San Francisco, CA — Mayor London N. Breed today announced a comprehensive plan—UrgentCareSF—to provide mental health care for those suffering from homelessness, mental illness, and substance use disorder. San Francisco’s Behavioral Health System serves 30,000 people every year, but is not working for the most vulnerable people on our streets. The plan includes immediate actions and a long-term vision for a system where the people who are most in need of care receive it in a way that meets them where they are. With UrgentCareSF, treatment for mental health and substance disorders is available as soon as it is desired, with no significant waits. The detailed elements of UrgentCareSF can be found at http://sfmayor.org/urgentcaresf.

“People are suffering on our streets, and we need to act now to get them connected to the mental health care and substance use treatment that they desperately need,” said Mayor Breed. “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. We will work to meet people where they are with solutions and treatment, including for those who refuse services. We need to help people right now—people we know need care can’t afford to wait years for help.”

UrgentCareSF is based in clinical expertise, evidence-based programs, data analysis, and the principles of harm reduction and compassion. The four priorities of the program are:

• Building a new system of care coordination, outreach, low-barrier services, and harm reduction, including for those who cannot make decisions for themselves.
• Expanding treatment capacity and reducing administrative barriers to eliminate wait times for services.
• Focusing on the workforce needs that are required in order to provide mental health care and substance use treatment to people.
• Providing housing options for people exiting treatment services in order to support behavioral health chronic disease management.

In March 2019, Mayor Breed hired a Director of Mental Health Reform, Dr. Anton Nigusse Bland, to evaluate the City’s behavioral health system and identify actions the City and Department of Public Health can take to improve the system. San Francisco’s existing mental health system treats about 30,000 people per year, focused on people with Medi-Cal or who are uninsured and in need of care for substance use and serious mental illness. For many of those people, the system works well, however there are is a population of people for whom the system is falling short.

Through his research, Dr. Nigusse Bland identified a population of about 4,000 people who are experiencing homelessness, and have both a mental illness and a substance use disorder.

“We have a clear plan ahead for our behavioral health system, grounded in analysis of the data, and investment in solutions for the people in greatest need,” said Dr. Anton Nigusse Bland, Director of Mental Health Reform. “At the same time, we will strengthen and grow our workforce, cultivating a culture of excellence in San Francisco. It’s exciting to see our community, health leaders and city leaders coming together with compassion to embrace this change.”

“UrgentCareSF is a bold transformation of our behavioral health system,” said Dr. Grant Colfax, Director of Health. “The status quo for people experiencing homelessness, mental illness and substance use disorder is not acceptable. Working together with the community—as we learned from our experience with HIV—we will be relentless in finding solutions and making sound investments that heal our patients and improve our city for everyone.”

In order to serve this population, UrgentCareSF will build a new system of care coordination, outreach, low-barrier services, and harm reduction. UrgentCareSF is designed to meet the specific needs of this population and has already begun by immediately serving the 230 people of the 4,000 who are most in need.

The City will also work to expand treatment capacity and reduce administrative barriers to eliminate wait times for services. This will include building on the Mayor’s efforts to add new behavioral health treatment beds, creating new meth sobering centers and managed alcohol facilities, and expanding access to existing city services, such as the Behavioral Health Access Center, and the Behavioral Health Pharmacy.

UrgentCareSF also focuses on the workforce needs that are required in order to provide mental health care and substance use treatment to people. The City will implement policy changes to expand and support the behavioral health workforce to meet today’s needs. This element will include wage increases for community based organizations, and working to ensure that mental health and substance use treatment positions are fully staffed.

Finally, the City will provide housing options for people exiting treatment services in order to support behavioral health chronic disease management. This will include increasing the payment rate that Board and Care facilities receive and supporting the development of new permanent supportive housing units. San Francisco has approximately 8,000 permanent supportive housing units, more per capita than any other city in the country, with over 1,000 units in the pipeline to be built over the next few years. San Francisco also has over 300 new units of master-leased housing that will be available in the next year.

“San Francisco has a history of not backing down when it comes to creating solutions to improve the public’s health,” said Joe Hollendoner, CEO of the San Francisco AIDS Foundation. “Through stakeholder engagement, community planning, targeted investments, and structural interventions—the same approach that has made our city successful in responding to the AIDS epidemic—UrgentCareSF has the opportunity to improve the quality of life and health of countless people.”

“Subsidized housing is the key to ending homelessness. That said, there is strong evidence that people who experience homelessness with behavioral health disabilities need additional behavioral health services,” said Dr. Margot Kushel, Director of the UCSF Benioff Homeless and Housing Initiative. “Intensive case management, combined with subsidized housing, has been shown to keep people who struggle with mental health and substance use disorders housed successfully. We know what types of services people need to thrive in the community; we just need the resources to do it. I am pleased that the San Francisco Department of Public Health has a plan to provide these crucial services.”

UrgentCareSF was designed based on public health data and a comprehensive assessment of the City’s mental health system. Each element of the initiative is rooted in data analysis and clinical expertise.

For more details on UrgentCareSF, visit http://sfmayor.org/urgentcaresf.

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