Mental Health Services Overhaul Will Go Before Voters This Spring

California voters will be asked to reform the state’s mental health system in March, following the approval of two bills by lawmakers last week.

The bills are SB 326 (Eggman, D – Stockton) and AB 531 (Irwin, D – Thousand Oaks), which were championed by the Governor and will appear jointly on the ballot as Proposition 1. Together, they would dramatically expand the number of treatment beds for the mentally ill and change the way counties spend mental health services funds.  

Under Proposition 1, the Mental Health Services Act (MHSA) would become the Behavioral Health Services Act. A $6.38 billion general obligation bond would allow for 10,000 new treatment beds and supportive housing units — the single largest expansion in state history. Counties would be required to invest 30% of revenue from the MHSA into housing, with half of the money targeting people who experience chronic homelessness or who live in encampments. Counties could also use MHSA funds for addiction treatment services.

One of the biggest proponents of the overhaul is Sacramento Mayor Darrell Steinberg, who authored the MHSA when he was in the Legislature.

“Nearly 20 years ago, I authored proposition 63, California’s Mental Health Services Act, to help address the most serious consequences of untreated mental illness. It has done much good but can do so much more. Simply put, more of these precious resources need to be spent on a uniform set of services and strategies that address the immense suffering of people living with mental Illness who are also homeless, in and out of the criminal justice system, and having little or no chance of living full and productive lives. Thank you to Governor Newsom and Senator Eggman for championing these reforms and to the Legislature for acting quickly to place them on the 2024 ballot.”

The California State Association of Counties has expressed deep reservations about the bills. CSAC says the overhaul would reduce funding for current behavioral health services and put important mental health programs at risk — a step backwards in the fight for mental health. The requirements are too restrictive for counties, especially given the volatility of the MHSA funding stream, and they create potential unfunded mandates for counties, according to CSAC.

CSAC CEO Graham Knaus likened it to taking money “from our left pocket and putting it in our right pocket and calling it new money,” as funds for behavioral health services would be shifted to housing. The state has already spent over $20 billion on housing and homelessness in the past five years.

County supervisors from some of the state’s largest regions, including Los Angeles and San Francisco, support the effort. San Francisco District 8 Supervisor Rafael Mandelman called the reforms “long overdue.”  

Read more about the changes and their potential impacts at CalMatters.