by Anisha Tammana
Supervisors Ronen and Haney recently introduced new mental health legislation after a long history of criticism of what has often been called a broken system. Mental Health SF will be on the ballot in November 2019, and proposes a radical shift to the system, attempting to support underserved populations in San Francisco by providing easier access to mental health care, substance use treatment, and medications.
If passed, the ordinance would create a community mental health service, establishing a working group to advise the Mental Health Board, as well as the Board of Supervisors and city departments. Called the Implementation Working Group, the members will be appointed by the Board of Supervisors to represent medical and housing professionals, as well as individuals with lived experience.
Mental Health SF would also greatly expand services to uninsured San Franciscans (“core” patients) as well as providing immediate treatment for patients without access due to various insurance-related reasons (defined as “bridge” patients). Another population served would be those exiting the County Jail, who haven’t re-enrolled in Medi-Cal.
Making treatment low barrier and easily accessible is a stated priority, according to the drafted legislation. By creating a Mental Health Service Center to centralize services, hub offering treatment, assessment. By offering services before considering eligibility for coverage, Mental Health SF would be better able to serve a wider array of vulnerable citizens.
A common topic of discussion around treatment in San Francisco is harm reduction. The legislation provides a framework for how the program will seek to customize services using the harm reduction model. According to the Harm Reduction Coalition, the principles of harm reduction include judgement-free, knowledge-based treatment that seeks to reduce the harm of drug use, rather than criminalizing it and coercing patients. Considered a more “progressive” model of treatment, harm reduction has been praised as being far more effective than traditional, often forced methods which have a history of oppressing and exploiting marginalized communities.
Services offered will include triage (prioritizing patient needs and assessing care options), psychiatric assessment and treatment by a medical professional and medication if needed, and many other essential ways to meet patient needs. The Service Center will provide a pharmacy onsite, as well as critical intervention for individuals experiencing psychiatric crises. Case management and social workers will also be a part of Mental Health SF. The crucial need for transporting patients will be met by the ordinance, with accompanied transportation from the hospital and county jail to the service center.
Aiding formerly incarcerated individuals in the re-enrollment process is a significant step towards achieving healthcare. By serving every San Franciscan, most of us hope to see Mental Health SF transform the system of care in the city.
