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The latest news and announcements from Mayor London N. Breed

Mayor London Breed Moves Forward Effort to Implement Mental Health Solution in City Hall

Mayor commits to working out a plan legislatively to help those most in crisis while maintaining flexibility to go to the ballot only as a last resort

San Francisco, CA — Today, Mayor London N. Breed moved forward with a process to ensure that solutions to San Francisco’s mental health crisis are tackled in City Hall, not unnecessarily at the ballot. Mayor Breed earlier today announced her initiative, UrgentCareSF, to provide help to those most in crisis in our City—the 4,000 people who are homeless and suffer from mental illness and substance use disorder. To move forward solutions in City Hall, Mayor Breed will introduce a legislative framework for her initiative at the Board of Supervisors, which would enshrine the main principles of UrgentCareSF’s approach to address the City’s mental health crisis.

To preserve flexibility to protect the program if legislation does not move forward in City Hall, the Mayor also submitted an initiative ordinance that would go before the voters in the March 2020 election. This initiative ordinance can be withdrawn any time within the next six weeks, and the Mayor introduced it to have as a last resort.

“I have been clear that we can and should be moving forward with solutions to help our most vulnerable residents who need our help today,” said Mayor Breed. “Under UrgentCareSF, we are already undertaking a broad and ambitious new approach to delivering treatment and housing for those in crisis on our streets, including those who won’t accept our services. I believe our City leaders can come together on a unified program to address our City’s most immediate challenge. We were all elected to make the hard choices and to do the work to implement solutions, and that’s what I’m committed to doing.”

UrgentCareSF 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

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 that 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.