Mental Health Portal for Kids and Young Adults Goes Statewide

Primary care providers can access expert consultation, training, and resources to help guide treatment for patients under age 26.

Forty percent of high school students say they feel sad and hopeless, and 20% have seriously considered suicide. A chronic shortage of mental health experts has made the problem worse, but UCSF has created a way for all California youths to access quality mental health care.

UCSF child and adolescent psychiatrist Petra Steinbuchel, MD, directs the California Child and Adolescent Mental Health Access Portal (Cal-MAP), formerly known as the Child and Adolescent Psychiatry Portal (CAPP), which we introduced readers to in our Winter 2024 issue. The resource allows primary care providers to consult with UCSF psychiatrists and psychologists for advice on treating young patients with mental health concerns. In late 2024, the portal expanded to licensed providers statewide.

Steinbuchel explains how the portal has evolved in addressing the state’s youth mental health crisis and what comes next.

Who is the portal for?

It’s for the primary care doctor in a rural area where there are limited specialists, or the nurse in an urban area where it’s difficult to get an appointment to see a psychologist. More broadly, it’s for any outpatient primary care provider in California who wants immediate support in addressing mental health and substance-use disorders in a patient age 25 or younger. It’s free, and insurance status doesn’t matter.

Why is it needed?

Fifty percent of all lifetime mental illnesses start by age 14, and 75% start by age 24, and there can be up to a 10-year lag time between the onset of symptoms and diagnosis and treatment. It’s crucial to address mental and behavioral health problems when they first emerge to prevent more severe and chronic problems later. There’s been a national shortage of experts to treat children’s mental health for decades, coupled with a decline in youth mental health since COVID-19. One-third of California counties have no child psychiatrists at all.

This means that pediatricians, family doctors, nurse practitioners, and physician assistants are on the front lines of diagnosing and treating mental health conditions, often with little support or training. We help the children and families by supporting their primary care clinicians.

What services does it provide?

We offer guidance and coaching by telephone so primary care providers can address mental health concerns. We’ll be offering secure emails and texts soon. We also have free training that primary care and school-based clinicians and staff can access for continuing education credit, and guidance on outside resources and referrals, which any licensed California clinician can use.

Education is at the heart of what we do. Providers gain the skills, knowledge, and confidence to address a wider range of mental health challenges on their own, and eventually they consult us less frequently. Each one sees thousands of patients during their careers, so we’re creating a real ripple effect that impacts many youths over time.

How did the portal start?

UCSF Benioff Children’s Hospital Oakland received a generous $15 million gift with the goal of expanding mental health services for children and adolescents. Part of this gift went to creating Cal-MAP in 2019, including recruiting psychiatrists to help staff it.

How has Cal-MAP grown over time?

In 2020, our first full year, we received about 300 consult requests through the portal. By late 2024, we had registered more than 3,000 primary care providers in 47 counties and had provided more than 4,500 consults. When we first launched, we enrolled primary care providers within UCSF and our affiliated providers. We then expanded to a four-county region in the Bay Area, followed by the Central Valley and Northern California. Now, in partnership with the state Department of Health Care Services, Cal-MAP is available to all 58 counties in the state.

Moving forward, we will continue to expand our partnerships with additional sites across California so primary care providers can consult with mental health experts from their own geographical area.