Nationally nearly half of LGBTQIA+ youth have considered taking their own lives and LGBTQIA+ youth are 120% more likely to face homelessness. Lesbian, gay, and bisexual people face incarceration at a rate three times that of straight people. In our 2019 #Out4MentalHealth survey of LGBTQ+ Californians, 78% of 12 years old to 24 years old reported that they had considered suicide in their lifetime. All of this is tied to systems which seek to control people’s bodies and impose strict gender norms on people. Existing within these systems takes a huge toll on the mental health of our community members.
Unfortunately, we struggle to quantify the impact because sexual orientation and gender identity (SOGI) data has been collected infrequently, inconsistently, or not at all by health plans. When it comes to Medi-Cal mild to moderate mental health utilization, LGBTQIA+ data is nonexistent. We need to know where the gaps are in order to fill them. When we are not seen, we are not served.
What can be done? SB 1019 by Senator Lena Gonzalez would strengthen access to Medi-Cal mental health for communities of color, LGBTQIA+ communities, limited English proficient communities, and immigrants and refugees.
At the Network, we have heard from community members across the state who have felt as though they had no other choice but to seek care outside of their health insurance plan because navigating the system to find and access a culturally affirming provider felt impossible. Many others have forgone care altogether because they couldn’t afford to pay out of pocket. When systems are not set up for us, our communities face significant barriers. The California Pan-Ethnic Health Network’s partners identified specific challenges, such as lack of awareness, confusion over services offered and covered, and difficulty navigating managed care plan websites as key reasons of low access.
SB 1019 will ensure managed care plans, those who oversee around 12 million Medi-Cal members and provide services, inform members of their right to timely mental health services, how to find a provider, and how to navigate mental health services in culturally and linguistically appropriate ways.
This bill would also require the Department of Health Care Services (DHCS) to work with community members and stakeholders to understand why disparities exist and to enforce best practices to reduce disparities. DHCS will also be required to report and publish data on their website that contains information on why racial, ethnic, linguistic, and sexual orientation disparities exist and recommendations for improvement.
Our communities deserve better and California is leading the way. But, access and knowledge of rights is just the first step. We must continue to work to ensure patients are seen, heard, and validated in their experiences with mental health and are met with trauma informed services. Mental health is a right and we have a chance to address the growing needs in our communities.