Silicon Valley mental health crisis team at risk of losing funding

People are seeking out Santa Clara County’s non-police mental health crisis team more than any other response program. But it’s about to run out of money.

County leaders are looking for ways to keep the Trusted Response Urgent Support Team (TRUST) program alive after state funding — which gave the program four years to evolve since launching in 2022 — expires in November. One option is to boost billing for the program’s services under Medi-Cal. But Gov. Gavin Newsom wants to make mobile crisis services an optional benefit under Medi-Cal, which could slash reimbursements to cover only 25% of TRUST’s annual budget, compared to 36% today, according to county officials.

County reports going back to 2024 consistently show more calls going to TRUST than the county’s other crisis support programs that involve police to varying degrees. The most recent report published this week shows TRUST received 1,484 calls from January to March, and saw the highest amount of calls resulting in someone’s “stabilization” and being linked to resources — at 94% of all calls over that time period.

Compare that to the county’s Mobile Response Stabilization Services unit, which received 842 calls over the same time period. The county’s Mobile Crisis Response Team (MCRT) received 847 calls and the Psychiatric Emergency Response Team (PERT), which has one Crisis Intervention Trained (CIT) police officer and clinician dispatched by 9-1-1, received 122 calls. County funding for the PERT program ended on Dec. 31, but Santa Clara and Palo Alto are funding their own PERT programs.

Despite its high call volume, opinions on TRUST’s overall progress vary. Sharon Watkins — whose 23-year-old son was fatally shot by San Jose police in 2015 while he was having a mental health crisis — has long advocated for TRUST. She said she doesn’t want to see funding go away, but has issues with how the program has evolved.

“One of the issues I have with TRUST is they don’t have a clinician all the time to declare a 5150,” Watkins told San José Spotlight, referring to a section of the state welfare code authorizing an involuntary 72-hour hold for someone in a mental health crisis.

TRUST teams have trained staff members on scene to stabilize someone in a mental health crisis before involving law enforcement. If it escalates, county policy requires TRUST workers to defer to the MCRT to conduct a 5150 assessment or law enforcement.

“There have been hiccups along the way,” Corina Cardenas, a TRUST advocate and organizer with Silicon Valley De-Bug, told San José Spotlight. “I do know there were also questions about two different teams arriving at the same location. If TRUST is dispatched and (the MCRT) arrives first, what happens to TRUST’s ability to bill? Can both entities bill? That’s been a source of confusion.”

A spokesperson for the Santa Clara County Behavioral Health Department said crisis response contractors’ payments are not tied to individual calls.

Cardenas said the program can’t evolve without a steady funding source and  Newsom’s proposal is going to impact not just TRUST, but the other non-police crisis response teams as well.

“I think that should be concerning for everyone,” Cardenas said. “We really want TRUST to succeed and I don’t think the governor cutting this realizes how many families he’s going to affect.”

Representatives for Newsom’s office didn’t respond to requests for comment.

Santa Clara County leaders say they’re committed to finding a path forward for the program.

“We are strongly advocating that the state protect critical funding for mobile crisis response in 2027 so that we can continue to provide this effective, highly responsive form of care for our community,” County Executive James Williams told San José Spotlight.

Funding on the ropes

The funding issue also comes amid a brewing fight between county officials and the leaders of the county’s largest city, San Jose. The city has for years lagged on raising the number of calls diverted to non-police intervention teams, and city officials have faced questions from TRUST advocates about their commitment to making the program work. Earlier this month, lawyers for Silicon Valley De-Bug lambasted the city for failing to do so. The lawyers said county officials have engaged in efforts to resolve the issue, while San Jose hasn’t.

“The city of San Jose has been working closely with the county of Santa Clara and community partners to raise awareness of mental health resources, including TRUST and the 988 Crisis Lifeline,” Carolina Camarena, a spokesperson for the City Manager’s Office, told San José Spotlight. “These efforts are making a measurable difference, with resident awareness up by 13% over the past year, according to recent city polling.”

The city attributed that polling statistic to its public-facing community safety data dashboard.

Camarena said the city has been telling residents about TRUST through social media, multilingual materials at community centers and library branches and with resource cards to community-based organizations.

The City Council has repeatedly directed staff to improve efforts to divert 9-1-1 calls to crisis intervention teams. But city officials have suggested the county isn’t helping enough as the primary provider of health services — while county officials have pointed blame back at the city. Mayor Matt Mahan has also been publicly skeptical of putting city money toward the program, questioning its long-term sustainability.

Representatives for Mahan’s office didn’t respond to a request for comment.

Drew Siegler, a member of the TRUST Community Advisory Board, said San Jose struggles to grasp that public safety is much more than bolstering police budgets.

“Meeting people in crisis with peer-led, non-police response is much more effective and cheaper,” Siegler told San José Spotlight. “But between San Jose underfunding the (San Jose-specific TRUST team) and Newsom’s budget proposal that would strip counties’ ability to reimburse via Medi-Cal, we keep defaulting to the more expensive, more dangerous option.”

Camarena said the city fulfilled its funding commitment, and that the program’s challenges are unresolved and related to county-contractor disputes rather than city underfunding.

“The program’s discontinuation was not due to a lack of city funding, but rather stemmed from contractual and budget disputes between the county and its service provider, including disagreements over invoicing and program administration,” Camarena said. “These issues remain under discussion between the county and the contractor.”

The issue is close to Watkins’ heart.

“Had a group like TRUST shown up when my son was having a mental health crisis, I can’t say 100% he would still be alive, but I think it would be close to 90%,” Watkins said. “I have my critiques of TRUST, but the funding shouldn’t be taken away. That’s not an improvement. You’re creating more victims.”

Contact Brandon Pho at [email protected] or @brandonphooo on X.

Story updated April 28 at 3:14 p.m. Original story published April 27 at 8:30 a.m.