.Mental Health Advocates, Patients and Practitioners Say No to SB326

When Kelechi Ubozoh needed a fresh start and a safe place to land and recuperate after dealing with trauma and a suicide attempt, she sought refuge in California a little over a decade ago. “The Mental Health Services Act, also known as Prop 63, changed my life. It’s the reason I moved to California,” Ubozoh says. “It funded peer and community-based innovative solutions. I found radical ways to look at healing that were culturally responsive. I found my people.”

The MHSA, which passed in 2004, serves as a lifeline for people like Ubozoh, who are both beneficiaries of and providers of community-based peer mental health support. Funded by a 1% income tax to those with annual incomes of more than $1 million, it provides a spectrum of services including prevention, early intervention and training for effectively supporting the continuum of public behavioral health.

Now, as Sacramento lawmakers aspire to push through Senate Bill 326—a bill purporting to modernize the MHSA by redirecting funding to prioritize a subsection of California’s growing unhoused population dealing with mental health and substance abuse issues by building 10,000 new beds in treatment centers and facilities—Ubozoh is part of a growing group that fears California will no longer live up to its reputation as a safe haven.

Parties on all sides seem to agree that the intention behind the $4.68 billion bond measures SB326 and AB531—proposed by Gov. Gavin Newsom, Sen. Susan Talamantes Eggman and Assemblymember Jacqui Irwin to build 10,000 new beds in California treatment centers and facilities to help unhoused Californians impacted by severe mental health and substance use issues—is positive.

But the sentiment among opponents is that SB326 is a shortsighted band-aid approach to a complex problem that threatens to unravel the peer and community-run programs keeping many Californians afloat, by focusing only on a subsection. And the numbers just don’t add up. Here’s why: California is home to the vast majority of unhoused people in the United States, with estimates ranging from 115,000-170,000 people. It’s also home to 1,243,000 adults with serious mental illnesses, 396,000 youth between the ages of 12-17 struggling with depression and as many as one in six youth between the ages of 6-17 struggling with a mental health disorder.

Ubozoh, one of dozens of opponents who showed up at one of the informational hearings in August, spoke during the hearing, but says that simply wasn’t enough. “There is a difference between a listening session where policymakers listen to the concerns of stakeholders and co-creation of policies,” Ubozoh says.

“Unlike the Mental Health Services Act, which had the active participation of all stakeholders—particularly mental health clients and their families in its development—SB326 was drafted without meaningful involvement of mental health consumers. ‘Nothing about us without us’ is a disability rights and mental health consumer-movement slogan that means no policy changes should be decided without the direct participation of members of the group that will be affected. This policy has been all about us without us, and has had no representation from unhoused communities,” she continues.

Tiffany Elliot, a project manager with Painted Brain, a peer-run organization providing community-based solutions through arts, advocacy and enterprise, is also involved with the Medi-Cal Peer Support Specialist Training program, which empowers people who have been impacted by mental and health challenges, trauma and interpersonal violence to support peers after completing an extensive, multiple-module program. As a person who lives with PTSD and physical disabilities and who has benefited from the peer-run program and now works within it, Elliot has many concerns about SB326, starting with the pacing.

“When I made my public comment, I questioned the rush,” Elliot says. “This isn’t a crisis that came up yesterday. The crisis with homelessness has been going on in California for a long time. There is room to get the voices of people impacted by homelessness, those affected by mental health challenges and those who’ve experienced 51/50s or 52/50s—involuntary mental health hospitalizations. Get those voices heard, especially by people with disabilities, people who are Black, Indigenous, people of color, people with disabilities. Our anthem in the peer movement is: ‘Nothing about us without us.’”

Elliot says that even if it’s complicated, there needs to be an individualized way of addressing mental health. “Programs like the Care Act, part of Care Court, aren’t looking to conserve people forever,” she says. “If someone who doesn’t want to take medication is forced to take it, as soon as they’re out of the program, they are going to turn away—not only from the medication but from the mental health care system in general.”

Elliot shared a breakdown of how funding under SB326 might change things. This bill raises the administrative cost from 5%, which it currently is under the Mental Health Care Act, to 10%. Of the remaining funds, 35% will be earmarked for the housing initiatives, which she says lacks specificity. The remaining funding will be used to help with mental health and co-occurring substance challenges.

With nearly 1.5 million Californians struggling with severe mental health challenges and likely many more with more moderate forms, Elliot says organizations will be placed in an impossible predicament. “A lot of these nonprofits are led by people of color,” she says. “This one is. Black Men Speak is another organization that came to the capital. There are so many amazing organizations whose funding will be in jeopardy. There’s not going to be much funding left over to support community agencies provided by non-county sources. We’ll be tasked with doing 125% of the work with 65% of the funding.”

Julia Ford has experienced addiction, homelessness and recovery. Even before Ford began her own recovery program, she connected with the Healthy Babies Project, a program started by Majeedah Rahman, a former Black Panther, to help mothers struggling with addiction get the resources and support they needed to care for their children. Although Ford’s four children are now in their 30s and 40s, she still speaks highly of that organization for giving her a different outcome. She was living in a bus, courting the idea of recovery, when she was arrested.

“I went to a place called Shepherd’s Gate, where I had to work a 12-step program and scrape all the way to the bottom of my trauma that brought me all the way to when I was 17 years old, when I was sexually assaulted,” Ford says. Although gearing up on her own to get back on her feet with the help of a program, an Alameda court judge mandated she do it. “I had forgotten all of that. I was working the program at Shepherd’s Gate, getting better and saying, ‘I brought myself here.’ When I went back to court, the judge didn’t even recognize me. He told me he didn’t recognize me, and he closed out my case.”

Twenty-five years later, Ford is still going strong. She might not have a formal peer certification, but she offers advice and referrals to the spaces that changed her life and the lives of her children. She’s not opposed to court care, but she’s a huge proponent of self agency. “I think intervention can be helpful,” she says. “If people have 30 days with access to food, water and shelter, [which] allow[s] them to have a clear brain, many people would choose to be sober if they’re able to work the program, and be honest with themselves and deal with their adverse childhood experiences.”

That said, Ford recalls not having anyone to lean on after she was victimized as a 17-year-old child. She now wonders how her outcome might have been different if she’d had access to a community resource after that happened. “My mom was loving, but I didn’t know how to tell her that someone tampered with me,” she says. “I didn’t want to tell my brother because he would’ve wanted to harm the person who harmed me. So I kept it to myself and didn’t deal with it until the recovery program.”

Although Ubozoh and Elliot have never met Ford, her story represents the dichotomy of the state of mental health in California, and likely the nation as a whole. From this vantage point, it’s plausible that if the 17-year-old Ford had a safe community space to turn to, she might have healed instead of using substances in the first place. “If we don’t have culturally informed and accessible resources and interventions for support that meet people where they’re at,” Ubozoh says, “we’ll have more crisis situations, and the problem[s] will be even bigger.”