California’s mental health system is too slow for young people on Medi-Cal


Despite recent policy changes, many California families seeking behavioral health treatment through Medi-Cal are struggling to get the services they need in a timely manner. Given the scale of the emergency, country leaders must ensure that these systems are provided with sustainable resources.

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Nancy Holland

Nancy Holland is a mother of two with complex health conditions. She founded Kids and Caregivers and is the Carer Engagement Director for the California Children’s Fund.

Despite California’s unprecedented investment in child and family well-being, the gap between what policies promise on paper and what they actually achieve for young people and families has never felt this wide.

My children, former foster youth living with complex medical needs, are a high priority for behavioral health care yet still have waiting times for services that are measured in months and — on more than one occasion — years.

I have many perks and experience working in the healthcare field that spans decades. But despite my understanding of the necessary health policies, I am unable to access my children’s behavioral health care in a timely manner, if at all.

I can only imagine what it is like for families with less understanding and fewer resources to navigate this system.

While in a recent meeting quoting American Surgeon General’s 2021 Report Warning that young people’s mental health has become a “devastating” crisis, I’ve already been on my way for a few months trying to get my 15-year-old daughter back into medical care for her attention deficit hyperactivity disorder (ADHD) and depression. Her psychiatry referral had been in place since she was 12, but was inexplicably closed due to an apparent defect in the paperwork. We were told we would have to redo the whole process.

So while I appreciate the Instagram posts that raise awareness of teen mental health, and I applaud the efforts to highlight the disparities black children (like my daughters) face in terms of High risk for depression and anxietyI also know firsthand that the system is very flawed.

This is especially true for families like ours who are insured through Medi-Cal. At best, Medi-Cal behavioral health services are hard to come by. Most of the time, they are a vast sieve through which children and families get lost through no fault of their own.

This is not a new problem. When my youngest daughter was diagnosed with a debilitating, incurable disease at the age of five, I asked her pediatrician how I could access behavioral health resources to build her resilience and support our family. Unfortunately, my daughter needed a mental health diagnosis to get these services through Medi-Cal, which took longer.

There was no preventive care available for her or our family.

While this specific policy changed last year and children with Medi-Cal who participate in the system or who have experienced trauma now theoretically have access to benefits, the ability to receive care in reality has not materially improved.

My own daughter, who is 14 years old, was diagnosed with post-COVID post-viral syndrome, and her symptoms exacerbated her existing illness, resulting in the onset of depression and anxiety. Her pediatrician (who is awesome) told me there were no more child psychiatry referrals available through the practice, but if she became a danger to herself, I could call 911 or visit urgent care.

As a former therapist, I know that when children—especially teens—tell you that they are struggling, there is a critical opportunity for treatment that cannot be delayed. However, all the California mental health system could do was tell me to wait.

Our children are not well. We need something better than hotlines, first responders, and local hospitals as a safety net. State leaders must acknowledge the depths of the current emergency and support the mental health needs of our young people participating in our system, who are some of the most vulnerable populations in our state.

Specifically, the state needs to allocate non-federal funding earmarked for counties in this year’s budget to get the promising new jumpstart going Specialized mental health services Eligibility criteria policy in practice. If we are going to help our children, local behavioral health delivery systems need to be resourced, supported and informed immediately and sustainably.

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