Lawmakers must do more to fund mental health care at the University of California. Here’s how to get the money

By Emily Estus, Special to CalMatters

This summer, Gov. Gavin Newsom and the California Legislature passed a $214 billion budget that includes $5.3 million earmarked for improving mental health services in the University of California system.

Students returning to campus this fall might cheer that a long-underfunded issue is finally getting state attention and, more importantly, an injection of cash. Sadly, that’s not the whole story.

Here’s why: This is only a stopgap, a temporary infill of cash forestalling a serious and still growing funding crunch for mental health at the University of California. 

In this case, the Legislature is stepping in to cover the bill for a student fee increase that the UC system was already planning on implementing to pay for student mental health services. 

This means the state’s $5 million allocation was not a new investment in mental health. In May, before the budget was passed, the UC system had already promised those funds to just maintain the current level of counselors within university health services.

To be sure, it’s great that the state is lessening the cost burden of mental health on students. In the early 2000’s, UC system student fees alone could cover nearly all of the cost of student health, keeping copays and other campus-based fees largely at bay. 

But over the course of the past two decades, growing enrollment, medical inflation, and a 78% increase in student demand for mental health services have far outpaced increases in the UC system-wide student services fee, creating a funding gap that does need outside investment. But $5 million simply isn’t enough to meet the growing need for mental health services

And while the Legislature has established these funds as an ongoing appropriation, it does not build in adjustments for rising health care costs or student enrollment growth

Increased demand, coupled with severe financial constraints on the part of the university, has meant that student health centers have had to start charging copays for office visits in order to stay solvent. 

Counseling services have started instituting limits on the number of visits each student can receive before being referred out to the community. UCs have had difficulty hiring enough counselors to meet recommended student-to-counselor ratios and have struggled to pay for targeted mental health interventions for statistically at-risk students.

The UC system should ask the Legislature for another 5% increase next year, adjusted to inflation. But to really improve services and get students the help they need, we need to break the cycle of perpetually underfunding student health and counseling by changing how we think about providing and funding care. 

We could start by investing in early intervention. The revenue from past student fee increases was specifically limited to paying for direct services providers, slowing the development of early intervention programs specifically for at-risk and high-need students, including undocumented students, students with chronic illness, or international students.

Early intervention and preventative measures tend to have greater returns than direct services for the same money spent. By redirecting new funding to these programs, the UC system could both reduce the overall number of students needing individual counseling and provide more support to high-need students who may be less likely to seek it out on their own. 

Externally, the UC system should partner with the California State University System and community colleges to apply for other sources of public funding. 

For example, they could take advantage of the Mental Health Services Act reserves, which are allocated to California counties and represent approximately $2 billion in untapped funds. Applying these reserves to higher education would be a new use of Mental Health Services Act money, and California’s public higher education systems should work jointly on a proposal to the Mental Health Services Oversight and Accountability Commission for the best chance of success.

There’s a strong rationale for doing so: colleges and universities work directly with the age group most at risk of developing a serious mental illness, and a sizable number of students are on public insurance through Medi-Cal and should benefit from public funds for mental health services.

Likewise, Gov. Newsom and the Legislature have expressed interest in revisiting uses of Mental Health Services Act funding. This would be an ideal time to act.

____

Emily Estus is a graduate student at UC Berkeley’s Goldman School of Public Policy and School of Public Health, who researches mental health outcomes with the Berkeley Institute for Young Americans and  Well Being Trust, [email protected]. She wrote this commentary for CalMatters.

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