Shifting how California funds its mental health system is critical to getting more people off the streets

What if we could reach each person suffering from mental illness or addiction on California’s streets and assertively surround them with the resources they need to get well and to get housed? What if we could get them a mental health therapist, a bed in an addiction treatment facility? Someone to help them find an apartment and to pay their rent?

This is not an impossible dream. To reach tens of thousands of people living in tent encampments, we must prioritize and focus the billions generated through our existing Mental Health Services Act, the millionaire’s tax I authored in the Assembly and was approved by voters 20 years ago as Proposition 63.

California needs more money for housing and more money for mental health and substance abuse treatment – all targeted for those with the most severe needs.

The effort is well underway with Gov. Gavin Newsom’s mental health system overhaul, which requires that more of the $4 billion raised annually by the MHSA is spent in a much more focused way. Thirty percent for housing, 35% for wraparound services, and the remainder for other services and ensuring children get the help they need before they suffer the worse consequences of untreated mental illness.

In March, voters will have a chance to weigh in on these crucial changes in addition to a second key piece of the governor and legislature’s agenda for behavioral health reform. Proposition 1 would modernize the MSHA – renamed the Behavioral Health Services Act – and raise an additional $6.2 billion in one-time bond funding to build more housing and treatment beds for those with the most severe needs.

Currently, the funds produced by Proposition 63 flow to counties to care for adults and children with serious mental illness. MHSA’s 20-year history and $31 billion of community-based services has saved many lives.

But the work is so incomplete.

Counties currently spend this money to help many people in need. But there has not been enough focus on identifying and enrolling the unhoused people suffering in plain view on our streets.  

The updated Behavioral Health Services Act shifts the dynamic by requiring more funding – an estimated $1 billion – to be spent on housing those with severe mental illness and substance use disorders. It expands the successful full service partnerships, the wraparound services that is the proven formula to end homelessness for thousands when combined with housing.

The law would also require the prevention and early intervention resources required by the original MHSA to be spent on proven strategies like investing in early psychosis identification so teenagers do not suffer that life-altering first break.  

In Sacramento, our city and county governments in December took an important legal step toward a more robust encampment outreach and enrollment strategy. Sacramento County pledged in this agreement to do “whatever it takes” to get people off the streets, including adding as many full-service partnerships as needed. New city-county outreach teams are working the encampments and identifying the people who qualify for this level of care.

Our agreement is a model that could be replicated by cities and counties statewide to reach more people.

Passing the accompanying bond next year to build community treatment and housing facilities will move us much closer to fulfilling the promise made by Gov. Ronald Reagan and the Legislature when they closed old hospitals and promised a decent system of community based mental health care. Closing the hospitals was the right decision. For decades the community promise was forgotten.  

The MHSA in 2004 was a major step towards upholding that promise. The BHSA and the bond has the chance to move us even closer.

Every dollar, every program, every roof, every bed, every newly trained care provider means one more person off our streets, out of the hospital, out of jail, out of a lonely back bedroom with the chance for a better life.

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