We’ve missed chances to boost mental health

California has not solved the mental health crisis; neither has Congress. We see the reality of the crisis every day in every community. We have made progress, but we have missed opportunities that could have helped more people, more families.

Take the Helping Families in Mental Health Crisis Act (HR 2646) that was passed by the U.S. House on July 6. Assuming it becomes law, it will fund programs for people in psychiatric hospitals and those in crisis.

But it is far more limited in its support for everyday Americans who need help but aren’t in crisis.

A modest proposal to let a Medicaid patient see their primary care physician and mental health provider on the same day – a practice currently prohibited at California’s community health centers – was shelved.

This runs contrary to health centers’ successful integration of primary care and mental health, and affects our patients daily. It may seem minor, but a struggling mother on the brink of collapse shouldn’t have to take a second day off work to get help. That is a missed opportunity.

Of course, that assumes there is a mental health provider available for patients to see. The health care workforce crisis is crippling our ability to address mental health needs.

Health centers spend years trying to recruit psychiatrists, psychologists and social workers to no avail. Health centers have plenty of marriage and family therapists who speak their patient’s language, but Medi-Cal doesn’t cover a visit with them in a community health center. That is another missed opportunity.

California’s landmark Mental Health Services Act has undoubtedly expanded access to treatment and other services. But has the $13 billion program been a success?

We don’t know.

According to the Little Hoover Commission, the lack of effective oversight and outcome data make it difficult to measure its progress, or the success of county programs or whether they used MHSA funding to partner with nonprofit primary care providers such as community health centers. These are providers who often share the same patients and deliver complimentary services. That is a missed opportunity, too.

We need to do better. We can’t make a patient choose between a medical visit and a mental health visit. We can’t artificially limit our pool of mental health providers. We can’t fail to measure the progress of the state’s single largest mental health services program.

If we are going to solve the mental health crisis in California, we can’t miss opportunities anymore.

Carmela Castellano-Garcia is president and CEO of CaliforniaHealth+ Advocates, which promotes nonprofit community health centers. She can be contacted at