#calaim

Homelessness and mental health are deeply intertwined in California. Many people experiencing homelessness also struggle with serious mental illness, trauma, substance use, and cycles of crisis. Benioff Housing Initiative+2California Healthline+2

Providing effective care to people without stable housing is especially difficult, because services must overcome barriers of accessibility, continuity, stigma, and resources. Below is a guide to how California is trying to meet this need—and where it’s still failing.

🧭 Key Programs & Services

No Place Like Home (NPLH)

A statewide program dedicated to building permanent supportive housing for people experiencing homelessness who also need mental health services. It funds housing + supportive services together. Cal HCD

Behavioral Health Bridge Housing (BHBH)

Provides interim housing and mental health support for people with serious mental illness or substance use disorders, serving as a bridge to longer-term care. Bridge Housing

Medi-Cal & CalAIM Reforms

Under CalAIM, California is expanding Medi-Cal’s role in addressing homelessness: managed care plans can now fund “community supports” tied to housing, navigation, security deposits, and incentives for homeless systems of care. California Health Care Foundation+1

MHSA / Supportive Housing Programs

The Mental Health Services Act funds capital and operating subsidies for supportive housing serving individuals with serious mental illness who are homeless. Counties use this to develop housing + mental health support. Department of Mental Health+1

Outreach & Mobile Engagement

Programs that bring mental health clinicians to the streets (field-based care) help engage people who don’t or can’t show up at clinics. For example, The People Concern in L.A. has on-site and field-based mental health services integrated into housing and outreach programs. The People Concern

Homeless / Housing Incentive Program (HHIP)

A funding initiative that gives Medi-Cal managed care plans incentives to partner with homeless systems and invest in homelessness-related interventions. California Health Care Foundation

County Teams & Local Crisis Response

Some counties have special teams combining outreach, mental health, and social services. For instance, Sacramento’s “HEART” team includes homeless outreach + specialty mental health services. DHS

🔍 Challenges & Gaps

Fragmentation & Coordination Problems Many programs operate in silos (housing agencies, mental health departments, nonprofits) without seamless linkage.

Capacity Limits & Waitlists Supportive housing and clinical service slots are insufficient to meet demand in many counties.

Continuity of Care Is Hard People move often, lose contact, or have no means (phone, address) to keep appointments.

Funding & Resources Many counties struggle to staff or maintain these programs due to budget constraints and high operating costs.

Stigma & Access Barriers People experiencing homelessness frequently face discrimination, distrust, or real obstacles (transport, ID, insurance) to accessing care.

High Need, Complex Cases Nearly half of homeless individuals in California have complex behavioral health needs (dual diagnoses, severe illness) Benioff Housing Initiative

Policy & Implementation Lags New reforms (e.g. Prop 1, behavioral health bond funds) take time to roll out; counties vary in readiness. Governor of California+1

🌱 What Must Improve

Full Integration of Housing + Therapy Services must come together—housing without mental health care fails; mental health without housing is unstable.

Expand Mobile & Street-Based Care Bring clinicians, peer workers, and case managers to people who are homeless, especially unsheltered populations.

Increase Capacity & Incentives More beds in supportive housing, more clinicians in underserved areas, better pay to attract staff.

Streamlined Coordination & Data Sharing Shared client records, unified case management, and cross-agency systems would reduce drop-off and gaps.

Focus on Equity & Trust-Building Culturally competent services, trauma-informed care, and community engagement are essential.

Sustain Funding & Oversight Prop 1 and the behavioral health bond fund provide new funding, but oversight must ensure money reaches front-line services. California Budget & Policy Center

Prevention & Early Intervention Street outreach, crisis counseling, and diversion before people fall into chronic homelessness.