California’s Mental Health Conservatorships Face Implementation Hurdles

Despite an expansion of conservatorship programs, **San Francisco** grapples with significant challenges, lacking resources and a coordinated system to support individuals under its care, raising questions about the effectiveness of the initiative.

Lack of Resources Hinders Progress

A 2022 audit highlighted a critical gap: **San Francisco** lacked a system for assessing the success of conservatorships. Compounding this, the city forged ahead by implementing SB 43 early, mirroring **San Luis Obispo County**, while most others awaited the 2026 deadline.

Despite training around 1,700 staffers and clinicians, the implementation of these new conservatorship rules in **San Francisco** did not come with corresponding resources needed for proper care.

Expert Opinions

“It does no one any good if we conserve somebody and have no care lined up,” stated **Dr. Daniel Tsai**, director of the **SF** Department of Public Health. “They’re still on the street, not getting care. It’ll look nice on a chart for an upward line, but it won’t actually solve the outcome we’re looking for.”

**Keris Jän Myrick**, vice chair of Disability Rights California, offered a stark analogy: “it’s like fixing a bullet wound with a Band-Aid.” She added, “If there are no services and supports there — which they weren’t there before — they certainly aren’t going to be there now.”

According to the Pew Research Center, nearly half of Americans say the mental healthcare system in the U.S. needs significant improvement (Pew Research Center 2023).

Statewide Issues

**Aaron Meyer**, chair of the governmental affairs committee for the California State Association of Psychiatrists, pointed out that **San Francisco’s** difficulties reflect a broader statewide issue. He noted the lack of uniform guidance and sufficient state funding for residential treatment centers.