I learned from a panel discussion held on Dec. 14 at the Los Gatos Town Hall, that mental health care is riddled with gaps, leaving many individuals struggling to access the services they need.
From a shortage of qualified providers, to inadequate insurance coverage, to insufficient Medi-Cal reimbursements to providers, to burdensome and non-uniform paperwork requirements for obtaining reimbursements for services provided, to a disparity in the approach to treatment of mental health issues compared to the treatment of physical health issues, the barriers to quality mental health care are numerous and complex.
This panel discussion, titled “The Select Committee on Mental Health Crisis,” was ably moderated by Assemblymember Dr. Corey A. Jackson, Assemblymember Gail Pellerin and State Senator Dave Cortese. Those in attendance heard from panelists from Behavioral Health Contractors Association, Maternal Outreach Mood Services, the Santa Cruz Chapter of the California Association of Marriage and Family Therapists, Counseling and Support Services for Youth, Momentum for Health and the Santa Clara County Office of Education. Their compelling testimony made it clear that to effectively address the gaps in the delivery of mental health services, a legislative approach is necessary.
Whenever I think about legislative fixes to a problem, I harken back to the lessons delivered by Jennifer Pahlka in her book titled “Recoding America: Why Government Is Failing in the Digital Age and How We Can Do Better.” This is a must-read book for anyone who is involved in creating, drafting, passing and implementing legislation.
Pahlka founded Code for America, served as U.S. Deputy Chief Technology Officer under President Obama, helped found the United States Digital Service, and also co-founded United States Digital Response, which helps government meet the needs of the public with volunteer tech support. Pahlka discusses how government is often hamstrung by a rigid industrial-era culture in which higher ups dictate policy, disconnected from and often contemptuous of the details of implementation.
The moderators in this mental health presentation are well informed and experienced legislators. They are not elitist or out of touch. However, I did not hear anyone, including the moderators or the very knowledgeable panelists, discuss the need to bring into the process other essential players. We did not hear from any of these other players. They were not in attendance. This left me concerned that by oversight or due to the urgency of the issue, a thorough legislative process may not occur.
Channeling Jennifer Pahlka, I hope that the following process is utilized in creating new policies and/or legislation:
Inclusive stakeholder engagement: This means convening all stakeholders, including service providers, mental health advocates, patients, representatives from insurance companies, IT firms, Medi-Cal representatives, and the personnel responsible on a day-to-day basis for putting the policy/legislative changes into action, to share their expertise and perspectives throughout the new policy/legislative development process.
Ground-up policy development: Prioritizing evidence-based practices and incorporating feedback from stakeholders to craft legislation that is not only comprehensive but also feasible and sustainable.
Technology as an enabler: Leveraging technology to bridge geographical gaps, improve data sharing, and streamline care coordination. This could involve initiatives like teletherapy platforms, electronic health records integration, data-driven resource allocation, and as was discussed at the meeting, a common application form for reimbursement claims made by mental health providers.
Implementation focus: Ensuring that the legislation includes clear implementation plans with dedicated funding and resources to support the transition and address potential challenges.
With a collaborative approach, legislators can tap into a broad spectrum of knowledge and experience, leading to:
More effective legislation: Policies that are grounded, address specific needs, and are more likely to be successful in implementation.
Enhanced trust and buy-in: Stakeholders who feel heard and valued are more likely to support and advocate for the legislation, fostering greater public trust and ownership.
Sustainable solutions: Collaborative efforts can lead to the development of long-term, sustainable solutions that address not just immediate needs but also future challenges.
I have zero experience as a legislator but lots of experience in developing policies in a variety of volunteer positions. These volunteer experiences, in addition to my many years of experience as a mediator and volunteer settlement judge, when added to the lessons I gleaned from Jennifer Pahlka’s book, lead me to conclude that the gaps in the delivery of mental health services must be filled via a comprehensive and collaborative approach in which all players are involved.
Jeffrey P. Blum is a family law mediator who lives in Los Gatos. He can be reached at bl*****@ao*.com .
