The Mental Health Services Act: A Journey of Transformation and Lives Impacted

Redwood City - In a new report, San Mateo County Health's Behavioral Health and Recovery Services (BHRS) division reflects on two decades of service transformation thanks to funding from the Mental Health Services Act (MHSA).

Approved as Proposition 63 by California voters in November 2004, the MHSA has provided supported the expansion of programs serving persons of all ages living with serious mental illness and/or substance use disorders and their families via a 1 percent tax on personal income over one million dollars. In San Mateo County, BHRS has allocated $476 million in investments to reduce the duration of untreated mental illness, fight stigma and discrimination and increase the number of individuals receiving public mental health and substance use services.

Focused on three priorities - community services and supports (receiving 76 percent of funding), prevention and early intervention (19 percent) and innovation (5 percent) - the MHSA has funded 66 programs that contribute to housing expansions, school-based interventions, workforce development, community-based services and more. Over the past 5 years alone, MHSA programs have served 4,275 clients in direct treatment programs and over 6,555 clients in prevention and early intervention programs in the county.

"The passing of MHSA was a defining moment for California residents living with mental health and substance use challenges, their families, and the broader community," said BHRS Director Dr. Jei Africa. "Support from MHSA has transformed public behavioral health systems and services throughout the state, aligning with BHRS's mission and positively impacting clients' lives."

These investments represent County Health's commitment to community-based strategies that promote health equity, supportive social connection and overall wellness. In the Coastside region, which has the highest income inequality in the county, programs such as the ALAS Farmworker Equity Express Bus, a mobile resource center that brings mental health and substance use services to farmworkers on the Coast, demonstrate innovative ways for BHRS and partners to engage and serve hard-to-reach communities. In Daly City, the Kapwa Kultural Center serves primarily Filipina/x/o youth aged 16-24 with programs that support cultural identity, mental health education, workforce preparedness and more. Among clients of the Pride Center in San Mateo, the first LGBTQ+ community center in the county, 80 percent reported an increase in natural support (non-familial social supports).

Throughout the county, the MHSA has expanded on another priority, providing housing for individuals living with serious mental health and substance use challenges. In collaboration with the County Department of Housing, BHRS has used MHSA funds to create 130 units of supportive housing, with onsite or offsite supportive services for residents.

Prior to the passing of the Mental Health Services Act, behavioral health treatment was largely limited to the diagnostic-focused medical model of treatment. Now, there are a variety of community-based client supports aligned with a recovery and resilience model of care that emphasizes a holistic approach and individual empowerment, including peer support, drop-in centers, supported employment, support groups and access to alternative care interventions, such as equine therapy, yoga and art-based healing.

When the MHSA funding began two decades ago, Africa was working in a local community organization.

"I learned about the MHSA Community Program Planning process, and for the first time I felt that the County's behavioral health system cared about my experience as a provider and as a Filipino community member," he said.

In March 2024, nearly 20 years after Proposition 63, voters passed Proposition 1 to amend the MHSA to the newly named Behavioral Health Services Act (BHSA), which significantly shifts funding allocations for counties. With this change on the horizon, BHRS remains committed to supporting continued improvement of the behavioral health delivery system, which is focused on the most vulnerable and unhoused individuals living with mental health and substance use challenges in San Mateo County.

Media Contact

Audrey Davis
Communication Specialist
Behavioral Health and Recovery Services
[email protected]
650-586-2162