Advancing Mental Health Equity in Medi-Cal
The COVID-19 pandemic underscores the need for an equitable mental health system. The pandemic and its associated economic and educational disruptions disproportionately affect people of color, especially those with low incomes. People who are Black and Latinx have been more likely than people who are White to report symptoms of anxiety or depression during the pandemic, according to a KFF (Kaiser Family Foundation) analysis.
People insured through Medi-Cal who seek mental health or substance use treatment often have a hard time getting care, in large part because they face a system challenging to navigate. Latinx, Asian American, and Pacific Islander Californians access care for many mental health services in Medi-Cal at lower rates than their counterparts.
CHCF supports the California Pan-Ethnic Health Network (CPEHN) in its work to advance equity in Medi-Cal mental health care through research, publications, and its Behavioral Health Equity Collaborative. Launched by CPEHN in 2016, the collaborative convenes community-based organizations in communities of color to develop shared strategy, provide training and technical assistance, and collectively mobilize for mental health equity and greater investment in appropriate and quality mental health services. It is the largest collaborative of organizations working on the behavioral health needs of people of color and LGBTQ communities, and works collectively to improve mental health services in Medi-Cal.
Why This Work Matters
Mental illnesses are common conditions, affecting roughly 15% of all adults, and people’s health depends on getting access to quality care. While Medi-Cal covers a broad range of mental health and substance use disorder services, a fragmented system makes it hard to access care.
Medi-Cal enrollees with mild or moderate mental health conditions receive care through one system — their managed care plan. Those with serious mental illness are treated through another system — their county’s mental health plan. There is variation among racial and ethnic groups in receiving treatment. Latinx, Asian American, and Pacific Islander Medi-Cal enrollees receive mental health services at the lowest rates of all racial and ethnic groups in both managed care plans and county mental health plans. Black Medi-Cal enrollees use county mental health services at the highest rate of all racial and ethnic groups but use managed care plan mental health services at a much lower rate than White enrollees.
Hundreds of thousands of people enrolled in Medi-Cal who have mental illness are not receiving care.
CPEHN Activities in Mental Health
Policy and Publications
CPEHN has been working to improve the Medi-Cal mental health system and to advance mental health equity for many years. Starting in 2012, CPEHN worked with statewide organizations collectively known as the California Reducing Disparities Project Partners to develop and publish The Strategic Plan to Reduce Mental Health Disparities.
In 2017, CPEHN sponsored California Assembly Bill 470, which directs the California Department of Health Care Services to update the performance and outcome reporting system on mental health for Medi-Cal enrollees who use county mental health services. Under the law, the department must stratify the performance and outcome data by race and ethnicity as well as by age, sex, sexual orientation, gender identity, and primary language. In 2020, CHCF published CPEHN’s analysis of the law’s newly available data, titled Mental Health Disparities by Race and Ethnicity for Adults in Medi-Cal.
Behavioral Health Equity Collaborative
The Behavioral Health Equity Collaborative was first convened by CPEHN in 2016 to bring voices from diverse communities to statewide policymakers. In the wake of the COVID-19 pandemic, CPEHN recently relaunched the group with these organizations:
- API Equality-LA (Los Angeles)
- Central Valley Immigrant Integration Collaborative (Clovis)
- El Sol Neighborhood Education Center (San Bernardino)
- Empowering Pacific Islander Communities (Los Angeles)
- Gender Health Center (Sacramento)
- Korean Community Center of the East Bay (San Leandro)
- Little Manila Rising (Stockton)
- Mental Health Advocacy Services (Oakland)
- Multi-Ethnic Collaborative of Community Agencies (Santa Ana)
- Native American Health Center (Oakland and San Francisco)
- Painted Brains (Los Angeles)
- Regional Pacific Islander Taskforce (San Francisco Bay Area)
- San Diego Refugee Communities Coalition (San Diego)
- United Women of East Africa (San Diego)
The collaborative engages in policy research and development. It also has a special focus on improving access, quality, and cultural competence of the mental health services provided through Medi-Cal managed care plans to treat people’s mild or moderate conditions. The collaborative facilitates capacity building of other community organizations led by and serving people of color, with a goal of increased investments in quality mental health services.