As behavioral health needs skyrocketed when the COVID-19 pandemic took hold, specialty behavioral health organizations which provide services to people with serious mental illness and/or substance use disorder pivoted to delivering significantly more care via telehealth. While behavioral telehealth access may be a point of pride, racial inequity is also evident in telehealth access. It is disproportionately inaccessible to people of color, in particular those from the Black and Latinx communities, people with limited English proficiency, people facing poverty, and older adults. The key structural barriers often cited are limited access to broadband or technology and lack of digital literacy. However, institutional racism in behavioral health organizations also influences other practices and policies that negatively impact not only telehealth access but also quality. When behavioral telehealth access and quality are both compromised due to racism at structural, personal, and interpersonal levels, inequities in behavioral telehealth outcomes will also persist. As the specialty behavioral health system integrates learning from the dual public health crises of COVID-19 and racism into more permanent telehealth practices, racial equity must be named as a central aim.

This CHIP aims to help organizations address these issues by launching Cultivating Outcomes through Equity in Behavioral Telehealth, a 16-month learning collaborative. I designed the model using feedback gained between January-December 2021 from key informant interviews and Expert Meetings with behavioral health leaders, providers, and clients from underserved communities. I recruited diverse faculty and coaches with expertise in operationalizing strategies to counter structural racism in behavioral health and improve the engagement of people from minoritized communities in telehealth. This collaborative is funded by the California Health Care Foundation. Its goal is to help specialty behavioral health organizations make racial equity in telehealth a strategic priority to improve their behavioral telehealth and hybrid practices. The initiative aims to ensure clients have equitable access to high-quality services that promote meaningful outcomes and flourishing for people from communities with historic behavioral health inequities.