For many California children, Medi-Cal mental health services lack urgency they need

Despite California’s unprecedented investment in child and family wellbeing, the gap between promising policies on paper and what they actually accomplish for young people and families has never felt so vast.

My children, former foster youth living with complex medical needs, are considered high priority for behavioral health care and yet still have waiting times for services measured in months and – on more than one occasion – years.

I have a lot of privilege and experience working in health care that spans decades. But despite my understanding of the necessary health policies, I am unable to access behavioral health care for my children in a timely manner, if at all. 

I can only imagine what it is like for families with less understanding and fewer resources to navigate this system.

While at a recent meeting citing the U.S. Surgeon General’s 2021 report warning that youth mental health had become a “devastating” crisis, I was already a few months into my attempt to get my 15-year-old daughter back into medical care for her ADHD and depression. Her psychiatry referral had been in place since she was 12, but it was inexplicably closed due to an apparent paperwork glitch. We were told we would have to restart the entire process.

So while I appreciate Instagram posts raising awareness of adolescent mental health, and applaud efforts to highlight the disparities Black children (like my daughters) face in terms of elevated risks for depression and anxiety, I also know firsthand that the system is deeply flawed.

This is especially true for families like ours who are insured through Medi-Cal. At best, Medi-Cal’s behavioral health services are hard to access. Most of the time they are a vast sieve through which children and families are lost by no fault of their own.

This is not a new problem. When my youngest daughter was diagnosed with a debilitating and incurable disease at 5 years old, I asked her pediatrician how I could access behavioral health resources to build her resiliency and support our family. Unfortunately, my daughter needed a mental health diagnosis to get those services through Medi-Cal, which required a longer wait.

There was no preventive care available for her or our family.

While that particular policy changed last year and now children with Medi-Cal who are system-involved or have experienced trauma theoretically have access to benefits, the ability to actually receive care has not materially improved.

My same daughter, now 14, was diagnosed with post-viral syndrome after COVID, and her symptoms exacerbated her existing illness, triggering the onset of depression and anxiety. Her pediatrician (who is fantastic) told me there were no more pediatric psychiatry referrals available through the practice, but if she became a danger to herself I could call 911 or visit urgent care. 

As a former therapist, I know that when children – especially adolescents – tell you they are suffering, there is a critical window of opportunity for treatment that cannot be delayed. And yet all California’s mental health system could do was tell me to wait.

Our children are not OK. We need something better than hotlines, first responders and local hospitals as a safety net. State leaders must acknowledge the depths of the current emergency and support the mental health needs of our system-involved youth, who are some of the most vulnerable populations in our state. 

Specifically, the state needs to allocate dedicated, non-federal funding to counties in this year’s budget to move the promising new Specialty Mental Health Services eligibility criteria policy into practice. If we are going to help our children, local behavioral health delivery systems need to be immediately and sustainably resourced, supported and informed.