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Research Questions

  1. What is the reach of the PEI campaigns into various diverse groups in the state?
  2. How are Californians faring with respect to attitudes, beliefs, and behaviors related to mental illness? Are there demographic differences in how California's diverse communities fare?
  3. Is exposure to CalMHSA's PEI mental health campaigns associated with these key mental health outcomes?

Many Californians experience serious and impairing mental health issues, but fewer receive the care that they need. In light of this, the California Mental Health Service Authority (CalMHSA), a joint power authority of counties working together on statewide mental health projects, administers prevention and early intervention (PEI) campaigns that seek to address mental health stigma and encourage people to get mental health support. This report describes surveys of a representative sample of California adults, conducted at two time points, to understand (1) the reach and impact of CalMHSA's mental health PEI campaigns and (2) how Californians are faring with respect to their mental health attitudes, knowledge, and use of mental health resources.

Key Findings

  • The current evaluation provides evidence that the CalMHSA PEI campaigns are reaching a large number of Californians, including some key target populations, such as Spanish-speaking Hispanic Californians.
  • The vast majority of California adults had positive attitudes toward mental health help-seeking, but somewhat fewer had the knowledge they needed to actually pursue mental health help or intervene with someone at risk of suicide.
  • Key demographic differences emerged: Men lagged behind women in their mental health knowledge, attitudes, and access to care. Similarly, Hispanic Californians and Asian Californians also had lower mental health knowledge, attitudes, and access to care when compared with White Californians.
  • For the most part, mental health indicators did not shift in the California general population between the two time points examined.
  • There is evidence that those reached by the campaigns are faring better with respect to mental health knowledge, attitudes, and behaviors; confidence to intervene with those at risk for suicide; stigma toward those with mental illness; and capacity to recognize if they had a mental health problem that needed professional help.


  • CalMHSA should consider ways to both directly reach more men with the campaign and indirectly affect men via the women they are already effective at reaching. Take Action should explore new ways to reach young people directly and ways to leverage its excellent reach of a middle-aged population into impact on young people (e.g., by providing materials targeted toward parents of the key transition-aged youth demographic).
  • CalMHSA should focus on increasing Californians' awareness of the mental health resources in their communities, working with local counties.
  • CalMHSA should continue to promote awareness of the warning signs of suicide, including a focus on deeper engagement with Know the Signs messages.
  • CalMHSA should continue its efforts to give family members and friends the tools they need to support others' mental health.
  • CalMHSA should consider whether to include mental health stigma reduction as a goal of Take Action, because the state appears to be losing ground in this area despite better outcomes among those exposed to the campaigns.
  • CalMHSA should intensify its efforts to address mental health knowledge, attitudes, and access to care in men and in Hispanic and Asian populations. This effort will likely require materials that are designed to specifically appeal to these populations and more-targeted dissemination efforts.

Research conducted by

This evaluation was funded by the California Mental Health Services Authority (CalMHSA) and carried out within the Access and Delivery Program in RAND Health Care.

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