Abstract
This paper focuses on the connections between mental health policy, regional disparities, intergovernmental relations, and specific revenue sources from the analysis of the transformation of mental health policy in California since the 1990's.
In 1991, the state of California faced a severe budget shortfall. The state enacted a major change in the relationships between state and county, known as "Realignment". This realignment shifted program responsibility from the state to counties and got financial resources that were specific revenue sources for mental health, health, and social services. This realignment was aimed to help counties stabilize the mental health budget. It had, however, several risks like "trans-hospitalization", "the lack of entitlement", "the failure of access", and "Inequality of equity among counties". In order to overcome these failures and limitations, the state of California enacted the Mental Health Service Act (MHSA) in 2004.
From t h e analysis of these two changes, I reach the following conclusions:
1. The risks of the realignment pointed out from the very begi n n ing were verified by the program failures and limitations implemented in the 90's.
2, Through the MHSA, mental heal t h policy became virtually an entitlement program at state level in order to implement the pilot programs which were intended to overcome these program failures and limitations.
This analysis, I believe, contains many useful hints about the transformation of mental health policy in Japan.
