How SF heeds cries for help from the homeless

San Francisco spends more than $300 million every year on homeless services and supportive housing, yet the number of people in significant distress only seems to increase. (Mike Koozmin/2015 S.F. Examiner)

A few weeks ago, a good friend of mine who grew up in — and still lives in — New York City was visiting the Bay Area. We hadn’t said more than a few words to one another when she told me how shocked she was to see how bad the situation on the streets of San Francisco had become.

During the few hours she was in The City, she saw two different people screaming either at her or just into the air, cursing with the wild rantings of someone suffering serious mental health issues or in the throes of very bad drugs. There are lots of homeless people in New York City, she told me, but they’re not screaming on street corners.

My friend’s experience has become all too common in San Francisco. Those of us who live here have become inured to the horrible conditions on the streets. We see it so often that, sadly, it’s become just part of living here.

San Francisco spends more than $300 million every year on homeless services and supportive housing, yet the number of people in significant distress only seems to increase.

It is inhumane to allow someone who is in deep distress to remain in that state for days, weeks or even months at a time. There is no compassion in allowing someone who clearly needs help — and who is not in their right mind to decide for themselves — to avoid getting it.

Yet, as a city, we’ve been reluctant to force people to get help. In 2014, the Board of Supervisors intensely debated whether to adopt Laura’s Law, a state law that allowed family members and others to ask a judge to compel a small subset of people with severe mental illness — those with a history of violence or repeated hospitalizations — to undergo intense outpatient psychiatric treatment, even if the person initially refused the care.

A report issued last year by the San Francisco Department of Public Health found largely positive results for the 60 or so people participating — most voluntarily — in the local program that grew out of Laura’s Law. Even the six ordered by a court to participate saw improvements in their conditions.
Overall, a clear majority of participants (from 65 percent to 87 percent) had fewer hospitalizations, incarcerations or other contact with psychiatric emergency services. Nearly 90 percent reported having a positive outlook on their future. After one year of operation, the program seems to be working.

Hoping to get even more people into treatment, state Sen. Scott Wiener has proposed legislation that would allow communities to expand who is eligible for a conservatorship; that’s when a judge appoints someone to help manage a person’s finances, health care or daily activities when the person is not able to do so themselves. Currently, counties can only create conservatorships for seniors who are at risk of abuse or for people who are “gravely disabled.”

Wiener’s legislation would expand conservatorships to include chronically homeless individuals suffering from severe mental illness or drug addictions. He wants the conservatorship to come with housing attached, so individuals are off the street while getting the help they need.

At the same time, Board of Supervisors President London Breed has introduced legislation that would designate the City Attorney’s Office as the overseer of conservatorships — not the District Attorney’s Office, as is currently the case. The hope is that this move will allow increased coordination between city agencies.

Breed’s legislation would also create a working group to meet regularly to discuss how to deal with the most severely mentally ill and drug-addicted people on the street, with plans tailored to each individual’s specific problems.

I hope advocates on all sides of this issue will focus on how to get more people into treatment that really works, rather than knee-jerk oppose these ideas because of who proposed them.

Neither of these two pieces of legislations will “solve” homelessness. But they could help larger numbers of chronically homeless people with serious mental health problems or drug addictions get the help they desperately need, to take their first steps to stop the screaming on the streets. That is the compassionate, humane thing to do.

Sally Stephens is an animal, park and neighborhood activist who lives in the West of Twin Peaks area.

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How SF heeds cries for help from the homeless