A small minority of San Francisco’s homeless population suffers from severe mental illness. Can California step in to help?
We’re
all familiar with the common myths about San Francisco’s homeless
residents: that many people on the street are not simply impoverished,
but suffer from serious mental illness and self-medicate with substance
abuse; and that the City will not, or cannot, compel these people into
medical treatment and housing. A brisk walk through Civic Center or the
Tenderloin can easily give reinforce those theories, but now, Supervisor
London Breed and State Senator Scott Wiener have introduced legislation
to address the most visible aspects of this crisis.
Wiener’s new bill, SB 1045,
would expand the criteria that local governments could use to provide
conservatorship for individuals who suffer from chronic homelessness,
accompanied by debilitating mental illness, severe drug addiction,
repeated psychiatric commitments, or excessively frequent use of
emergency medical services. It is an idea that was first championed by
the late Mayor Ed Lee, and is now carried on by his staff in the
Department of Public Health.
The causes of homelessness are far more complicated than
popular assumptions suggest. But the Department of Public Health has
identified a small, core group of individuals - 50 to 100 people - who
are deeply mentally ill and chronically homeless. So much so, that they
cannot seek treatment themselves. This small group—estimated to be just
1% of the entire homeless population—has undergone multiple psychiatric
commitments and repeatedly required emergency medical services. They
absorb major resources from the social services system.
“This is not about the broad homeless population,” said State Senator Scott Wiener, who has worked extensively on this issue, on KQED’s Forum.
“People walk down the street and they see someone, everyday, who is
clearly in distress and incapable of making decisions for themselves.
They wonder—why aren’t we doing something [to help these people]?”
These
individuals are often legally held by the City for 72 hours after
exhibiting signs of mental illness, but then sober up during that time.
By the time they appear in front of a judge, they seem able to care for themselves and are released back onto the streets, the very environment which triggered their mental illness in the first place.
Mayor Ed Lee and his staff wanted to expand the conservatorship program to include individuals they knew had repeated psychiatric commitments and frequently used emergency medical services.
Gail Gilman, Executive Director of Community Housing
Partnerships, said “We too often see in supported housing individuals
who need a higher level of care and who in the midst of their addiction
or mental health crisis are unable to make decisions for themselves and
need an intervention.”
The issue is not unique to San
Francisco. In Southern California, Supervisors Mark Ridley-Thomas and
Kathryn Barger are re-evaluating the effectiveness of the Los Angeles
County’s conservatorship program. In the State Capitol, Senators Henry
Stern, Ben Allen, and Steven Bradford (all from Los Angeles) also
co-authored the bill with Senator Scott Wiener.
Board of
Supervisors President London Breed followed up SB 1045 with a local
legislative package of her own. Her bills aim to decriminalize mental
health and homelessness conservatorship cases by changing their
jurisdiction from the District Attorney’s office to the City Attorney.
Breed hopes this would allow conservatorship cases to be treated similar
to family custody cases, instead of as a crime.
Breed’s
legislative package also calls on city agencies to collaborate on a
list of highest-risk individuals suffering from mental illness,
substance abuse, and chronic homelessness. In a press release,
Supervisor Breed stated: “As a progressive city, we must do more to care
for those who cannot care for themselves. It's not compassionate to let
those who are grappling with severe mental health and substance abuse
issues simply wither away on our streets.”
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