Enhancing access to behavioral health services for groups that have been historically marginalized in California: executives’ views and recommendations
Year: 2025
Type: article
Abstract: Background: The opioid crisis and coronavirus disease 2019 (COVID-19) pandemic have underscored significant gaps in California’s behavioral health system, particularly in substance use disorder (SUD) treatment for underserved populations. Despite California’s extensive behavioral health infrastructure, barriers such as limited insurance, transportation, and systemic discrimination persist. The Health Equity in Access to Behavioral Health Recovery Services (HEAR US) project, funded by the California Department of Health Care Services, aimed to enhance equity and access to behavioral health recovery services by leveraging community insights and evidence-based practices. Methods: A descriptive qualitative approach was employed, involving six online focus groups with 23 executive leaders of SUD programs in California. Participants were recruited via purposive and snowball sampling, ensuring demographic and experiential diversity. Data were collected and analyzed using thematic analysis, guided by the principles of the Substance Abuse and Mental Health Services Administration (SAMHSA) Recovery Roadmap, focusing on culturally responsive care, low-barrier access, and harm reduction. Results: Participants identified three primary areas to improve access to care: (I) culturally responsive policies, (II) adequate funding and sensible reporting, and (III) purposeful multi-sectoral coordination. Diverse and non-diverse groups provided complementary perspectives, emphasizing both systemic reforms and practical solutions such as payment reform and improved coordination among state and local agencies. Specific recommendations included expanding treatment-on-demand programs, integrating peer support across the continuum, and addressing workforce challenges through livable wages and professional development. Conclusions: The HEAR US project offers actionable pathways to bridge gaps in California’s behavioral health system. Key strategies include aligning payment structures, fostering integrated care, and supporting a culturally competent workforce. These efforts, grounded in community-driven insights, can transform California’s behavioral health landscape, ensuring equitable and sustainable access for groups that have been historically marginalized.
Institutions: University of Louisville, Texas A&M University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4411333325