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Guest Commentary written by
Amaya Noguera
Amaya Noguera is a program officer at Sierra Health Foundation.
Pedro Noguera
Pedro Noguera is dean of the University of Southern California’s Rossier School of Education.
Mental illness is personal for us, as it is for millions of others in this country. Our son and brother has lived with schizophrenia since he was 21. We saw a vibrant, kind young man become consumed by paranoia and fear, isolating himself and turning away from medical and therapeutic care.
Fortunately, he has a roof over his head because we have the means to provide it. Many others do not.
Every day, we witness people on our streets sleeping outdoors, unwelcome in public spaces and treated with fear or contempt. Black people disproportionately suffer these conditions, making up 7% of the general population but 26% of Californians experiencing homelessness.
Black men are overrepresented nationally among unhoused individuals with mental illness. It’s an inequity rooted in decades of discriminatory housing policies, over-policing and inadequate access to culturally responsive care.
This is not incidental context; it is the center of the problem. Traditional mental health infrastructure, however well-resourced, has repeatedly failed to reach the people who need it most.
In recent years, a community-centered model of mental health care has emerged as a viable alternative — not a replacement for clinical services, but a bridge that makes them accessible. It is led by organizations embedded in the neighborhoods they serve. It treats housing, food, safety and mental health as inseparable, and it uses data to design services responsive to the identities and experiences of the populations it serves.
One such program in Oakland, the Peer Wellness Collective, trains and employs community members as certified Medi-Cal peer support specialists, to serve people with mental health and substance use challenges. In Los Angeles, the Black Emotional and Mental Health Collective connects individuals and families to culturally responsive therapists through a free online directory and provides financial support to Black or marginalized families navigating mental illness.
In Sacramento, the Community Responsive Wellness Program — funded by Sacramento County’s Department of Behavioral Health Services and administered by The Center at Sierra Health Foundation and local organizations — works with providers to offer culturally informed therapy and wellness services. From 2024 to 2025, it delivered more than 13,000 services to more than 2,700 residents. Many had not accessed mental health services before; 9% reported being unhoused, but the number is likely much higher.
A Community Responsive Wellness outreach worker got a desperate call from a parent with six children who had been sleeping in bus stations for more than a year. Within hours, the program’s partner organizations had the family in a hotel, located a housing voucher that had been issued but never delivered, got the children fed and back in school, and connected every family member to mental health services.
Community-based programs like these mobilize support networks to close system gaps and prioritize holistic care.
But this model is now threatened by federal policy changes. H.R. 1 — the so-called Big Beautiful Bill — and President Donald Trump’s executive orders are targeting inclusive programming, cutting federal funding streams that flow to counties and, ultimately, to organizations doing this work.
Meanwhile state-level funding reallocation has further reduced the availability of resources once provided directly to counties. Funding decisions are no longer guided by local knowledge and community connections, so programs such as the Community Responsive Wellness Program face increased difficulty securing sustainable funding aligned with local needs.
Even with limited resources and no guarantee of support, our communities have successfully reimagined what mental health care looks like: culturally responsive programming, holistic supports and targeted strategies that expand access to services. But federal cuts threaten that vision.
We must defend and invest in models of care that make mental health accessible for California’s most vulnerable.
CalMatters is a Sacramento-based nonpartisan, nonprofit journalism venture committed to explaining how California’s state Capitol works and why it matters. It works with more than 130 media partners throughout the state that have long, deep relationships with their local audiences, including Embarcadero Media.
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