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Originally Posted by Pedestrian
Pretty much every objection to the behavior of the homeless applies to one group: the long term homeless (homeless for at least many months, usually years) who are mostly mentally ill and/or addicted. In SF services are available but there is no effort to compel those living on the street to access outpatient treatment. Two things need to be noted: All those non-profits supplying services have city contracts and the city has a “Homeless Services Coordinator” who is supposed to coordinate what they do.
Finally to the degree money is the problem, more is coming in the form of a new $300 million tax—just about double current city spending—that a judge just found legal.
But what no one has done or plans to do is to enforce laws on public behavior . . . and that’s in spite of CA having a law that allows a judge to order “conservatorships” that includes the power to authorize compulsory institutionalization for those clearly beyond managing their own lives.
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One frequently homeless person I knew quite well by the name of Thomas was an on-again/off-again resident of SF. Thomas was almost 60 years old and a very talented and trained artist with schizo-affective disorder/bi-polar type. He knew how to work the system for housing and mental health care. Usually he was medication compliant. He was also a somewhat recovered alcoholic. I met him here in Austin in 2008 or so at a 12 step meeting. Somehow he'd saved enough money to move to Austin (he'd heard it might be a congenial place for him) and was staying in a youth hostel near downtown. He was on his meds and managed to get his entitlements switched to Texas. He also got hooked up with local state run mental health services and was able to obtain meds from them as long he he stayed in the system. He supplemented his income by making small "aht" items (he was originally from Boston) that he sold in a street market near the UT campus. He even managed to find a little efficiency apartment through a housing program sponsored by Goodwill. For a while, he was pretty happy, but eventually he started missing appointments at the psych clinic. As a result, he was automatically removed from the system. He could not get psych med prescriptions refilled until he was re-enrolled in the system, which took the better part of 6 weeks! This was exactly the kind of stress he was not equipped to handle, but the system had very inflexible rules probably designed to trim the patient rolls and stay within budget. There had been large recent cuts in the mental health budget for the state. Thomas quickly became very manic and then suicidal. He ended up with a brief psychiatric hold and when he got out, he was facing eviction for non payment of rent and also for disruptive behaviors in the complex. Thomas spent the next several months couch surfing or living on the streets. He finally decided to go live with his mother in Boston.
The next time I heard from Thomas was about two months later. He was back in San Francisco. Boston had not worked out for him. He was calling because he was now completely homeless living in encampments either in Golden Gate Park or down near the Civic Center. He was hoping I could send him some money. This proved very difficult because he had ID and other belongings stolen from him by a knife wielding homeless person in the GG Park encampment. I talked a SF friend into giving Thomas some money, which is another story altogether for another time. Thomas did manage somehow to work the system again in SF, get back on meds, and find some housing in a group home or flat somewhere in the Outer Mission (I wonder whether such places still exist in today's SF with the high housing costs).
I though that might be the last I heard from Thomas, but Austin still beckoned to him. Within a year, Thomas was back in the ATX. Once again he got his entitlements switched to Texas (he really bitched about the differential between SSDI in Texas vs California) and got hooked up with outpatient services again too. He continued to make and sell his "aht" up on The Drag across from UT. With help from Austin Resource Center for the Homeless (known locally as the Arch), Thomas found housing in a facility run by Foundation Communities of Austin. He had his own room and bath in a very attractive, secure, and well run former nursing home. He had access to a communal kitchen, lounge areas, and garden. He was free to come and go as he pleased, no visitors after 10PM. His rent was about 1/2 of his SSDI check. At first Thomas was thrilled with this set up, but he soon was bothered by the fact that it was located 6 miles south of downtown. He had to take a 45 minute cross town bus trip (with transfer) to get up to the UT area. Somebody from the 12 step meeting gave him a very old and rusted out car that still ran. Thomas never got a license but he drove the car until one day a tire shredded. Thomas needed to get a tire for the car. Clearly a cheap retread would do the job, but Thomas just did not have the skill set required to make this happen. He got quite huffy about it, pointing out that he was a Boston and San Francisco kind of guy who just did not know about such things. Back on the bus, Thomas started having unpleasant interactions with a surly female bus driver. She threw him off the bus. Now Thomas did not want to ride the bus. This meant Thomas was not going up to campus to sell his "aht", and he also was not keeping his appointments with the mental health provider. Sure enough he was again kicked out of the mental health system and unable to fill precriptions. Another psychotic episode ensued and another inpatient stay followed. Shortly after being released Thomas was diagnosed with prostate cancer. He opted to go back to Boston for treatment and surgery. His family paid for his return. I lost touch with him shortly afterwards, and he disappeared off of Facebook. He did not own a computer by the way. He always went online at the public library.
I'm sharing my Thomas story here, Pedestrian, because of the SF connection, but also to illustrate how difficult it is for even a fairly high functioning and generally compliant mentally ill person to stay in the system and maintain housing. Clearly there are some options for those that are able to do so, and San Francisco seems to spend a good bit of money trying to deliver services. Austin also spends a pretty penny, especially for a city in Texas. It still isn't enough and there is a complete lack of coordination and tailoring of services even to help those who want to help themselves. I don't have an answer, but I know we are doing nobody a favor to allow the homeless population to run amuck and degrade the environment for themselves and everybody else as well. Even somebody as high functioning as Thomas would benefit from conservatorship. He wouldn't like it, but he'd be a lot better off with some mandatory supervision and timely interventions.