San Francisco OKs Expanding Involuntary Mental Health Treatment

SAN FRANCISCO (CN) – San Francisco leaders approved a controversial measure Tuesday that will empower city health officials to force certain people with mental health and drug use problems off city streets and into treatment.

“I believe we have a duty to help the most vulnerable in our city struggling with mental illness and substance use disorders,” San Francisco Board of Supervisors President Norman Yee said Tuesday before the proposal was approved in a 10-1 vote.

The ordinance, supported by Mayor London Breed, will expand a legal process known as conservatorships through a five-year pilot program. It will allow courts to appoint a public conservator to those involuntarily detained for psychiatric hospitalization at least eight times in one year under section 5150 of California’s welfare and institutions code.

The city’s Department of Public Health estimates it will affect 50 to 100 people who were detained at least six or seven times over 12 months. The involuntary residential treatment can last up to a year.

In the city’s Tenderloin District, people perched on sidewalks injecting needles in limbs, splayed out over sewer caps soaking up steam or speaking incoherently as they dart into rush-hour traffic is an all too common scene.

Critics of the conservatorship expansion say it violates the civil rights of the city’s most vulnerable population and gives police officers enhanced power to recommend certain people be forced into treatment. 

San Francisco Supervisor Shamann Walton, who voted against the proposal, said he was particularly concerned with its impact on people of color.

“What can we try to do to mitigate the fact that any time we take freedoms away from populations, it’s typically black people and people of color,” Walton asked. “I haven’t gotten any response from the Department of Public Health in terms of what they would even try to do to mitigate that fact.”

To alleviate some of the concerns raised, the ordinance was amended to include requirements that one must refuse voluntary treatment and housing assistance before they can be compelled into treatment.

Supervisor Rafael Mandelman, who co-sponsored the legislation, also added requirements to track data on how many people are placed in conservatorships and how many are initiated by police officers. The first report will be delivered to the mayor and board of supervisors after six months.

Representing the city’s Sunset District, Supervisor Gordon Mar said the conservatorship expansion should be part of a broader strategy to address the city’s mental health and drug addiction crises.

The city spends nearly $400 million a year on mental health services, serving about 30,000 people through 300 programs with 2,000 mental health beds. In April, the mayor announced plans to add 100 residential treatment beds to the city’s behavioral health system.

Several supervisors are also proposing a ballot initiative this year that would guarantee universal mental health services for all city residents.

The mayor’s office did not immediately respond to an email seeking comment Tuesday afternoon, but as a sponsor of the legislation Breed is expected to approve the conservatorship expansion. It will require one more vote of approval by the board.

Also on Tuesday, the board voted to close the city’s 150-bed juvenile hall, which is typically less than a third full while the annual cost of incarcerating a child rose to $374,000 in 2018. The juvenile hall is set to close by December 2021 as city officials work on developing alternatives to incarceration.

%d bloggers like this: