San Diego County will more than double youth crisis mental health care capacity under a sweeping expansion led by Supervisor Terra Lawson-Remer — the largest investment in youth behavioral health services in County history and a major shift toward prevention-focused care.

Over the next five years, the County is setting ambitious targets to expand youth behavioral health services by more than 10,000 additional care opportunities, including increasing youth crisis care capacity from roughly 3,000 to nearly 8,000 young people served annually. Officials say the expansion will help thousands more families access timely support before situations escalate into hospitalization, homelessness, or justice involvement.

The commitments build on a youth system reform policy authored by Lawson-Remer in 2024, directing the County to apply its data-driven Optimal Care Pathways framework — previously focused primarily on adult services — to children and transition-age youth. That action established the County’s first youth-specific systemwide service targets and laid the groundwork for the historic expansion underway.

“For years, we have been expanding behavioral health services across San Diego County, but I pushed for us to set clear youth-specific goals so prevention could truly become the backbone of our approach,” Lawson-Remer said. “These commitments mean more families will get help earlier — before a crisis changes the course of a young person’s life.”

Expansion Driven by Rising Youth Mental Health Needs

County leaders say the expansion responds to worsening behavioral health indicators among local youth.

Emergency department visits related to suicide attempts and self-harm among youth ages 10–17 have increased 24 percent since 2019, underscoring the urgent need for stronger early intervention and crisis response systems.

Student survey data further highlight the scale of the challenge:

• 28 percent report chronic sadness
• 36 percent report loneliness
• 24 percent have considered suicide
• 10 percent report recent emotional distress
  
  

Lawson-Remer said she regularly hears from parents struggling to find timely mental health care for their children — a reality that helped drive her push to prioritize youth prevention services.

“When young people don’t get help early, they too often end up in emergency rooms, shelters, or the justice system,” she said. “This plan is about redesigning how care is delivered so prevention becomes the default, not the exception.”

Historic Growth Across the Youth Behavioral Health Continuum

The County’s strategy sets ambitious targets to significantly expand services at every level of youth behavioral health need.

• Early mental health services: capacity projected to grow from approximately 16,400 to more than 21,000 youth served annually
• Early substance use treatment: projected to increase from about 650 to nearly 950 youth served
• Youth crisis services: projected to expand from roughly 3,000 to nearly 8,000 youth served annually
• Intensive mental health treatment: projected to grow from about 650 to more than 1,100 youth served
• Intensive substance use treatment: projected to increase from about 70 to more than 150 youth served
• Residential mental health treatment: projected to grow from approximately 185 to more than 230 youth served
• Residential substance use treatment: projected to expand from about 80 to more than 115 youth served

Taken together, these targets represent the County’s ability to serve thousands more young people each year across the behavioral health continuum.

Officials say expanding community-based care will help stabilize families earlier, reduce costly emergency interventions, and improve long-term outcomes.

Building on Major Behavioral Health Progress

The youth expansion represents the next phase of significant system growth already underway.

Since 2021, the County of San Diego has undertaken one of the most significant expansions of behavioral health services in its history. In just five years, the County has:

• Increased the number of County Behavioral Health Services staff by approximately 32 percent 

• Increased investments into behavioral health by over $475 million per year, an increase of over 60 percent 

• Opened new crisis stabilization centers, bringing the total to six, with two more slated to open later this year, improving  access to crisis care while diverting people from emergency rooms and jail 

• Launched and expanded Mobile Crisis Response Teams to a total of 44, to ensure clinicians and peers can respond to people experiencing non-violent behavioral health emergencies. 
  • Since the launch in 2021, Mobile Crisis Response Teams have responded to over 30,000 calls countywide with 98% of calls responded to in under an hour and 57% of calls stabilized in the field
  • Since expanding to schools in September 2024, there have been 580 trauma-informed crisis responses to school campuses countywide. 

• Invested $75 million to support  workforce recruitment and retention strategies designed to address long-standing shortages in psychiatric and addiction treatment professionals, 

• Been awarded more than $250 million in grant funding to develop critical behavioral health infrastructure and services 

County leaders say focusing these investments more intentionally on youth will help address long-term challenges such as homelessness, school disengagement, and justice involvement.

“This didn’t happen overnight,” Lawson-Remer said. “It reflects sustained work to bring the Board together around a shared commitment to grow our behavioral health system at the scale families need.”

Next Steps

Implementation efforts will include:

• Expanding school-based early intervention programs
• Strengthening coordination across behavioral health, child welfare, probation, and healthcare systems
• Increasing partnerships with Medi-Cal plans and hospitals
• Developing holistic care environments that support youth wellbeing