Working to Expand Access to Mental Health Treatment

By Rafael Mandelman, President, San Francisco Board of Supervisors –

We’ve taken on numerous projects this year, from increasing traffic enforcement to expanding shelter capacity, but we would now like to update you on one of our ongoing projects: the Residential Treatment and Care Workgroup.

I have been working on expanding access to mental health treatment since I became Supervisor. I believe strongly in using conservatorship to care for people who cannot care for themselves, and whose mental illness prevents them from voluntarily accepting care, but the reality is that, without an adequate supply of appropriate facilities, we will be stymied in our efforts to get the hardest-to-treat people off the streets, and out of the jails. And the tragic reality is that, San Francisco and California more broadly simply do not have enough treatment facilities or placements for people with severe mental illness. Earlier this year I asked the Mayor to convene a Residential Care and Treatment Workgroup to analyze and address our acute lack of such facilities.

The Workgroup, which I co-chair along with the Director of the Department of Public Health, includes public and private stakeholders, including UCSF, Kaiser, and Sutter Health. It has met several times already, and its work is being informed by interviews and focus groups with community health providers and other stakeholders. We are aiming to complete our work and provide recommendations to guide future city investment and advocacy by the end of the year.

The Workgroup comes at an opportune time, as the passage of Prop 1 allows San Francisco to apply for funds to buy and build mental health facilities, while Senate Bill 43 has expanded conservatorship criteria to include people with disabling substance addictions. If you’re interested in learning more about our work on mental health treatment beds, feel free to reach out to my staffer on this issue, Adam Thongsavat (Adam.Thongsavat@sfgov.org).

Thanks for reading, and, as always, don’t hesitate to get in touch with our office. You can always reach us at mandelmanstaff@sfgov.org and 415-544-6968, or you can stop by to visit us in Room 284 of City Hall. See you in the District!

Rafael Mandelman is the San Francisco District 8 Supervisor and the President of the San Francisco Board of Supervisors. https://bit.ly/4iQvwvY

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Published on November 6, 2025