Mental Health
Engage Magazine Winter 2022

Critical workforce shortages and COVID-19 pushes California’s mental health system closer to breaking point

By Jason Shoultz, Director of Communications, Steinberg Institute 

The signs of a mental health crisis worsened by the pandemic can be found throughout California: in our families, on our streets, and in our schools. According to the Kaiser Family Foundation, at the height of the pandemic in 2020 more than three in ten adults in the U.S. reported symptoms of anxiety and/or depressive disorder vs. one in ten pre-pandemic in 2019.

Jason Shoultz, Steinberg InstituteOur youth are struggling. In December, the U.S. Surgeon General issued an advisory calling attention to growing youth mental health concerns. Youth mental health care in California was already woefully inadequate prior to the pandemic. In 2018, the state ranked 48th nationally for mental health services for children.

In our communities, tent encampments continue to grow under freeway overpasses, unsheltered individuals are dying during severe weather, and public safety agencies are overwhelmed with calls for service. Our homelessness crisis is directly linked to our failure to adequately provide mental health care. An estimated one-third of our neighbors experiencing homelessness live with an untreated serious mental illness. 

At the heart of this challenge lies a critical shortage of behavioral health workers. There simply are not enough psychiatrists, counselors, and social workers. Factors like low pay and job stress force talented individuals out. A 3,000-hour requirement to work without pay before becoming a licensed social worker keeps people away from the field.

The result: most people needing mental health care are not receiving it. It’s estimated that nearly one in six Californians lives with a mental illness, but only one-third receive treatment. 

But there is reason to be hopeful. The pandemic has made the seriousness of this crisis unavoidable for lawmakers, leaders, and all Californians. Last year Governor Newsom’s budget included a historic $4.4 billion investment to address youth behavioral health. This has the potential to positively impact an entire generation – providing mental health resources at an early age and decreasing discrimination that has led to a broken mental health care system.

The Steinberg Institute believes ending the workforce shortage is critical to addressing the mental health crisis we face. This year we are focusing on innovative legislative solutions to meet this moment. In late 2021, we created a Behavioral Health Workforce Strategy Group, to bring together legislators interested in tackling the shortage.  

The strategy group heard from experts in the field – sharing real-world examples of the causes and impact of the shortage. The group also dove into potential solutions that would encourage careers in behavioral health and address disparities that cause workers to leave the field.

While the consequences of the behavioral health workforce shortage are felt statewide, they are not felt equally across regions. Californians in rural areas face a serious challenge accessing mental health care. The Inland Empire and San Joaquin Valley are two of the most underserved regions in the state. 

We support a robust stipend program to provide financial support to social work students in exchange for working two years in our public behavioral health system. We know these programs work. The California Social Work Education Center’s stipend program funded by the Mental Health Services Act offered students $18,500 for their second year of instruction in exchange for one year of service. Up to 13 years post-graduation, 55.6 percent of these stipend graduates were still employed in California’s public behavioral health system. 

Other ideas include increasing the number of non-licensed peer providers, utilizing team-based care models that bring together behavioral health professionals and primary care doctors and nurses. Finally, we need to ensure that our behavioral health workforce is supported through fair wages, opportunities for growth and a supportive work environment.

There is much uncertainty ahead, but we’re hopeful that California’s leaders will seize upon the opportunity we have right now. Our mental health care system faces a crisis that will worsen without bold action. It’s time that our courage to act matches our compassion for our fellow Californians.  

The Steinberg Institute was created to upend the status quo and dramatically raise the profile and increase the effectiveness of mental health policymaking in California. Founded by Sacramento Mayor and former state Senate President Pro Tem Darrell Steinberg, the institute is an independent nonprofit organization dedicated to advancing sound public policy and inspiring leadership on issues of brain health. Learn more at