Supervisors hear plan for behavioral health justice center to divert people with serious mental illness from jail

A San Francisco Board of Supervisors committee on Wednesday heard detailed testimony on a proposed Behavioral Health Justice Center intended to provide a coordinated alternative to jails and emergency rooms for people with serious mental illness and co-occurring substance use disorders.

Supervisors heard from the plan's authors and partners, including Jennifer Johnson, a public defender and founder of the city's behavioral health court, Kathleen Lacey of UCSF Department of Psychiatry, and Susan Christian of the District Attorney's Office. The proposal, which District Attorney George Gascón circulated as a concept paper, describes a multi-level facility: Level 1 would be a 24/7 emergency mental health reception center; Level 2 would offer short-term transitional/crisis beds; Level 3 would provide long-term residential dual-diagnosis programs; and Level 4 would be a secure therapeutic unit for people in custody awaiting placement.

"The whole point of this document was to create something that is not a jail," Jennifer Johnson said, urging the supervisors to view the design as a treatment-centered system rather than a detention facility. Kathleen Lacey described the facility as a "hub" to bring together mental-health professionals, community nonprofits and criminal-justice partners so people in crisis can be assessed and moved through appropriate levels of care without long waits in jail.

Panelists and city agencies described persistent capacity and pipeline problems. Johnson and Lacey said that psychiatric emergency services at San Francisco General had dramatically reduced bed capacity over recent years and that many criminal-justice–involved clients are repeatedly screened and delayed for community treatment slots. Sam Dodge of the Department of Homelessness and Supportive Housing emphasized that successful discharge planning and a flexible housing pool would be essential to preventing people from returning to the street or shelter system after treatment.

San Francisco Police Department sergeants described operational strains: officers frequently must wait at hospitals while psychiatric holds are processed, and 24/7 reception capacity is limited, taking officers off the street for extended periods. Sgt. Kelly Krueger said better 24/7 options would reduce repeated cycles that currently burden officers and the system.

Public speakers were split. Some, including formerly incarcerated people who work in reentry programs, supported the concept and the additional treatment capacity it would provide. Others warned the proposal did not yet clarify individual rights, HIPAA protections, the sheriff's role, or how consumer and formerly incarcerated people would be meaningfully involved in design and oversight. Leslie Levitas, who said she is formerly incarcerated and now works in county reentry services, asked for more substantive detail and consumer input.

Susan Christian of the district attorney's office told supervisors the proposal grew from years of work by court and clinical staff and that the office supports the concept while recognizing community concerns around secure units. "There is a real need for a secure therapeutic place," Christian said, citing violent felony charges among those awaiting residential beds and the lack of appropriate treatment in jails.

After several hours of testimony and public comment, the committee voted without opposition to table the item for further work and community outreach, including more clarity on the secure unit's design, roles for justice agencies, individual rights protections and bed‑count analysis.

Next steps: the committee asked city agencies and authors to provide additional details on capacity, oversight, discharge planning and consumer input before returning with a more developed plan.