Private insurance has historically lacked mental health services, so patients often seek care through the public system. Nearly $7.8 billion in public money was spent in fiscal year 2012-13 on mental health care, with the largest share — $3.3 billion — paying for Medi-Cal beneficiaries. The Affordable Care Act, however, is expected to improve access for many. The law expands who is eligible for Medi-Cal, the coverage program for poor and disabled residents, enabling them to get comprehensive mental health services, and California residents purchasing insurance through the healthcare marketplace will also have access to mental health care.

“We should be seeing the opportunity for that whole infrastructure to bulk up to meet the demand,” she said.

In addition, the law promotes more integration between mental health care and physical health care. There is an increasing awareness about how important it is for doctors to address mental health and substance abuse needs among their medical patients, said Neal Adams, deputy director of the California Institute for Mental Health. “When we talk about pursuing health for people, it really needs to include emotional well-being as well as physical well-being,” said Adams, a psychiatrist and the project manager for one of the reports.

Even with the changes in the national healthcare law, policymakers will still face challenges. “As we bring more uninsured and poor people into the healthcare delivery system … there is a really serious question about how and where those needs are going to be met,” Adams said. “People are very worried about workforce shortages.”

• From LA Times, July 17, 2013, by Anna Gorman