Position Category: Senate Bill

April 4^th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento , CA 95814

RE: OPPOSE Senate Bill 367 (Allen)

Dear Chair Menjivar,   

Mental Health America of California (MHAC) respectfully opposes Senate Bill 367 (Allen), which would expand Lanterman Petris Short (LPS) Act involuntary commitment and conservatorship statutes by: 1) Requiring information about the historical course of a person’s medical, psychological, educational, social, financial, and legal conditions to be included in the assessment for an involuntary hold; 2) Authorizing conservatorships for people who have accepted voluntary care; and 3) Expanding the list of individuals or entities that can recommend conservatorship. These expansions of current law will risk infringing on peoples’ civil rights by inappropriately increasing conservatorships.  

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. In accordance with our mission, MHAC supports increasing the availability of voluntary, accessible, culturally responsive, community-based services.

MHAC is opposed to SB 367 for the following reasons:

Requiring information about the historical course of a person’s medical, psychological, educational, social, financial, and legal conditions to be included in the assessment for an involuntary hold is an egregious and inappropriate expansion of involuntary commitment statute. Current law requires information on the historical course of a person’s mental disorder be considered only if it is determined that the information has a “reasonable bearing” on whether the individual meets criteria for involuntary treatment. Furthermore, current statute specifies limited sources of the historical information.[1] In contrast, SB 367 requires information on the historical course of a broad range of factors that are not relevant to an immediate mental health crisis, including educational, social, financial, and legal. We struggle to understand how the historical course of an individual’s education, for example, bears on their potential status as currently gravely disabled. Requiring this information in assessments risks wrongful involuntary commitments based on bias and prejudice rather than immediate mental health needs, and threatens the privacy of the individual. Furthermore, by not limiting or specifying the sources of this information, the bill would create excessive burdens on evaluation staff who are now required to collect this historical information.

Allowing conservatorships for individuals who have “demonstrated an inability to follow through with stated plans of self-care” is untenably broad and will likely result in wrongful conservatorships. Self-care is a term that can encompass a wide range of activities, including simple things like getting outside, getting enough sleep, meditating, etc.. Moreover, “stated plans” is a vague term that implies an unwritten expression of self-care goals.

Conservatorships remove individuals’ rights, autonomy and self-determination and should only be used when absolutely necessary and only after significant evaluation of the individual’s mental health. SB 326 expands authority to recommend conservatorships to a judicial officer, a treating physician or an emergency physician. These individuals are not likely to have sufficient knowledge of an individual’s mental health history to make an accurate conservatorship recommendation, which runs the risk of inappropriately increasing unnecessary conservatorships.

It is for these reasons MHAC is opposed to SB 326 (Allen). If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org. 

In Community,   

Heidi L. Strunk   
President & CEO 

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[1] California Welfare & Institutions Code Section 5150.05

March 24^th, 2025  

The Honorable Caroline Menjivar  
Chair, Senate Health Committee 
1021 O Street, Room 3310 
Sacramento, CA 95814 

RE: Support for Senate Bill 418 (Menjivar) 

Dear Chair, 

Mental Health America of California (MHAC) is pleased to support Senate Bill 418 (Menjivar), a bill that would prohibit discrimination or a denial of benefits from a health plan or insurer based on race, color, national origin, age, disability, or sex with specific protections for the LGBTQ+ community.  

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. 

As healthcare institutions face increasing scrutiny from the federal administration for providing gender-affirming care, denials of such care are expected to rise unless specific protections are established. These denials include limiting access to essential services and adopting policies that restrict or exclude the LGBTQ+ community from receiving gender-affirming care. 

This bill strengthens protections for the LGBTQ+ population by explicitly defining discrimination based on sex to include sex characteristics, pregnancy and related conditions, sexual orientation, gender identity, and sex stereotypes. Ensuring access to gender-affirming care is critical for the well-being of transgender individuals, as it provides access to necessary medical, mental health, and substance use services and supports. According to The Trevor Project, there has been a 72% increase in suicide attempts among transgender youth due to the rise in anti-transgender laws.[1] These laws attempt to erase the existence of the transgender community by denying access to direct services and critical care.

Everyone deserves access to essential services and support. It is for these reasons MHAC supports Senate Bill 418 (Menjivar) and asks for your “Aye” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.

In Community, 

Heidi L. Strunk 
President & CEO

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[1] News, T. (2025a, February 11). Anti-transgender laws cause up to 72% increase in suicide attempts among transgender and nonbinary youth, study shows. The Trevor Project.

March 18^th, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento, CA 95814

Re: MHAC Opposition to Senate Bill 823 (Stern)

Dear Chair,

Mental Health America of California is writing to oppose SB 823 (Stern), legislation that would add Bipolar I Disorder to the criteria for a person to be petitioned into CARE Court and forced into involuntary treatment. CARE Court represents an ineffective approach to mental healthcare in California. It fails to address the systemic barriers individuals face and, in some cases, comes at the cost of their civil liberties.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy.

The primary barriers to accessing mental health services include a shortage of providers, stigma, and lack of voluntary services and supports. Investing in the behavioral health workforce, reducing stigma through community engagement, and voluntary community-based services has proven to prevent mental health crisis, reduce hospitalizations, institutionalization, and incarceration.[1] In contrast, CARE Court fails to address the provider shortage, inadvertently increases stigma due to its court-based setting, and provides no additional funding to increase mental health services and supports beyond what’s currently available.

The ineffectiveness of CARE Court is demonstrated in the enrollment numbers. When San Francisco rolled out CARE Court in 2023, city officials projected approximately 2,000 eligible individuals, but only 11 referrals were made.[2] The Department of Health Care Services also released its Early Implementation Report in November of 2024 which recorded a total of 100 Care Court participants, yet state officials estimated 7,000 to 12,000 people would be eligible.[3][4] One of the primary reasons for the low enrollment is due to the many respondents who are receiving care voluntarily or receiving supports and services in a different way other than CARE Court. This further supports the idea that when voluntary supports and services are available, people will accept them.

The state’s failure to meet expectations shows an inherent flaw in the system that won’t be solved by expanding the criteria of who can be forced into treatment via a court order. For these reasons MHAC opposes SB 823 (Stern) and asks for your “No” vote. If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org.  

In Community, 

Heidi L. Strunk 
President & CEO

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[1] Yehya, N. A. (2024, November 27). Report finds State’s mental health programs need consistent funding, community engagement. UC Davis Health News.

[2] SF Chronicle “S.F. Helped Only a Handful of People So Far through California’s Ambitious New Health Program” (2024)

[3] Depart of Health Care Services . (2024, November). CARE Act Early Implementation Report. Community Assistance, Recovery, and Empowerment Act.

[4] Mai-Duc, C. (2024, November 27). California falling short of enrollment goal as Mental Health Courts Roll Out Statewide. California Healthline.

April 3^rd, 2025

The Honorable Caroline Menjivar
Senate Health Committee
1021 O Street, Room 3310
Sacramento , CA 95814

RE: OPPOSE UNLESS AMENDED Senate Bill 331 (Menjivar)

Dear Chair Menjivar,   

Mental Health America of California (MHAC) respectfully opposes unless amended Senate Bill 331 (Menjivar), which would define a “mental health disorder” as a condition outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. In accordance with our mission, MHAC supports increasing the availability of voluntary, accessible, culturally responsive, community-based services.

The definition of “mental health disorder” as outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is not only overly broad, but also misaligned with the intent of the statute regarding involuntary commitment.

The current version of the DSM lists 265 conditions, a large number of which are inappropriate grounds for involuntary commitment. Some of these include sexual dysfunction, sleep wake disorders, communication disorders, stuttering, caffeine use disorder, and tobacco use disorder. [1]

The Lanterman-Petris-Short (LPS) Act was intended to “end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders” by authorizing involuntary treatment in very limited circumstances. By defining “mental health disorder” as broadly as the DSM criteria, California risks expansion of involuntary commitment far beyond the intent of the LPS Act. Furthermore, the LPS Act requires the provision of evaluation and treatment services for individuals placed on involuntary holds. Yet, many of the conditions listed in the DSM are not appropriate for treatment within locked facilities.

While we are opposed to the current bill language defining a “mental health disorder” as outlined in the current edition of the DSM, we are not necessarily opposed to defining “mental health disorder” in statute. Ideally, we would like this provision removed from the bill but if that is not possible, we would welcome the opportunity to work with the author and sponsors to develop a more suitable definition.

It is for these reasons MHAC must oppose SB 331 (Menjivar). If you have any questions, or if MHAC can provide any assistance on this bill or any behavioral health legislation, please do not hesitate to contact me at hstrunk@mhac.org or our Director of Public Policy, Karen Vicari, at kvicari@mhaofca.org. 

In Community,   

Heidi L. Strunk   
President & CEO 

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[1] American Psychiatric Association. (2013). DSM-5 Table of Contents.

June 14, 2024

The Honorable Aisha Wahab
California State Senate
1021 O Street, Suite 7330
Sacramento, CA 95814

RE: Senate Bill 402 (Wahab) – OPPOSE

Dear Senator Wahab:

Mental Health America of California (MHAC) respectfully opposes Senate Bill 402, legislation which expands eligibility of people who can place individuals on a 5150 hold to private practicing licensed mental health professionals.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Access to voluntary mental and behavioral health support and services are key to preventing people from experiencing a crisis.

If a person is experiencing a crisis and needs to be placed on a 5150 hold, the decision should be made by professionals held to the highest standards. However, Senate Bill 402 lowers these standards by allowing private practicing licensed professionals to be eligible for county designation to write holds. These professionals do not need to be county employees or contractors, which creates a gap in accountability. Not all mental health professionals receive the same training or have experience with crisis response, and this bill does not ensure that the most qualified professionals are making these critical decisions.

Previously adopted legislation, Senate Bill 43 (Eggman), expanded the criteria for placing individuals on a 5150 hold to include those with a “severe substance use disorder” or a “co-occurring mental health disorder and a severe substance use disorder.” Under the current bill language, this expansion would allow a marriage and family therapist to write a hold for someone with a substance use disorder, which may not be appropriate given their training and experience.

This bill poses a variety of challenges regarding the accountability of hold writers and the applicability of the different types of licensed mental health professional to be writing holds during different types of mental and behavioral health crises. Furthermore, denying an individual of their civil rights is not conducive to the recovery of an individual and the decision should not be made by unqualified persons.  For these reasons, we oppose Senate Bill 402. If you or your staff have any questions, or if Mental Health America of California can be of any assistance on this or any other behavioral health bill, please do not hesitate to contact me at hstrunk@mhac.org, or our Interim Director of Public Policy, Karen Vicari at kvicari@mhacofca.org.

In Community,

Heidi Strunk
President & CEO
Mental Health America of California