California is leading the nation in improving access to mental health and substance use disorder care for Medi-Cal patients.

In an media briefing on May 16, hosted by Ethnic Media Services, a panel of experts discussed how Medi-Cal is helping Californians receive necessary treatment for mental health and substance use disorders, promoting healthier lives overall.

Speakers

  • Autumn Boylan, Deputy Director, Office of Strategic Partnerships, California Department of Health Care Services
  • Paula Wilhelm, Interim Deputy Director, Behavioral Health, California Department of Health Care Services
  • Jennifer Oliphant, LCSW, Chekws: Hope for Tomorrow Program Director at Two Feathers Native American Family Services
  • Tricia Nguyen, CEO, Southland Integrated Services (formerly Vietnamese Community of Orange County)

What is Behavioral Health?

Behavioral health is the mental health and substance use disorders, as well as an impact on physical health by stress.

Medi-Cal, California’s Medicaid program, offers coverage to one-third of Californians, equating to 15 million people. To facilitate easier access to care, Medi-Cal collaborates with community organizations to offer services such as mental health and substance use disorder screenings, outpatient therapy, and inpatient treatment. Members can access these services by calling their local county’s 24-hour access line.

Paula Wilhelm noted, “One thing we continue to hear from our MediCal members is that the complexity of navigating the healthcare system can keep people from accessing care.”

To address this, DHCS is transforming Medi-Cal with initiatives like the Mental Health Services Act, which funds treatments for substance use disorders and severe mental health conditions. Additionally, they are expanding early intervention and housing support and implementing the No Wrong Door policy to ensure treatment is accessible.

Addressing Youth Mental Health

According to the U.S. Surgeon General, the youth mental health crisis is the most colossal public health issue right now. Medi-Cal is reforming to target this through the Children and Youth Behavioral Health Initiative, a $4.7 billion investment under Governor Newsom’s Master Plan for Kids’ Mental Health.

“For over a decade, outcomes for youth have been worsening,” said Autumn Boylan. “Half of all lifetime cases of diagnosable mental illnesses emerge for youth by age 14, and 75 percent begin by age 24.” In California, more than quarter of a million children suffer from major depression, with two-thirds of them not receiving treatment.

To combat this crisis, mental health care is being expanded to schools in order to reach children directly.  They are particularly targeting youth of color, from low-income households, LGBTQ+, justice-involved, and facing housing challenges.

Growing Coverage of Behavioral Health Care

A Medi-Cal contract has allowed Chekws to expand significantly, now one of the larger providers of mental health and substance use care in Humboldt County. Jennifer Oliphant said they have “built up intensive and rehabilitative care, workforce training with local universities, cultural workshops, peer counseling and horse therapy.”

In 2022, Two Feathers also launched a youth leadership development program. This initiative engages teenagers in adult-led groups to prepare them for employment, hone in social and emotional skills, participate in college tours, and learn local culture.

Jennifer Oliphant shared, “We had one youth come in a few years ago who was struggling with substance use and on the fence about whether to seek counseling. They entered our youth leadership program and got connected with a peer group, and then was motivated to get connected with our counselors … they’ve been with us nearly two years now and the change has been remarkable.”

Drugs have also taken the youth of Humboldt County by storm. They have incorporated the substance abuse therapy into the mental health services in order to help break down the barriers. 

“Expanded Medi-Cal has let us have a sustainable, growing behavioral health program with a consistent clinical roster, whereas before we’d have temporary grants here and there,” she added. 

Tricia Nguyen recounted, “When I first started in 2008, we didn’t have any mental health program at all, but I saw such a need for it here” Originally established in 1979 as a Vietnam War refugee resettlement agency, the clinic is now in the largest Vietnamese enclave outside Vietnam, home to over 209,000 Vietnamese people, which constitutes more than 6% of the area’s population, according to the U.S. Census.

Nguyen explained the generational mental health gaps, “the older generation who has suffered so much, and pass the guilt of needing to be a traditionally successful doctor, lawyer, engineer onto the kids … so we have isolation among seniors and anxiety, depression and suicide among pressured youth.”

CDC reported in 2020 that suicide was the leading cause of death for AAPI Americans aged 10 to 19 and the second-leading cause for those aged 20 to 34.

Nguyen highlighted the breadth of services at Southland Integrated Services. With senior wellness classes, veteran counseling, psychiatric rehabilitation, and digital literacy workshops, the “Medi-Cal grants allowed us to build six-week youth wellness workshops.” These workshops are outfitted with arts and craft, healthy sleep and eating classes, and teach proper nettiequte.

She elaborated on the cultural challenges by how “parents feel that they’ve sacrificed everything for the kids’ success, while the kids feel that the parents don’t care about their wellbeing.” As a society we are open about having illnesses hypertension and diabetes but talking about mental health is still taboo. 

“Parents will come in now and ask for a therapist or screening for their child. It’s difficult to break taboos around mental health and substance abuse, but through these programs, we’re doing it.”