As the pandemic continues to threaten the physical health and well-being of many Californians, mental health professionals across the state have also acknowledged its widespread psychological impact. Although the mental health consequences of epidemics are not well documented—in part due to the rarity of these events—existing research shows an association between large-scale disasters and mental and behavioral challenges.

The threat to Californians’ mental well-being—which may stem from fear of falling ill, social isolation, job loss, or other factors—has raised concerns about a behavioral health crisis in the state. The pandemic’s psychological toll may also be exacerbated by the recent wildfire siege, which has led to evacuations and poor air quality for many residents.

Since the beginning of the pandemic, more Californians have reported experiencing anxiety, worry, and other mental health challenges. According to the US Census Bureau Household Pulse Survey, 69% of adult Californians reported experiencing any mental health symptoms at least several days out of the week between April 23 and May 5. That proportion has increased as the virus progressed through the state, peaking at 73% in the second week of July.

Vulnerable populations are more susceptible to many of the health and economic consequences of the pandemic. For example, there are stark disparities in COVID-19 mortality rates (highlighting the need for culturally competent care) and the risk of being evicted. In July, adults in California who face housing instability and food insufficiency, as well as those who have lower incomes, were more likely to report mental health symptoms than adults overall.

Mental and behavioral health services could be a lifeline for those who are struggling. Since these services are well suited to remote delivery, policymakers may consider channeling resources toward building up the state’s capacity for online medical care. Telehealth services for mental health are still fairly underutilized. In a June survey, conducted by the California Health Care Foundation, 31% of California adults said they have taken extra steps to improve their mental health since the start of the pandemic, but only 4% have sought a remote counseling appointment.

Health officials at all levels of government have recognized and started to respond to the need for safe and effective mental health services. At the federal level, the CDC has raised awareness of the increased stress caused by the pandemic, and the CARES Act includes provisions for the expansion of coverage and availability of telehealth services.

At the state level, several bills focusing on mental health and remote delivery have made it to the governor’s desk. These include bills that address mental illness in residential care facilities, require all counties to implement specified mental health programs, and require insurers to develop telehealth networks to support mental health treatment.

At the local level, several counties’ behavioral and mental health departments have provided mental health resources to residents and examined the potential strain on the public behavioral health system.

The passage of multiple bills in the middle of the pandemic signals that policymakers consider mental health an important priority. Addressing both the mental and physical well-being of Californians will be crucial as the state continues its efforts to manage the health consequences of the pandemic.