Mental health care without fear

If you feel stressed, afraid or low, you are not alone. Living with uncertainty about your future or your family's is heavy. Asking for help is a strong step. Many people find comfort in faith and community, and counseling can stand beside that.

This page covers counseling for adults and families. Worried about a teenager? See When your teen is struggling. This page is not medical or legal advice. Do Not Lose Hope does not provide counseling or crisis help.

Who do I call first?

Call your county line. It is the main way into public mental health care. Every California county has one; the DHCS list gives each county's number. San Mateo and Santa Clara counties both say they serve residents who have Medi-Cal or no insurance. A staff member asks a few questions about what you are going through, then helps you find the right service.

San Mateo County: Behavioral Health and Recovery Services ACCESS Call Center

• Call (800) 686-0101. TTY: 711. Open 24 hours a day, every day. The county says it serves residents with Medi-Cal and people without insurance (BHRS resources).
• Staff speak English, Spanish and Chinese. A free phone interpreter can help in other languages.
• The county runs a counseling center for youth and adults in East Palo Alto at 2415 University Avenue, Suite 301. To start there, call the ACCESS line first.

Santa Clara County: Behavioral Health Services Call Center

• Call (800) 704-0900, then press 1. Open 24 hours a day, every day, including holidays.
• Interpreters are available in all languages spoken in the county.
• The county says most of its therapy programs are for people enrolled in Medi-Cal. Not on Medi-Cal? Staff can check whether you qualify and help you sign up. The county also has a financial assistance application to help pay for services.

Can I go to a community clinic instead?

Yes. Community health centers often offer counseling along with regular medical care. Centers that get federal health center funds may not turn you away because you cannot pay. They must offer a sliding fee scale based on income and family size. If your income is at or below the federal poverty level, they must give you a full discount, though a small fee is allowed.

Find one near you with the federal Find a Health Center search. When you call, ask if the clinic has counseling or "behavioral health" visits.

In East Palo Alto: Ravenswood Family Health Center, 1885 Bay Road, offers counseling for children and adults. You can ask for it yourself, or your doctor there can refer you. Call (650) 330-7400 to ask about appointments, cost and languages. Ravenswood also has clinics in Mountain View, Sunnyvale and Palo Alto.

What should I say on my first call or visit?

• Keep it simple. You do not need to explain everything at once. You can start with "I have been feeling very stressed and I would like to talk to someone."
• Ask for a counselor who speaks your language, or for a free interpreter.
• If a form asks about immigration status and you are not applying for Medi-Cal, you can ask why it is needed and whether you can leave it blank.
• If you have to wait for an appointment, ask what you can do in the meantime.
• If cost is a worry, say so. Ask about sliding fees, financial help and county coverage.

Will what I share stay private?

What you tell a counselor is private. Federal law (HIPAA) and California's medical privacy law (the Confidentiality of Medical Information Act) protect your health records.

Your immigration status counts as medical information. In California, if a clinic or health plan learns your immigration status or place of birth, the law treats it as private medical information.

Clinics may not share medical information for immigration enforcement. The law allows only limited exceptions, such as when you give written permission, or when a California or federal court order or a valid search warrant requires it.

Some clinics must keep immigration agents out of private areas. Health care providers that receive public funds must mark the areas where patients get care as not open to the public. They may not let immigration agents into those areas without a valid judicial warrant or court order that allows it, unless state or federal law requires it.

Can I get Medi-Cal in 2026?

It depends on your situation. Medi-Cal is California's free or low cost health coverage, and full Medi-Cal includes mental health care. The rules for adults without a qualifying immigration status changed this year.

If you already have full Medi-Cal

• You can keep it if you renew on time and still meet the rules. Open and answer every letter from the county.
• If your Medi-Cal ends, you have three months to sign up again. After that, you can only get restricted scope Medi-Cal.
• Starting January 1, 2027, people the state lists with "unsatisfactory immigration status" (undocumented, DACA and other PRUCOL statuses, and green card holders in the five year wait) will get Medi-Cal through Fee for Service instead of a health plan. The state says specialty mental health and substance use care will continue through your county's behavioral health plan.
• Starting July 1, 2027, most adults ages 19 to 59 in that group will pay a monthly premium to keep full Medi-Cal. The amount is not set yet. State law says it will be $30 to $50 a month per person, and the governor will set the exact amount in May 2027 (LAO, checked October 23, 2026). Some county pages show $30, the amount set in 2025. See Medi-Cal for adults in 2026. If the premium is not paid, coverage changes to restricted scope. More: Medi-Cal changes in 2027.
• Starting July 1, 2027, most adults 19 to 59 in that group (21 to 59 for some statuses) will get dental care for emergencies only.

If you do not have Medi-Cal now

• Since January 1, 2026, most adults 19 and older without a qualifying immigration status cannot newly sign up for full Medi-Cal.
• These people can still sign up for full Medi-Cal, whatever their status: children under 19, people who are pregnant (and for one year after), and people under 26 who were in foster care at age 18. If your child is struggling, they may still qualify.
• Adults can get restricted scope Medi-Cal. It covers emergency care, pregnancy care and nursing home care. It is not the same as full coverage. Routine counseling is not on the list of restricted scope benefits. A psychiatric emergency is different: DHCS tells county mental health plans to cover psychiatric hospital care in an emergency for these members (BHIN 23-046). Ask the county line what counseling you can get. Pregnancy related care lasts through one year after birth, so ask about counseling then too.

Other county coverage in San Mateo County San Mateo County says legal status is not required for county funded coverage. Its ACE program gives health coverage to low income adults who do not qualify for other programs. The ACE page lists a $360 application fee and a $360 yearly fee, which can be paid $30 a month. To ask whether ACE fits you, and what it covers for mental health, call the Health Coverage Unit at (650) 616-2002.

Is there someone to talk to if I am not in crisis?

Yes. The California Peer Run Warm Line is for anyone living in California who wants to talk with someone who has been there. Call or text 855-600-9276, or chat at mentalhealthsf.org. It is open Monday, Tuesday, Wednesday and Friday from 7 a.m. to 11 p.m., and Thursday from 8 a.m. to 10 p.m. It is not for emergencies.

Who can help

These are public programs and community clinics. Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• San Mateo County Crisis Line (StarVista), for San Mateo County residents: mental health and substance use crisis line, 24 hours. (650) 579-0350. County crisis resources
• Other California counties: DHCS county mental health plan list
• San Mateo County BHRS ACCESS Call Center: counseling and drug or alcohol support for residents with Medi-Cal or no insurance. (800) 686-0101, 24 hours. smchealth.org
• San Mateo County East Palo Alto Community Counseling Center: youth and adults. 2415 University Avenue, Suite 301. Start through the ACCESS line. BHRS contacts
• San Mateo County Health Coverage Unit: help with Medi-Cal, ACE and paying for care. (650) 616-2002. BHRS insurance help
• Santa Clara County Behavioral Health Services Call Center: residents with Medi-Cal, Medicare or no insurance. (800) 704-0900, press 1, 24 hours. Get therapy and support
• Ravenswood Family Health Center: counseling for children and adults. 1885 Bay Road, East Palo Alto. (650) 330-7400. Counseling (ravenswoodfhn.org)
• Community health centers near you: Find a Health Center (HRSA)
• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Free and confidential, available 24/7/365. 988lifeline.org
• 211: free help finding other local services. 211