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Breed, state lawmakers push for reforms to California’s conservatorship laws

Mayor London Breed prepares to speak to a crowd at the new Google office location at One Maritime in Embarcadero on April 27, 2022. | Camille Cohen/The Standard

Mayor London Breed on Wednesday joined state lawmakers and a cadre of health professionals to urge the passage of two bills that would reform California’s rules for conserving people with serious mental illness. 

The bill’s sponsors say that the two bills, Senate Bill 43 and Senate Bill 363, would modernize the state’s behavioral health system and help to improve San Francisco’s conservatorship programs, which are viewed as ineffective as people suffering from behavioral or mental health conditions frequently cycle through emergency rooms and other short-term treatment settings with few places to go for longer-term assistance.

Underscoring the scarcity of long-term beds for mental health treatment, the California Department of State Hospitals said in October that it was 99 people over its contracted bed allotment for individuals under conservatorship.  

"My hope is that these commonsense changes to an outdated law will help make a significant difference for those who are struggling in crisis, whether they have an advocate or not," said Mayor Breed, who is co-sponsoring the bills as part of the Big City Mayors Coalition.

At a press conference on Wednesday, state Sen. Susan Talamantes Eggman of Stockton, state Sen. Scott Wiener of San Francisco and others backing the bills said the reforms were critically needed as the state faces a shortage of mental health facilities.

Conservatorships are reserved for people deemed gravely disabled due to a mental health conditions or other serious impairments. Teresa Pasquini, a mental health reform activist, described the reforms as a civil rights issue and discussed her son, who was diagnosed with a severe mental illness as a teenager and had cycled through jails, facilities and the streets before being placed under a conservatorship.

"He has experienced every jagged edge and broken piece of the California mental health systems," she said. "But because of heroics, and access to appropriate and medically necessary treatment, my Danny is currently living in safety and recovery."

SB 43 seeks to update California’s conservatorship law, called Lanterman-Petris-Short, by changing the criteria for determining whether someone is “gravely disabled.” The changes would take into account the likelihood of physical and mental harm resulting from an individual’s mental or substance use disorder, as well as their ability to care for themselves. 

SB 363 would create a dashboard to aggregate and display information on the availability of beds in psychiatric and substance abuse facilities, with the goal of expediting care and reducing reliance on emergency rooms or short-term hospital stays.

"We know that California is in desperate need of beds," said Eggman on Wednesday. "This will at least give us insight into beds that are actually available, but a whole lot of insight into the lack [of beds] that we have available within the state."

Annie Gaus can be reached at