J. didn’t complain much when she was living in her car, despite her multiple mental health conditions and a diagnosis of stage-three cancer. At least she could lock her car doors for safety, she told me. But when her vehicle was repossessed on New Years Eve, life became unbearable. As her mental health symptoms flared, J. frantically reached out to local nonprofit, city, and county programs for help. No one even answered the phone. Only when a local parish paid for a motel room did J. avoid sleeping outside that night.
California ACLUs envision a world in which people like J. have immediate access to the voluntary care and permanent housing they require to live fully and equally in their communities, free from coercion, deprivation, and fear. Housing and health care are human rights, and affordable housing with voluntary wrap-around services is the solution to our state’s houselessness crisis. But decades of disinvestment have left California’s affordable housing and community mental health systems in shambles, unable to come close to making this dream a reality. Wait lists for subsidized affordable housing are typically years long, and sometimes over a decade long, while people are often unable to access the community-based mental health care they require to stay well. These deprivations are linked: the grinding hardship and discrimination unhoused people face contribute to the deterioration of health and mental health, increase the risk of premature death, and interfere with the effectiveness of treatment. Black people, who confront discrimination in all areas of life, are hit hardest by these inequities.
We cannot accept Proposition 1’s false narrative that the only way to solve houselessness is to take money away from other critical community-based services.
Instead of replenishing our system of care, state legislators are asking voters in the March primary to consider Proposition 1, a zero-sum initiative that pits California’s housing and voluntary community-based mental health needs against one another while taking us back to a dark era of forced treatment and institutionalization.
Proposition 1 would take Mental Health Services Act dollars away from community-based mental health programs, voluntary crisis care, and other critical mental health services to fund a small number of housing opportunities for unsheltered Californians. Moreover, the initiative is horribly inefficient. Though touted as a solution to houselessness, according to the Legislative Analyst’s Office, Proposition 1 would provide housing for only about three percent of the total number of Californians who are unhoused on any given day—while a separate, upcoming housing measure with a similar price tag would provide 20 times that amount. Meanwhile, many of the community-based mental health care programs targeted by Proposition 1 for defunding would likely disappear.
With enormous cost to taxpayers, Proposition 1 would also impose a new $6.8 billion bond to primarily fund forced treatment and institutionalization—not the community-based mental health services and housing that Californians like J. need to avoid more expensive, restrictive, coercive, and often traumatizing interventions.
What would it take to create a state in which everyone can thrive? First, voters should send a clear message to their representatives in the state legislature by voting NO on Proposition 1.
In a state as rich as California—which boasts the world’s largest sub-national economy and 5th largest economy in the world—funding sources are available.
Moving forward, Californians should demand real solutions, starting with investments in voluntary housing and care that are generous enough to end the houselessness crisis and to meet the mental health needs of all Californians—delivered in the community and on demand. These housing programs cannot be delivered at the expense of closing our community mental health programs and setting back decades of progress.
To achieve this goal, Californians should call for a fair, just, and equitable tax and transfer system. California gives away tens of billions of dollars annually in tax breaks to corporations and the wealthy instead of investing those dollars in our communities, while starving critical services for everyone else. At the same time, California’s tax policies are regressive, with our poorest community members, like J., paying a larger share of income in taxes than most other income groups when income, sales, and excise taxes are combined.
In a state as rich as California—which boasts the world’s largest sub-national economy and 5th largest economy in the world—funding sources are available. We cannot accept Proposition 1’s false narrative that the only way to solve houselessness is to take money away from other critical community-based services. California can easily raise the revenues to meet the housing and mental health needs of all our community members by creating a fair and equitable tax and transfer system.
J. was overcome with gratitude and relief when the local parish stepped in to spare her from a night on the streets. But J.’s safety and wellbeing on that bitterly cold evening should never have hinged on charity. Her harrowing experience is a reminder that Californians must come together to reject false promises like Proposition 1. We must demand tax equity and the public investments needed to create a healthy and vibrant state in which everyone is treated with dignity, and no one is left behind. This is what we owe to one another.
FAQ: California ACLUs’ Opposition to Proposition 1
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What is Proposition 1?
Proposition 1 is a Governor-led statewide behavioral health system reform that will be on California’s March 2024 ballot.
Though touted as a solution to houselessness in California, Proposition 1 would make, at most, a tiny dent in the statewide housing crisis. Proposition 1 would fund a small, inefficient number of housing opportunities for around 3% of unhoused Californians and prioritize coercive and involuntary behavioral health treatment options, while taking dollars away from community-based mental health programs, voluntary crisis care, and other critical mental health services.
Proposition 1 has two components. First, it would change the rules about how counties can spend the existing stream of funding from the Mental Health Services Act (MHSA) each year on safety-net mental health care, resulting in a net reduction in community-based and culturally responsive mental health services. Second, it would create new debt for California via a $6.4 billion bond that would primarily fund the most expensive and least effective forms of mental health treatment.
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What is the Mental Health Services Act, anyway?
The Mental Health Services Act (MHSA) was passed by California voters in 2004 as Proposition 63 and is funded by a 1% income tax on personal income in excess of $1 million/year. Considered groundbreaking in 2004, the MHSA was designed to expand and transform California’s mental health system to address prevention, early intervention, and service needs and strengthen the mental health safety net for all Californians through improvements in infrastructure, technology, and training. The MHSA creates a statewide revenue stream of about $4 billion per year, and counties currently spend 95% of those funds on programs like youth mental health education, free and subsidized outpatient programs, and non-police mobile crisis response teams. These are the types of programs that Proposition 1 would defund.
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Why is the ACLU weighing in on Proposition 1?
The ACLUs across California believe access to healthcare and housing are civil rights. California is experiencing an affordable housing and houselessness crisis. We believe Californians should demand real solutions, starting with investments in voluntary housing and care that are generous enough to end the houselessness crisis and to meet the mental health needs of all Californians—delivered in the community and on demand. In a state as rich as California, we cannot accept Proposition 1’s false narrative that the only way to solve houselessness is to take money away from other critical community-based services.
Nationally, the ACLU has historically opposed involuntary treatment and institutionalization. Our statewide Racial and Economic Justice program staff partner with our National ACLU Disability Rights Project to advance the long-term goals of reducing the institutionalization and segregation of people with mental disabilities, expanding access to community-based, voluntary treatment and support, and reducing the violence against and criminalization of people with mental disabilities.
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Why does the ACLU across California oppose Proposition 1?
The ACLUs across California believe that our housing and mental health systems need reform, but the numbers show that Proposition 1 is not likely to have any long-term impact in addressing California’s houselessness crisis, improving mental health systems, or helping alleviate mass incarceration. We are concerned that Proposition 1 will merely move some individuals from the street into institutional settings that segregate them from their communities and violate their civil rights, rather than investing in evidence-based long-term solutions to our community’s mental health and housing needs.
Proposition 1 would cause a net reduction in community-based and culturally responsive mental health services for the most vulnerable populations, and would also put at risk California’s critical new efforts to reduce contact for people in mental health crisis with law enforcement and criminal systems.
The State rushed Proposition 1 through the Legislature without sufficient data and research, failing also to engage critical stakeholders such as community providers, counties, and those who would be directly impacted. As such, this Proposition lacks an evidence-based picture of what its impact, unintended consequences, and alignment with best practice will be.
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Shouldn’t I support efforts to provide housing for unhoused Californians?
Absolutely – but Proposition 1 is not the answer. Despite supporters’ framing of the Proposition as an investment in housing the houseless, Proposition 1 will not create significant housing. According to the Legislative Analyst’s Office, Proposition 1 would provide housing for only about 3% of the total number of Californians who are unhoused on any given day. A separate housing measure with a similar price tag that voters may see on the November ballot would provide 20 times that amount.
Additionally, Proposition 1’s changes may exacerbate our houselessness crisis by shifting money away from pre-crisis support and preventative mental health care. Proposition 1 is a downstream solution, focused on treating/providing shelter for a narrow set of Californians who have been unhoused and extremely ill for a long time – and it diverts funds from upstream programs that can keep people’s disabilities from worsening and keep them from falling into houselessness. Addressing people’s mental health needs as early as possible and in their communities keeps people housed and stable. Once housing is lost it is more difficult to regain. Early and supportive mental health care is important houselessness prevention, and Proposition 1 threatens counties’ abilities to provide such care, while providing very limited housing.
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Will Proposition 1 expand mental health care in our community?
Not really – in fact, it would have some catastrophic effects. Proposition 1’s changes to the Mental Health Services Act would force mental health, housing, and substance use disorder programs to compete for funding and would cause one set of life-saving services to be provided at the expense of the other. Proposition 1’s new regulations on counties are projected to lead to a 30-50% reduction in voluntary outpatient, peer-run, and community-based culturally responsive treatment programs. California ACLUs are especially concerned about the risk to programs like non-police mental health crisis response, and diversion programs for people with mental health needs into treatment instead of incarceration.
Additionally, Proposition 1 encourages expanding ineffective, force-first approaches to mental health treatment. Instead of housing, Proposition 1’s bond measure focuses on funding about 10,000 inpatient psychiatric beds, which are typically used for involuntary treatment, and creates a funding stream for for-profit locked mental health facilities, where people with mental health needs can be placed long-term without the right to leave, consent or refuse certain treatments, or other basic civil liberties.
Forced treatment facilities are significantly more expensive than community-based, voluntary care programs, and they are also not effective long-term. People who are involuntarily hospitalized and/or warehoused in institutions typically do not recover and stabilize – when they are released, they quickly end up back in crisis or on the streets. People who feel they are being coerced into mental health hospitalization against their will are more likely to attempt suicide after being released from the hospital [Jordan, J.T. and McNiel, D. E., Perceived Coercion During Admission Into Psychiatric Hospitalization Increases Risk of Suicide Attempts after Discharge, Suicide and Life Threatening Behavior Journal (2020)].
Most people with mental health conditions and substance use disorders, and those experiencing houselessness, can live independently in the community in housing with the appropriate, voluntary support. Institutionalizing individuals who do not require that restrictive of a setting simply because that is the only placement available presents serious civil rights and constitutionality concerns.
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Despite your concerns, couldn’t Proposition 1 do some good?
Yes and no. The Legislative Analyst’s Office predicts that Proposition 1 could get 6,000 Californians off the streets, and that would be great. But the tradeoff for 6,000 people housed through this proposal is a $1-2 billion yearly reduction in funding for community-based, voluntary mental health care that doesn’t involve police, jails, force or coercion.
There are other ways to approach this issue that would house more people, more cost-effectively, and without catastrophic consequences. This includes existing proposals that have been delayed due to the vote on Proposition 1 or defeated in the Legislature. Californians are being presented a false choice – it’s not Proposition 1 vs. the status quo. Our state has opportunities to solve this issue in more effective ways; they’re just not doing it.
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What would you like the State to do about houselessness instead?
Put simply, housing ends houselessness, and housing and healthcare are human rights. Our rich but unequal state can easily raise the revenues needed to meet the housing and mental health needs of all our community members without decimating critical programs. After all, California is the richest state in the nation and the 5th largest economy in the world. Yet, the state gives away tens of billions of dollars annually in tax breaks for corporations and the wealthy —resources that should be invested in our communities.
We need tax equity, ongoing funding streams, and committed policymakers to ensure that everyone has access to the voluntary, community-based care and permanent, affordable housing they require to live fully and equally in their communities, free from coercion, deprivation, and fear. All that is lacking is political will. It will take all of us, working together, to demand a fair, just, and humane state in which everyone can thrive, and no one is left behind.
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Where can I learn more?
More information about Proposition 1 and its impacts can be found at https://www.prop1no.com/.
Issues: Racial and Economic Justice