Mental health care for homeless blacks is at risk

By Amaya Noguera and Pedro Noguera, especially for CalMatters

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Mental illness is personal to us, as it is to millions of others in this country. Our son and brother has lived with schizophrenia since he was 21 years old. We saw a vibrant, kind young man 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 in the open, unwanted in public places and treated with fear or contempt. Black people suffer disproportionately from these conditions, making up 7% of the total population, but 26% of Californians are homeless.

Black men are overrepresented nationally among the unhoused with mental illness. It’s an injustice rooted in decades of discriminatory housing policies, excessive policing, and inadequate access to culturally sensitive care.

This is not a random context; this is the heart of the problem. Traditional mental health infrastructure, however well resourced, often fails to reach the people who need it most.

In recent years, a community-based model of mental health care has emerged as a viable alternative—not as a substitute for clinical services, but as a bridge that makes them accessible. It is run by organizations embedded in the neighborhoods they serve. It treats housing, food, safety and mental health as indivisible and 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 hires community members as certified Medi-Cal Peer Support Specialists to serve people with mental health and substance use issues. In Los Angeles, the Black Emotional and Mental Health Collective connects individuals and families with culturally responsive therapists through a free online directory and provides financial support to Black or marginalized families struggling with mental illness.

In Sacramento, the Responsive Community Wellness Program—funded by the Sacramento County 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 provided more than 13,000 services to more than 2,700 residents. Many had not accessed mental health services before; 9% reported not being housed, but the number is likely much higher.

An outreach worker at Community Responsive Wellness received a desperate call from a parent with six children who had been sleeping in bus stations for over a year. Within hours, the program’s partner organizations put the family up in a hotel, found a housing voucher that was issued but never delivered, fed the children and returned them to school, and connected each family member to mental health services.

Community-based programs like these mobilize support networks to fill system gaps and prioritize holistic care.

But that model is now threatened by changes in federal policy. HR 1 — the so-called Big Beautiful Bill — and President Donald Trump’s executive orders are aimed at inclusive programmingreducing federal funding streams that flow to counties and ultimately to the organizations doing this work.

Meanwhile, reallocation of funding at the state level has further reduced the availability of resources once provided directly to counties. Funding decisions are no longer driven by local knowledge and community connections, so programs like the Community Responsive Wellness Program face increasing difficulties in securing sustainable funding tailored to 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 support, and targeted strategies that expand access to services. But federal cutbacks threaten that vision.

We must protect and invest in models of care that make mental health accessible to California’s most vulnerable.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.