mental health. CalMHSA selected the RAND Corporation to conduct an independent evaluation of the PEI initiatives. This brief reviews RAND's key evaluation findings. Overall, results show that many program components were successfully implemented and achieved their intended impacts in the short term. Continued dissemination and support of effective programs will be required to sustain short-term gains and to observe longer-term impacts on the mental health, quality of life, and productivity of Californians.

In 2004, California voters passed the Mental Health Services Act, which was intended to transform California0́9s community mental health system from a crisis-driven system to one that included a focus on prevention and wellness. The vision was that prevention and early intervention (PEI) services comprised the first step in a continuum of services designed to identify early symptoms and prevent mental illness from becoming severe and disabling. Twenty percent of the act0́9s funding was dedicated to PEI services. The act identified seven negative outcomes that PEI programs were intended to reduce: suicide, mental health-related incarcerations, school failure, unemployment, prolonged suffering, homelessness, and removal of children from the home. The Mental Health Services Oversight and Accountability Commission (MHSOAC) coordinated with the California Mental Health Services Authority (CalMHSA), an independent administrative and fiscal intergovernmental agency, to seek development of a statewide framework for evaluating and monitoring the short- and long-term impact of PEI funding on the population. CalMHSA selected the RAND Corporation to develop a framework for the statewide evaluation. This report describes the approach, the data sources, and the frameworks developed: an overall approach framework and outcome-specific frameworks.

There are more than 3,000 suicide deaths in California each year -- roughly nine deaths for every 100,000 California residents. To prevent suicides and other mental health problems, the California Mental Health Services Authority (CalMHSA) is implementing a variety of Prevention and Early Intervention (PEI). CalMHSA asked RAND to evaluate the PEI initiatives to prevent suicide. To help inform the design of this evaluation, we reviewed some key aspects of the suicide prevention (SP) program evaluation literature, including relevant theories of change, what is and is not known about suicide prevention program effectiveness, and what kinds of methodologies have been previously used in evaluations of suicide prevention programs. This report summarizes this scientific literature related to suicide prevention and is organized into three sections. First, we provide an overview of the epidemiology of suicide and of non-fatal self inflicted injuries in California, as well as the empirical support for suicide risk factors, and explain why understanding this epidemiology is a critical first step in any effort to evaluate the effectiveness of suicide prevention programs. Second, we present our framework for conceptualizing suicide prevention programs that can be used to guide evaluation; it is based on a review of the relevant scientific literature. Finally, we conclude with a discussion of the measures that have been used to evaluate suicide prevention programs in the past.