Mar 22, 2023 - News

California proposals seek to address mental health crisis

Illustration of the California State Capitol with lines radiating from it.

Illustration: Brendan Lynch/Axios

State and city officials are pushing for bills and ballot measures to address the shortage of space at facilities for those struggling with mental health issues and substance abuse disorders and improve treatment options for those who need it.

Why it matters: The state faces a shortage of 6,000 beds to care for patients with mental health disorders, the Los Angeles Times reports.

  • Meanwhile, mental health and addiction cases accounted for one-third of all inpatient hospitalizations and one-fifth of emergency department visits, according to the office of California Assemblymember Matt Haney (D-San Francisco).

What's happening: Gov. Gavin Newsom this week proposed a 2024 ballot initiative that would raise at least $3 billion through a bond to build new mental health facilities and create housing for unhoused veterans.

  • The ballot measure would also redirect $1 billion from an existing income tax on wealthy people to operate those facilities.
  • Newsom, in a press release, said the initiative would create thousands of new beds in residential facilities, calling this "the next step in our transformation of how California addresses mental illness, substance use disorders, and homelessness."

By the numbers: The number of psychiatric beds per 100,000 people in California decreased 31% from 1998 through 2017, according to the California Health Care Foundation.

  • California's need for psychiatric beds is expected to grow by 1.7% by 2026, according to a 2022 study in the National Library of Medicine.
  • In San Francisco, 52% of unhoused people suffer from mental health issues and/or substance use disorders, according to the city's 2022 homelessness count.

Last month, Haney introduced a bill to improve staffing for mental health and addiction emergencies at general facilities.

  • The bill, AB 1001, would mandate each general emergency department have at least two registered nurses with experience providing psychiatric care and one staff member licensed to provide psychiatric care.
  • There would also need to be at least one other staff member, such as a licensed clinical social worker, who can respond to the psychosocial needs of someone experiencing a mental health crisis.

What they're saying: "California is experiencing a mental health and addiction crisis and the first place people come to get help is our hospitals," Haney said in a press statement, noting that hospitals often don't have enough staff to care for those patients.

  • "Instead of treating people with mental health and addiction issues, we’re pushing them back onto the street," he said.

Zoom in: San Francisco District Supervisor Rafael Mandelman supports Newsom and Haney's proposals.

  • Over the weekend, Mandelman tweeted that Newsom's proposal is "a significant step toward more direct State responsibility for the humanitarian crisis of untreated mental illness and addiction unfolding on our streets."
  • At yesterday's Board of Supervisors meeting, Mandelman introduced a resolution supporting AB 1001.

What's next: Newsom's office plans to work alongside lawmakers to get the measure on the November 2024 ballot. Before it appears on the ballot, the measure would need the approval of each chamber of the state legislature.

  • As for Haney's bill, it needs to go through the full legislative process in the state legislature.
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