Ending Systemic Inequities through the Behavioral Health Racial Equity Collaborative (BHREC) Model
CIBHS recognizes that behavioral health inequities are deepening as national and local crises in housing, education, and income continue to disproportionately harm Black, Indigenous, and Latinx communities.
Federal immigration policies, increased Immigration and Customs Enforcement (ICE) activity, and widespread misinformation have generated fear that directly impacts well-being, family stability, and willingness to seek services. For many, particularly those who are undocumented and mixed-status, routine activities such as accessing health care, attending school meetings, or engaging with public systems are now perceived as harmful and life threatening.
Amid this mounting distress, community members and providers alike are signaling that current tools and supports are no longer sufficient to meet the scale and complexity of the trauma unfolding in real time. In response, CIBHS identified the need to move beyond knowledge-based training toward deeper, systemic change. Systemic behavioral health equity requires all communities to receive what they need to achieve optimal emotional health and wellness.
Five years ago, CIBHS partnered with the Sacramento County Division of Behavioral Health Services to implement the Behavioral Health Racial Equity Collaborative (BHREC) model. Originally developed in 2020 to meet the needs of the African American/Black/African Descent communities in response to the murder of George Floyd.
Generative Equity
Actively creating the conditions where equity continuously grows and sustains itself over time.
The model has since demonstrated its ability to adapt to the priorities of any underserved and marginalized community. Grounded in the principles of generative equity—actively creating the conditions where equity continuously grows and sustains itself over time—the BHREC model moves beyond traditional support or training to build lasting value within communities.
It is a proactive, localized capacity building collaborative designed to meet community needs in real time and support providers to respond to these needs with community defined and evidence-based practices, quality improvement tools, practical community-led guidance, and ongoing peer support that strengthens the work of providers and the communities they serve.
At a time when traditional service models are overwhelmed by the scale and complexity of trauma, the BHREC offers a different path forward. CIBHS adapted the BHREC model specifically to meet the urgent needs of the Latinx community in 2025 launching a new Latino/Latinx/Latine/Hispanic BHREC that served 19 behavioral health care providers in Sacramento County. In our 2026 BHREC for the same community, our provider teams have grown to 26 with a combination of mental health, substance use disorder, and community service agencies. This increased participation underscores how timely, needed, and urgently welcomed this work is—and we are eager to share its impact with the world. This is a model that can be scaled with communities and providers throughout the nation.
BHREC grew 37% from 2025 to 2026
Increase participation from Mental Health and Substance Use Disorder Providers, and Community Service Agencies
The Power of the BHREC Model
Unlike traditional “one-off” trainings or passive webinars, the BHREC model is designed to move providers from awareness to action. Traditional training often delivers information in isolation, leaving organizations to independently figure out how to apply what they’ve learned. In contrast, CIBHS’s proprietary BHREC approach emphasizes continuous engagement, shared problem-solving, and peer-based iterative learning—allowing providers to adapt quickly as conditions change.
The 2026 Sacramento Latino/Latinx/Latine/Hispanic BHREC is built on six core components:
Targeted Technical Assistance
Expert guidance on policy, legal, and systemic factors impacting Latinx communities, including immigration-related behavioral health stressors.
Peer-to-Peer Learning
A structured environment that breaks down silos, enabling providers to share practical strategies, challenges, and successes emerging from frontline work.
Hands-on Coaching
Direct support that moves beyond theory, helping organizations translate concepts like cultural humility, trauma-informed care, and equity into daily practice.
Cultural Humility and Responsiveness
An explicit emphasis on understanding community context, lived experience, and trust-building—not just policy compliance.
Implementation Science Framework
Our model is intentionally designed to support sustainability—so new practices “stick” and become part of an organization’s operational DNA.
Facilitated Breakthroughs
CIBHS leads structured brainstorming and collective problem-solving to break through complex logistical, legal, and systemic barriers.
Adapting the BHREC Model to Support Communities Amid Rising Immigration-Related Harm
Like many behavioral health providers across the country, providers in Sacramento are deeply committed to supporting immigrant clients, yet increasingly unequipped and understaffed to respond to the cultural, psychological, ethical, and legal complexities created by external immigration enforcement pressures. Providers are asked to navigate questions around community trust, confidentiality, documentation, safety planning, and trauma-informed care—often without real-time guidance or peer support. Traditional cultural competence trainings, while valuable, are not designed to respond to rapidly evolving external threats or to support providers in translating knowledge into practice under crisis conditions.
Prior to launching the Latinx BHREC, CIBHS conducted on the ground research to inform the focus and approach of the work. Grounded in insights from seven focus groups conducted between March and July 2024, the BHREC is informed directly by community voice. Data from the focus groups was analyzed using a thematic approach adapted from the Community Readiness Model (CRM), elevated lived experiences from monolingual Spanish-speaking adults, immigrants, farmworkers, youth, LGBTQIA+ individuals, seniors, and community members with lived experience of homelessness, substance use, public benefits, and child welfare involvement.
The findings revealed:
- Low utilization of specialty mental health or substance use prevention and treatment services despite the percentage (24%, US Census. 2021: ACS 5-Year Estimates Data) of Hispanic or Latinos residing in Sacramento County;
- The need for more bilingual BHS providers and staff to serve this community;
- The Latinx community in Sacramento is not monolithic. There is an urgent need to tailor engagement strategies and services to a community that is ethnically and demographically diverse; and
- The escalating moral injury and trauma resulting from ongoing ICE raids, deportations, and immigration-related fear have significantly disrupted families, elevated community stress, and increased the urgency for culturally grounded behavioral health support that is also rooted in evidence-based practices.
Upon launching the 2026 Sacramento County Latino/Latinx/Latine/Hispanic BHREC, community Steering Committee members—grounded in their first-hand experience and lived expertise—identified urgent needs, including fear of accessing services, pervasive disinformation and misinformation about the availability and access to services, and deep-rooted mistrust of systems shaped by historical and ongoing harms. Through a co-production process of peer learning and coaching, 26 diverse provider teams, ranging from grassroots community-based organizations to larger service systems, will co-develop and implement practical, culturally responsive strategies.
2026 BHREC Identified the Following Initial Strategies:
- Reimagining intake processes to minimize documentation-related anxiety.
- Deepening partnerships with trusted community organizations.
- Embedding culturally grounded, community-affirming messaging throughout outreach and service delivery.
These efforts are intentionally designed to shift power toward community and to ensure that services are shaped by the realities, strengths, and priorities of Latino/Latinx/Latine/Hispanic communities across Sacramento County. Provider teams will center lived experience, cultural knowledge, and community wisdom as essential forms of expertise, recognizing that trust is built through relationships, transparency, and consistency over time. Through this collaborative, providers will engage in ongoing reflection and learning to examine how policies, practices, and organizational cultures may unintentionally create barriers to access or reinforce inequities. With support from CIBHS’ BHREC, teams will test and refine strategies that promote safety, dignity, and belonging for community members, particularly those who are immigrant, mixed-status, or historically marginalized within behavioral health systems.
Collaboration as Resilience
The Sacramento County Latino/Latinx/Latine/Hispanic BHREC reflects CIBHS’s mission and commitment to advancing behavioral health equity through evidence-based, culturally defined solutions that center community voice, culturally responsive care, and lived experience. In times of uncertainty and systemic stress, collaboration is not optional, it is our greatest tool for resilience.
By investing in BHREC, Sacramento County BHS and CIBHS are responding to the most pressing needs of the behavioral health system with urgency, humility, and purpose—working collectively to ensure that all communities have an equitable opportunity to access behavioral health and wellness.
The success of this collaborative demonstrates what is possible when behavioral health systems invest in generative equity, community rooted partnerships, and real-time provider support. CIBHS’ BHREC model’s adaptability (first developed to support African American/Black/African Descent communities and now serving the Latino/Latinx/Latine/Hispanic community amid heightened trauma related to ICE activity) shows that this approach is both replicable and scalable.
Across the country, communities are facing similar waves of fear, moral injury, and structural barriers to care. Providers everywhere are signaling the same urgent needs: culturally responsive tools, peer support, real-time guidance, and sustainable equity driven practices that endure beyond any single crisis.
The BHREC model offers a pathway forward. Its core components of technical assistance, peer to peer learning, hands on coaching, cultural humility, implementation science, and facilitated breakthroughs can be implemented in counties, regions, and states seeking to transform behavioral health systems from within. By scaling this model nationally, behavioral health systems can build durable capacity, strengthen provider resilience, and create community environments where safety, dignity, and belonging are not aspirational—but expected.
The moment demands solutions that work. BHREC is one of them. CIBHS is ready to partner with communities across the nation to expand its impact.
