Mar 5, 2024 - News

Mental health system overhaul on the ballot

A ballot with a thought bubble filled in.

Illustration: Brendan Lynch/Axios

California voters today could approve an overhaul of the state's approach to mental health treatment and homelessness, creating a blueprint that supporters hope — and opponents fear — could be replicated elsewhere.

Why it matters: The measure is Gov. Gavin Newsom's answer to a chronic crisis that ranks among residents' biggest concerns in a state that is home to 28% of the country's homeless population.

How it works: Proposition 1 would let the state borrow $6.4 billion to build mental health treatment space and supportive housing for homeless residents, and allow the state to keep a larger percent of its existing "millionaire tax," with less going directly to counties.

  • It also would require counties to redistribute state dollars toward the most severe behavioral health needs — away from prevention.

The big picture: Sacramento Mayor Darrell Steinberg tells Axios that Prop 1 could become a model for addressing chronic homelessness. It prioritizes the greatest behavioral-health needs over less-urgent programs that allow homelessness to persist, he said.

  • Steinberg, who authored the "millionaire tax" as a state lawmaker in 2004, told Axios the money "has been spent in a variety of good ways … but it did not do enough for people who are chronically homeless."

The intrigue: Newsom has put his weight behind Prop 1 after the state spent $17.5 billion on homelessness-related programs from 2018 to 2022, only to watch its homeless population jump by 40% over about the same time frame.

By the numbers: The new revenue would build an estimated 4,350 homes for those experiencing homelessness or those at risk of becoming homeless.

Yes, but: California's homeless population is estimated at 181,000.

Friction point: While the measure had bipartisan support when the legislature proposed putting it on the ballot last year, a last-minute change to allow funding for facilities that involuntarily hold patients outraged some mental health advocates.

  • Proponents say it aligns with recent policy changes that have embraced compelling some mentally ill people on the streets into treatment, but others protest the constitutionality of doing so.

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