Press Release

San Diego, CA —Acting on direction from Supervisors Terra Lawson-Remer and Monica Montgomery Steppe, the San Diego County Board of Supervisors advanced an ordinance to extract Behavioral Health Services from Health and Human Services Agency as a standalone department. This major structural reform is designed to expand treatment capacity, strengthen coordination of care, and modernize the region’s safety net system. This proposal reflects years of rapid growth in behavioral health programs and the urgent need to build a system capable of meeting rising demand for mental health and substance use treatment.

A Much-needed System Expansion

Since 2021, the County of San Diego has undertaken one of the most significant expansions of behavioral health services in its history. In just five years, the County has:

• Increased the number of County Behavioral Health Services staff by approximately 32 percent 

• Increased investments into behavioral health by over $475 million per year, an increase of over 60 percent 

• Opened new crisis stabilization centers, bringing the total to six, with two more slated to open later this year, improving  access to crisis care while diverting people from emergency rooms and jail 

• Launched and expanded Mobile Crisis Response Teams to a total of 44, to ensure clinicians and peers can respond to people experiencing non-violent behavioral health emergencies. 
  • Since the launch in 2021, Mobile Crisis Response Teams have responded to over 30,000 calls countywide with 98% of calls responded to in under an hour and 57% of calls stabilized in the field
  • Since expanding to schools in September 2024, there have been 580 trauma-informed crisis responses to school campuses countywide. 

• Invested $75 million to support  workforce recruitment and retention strategies designed to address long-standing shortages in psychiatric and addiction treatment professionals, 

• Been awarded more than $250 million in grant funding to develop critical behavioral health infrastructure and services 

These investments are part of a broader “Care Before Crisis” strategy aimed at helping residents access treatment earlier and reducing homelessness, hospitalization, and incarceration.

“For too long, people in our region have had to wait until they were in crisis to get real mental health care,” said Chair Terra Lawson-Remer. “We are changing that. By expanding treatment and modernizing how the system works, we are building a behavioral health infrastructure that helps people stabilize earlier — before homelessness, hospitalization, or incarceration. This reform ensures government can keep pace with the scale of need and deliver real results for working families.”

“The scope and impact of our Behavioral Health Services Department have grown well beyond its current structure,” said Vice Chair Monica Montgomery Steppe. “We cannot allow familiarity to justify stagnation—especially when there is a meaningful opportunity to strengthen support for our most vulnerable communities. This moment calls for intentional, forward-thinking action, and this reform will prioritize just that.

Modernizing Government to Meet Rising Need

Behavioral Health Services currently operates within the County’s Health and Human Services Agency. This structure was created nearly three decades ago, before major expansions in Medi-Cal coverage, behavioral health funding, and treatment demand.

Today, the County serves as the specialty behavioral health plan for Medi-Cal beneficiaries with the most serious mental illness and addiction conditions, coordinating care through a large network of providers and County-operated programs.

Officials say creating a dedicated department will help:

• Expand provider networks and improve access to care
• Improve coordination across treatment programs
• Strengthen data systems and accountability
• Support long-term workforce development
• Optimize funding opportunities to support sustainable service expansion 

Next Steps

Today’s action authorizes the introduction of an ordinance establishing the new department. A final vote is scheduled for April 21, 2026. If approved, the new department would take effect July 1, 2026 and implement the transition through a phased process designed to ensure continuity of care for patients and providers.