SACRAMENTO, Calif. — Polls are open in California and when people cast their ballot they will decide on one ballot proposition: Prop 1, which aims to reform the Mental Health Services Act that was enacted two decades ago.

Prop 1 also asks voters to approve a $6.38 billion bond to fund more treatment beds and permanent supportive housing to help vulnerable people currently living on the streets. 

According to the U.S. Department of Housing and Urban Development, there were more than 181,000 homeless Californians in 2023, accounting for 28% of the nation’s total homeless population.

The bond measure would add more than 10,000 treatment beds for people experiencing a serious mental health illness and/or substance abuse issues. 

One of the main supporters for the modernization of the MHSA is Sacramento Mayor Darrell Steinberg. 

Back in 2004, while serving in the California Legislature, Steinberg authored the original MHSA, which raised taxes on Californians making over $1 million to fund mental health services.

“When I started with this, there were very few elected officials who wanted to take this on. In part, because the society wasn’t talking about this,” said Steinberg.

Addressing people’s mental health became even more personal for Steinberg when he was a state senator. His commitment to transforming California’s mental health laws deepened when his daughter suffered from a severe childhood mood disorder. He shares that she’s almost 30 years old and doing great.

Twenty years later, the Sacramento mayor says it’s time to update the MHSA in order to shift the focus to the most vulnerable people.

“The Mental Health Services Act, in my opinion, has gotten away from its original purpose. The original purpose was to focus those dollars on the homeless mentally ill and people with the most serious and persistent mental illnesses who were not getting the attention,” Steinberg said.

Prop 1 would allow the state to use revenue from the so-called millionaires tax to create more housing and increase access to support services for people experiencing mental health and substance abuse issues. 

“I think people feel — and rightfully so — that we have a broken mental health system,” Steinberg said. “How to fix it? Make sure that the money is aligned with the need and now we have more sources of money and now we match it to where the need is.”

Multiple mental health groups are opposed to Prop 1 because of cuts it would make to community-based mental health services.

“This is going to be devastating to our mental health system. Thirty percent of funding is diverted away from community-based services. People are going to lose services. People are going to get hurt,” said Karen Vicari, the Interim Director of Public Policy for Mental Health America of California. 

Steinberg indicates both the legislature and Gov. Gavin Newsom have made investments in the mental health space over the last few years, so diverting the MHSA funds would not be as disruptive to services. 

“We have something now called Cal AIM, which is the Medicaid reform. It has generated over $3 billion over the last two years in California for mental health — and most of these are people with more mild and moderate conditions,” Steinberg explained. 

Steinberg adds Prop 1 is not the only solution to ending the homelessness crisis in California, but it is an important piece in helping the most vulnerable receive the treatment they need.

“Treatment instead of all these tents and so much more to help people before they become so sick that they find themselves out in the streets,” he said.

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