By SDCN Editor
San Diego, CA–San Diego County’s Behavioral Health Services has spent the past year coordinating extensive training and planning in anticipation of significant changes to California’s civil detention and conservatorship laws.
The updates, prompted by State Senate Bill 43 (SB-43), represent the most substantial reform in over 50 years and took effect on January 1.
SB-43, signed into law by Governor Gavin Newsom on October 10, 2023, broadens the criteria for individuals with behavioral health conditions to be involuntarily evaluated, treated, or placed under conservatorship. Previously, civil detainment was limited to those deemed a danger to themselves, and others, or unable to secure necessities like food, shelter, or clothing due to mental illness.
Under the new law, the definition of “grave disability” now includes individuals unable to keep themselves safe or access necessary medical care. Additionally, grave disability can be attributed solely to mental illness or substance use disorders.
While counties like San Francisco and San Luis Obispo began implementing SB-43 in January 2024, San Diego deferred for a year to ensure proper training and collaboration. Most other counties plan to adopt the new law in 2026.
Over the past year, San Diego County’s Behavioral Health Services has conducted an extensive training initiative, uniting law enforcement, emergency department staff, harm reduction advocates, legal representatives, and other community partners. Training sessions, led by Jewish Family Service’s Patient Advocacy program, were provided to law enforcement officers from all 18 cities and the County Sheriff’s Office.
“I cannot emphasize enough the remarkable collaboration among stakeholders to compassionately and effectively implement this new law,” said Luke Bergmann, Director of County Behavioral Health Services. “With our Crisis Stabilization Units and substance use treatment providers ready, we are prepared to help some of our most vulnerable residents. While challenges lie ahead, our community is ready to navigate this learning process together.”
The updated law applies to processes like 5150 holds, which allow for a 72-hour involuntary psychiatric evaluation. If necessary, intensive treatment may be extended up to 60 additional days. For cases requiring long-term care, conservatorships of up to one year, renewable with court approval, can be established.
County Behavioral Health Services anticipates approximately 1,500 additional 72-hour detentions annually under SB-43, though the final number will depend on decisions by law enforcement and clinicians. Individuals on 5150 holds are transported by peace officers or mobile crisis response teams to crisis stabilization units or emergency departments, where they receive tailored care.
Detained individuals may be released if they no longer meet involuntary treatment criteria or agree to voluntary care.
Bergmann stressed that implementing SB-43 will require ongoing collaboration among community members, health providers, and legal advocates. He drew parallels to the county’s successful management of the CARE Act, which similarly relied on collective efforts to support vulnerable residents.
As one of the first counties to fully implement SB-43, San Diego aims to set a precedent for balancing compassion, public safety, and effective behavioral health care.
