San Francisco’s new homeless road groups make progress, garner reward

Shari Lachin works on one of San Francisco’s new street outreach teams that respond to homeless people experiencing mental health problems instead of the traditional system that relies on police officers. On a recent phone call, she met someone who lived on the streets of Castro, who suffered from severe psychosis and “argues a lot with himself, really with the voices on his head”.

The person had a tendency to curse and “say all these really horrible things,” leading to a story of fighting and isolation in the streets. You and another team member took their time. They approached and talked to the person, encouraging the person to respond to reality rather than internal voices.

“They could argue with us in between so that they could hear us,” said Lachin.

As a result, the team was able to accommodate the person in a shelter-in-place hotel. “It was the same day,” said Lachin. “It’s so magical.”

It’s stories like this that praise the San Francisco Street Crisis Response Team, which started back in November.

This week, San Francisco’s efforts to divert tens of thousands of nonviolent emergency calls away from law enforcement agencies were given greater focus in Mayor London Breed’s two-year budget proposal, which called for additional street response teams, increased 311 callers and the creation of a new position to coordinate dispatches .

Breed said the initial results are promising in meeting the needs of “people who all too often get into dire situations when faced with law enforcement agencies”.

“These teams are working,” Breed said this week. “I’ve seen the results myself.”

Lachin admitted that they were struggling to find accommodation or treatment beds for some of those they engage with. Breed this week also recognized the need for more treatment beds and permanent supportive housing for those encountered. Its budget proposal is to spend more than $ 1 billion over two years on housing and other services for the homeless and to fund the operation of 343 additional treatment beds in addition to the approximately 2,000 existing treatment beds.

The Street Crisis Response Team responds to emergency calls for “calls from mentally disturbed people” that do not involve guns or violence. It started with a crew consisting of a community paramedic, a behavioral medicine clinician, and a peer behavioral health worker from the public health and fire departments. There are now four crews, with two more expected to take off by the end of summer. The six crews cost $ 10.6 million annually. Breed suggests adding a seventh crew to their budget for an additional $ 1.8 million per year.

“The seventh team would provide additional daily coverage to ensure that all nonviolent calls for ‘mentally disturbed adults’ can be answered,” said Breed spokesman Andy Lynch.

It is expected that the seven crews will be able to respond to the approximately 17,000 non-violent emergency calls for “mentally disturbed adults” per year.

Between late November and April 2021, crews in the Tenderloin, Mission, Castro and Bayview neighborhoods responded to 1,027 calls, 20% of all non-violent calls to “mentally disturbed people” made during the same period, and connected with 592 people in need, most of whom were homeless according to the latest city data.

Sometimes they respond to calls and can’t find the person. Fifty-five percent had resolved their crisis on the spot, 18 percent were taken to hospital, 18 percent to behavioral medicine facilities such as treatment beds or accommodations, and 9 percent to a 5150, an involuntary psychiatric institution.

After the police murder of George Floyd by police in Minneapolis last year, alternatives to a police response are gaining traction in cities like San Francisco. One of the most popular models was launched in 1989 in Eugene, Oregon, where it is known as Crisis Assistance Helping Out on the Street, or CAHOOTS.

Breed’s budget also includes a new type of team that responds to 911 or 311 emergency calls for so-called health checks. This is the case when people on the street need wound care, stand unconscious in a doorway or are underclothed according to the weather.

She proposes spending $ 9.6 million on five crews on a new Street Wellness Response Team over a two-year period. These crews combine community paramedics and paramedics from the fire department with members of the homeless outreach team.

The five crews will both be proactive in contacting and handling some of the estimated 18,000 health control calls that armed police officers respond to each year. But it would take five additional teams to respond to all of these calls. The aim is to start the first team in January 2022.

As the alternative police models take shape, The City expects an increase of 311 calls. Because of this, Breed’s proposed budget calls for the addition of 10 additional 311 callers with more than $ 1 million a year in salary and benefits. At 311, with an annual budget of $ 16.8 million, there are currently 80 full-time and five part-time call takers.

“These constant changes in our response to public safety require that we offer a workable alternative,” said Lynch. “311 operators are an essential part of this effort.”

To coordinate calls and ensure the proper dispatch of teams, Breed’s budget is to add a position in the business continuity management department at approximately $ 200,000 per year.

For some, however, these efforts do not go far enough.

The Coalition for Homelessness supports the use of a different model of wellbeing and expanding the response to other police calls involving the homeless, such as: B. Low priority calls such as trespassing.

Their proposed model, the Compassionate Alternative Response Team, or CART, which is estimated to cost an estimated $ 6.8 million a year, excludes city departments and relies on community members with crisis response training and those who have experienced poverty or homelessness. They want the funding to come from the police department budget, which is increased in Breed’s budget proposal.

Lynch said the breed administration does not support CART as it excludes city workers.

With the Board’s Budget and Appropriations Committee reviewing Breed’s budget proposal in the coming weeks, a debate on police funding is expected.

Supervisor Hillary Ronen, who sits on the committee, told the auditor that she “most likely would not” support the police budget increase.

“I want the new teams, which respond to mental crises and complaints about the homeless, to work around the clock and to be fully staffed so that the police no longer have to perform these functions,” said Ronen. “If that’s not the case in this budget, I am willing to transfer money from the SFPD budget to instead fund the teams led by community and trained health professionals.”

Those involved in the work believe they will make a noticeable difference on the streets of San Francisco.

“We believe the work we do makes a change, and we see this anecdotally, even in the short amount of time we’ve been out there,” Lachin said. “We hope it continues like this.”

As for the person they met at the Castro, weeks later, Lachin said she had heard positive news about her progress. They stayed in the hotel room, were put in touch with a psychiatrist, were given medication, and met with a housing coordinator in hopes of moving to permanent supportive housing.

“That’s incredible,” said Lachin. “At that moment we were able to change course for this person and hopefully end their cycle of homelessness.”

jsabatini@sfexaminer.com

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