For Many California Children, Medi-Cal Mental Health Services Lack the Urgency They Need

Despite California’s unprecedented investment in the well-being of children and families, the gap between promising policies on paper and what they actually accomplish for young people and families has never been greater.

My children, former foster youth living with complex medical needs, are considered high priority for behavioral health care and yet wait times for services are measured in months and – more than a occasion – in years.

I have a lot of privileges and work experience in health care that spans decades. But despite my understanding of the necessary health policies, I cannot access behavioral health care for my children in a timely manner, if at all.

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

At a recent meeting citing the US Surgeon General’s 2021 report warning that youth mental health had become a “devastating” crisis, I had already been a few months into my attempt to put my 15-year-old daughter back in medical care for his ADHD. and depression. Her referral to psychiatry had been in place since she was 12, but it was inexplicably closed due to an apparent paperwork problem. We were told that we had to start the whole process over.

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

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

This is not a new problem. When my youngest daughter was diagnosed with a debilitating and incurable disease at age 5, 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 meant a longer wait.

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

Although this particular policy changed last year and children with Medi-Cal who are involved in the system or who have suffered trauma theoretically have access to benefits, the ability to actually receive care has not changed. not significantly improved.

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

As a former therapist, I know that when children – especially adolescents – tell you they are in pain, there is a critical window of opportunity for treatment that cannot be delayed. And yet, 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 recognize the scale of the current emergency and address the mental health needs of our youth involved in the system, who are among the most vulnerable populations in our state.

Specifically, the state must allocate dedicated non-federal funds to counties in this year’s budget to put into practice the promising new policy of eligibility criteria for specialized mental health services. If we are to help our children, local behavioral health service delivery systems must be immediately and sustainably funded, supported, and informed.