California’s Mental Health Wellness Act (MHWA) grant program provides $20 million each year to improve community response to people facing behavioral health crises. Grants enable crisis responders to connect those in crisis with wellness, resiliency, and recovery-oriented programs that offer the least restrictive settings appropriate for their needs.
Background and Goals
Established by Senate Bill 82, Governor Jerry Brown signed the investment in the MHWA into law in June 2013. It provides grant funds to California counties to improve access to and capacity for behavioral health crisis services, including crisis intervention, stabilization, treatment, rehabilitative services, and mobile crisis support teams. These supported services reduce the costs of expensive inpatient and emergency room care, reduce incarceration, and better meet the needs of people experiencing behavioral health crises.
Project Summaries
The Commission identified six areas of focus for funding, and grants focus on those priorities. Multiple programs in various stages of development, funding, and build-out fall under the MHWA at the Commission.
EmPath
Emergency Psychiatric Assessment Treatment and Healing (EmPATH) units are ideally located adjacent to regular hospital Emergency Departments, and deliver acute behavioral health care to patients in crisis in a calm, therapeutic setting not always found in a typical emergency room. Most emergency departments are not equipped to handle patients in a behavioral health crisis, which can lead to increased stress in an already stressful situation for both ED workers and patients. The goal of an EmPATH unit is to reduce ED boarding time for those patients and to reduce unnecessary psychiatric hospitalizations. The Commission approved grant funding in 2022 to build 11 EmPATH units throughout California.
PEARLS and Age Wise
Program to Encourage Active Rewarding Lives (PEARLS) is a brief, time-limited, and participant-driven program developed by the University of Washington that educates older adults about depression and helps them develop the skills they need for self-sufficiency and more active lives. Age Wise is a traditional mental health program for the high-risk and underserved older adult population developed by the County of San Bernardino. Its goal is to help individuals, families, and agencies maintain the best possible behavioral and physical health to promote independent living and wellbeing. The Commission approved grant funding for both PEARLS and Age Wise in 2023.
Maternal Behavioral Health and Children Ages 0-5
Helping families with children at an early age improves the lives of those families as well as their communities. Through robust engagement and analytic processes, the Commission in 2023 identified children ages zero to five and their parents/caregivers as a priority for MHWA funding. This focus will promote early childhood social-emotional wellbeing and develop local systems of care to identify issues early, while also ensuring connection to culturally relevant services.
Substance Use Disorder Pilot Program
California adopted the American Society of Addiction Medicine Criteria as the standard for treating substance use disorders (SUD) using a holistic, person-centered approach to treatment and co-occurring disorders. The Commission recognizes that counties and their partners are struggling to meet those standards due to a lack of adequately trained medical prescribers available to provide evidence-based medications for addiction treatment (MAT), an underutilized and high-impact intervention for SUD clients. As a result, the Commission in 2024 authorized $20 million to increase access to MAT via a pilot program intended to reduce financial barriers to meeting these best practice standards.
Full Service Partnership Technical Assistance
Full Service Partnerships (FSPs) are recovery-oriented, comprehensive services created to help people with severe, chronic behavioral health challenges who are at risk of becoming or already are unhoused. It provides the “full” spectrum of community services with a “whatever it takes” approach. The Commission’s work in creating a capacity-building strategy for FSPs is part of four-year funding from the MHWA; information about the Commission’s other efforts to improve FSPs, including biennial reports to the Legislature, can be found on the FSP program page.
The Commission’s MHWA grant funding for improving FSPs takes the form of technical assistance and capacity building focused on value-based contracting and performance management and improved service delivery. The Commission is examining strategies to improve outcomes for FSP clients and develop adequate and reliable funding methods through outcomes-based billing. The Commission approved grant funding for FSP technical assistance in 2024.
Peer Respite
A peer respite is a voluntary, short-term program, usually overnight, that provides community-based, non-clinical support to people experiencing or at risk of experiencing a psychiatric crisis. Peer respites are staffed and operated by people with lived experience with behavioral health challenges. Inside a homelike environment, individuals who are struggling with a behavioral health challenges – whether emotional or psychological – can receive support from their peers. The Commission is currently exploring peer respite and anticipates opening a Request for Applications for peer respite grants in 2025.
Improving Outcomes
The Behavioral Health Services Act (BHSA) passed by voters in 2024 allows MHWA funds to support innovation and incentivize the adoption of best practices in response to crises. The Commission looks forward to engaging state, county, local, and community partners to explore how to best use MHWA funding as the BHSA is implemented over time.
Resources