Our plan to transform mental health and substance use care in California
The Challenge
California's mental health crisis is at a breaking point
California faces a crisis. Substance use rates have skyrocketed. Tens of thousands of people struggling with addiction and mental illness are cycling through our city streets, hospital emergency rooms and jail cells. At the same time, our behavioral health workforce is overwhelmed and understaffed, hospitals are overcrowded and our criminal justice system is dealing with a challenge it isn’t built for.
Over the past decade, billions of dollars have been invested through initiatives like the Behavioral Health Services Act and the Children and Youth Behavioral Health Initiative.
Yet access to care hasn’t meaningfully improved. Without clear accountability and research, we still don’t know which programs are delivering results.
Close to two-thirds of adults with a mental illness and two-thirds of adolescents with major depressive episodes did not get treatment.
In 2023, more than half (53%) of inmates in California's county jails had mental health needs.
Nearly half (48%) of people experiencing homelessness in California have complex behavioral health needs.
In 2022, almost 2 million Californians with a behavioral health diagnosis ended up in the emergency room.
California Health Care Foundation, 2022
Public Policy Institute of California, 2023
UCSF BENIOFF HOMELESSNESS AND HOUSING INITIATIVE, 2023
Department of Health Care Access and Information, 2022
Our Plan
Vision 2030: A plan for change
Vision 2030 is a new initiative to intervene in the mental health and substance use humanitarian crisis gripping California and get people the help they need. Vision 2030 will bring new research and data to the table to understand and address these challenges.
Vision 2030 is our plan to come armed with information, ready to rally resources where they are needed, and ultimately have care systems in this state that are rising to the challenge and helping people. We’ll challenge assumptions, ensure transparency and provide recommendations based on solid data to fix what’s broken and rapidly scale what’s working.
This plan focuses on four key areas of focus – four areas that are crucial to building a behavioral health system that works for all Californians.
Vision 2030 Goals
Modernize and strengthen California's behavioral health workforce to meet the diverse needs of the entire state.
California has the highest number of Health Professional Shortage Area (HPSA) areas in the nation, meaning a grave shortage of mental health service providers in many parts of the state. Additionally, our behavioral health workforce is not representative of the diversity of our great state.
Our research will dive deep into the root causes of these issues and recommend strategies to build and sustain a workforce that reflects and supports California’s diverse population.
Reduce the number of unhoused people with mental illness or substance use disorder by half.
An estimated 187,000 people are living unhoused in California, and as many as two-thirds may be living with symptoms of a significant mental health and/or substance use condition.
Our research will center on understanding the mental health care that is most successful with the state’s unhoused and spreading these care delivery solutions statewide.
Reduce the number of people entering hospital emergency departments due to behavioral health crises by half.
In 2022, almost 2 million Californians with a behavioral health diagnosis ended up in the emergency room. Hospitals are not conducive to resolving an acute mental health or substance use crisis.
Our research will explore how to significantly reduce behavioral health hospitalization rates across the state and get people into appropriate care in a community-based setting.
Reduce the number of people with mental illness entering our criminal justice system by half.
More than a third of people who make up the California prison population live with a mental health and/or substance use condition, and many of those individuals become involved in the justice system because of a lack of access to adequate community mental health care.
Our research will examine the mental illness-to-prison pipeline and identify effective diversion strategies.
Our Approach
Turning insights into action
Research
We conduct independent, rigorous public policy research to identify what’s broken and what’s working in California’s behavioral health system.
Policy
Using our research as a foundation, we develop bold, actionable legislation designed to transform systems, support long-term solutions, and improve outcomes.
Implementation
After legislation passes, we work with state and local leaders to help implement new laws effectively to ensure statewide solutions work in communities of every size.
Vision 2030 Timeline
Featured Research
This position paper examines more than 70 years of behavioral health funding in California and its impact on delivering consistent care.
Proposition 36 falsely promised voters a continuation of this treatment-first approach but neglected to commit additional funding or support to an already stressed behavioral health system.
Findings from surveying 300 behavioral health professionals in California give insight for addressing California’s workforce shortage.
Become a Vision 2030 Partner
Become an official Vision 2030 Partner to help make our Vision 2030 goals a reality. By becoming a monthly donor, you will power the research, advocacy, and implementation needed to ensure every Californian can access care when and where it’s needed.
Vision 2030 Partners receive exclusive benefits, including gifts, early access to Steinberg Institute events, quarterly debriefs, policy briefings, and more — plus the knowledge that you’re part of building a future where recovery and dignity are possible for all.
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