Standing with behavioral health providers and parents at a Rady Children’s Hospital location that provides mental health services, Supervisor Terra Lawson-Remer announced a policy to leverage an existing county tool (Optimal Care Pathways) that’s used for adult behavioral health services, to maximize services, infrastructure investments, and staffing for children, youth and transition-aged youth (0-25).

The Optimal Care Pathways model is a data-informed tool the County of San Diego’s Behavioral Health Department created to quantify the best utilization of services across many categories of mental health and substance misuse treatment. Currently, the primary group being helped by the Optimal Care Pathways model is adults. 

There is a growing and intense need for behavioral health services for kids. California ranked 51 out of the 50 states and the District of Columbia for parents reporting difficulty in accessing mental health care, and 50% of adults with behavioral health disorders developed symptoms around the age of 14. 

“Using OPC is a smart approach to delivering behavioral health treatment. It will help use our resources better, and ensure the services needed are more accessible, especially for low-income children and youth, and those served by Medi-Cal,” said Supervisor Lawson-Remer, Vice Chair of the San Diego County Board of Supervisors. “The statistics show earlier interventions are needed to ensure kids with behavioral health struggles don’t become adults with the same challenges. It’s a situation that requires us to do more and do it differently than we are doing it now, and my policy gives us a path forward.”   

Supervisor Lawson-Remer’s policy, if passed by the San Diego County Board of Supervisors, on Tuesday, September 24, 2024 and implemented will:  

• Initiate a critical dialogue within our community about the behavioral health challenges and unmet needs;

• leveraging data, quantify optimal service levels;  

• identify service needs and gaps for youth care and treatment; 

• Establish a long-term, comprehensive plan to ensure the strategic investment of resources to help young people; 

• ensure our County has the workforce, infrastructure, and service capacity to support the mental and emotional well-being of kids;

• Find methods to optimize payments for all payers that hold Medi-Cal products to support the implementation of these actions. 

Healthcare experts, providers, and advocates who serve kids support this policy. They are the people in the trenches every day helping kids with their behavioral health.  

“As a pediatrician and child psychiatrist, I know first-hand how identifying a mental health issue early and providing timely support and treatment can positively change the trajectory for a young person,” said Anne Bird, M.D., Medical Program Director of Behavioral Health Integration at Rady Children’s Hospital-San Diego. “Yet families frequently face substantial barriers to receiving the care they need, including long wait times and a shortage of qualified mental health specialists. Finding ways to advance San Diego County’s behavioral health system, particularly around early identification and early intervention, for our children and youth represents an important and critically needed step forward.”  

“As the County's oldest provider of children's behavioral health services, we at SDCC are deeply concerned that resources and workforce are not keeping up with the significant and growing behavioral health needs in our community for children and families,” said Cheryl Rode, Vice President Clinical Operations, San Diego Center for Children. “We appreciate and support the efforts of Supervisor Lawson-Remer to ask the Board to explore how our public and private institutions can better work together to address this challenge.” 

If Supervisor Lawson-Remer’s policy passes, families will have greater access to providers of all sizes – it's about providing options that work for the kids. 

“Early identification and intervention in mental health issues can prevent more serious problems from developing. There is an urgent need and opportunity to build more capacity to detect and treat signs of mental health distress upstream before they escalate,” said Marlon Morgan, Founder and CEO, Wellness Together. “Supervisor Lawson-Remer’s Children and Youth Behavioral Health Continuum Framework proposal will support all stakeholders working together to more efficiently meet the overwhelming need for effective and accessible youth mental health services.”

Parents also see value in the policy. The lack of easily accessible mental health and addiction treatment resources for kids is constantly being battered by parents.  

Kristina Halmai-Gillan, LMFT Director of Service Innovation for YMCA San Diego, and a District 3 parent spoke about her experience as a community-based clinician advocating for prevention, early intervention, and innovative treatment strategies to support children’s mental-emotional well-being. Children’s mental health deserves a robust continuum of care and a cross-disciplinary response. The Children and Youth Behavioral Health Continuum Framework is the best way forward and the time to act is now, children’s lives depend on it.