As the COVID-19 pandemic took hold and shut the world down, behavioral health providers — like all health care providers — had to move quickly to change how they served clients. Demand for behavioral health services was skyrocketing, but people were told to stay home and were unable to receive care in person. Providers responded by pivoting to delivering more care via telehealth. The pandemic also sparked a hard look at inequities in health care. Behavioral health providers began to talk more about how structural racism affected their communities and their own practices. They asked if telehealth could minimize or might exacerbate these inequities. And more broadly, how could they better reach people in their communities who were not engaged in care because of a wide range of issues? Perhaps they lacked transportation or couldn’t get time off work. Or maybe it was because providers didn’t speak their language or understand their background, and they felt unwelcome.
These problems were even more challenging for people with serious mental illness or substance use disorder. In California’s Medi-Cal system, people with these more serious conditions are treated through what’s known as the county-based “specialty” system.
Learning Collaborative for Behavioral Health Organizations
To help organizations address these broad issues, in July 2022 CHCF and the California Institute for Behavioral Health Solutions launched an 18-month learning collaborative, Cultivating Outcomes through Equity in Behavioral Telehealth. The project partnered county-based specialty mental health and substance use providers with local community-based organizations in 11 teams across the state.
The collaborative sought to help specialty behavioral health organizations develop both their telehealth and hybrid practices (the combination of in-person and telehealth) to make them more accessible and equitable. The goal was that all clients — especially those from communities that experience historic behavioral health inequities — experience high-quality services that promote resilience and emotional well-being.
Videos
The two videos below show some of the participants in the collaborative.
In the first, behavioral health clinician Vong Chang, LCSW, talks about his own experience in fighting racism, both for himself and to help the team that he leads at Turning Point Community Programs in Merced.
The second video tells the story of the partnership between New Beginning Fellowship Center and Second Baptist Church, both in Orange County.
Overall, in the collaborative the teams worked to:
- Include clients and community members in the development of behavioral health organizations’ practices and policies
- Learn and practice strategies that promote equity in access and outcomes
- Develop strategies to support clients’ engagement in their own care; this is known as patient activation
- Enhance digital literacy for both providers and clients
A pathbreaking achievement of this learning collaborative was its partnerships. To ensure that people underrepresented in the current system were reached, the partnerships were composed of behavioral health providers and community-based organizations that operate in areas not well served in the behavioral health care system. The teams received training on a wide range of topics, including structural racism in health care, patient activation, community engagement and community-based participatory research, and digital navigation. Teams also received monthly coaching and support with data collection and analysis, including patient-reported outcomes.
Participating Teams
The 11 teams of behavioral health providers and community-based organizations in the collaborative included the following, all based in California:
Agape Counseling Center and Network (Fairfield)
Solano for Victims of Violence (Fairfield)
Korean Community Services (Anaheim)
Southland Integrated Services (Orange Grove)
Lincoln Families (Oakland)
Contra Costa County Children and Family Services (Pleasant Hill)
Modoc County Behavioral Health Services (Alturas)
Promotores del Norte de California (Alturas)
Native American Health Center (Oakland)
Center for Empowering Refugees and Immigrants (Oakland)
New Beginning Fellowship Center (Fountain Valley)
Second Baptist Church (Santa Ana)
Riverside University Health System (Riverside)
From Peace to Chaos (Blythe)
Sycamores (Pasadena)
El Centro de Amistad (San Fernando)
Turning Point Community Programs — Community Assistance Recovery Enterprise (Merced)
Sacramento Youth Center (Sacramento)
Turning Point Community Programs — Community Outreach Recovery Empowerment (Sacramento)
Golden Valley Health Centers (Modesto)
Unity Care (San Jose)
Culturally Coordinated Services (San Jose)
