Building Behavioral Health Capacity in Every Care Team

In response to workforce shortages in licensed mental health professionals, the California Quality Collaborative (CQC), through its Behavioral Health Integration Initiative, sponsored eight individuals from collaborative participants to complete the Lay Counselor Academy (LCA) in 2025. The 14-week training equips care team members such as community health workers and medical assistants with the skills and knowledge to deliver empathic, evidence-based behavioral health support and expand access to culturally responsive services.

The LCA is designed to build frontline behavioral health capacity in  nonlicensed professionals, including community health workers, case managers and other frontline staff. Through the course, participants developed  practical, evidence-based mental health counseling skills that strengthened confidence, clarified roles and improved patient engagement.

After the LCA, CQC conducted interviews with participants and their supervisors, as well as reviewed course survey responses. Interviews with participants and supervisors showed that the LCA supported not only skill development, but meaningful shifts in mindset, scope and care delivery. Participants moved beyond task-based support toward more intentional, relationship-centered behavioral health work, while supervisors reported clearer role definition and stronger team integration.

Skills and Confidence in Patient Support

Across the organizations that participated in the LCA, which included Chinese Hospital, Community Memorial Health System, Mallu Reddy MD Inc and Sharp Rees Stealy, the LCA trainees demonstrated stronger communication, active listening and greater confidence guiding patients through behavioral health screenings with empathy and flexibility.

One physician noted their front office team member “has developed great communication skills and rapport with patients,” highlighting a shift from administrative responsibilities to direct patient care alongside clinical staff. At Chinese Hospital, one supervisor emphasized the value of skill development and capacity‑building, describing deeper, more confident patient interactions.

Participants reported increased comfort using open‑ended questions and relational techniques: one trainee entered the program unsure and fearful of saying the wrong thing but left with practical skills and a stronger sense of professional confidence. Participants demonstrated a 30.82‑point increase (on a 0–100 scale) in confidence supporting individuals with mental and emotional health challenges, translating into more grounded engagement and broader readiness across behavioral health needs.

Role Clarity, Reduced Drift

Teams consistently reported that the LCA participation clarified the lay counselor role within care teams equipping staff to engage more intentionally in behavioral health conversations while reinforcing clear role boundaries. Improved clarity supported cross‑team collaboration and shared accountability for behavioral health support, reducing uncertainty about scope while strengthening integration within clinical workflows.

The LCA not only strengthened existing roles, but also enabled staff to assume new clinical and project leadership responsibilities. One trainee is launching an initiative supporting patients with schizophrenia, while another is leading a brain health screening project that includes memory assessments and referral protocols.  In collaboration with leadership, trainees are identifying patients in need and helping design workflows that connect patients with social work or appropriate levels of care. These developments underscore the return on investment of structured behavioral health training and sustained mentorship.

From Fixing Problems to Guiding People

Participants described a meaningful mindset shift moving away from “fix” problems and toward guiding patients through reflection and emotional regulation. Grounding techniques, mindful breathing and presence became central tools, particularly during intake and crisis situations.

One participant shared:

“I’ve learned the value of just being present—not rushing to solve, but helping others become better versions of themselves.”

Across all participating sites, cultural humility emerged as a foundational principle. Trainees adopted a “know‑nothing” mindset, approaching each interaction with openness and curiosity. One participant reflected on uncovering biases around food assistance rooted in childhood experiences, noting that the course reinforced how assumptions shape care and how self‑awareness is essential to effective behavioral health support.

Why This Matters for California

California faces a persistent behavioral health workforce shortage, rising demand for services, and deep inequities in access, particularly in community‑based and safety‑net settings. The LCA demonstrates a scalable approach to expanding behavioral health capacity by equipping trusted, nonlicensed frontline staff with practical, evidence‑based skills.

By strengthening confidence, clarifying roles and supporting integration within care teams, the LCA helps organizations respond to behavioral health needs without relying solely on licensed clinicians. This model aligns with California’s goals to improve access, advance equity and build a more sustainable behavioral health workforce, especially in underserved communities where trusted relationships are critical to engagement and outcomes.