During our Fall Advocacy Day 2025, we had a turnout of over 45 people despite the heavy rainfall. Every ROCAP was represented. About half of the attendees were medical trainees, including medical students. This was an inspirational moment because, at this rate, the future of child and adolescent psychiatry in the state will be in great hands. As we all brainstormed and strategized ways to move forward, it was very apparent that our young physicians and medical students were asking critical questions about healthcare policies. Even more impressive was the fact that they were clearly incorporating advocacy and community engagement as integral parts of their professional identities. The most pressing needs of our members appeared to be concerns about the impact of disintegrating healthcare infrastructure at the federal level, including a lack of trust in the sustainability of pre-existing policies. This has led to gaps in the delivery of care and access for our patients. We also received a lot of interest around artificial/augmented intelligence and social media use among youth and its impact on youth mental health, as well as issues related to access and its intersection with scope of practice.

We are pleased to announce that we weighed in through meetings, letters of support, and even letters of opposition on these issues in the last several weeks—namely, signing on to an amicus brief regarding enactment of the Protecting Our Kids from Social Media Addiction Act (SB 976), with the goal of protecting the mental and physical health of children; support for a CMA resolution asking for equitable access to clinically indicated standardized intelligence testing for Black students in public schools; participation in a coalition opposing the Governor’s Budget proposal to eliminate the statewide mobile crisis benefit; participation in a coalition opposing changes to SB 855; and participation in the Coalition of Associations for Behavioral Health & School-Based Providers (CABHASP), which exists to strengthen cross-disciplinary collaboration, align policy perspectives, and advance coordinated approaches to meeting the behavioral health needs of Californians, particularly children and youth.

Please let us know if there are issues that we ought to focus on. Get involved through our current committees—Government Affairs and Advocacy (GAA) and the Committee on Anti-Racism and Equity (CARE)—or consider getting a new committee off the ground.

There are approximately 200 bills of relevance to CALACAP: some of these we will just watch, and others we will take vocal positions on. We are just starting the process of digging through these policies in our Government Affairs and Advocacy Committee. These bills cover an expanse of topics, including suicide prevention, Medi-Cal insurance coverage post HR-1, and AI chatbots.

We are cosponsoring two bills this year. First, we are picking up where we left off on SB 363 (Wiener), which became a “two-year” bill at the end of the process and is eligible to move again in late summer. This bill holds health plans accountable for high rates of overturned health care denials. It unfortunately stalled late in the process after we received substantial feedback from DHCS that required additional negotiations. We have also signed on to cosponsor AB 2011 (Hart), which codifies the 2024 federal Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule into California law in preparation for any federal rollbacks.

We invite you to join us in Sacramento on Monday, May 11, to advocate on these bills and other priority legislation as part of our Spring Advocacy Day. We are excited to be partnering with Children Now and the California Medical Association, who will both join us to share updates on overlapping priorities. For our lunchtime keynote, we are honored to be joined by Assemblymember Dawn Addis, who is the Chair of the Budget Subcommittee that oversees health. You can register here.

If you have any questions about state advocacy or policy issues CALACAP should be prioritizing, please don’t hesitate to reach out to me via email at Lizzie@syaslpartners.com.

We have had significant success in cosponsoring legislation that went on to pass, including measures that limit gratuitous prior authorization requirements and reduce unjustified denials of care. While we are not able to pass all of our priorities, we were able to make meaningful progress in expanding access to care and reducing administrative barriers that delay treatment.

Equally important, we have seen continued and growing advocacy by child and adolescent psychiatrists (CAPs) at all stages of practice. This engagement is critical, as we operate within a fragmented system of care that will only become more strained without sustained advocacy and reform. There are many groups seeking to reshape how children’s mental healthcare is delivered. While many are well-intentioned, some proposals risk being short-sighted or creating unintended consequences. It is therefore essential that we remain actively engaged in these conversations and thoughtfully consider upstream causes, such as prioritizing education, prevention, and early intervention, rather than relying solely on crisis-driven, emergency responses.

The CALACAP Government Affairs and Advocacy Committee (GAA) meets monthly to review and discuss legislation identified by our lobbyist. During these meetings, we analyze each bill’s purpose, statutory language, and both its intended and unintended effects. Our discussions often reflect a diversity of perspectives, which ultimately strengthens our analysis and recommendations. These recommendations are then shared with the CALACAP Executive Committee, which determines whether to support, oppose, or monitor each bill. While the process can be complex, it is strengthened by both experienced legislative reviewers and clinicians who bring practical, on-the-ground insight into how these policies affect patient care. Notably, prior legislative experience is not required. Your expertise in clinical practice and system navigation is invaluable, and in many cases, your perspective may highlight issues that would otherwise go unrecognized.

If you are interested in advocacy, we strongly encourage you to attend a GAA meeting or participate in other advocacy opportunities, such as our spring and fall advocacy days. Expanding participation is key to ensuring that policy decisions reflect the realities of clinical practice and the needs of the patients we serve.

We are currently focused on the ongoing legislative cycle, which is the second year of a two-year session and will conclude in September. This year, we are prioritizing bills that address access to care, scope of practice in child psychiatry, and protections for youth. In addition to legislative work, we are actively engaging in regulatory advocacy, including addressing concerns about pharmacies declining to fill valid prescriptions and the limited access to ECT for youth with treatment-resistant catatonia. These issues underscore the broader need for systemic accountability and improved coordination across healthcare delivery systems.

We remain committed to advocating for a more effective, equitable, and responsive system of care for children and adolescents, and we welcome your involvement in this important work.

Some examples of the work we are doing include working with our legislative advocates in supporting and helping to create legislation that advances the health and care of our most disenfranchised and marginalized children, adolescents, and young adults.

We have also partnered with the California Racial Equity Coalition, created by NexGen Policy, to advocate and provide guidance to the California Racial Equity Commissioners. This has helped lead to advocacy in much-needed areas of child psychiatry.

We are also working on collating and creating mental health resources for families and providers to be made available on the CALACAP website. These crucial resources can be easily referenced and are available to support you and the care of your families.

We would also—if you are interested in becoming a member or sharing any mental health resources you have—please don’t hesitate to reach out to us at info@calacap.org.

I was fortunate to lead a team of child and adolescent psychiatrists in all stages of their careers. I have asked two of them to share their experiences so that others can have an idea of what the experience is like. The members I spoke with are Nanelle Jones-Sullivan, MD, from Vacaville, and John Stewart, MD, PhD, from Los Angeles. Nanelle is a “retired” child and adolescent psychiatrist who works as a court-appointed special advocate (CASA) worker, as well as with several other nonprofits that focus on community service. She’s also studying to become a horticultural therapist. John is an early-career child and adolescent psychiatrist who was finishing his fellowship at USC when he participated. He is now building a private practice in Los Angeles (Steward of Mental Wealth) and also works at Amae Health, a partial hospital program. I interviewed them separately and edited their answers slightly, with their permission. The following is a summary of my conversations with them.

Robert: What were your goals, or what led you to attend Spring Advocacy Day in Sacramento?

John: My main objective was to learn the process and, beyond that, to see whether it was appropriate to raise my own agenda. By the end of the day, I realized I didn’t want to sideline the CALACAP team’s highly intentional efforts. I wanted to see if the current methods of influencing legislation were a good fit for me.

Nanelle: I wanted to learn more about politics, especially local politics, and bills that impact how I practice medicine. I want to have an impact and understand what’s going on at a higher level. There’s a parable of The River where people are rescuing people from the river, and they’re so busy jumping in to rescue that they never investigate who is upstream throwing people into the river. Healthcare can be like that. I also thought about my own health and how legislation affects me personally. Also, living in Vacaville allows me to see how personal politics can be. You know your elected officials, and you see them in the community. I think that inspired me.

Robert: Did you feel adequately prepared by CALACAP?

John: I’m the type of person whose eyes glaze over when I encounter legalese, but the prep work our lobbyist did, both in printed materials and in training, made it feel accessible. Also, because I wasn’t the main person in my group leading the effort, this removed pressure and allowed me to adapt and join the other members of the team once I felt ready.

Nanelle: No, but I was prepared better than really needed. I think of it like skiing. At the top of the hill, it feels terrifying, but by the third or fourth run, it feels enjoyable. However, the next year I feel just as anxious at the beginning. I always feel like I’m not prepared, but it turns out I’m better prepared than I need to be. In addition, there’s always someone else there you can rely on. You don’t have to be in charge.

Robert: What was it like to share your story and experience as related to the bills and policies we supported?

John: I felt both nervous and intimidated at the beginning of the day, and as the day progressed, I became more confident in playing an active role. I started looking around the room while in the legislative offices and gathering information on how to connect with that person. I was eventually able to share personal experiences, including witnessing the state of the mental health care system through the lens of my brother’s struggle with severe mental illness, my own dependency on expensive biologics and need to have 40+ cm of my small intestine removed, and my deep love for nature in all corners of California. This helped me to connect to the offices beyond my degrees and profession. Access to health insurance is important to me and has shaped my personal life and career path so that I can maintain access to my incredibly expensive medication. “I’ve had to rely on other doctors to fight for me to retain access to my biologic treatment.” This made the issue of prior authorizations both a professional and personal priority.

Nanelle: Since retiring, I’ve been facing a chronic health problem. I felt ambivalent about sharing my personal health story because my training and practice as a psychiatrist advised against sharing personal stories. I felt more comfortable sharing my professional and community experience but found it interesting to see how my individual experience matters to others. I think doctors should know that.

Robert: Sharing both personal and professional experience is very important in advocacy. It’s interesting how people can think we are just doctors, rather than people with our own personal and family struggles. We don’t share those struggles with our patients, but it’s powerful when we share them with policymakers.

Robert: Were you anxious, and did that change throughout the day?

John: I’d had past experiences with other advocacy groups that were less than ideal, so I went in nervous but encountered many people who were not only skilled but also eager to build my skills and confidence. “As the day progressed, I realized the same skills that make it easy to connect to patients also apply in advocacy.”

Nanelle: Yes. I addressed that a little before when I said it’s like skiing. At the beginning of the day, you’re anxious, but after a few runs, you feel good. I started very anxious, but by the end of the day, I was excited and enthusiastic.

Robert: What would you want psychiatrists to know about the experience?

John: Incremental and sustainable change is just as important in government advocacy as it is in the clinic. The same skills that make us excellent child psychiatrists also apply to advocacy and to working in concert with others toward a common goal, regardless of our political affiliation. I’d also like to make clear how easy it is to show up. You can fly into Sacramento and back home on the same day, and the preparation provided by CALACAP is transformative. You meet like-minded people, and it’s not intimidating—it’s invigorating. The people I serve in my career are a big part of the reason I get up every morning, and that drive applies to advocacy in all forms.

Nanelle: I want other psychiatrists to know it’s possible to make changes upstream. With a busy practice, it can feel hopeless trying to help everyone. Knowing that we can make changes before things become overwhelming is very helpful. I also found it surprising that people wanted to know what doctors think. In our practice, we get feedback that implies we’re overly influenced by money or other factors, so it’s rewarding to hear people wanting to know what we honestly think.

I’m really glad I got to share the experience with both Nanelle and John. I feel inspired and invigorated when I’m advocating and meeting other child and adolescent psychiatry advocates. It can be easy to feel stuck in a system that doesn’t work, caught up in rescuing others from a river. It’s good to know that it’s possible to go upstream and prevent problems rather than just responding to them later. I hope others will come to Spring Advocacy Day and other advocacy events, both to keep themselves motivated and to build a better healthcare system for all.

CALACAP's Fall Advocacy Day took place on Saturday, November 15, 2025, bringing our very own Dr Dawn Sung, and residents Samantha Avila, Abyson Kalladanthyil, and Dorothy Wu, together with trainees and CAP psychiatrists from across California, despite a torrential rainstorm, to Spice Affairs in Beverly Hills for a day rich in connection, learning, and shared purpose.

Highlights included an insightful policy update from the California Alliance of Child and Family Services delivered by Selena Liu Raphael, Senior Behavioral Health Policy Advocate, followed by Byron Young, MD of the LA County Department of Mental Health, who captivated attendees with "Meeting Patients Where They're At... Literally!"-a compelling look at delivering psychiatric care directly in patients' homes. Johanna Olson-Kennedy, MD, Director of Prosilio Care, provided a timely and rigorous overview of the national landscape of genderaffirming care for minors, while Bill Arroyo, MD (SCSCAP Delegate and Adjunct Clinical Assistant Professor at Keck USC School of Medicine)offered a passionate  retrospective on a compelling decades-long career shaped by steadfast advocacy.

Under CYBHI, the state launched BrightLife Kids app (for children 0--12 and their caregivers) and Soluna app (for teens and young adults 13-25), both offering free on-demand live wellness-coach support, peercommunity forums, family therapy, wellness tools, and multilingual access regardless of insurance or immigration status. For more about state-funded programs and resources for youth and family mental health in California, visit the CYBHI website: dhcs.ca.gov/cybhi.

The day reflected CALACAP's enduring commitment to policy engagement, interdisciplinary collaboration, and advancing mental health care for California's youth. For anyone interested, CALACAP also sponsors an annual Spring Advocacy Day which occurs in Sacramento in May 2026, and offers an opportunity for participants to head to our state's legislative offices to meet with representatives, senators and their staffers to talk about selected bills that are selected each year to help advance youth mental health across California. Travel and lodging expenses are reimbursed to $500 for residents.

Then come the grueling years of medical school, followed by the even more demanding workload of residency. And through this journey, each trainee starts to realize—at their own pace—there is more to helping others than can be accomplished in a 20-minute appointment. One starts to see the patterns of poor access to care, the stigma of seeking care, the conduciveness to wellbeing of the patient’s environment, and the insufficient time necessary during an appointment to address all these gaps—especially in psychiatry. For most of us, these are themes we have become familiar with during our training as they are often highlighted in didactics and during clinical care. However, not enough attention is given to what can be done about these systemic problems outside of learning to be cognizant of them. Learning to name a problem is a great place to start; building the necessary tools to start tackling it makes the difference.

Cut to November 15, 2025, at the California Academy of Child & Adolescent Psychiatry’s (CALACAP) Fall Advocacy Day. It was my first time attending such an event, and I was excited, having received the invitation from Dr. Ijeaku, the president of CALACAP. The day started with an inspiring introduction from Dr. Ijeaku emphasizing the importance of advocacy work outside of the clinic, particularly when treating pediatric populations. I myself worked with Dr. Ijeaku during a month of outpatient child psychiatry and was amazed at the noticeable impact she was having on her patients. Not because she had a secret medication guide that I was not privy to, but because she intently listened to her patients and their families, identified the areas in which they were struggling (often without realizing it), and connected them to the resources that could help. And despite there being a scarcity of resources in the Inland Empire where she works and I train, she proved to be a fierce advocate by going above and beyond to secure these resources for her patients. Resources that her organizational advocacy has helped to make a reality. It was during these interactions that I witnessed all the education I had received about recognizing barriers to care transform into action, with a roadmap for getting there myself starting to form.

Following introductions, we had the pleasure of hearing from various speakers on current policy efforts and advocacy projects, including several UCR medical students involved in the California Medical Association who provided the room with recent policy updates. Later in the morning, we heard from Dr. Byron Young, a psychiatrist at the LA County Department of Mental Health who spearheaded a community outreach program. His talk, titled “Meeting Patients Where They’re At… Literally!”, highlighted the unique barriers that marginalized communities face when accessing mental health care and provided some creative solutions he has come across in his work. One recurring problem that he noted working in Los Angeles was high rates of missed appointments and patients lost to follow-up. In response, he established a mobile clinic to meet patients at their homes, rather than patients presenting to the office, and found significant, meaningful success in improving continuity of care. His presentation challenged the traditional practice of centralized outpatient psychiatry and offered insights into unconventional ways of practicing to increase access to marginalized communities.

We also had the honor of meeting Dr. Corey Jackson, assemblymember for District 60, which incorporates portions of Riverside County, including Moreno Valley where I reside. Dr. Jackson holds a doctorate in social work and has spearheaded several pieces of legislation to improve access to mental health services across California, particularly for adolescents and in communities with high levels of poverty. I had the joy of meeting Dr. Jackson and sharing insights into challenges I had come across while working in Riverside County. An opportunity I would not have had otherwise.

A collection of initiatives that sought to increase financial incentives for those going into behavioral and mental health professions, especially those opting to work in schools. In addition to increasing Medicaid coverage to target early intervention for both mental health and substance abuse. This work could not have been achieved without the persistence of a California senior in high school whose speech to Governor Newsom was cited to be a direct influence on the plan–further illustrating how advocacy can begin at any stage.

After a full day of learning about policy and advocacy, we split off into groups to discuss challenges our patients are currently facing. At my table, we discussed the increase in AI use for health education, which is unverified and not evidence-based. There was concern AI can lead to increasing confusion and fear regarding important healthcare initiatives. Healthcare professionals can advocate for more control of online platforms when disseminating this type of information. AB 489 was brought up as a bill that was recently signed into law by Governor Gavin Newsom that specifically bans AI developers from acting as licensed medical professionals. This experience emphasized that this work is collaborative, strategic, and rooted in awareness of local and national initiatives and legislation. What I appreciated most while engaging in this discussion is that my thoughts as a medical student were supported and encouraged–my voice was valued.

The lessons that I took away from the Fall Advocacy Day were later reinforced in an advocacy course I took at UCR with Dr. Ulrich. We examined aspects of healthcare that are often assumed but rarely taught, such as how funding is allocated, how insurance structures create barriers to care, and how new forces such as private equity and vertical integration influence access and delivery. Understanding these systems is essential, as effective advocacy begins with recognizing where change can be made. Equally important is acknowledging the power of our voices as trainees and physicians who are among the most trusted professionals. Advocacy is not separate from clinical care; it is embedded within it. Civic engagement, like voting, plays a critical role in shaping policies that influence access, equity, and ultimately patient outcomes, and is something we should encourage patients to participate in. 

Medical students and residents can participate in advocacy by staying informed on policy developments, engaging with organizations such as the APA and AACAP (and their respective local chapters of SCPS and CALACAP), communicating with legislators, and contributing to local or institutional efforts. These actions collectively drive meaningful change. Especially in child psychiatry, where patients cannot advocate for themselves, it is our responsibility to ensure their voices are reflected in the policies that shape their lives.

SCSCAP held its Spring 2026 Luncheon Meeting at Luskin UCLA on March 14. Dr. Adrian Jacques Ambrose, a child and adolescent psychiatrist, presented a fascinating talk entitled Minds in the Machine (Learning): Practical Applications and Equity & Ethical Concerns of AI in Child and Adolescent Psychiatry. Lizzie Guansona, the advocate for the California Association of Child and Adolescent Psychiatry (CALACAP), presented a California legislative update for attendees. Ms. Guansona indicated that CALACAP will soon be co-sponsoring a bill that would ensure that the federal mental health parity act is codified in California state statute.

Drs. Sabrina Reed and Chris Chamandjian have launched the second cycle of the SCSCAP Mentorship Program. This program was created to encourage meaningful professional connections between trainees and child and adolescent psychiatrists. A mixer will take place at Café Amici in Beverly Hills in June.

SCSCAP is also in the throes of finalizing its upcoming newsletter, to be issued in April.

Our leadership also represented the Northern California region at the Fall AACAP Assembly Meeting, ensuring our local priorities were discussed on a national stage. Looking ahead, we are eager to continue this momentum and are excited for the upcoming CALACAP Spring Advocacy Day to further our impact at the state level. We hope to see you there!

Recent and Upcoming Meetings
Our Spring Annual Meeting was a resounding success. We were privileged to host a lineup of stellar speakers who provided cutting-edge insights into the field and sparked engaging discussions among attendees.

Looking ahead, we are excited to host a Welcome Reception for the CAP fellows in our regional programs. This event is a cornerstone of our mission to foster a supportive community for trainees as they transition into their professional careers in Northern California.

Leadership Updates
We are thrilled to officially welcome Dr. Cory Patrick to our Executive Committee. Dr. Patrick will be serving as NCROCAP State Delegate, representing us at CALACAP. His clinical experience and dedication to the field will be invaluable as he represents our region’s interests at the state level.

As we welcome new leadership, we also bid a fond farewell to outgoing Executive Committee members Dr. John Leikauf and Dr. Roger Wu. We are incredibly grateful for their dedicated service and the significant contributions they have made to our organization and the wider psychiatric community.

Stay Connected
We plan to host additional events this coming year to keep our community vibrant and engaged. For the latest updates, resources, and to connect with the Executive Committee, please check out our recently updated website at ncrocap.org.

Thank you to all our members for your continued dedication to the mental health of children and adolescents in Northern California.

Advocacy feels different right now. It is not abstract, it is personal. Whether it is access to care, prior authorizations, the role of AI, or the impact of social media on our patients, these are things we are all navigating in real time. Increasingly, we are not just reacting to them, we are trying to shape what comes next.

I was especially struck by the reflections from Advocacy Day. That mix of anxiety at the beginning of the day and excitement by the end feels very familiar. It is a reminder that showing up, especially in spaces that feel unfamiliar, is often the hardest and most important step.

There is also a deeper thread running through many of these pieces. In our clinical work, we are often helping patients in moments of crisis. Through advocacy, education, and collaboration, we have an opportunity to influence what happens long before those moments occur. To look upstream, not just downstream.

That work is not always easy. It can be slow, sometimes frustrating, and often uncertain. But it matters.

If there is one thing I hope you take from this issue, it is that there are many ways to be involved, and they all count. Whether you are attending Advocacy Day, joining a committee, mentoring a trainee, or simply staying informed, you are contributing to something larger.
That collective effort is what will move this field forward.

Thank you for being part of it.

We’d love your input! Your feedback helps us improve our newsletter to make it more relevant, engaging, and useful for our readers. Please take a few minutes to share your thoughts — your responses will help guide future content and topics. Thank you for helping us make our communications better!