New S.F. Pilot to Target Homeless Residents Most in Need of Mental Health, Addiction Services

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A homeless man in San Francisco pushes a cart with his belongings on May 17, 2019. (Justin Sullivan/Getty Images)

San Francisco Mayor London Breed on Wednesday announced a new long-term plan to help get more homeless people suffering from mental illness and substance abuse off the streets and into treatment programs.

The initiative aims to provide lasting care for the nearly 4,000 people on the streets that public health officials have identified as having the highest level of service needs, Breed said, calling it a necessary alternative to simply cycling that population in and out of city jails and emergency rooms.

The care would come through a multi-agency pilot program that would streamline housing and health care and increase access to behavioral health services by expanding hours at the city's Behavioral Health Access Center.

Breed, a lifelong San Franciscan, said she was acutely aware of the harrowing scenes on the city's streets.

"We know that there's a mental health crisis here in San Francisco," Breed said during Wednesday's news conference at South of Market Mental Health Services on Harrison Street. "What I see is something I've never seen in my lifetime of growing up in the city, and that is people who are in serious, serious crisis. And the fact is, that in San Francisco, the frustration is that we have a lot of resources, we have a lot of dedicated revenues to help support people, but we have discovered that the coordination has to be better, it has to be more efficient."

The first stage of the pilot will target a select group of 230 — out of 4,000 — of the most vulnerable homeless individuals, who will receive immediate care and be placed in permanent supportive housing, Breed said.

The initiative is largely centered on data gathered by the city's Department of Public Health, according to Dr. Anton Nigusse Bland, San Francisco's newly hired Director of Mental Health Reform.

"We looked very closely at who used San Francisco's social and health care services in the most recent fiscal year," he said. "Out of nearly 18,000 people experiencing homeless, we found that close to 4,000 of them also have both a history of serious mental illness and of substance abuse disorder."

Bland acknowledged the challenge of getting many of those most in need of treatment to participate voluntarily, but said the new program would be "relentless" in pursuing them and offering help. On average, it takes about four months of contact before individuals in this high-need population accept help, he noted.

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"We're going to do whatever it takes to reach these people, to engage them into services and to make sure they can achieve stability and wellness," he said.

Some city leaders, however, say the plan falls far short of fulfilling the massive need on the street.

"I unfortunately wish the Department of Public Health would begin to react to the scale of the problem instead of nibbling around the edges," said Supervisor Hillary Ronen, who has advocated for extending these services to everyone who needs them.

Ronen is pushing for an overhaul of the city's mental health system with a measure slated for the March 2020 ballot. Dubbed “Mental Health SF," the program, if approved by voters, would provide free and immediate access to mental health care to San Francisco residents, regardless of insurance. It would also require the creation of a new round-the-clock drop-in center for people seeking help with mental health or substance abuse issues.

Yolanda Morrissette, a recovering drug addict who was able to overcome her struggles thanks to city services and programs, said that she hopes to serve as an example of someone who can turn her life around despite suffering from mental health and addiction issues.

"They were able to help me get on medication. They were able to get me therapy to get to the root of the problem," she said. "I had a lot of anger issues, depression, suicidal thoughts."

Morrissette said she now lives in a one-bedroom apartment and works full-time as a mental health advocate.

"I just slowly said I was going to build myself up," she said.

Additional reporting was provided by Bay City News.