Recommendations for Designing Inclusive Stakeholder Engagement Processes for Systems IntegrationLessons from Third Sector's Work with the California Children and Youth Behavioral Health Initiative (CYBHI)

California’s Children and Youth Behavioral Health Initiative (CYBHI) is a historic five-year investment in transforming the way young people in California access behavioral health support. The state is taking a systems integration approach, bringing together often siloed departments, services, data, and funding so young people and families can access care when, where, and how they need it most. 

As health and education systems become more integrated, young people, families, and providers often experience confusion about how students’ mental health information is shared and how privacy is protected when students receive care at school. Third Sector led an inclusive stakeholder engagement process to address this and developed resources that can help key audiences better understand the laws and their rights.

Third Sector has several recommendations from this work that can support others in designing inclusive stakeholder engagement processes, especially when developing resources to address barriers to systems integration.

Start with the right framework for how stakeholder engagement will inform your work:

  • Consider Implementation Early & Often:  Focus on how stakeholders envision using processes or resources in their context to ensure final designs are user-friendly and responsive. Third Sector developed each tool both as standalones for specific audiences and also to complement each other as a suite of resources.
  • Be Intentional about Engaging Diverse Perspectives: Success requires engaging a diversity of stakeholders, from community members to system leaders. Be expansive in how you define diversity for your context (e.g., geography, gender, race, language, cultural background, organization/institution type, role). At the system level, include both administrative and direct service roles. 
  • Co-creation is Key: Community member stakeholders often experience extractive engagement processes where they provide valuable information but rarely hear how it will be used. Third Sector initially engaged stakeholders to understand challenges, needs, and opportunities. We followed up to share what we learned and again later on so they could review and provide feedback on draft resources. Stakeholders shared that they felt heard and included and were excited about the resources that were developed.

Build authentic relationships:

  • Partner with Trusted Messengers:  Third Sector worked with five grassroots community-based organizations (CBOs) across California to host listening sessions with young people and parents/caregivers. These partnerships helped us recruit participants, build relationships, create safe and trusting spaces, and enable continued communication.

    • What authentic partnership means:

      • Pay both the organization and the participants for their time and expertise

      • Co-create facilitation materials and co-facilitate spaces.

      • Debrief your learnings together and ask for feedback.

  • Meet People Where They Are: Use multiple engagement options (e.g., virtual or hybrid sessions, leverage existing meetings or events, shorter-form surveys). Conversations and focus groups are often most effective for deeper insights and context, while surveys allow you to hear from more people and introduce them to the work to invite more engagement later.
  • Consider an Advisory Committee: This is a structural way to foster co-creation with stakeholders and bring together diverse perspectives. Third Sector convened an advisory committee of health, education, and legal stakeholders, who leveraged their relationships and networks to engage additional stakeholders at key junctures. We integrated young people and parent feedback into these conversations to ensure resources for system-level stakeholders were being developed with the community’s challenges and needs in mind.

At a recent conference about systems integration for youth behavioral health, a young leader raised the need for a simple resource for parents about key privacy laws—an exact description of one of the resources Third Sector developed in response to what we heard community members wanted. 

While engaging every stakeholder is impossible, our engagement process allowed us to recognize and address common barriers. For the ongoing work of systems integration to be effective, stakeholder engagement must drive the process.

Resources will be available in 2025 and will be linked when ready. Contact Will Rhett (wrhett@thirdsectorcap.org) or Michael Berton (mberton@thirdsectorcap.org) for more information about this work or to find out how Third Sector can support your state’s efforts.