Santa Clara County lawmakers are recognizing that mental illness and substance abuse is contributing to a major public health crisis in the region, and they want to do something about it.
The Board of Supervisors voted unanimously on Tuesday for staff to explore a coordinated response to the mental health and substance use treatment needs of county residents.
Supervisor Susan Ellenberg, who announced the referral with Supervisor Otto Lee at a Monday news conference, said she is alarmed by the scope of behavioral health problems in the county.
“I am certain that my colleagues will all agree the current fractured system of care is unacceptable,” Ellenberg said, adding the county must consider the policy and resource barriers preventing people from receiving better care.
The referral cites a number of critical issues: a record increase in suicides and drug overdoses, a statewide shortage in behavioral health workers, along with an inadequate number of beds in treatments facilities and the overuse of prisons as a “place of last resort” for those in need of treatment.
Lee, who grew up in a household afflicted by mental health issues and alcohol abuse, said there is an urgent need to address substance use issues, especially with the prevalence of methamphetamine and fentanyl.
“This referral isn’t simply a verbal declaration—it is a call for action, and action now,” Lee said.
The board’s referral requests a series of studies over the next three months. It also declares the situation a public health crisis, identifies actions that will lead to systemwide planning to address the issues and addresses the workforce shortage in the mental health care sector. It does not propose specific funding or legislation to combat the problems. Instead, the objective is to outline a process for establishing a comprehensive treatment plan to be presented in April.
Mental health advocates supported the proposal and joined the meeting to share stories of how the current systems to address mental health care and substance use have failed.
“We have what we call a revolving door,” said Allan Kamara, president of the Registered Nurses Professional Association, describing how substance use patients are admitted into treatment, discharged and readmitted into treatment shortly thereafter. “This has been a very silent public health crisis in this community.”
Several members of the National Alliance on Mental Illness (NAMI) Santa Clara County emphasized supervisors should consider community-driven solutions as it addresses mental health needs.
“I think what we need is a model of a therapeutic housing setting, where clients can get services, live in a home-like setting, and have an opportunity to be supported, loved and get the services they need,” said NAMI member Mary Lou Snowden.
District 1 resident Sandra Asher warned supervisors that community demand for better mental health resources is high and current programs are unequipped to handle it.
“Our system of care is fragmented, underfunded and understaffed,” she said.
During Monday’s news conference, Judge Stephen Manley said the criminal justice system has become a way of warehousing the mentally ill.
“Mental illness is not a crime,” he said. “Yet our criminal justice system and our courts have been inundated with mentally ill individuals who are being held in custody far beyond the time of their sentence and are remaining in custody longer than other individuals who are not mentally ill and have committed the same crime. Our jails are turning into mental health institutions which are not their purpose and never was.”
According to the referral, over the last decade, the number of incarcerated individuals with active mental health cases rose by 63% and two-thirds of current inmates have a moderate to high need for substance abuse treatment.
While Santa Clara County approved a $233 million psychiatric hospital last February, the 77-bed facility falls short of the 969 beds required to meet the county’s needs, according to a 2019 California Hospital Association report.