Robert Steiner
Psychiatric Counselor, San Francisco County Jail

My job is to figure out what needs to happen to make sure inmates are safe. So it could be assessing whether they should go to a forensic psychiatric hospital, San Francisco General Hospital, or do they need to stay in a safety cell for a while. It could also be that they need psychiatric housing, or maybe they need to be watched 24 hours a day because [the symptoms of their illness] are so acute.

Psychiatric housing is so extremely overcrowded all the time that sometimes we are making decisions based on capacity. So maybe there is no room in psychiatric housing, and this person you are assessing is psychotic, but they have to go back to the general population. It is not great to sign off on something like that, but because of availability, unfortunately, you are limited.

I think a lot of the people I see probably should be in state hospitals. Instead, I see them get released, and I know there is a good chance they are going to come back. There are many that come back and say, "Do you remember me?" Some people I see very frequently, and it may just be they are intoxicated in public, or they are trespassing, because maybe they don't have a place to stay. Or it's a drug charge. And [the misdemeanor charges] just keep adding up until eventually they do something severe. I feel bad saying this, but I almost wish their crimes were felonies, so they could get better treatment or maybe get to a state hospital.

We do have a jail aftercare system, so if a person is open to it, then we can hook them up to treatment in the community. But we need more resources out there. You hear that the community feels that we are turning the neighborhoods into jail, and then we complain, "Well, you are turning us into a mental health treatment facility." Both are true, but it's frustration over the same thing--a lack of resources.

What do I like about my job? It's never boring. Extremely challenging. And I do get to see people when they are on medications, when they are off street drugs and alcohol, and when they are eating and sleeping. So I get to see how treatment can work, and see a complete change. And, I mean, I feel like if I can help people stay safe while they are incarcerated, I feel like I've done a pretty good job.

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