Our mission and values: The Bay Area Clinical Associates, P.C., (BACA) is a physician-owned and operated organization offering  evidence-based mental health services to youth and their families in the San Francisco Bay Area. We believe that all youth, regardless of socio-economic status, should have equal access to gold-standard mental health interventions. We strive to cure mental illness in our clients so that they may develop into healthy, productive adults and realize their full potential. We believe that every individual’s mental health is an essential component of the overall well-being of our community.

Addressing the state of our current mental health care system: There is evidence indicating that most mental illnesses originate in childhood, however many youth remain undiagnosed or inadequately treated until much later in life. There are solid, evidence-based treatments to alleviate the suffering associated with mental illness, yet there are many obstacles to getting available services to the children who need them the most. Did you know that 1 in 3 adults and 1 in 4 kids will be diagnosed with mental illness in their lifetime?

Stigma against mental illness still exists. This bias manifests itself in many ways – from lack of available care, over-prescribing of medications, and discrimination in funding research and clinical support for individuals with mental illness. For example, three times as many youth die from suicide than from cancer, and suicide is now the second leading cause of death in 5-24 year olds. Yet funding for research and treatment on pediatric physical illnesses continues to exceed that for mental illness. While life-threatening illness in a child is traumatic for families, death from suicide or homicide due to mental illness is just as tragic. 

There is an overwhelming shortage of youth-focused mental health services. As such, navigating the mental health system can be a frustrating, confusing process for parents. When parents contact their pediatricians to get help for their child, they are typically advised to consult with insurance companies for referrals to a psychiatrist. A majority of these psychiatrists are often unavailable to take on new clients. If they are, these providers are often limited by current systemic constraints of large, private medical organizations and the county mental health system- including a daily demand to see a certain number of clients – and they are often unable to provide proper care. Many psychiatrists are pushed into situations in which they are only able to prescribe medications and are unable to integrate evidence-based practices, such as psychotherapy, family interventions and academic support. There is clear evidence that psychotherapy is the better treatment modality for depression than medication alone. With other mental health diagnoses, the evidence clearly supports the involvement of parents and caregivers in treatment, rather than the youth client alone.

Due to these issues, psychiatrists typically need to refer families back to their medical organization or insurance company to find a different clinician to provide therapy. This creates an additional burden for coordination of care between providers. Concurrently, youth continue to struggle with behavioral or psychological difficulties. This ultimately may lead to several negative outcomes, including parental stress, deterioration of caregiver relationships, additional stress on siblings and the family system, repeated trips to the emergency room, psychiatric hospitalizations, over-prescribing of medication, and, potentially, youth suicide.

Most mental health providers want to do the right thing for children and families, but are not given the degrees of freedom to provide care in a way that is empirically supported. The result is that children and families receive sub-standard treatment for months to years, with limited improvement in functioning. Families, insurance companies, and county mental health systems invest countless dollars and time with minimal returns. Clinicians may begin to feel burned out, and both providers and consumers of mental health become frustrated with our existing system.

To begin to address concerns about access to treatment, we have implemented several strategies. BACA has contracted with insurance panels, which is uncommon for most mental health providers in private practice. We offer financial aid and scholarships to those in need. We developed an innovative Intensive Outpatient Program (IOP) to facilitate access to appropriate levels of care. IOP offers youth and families an alternative to inpatient psychiatric hospitalization and a transition for those who need more support than can be provided in a typical outpatient setting.

Since 2007, BACA has provided innovative mental health services to youth and families from across the Bay Area. While many large medical organizations and academic medical settings are unable to easily adapt their system of care due to organizational demands, BACA remains a lean, nimble organization, not stymied by political issues, academic advancement, or bureaucratic delays. Due to the apparent need for youth-focused mental health care in the East Bay, we sought to expand our clinic reach beyond our existing location in West San Jose. We now have clinic locations in San Jose, Oakland and Menlo Park and are looking forward to exploring new sites as well.

Get involved!: As Gandhi said, “Society can be judged by how it treats its least fortunate members.” Children with mental illness are among the least fortunate members of our society. The quality of their health impacts themselves, their families, and our communities. We believe that our society cannot continue to turn a blind eye to the needs of youth and families with mental illness.