Lurie Backs Proposed California Law to Allow Court-Ordered Psychiatric Drugs

San Francisco Mayor Daniel Lurie is backing a proposed state law that would allow courts to authorize involuntary medication for people struggling with behavioral health issues.

Under current law, judges can order people to participate in assisted outpatient treatment, but they cannot require medication that officials said is “often essential” to stabilizing severe mental illness. This bill would allow courts to implement involuntary medication into an individual’s treatment plan “when clinically necessary,” and assign a psychiatrist to oversee case specifics like dosages and effectiveness over time.

Lurie, San Francisco Assemblymember Catherine Stefani — the bill’s author — and Supervisor Rafael Mandelman gathered with other local and state officials on the steps of City Hall on Monday to emphasize the need for additional care options for the city’s most vulnerable residents.

“We have a situation where courts can mandate so-called treatment, but can’t actually mandate treatment like necessary medication that provides the relief that is desperately needed,” Stefani said. “The result is predictable: people fall off their care plans, they deteriorate, they cycle again through our emergency rooms, psychiatric holds, jails and back out onto the street. This is not compassion, it’s failure.”

The program marks the latest in the city’s recent efforts to curb a visible behavioral health crisis. Lurie last week announced the launch of the Rapid Enforcement, Support, Evaluation, and Triage Center — which offers an alternative to jail or hospitalization for individuals arrested for public intoxication. Last year, the mayor’s office consolidated the city’s 10 street outreach teams and opened a drop-in mental health stabilization center at 822 Geary Street in the Tenderloin as part of the city’s 2025 Breaking the Cycle plan.

“Too many people in San Francisco are falling into crisis when intervention could — and should — come sooner. At the center of this effort is a simple reality: Stability is the gateway to recovery,” Lurie said. “For many people with severe mental illness, medication is what allows treatment to work at all. Without it, housing placements fail, care plans break down, and crises repeat themselves — often with greater harm each time.”

Involuntary commitments and forced treatment of mental health in California have long been controversial. And past attempts by the city to place those struggling with mental health issues into involuntary medical treatment have been called “disappointing” by city leaders — in part due to a shortage of facilities that can specifically address the combination of mental illness and addiction.

Officials are hopeful that this addition of medication authorization will provide care to individuals who may not need a full conservatorship.

“We certainly do not have the beds or the staffing capacity to provide full-blown conservatorships for all of those people,” Mandelman said. “So, this is a less-intrusive intervention to get medical care through assisted outpatient treatment to people who could benefit [from] it.”