How To Get Affordable State Sponsored Therapy in California

In general, community mental health programs are not the right place for people who have mild mental health issues and are covered by a private insurance plan. If you need couples counseling to work through a communication problem with your partner or want to gain insight into why you have a certain fear, you probably won’t qualify for public services or find what you need in the public mental health system.

If you are in crisis, have recently been hospitalized for mental health reasons, or are unemployed or homeless due to a mental health condition, you should definitely check first with your local county program, as their services are designed to meet your specific needs. However, you don’t have to have these particular issues to benefit from public mental health programs in California. For example, many county programs provide integrated treatment for dually-diagnosed mental health and substance use disorders. Integrated programs lead to better outcomes and can be hard to find in the private sector.

County mental health programs serve a wide range of people and are great places to start your search for free or low-cost services, especially if you lack insurance and otherwise lack the means to access services in the private sector. However, if you have the ability to pay out-of-pocket for care or have a good insurance plan that includes mental health benefits, your needs may be better met by searching for a therapist on OpenCounseling or on your insurance company’s website. Online therapy with BetterHelp (a  sponsor of OpenCounseling) can be another great option, especially if the nearest therapist to you is a long drive away.

About 1 in 6 people in California experience mental health issues at some point in their lives, and 1 in 24 have a serious mental health condition that impacts their ability to function. Over 60 percent of people who have a mental illness in California don’t get treatment for it, many of whom qualify for public mental health services but don’t know about them. If you’re not sure whether you qualify, call your county’s access line. You may find out that you can get mental health services through your county’s program or that there’s another affordable option nearby. The most important thing is to reach out and get the information you need to start your journey to recovery.

In California, the services people can receive at a community mental health program vary from county to county. All county programs provide emergency and crisis intervention services. These typically include suicide prevention hotlines, walk-in centers, and mobile assessment teams who evaluate people who have been placed on an involuntary psychiatric hold (commonly known as a “5150 hold”) to determine if they require involuntary inpatient treatment.

Many of the additional services that county mental health programs provide follow from the outcome of these crisis interventions. Most county programs provide case management services for people who have been hospitalized or who have a severe mental illness that impacts their ability to function and puts them at risk of hospitalization. Case managers help link their clients with all of the different services they need and monitor their progress in treatment and recovery.

Full-service partnerships pair case management with other services including field- and home-based services, psychiatric services, counseling, and a wide range of linked social services. All full-service partnerships provide therapy to clients who need it. Many county mental health programs that aren’t full-service partnerships have counseling departments, but some do not. Whether they do depends on the budget for the program and the size of the county they serve.

One of the most important requirements people need to meet to receive services at a community mental health program is to be a resident of the county it serves. County residents who qualify for Medi-Cal are usually eligible for publicly-funded mental health services. Some individual plans offered through Covered California, the California health insurance marketplace, are accepted by county mental health providers. Most county programs also provide services to people who have no insurance. Income requirements vary, but community mental health programs in California usually restrict services to people whose income is 200% of the federal poverty level or less.

Some county mental health programs provide services to people regardless of income. The most important factor in determining eligibility for is the severity of a person’s mental health condition. All county mental health programs in California provide crisis intervention services for people experiencing mental health emergencies. Regardless of their income or insurance status, people are encouraged to call the county mental health crisis line for help when they or their loved ones are in a crisis that puts them or others at risk of harm.

The public mental health system also serves people whose mental health conditions are severe enough that it impacts their ability to function. This ranges from people with schizophrenia who have hallucinations that can’t be fully controlled by medications to people with major depressive disorder whose symptoms are so severe they are unable to care for themselves safely at home. Community mental health programs also provide services to people in certain vulnerable groups:

• People who are or who have recently been homeless
• People with co-occurring mental health and substance use disorders
• People who have recently been discharged from an inpatient psychiatric facility
• People involved in the criminal justice system, including people on probation and parole

This does not mean the only people who can go to a county mental health program to inquire about counseling or therapy are people in one of these groups. The mission of the public mental health system is to help all people in the community access mental health services.

Most county programs in California have an “access line” people can call to inquire about getting mental health services. The intake and assessment counselors who answer can often tell people over the phone whether they qualify and give them alternative referrals when they don’t. Depending on the particular county provider, the person who answers the access line may ask the caller to come in to a local office for an in-person eligibility assessment. Intake staff often have a list of local non-profits where people who don’t qualify for public mental health programs can receive free or low-cost counseling or other mental health services.

In the 1960s, Americans started thinking differently about how to treat mental health conditions. State and federal laws required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. Many states’ current public mental health programs can trace their origins back to this period.

California is no exception. The 1957 Short-Doyle Act and 1968 Lanterman-Petris-Short Act laid the foundations for the state’s community mental health system. These laws established a system of publicly-funded community programs that provide essential mental health services to people with serious mental health conditions so they can live in the least restrictive settings possible in the community.

A more recent law, the 2004 Mental Health Services Act, made many important updates that now define how public mental health services are delivered in the state of California. Full-service partnerships are the focus of the state’s updated community health system. These programs use an integrated treatment model that provides a suite of services through a central organization to improve mental health outcomes for state residents. Services often include crisis intervention, medication management, group and individual therapy, and housing and employment services.

One of the most important things consumers need to know to understand the California public mental health system is that it is not uniform. While California funds mental health programs throughout the state, each county in California administers its own program separately. What this means for mental health consumers is that eligibility requirements and the types of services offered vary from county to county. Whether a person qualifies for counseling through a public mental health program depends on where they live. However, a few general guidelines apply widely throughout the state.