The Children and Youth Behavioral Health Initiative’s (CYBHI) Stories from the Field series aims to highlight the critical work being done to address the behavioral health needs of children and youth, as well as the ongoing efforts to improve systems and create sustainable change. These stories showcase the values, vision and goals of the Initiative through personal experiences, composite stories and audiocasts. They demonstrate how the CYBHI can build on existing efforts, learn from them and work towards scalable and systemic change.

The mental health needs of California’s children and families have been on the rise, but the workforce that addresses them isn’t growing enough to match it. The Wellness Coach role was created as part of the CYBHI’s efforts to help address this issue by developing a larger, more representative behavioral health workforce.

The Wellness Coach is a new, certified position that will offer primary prevention and early intervention services to support behavioral health and overall well-being of California’s children and youth. With a focus on cultural humility and responsiveness and pre-clinical supports, services include wellness promotion and education, screening, care coordination, pre-clinical individual and group support, and crisis referral. The position, which is open to associates- and bachelor’s-degree-holders who meet specific certification requirements, will supplement and support existing behavioral health roles and fill gaps in the current behavioral health workforce. With a focus on recruiting and supporting a diverse applicant pipeline, Wellness Coaches will build trust and credibility with the young people they serve from the most underserved communities.

The CYBHI is investing $338 million to develop the new model, implement training statewide, provide certification and integrate Wellness Coaches into a wide variety of settings, such as schools and community-based organizations.

Roles of this type can be found across the state, including in Alameda County. During COVID-19, members of the Behavioral Health Collaborative of Alameda County, an association of mental health and substance use treatment providers supporting the county’s most vulnerable residents, recognized that workforce shortages were steadily getting worse. “Turnover was high in the Bay Area, and there weren’t enough master’s-level clinicians to meet community needs,” said Executive Director Matthew Madaus.

In response, members of the Collaborative reimagined how to expand their workforce and make it more representative of the people they serve. They created, highlighted and expanded roles that 1) provide individual and group support; 2) integrate between systems and within broader teams; and 3) are accessible to people who are interested in behavioral health careers but have not earned a master’s degree, creating accessibility to a wider range of candidates.

“Formal education is really important, but it is not everything,” Matthew said. ‘It should be an enhancement or supplement to life experience, character and values.”

So, what do these types of roles look like in practice? One example can be found at East Bay Agency for Children (EBAC), which for 70 years has helped East Bay children, youth and families to recover from trauma, build resilience and avoid exposure to adverse childhood experiences.

Integrating Mental Health in the School System: Behavioral Health Counselors

As a Behavioral Health Counselor at EBAC, Harold Jefferson works in partnership with the school system to help students understand, respond to and heal from the effects of trauma. “A lot of the kids we work with are definitely lost in the shuffle,” Harold said. “These kids are amazing and wonderful, and if you come in with an open heart, you can make some breakthroughs.”

EBAC understands that addressing youth mental health needs begins with meeting them where they are. Rather than expecting children who need support to trek out to their offices, Behavioral Health Counselors are embedded into the classroom, where they can give kids the support they need, when, where and in the way they need it.

For Harold, that means doing a little bit of everything. “I provide academic support, emotional support, one-to-one counseling, group counseling,” Harold said. “I’m pretty much a good listener.”

It didn’t always work this way. When Harold started with EBAC 28 years ago, youth behavioral health work was mainly focused on talk therapy, treated separately from students’ educational needs. Today, behavioral health is integrated directly into the educational system, and roles like Harold’s form a critical bridge between our education and mental health systems. The result is an environment that’s more conducive to learning and healing. “In order for kids to learn, they have to have trust and feel safe. Meeting kids where they are, you can connect, build a relationship and make that happen.”

Harold has seen the education and mental health systems grow more collaborative over the years. Looking forward, Harold believes that finding ways to combine the strengths of our education and mental health systems will help them serve students together from a place of empathy.

“I would love for schools to implement trauma-informed training for all staff.” Harold said. “Training everyone, from the teachers to the front office, custodians and cafeteria staff, would help not just students but the whole school.”

EBAC’s Behavioral Health Counselors are just one of the innovative approaches being used to expand the behavioral health workforce in Alameda County. Roles that integrate into care teams and bridge the gaps between systems are being incorporated into a wide range of areas, from education to social services and substance use recovery. “The compassion and ability to restore hope that paraprofessionals exhibit can be extraordinarily effective,” said Matthew.

Integrating systems, coordinating care and embracing trusted voices for education and skill-building can make our systems more equitable and effective for all our children and families. “When kids see us, all pulling in the same direction for them, that’s big,” said Harold. “They see all that love and attention coming, and they know it’s for them.”

Learn more about the Department of Health Care Access and Information’s (HCAI) Wellness Coach Workstream.