Housing, Behavioral Health Services, and Disability Rights: A Narrative Policy Analysis of California's Proposition 1

Background and Purpose: California’s housing crisis and homelessness is drawing increasing public and academic attention. In response, Californian voters narrowly passed Proposition 1 which restructures behavioral health (BH) funding facilities and housing in March 2024. This study examined Proposition 1 policy narratives to determine the characteristics of effective narratives at the intersection of housing and psychiatric disabilities.

Methods: A meso-level Narrative Policy Framework (NPF) analysis was used to examine debate on California’s Proposition 1. Data were collected from Newsback and public web searches from June 2023 to March 2024. Policy narratives were defined as texts including a policy stance and at least one actor and divided by support or opposition to Proposition 1. The unit of analysis was groups, coalitions, and organizations. Story type, causal mechanisms, policy solutions, evidence, policy beliefs, and characters were coded for each policy narrative. Chi-Square and t-tests then quantified differences in story type, causal mechanism, and characters between coalitions.

Results: Supporting policy narratives (n = 297) emphasized stymied progress, positioned people with psychiatric disabilities as victims, and a heroic Governor Newson solving the housing crisis. Opposition narratives (n = 112) portrayed a villainous Governor Newsom harming people with psychiatric disabilities due to service cuts and involuntary treatment. Distributions of story type, χ² (5, n = 409) = 369.05, p <0.0001 and causal mechanism, χ² (1, n = 409) = 100.86, p < 0.0001, were not equally distributed. Supporters (M = 0.86, SD = 0.68) used more beneficiary characters per narrative than opposition (M = 0.03, SD = 0.20), t(562) = -15.96, p < 0.0001. Supporters (M = 0.33, SD = 0.33) also used more hero characters per narrative than opposition (M = 0.07, SD = 0.21), t(264) = -9.08, p < 0.0001. Opposition (M = 0.24, SD = 0.38) used more opponent characters per narrative than supporters (M = 0.02, SD = 0.11), t(195) = 7.42, p < 0.0001. Opposition (M = 1.28, SD = 0.76) used more victim characters per narrative than supporters (M = 0.70, SD = 0.51), t(1,215) = 8.76, p < 0.001. Opposition (M = 0.20, SD = 0.35) used more villain characters per narrative than supporters (M = 0, SD = 0.04), t(150) = 7.67, p < 0.0001.

Conclusions and Implications: Coalitions offered contrasting narratives. Supporters of Proposition 1 delivered a unified message: it would address California’s housing crisis and support people with psychiatric disabilities. In contrast, the opposition presented a fragmented message focused on the numerous significant risks of expanding involuntary interventions. Harms included violations of civil liberties and disability rights, increased tax burdens, and threats to existing peer support and wraparound services that address housing and basic needs. The lack of a cohesive messaging and policy alternatives made it difficult to unify their message. Future opposition coalitions should prioritize coordinated messaging, offer clear housing solutions, and feature characters with whom voters identify.