As the COVID-19 pandemic took hold, behavioral health organizations pivoted to delivering significantly more care via telehealth. Access to primary care–based behavioral health services has been a point of pride in the telehealth story, with data showing far fewer people missing appointments as a result of clinics offering mental health services virtually. But much less is known about the specialty behavioral health system, where people with substance use disorder or serious mental illness are cared for.

In addition, despite the overall telehealth expansion, telehealth practices may have exacerbated inequities in access to behavioral health care. People of color, those with low incomes or who do not speak English, as well as older people are too often unable to use telehealth services, for a variety of reasons. Significant barriers include limited access to broadband or technology, lack of digital literacy, and provider training and capacity.

As behavioral health organizations, especially those working in the specialty system, integrate learning from the pandemic into more permanent telehealth practices, they must bring health equity and racial justice into their design, practices, and policies.

Learning Collaborative for Behavioral Health Organizations

To help organizations address these issues, the California Institute for Behavioral Health Solutions launched Cultivating Outcomes through Equity in Behavioral Telehealth in July 2022, an 18-month learning collaborative supported by CHCF. Its goal is to help specialty behavioral health organizations deliver care that leads to meaningful outcomes for people from communities with historic behavioral health inequities.

In this initiative, participants are working to improve both their behavioral telehealth practices and their hybrid practices — that is, the combination of in-person and telehealth — so that patients will have equitable access to high-quality services that promote resilience and emotional well-being.

Participating Teams

This collaborative supports teams that are county- or community-based providers of both specialty mental health and substance use disorder services. The 13 participating behavioral health teams are:

Agape Counseling Center and Network, Newark
Korean Community Services, Anaheim
Lincoln Families, Oakland
Modoc County Behavioral Health, Alturas
Native American Health Center, Oakland
New Beginning Fellowship Center, Fountain Valley
Riverside University Health System, Riverside
Southern California Health and Rehabilitation Program, Lynwood
Sycamores, Pasadena
Turning Point Community Programs — CARE, Rancho Cordova
Turning Point Community Programs — CORE, Rancho Cordova
Unity Care, San Jose
WellSpace Health, Sacramento

Through this initiative, participants are working to:

• Incorporate codesign and community engagement strategies into behavioral telehealth and hybrid practices and policies
• Promote equity and client activation through behavioral telehealth and hybrid services
• Enhance provider and client digital literacy
• Expand assessment of behavioral telehealth outcomes

Teams will also receive training on equity and patient activation, support for community engagement, monthly coaching, support with data collection and analysis, and access to a digital navigator academy.