San Jose mayor supports state mental health reforms

San Jose Mayor Matt Mahan is voicing support for reforms to the state’s Mental Health Services Act, which targets those with severe mental illness and are homeless.

The plan—first announced by Gov. Gavin Newsom in March—includes putting a new $4.68 billion bond measure on the 2024 ballot to fund more behavioral health beds and carve out a third of the revenue from the state’s Mental Health Services Act (MHSA) tax to fund housing for those coping with mental illness and substance abuse.

Mahan announced today he believes these reforms will help provide the severely mentally ill with both the housing and supportive services they lack. But local children’s advocates have concerns the program could divert funds away from children and youth, since it reworks how counties must allocate funds from MHSA.

“(Addressing homelessness) is literally the community’s No. 1 priority, particularly for those who are suffering the most and for whom housing on its own is not sufficient,” Mahan told San José Spotlight. He is currently forming a coalition with other California mayors, county supervisors and state leaders in support of Newsom’s plan. “This is really about investing in evidence-based approaches for those who have an acute need for behavioral health treatment.”

Newsom’s plan includes funding 10,000 new residential treatment beds. It is now going through the state Legislature, where Sen. Susan Talamantes Eggman of Stockton and Assemblymember Jacqui Irwin of Thousand Oaks introduced two bills—SB 326 and AB 531—to require the new beds and changes to how counties allocate revenue from MHSA. Two-thirds of the Legislature needs to vote in favor of the bills for approval, and if passed, the bills will be combined into a single ballot measure for voters in March 2024.

The original Mental Health Services Act, Prop. 63, was passed in 2004 and created a 1% tax on residents earning more than $1 million. The revenues went toward providing mental health services.

Newsom’s new plan would change the current law to allow counties to spend 30% of the funding they receive from the tax on housing people with mental illness or substance abuse issues, while also ensuring counties use funds on treatment programs. It would also allocate funds for early treatment for young people with severe mental illness.

Eva Terrazas, chief public policy officer for Pacific Clinics, a nonprofit provider for behavioral and mental health services, expressed concern that the new language in the reform bills erases the funding requirement from MHSA to be specifically allocated to children, ages 25 or younger. She said this could have consequences for counties across California, including Santa Clara County, by making it trickier to prioritize and dedicate funding to prevention and early intervention youth services.

“(If) there is no dedicated (funding) set aside for children, (we) are concerned that children will be left out of some significant fundings in the future for behavioral health,” Terrazas told San José Spotlight.

This is just one of several reforms Newsom has pushed. The governor unveiled the controversial CARE Court last year. The program targets individuals with untreated psychosis and severe mental illness through intervention, medication, housing assistance and mental health directives. Santa Clara County is required to implement the program starting in 2024. It has faced opposition and skepticism from San Jose and county leaders who worry about its lack of a housing component and that it will disproportionately affect homeless populations.

Mahan’s support for Newsom’s agenda comes as Santa Clara County continues to deal with an ongoing mental health and substance use crisis of its own. The county declared a mental health emergency in January 2022, citing an increase in suicides and drug overdoses, a shortage of treatment beds and the overuse of prisons as treatment centers.

The county is already slated to open a new 28-bed residential treatment center at 650 S. Bascom Ave. this fall to help alleviate a need for further stabilization following acute psychiatric care services. The county is also opening its first facility for children and adolescents with acute psychiatric needs. The facility, set to open in 2025, will be a 207,000-square-foot behavioral health building at Santa Clara Valley Medical Center that will house 77 beds, including 14 for children, 21 for teens and another secure segment for 42 adult beds.

Mahan said this new effort is about prioritizing more acute cases, and while this might come with some trade-offs, this is what should be done to help address severe mental illness.

“There’s a lot of collaboration and progress going on on that front to make sure that other populations that need access to health care aren’t negatively impacted by making this investment,” Mahan said.

Contact Julia Forrest at [email protected] or follow @juliaforrest35 on Twitter.