New mental health center doubles conservatorship beds in city for seriously ill

A number of Bay Area hospitals have banded together with city officials to try to help the toughest cases among San Francisco’s homeless.

The San Francisco Healing Center, a new 54-bed psychiatric facility, occupies an entire floor at St. Mary’s hospital and is intended to serve the city’s most vulnerable individuals: those suffering from severe mental illness or addiction, who are also some of the most difficult to channel off the streets and into stable housing.

Businesses in San Francisco have been concerned about the impact of the city’s sizable homeless population for years, especially as both residents and tourists continue to note aggressive behavior, open drug use and needles littering streets in surveys.

While the new center will not solve homelessness, it will add more resources and the center could be a model that’s scaled up in the future. It’s designed for a spectrum of treatment that includes 24-hour nursing and psychiatric care, counseling, medical treatment, community support and activities, and individual recovery and discharge planning.

“We have all worked together really well in trying to get this facility off the ground,” said Barbara Garcia, director of health at San Francisco’s Department of Public Health, which is involved in the project. “It’ll be providing mental health support, vocational training — it really is a recovery model.”

The center will double the city’s number of conversatorship beds. Granted by a judge, conservatorships are assigned in cases where an individual is mentally ill or drug addicted — or both — and unable to live independently. Previously, individuals who couldn’t be accommodated needed to wait for placement in out-of-county facilities, hospitals or jail.

What makes the center’s approach unique, according to Crestwood Behavioral Health Executive Vice President Patricia Blum, are practices that take into account multiple factors. Crestwood Behavioral Health is one of the partners involved in the project.

“We use really promising, evidence-based practices that include trauma-informed services, with a focus on treating trauma and not just the diagnosis,” she said. “We also use an employment model, helping to connect people with jobs in the community. If people have a meaningful role and purpose, there’s a significant impact.”

Although the number of beds is relatively small when compared to the city’s homeless population of nearly 7,000 — 40 beds, plus an additional 14 beds available to outside providers to purchase — getting help to more people should help both them and the city.

“We’re here as a business community worried about the very future of San Francisco’s brand,” Joe D’Alessandro, president and CEO of San Francisco Travel told the Business Times in 2016. In the past several months, property owners in both the Financial District and western SoMa have started working on creating community benefit districts to combat homelessness and dirty streets.

The 40 beds are for individuals who wind up in inpatient treatment through conservatorships. Conservatorships have been relatively rare until now, but they may also be expanding if SB 1045, a state Senate bill sponsored by Sens. Scott Wiener and Henry Stern, is successful. The bill proposes broadening the authority of counties to assign conservatorships to individuals who are too impaired by mental illness or severe drug addiction to care for themselves.

Wiener said that strengthening conservatorship laws for “extreme cases” are a necessary lever for getting chronically homeless into treatment.

“Here in San Francisco our public health officials and community organizations have been working tirelessly, but they need more tools to help the people that are suffering on our streets,” he said.

If the bill is successful, San Francisco Healing Center may serve as a particularly important partnership model for connecting some of the city’s neediest to a network of care beyond an initial hospital stay.

The healing center is a public-private partnership between the San Francisco Department of Public Health, Dignity Health, UCSF Health and Crestwood Behavioral Health.

The Department led the partnership, and will oversee the center and contribute $5 million per year to its operations. Dignity Health contributed the space. UCSF Health contributed $1 million toward renovations and programming. The program will be run by Crestwood Behavioral Health, a longtime partner of the city of San Francisco in providing mental health and addiction care.

“It’s difficult to find space in San Francisco. We were fortunate to find an empty space in a hospital, and I’m working right now on the potential for adding more beds,” Garcia said. “Having the facility on a hospital campus, individuals are a bit more protected and have access to more resources.”

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New mental health center doubles conservatorship beds in city for seriously ill