The Imperative of Transformational Change

The Levers of Transformational Change

From a State perspective, and particularly from the viewpoint of the Commission, seven levers enable transformational system change:

1. Goals and metrics are required to establish agreement on desired outcomes and to measure progress. There must be a commitment to do whatever it takes to achieve success.
2. Engaged diverse communities – including consumers and families from varied cultural and social backgrounds, service providers, local governments, employers, and others involved in the public and privately funded behavioral health systems – drive changes needed to increase access to high-quality services and improve outcomes.
3. Data systems inform policy-making, program design, service management, and continuous improvement efforts.
4. Knowledge transfer and access to information enable all public agencies, partnerships, and communities to deploy the best possible solutions.
5. The capacity to design, build and manage programs and services enables agencies to integrate appropriate resources, develop service delivery systems, and improve quality.
6. Incentives, including financial resources, enable and encourage agency officials to risk starting something new and trying something different.
7. Transparency and accountability focus agency staff on goals, increase public trust, and affirm a public commitment to improved outcomes.

These elements are essential for policymakers, executives, managers, and professional staff to better communicate, cooperate, coordinate, and collaborate to improve results.

The Commission’s Authorities and Strategies for Catalyzing Transformation

The Mental Health Services Act created the Commission to promote a public health approach to mental well-being. Commissioners include consumers of mental health services, family members, lawmakers, and representatives of healthcare and mental health care providers, education, law enforcement, employers, and labor.

The MHSA grants the Commission specific authorities and responsibilities. The Legislature has interpreted those authorities by directing the Commission to prepare strategies, coordinate actions among state and local governments, administer grants, and prepare voluntary standards to promote mental health far beyond the publicly funded mental health system. Following are some of the Commission’s functions:

1. The Commission provides clarity on funding, services, and outcomes, articulates how fragmented and siloed programs can be better coordinated and integrated, and identifies opportunities to link and leverage funding from varied sources.
2. Program Review and Data collection. The Commission collects data on programs to enable program review and establish current practices and impacts; assesses gaps in the service continuum; assists in developing, monitoring, and communicating improvement efforts within and among counties; and identifies opportunities to change practices to support system-scale changes.
3. Policy projects. Upon its initiative and direction from the Legislature, the Commission executes projects designed to elevate and integrate research findings and experiential knowledge, particularly from those with lived experience. Examples of projects include tracking criminal justice involvement, helping develop a state suicide prevention plan, helping promulgate voluntary workplace mental health standards, developing prevention and early intervention strategies, and helping launch new school-based mental health programs.
4. Strategic partnerships. The Commission partners with universities, institutes, civic entrepreneurs, and other public agencies to develop, field-test, and implement system changes and policy solutions. The Commission’s partnerships include the Full-Service Partnership Pilot, the Early Psychosis Learning Health Care Network, the Youth Innovation Project, and multicounty collaboratives the Commission supports through an Innovation Incubator. These efforts connect researchers, county leaders, and practitioners to learn from each other, deploy the latest strategies, and build capacity for continuous improvement.
5. Grant programs. The Commission manages grant programs that pay for essential and innovative services in ways that incentivize stronger partnerships, integrated services, braided funding, and the evaluation required for ongoing improvement. The Mental Health Wellness Act (for local hiring of triage personnel), drop-in youth centers, the early psychosis project, and the Mental Health Student Services Act (for expanding student access) are examples of grant-funded programs.

The Commission’s Five Primary Functions

The Commission’s five primary functions align with the levers for transformational change and can be used to strategically drive change to systems, policies, and practices.