California’s behavioral health workforce is buckling under demand, with critical shortages of psychiatrists, therapists, and substance use counselors making it difficult to expand treatment capacity despite significant state investments. In April, state health officials revealed that California was short roughly a third of the 8,100 psychiatrists and 117,000 licensed therapists it needed based on 2022 data. Six years ago, the California Future Health Workforce Commission warned of a “severe and growing” shortage and noted that two-thirds of Californians with a mental illness go without treatment.
Investment and Training Gaps
Since the pandemic exacerbated mental health and addiction issues, Gov. Gavin Newsom and state lawmakers have dedicated more than $1 billion to train and recruit providers. In 2025, 239 first-year residents enrolled in California psychiatry programs, an all-time high and up from 152 seven years ago. Yet this fell far below the 527 first-year psychiatry residents the workforce commission estimated are needed annually from 2025 to 2029. Training a psychiatrist costs as much as $250,000 a year and requires 12 years of postsecondary education. Janet Coffman, a University of California-San Francisco associate professor specializing in health care workforce issues, noted that state-funded psychiatry programs “haven’t graduated their first class yet.” California is also tapping $1.9 billion in Medicaid funds to train, recruit, and retain behavioral health workers through scholarships and loan repayments, a program that took effect in January, though it faces uncertainty from potential Trump administration changes.
Patient Impact and Burnout
In Shasta County, where the suicide rate is more than double the state average and overdose deaths increased more than threefold during the pandemic, patients often turn to costly emergency care when unable to access outpatient appointments. In 2022, patients with mental health or substance use disorders accounted for 1 in 3 inpatient hospitalizations and 1 in 6 emergency room visits. Shasta County has about a third of the psychiatrists and little more than half the licensed therapists it needs. Workers consistently report burnout from the volume of patients with insufficient resources. The state’s first psychiatric residency program north of Sacramento, launched last year by Healthy Rural California in Chico with a $1.5-million state grant, required private donations and a GoFundMe campaign to secure an additional $75,000 to welcome its first class of four residents. The program’s first graduates are expected in 2028.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.latimes.com/business/story/2025-08-11/as-californias-behavioral-health-workforce-buckles-help-is-years-away