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About Mental Health

Proposition 1 would enact a key part of Gov. Gavin Newsom’s plan to get people with severe mental illness off the streets and into treatment.

It would authorize $6.38 billion in bond money to build residential treatment facilities for people with mental illness, and would divert some existing mental health tax revenue to cover addiction treatment and housing.

Members of Families Advocating for the Seriously Mental Ill and other supporters rally for Proposition 1 in Sacramento on Jan. 31.
Jessica Christian/The Chronicle

Newsom unveiled the plan a year ago, and state lawmakers passed legislation to put the measure on the ballot.

It’s the only statewide measure California voters will see on their primary ballots.

It would amend the Mental Health Services Act, which voters passed in 2004 to levy a 1% tax on people whose incomes exceed $1 million to pay for mental health services. Supporters of Proposition 1 argue the law needs to be updated to reflect the reality in California, where addiction and mental illness are often intertwined and where a huge housing shortage has driven living costs out of reach for many.

Some mental health organizations oppose the measure because they point out that it would divert money from some programs funded by the Mental Health Services Act. Newsom and his allies contend that the money needs to be shifted around to help people with the most severe mental illness who are falling through cracks in the system. They also argue that some programs funded by the act should instead be using money from other sources, including expanded funding for government-backed health insurance plans, to cover some of their costs.

Some fiscally conservative groups argue the state shouldn’t take on more bond debt to pay for construction of more mental health facilities. Bond financing allows the state to borrow money and pay it back with interest over time. The nonpartisan Legislative Analyst’s Office estimates that the state would need to pay $310 million over 30 years to cover the cost, amounting to about $9.3 billion. Opponents contend that figure could be higher if interest rates remain high.

Support and opposition for the measure doesn’t break down neatly along party lines, with each side garnering support from both liberals and conservatives.

The measure is backed by San Francisco Mayor London Breed, many unions including the Service Employees International Union California, and by mental health advocacy organizations including NAMI California and the Steinberg Institute. The measure has also won support from veterans groups. It requires that roughly $1 billion from the bond money go to housing for veterans.

Family members of people with severe mental illness held a rally at the Capitol on Wednesday to support the measure. Oakland resident Katy Polony said she supports the measure primarily because it will pay for construction of more hospitals to treat people like her son, who has severe mental illness.

“That is sunshine shining in a door that has been closed for 60 years,” she said of the prospect.

Proposition 1 is opposed by Disability Rights California, which argues it will lead to more involuntary treatment. Other opposing groups include the Howard Jarvis Taxpayers Association, which has concerns about increased costs to the state, and the League of Women Voters, which raised concerns about diverting money from existing mental health services. Opponents have also pointed to the state’s budget deficit as a reason not to take on more debt, and argue that the money diverted from existing services would be devastating.

“We believe it should be defeated for many reasons, including its devastating cuts to mental health services,” Paul Simmons, a representative for the campaign against the measure, said in a statement. “The budget situation simply makes its defeat more urgent.”

Reach Sophia Bollag:; Twitter: @SophiaBollag