California’s mental health system is too slow for youth on Medi-Cal.

Guest Comment by

Nancy Netherlands

Nancy Netherland is a mother of two teenagers with complex medical conditions. She founded Children and Caregivers and is the Director of Caregiver Engagement for Children’s Trust of California.

Despite California’s unprecedented investment in child and family well-being, the gap between promising policies on paper and what actually works for youth and families has never been wider.

My children, former foster youth living with complex medical needs, are considered a high priority for behavioral health care but still have wait times for services that are months—and sometimes—years long.

I have had the privilege and experience of working in healthcare spanning decades. But despite my understanding of the important health policies, I was unable to access behavioral health care for my children in time.

I can imagine what it must be like for families with little understanding and few resources to manage this system.

At the recent meeting 2021 American Surgeon General’s Report I was a few months into my attempt to return my 15-year-old daughter to medical care for her ADHD and depression, warning that youth mental health had become a “tragic” crisis. Her psychiatric referral dates back to age 12 but was inexplicably closed due to an apparent paperwork error. We were told we had to start the whole process over.

So Instagram posts raise awareness of adolescent mental health and I appreciate the effort to highlight the disparities that black kids (like my daughters) face. High susceptibility to stress and anxietyI also know firsthand that the system is deeply flawed.

This is especially true for families like ours who are insured by Medi-Cal. Access to Medi-Cal behavioral health services is difficult at best. They are a wide sieve through which children and families are often lost through their own fault.

This is not a new problem. When my youngest daughter was diagnosed with a debilitating and terminal illness at age 5, I asked her pediatrician how I could find behavioral health resources to help build her own resilience and support our family. Unfortunately, my daughter needed a mental health screening to get those services through Medi-Cal, which required a longer wait.

There was no preventative care for her or our family.

While that particular policy changed last year and now Medic-Cal children who are involved in the system or have experienced traumatic injuries can access benefits, access to care has not materially improved.

My same daughter, now 14, was diagnosed with post-viral syndrome after covid, and her symptoms worsened, leading to the onset of depression and anxiety. Her pediatrician (who is awesome) told me that there are no more pediatric psychiatric referrals through the practice, but that if she is a danger to herself, I can call 911 or visit urgent care.

As a former therapist, I know that when children – especially adolescents – are told that they are suffering, there is a critical window of opportunity for treatment that cannot be delayed. And still, all the California mental health system could do was tell me to wait.

Our children are not safe. We need something better than hotel lines, first responders and local hospitals as a safety net. State leaders must recognize the depth of the current crisis and support the mental health needs of youth in our system, some of the most vulnerable populations in our state.

In particular, in this year’s budget, the region should allocate separate and non-federal financial support to the regions to move the promising innovation. Special mental health services Eligibility criteria policy in action. If we are to help our children, local behavioral health delivery systems must be urgently and sustainably utilized, supported and informed.