Opinion

Urgent: Protect mental health services

A depressed man sits alone on a park bench. (Photo: Mikael Damkier)

Nearly two decades ago, California raised the bar for our state’s wellness by requiring insurers to equally cover services for both physical and mental health conditions. Now a national standard, California’s groundbreaking Mental Health Parity law was among the first to recognize how grave inequities in the form of higher co-pays or fewer allowable visits diminish wellness and productivity.

California’s trailblazing path for equity was elevated further with the Affordable Care Act, which expanded parity requirements and insurance coverage – resulting in millions more Californians having equal access to mental health services.

But now that progress is at risk with the Affordable Care Act under threat and millions of Californians potentially losing health coverage and mental health services. To head off a mental health crisis, lawmakers must act proactively to protect care and prevent more homelessness.

Advocates are warning of a mental health crisis that would result from proposed federal repeal of healthcare reform.

The California Coalition for Mental Health has released an urgent priority list for legislators to consider this session as California gears up to protect our hard-fought gains under the ACA.  Our action list includes:

  • Strengthening the mental health workforce to meet the needs of a growing and diverse state, including supporting student loan repayment/forgiveness, improving service reimbursement rates and expanding the mental health workforce through the use of certified psychiatric rehabilitation practitioners and peer support specialists.  By increasing the use of community supports by non-licensed professionals, including peer support, states can save mental health money by reducing hospitalizations and other emergency interventions. According to a September 2013 article in Stateline people with mental illness who are helped by peers tend to experience more thorough and longer-lasting recoveries.
  • Reforming justice policies to prevent unnecessary and costly incarceration of people with mental illness and substance abuse disorders. The criminalization of individuals with mental illness persists as one of the most substantial human rights and criminal justice issues in California and nationally.  Jails and prisons have become California’s defacto mental health facilities, with those who live with mental illness being far more likely to be incarcerated than to be receiving the care they need. In fact, the number of inmates with mental illness has grown in both county jails and state prisons, although overall inmate populations have shrunk.
  • Investing in affordable housing and reducing barriers to building homes for those living with mental health and substance abuse disorders. Untreated mental illness increases the risk of homelessness.  Conversely, housing is a key factor for stabilization, recovery and improved outcomes for individuals living with a mental illness.

The CCMH recommendations represent a rare consensus among mental health stakeholders, including family and consumer organizations, nonprofit service providers, clinicians, professional associations, hospitals, and advocacy organizations.

Since the Affordable Care Act was adopted, 5 million Californians gained access to health insurance. Advocates are warning of a mental health crisis that would result from proposed federal repeal of healthcare reform.  More than 14 million Californians who are insured through Medi-Cal could see benefits slashed and millions could lose insurance access to both physical and mental health services.

California’s mental health infrastructure has been strained to meet the needs of the Golden State for decades, and now our recent gains in coverage for mental health care stand at risk. It is all the more urgent that legislators act on these cost-effective, common-sense and evidence-based recommendations to move California forward rather than backward.

Ed’s Note: Joseph Robinson is chair of the California Coalition for Mental Health.


  • Pete Lafollette

    Federal reform trends need prevention and wellness along with the resources and funding to make this a practical reality given the public tax expense of non-recovery- disability, substance abuse, rehabilitation, incarceration, hospitalization, institutionalization, long list of atrophy. In CA they obfuscate MHSA services delivery, making it incomprehensibly difficult to understand and know where and who the billion$ of dollars are actually reaching- a very tangled web of where the funding is actually received, how they are not promoting recovery models, how they are not including stakeholder process, how there is no treatment of severely mentally ill, how tech and data driven business outcomes disregard MHSA law and eliminate broad oversight, especially stakeholders.

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