Young Hearts & Minds: Making a Commitment to Children's Mental Health

Report #161, October 2001
Young Hearts & Minds: Making a Commitment to Children's Mental Health

Full Report

Executive Summary

Press Release

October 17, 2001

For Additional Information Contact:
James P. Mayer, Executive Director
(916) 445-2125

Mental Health System Fails More Children Than It Serves

The Little Hoover Commission today recommended reforms to the mental health system that would help children succeed in school, stay out of trouble and develop into healthy adults.

If enacted, the reforms would encourage communities to make better use of existing resources, increase the role of private health insurance in financing care, and allow policy-makers to confidently spend more public money when it is available.

In its report, Young Hearts and Minds: Making a Commitment to Children’s Mental Health, the Commission concluded that California rations care to those children with the greatest needs – missing the opportunity to provide cost-effective preventive care. Without adequate care, many children end up in the juvenile justice system, drop out of school and carry their troubles into adulthood.

Each year, about 1 million children in California experience a mental healthrelated problem, but only about 150,000 of those children are served through the public system. As with the adult system, the Commission asserted that the goal should be to provide services to everyone who needs care by improving public services and expanding the role of private-pay care.

The Commission also concluded that many of the problems limiting the quality of mental health care are the same problems that plague juvenile justice, child welfare and other services that are attempting to help troubled children and their families.

“We forego opportunities to prevent harm. We fail to integrate services. We measure little and demand even less,” said Michael Alpert, chairman of the Commission. “We must redesign this billion-dollar system.”

In addition to the mental health-related reforms, the Commission recommended ways the State could better support communities that are fundamentally rethinking how they serve children and families who are dealing with a variety of related challenges.

Under the guidance of the state Department of Mental Health, California’s counties are the primary providers of mental health services to children. Statewide, community mental health programs spend $2 billion a year; less than half of that is estimated to be spent on children. Additional services are available through schools, the juvenile justice system or health care programs.

But whether children are adequately served depends on how they are defined by a complex set of eligibility rules and whether the right services are even available where the family lives. Some communities receive more funds from the State than others, but no community is held to
statewide standards or even guided by a comprehensive set of best practices. To solve these and other problems, the Commission recommended the following:

  • Counties should comprehensively assess the needs of children in their communities, whether those are being met, and what is needed to fill the gaps in services. The State should set standards and provide clear expectations for desired outcomes and support cost-effective prevention strategies.
  • The State should streamline funding rules to reduce administrative costs and create incentives to continuously improve services. 
  • Counties must be able to hire, train and retain managers and staff who can set and achieve goals for children. State education, training and workforce development programs should coordinate their efforts to attract and train – and help providers retain – competent professionals.
  • The State should reform funding and regulations for a variety of children’s programs to give counties greater flexibility for using resources based on the needs of children in exchange for clearer accountability for progress.

“The mental health field is filled with dedicated, hard-working people who are trying to help children succeed, but the rules and regulations work against them,” Alpert said. “Some of these people work in schools, others in health care or social services. For the sake of the children, we need to give these professionals a fighting chance to change lives.”

The Little Hoover Commission is a bipartisan and independent state agency charged with reviewing state programs and policies and recommending ways to increase their efficiency and effectiveness. The Commission’s recommendations are sent to the Governor and the Legislature for their consideration. The Commission released a report on the adult mental health system in November 2000 titled Being There: Making a Commitment to Mental Health. Copies of both reports can be obtained by contacting the Commission or visiting its Web site:

Fact Sheet

Study Description

Previous Studies:



In this report, the Commission calls on California to rethink its strategy for serving children in need of mental health services.

During its review, the Commission found that too many children suffer through mental health needs without the benefit of appropriate, compassionate and holistic care. The Commission found that mental health funding fails to promote quality, efficient care. Additionally, children and families are denied access to adequate and appropriate care because California has not appropriately addressed the acute shortage of qualified mental health professionals. California does not fund, organize or administer services to comprehensively meet the needs of children and families.

The Commission recommends that access to the right care at the right time should be guaranteed for all children. The Commission also recommends for policymakers and community leaders to support the capacity of service providers and provide services organized around the needs of children and families. Taken together, these recommendations will improve the ability of California to enhance the prosperity of its children, its communities and the state.