In summary

It is time to transform our behavioral health system; here’s a blueprint with several key performance indicators.

By Carmela Coyle

Carmela Coyle is president and CEO of the California Hospital Association, ccoyle@calhospital.org.

Jessica Cruz, Special to CalMatters

Jessica Cruz is CEO of NAMI California, jessica@namica.org.

Californians are looking forward to when immunity from COVID-19 is widespread. It is a goal that is closer thanks to the multiple vaccines and expanded statewide distribution.

Even when the virus is beaten clinically, a global behavioral health crisis will still exist, and it’s been exacerbated by the pandemic. Now is the time to double down to address this next pandemic – affecting, not millions, but billions of people all over the world.

Since COVID-19 changed our lives, there has been an alarming spike in the number of people who need mental health and substance use disorder care and treatment. People are struggling. No one is immune. This struggle is deeply personal and can be incredibly isolating. We all know someone who has faced these feelings.

Before the pandemic, behavioral health was a complex challenge. It is now much worse. Last July, nearly half of all Californians reported they were experiencing symptoms of generalized anxiety disorder or major depression tied to the health crisis. A national study found that 13.3% of adults were reporting new or increased substance use as a way of coping with the stress they were facing.

The effects are disproportionately worse for low-income Californians and communities of color. More than a third of adults with an annual income under $40,000 say stress related to COVID-19 had a major negative effect on their mental health. Black and Latino adults were more likely to say that they or someone in their household has experienced economic loss due to the pandemic.

Against this backdrop, there is hope in new solutions and a united effort to improve Californians’ behavioral health and wellbeing.

Behavioral Health Action, a diverse coalition of more than 50 statewide organizations with extensive behavioral health experience and expertise, released a new blueprint for behavioral health care in California to guide policymakers as they address the many challenges to the current system to solve the crisis with proactive, preventive solutions. The BHA Blueprint for Behavioral Health flips the script. 

Instead of reactive and expensive alternatives including acute care, the BHA Blueprint prioritizes investments in prevention, early assessment, identification of needs and aggressive treatment. This minimizes the impacts, protects resources and – most importantly – is better for people’s health and wellbeing.

This blueprint includes measurable targets. California must improve by at least 10% per year in several key performance indicators:  

  • Reduce the delay from onset of symptoms to engagement in treatment for mental health and substance use disorder needs. 
  • Reduce the disparities in behavioral health service utilization among racial, ethnic and sexual orientation/gender identity populations. 
  • Reduce the proportion of individuals with mental health and substance use disorder needs in jails and prisons. 
  • Reduce the rate of re-hospitalization following a psychiatric hospitalization. 
  • Increase the number of children and youth receiving screening for behavioral health needs. 
  • Improve the satisfaction of consumers and families with the behavioral health care services they receive. 

While we must always provide care for those who are suffering, prevention, early intervention and treatment to support a person’s overall wellbeing will save lives and resources. Investment priorities in behavioral health should mirror that of primary care, in which the goal is to prevent illness and detect signs of trouble as early as possible.

A broad continuum of behavioral health care holds the promise of saving lives by promoting behavioral health as a part of overall health. California has an enviable nationwide reputation for leading the way to meaningful solutions. It is now time to transform our behavioral health system with the same sense of urgency that went into the discovery of the COVID-19 vaccine. Until then, the pandemic will not be over. The BHA Blueprint is a critical resource for leaders seeking long-term success.

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