Biweekly Briefing Articles

Shining the Spotlight on Behavioral Health

May is Mental Health Awareness Month, and this year — more than ever — it’s important to put the spotlight on this issue.

Accessing behavioral health care is a big problem in California — and it’s only getting worse. While the impending tsunami of behavioral health issues due to the COVID-19 pandemic has yet to hit, we must brace ourselves for its arrival.

In any given year, an estimated 7.5 million people in California experience a mental health condition, and only one-third of adults who experience mental illness are getting treatment. In July 2020, 44% of Californians reported symptoms of generalized anxiety disorder or major depression since the start of the pandemic.

At the same time, behavioral health demands on the state’s hospitals are increasing. While emergency departments are a safety net — providing care to tens of thousands of people with a mental health or substance use disorder — they should not be the first or only option for those with chronic illnesses. Especially given that in the past 15 years, the number of inpatient psychiatric beds in California has decreased by 6%, while the population has grown 12%.

Early detection of behavioral health issues can lead to early intervention and better treatment outcomes, and HASD&IC and CHA continue to advocate for urgently needed changes in the state’s behavioral health care system.

We are encouraged that the governor’s May budget revision, released last week, includes a major investment of $4 billion in children’s behavioral health. The goal of the Children and Youth Behavioral Health Initiative is to transform California’s behavioral health system for children and youth into an innovative, prevention-focused system where all children are routinely screened, supported, and served for emerging and existing behavioral health needs. The initiative will identify children who need help early, provide services where and when needed, and make programs and services available to meet their needs. In addition, it includes resources for the Office of Statewide Health Planning and Development to support behavioral health providers through existing and new health workforce development programs.

The governor’s initiative is the cornerstone of the Blueprint for Behavioral Health, which CHA, NAMI California, and a coalition of more than 50 statewide organizations released earlier this month. The BHA Blueprint is a proactive approach to transforming California’s behavioral health system. Instead of reactive and expensive alternatives, including emergency department care and hospitalization, the BHA Blueprint prioritizes investments in prevention, early assessment, identification of needs, and aggressive treatment.

Another priority for HASD&IC and CHA is leadership that would develop an effective behavioral health crisis care system at the statewide level. California’s current piecemeal approach has not addressed the fundamental problems with the behavioral health care delivery system — creating more fragmentation, higher costs, and frustration. CHA and NAMI-sponsored legislation, Assembly Bill 1331, would establish, under the Department of Health Care Services, a full-time statewide director of crisis services — moving away from a county-based system and establishing standardized, core services at the state level. The director would be responsible for various tasks, including coordinating behavioral health programs and services statewide, to ensure continuity of services and access points and to enhance cross-agency information exchange and resource sharing.

COVID-19 has only exacerbated behavioral health challenges by creating new obstacles for those already suffering and increasing the ranks of those who need care. Proactive steps are urgently needed to address current and future challenges and ensure that all who need who are able to get it in a timely manner.