Expanding Access and Equity in Behavioral Health Care

To break cycles of trauma and displacement, our Behavioral Health programs are designed to expand access to care, reduce barriers, and foster long-term wellness for families who have been historically excluded from conventional mental health systems. By meeting families where they are (at home, in schools, in the community, and through telehealth), we center cultural identity, language, and lived experiences to build trust and engagement.

In this piece, we outline the programs and related outcomes of this work. We also celebrate our collective progress and encourage others to implement culturally rooted models of care that inspire communal relationships among families, children, clinicians, and providers.

Program Summaries

Ma’at: Culturally Responsive Behavioral Health

The Ma’at Program provides culturally responsive behavioral health approaches for all children, youth, and families in San Francisco in need, with expertise in serving those who have been historically marginalized, including Black youth and families, and those impacted by systemic inequities, intergenerational trauma, and racism. Ma’at uses a whole-person approach to deliver Afri-centric, culturally grounded, heartfelt mental health and wellness care. Many Ma’at therapists and program staff reflect the diverse identities of the communities they serve, working with youth and their families to ensure they feel seen, understood, and affirmed.

General EPSDT: Comprehensive Support for Underserved Youth

General Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) is HCN’s citywide behavioral and mental health treatment program. This program targets the specific needs of underserved youth populations, including newcomer and immigrant youth, LGBTQIA+ youth, and youth not attending school with pre-existing mental health disorders, using evidence-based practices to strengthen the parent-child relationship after traumatic events, behavioral problems, or attachment issues. HCN’s therapeutic model employs a culturally responsive, inclusive, whole-person approach to mitigate the long-term effects of traumatic events and intergenerational trauma.

Clinical Traineeship: Building the Next Generation of Culturally Responsive Clinicians

Each school year, the Clinical Traineeship prepares Master’s-level students (trainees) for future roles in mental health and clinical services through hands-on skills that support professional readiness and confidence as clinicians. This training strengthens trainees’ understanding of clinical theory within the therapeutic relationship, so they can apply it in ways that benefit the children and families served through the program. Trainees each hold a caseload of children and families in the General EPSDT and Ma’at programs and meet with children at their school sites.

Impact Findings

We measure program impact through client satisfaction, which is overwhelmingly high across participant groups. Here is a summary of recent findings, in partnership with Indigo Cultural Center, which demonstrate our Behavioral Health Services impact:

1. Positively impacted children’s well-being, self-concept, coping, and relationships. Participating youth shared that services helped them to feel safe, heard, and supported—all of which promotes positive therapeutic outcomes.

2. Improved parent-child relationships. HCN’s Behavioral Health Services not only positively impacted child outcomes but also facilitated improvements in the parent-child relationship.

3. Positively impacted family wellness by providing parents/guardians with support and community connection. Parents/guardians reported increased trust and engagement with mental health services and felt more connected to their community.

4. Relational, cultural, and programmatic dynamics strengthened engagement in Behavioral Health Services. A commitment to culturally responsive care, including cultural/linguistic understanding and genuine care, respect, responsiveness, and relational support, strengthens the healing impacts of Behavioral Health Services.

Learnings & Applications

Our experience shows that culturally responsive, relationship-based, and community-embedded supports are foundational to intergenerational healing. Youth and families consistently report that trust, safety, and clinicians’ cultural responsiveness are key to positive outcomes. These findings inform community health and wellbeing in the following ways:

• Culturally Responsive Healing: Youth and families cite trust, safety, meaningful connection, and clinicians’ cultural responsiveness as the foundation for outcomes like improved emotional regulation, stronger communication, greater confidence and resilience, and healthier family relationships.

• Intergenerational Impact: Program benefits extend beyond the child. Parents and guardians feel more confident supporting and advocating for their children, more connected to their community, and more trusting of mental health services.

• Evidence-Based Results: These outcomes align with recent research showing that culturally responsive care, including language support and care that reflects the communities served, builds the trust and therapeutic alliances that make treatment effective.

• Strengthening the Community: Partner organization staff report fewer behavioral incidents at school and stronger peer relationships, evidence that an integrated, wraparound approach reduces barriers to care and supports lasting change.

We offer our program model as a roadmap for other organizations and practitioners seeking to address disparities and break cycles of trauma. By prioritizing collaboration, cultural humility, and integrated supports, the behavioral health field can achieve more equitable outcomes and contribute to community wellness and systemic transformation.

Interested in therapy with HCN? Reach out to clientreferrals@hcnkids.org