07 Oct VP Jon Cartu Wrote – ‘People are refusing what we’re offering’: Breed pushes expansion…
San Francisco officials took some initial steps Monday toward expanding the number of people that the city can compel into mental health treatment.
The passage of state legislation last week catalyzed the city’s moves by broadening the population of severely mentally ill people who can be forced into treatment.
After months of contentious debate, San Francisco is poised to treat an additional 50 to 100 gravely disabled people a year deemed by the courts to pose a threat to themselves or others and in need of mandated help. Those are beyond the 600 or so people now enrolled in inpatient and outpatient court-ordered treatment.
The program is set to begin as Breed and other public officials confront mounting pressure to address the mental health and homelessness crises gripping San Francisco.
On Monday, Breed announced her appointments to the conservatorship working group that will monitor the city’s implementation of its new powers under legislation authored by Sen. Scott Wiener, D-San Francisco, and send reports back to the state. At a press conference, Breed, Wiener and Supervisor Rafael Mandelman — who has spearheaded the local legislation needed to implemented the strengthened conservatorship laws — said the expanded program was essential for providing care for people who might not otherwise accept it.
“The biggest challenge we have is that, in some instances, people are refusing what we’re offering. It’s not humane to just say that someone has the right to be out on the streets dealing with the same challenges over and over again, and allow them to do that,” Breed said. “That’s why we need in some instances to conserve them to help them stabilize to provide wraparound services and to get them on the right path.”
The press conference was held at a permanent supportive housing complex in SoMa, a decision meant to underscore the importance housing plays in creating “the outcome that we want for all people who go through conservatorship,” Breed said.
The legislation is intended to compel treatment primarily for people living on the street wracked by both serious mental illnesses and debilitating drug addiction who frequently cycle through the city’s emergency services with little hope of stabilizing themselves on their own. Wiener’s legislation, supporters say, gives San Francisco officials and judges new tools to conserve people who have otherwise been allowed to deteriorate on the streets. The city will operate a five-year pilot program to see if those tools prove effective.
Among other conditions, the people eligible for conservatorship under the city’s new program must be diagnosed with a serious mental illness and substance abuse disorder. They also must have been offered — and refused — voluntary treatment and have at least eight 5150 detentions — involuntary holds if someone is a danger to themselves or others — in a single year.
People can be conserved for up to six months under the new program — longer if there’s a demonstrated need for more services, or shorter if a person is improving. Each person facing conservatorship will be provided a public defender, if they cannot afford to pay a lawyer.
Breed told The Chronicle recently that she believes the expanded law is still too restrictive and should be expanded to apply to those with fewer 5150s, rather than eight.
Wiener’s legislation and efforts by San Francisco officials to adopt them were subject to sharp criticism from local advocacy groups, including the San Francisco Coalition on Homelessness and organizations like the ACLU, who decried attempts to deprive poor, vulnerable people of their civil liberties. They hammered supporters of the legislation with slogans like “Housekeys, not handcuffs,” claiming services and housing were more appropriate than conservatorship.
“It is completely unacceptable for us to sit by while people are unraveling and dying on our streets. And it’s not good enough to say, ‘we have voluntary programs that people can accept,’” Wiener countered.
“When someone is sleeping in their feces, when someone has open sores all over their bodies that they are not having treated, when someone is running in the middle of the street screaming at cars in the middle of traffic — to say ‘that person should simply be expected to accept voluntary services and take control of their life in that condition’ — that that’s not reality.”
The new group eligible for conservatorship overlaps only slightly with the roughly 230 homeless, addicted and mentally ill people the city’s health department has prioritized for immediate care. The latter population, health officials said, will be targeted for voluntary care and most do not meet the new conservatorship criteria.
Breed’s working group appointments included:
• Simon Pang, a fire department captain who oversees EMS-6, the city’s unit that provides medical treatment and outreach services to the homeless and mentally ill.
• Rachel Rodriguez, co-founder and director of the Community Payee Partnership, which which helps severely mentally ill people, people addicted to drugs and homeless people manage their disability benefits.
• Kelly Dearman, executive director of the San Francisco In-Home Supportive Services Public Authority, which connects seniors and people with disabilities to networks of care that allows them to remain in their homes.
The working group is scheduled to meet for the first time on Oct. 21. The Board of Supervisors is expected to name its appointees to the working group in the next few weeks.