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Proposition 1<\/span><\/a> on California\u2019s March 5 primary ballot <\/span>exploits widespread prejudice against people with mental health disabilities to lock up victims of California\u2019s affordable <\/span>housing<\/span><\/a> crisis<\/span><\/a> under the guise of care, while cutting funding from <\/span>effective<\/span><\/a>, voluntary, community-based mental health services. Replacing voluntary community services with involuntary institutionalization disregards evidence-based practices in mental health and substance use disorder (SUD) treatment, increases mistrust of medicine, and facilitates discrimination against the most marginalized among us. As a scholar with mental health and physical disabilities conducting research in health equity and disability studies at the University of California, I urge you to reject Proposition 1.<\/span><\/p>\n Proposition 1 follows a <\/span>series<\/span><\/a> of Newsom-endorsed bills since 2019 that erode the civil rights of persons with mental health disabilities and widen the path to institutionalization. They weaken patient <\/span>privacy<\/span><\/a> and <\/span>hearsay<\/span><\/a> protections, <\/span>create<\/span><\/a> a new <\/span>system<\/span><\/a> of mental health (\u201cCARE\u201d) <\/span>courts<\/span><\/a>, <\/span>drastically<\/span><\/a> expand<\/span><\/a> criteria for involuntary psychiatric holds and forced treatment, <\/span>allow<\/span><\/a> private <\/span>therapists<\/span><\/a> to initiate those holds, and <\/span>spend<\/span><\/a> billions<\/span><\/a> to create <\/span>several thousand<\/span><\/a> new institutional beds. Proposition 1, approved by the legislature in 2023 pending the popular vote, continues this trend.\u00a0<\/span><\/p>\n The <\/span>first part<\/span><\/a> of <\/span>Proposition 1<\/span><\/a> issues a $6.4 billion bond for buildings, not services. While less than one third of it promises 4,350 units of permanent supportive housing, the remaining more than two thirds, $4.4 billion, funds 6,800 new beds in treatment facilities. These institutional beds, which are not long-term housing, will cost California taxpayers over $646,000 each before bond interest. Worse, after the bond\u2019s <\/span>author<\/span><\/a>, <\/span>proponents<\/span><\/a>, and original <\/span>language<\/span><\/a> promised <\/span>for<\/span><\/a> months<\/span><\/a> that all the beds would be community-based, unlocked, and only for voluntary treatment, the authors <\/span>betrayed<\/span><\/a> disabled <\/span>advocates<\/span><\/a> by <\/span>amending<\/span><\/a> the bill <\/span>less than 81 hours<\/span><\/a> before passage to replace every instance of \u201cvoluntary\u201d and \u201cunlocked\u201d with language allowing forced treatment.\u00a0<\/span><\/p>\n The <\/span>second part<\/span><\/a> of Proposition 1 restructures the <\/span>Mental Health Services Act<\/span><\/a> (MHSA) into the Behavioral Health Services Act (BHSA). MHSA was <\/span>designed<\/span><\/a> by disabled people <\/span>themselves<\/span><\/a> to fund voluntary, community-based treatment programs through a tax on incomes over $1 million that generates <\/span>over $3 billion<\/span><\/a> per year. BHSA, designed <\/span>without<\/span><\/a> disabled<\/span><\/a> people<\/span><\/a>, <\/span>redirects<\/span><\/a> much of that money to cover stand-alone SUD treatment and a new housing mandate. Counties <\/span>testified<\/span><\/a> that they must <\/span>cut<\/span><\/a> existing<\/span><\/a> mental health <\/span>services<\/span><\/a> to compensate. Losing MHSA-funded services risks the mental health of Californians using them and will likely cause some to lose their homes.<\/span><\/p>\n Evidence<\/span><\/a> supports<\/span><\/a> such <\/span>voluntary<\/span><\/a>, community-based services over the involuntary hospitalizations that Proposition 1 funds. <\/span>Suicide<\/span><\/a> rates<\/span><\/a> skyrocket<\/span><\/a> after psychiatric hospitalizations, and coercion <\/span>increases<\/span><\/a> the risk. Involuntary hospitalization <\/span>particularly<\/span><\/a> backfires<\/span><\/a> for <\/span>SUDs<\/span><\/a>. Mere fear of involuntary hospitalization leads people to <\/span>hide<\/span><\/a> distress<\/span><\/a> from clinicians or <\/span>avoid<\/span><\/a> treatment<\/span><\/a> entirely. Those of us with mental health disabilities deserve to seek care and develop honest, trusting relationships with clinicians without fear of force.<\/span><\/p>\n Proposition 1 also flouts international and national standards for the civil rights of people with mental health disabilities. <\/span>World Health Organization<\/span><\/a> and <\/span>United Nations<\/span><\/a> guidance and several <\/span>international treaties<\/span><\/a> prohibit <\/span>involuntary institutionalization<\/span><\/a> and <\/span>forced treatment<\/span><\/a>. Proposition 1 drags California even further <\/span>out of compliance<\/span><\/a>. It also violates <\/span>federal constitutional standards<\/span><\/a> that require treatment in the least restrictive setting possible, which California counties <\/span>already<\/span><\/a> ignore<\/span><\/a>.<\/span><\/p>\n Proposition 1\u2019s legislative authors exposed their discriminatory intent during the hearings. They called no unhoused witnesses and none who disclosed a mental health disability. They ignored the recommendations of <\/span>opposing<\/span><\/a> witnesses<\/span><\/a> who did. In hearings for both Proposition 1 and the companion bill expanding forced treatment criteria, Proposition 1\u2019s proponents deployed racist and sanist stereotypes, portraying Black and brown people as <\/span>criminal<\/span><\/a> and people with mental health disabilities as <\/span>
\n<\/b>California\u2019s affordable housing shortage has left <\/span>over 180,000 people<\/span><\/a> homeless, creating political pressure on Governor Gavin <\/span>Newsom<\/span><\/a> and <\/span>city<\/span><\/a> mayors<\/span><\/a> to make encampments disappear. <\/span>Since the 2018 Ninth Circuit decision <\/span>Martin v. Boise<\/span><\/a> imposed moderate constitutional limits on California cities\u2019 ability to arrest unhoused people for existing in public without offering alternate shelter, <\/span>Newsom<\/span><\/a> and mayors have <\/span>sought<\/span><\/a> alternate<\/span><\/a> ways<\/span><\/a> to eliminate encampments. Luckily for them, <\/span>involuntary psychiatric holds do not count as arrests under <\/span>Martin<\/span><\/i>, and institutional beds count as shelter. Thus, <\/span>with over $14 million in <\/span>financing<\/span><\/a> from <\/span>rich<\/span><\/a> special<\/span><\/a> interests<\/span><\/a>, Newsom and California\u2019s big city mayors are <\/span>promoting<\/span><\/a> Proposition 1 not to improve mental health care for Californians, but to <\/span>remove<\/span><\/a> people without housing from sight (<\/span>\u201cTreatment Not Tents\u201d<\/span><\/a>).<\/span><\/p>\n