Behavioral Health services act

BHSA Population-Based Prevention

Behavioral health challenges are on the rise in part due to early life adversity and exposure to harms from behavioral addictions, chemical substances, and negative digital stimuli. BHSA presents a renewed opportunity to address significant population health burdens and disparities related to behavioral health and well-being through a coordinated, statewide population-based prevention approach. The BHSA is foundational to California’s commitment to transform our behavioral health systems and achieve positive behavioral health and well-being for all. CDPH is leading the new BHSA investment in a statewide population-based prevention program. This facet involves two major shifts: 1) establishing dedicated resources focused on population-based prevention and 2) improving the impact of prevention efforts through statewide leadership and alignment.

Statutory Requirements

As part of the broader BHSA, dedicated ongoing resources for population-based prevention were established to lead a strategic population health approach to behavioral health prevention designed to reduce the prevalence of mental health and substance use disorders and resulting conditions.

A minimum of four percent of the BHSA funding is allotted to CDPH for Population-Based Prevention and at least 51 percent of the funds must be used for populations who are 25 years old or younger. Population-based prevention programs must incorporate evidence-based practices or promising community defined evidence practices and meet one or more of the following:

Benefit the entire population of the state, county, or particular community
Serve identified populations at elevated risk for a mental health or substance use disorder
Aim to reduce stigma associated with seeking help for mental health challenges and substance use disorders
Serve populations disproportionately impacted by systemic racism and discrimination
Prevent suicide, self-harm, or overdose

The full statutory requirements for the BHSA Population-Based Prevention funding can be found in Appendix A.

Populations of Focus

Of the five conditions that statute stipulates BHSA population-based prevention programs must meet, two are specific to populations of focus. Those populations are:

populations at elevated risk for a mental health, substance misuse, or substance use disorder
populations disproportionately impacted by systemic racism and discrimination³

Cultural Responsiveness⁴

All population-based prevention programs must be culturally responsive and linguistically appropriate to the community served. These programs must be able to reach underserved cultural populations and address specific barriers related to racial, ethnic, cultural, language, gender, sexual orientation, age, economic, or other disparities in mental health and substance use disorder. Integral to cultural responsiveness is the recruitment and engagement of well-trained staff who reflect the diversity and lived experiences of the communities served. Additionally, population-based prevention programs must engage communities, especially community members who are historically underrepresented and/or marginalized, as partners in planning, developing, implementing, and evaluating programs and strategies.

Use of Evidence-Based, Promising, or Community-Defined Evidence Practices⁵

Population-based prevention programs shall incorporate evidence-based, promising, or community-defined evidence practices designed to reduce the impact of mental health and substance use challenges and resulting conditions. Population-based prevention programs must also be responsive to the cultural and linguistic needs of diverse communities.

Stigma and Discrimination Reduction

All population-based prevention strategies must aim to reduce stigma and discrimination, which seek to reduce negative feelings, attitudes, beliefs, perceptions, stereotypes and/or discrimination related to expressing emotion, dealing with mental health challenges, being diagnosed with a mental illness or substance use disorder, or seeking mental health or substance use disorder services.

³ W&I Code § 5892 (f) (1) (E)

⁴ W&I Code § 5840.6

⁵ W&I Code § 5892 (f) (1) (E) (ii)