Provide free universal mental healthcare to all Californians, with comprehensive and cost-effective solutions that include humane and equitable innovations in artificial intelligent counseling.

BACKGROUND

Mental health is a critical aspect of overall well-being, and polling shows that over 75 percent of Californians support the provision of free, universal mental healthcare. Despite overwhelming support across party lines, access to mental health services remains a significant challenge for many individuals. The limited availability of mental health professionals, high costs, and stigma associated with seeking help often deter individuals from receiving the care they need in a timely manner. This proposal would increase access to mental health services and address staffing shortages by increasing funding through federal and state sources and by thoughtful and careful adoption of technological solutions.

KEY FEATURES 

  • Addressing the unmet needs for mental healthcare in the state is a “multi-solver” solution that provides benefits in areas ranging from homelessness to learning loss, escalation in law enforcement, and mass shootings.
  • Artificial Intelligence counselors would be part of a comprehensive system that provides free mental healthcare services to all residents of California,  encompassing traditional and other healing practices involving prevention, assessment, counseling, therapy, medication, crisis support, and rehabilitation.
  • Strengthen provider capacity and flexibility to bill Medi-Cal for mental health services—including in novel settings and with non-traditional providers—and target training funds toward building the workforce and skills needed to achieve the state’s growing MH policy objectives.
  • Address important concerns about cost containment and staff/pipeline shortages. The careful and humane deployment of AI counseling can augment the existing mental health workforce, increasing accessibility, addressing staffing shortages, and containing costs associated with universal mental health care.

IMPLEMENTATION AND SEQUENCING CONSIDERATIONS

  • Mental health services would be optional, not mandatory, nor would they be provided in a coercive manner.
  • Would build on current efforts to strengthen the Mental Health Service Act of 2004, with a proposed bond measure in 2024 that would allow spending on substance abuse programs and redirect up to $1 billion in annual funding to provide community housing for those at risk of homelessness.
  • Would ensure that any solution is fundamentally grounded in human dignity, that services recognize and support traditional healing practices, and that racial disparities in AI service provision are monitored, regulated, and corrected.
  • Related, a California Commission on Artificial Intelligence can be used to research and monitor opportunities, threats, benefits, and drawbacks from AI counseling to provide the necessary guardrails and supports to ensure access, equity, and human dignity in the provision of care.
  • We need to take special care when approaching mental health among those who are incarcerated, formerly incarcerated, or otherwise involved in the justice system; those with disabilities; and members of historically excluded populations.
  • California could learn from Japan, South Korea, and other large-scale examples of mental healthcare provision to elders.