The San Francisco Department of Public Health (SFDPH) held a meeting on July 4, 2025, to discuss significant updates regarding behavioral health services in the city. Dr. Hilary Coonens, the director of Behavioral Health Services (BHS), presented a comprehensive report highlighting recent progress and future initiatives.

Dr. Coonens began by outlining the department's evolving vision and mission, emphasizing the importance of ongoing audits and compliance with state and federal regulations. The SFDPH recently participated in a triennial audit of its mental health plan, which is conducted every three years to ensure adherence to legal and contractual obligations. The findings from this audit are expected soon, and the department is committed to addressing any areas for improvement identified.

A key focus of the meeting was the proposed budget investments aimed at enhancing mental health and substance use services. The budget includes funding for new initiatives such as care courts and wellness hubs, as well as the continuation of existing programs like overdose prevention and street outreach. Notably, the city has reached a $230 million settlement with Walgreens related to opioid litigation, with funds allocated to support various behavioral health priorities over the next 14 years.

Another significant update involved the extension of authority for initiating involuntary psychiatric holds, known as 5150s, to community paramedics. This initiative aims to improve crisis intervention by training paramedics in behavioral health and de-escalation techniques. The training is set to begin this month, with the goal of enabling paramedics to execute 5150 orders by July.

Dr. Coonens also discussed the Care Court program, established under state legislation, which aims to provide structured support for individuals with severe behavioral health issues. The program is designed to facilitate access to care and improve outcomes for those in crisis.

In conclusion, the SFDPH is actively working to enhance its behavioral health services through strategic budget investments, expanded training for emergency responders, and new legislative initiatives. These efforts reflect a commitment to improving mental health care and ensuring timely interventions for individuals in crisis. The department will continue to monitor the effectiveness of these programs and share updates with the community.