A $9 Billion Gap in Funding for Public Behavioral HealthÂ
Amie Miller, PsyD., Executive Director
This month, RAND released a report that details a major funding shortage for behavioral health care in California. The report, Funding the Service Gap for Adult Outpatient Mental Health Services in California, shows counties need more than $9 billion in additional investment to meet the state’s critical need for evidence-based outpatient adult mental health services.
CalMHSA sponsored this research, beginning about 18 months ago, with an eye toward quantifying the true cost of public behavioral health. Since then, much has changed with the passage of Prop. 1, but we see some valuable opportunities to point to these findings in the context of new funding shifts.
The report does an excellent job of explaining the landscape of county behavioral health as a safety-net provider: the individuals served, their psychosocial and material needs beyond standard clinical service needs, counties’ charge to provide comprehensive and individualized care, and the current strain on treatment resources for those with severe mental illness.
The research looks first at existing spending levels and service volume, then at estimated spending levels for a fully funded system. It finds that:
- Under the status quo, the total cost of care to provide adult outpatient mental health care in county specialty mental health to 509,600 adults is around $2.9 billion.
- Providing expanded, evidence-based treatment to those individuals as well as to those not receiving treatment would cost $12.6 billion.
The study determines that expanded coverage of evidence-based care would correspond to a 17 percent increase in individuals served, a 280 percent increase in costs per user, and a 350 percent increase in total costs relative to current service.
We know that about one in 26 Californians lives with serious mental illness. We also know that you are stretched to your limits in trying to provide care.
This report demonstrates with robust research that, without increased funding, fulfilling your mission to provide accessible, effective mental health care for California’s most vulnerable becomes a Herculean effort.
April 21, 2025