Quote:
Originally Posted by austlar1
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.
|
Essentially, what could seem to be required is to entirely infantilize the homeless, assuming they have the social skills of a 2 year old and society is their parent so must do everything for them and tolerate the occasional temper tantrum while nevertheless accessing reources of never-ending love.
It might be a nice vision but seems slightly impractical.
I don't know anything about what other cities offer. Here is what San Francisco offers to try to prevent the periodic crises you describe in this man's highly dependent lifestyle.
First there is this group of really very dedicated people who constantly patrol some of the areas you mentioned including Civic Center and GG Park:
Quote:
San Francisco Homeless Outreach Team
The San Francisco Homeless Outreach Team (SF HOT) is a collaboration between the SF Department of Public Health, Human Services Agency, SF Public Library and the non-profit, Public Health Foundation Enterprises (PHFE). The program was reorganized in 2014, 10 years after its formation, to more effectively engage and stabilize the most vulnerable and at-risk homeless individuals and to help prevent the harmful effects of homelessness. Through outreach, medical services, engagement and advocacy, we are dedicated to transitioning individuals into stable living and healthcare environments with access to services that promote greater health and housing retention and reduce vulnerability and the utilization of emergency services.
We work in small teams to outreach and provide care management and medical services to homeless individuals. Each of our team members have expertise in the many complex barriers to stability. These barriers include mental health disorders, disabilities, lack of ability to trust and hopelessness. By focusing on the needs of our most vulnerable citizens, we hope to greatly reduce the negative effects of homelessness on individuals and the community as a whole.
|
As the photo shows, it's a sizeable group and they have vans in which to patrol as well as transport willing homeless persons to services.
Services they can utilize, aside from emergency rooms and psych clinics run by the Dept. of Public Health include:
Quote:
San Francisco Navigation Centers and SAFE Navigation Centers
San Francisco’s first Navigation Center opened in March 2015 and was a successful pilot serving San Francisco’s highly vulnerable and long-term unhoused neighbors who are often fearful of accessing traditional shelter and services. HSH subsequently opened 8 Navigation Centers and currently has 6 in operation.
San Francisco’s Navigation Center model is being replicated nationally and, here in San Francisco, we building on this best practice by developing SAFE Navigation Centers.
Similar to Navigation Centers, SAFE Navigation Centers are low-threshold, high-service residential programs for adults experiencing homelessness in San Francisco. SAFE Navigation Centers are one part of the Homelessness Response System and are an attractive service for people living unsheltered or in encampments.
SAFE Navigation Centers are essential to reducing unsheltered homelessness and connecting guests to services and housing assistance. SAFE Navigation Centers build off of the best aspects of Navigation Centers while making them more scalable, sustainable, and effective. The City is looking to expand SAFE Navigation Centers in neighborhoods across the city to respond to the homelessness crisis.
Navigation Centers and SAFE Navigation Centers are a proven way to get people off the street and on a pathway to housing and stability. In 2018, the Department of Homelessness and Supportive Housing helped over 2,200 people (out of a population of an estimated 4400 living outside on any given night) exit homelessness, and since their launch Navigation Centers helped 46% of their guests end their experience of homelessness after a stay in a Navigation Center.
Navigation Centers and SAFE Navigation Centers do not accept walk-ins. All individuals and couples who enter have been selected by the SF Homeless Outreach Team or a centralized referral system. Because Navigation Centers operate 24×7, there are no lines outside in the evening, and guests are not exited onto the street in the morning.
|
http://hsh.sfgov.org/services/emerge...ation-centers/
The Nav Centers are, of course, temporary measures. In addition, SF has built literally billions of $ of housing specifically for the "formerly homeless" (that is, people who would be homeless without it). Periodically, a new multi-hundred million $ bond issue for this purpose comes before voters. One for $600 million is, I believe coming this November. Some of these facilities even have on-site medical facilities. But there is, as you can imagine, a huge demand: Thousands of people get on the list for each few hundred new units.
Since many of the people living in tents on the sidewalk are substance-addicted, the city has recently started:
Quote:
In San Francisco, Opioid Addiction Treatment Offered on the Streets
By Abby Goodnough
Aug. 18, 2018
. . . in San Francisco, . . . city health workers are taking to the streets to find homeless people with opioid use disorder and offering them buprenorphine prescriptions on the spot.
The city is spending $6 million on the program in the next two years, partly in response to a striking increase in the number of people injecting drugs on sidewalks and in other public areas. Most of the money will go toward hiring 10 new clinicians for the city’s Street Medicine Team, which already provides medical care for the homeless.
Members of the team will travel around the city offering buprenorphine prescriptions to addicted homeless people, which they can fill the same day at a city-run pharmacy . . . .
|
https://www.nytimes.com/2018/08/18/h...addiction.html
This is in addition to a long-standing program of city-funded treatment on demand in established outpatient programs offering such modalities as methadone and buprenorphine.
And the city very much wants to establish "safe injection sites" where addicts can inject drugs indoors where safe needle disposal is the norm, but at the moment has been stymied by the Feds.
It seems to me really hard to know what else can be done aside from building on these initiatives to the extent possible. We need more Navigation Center beds. We may need more money for outreach programs.
But the one thing we haven't done is use law enforcement to clear the sidewalks. Unlike in many cities and suburbs, it's hard to think of a site in San Francisco where outdoor camping could be allowed with sanitary facilities, law enforcement and all the other things needed to keep it safe for residents and clean/disease-free. But maybe we need to try to find such a spot, then tell people if they want to live in a tent they have to do it there. It will necessarily be some distance from the downtown areas where a lot of existing treament and welfare programs are so someone like your Thomas may not want to go there. But really, must we let them have everything their way?
Prev
Linear Mode
