The Debate Around California’s Big Mental Health Bond Measure

Proposition 1 has been promoted by local and state authorities — including Gov. Gavin Newsom — as a crucial part of California’s plan to address mental health and substance use issues in the state. But while supporters and opponents of the measure agree the state needs more money for mental health treatment facilities, supportive housing and more, they disagree on how to best use that money.

Proposition 1, which could have far-reaching implications for the future of California’s behavioral health system, aims to expand access to behavioral health care by opening up more than $6 billion in bonds and reorganizing how existing funding is organized.

Some mental health advocates see it as a must for modernizing California’s behavioral health infrastructure and making it work for people who are most vulnerable.

Others are concerned that the measure, if passed, would lead to service cuts and more locked psychiatric facilities, which they say are unnecessary for treating people living with mental illness.

“For years and years and years the mental health system has been underfunded,” mental health advocate Karen Vicari told LAist. “It’s not a solution to move money around.”

‘Moving money around’

Proposition 1 has already gained strong support from officials and elected officials in Los Angeles, including county Supervisor Hilda Solis, Sheriff Robert Luna and L.A. Mayor Karen Bass.

According to Newsom’s office, the measure would make bond funds available for supportive housing “where over 11,000 Californians with the severest mental health needs can live, recover, stabilize and thrive.”

The proposition would also reallocate billions of dollars generated every year by the Mental Health Services Act, the so-called “millionaires tax” passed by California voters in 2004. It imposed a 1% tax on people earning $1 million or more annually, money that now funds a large portion of the state’s public mental health system.

If Proposition 1 passes, one of the biggest changes would require counties to spend 30% of Mental Health Services Act dollars on housing programs. That could mean less money for community-based organizations and possibly reduced county staffing, according to the California State Association of Counties and other groups.

“It’s going to directly result in service cuts, this huge funding diversion,” said Karen Vicari, interim public policy director for Mental Health America of California.

Opponents of Proposition 1 argue that it would also drastically reduce funding counties have available for preventive services and divert money from peer-support centers, outpatient clinics and mobile crisis teams.

“For years and years and years the mental health system has been underfunded,” Vicari said. “It’s not a solution to move money around.”

But longtime mental health advocate Teresa Pasquini, whose son lives with a serious mental illness, said it’s time to make substantial changes — particularly in funding — to public mental health care.

“The way the money has been used has not been properly tracked, and it’s not been going to the population that I believe that voters intended it to go for, which was the most gravely disabled and seriously mentally ill of the public system,” she said.

‘Rectifying policy’ or ‘exacerbating the issue’?

California has long been in need of thousands more mental health and substance use treatment beds. Some say Proposition 1 would go a long way to meet those needs.

“This is a measure to rectify policy that was done 50 years ago, when it was decided that we didn’t want to keep people in institutions, we wanted to have community-based facilities and we never delivered on that commitment,” Bass said during a news conference earlier this month, making the launch of the Proposition 1 campaign.

Proposition 1 would open the door to nearly $3 billion in funding for voluntary and involuntary behavioral health treatment facilities, according to the California Budget and Policy Center.

But some mental health advocates like Vicari, who said her sister lives with mental health and substance use challenges, say they believe locked treatment facilities are unnecessary when other options exist.

“We firmly believe that if people have access to appropriate, culturally competent, accessible, community-based care, we wouldn’t need all of these beds. And now we see this as further exacerbating that issue,” Vicari said.

Many have noted that for too long local jails have functioned as de facto mental health treatment facilities.

According to the L.A. County Sheriff’s Department, 40% of the total number of incarcerated adults in county jails were identified as having some type of mental health issue based on the latest count in February 2023. That’s down from a high of 41% in 2022 and up from 27% in 2017.