Skip to main content Skip to site navigation

Elevating Marginalized Voices
Reflections from the MHSA Three-Year Plan Development

Article Doris Estremera. MHSA Manager

The Mental Health and Substance Abuse Recovery Commission (MHSARC) voted to open a 30-day public comment period for the Mental Health Services Act (MHSA) Three-Year Plan FY 2017-2020 on June 7, which identifies priorities for future MHSA funding.  The plan is a culmination of five months and numerous staff hours of facilitation, engaging and empowering well over 500 clients and family members, diverse groups, untraditional partners and communities to participate in the planning process. 

This is my second time facilitating the development of the MHSA Three-Year Plan, which has allowed for some important reflections. First, throughout the planning process I asked myself if we really were doing all that we possibly could to ensure the most marginalized voices were heard. While this helped me improve the process, tough decisions had to be made about what gets prioritized for funding, and ALL the options for consideration represent voices, lives and communities that have been historically marginalized and stigmatized. Secondly, there are groups that face additional layers of marginalization, low income, undocumented status, geographical isolation, discrimination, physical disabilities, etc. that hinder their participation.  Elevating these particularly marginalized voices became my goal for the development of the Three-Year Plan. 

“I feel honored that today we will be able to hear directly from often missing voices,” I proudly stated at the final Prioritization Session for the Three-Year Plan. I was referring to the fact that some clients would be sharing their personal stories in support of priority needs being considered for funding. There were two clients in particular I had in mind, a transition age youth receiving full service partnership services and a young woman with a dual mental health and physical disability diagnosis.

Neither showed up as planned. The transition age youth felt overwhelmed with the large number of attendees, and the young woman goes to bed early and decided this meeting was too late for her. I will continue to find ways to ensure their voices are heard.

Following are some of the efforts made to elevate marginalized voices like these, as well as recommendations for the next three year planning process that will hopefully help individuals like these have a meaningful voice at the table.


  • Created MHSA Steering Committee guidelines and conducted targeted recruitment to ensure diverse and equitable representation of voting members
  • Facilitated input sessions with 26 diverse community collaboratives, committees, councils, etc.
  • Held a pre-planning session with about 30 clients, hosted by the Peer Recovery Collaborative covering what to expect from the planning process and how to provide public comment
  • Hosted a launch session with over 120 participants and a prioritization session with over 150 participants (about a third were clients and family members), which included stories and public comments for many of the priority needs being considered for funding
  • Facilitated three strategy development session with higher need communities (Coastside, East Palo Alto, veterans community)
  • Conducted over 30 key interviews with client, community and provider representatives of MHSA-funded programs


  • Build on developed priorities, especially those not prioritized for funding
  • Facilitate focused strategy sessions with all community service areas and other high need communities
  • Prioritize a Digital Storytelling process to support individuals in sharing their stories

The MHSA Three Year Plan and a Public Comment Form is available on the MHSA website You are welcome to submit public comment by July 7, 2017 to