A spatial analysis of Los Angeles County’s burden of serious mental illness in relation to public mental health service providers
| Pages | 231-239 |
| Published date | 05 December 2019 |
| DOI | https://doi.org/10.1108/JPMH-03-2019-0034 |
| Date | 05 December 2019 |
| Author | Sarah Simmons |
| Subject Matter | Health & social care |
A spatial analysis of Los Angeles
County’s burden of serious mental
illness in relation to public mental health
service providers
Sarah Simmons
Abstract
Purpose –The purpose of this paper is to identify regions of Los Angeles County with high burdens of serious
mental illness and determine whether these regions align with those experiencing the greatest economic hardship.
Design/methodology/approach –This cross-sectional study analyzed the estimated prevalence of serious
mental illness and the locations of publicly funded mental health service providers within each census tract of
Los Angeles County. The burden of serious mental illness was calculated for each census tract using these
variables and an optimized hot spot analysis was conducted to determine which regions were the most
underserved in terms of serious mental illness.
Findings –There is a significantly higher burden of serious mental illness in Southeastern Los Angeles and
Pomona Valley than in the rest of Los Angeles County (p ¼0.01). The same can be said regarding the
Lancaster-Palmdale area and San Fernando Valley (p ¼0.05). These areas do appear to align with the areas
of Los Angeles County with an economic hardship index in the fourth quartile.
Originality/value –Mental health initiatives targeting the four hot spot regions should be given priority by the
County of Los Angeles. This is especially true when allocating funds from Proposition 63, which aims to
address mental health disparities in underserved, unserved or inappropriately served populations.
Keywords California, Access to care, Geospatial analysis, Los Angeles County, Neighbourhood poverty,
Serious mental illness
Paper type Research paper
Introduction
The California Mental Health Services Act (MHSA) was passed in 2004 and put into effect in
2005. This bill proposed a 1 percent tax increase on adjusted gross incomes exceeding $1m
(Brown et al., 2018). These funds were to be allocated to mental healthcare services, especially
those targeting underserved, unserved or inappropriately served populations (DHCS). As a result
of this proposition, the state of California had an additional income of $1.798bn in 2016–2017,
$2.095 bn in 2017–2018 and a projected $2.235bn in 2018–2019 to spend on the mental
healthcare needs of those residing within the state (Brown et al., 2018).
These funds are distributed via contracts with individual counties, with the largest portion going
to Los Angeles County, as it home to a quarter of the state’s population (Ashwood et al., 2018).
As seen in Table I, 15.85 percent of adults living in California are in need of mental health services,
which totals more than 4m people. Of these 4m, nearly 1.5m people in need of mental health
services are living within Los Angeles County (Holzer, 2009). According to the UCLA Center for
Health Policy Research, only half of the millions of people who need mental health services in the
state of California are receiving appropriate care (Grant et al., 2011). Approximately 5.35 percent
of adults living in Los Angeles County struggle with a serious mental illness, defined as a “mental,
Received 14 March 2019
Revised 8 July 2019
Accepted 24 July 2019
This study was aided by the
third-party organizations
responsible for collecting and
maintaining the data sets utilized:
the Los Angeles County Enterprise
GIS Steering Committee which
maintains the Los Angeles Data
Portal, the Los Angeles County
Department of Mental Health
which regularly updates the
locations of publicly funded mental
health service providers and UCLA
which conducted the 2014 Health
Interview Survey. The author
would also like to recognize Mark
Bloomfield and Ryan Murphy, both
of Saint Louis University, for
providing their expertise and
guidance. The author has no
relevant financial or non-financial
relationships to disclose. This
research did not receive any
specific grant from funding
agencies in the public, commercial
or not-for-profit sectors.
Sarah Simmons is based
at the Department of
Epidemiology and Biostatistics,
Saint Louis University,
St. Louis, Missouri, USA.
DOI 10.1108/JPMH-03-2019-0034 VOL. 18 NO. 4 2019, pp. 231-239, © Emerald Publishing Limited, ISSN 1746-5729
j
JOURNAL OF PUBLIC MENTALHEALTH
j
PAG E 2 3 1
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