Federal and state laws mandating parity in coverage of mental and physical illness, together with expansion under the ACA of both Medi-Cal eligibility and scope of mental health services, have made more services available to more Californians. Public and private actors have devoted significant resources to expand access to care, better integrate physical and mental health care, and reduce stigma. Despite these efforts, the incidence of some mental illnesses continues to rise, many Californians still fail to receive treatment for their mental health needs, and many have poor overall health outcomes.