Key Messages: Learn What’s Driving Challenges in Behavioral Health Care

Californians with behavioral health care needs struggle to find treatment.  

• Almost one-quarter of adults with a mental illness are unable to receive the treatment they need  
  — with no improvement over the past decade. 
• California has a massive shortage of mental health and substance use disorder treatment professionals, and access to behavioral health care varies drastically depending on the county. 
• A report published by the RAND Corp. found that California has a shortfall of more than 7,700 beds for people with behavioral health needs. Residents in 24 of California’s 58 counties have no in-county access to acute psychiatric hospital services. 
• More than half of children and adolescents are not able to get the mental health services they need.   

Hospitals are on the front lines of the behavioral health crisis in California.  

• Nearly one-third of all inpatient hospitalizations and nearly one-eighth of all emergency department visits involve patients with mental health and substance use disorders. 
• On any given day in California, 550 patients remain in inpatient psychiatric care, even when they’re ready for discharge. The average number of unnecessary days spent in the hospital is 27. 
• Nearly all hospitals (92%) that provide psychiatric inpatient care report they are unable to admit new patients because discharging current patients to step-down care is so difficult. This congestion means patients are in more restrictive settings than they need, which leads to emergency department overcrowding. 

To address California’s behavioral health crisis, strategies must mirror those in primary care — where the goal is to prevent illness and provide the right care in the right setting. 

• The state is investing billions to create comprehensive services for people with all levels of behavioral health needs. California must focus on prevention, early intervention, and community-based services to help those in need avoid hospitalization, incarceration, conservatorships, and institutionalization. 
• In March 2024, California voters passed Proposition 1, a CHA-supported measure that will improve statewide access to behavioral health services, increase behavioral health treatment facility infrastructure, expand the behavioral health workforce, and increase investment in early intervention services with a focus on children and youth. As the California Health and Human Services Agency’s Crisis Care Continuum Plan recommends, California should also: 
• Build toward consistent statewide access to behavioral health care for every Californian. 
• Enhance care coordination by removing unnecessary, bureaucratic barriers that make care fragmented and complex for people to navigate. 
• Develop a comprehensive strategy for data measurement and quality of care that will ensure a high-quality and equitable system for all Californians.