California's AB 665: Equitable access to mental health services

Bill aims to support tweens, teens — regardless of income

Every child deserves safe spaces and opportunities to connect with supportive people as they grow, learn about themselves and the world around them, and develop the skills they'll need to navigate the many challenges of life.

The unfortunate reality, however, is many young people aren't receiving the support they deserve, want and need at this critical time in their lives. In California, where nearly a third of adolescents are reporting symptoms that qualify as serious psychological distress, the recently-introduced Assembly Bill 665 aims to counter this imbalance by providing all teens and tweens in the state with equitable access to mental health care.

AB 665, authored by Assemblymember Wendy Carrillo and co-sponsored by the National Center for Youth Law, was developed in partnership with young people, whose voices are at its core. Learn more from Rachel Velcoff Hults, Director of Health at the National Center for Youth Law, about how this proposed law can improve mental health outcomes:

What would AB 665 do?

AB 665, put simply, would align standards of mental health care consent in California for all youth ages 12 and older. Currently, young people 12 and older who receive health care through private health insurance plans are able to consent to outpatient mental health care on their own behalf when considered mature enough to participate in the care. Youth relying on the state's Medi-Cal program — offered to families with lower incomes — cannot access mental health care on their own without approval from a parent or guardian, unless they meet a much higher need level. This added barrier to support prevents many tweens and teens from getting the care they need and threatens their well-being. AB 665 would give all youth 12 and older the same opportunity to access mental health care based on their own consent, regardless of insurance type.

Why is AB 665 needed?

Supporting youth in getting the emotional, mental and physical care they want and need leads to healthy relationships, stronger families, and better connected communities — outcomes that benefit everyone. All health insurance plans should create equitable pathways, not barriers, to safe and quality healthcare.

Young people are telling us they need this access. Depression rates among teens have gone from 28 percent in 2011 to 42 percent in 2021, according to a recent CDC report. That same report recommends increasing access to needed services as an action to improve adolescent health and well-being.

No child's ability to obtain mental health care, particularly given what we know our youth are currently experiencing, should be based on income level.

What exactly would youth be able to access if AB 665 is adopted into law?

AB 665 would grant youth independent access to outpatient mental health services. This could include counseling, but it does not include medical procedures, inpatient care, or prescription medications, which would still require consent from a guardian. The mental health provider, per AB 665, would be required to discuss with the young person whether the involvement of a parent or guardian is safe or appropriate and must involve the parent or guardian unless that involvement is deemed unsafe or inappropriate. AB 665 has nothing to do with any custody laws.

How can I support AB 665 or a similar law in another state?

By letting your government representatives know that youth need and deserve the autonomy to learn and grow in healthy and safe environments. And by joining or supporting organizations or efforts that center the voices and experiences of young people — and then listening to, and acting upon, what those youth need.

What are young people saying about AB 665?

AB 665 was developed in partnership with young people, whose input and experiences were key. Additionally, many young people have voiced their support for the bill. These include Esther, a high school senior in the Bay Area, who was among youth participants in a recent AB 665-focused Instagram Live event that also included California Assemblymember Wendy Carrillo, the bill's lead author. Esther, who is insured by Medi-Cal, shared how she benefited from short-term mental health care — after she fought through systemic obstacles to get it from outside the Medi-Cal system. Her immigrant parents were supportive of her, but weren't able to help her due to language and cultural barriers.

​​“I was really lucky to have that support; that was really transformational for me," Esther said of the care she received. "I think that just goes to show the power of mental health care and support, even if it’s just for a short amount of time. Something that’s really important about AB 665 is that if it’s passed, it allows youth to gain access to both short-term and long-term support. If you think about the impact that 10 weeks can make on someone, imagine that for however long they really want.”

Fiona, a high school senior in Orange County and student leader with GenUp, was another participant in the Instagram Live session. She highlighted the importance of young people having options, no matter their specific situation.

“This bill serves just a wide variety of young people who could need it in any situation," she said. "Having [AB 665] as a safety net is really important."