by Anna Garfink
The COVID-19 pandemic has exposed many inequities of our dismal healthcare system. However, one specific inequity has not received the attention it deserves: disparity in access to mental healthcare. In honor of Mental Health Awareness Month, this blog post is dedicated to addressing our community’s highly stigmatized and urgent mental healthcare needs.
Think of the last time you had to make a healthcare appointment: how long did you have to wait for the appointment? Was it easy to find the right doctor? Was it insured?
Depending on whether you were making an appointment for a physical issue or a mental one, the answers to these questions would be vastly different because there are enormous barriers to accessing mental healthcare in California. Mental healthcare in California is in a state of extreme crisis, and the state’s leaders need to do better at providing care for those who need it.
Mental health disorders are widespread and incredibly common – it is estimated that one in five adults nationwide lives with a mental illness – and they are highly treatable, even the most severe ones. However, treatment is sparse. In California, 65 percent of adults with mental health problems receive no treatment. Barriers to treatment are high: many regions in California lack adequate numbers of therapists, and a majority of care providers do not accept insurance, which means that even if a patient manages to find a therapist, there is a good chance that it would be unaffordable.
The results in California have been disastrous and represent an unacceptable outcome, especially disquieting for a state that prides itself on its progressivism. Individuals with mental health disorders are overrepresented in the state’s prison population: over 30 percent of California prisoners have a severe mental health disorder. They are also overrepresented on the streets: approximately one-third of individuals experiencing homelessness have a serious mental health disorder.
Californians with mental illnesses are suffering on our streets and behind bars simply because there isn’t enough care, but it doesn’t have to be that way. The state should fund mental health services and reduce health insurance barriers through legislation. Having accessible, low-cost wrap-around mental health services in every county in the state – including therapy, medication, social work, and in-patient services – would improve outcomes for Californians with mental health disorders and enhance the quality of life for everyone statewide.
The City and County of San Francisco could serve as a good model for developing a program to meet the mental health needs of the state. In December, the San Francisco Board of Supervisors passed legislation that provides comprehensive 24/7 services to individuals in high need, establishes an Office of Coordinated Care to connect patients with the services they need, and institutes a Mental Health Street Crisis Team. It is too early to tell whether such a program will be effective (the Board of Supervisors intends to form a working group starting summer 2020, but it’s unclear how the COVID-19 pandemic will interrupt these plans).
However, it’s a step in the right direction in a state that has largely been ignoring the mental health needs of its residents for the past 40 years, and California leaders should consider adopting San Francisco’s plans statewide. To start with, California should work with local public health departments to establish 24/7 crisis drop-in centers in every community as well as ensure that staff can connect individuals to services they need by funding an increase in services statewide. Additionally, the state should pass regulations that require mental healthcare providers to accept insurance. This small change would vastly improve access to care because the hourly rates of most providers are out of reach for the majority of Californians.
Passing this regulation and funding these services would signal to Californians with mental health disorders that they no longer have to suffer on the sidelines. The state has a progressive agenda, but before it can see success it must address the emotional needs and well-being of its most vulnerable residents.
Anna Garfink is an MPP student at the UC Berkeley Goldman School of Public Policy.
The views expressed in this article do not necessarily represent those of the Berkeley Public Policy Journal, the Goldman School of Public Policy, or UC Berkeley.