Research visits to my beloved California always seem to be a source for blogging inspiration. Whereas a visit to San Quentin spurred me to write a blog the last time I was in the Golden State, this time the location of my apartment is “to blame”. As a Visiting Professor at UC Hastings I was offered an apartment in what is referred to as The Tower. The 24-story high former hotel now belongs to the Law School and houses students as well as visiting academics. The Tower – as well as the Law School – is located in quite an interesting area of San Francisco, also known as the Tenderloin. The Tenderloin district encompasses about 50 blocks and is known as a high-crime neighbourhood with particularly violent street crime such as robbery and aggravated assault. Although exact numbers are lacking, based on research, it seems plausible that a large chunk of the crime is committed by the sizeable homeless population in this area who are often suffering from drug addiction and severe mental health issues.
Growing numbers of mentally ill homeless on the streets
As shown by the biannual homeless report that was published by the Human Services Agency of San Francisco, the number of homeless individuals in San Francisco counted in the 2013 general street count and shelter count was 6,436. Of this number, about 2,039 are chronically homeless. Although the 2013 numbers remained seemingly flat when compared to 2011, of those counted, 3,401 were living on the street, an increase of about 300 since 2011, city officials said. As in previous years the greatest numbers of homeless (47%) were counted in District 6 which includes the Tenderloin and South of Market. Besides the increase in the number of homeless living on the street, the report also shows an increase in the percentage of homeless counted reporting having a mental illness, addiction or debilitating physical condition. In 2011 this percentage was 55% compared to 63% in 2013.
Lack of beds and patient dumping
San Francisco may have good community services, but it is still lacking two things many mentally ill homeless people need: outreach teams and crisis beds. Outreach teams play a pivotal role in connecting with homeless persons on city streets 24/7, pointing them in the direction of community services and psychiatric help. San Francisco currently only has one homeless outreach team. People in a mental crisis often need to be stabilised first before they can move on to community services. Yet the lack of available public crisis beds in San Francisco – as in the rest of the United States – forms a tragic obstacle in this process.
Besides less psychiatric beds, another reason for the increase of mentally ill homeless people on the streets of San Francisco can be found in the dumping of thousands of poor and homeless patients with mental illnesses by a Nevada state psychiatric facility. Over the course of five years, patients from Rawson-Neal psychiatric hospital were put onto buses with one-way tickets to California and were told to seek medical care there. Rawson-Neal psychiatric hospital’s “patient dumping” was exposed in an April 2013 investigation by the Sacramento Bee. Doctors allegedly told patients that Nevada lacked sufficient funding for affordable housing and mental health care services — two critical aspects of the social safety net for protecting the indigent and mentally ill — and that they would have better luck seeking care elsewhere. Patients were reportedly discharged with nothing but two or three days’ worth of medication, some snacks, and a one-way bus ticket. San Francisco’s City Attorney has sued the State of Nevada on behalf of 24 mentally ill and homeless people. The case is still pending.
A better future ahead?
Despite these rather depressing figures, there have also been some hopeful developments. The Investment in Mental Health Wellness Act of 2013 establishes a new grant programme to disburse funds to California counties or to their non-profit or public agency designates for the purpose of developing mental health crisis support programmes. Specifically, funds will “increase capacity for client assistance and services in crisis intervention, crisis stabilisation, crisis residential treatment, rehabilitative mental health services, and mobile crisis support teams.” Applications for the first round of funding are now under review. Also, the city San Francisco plans to double its investment in a homeless outreach programme to $6.6 million as those living on the streets have come under increased scrutiny amid a better economy and the conclusion of a 10-year plan to address homelessness. Although these plans sound promising, it will probably take a while before the results will be visible in the Tenderloin District and, more importantly, before those who are in imminent need of mental care can benefit from it. Until then, their crisis beds will be the hard stone streets of Fog City.
To a criminologist and legal scholar from the Netherlands, the homeless situation in the San Francisco is sad, shocking and academically intriguing at the same time. Over the next couple of months I am planning to continue doing some – modest – research into this topic. I hope to share my thoughts and findings on the Leiden Law Blog.