Sacramento Bee publishes op-ed on California's rural mental health crisis

The author is Inyo County supervisor Matt Kingsley, who is also Delegate to the Rural County Representatives of California.  He writes under the headline, "A California crisis: Too many rural communities have no access to mental health treatment."  

In rural California, where behavioral health provider availability already ranges from limited to nonexistent across large expanses of geography, the care crisis is particularly challenging. To ensure everyone in California has access to care, we need to invest in the behavioral health workforce, infrastructure and systems of the state’s rural communities.

Across rural areas, health care and behavioral health care facilities are often limited in number. This is due in part to financing restrictions that have diminished the ability of rural local governments to invest in providing the full continuum of treatment services.

Additionally, some rural areas have no community-based organizations to assist in providing behavioral health services. My county, Inyo, has a federally qualified health care center and an Indian Health Service provider in the town of Bishop. The rest of the county’s 10,000 square miles are underserved or completely unserved by a qualified health center or community-based organization. High job vacancy rates among rural mental health care providers add to this access disparity. As of fiscal 2021, 33 rural California counties were designated as having mental health professional shortage areas. With little behavioral health infrastructure and housing availability, the capacity to build the workforce in rural areas is limited.

This is exacerbated by high burnout and turnover rates among the small number of county behavioral health employees who are tasked with providing 24-hour crisis response on top of direct services to severely mentally ill people. In rural counties, these cases are complicated by significantly constrained placement options, sometimes requiring county staff to transport people in crisis across several hundred miles for stabilization.

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Addressing the mental health crisis in rural communities requires strategies such as loan forgiveness programs to build the necessary behavioral health infrastructure and workforce. Targeting such investments to underserved communities can help ensure that we serve the health care needs of vulnerable people in rural communities where the need is dire.

I note that Republican Kevin Kiley has just been declared the winner in California's 3d congressional district, which includes Inyo County and the rest of the eastern Sierra, along with many other rural counties.  In fact, Kiley's district stretches some 450 miles from north to south.  It'll be interesting to see if he supports the sort of government interventions that supervisor Kingsley is pleading for in his op-ed.