San Francisco Mayor London Breed will unveil her vision Tuesday for tackling the city’s deepening mental health crisis with a $200 million initiative representing perhaps her most ambitious proposal since taking office last year.

The plan, dubbed UrgentCareSF, is intended to chart the city’s course for treating and, eventually, housing the roughly 4,000 people in San Francisco suffering from homelessness, psychosis and substance abuse disorder — a population that Breed and health officials admit has been chronically underserved by the city’s existing offerings.

The announcement, shared exclusively with The Chronicle, comes as public outcry over the crisis on the streets has intensified. The Chronicle has spent months reporting on the state of mental health care and addiction treatment in San Francisco.

Breed’s political opponents on the Board of Supervisors have criticized her and the public health department for their handling of homelessness, addiction and mental illness. A dueling proposal to fix the system has ignited a feud with some supervisors.

UrgentCareSF bundles a handful of announcements that the mayor has already made over the past few months under one umbrella term with several new proposals. Many details of Breed’s plan are still forthcoming, including specifics on how UrgentCareSF will be funded and what costs will be one-time expenses compared to annual budget needs.

But the broad contours of Breed’s plan include embarking on a hiring spree for case workers and other health care professionals, creating sobering centers for people addicted to drugs and alcohol, adding about 800 new treatment beds and acquiring board-and-care facilities that provide long-term mental health treatment beds at risk of closing down.

“This really reflects what providers and what people who are experiencing these situations themselves have been asking for for years, if not decades,” said Dr. Grant Colfax, director of the Department of Public Health. The proposals stem from the ongoing work of Dr. Anton Nigusse Bland, whom Breed appointed as the city’s director of mental health reform in March.

Perhaps the most ambitious part of Breed’s plan is to significantly increase the number of case managers, who can help guide patients though the complex system of care. Currently, the ratio is about one case manager for every 17 patients. The mayor wants to reduce that to 1 provider for every 10 patients, allowing a case manager to spend more time with each client as they help guide them into services.

San Francisco currently spends more than $360 million on behavioral health services a year, which includes mental health and addiction treatment, with few results when it comes to finding permanent solutions for the city’s sickest, most vulnerable people.

“What’s frustrating for a lot of people is that there are so many situations where people have been attacked or spit on; people seeing folks who are completely deranged or delirious and out running in front of cars,” Breed said. “It just seems as though we have all seen this problem on the streets, and we need to make some serious changes.”

The plan comes as the mayor has been immersed in a political squabble with Supervisors Hillary Ronen and Matt Haney, who have their own sweeping proposal to overhaul the city’s mental health care system through a proposed March ballot measure called Mental Health SF.

Mental Health SF, unveiled earlier this year, aims to provide timely, free and 24/7 care access to psychiatrists and pharmacists to a broader array of patients than Breed’s proposal, which focuses on serving the sickest. The supervisors’ plan would also require the city to create a new drop-in center for patients, hire more mental health care workers, and change the way the city coordinates care and devises treatment plans.

Breed has said repeatedly that she strongly prefers to enact mental health reforms legislatively, rather than at the ballot, to maintain flexibility should the city’s needs change as time goes on. But barring support at the board, Breed may still take her proposal to the March ballot to get political buy-in from voters.

Breed has been highly critical of Mental Health SF. While she agreed to discuss the plan with the supervisors, she pulled out last month after failing to reach a consensus over key parts of the plan — such as whether insured people should be included.

City’s catch-22 Hiring for mental health professionals is a major issue in San Francisco, where the cost of living is soaring but salaries for mental health care workers are stagnant. To allay that problem, the mayor is proposing: Increasing wages for community-based organizations to allow them to better support and attract new employees to fill the many existing vacancies. Creating incentives for entry-level practitioners to work in San Francisco’s behavioral health system by establishing a loan repayment program. Expanding the Department of Public Health’s behavioral health staffing budget to fund vacant and unfunded positions. Establishing a new pay incentive program for civil service social workers and psychiatrists. Alcohol and meth sobering centers City officials are scouting sites for a proposed sobering center, where people with substance abuse disorders can get access to addiction treatment and other services. Exactly what the center might look like isn't yet clear, but officials envision a location where people could be referred by street-level care workers or by the police, as an alternative to incarceration. About the Broken Care series San Francisco spends nearly $400 million a year on mental health and addiction treatment, but thousands of people in crisis are still without sufficient care. In this ongoing series, Chronicle journalists investigate the failures of this complicated, costly system and explore solutions to the crisis.

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If Mental Health SF passes in March, it is unclear how the two plans would work together — and whether the city would be on the hook for paying for both.

Critics say the fact that there are now two plans to address the city’s mental health crisis is a stark example of City Hall’s inability to leave politics behind and work together to fix the city’s crisis.

“Can’t these people talk to each other?” said Dr. Paul Linde, a former psychiatric emergency room doctor at San Francisco General Hospital. “The plans are similar, and I don’t think one is better than the other. I’m frustrated that they can’t get together and hammer out some details.”

Haney and Ronen blasted Breed’s plan, and said the system needs a complete overhaul rather than a patchwork of new policies and initiatives. They also said her plan focuses too much on those who are already homeless, rather than preventive measures for keeping people off the street.

“This is the same set of incremental polices that the mayor announced three weeks ago, now she’s just changed the name to UrgentCareSF,” Haney said. “They still are refusing to restructure our system to effectively coordinate care so that people don't fall through the cracks back out onto the street.”

Lizz Cady, a social worker in the city who consulted with Haney and Ronen on Mental Health SF, said the broad strokes of Breed’s plan are similar to the proposed ballot measure: expanding services and improving relationships with community providers.

But, she said, she is skeptical of the cost — especially when it comes to the amount of new beds that Breed is proposing adding to the system. Breed’s plan would add 1,000 new beds at varying levels of care, the 800 announced Tuesday plus 200 previously in the pipeline. That includes 50 locked beds for patients exiting the criminal justice system and 250 post-treatment housing placements.

“It’s a bit strange to me because most of the pushback from Breed about why Mental Health SF couldn’t work was because of cost,” Cady said. “But what she’s proposing looks even more expensive.”

The most recent version of Mental Health SF would cap the city’s costs at about $100 million a year.

Linde said he appreciates how Breed’s plan focuses on hiring and increasing programs for substance abuse. But over the years, he said, his trust in the department being able to carry out ambitious plans like this one has dwindled.

“This looks very ambitious, and if they are able to follow through on most of this, it is going to be a huge upgrade,” he said. “But the devil is in the details.”

Dominic Fracassa and Trisha Thadani are San Francisco Chronicle staff writers. Email: dfracassa@sfchronicle.com, tthadani@sfchronicle.com Twitter: @dominicfracassa, @TrishaThadani