Two dueling ballot measures that aim to address mental health services for San Francisco’s homeless population may be pitted against each other in the March 2020 election, as city supervisors and Mayor London Breed debate how to approach the city’s ongoing mental health crisis.

In May, Supervisors Hillary Ronen and Matt Haney introduced Mental Health SF, a ballot measure focused on revamping the city’s mental health care system by creating new low-barrier services through the Department of Public Health. In response to this, Mayor Breed introduced Urgent Care SF last month, which shares many of the same goals as Mental Health SF but has received widespread criticism for its reliance on law enforcement to approach mental health concerns among unhoused individuals. 

“The Mayor’s measure brings back mass incarceration and the drug war by directing police to prioritize enforcement of possession, drug laws and uses police for street outreach, destroying the ability of health workers to develop trust with clients,” said Jennifer Friedenbach, executive director of the Coalition on Homelessness, an organization that advocates for San Francisco’s unhoused population. She said Mental Health SF would increase street outreach from mental health professionals instead of relying on police intervention. 

Over 100 supporters of Mental Health SF attended a rally on Oct. 30, where two community organizers were arrested after carrying signs and chanting inside City Hall. The rally preceded a public hearing on the measure held by the Board of Supervisors’ Rules Committee. The organizers were cited for “trespassing” and “resisting arrest” but released later that day.  

“We are finally in this country realizing that diseases of the mind are as important as diseases of the body,” Ronen said at the hearing. 

Mental Health SF, she said, would work to address failures in the city’s current mental health treatment system by offering services like sobering centers, transportation to and from programs and case management for every patient. It would cover those without health insurance as well as establish an “Office of Private Insurance Accountability” to advocate for privately insured people who aren’t receiving adequate mental health coverage. 

The mayor’s measure would also expand treatment capacity and reduce barriers for services. Instead of creating new services, however, it would rely mainly on investing money in the city’s existing Behavioral Health System. 

“UrgentCareSF is a comprehensive plan that tackles this issue from all

angles, from getting people connected to care, to making sure we have enough qualified healthcare workers in our City,” Mayor Breed said in an Oct. 15 press state.

Ronen and Haney said they’re willing to remove their ballot measure with Breed’s assurance that its concepts will still be implemented. They have until Nov. 27 to do so.