Community advocates have long highlighted the need for a mental health system that better serves California’s cultural and linguistic diversity. They have pointed out the need to assess how people are faring in the system and where there are differences in access and outcomes.

“Mental health disparities” are inequitable differences in risk of illness, access to services, utilization of services, and health outcomes experienced by individuals or groups based on age, race, ethnicity, gender identity, sexual orientation, immigration status, primary language, disability status, income level, or other factor, or a combination of these factors.

Although California has legal requirements for cultural and linguistic access for people who are enrolled in Medi-Cal, a lack of quantitative system performance data and measures has made it difficult to enforce these requirements or to meet performance targets.

In 2017, Governor Jerry Brown signed AB 470 into law. It requires robust tracking and evaluation measures for mental health services in Medi-Cal. The goal is to ensure that Medi-Cal enrollees receive timely access to quality mental health services, which would then reduce mental health disparities. Newly available Medi-Cal data, released as required by AB 470, demonstrate mental health access disparities for adults in Medi-Cal.

Medi-Cal’s Mental Health Care System

In Medi-Cal, responsibility for the mental health benefit is split between county specialty mental health plans and Medi-Cal managed care plans.

This report focuses on Medi-Cal mental health services for adults. California’s counties also provide mental health services for people with and without Medi-Cal through a variety of funding sources, across the entire spectrum of care, from prevention and early intervention through specialty care.