Low-Income Californians’ Need for Behavioral Health Services


A broad gap exists between behavioral health (BH) needs of low-income Californians and BH treatment, a recent report finds. The report from Blue Shield of California Foundation discusses the results of a survey, which measured low-income Californians self-reported needs for and barriers to BH assistance. The results found that 3 out of 10 survey respondents had a time in the past year when they have felt the need to talk with a health care professional about their BH; however, only half of these individuals actually talked with one about these issues. Barriers identified included stigma, cultural, and language barriers, as well as not knowing where to get help. The findings also highlight a mismatch between patient interest in receiving Services at a primary care (PC) facility and current availability of these services, with three-quarters indicating that it was “highly important” that their facilities provide BH services, but only half reporting that these services were available. The survey results demonstrated strong support for interest in integrated care among low-income Californians, with the majority indicating a strong preference for receiving BH services in the same setting as their PC. Sixty percent reported a preference for discussing BH issues with a professional at their PC facility, rather than off site.

The report provides several recommendations for how to bridge the gap between BH needs and services based on the survey results. A few of these recommendations include: 

  • Integrating BC specialists into PC practices;
  • Making patients more aware of BH resources; and
  • Having health care providers routinely ask patients about their emotional well-being.  

The authors explain that:

“By inviting patients to discuss their behavioral health needs within the primary care setting, primary care providers may vastly improve the chances that their patients will seek help. By strengthening and deepening their relationships with their patients, providers and healthcare facilities have the potential to dramatically enhance health treatment for low-income Californians.”

The Blue Shield of California Foundation research report findings add additional support to previous research on the benefits of integrated BH services in PC settings, particularly as a way to reduce stigma and increase ease of access by providing care within a PC clinic.

Read the Blue Shield of California Foundation (PDF - 270 KB) report:

View the Health Affairs article on bridging the gap.