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BHSA Population-Based Prevention Program Framework

Behavioral Health services act

BHSA Population-Based Prevention Program Framework

As the lead state entity for the population-based prevention program, CDPH has identified core strategies for the BHSA Statewide Population-Based Prevention Program that will ensure alignment of population-based prevention activities and contribute to achieving the 14 BHT population health goals.

Statewide Prevention Planning

In planning for the development of the Population-Based Prevention Program to meet the intended outcomes and goals of the BHSA, CDPH conducted a planning process to bring together information about the existing landscape of behavioral health initiatives and opportunities, such as activities implemented through MHSA Prevention and Early Intervention, CHHS California Plan for a Comprehensive 988-Crisis System (PDF), and the Children and Youth Behavioral Health Initiative (CYBHI), that could be built on or leveraged for further impact. The existing landscape included CDPH’s own programs and expertise that could be leveraged to meet the goals and outcomes of BHSA, including the Office of Health Equity’s California Reducing Disparities Project, the Office of Suicide Prevention, the Office of School Health, the Substance and Addiction Prevention Branch’s Overdose Prevention Initiative.

This process also included review of reports and research⁶ and data analysis to understand the trends in suicide, self-harm and overdose.

A comprehensive review of data, for example, indicates that while the highest rates of youth suicide are in Native American and Alaska Native and Native Hawaiian and Pacific Islander youth, the largest increases in suicide are among Black youth, followed by Latino youth (CCB, 2025). Additionally, suicide rates vary by region, with rural communities in Northern regions generally experiencing higher mortality rates (CCB, 2025).

Data also demonstrates that while the rate of increase has slowed, drug overdose death rates continued to increase in 2023, reaching an all-time high (CCB, 2025). Drug overdose is the leading cause of premature death, fifth leading cause of death overall for Californians, and the leading cause of death for ages 25 to 54 (CCB, 2025) and youth aged 10–18 had the highest rates of self-harm emergency department visits and experienced the largest increase (23.2%) from 2020–21.

CDPH’s approach considers needs and gaps, data, statutory requirements, and input from community partners, to identify population areas for initial strategic investment. They include:

Black, Indigenous, and other people of color
Children, youth, and families
Immigrant and refugee populations
Justice-involved populations
LGBTQ+ populations
Older adults
People experiencing economic and/or housing insecurity
People with disabilities
Rural populations
Socially isolated populations
Tribal communities
Veterans

Additionally, CDPH reviewed state and local programs plans (including existing MHSA Prevention work), academic research, community defined evidence practices, as well as reports that center youth and community voice. Part of the planning process also involved conducting interviews with subject matter experts and facilitation of engagement events to garner input from community partners. Panelists during the community engagement events also included experts serving populations with documented and emerging behavioral health needs such as veterans and older adults to ensure that those perspectives and voices were elevated as part of the planning process.

Subject matter experts and community engagement surveys also identified two potential focal areas as effective strategies to address behavioral health challenges that should be considered when developing statewide prevention strategies:

Increasing social connection and belonging
Increasing mental health and well-being awareness and development⁷

The review of existing prevention-focused behavioral health initiatives also highlighted that:

Approaches designed and implemented in collaboration with communities (rather than done “to” or “for”) and that are tailored to community and cultural context increase effectiveness.
Integrating mental health with community services addresses multiple areas of well-being.
Strategies that center compassionate and dependable relationships—within communities, among staff, and across systems—foster healing and well-being.
Peer-led interventions enhance outcomes, particularly in older and youth populations and other underserved and inappropriately served groups.

Finally, an assessment of current and emerging policy issues has also highlighted opportunities where prevention programs might be complementary and mutually reinforcing with statewide policy initiatives, including, for example, implementation of AB 1282, which requires CDPH to develop a strategy to understand, communicate, and mitigate mental health risks associated with the use of social media by children and youth.

Statewide Prevention Strategies

Based on the statewide prevention planning efforts and the input received as part of engagement with subject matter experts, community members with lived experience, and extensive feedback and learnings from those in the behavioral health field working on these issues, CDPH developed the following statewide prevention strategies for implementation. These strategies will create alignment across the state to ensure that the population-based prevention program is focused on advancing statewide BHSA goals and meets the intended outcomes to prevent suicide and overdose. These will be developed with a focus on:

Leveraging existing capacity, assets and expertise within CDPH and other system partners to build synergy across programs and the state and maximize scalability. For example, development of prevention strategies will start with utilizing the existing expertise of the CDPH Office of Suicide Prevention, California’s Strategic Plan for Suicide Prevention Striving for Zero (PDF), CDPH Office of School Health, and the Overdose Prevention Initiative. It will also leverage the groundbreaking California Reducing Disparities Project (CRDP) and the DHCS Behavioral Health Prevention Plan (PDF) and others as foundations for this work.
An understanding of key system partner roles and assets to ensure coordination and complementary functions for successful implementation. For example, coordinating with the DHCS Centers of Excellence and the Advance Behavioral Health Prevention California (which provides no-cost technical assistance and training for behavioral health prevention in California) as CDPH considers their implementation of technical assistance and training for behavioral health prevention activities. Leveraging existing statewide efforts, plans, and other system partners in prevention (including those within DHCS, the California Department of Aging, the California Department of Social Services, and the California Department of Education and others) to fill gaps and avoid duplication of efforts.

Statewide Prevention Strategies:

Statewide Policy Initiatives: Recommendations of policy, systems, and environmental actions to advance statewide goals, including reducing suicide, self-harm, and overdose for state and local policymakers to protect Californians.

Examples include:

Developing statewide policy platforms (as part of implementation of AB 1282) to reduce the mental health risks associated with the use of social media by children and youth

Focused Statewide Behavioral Health Prevention Strategic Plan: A focused set of strategies that advance the Statewide BHSA population behavioral goals to ensure implementation alignment across the state. These strategies will be informed by the Statewide Policy Initiatives to drive aligned and complementary efforts across the state.

Examples include:
- Strategies (in coordination with the statewide ACEs Aware Policy Initiative) to prevent adverse childhood experiences (ACEs) and promote positive childhood experiences (PCEs) by creating protective environments and strengthening supports for families
Statewide Awareness Campaign: An integrated set of mutually reinforcing public awareness and education campaigns to educate all Californians about mental health illnesses and substance use disorders, including addressing suicide and overdose prevention, stigma reduction around seeking help and opportunities for treatment, promotion of connectedness to raise behavioral health awareness, and support social norms change. These statewide campaign assets can be tailored to local needs and will be informed by Statewide Policy Initiatives to drive aligned and complementary efforts across the state.

Examples include:

Working with trusted partners to deliver locally tailored messages, especially for communities at risk for suicide and/or mental health or substance-induced crises.
Uplifting state and local resources, such as warmlines, peer supports, digital self-help resources, and crisis lines and services.

Prevention Training and Technical Assistance: Programmatic technical assistance and subject matter expertise that will equip health professionals, educators, and community leaders with the tools to promote behavioral health awareness, reduce stigma, and prevent suicide, self-harm, and overdose, especially among priority populations.

Examples include:
- Best practice clearinghouse for public health approaches to behavioral health promotion, including strategies to address shared risk and protective factors and reduce stigma
- Training in behavioral health awareness, including mindfulness, coping, and resiliency strategies, self-regulation, development of protective factors, calming strategies, and communication skills for schools, families, communities, etc., with a focus on suicide and overdose prevention
- Technical assistance for creating and sustaining behavioral health peer to peer
- Promotion of community-defined evidence practices and other community-driven, culturally responsive healing practices
- Support programs, including establishing inclusive safe digital and physical spaces.
- Training designed to help individuals working with children and youth recognize and respond to signs of trauma and stress.
- Universal and selective school-based prevention and wellness education, including SEL and behavioral health literacy learning collaboratives and other training for educators
- Integrated training and systems of support for teachers and school administrators designed to mitigate suspension and expulsion practices and assist with classroom management.
- Training on group coaching and consultation, designed to prevent substance misuse.
Community Engagement and Coalition Building: Developing relationships with and amongst community to create stigma-free environments and provide ongoing support through proactive outreach and relationship building.

Examples include:

Develop formal advisory committee to support collective statewide planning and continuous improvement
Work with local organizations that focus on suicide and overdose prevention/harm reduction and mental health awareness to engage people where they are and in the communities in which they live.
Work with communities impacted by systemic racism and discrimination to develop a deeper understanding of the challenges and experiences to inform a system-wide approach and strategies.
Community visits to foster relationships, coordinate prevention strategies, and disseminate resources.
Community events and listening sessions to elevate prevention best practices, uplift stories from people with lived experience, and identify opportunities for improving community conditions, including healing circles, restorative justice, and other inclusive practices.
Partner with local groups to promote opportunities for volunteerism, civic engagement, intergenerational mentorship, and youth leadership.

Data and Evaluation: Establish an aligned system of metrics, in conjunction with other behavioral system partners, to develop an evaluation framework that will determine data collection requirements, monitoring and reporting to increase transparency on outcomes, the effectiveness of strategies and policies, and how funds are being used across the state to prevent suicide, self-harm and overdose.
Examples include:

Evaluation of CDPH’s BHSA population prevention objectives, including key results and impact outcomes.
Evaluation of how public attitudes about behavioral health and perceptions of suicide, self-harm, and overdose have changed over time.
Data collection and visualization on suicide, self-harm, and overdose, particularly from marginalized communities, to strengthen prevention strategies and inform local interventions and investments.
County/local profiles with disaggregated data to support local prevention efforts.

⁶California State of Public Health Report 2024 (PDF) and Office of Suicide Prevention Youth Suicide Prevention Program Highlights 2023 (PDF)

⁷See Appendix B for examples of key prevention strategies that have surfaced through the planning and community engagement process that present opportunities for prevention work to contribute to the population goals and address the BHSA statutory requirements.