Mayor Lurie Announces 90 New Beds, Including Locked Mental Health Beds for People in Need of Intensive Stabilization

SAN FRANCISCO – Mayor Daniel Lurie today announced a plan for 90 new beds and expanded residential care for some of San Francisco’s most vulnerable residents—including more than 50 new locked subacute mental health beds for people under conservatorship and 40 new assisted living beds for individuals who need long-term, community-based support. San Francisco General Hospital will operate the 50 locked subacute beds in the Behavioral Health Center (BHC). 

These expansions represent a significant step in Mayor Lurie’s Breaking the Cycle plan to address San Francisco’s homelessness and behavioral health crisis. It comes after mayor recently celebrated the opening of more housing and shelter in San Francisco—including the launch of the San Francisco Interfaith Winter Shelter Program, 42 Otis Street which offers permanent supportive housing for young people exiting homelessness, and Dolores Shelter and Jazzie’s Place, which added 50 new beds for people experiencing homelessness and LGBTQ+ adults seeking shelter. Mayor Lurie has launched three new recovery-focused interim housing programs this year, and he is transforming the city’s response to the behavioral health and homelessness crisis—creating integrated neighborhood-based street outreach teams, opening a 24/7 police-friendly stabilization center, and introducing new policies to connect people to treatment. 

“San Franciscans who are struggling with severe behavioral health challenges need a clear path to stability. The new locked beds at BHC will give people the treatment and support they need, and they will help us move faster to connect individuals to the right level of care,” said Mayor Lurie. “This is a major step in strengthening our behavioral health system, and I’m grateful to our partners, our frontline workers, and everyone helping us bring this expansion to life.” 

With the addition of more than 50 locked subacute beds, San Francisco will double the number of locked subacute beds at the city-operated Behavioral Health Center (BHC) at San Francisco General Hospital. These beds provide highly specialized, medically supervised care for individuals with the most complex behavioral health needs—particularly those who are severely mentally ill and require a secure, medical environment. 

Because locked treatment facilities must meet stringent safety and construction requirements, they are challenging to acquire or build. The BHC, originally constructed as a locked facility, offers a rare opportunity for this type of expansion. The project is supported by $21 million in state funding, positioning San Francisco to increase its capacity to care for individuals under conservatorship and those who need intensive stabilization. 

As part of the expansion of locked beds, San Francisco is also expanding residential care and assisted living with two new facilities on Laguna Street in Hayes Valley. The second floor of the BHC, currently occupied by approximately 45 older adults in assisted living, will be moving to one of two new locations while the second is anticipated to serve approximately 40 adults with long-term, community-based assisted living. These assisted living beds will serve residents with support for daily living, allowing residents to remain connected to their communities and receive ongoing support without being displaced into more restrictive settings. 

“For the better part of 2024 the San Francisco Residential Care and Treatment Workgroup did a deep dive on our city’s shortage of appropriate behavioral health treatment beds for San Franciscans with severe mental illness. The Workgroup’s final report identified a pressing need for at least 100 additional locked subacute treatment beds to expand conservatorships and finally stop the relentless merry-go-round cycle that carries so many of our sickest people from the streets to the emergency room to jail and back again without ever getting the longer term care they need,” said Board of Supervisors President Rafael Mandelman. “This announcement from Mayor Lurie promises significant progress in achieving the goals laid out in the Workgroup’s report and is very good news indeed for all of us who care about finally breaking that tragic cycle. 

“These investments reflect our commitment to meeting people at the right level of care and supporting them through long-term stabilization,” said Daniel Tsai, Director of San Francisco Department of Public Health. “Whether someone needs a secure treatment environment or a community-based home, we are expanding access to the full continuum of care. The new Hayes Valley properties offer compassionate, 24/7 assisted living for more independent residents, while the additional locked mental health beds provide intensive care for individuals with the most severe and complex needs. We are grateful to our union partners for helping us design a bold, effective plan that will make a meaningful difference in people’s lives and maintain continuity of care for our existing patients.” 

The expanded care options for San Franciscans will add more than 30 new union positions. These additional positions will strengthen our public mental health workforce, provide professional growth opportunities for current staff, and expand pathways for recruitment and retention in one of our most strained systems.  

“Working with the mayor's office and SFDPH to ensure a net of both locked and unlocked beds has proven to be a success. Working together, we have ensured the continuum of care saw no decrease in bed availability for clients at all levels, and no civil service jobs eliminated. We are very relieved that the current residents of the Adult Residential Facility will stay where they are with their current care providers, and that the residents of the Residential Care Facility for the Elderly will be able to stay with their care providers when they move to their new facility,” said Jennifer Esteen, SEIU 1021 Vice President of Organizing and psychiatric registered nurse. “Beds are just furniture without the care providers who staff them. We are so pleased that the new locked beds will not come at the expense of longtime residents who have achieved stability thanks to the excellent care they have received at the BHC.” 

As part of Mayor Lurie’s Breaking the Cycle initiative, San Francisco is undertaking one of the largest expansions of the city’s behavioral health capacity in decades—adding more than 200 new behavioral health beds and placements by the end of 2025 across crisis care, stabilization, drug treatment, and recovery housing.  

These investments are designed to create a seamless, clinically appropriate pathway that moves people quickly from the streets into effective care and supports them through long-term recovery. The expansion includes new crisis stabilization units, detox and withdrawal management beds, low-barrier stabilization programs, residential treatment for substance use and dual diagnosis, and step-down recovery housing. By building capacity at every level of the behavioral health continuum, San Francisco is creating a system that ensures people not only access treatment faster but stay connected to care, regain stability, and have a real opportunity to rebuild their lives.