Mental health issues loom large in the minds of California residents as the state enters election season.

The annual California Health Policy Survey from the nonprofit California Health Care Foundation revealed that access to mental health care continues to be one of the biggest concerns for people across the state. 

The annual survey, conducted in partnership with NORC at the University of Chicago, queried 3,431 adults age 18 and over across California last fall about various health care topics. Increasing access to mental health services ranked as one of the most important issues the public wants politicians to address, only coming in behind reducing the overall cost of healthcare as the top priority statewide.

“I think the biggest takeaway from this poll is the mental healthcare system isn’t working for the majority of people in this state and they are looking to their leaders for fundamental change,” said Kristof Stremikis, the director of market analysis and insight for the California Health Care Foundation. 

The survey shows a strong appetite for change in mental health policy as voters get ready to mail in ballots and head to the polls for the March 5 primary. Mental health will again be on the ballot with Proposition 1, a statewide initiative that would significantly shift county mental health budgeting toward housing those with the most severe disorders and approve a $6.4 billion in bonds to pay for state housing and treatment facilities.

The annual CHCF poll also asked about the cost of services, medical debt, provider availability and other healthcare issues — and analyzed answers based on race, income levels and political affiliation. 

Some other major takeaways from the 2024 survey:

• 81% of Californians say access to mental health treatment is “extremely” or “very” important for the governor and legislature to address. It came in second only to “reducing the amount of money that people pay for care” at 82% as the top health-related priority.  
• 25% of Californians, or 1 in 4 residents, have needed or had someone close to them who needed treatment for “serious mental illness.”
• 52% of Californians who tried to make a mental health appointment reported difficulties finding a provider who took their insurance (up 6% from the previous year when 49% surveyed reported similar difficulties). 
• 67% of Californians overall believe “some” or “significant” improvement is needed when it comes to treating people with serious mental illness. That increases to 85% for residents who have had treatment or know someone close to them who has needed treatment. 

Strong support for mental health access across socioeconomic and political lines

When broken down along racial, socioeconomic and political lines, mental health remained one of the top priorities for most groups. 

Latino and white respondents all ranked increased mental health access as their top health-related concern — with 85% and 82% calling it “extremely” or “very” important, respectively. 

Black Californians polled also strongly supported increasing mental health access (92%), as well as “reducing differences in health care quality between racial/ethnic groups” (93%). Asian residents’ top health priority was reducing the cost of care (82%), though mental health issues were also “extremely” or “very” important to 70% of respondents. 

Mental health concerns also crossed economic and political lines. Lower income Californians polled said reducing health care costs and increasing mental access as their top two priorities, at 91% and 89%, respectively. Higher income Californians had the same top two health priorities, with 79% polled calling them both “extremely” or “very” important. 

Increasing mental health care access was also the most critical health issue for members of both major political parties, with 87% of Democrats and 74% of Republicans considering it “extremely” or “very” important. 

No party preference or other party also considered mental health access important, though their top priorities differed. Those with no party considered reducing overall costs the most important, at 87%, while other party members polled ranked increasing the number of health care providers across the state as the top at 91%. 

“When we ask about the system for treating serious mental health issues in the state, we have a large proportion of folks saying fundamental changes are needed,” said Stremikis of the CHCF survey results. “The message is to keep working on the system. Many, many Californians are unable to access that system. Those that are able to access the system are asking for significant improvements. It’s imperative that the mental health care system be at the top of our list.”

CHCF is a funder of CVJC’s Health Equity Lab

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Marijke Rowland is the senior health equity reporter for the Central Valley Journalism Collaborative, a nonprofit newsroom based in Merced, in collaboration with the California Health Care Foundation (CHCF).