4 ms·

Is homelessness in SF really about affordable housing? Obviously San Francisco has insane housing prices but there are dozens and dozens of shelters & programs

Is homelessness in SF really about affordable housing? Obviously San Francisco has insane housing prices but there are dozens and dozens of shelters & programs (I volunteer at a couple) for homeless people to take refuge and get their life back together. As I understand it (and as my friend who is an SF police officer where 90% of his job is dealing with the homeless), the much larger problem is SF's (& perhaps society in general's) failure to provide institutionalized care for people with severe mental disabilities. No amount of money, support systems, or opportunity for getting off the street is going to help people with severe schizophrenia or dementia who have no family or safety net. A lot of these people the only solution is for them to be institutionalized. Unfortunately, there isn't much of a way for someone to be institutionalized against their will (unless they are causing danger of harm to themselves or others) so they continue to live on the streets. I think what this city really needs is a place to send people deemed in need of institutionalizing, and the ability for that to be determined. Of course that would never fly in a place like SF, but I think it would be a happier life for those people than life on the streets.

adamrezich 8y ago
Being born in 1991 I didn't realize this until recently but apparently we used to be better about this before these institutions shut down in the 80s-90s. I still don't really understand why this happened or how the resulting issues haven't been addressed.
- aeternus 8y ago
  Simply shutting them down probably wasn't the best solution, but those institutions were generally more geared towards locking people away than recover & treatment.
- gumby 8y ago
  > apparently we used to be better about this before these institutions shut down in the 80s-90s. I still don't really understand why this happened or how the resulting issues haven't been addressed. There are two explanations, idealistic and cynical; I'll let you decide what percentage of accuracy applies to each (neither were 0% or 100%). The idealistic justification was that the institutional option was pretty grim (think "one flew over the cuckoo's nest") and that many of those patients would do better at home or in halfway houses. The cynical explanation was that this was at the beginning of the huge anti-tax / anti-government wave that began with Reagan's election and continues today: closing the institutions cut government expenditure.
- js2 8y ago
  I found this via Google and it seems to cover the highlights: https://www.thebalance.com/deinstitutionalization-3306067 https://www.thebalance.com/deinstitutionalization-3306067
- zapita 8y ago
  > I still don't really understand why this happened Reagan and his failed economic policy. > or how the resulting issues haven't been addressed. The ongoing personality cult around Reagan and his failed economic policy.
kareemsabri 8y ago
Couldn't the money be used for mental health facilities? Toronto has https://en.wikipedia.org/wiki/Centre_for_Addiction_and_Mental_Health https://en.wikipedia.org/wiki/Centre_for_Addiction_and_Menta... - which I believe is publicly funded
- core-questions 8y ago
  One problem is that we don't really "commit" people the same way as we did decades ago. It's a lot harder to just declare someone unfit and lock them in an institution - and for good reason, but the unfortunate result is that mental institutions no longer serve the same function of cloistering these people away from the rest of society. The reaction to unacceptable conditions was correct and justifiable, but we've thrown the baby with the bathwater in the sense that now, mentally handicapped people are homeless all over the place...
  - leetcrew 8y ago
    this is something i think about a lot, as one of my best friends from high school developed severe schizophrenia in his early twenties and has been living on the streets for several years now. his parents have plenty of money and would be willing to pay for pretty much any treatment program, but he completely refuses to try at all. they've had him involuntarily committed several times now, but he just walks out as soon as possible every time. the doctors say there is still a possibility of managing his condition, but that the time window is closing. on the one hand, it's really frustrating because it seems like his life could be greatly improved if he could be forced to undergo long term treatment. he might even be grateful on the other side. but on the other hand, living in a putatively free society, is there a point where you just have to take someone at their word that they don't want to do something? he doesn't seem to be hurting anyone but himself, and he claims to be happy.
    - cco 8y ago
      Depending upon the state a few ounces of weed could get him locked away for far longer than it would take to get his mental illness under control. That to me starkly calls out the hypocrisy.
snowmaker 8y ago
There is actually a severe shortage of shelter beds in San Francisco. You are right that mental health is a consideration, but the bigger problem is both simpler and easier to fix: the number of shelter beds (and other forms of supportive housing - including long-term housing) has decreased since 2004 and is woefully inadequate for the number of current homeless. For more reading on this topic I recommend this detailed analysis: https://medium.com/@josefow/the-one-stat-that-explains-sfs-street-homeless-crisis-e863329ba8ed https://medium.com/@josefow/the-one-stat-that-explains-sfs-s... Also Mayor London Breed's analysis and approach: https://medium.com/@LondonBreed/a-bold-approach-to-homelessness-a42121dc586c https://medium.com/@LondonBreed/a-bold-approach-to-homelessn...
abalone 8y ago
> the much larger problem is SF's... failure to provide institutionalized care for people with severe mental disabilities You can debunk this with a simple observation: Homelessness has grown significantly in the past 20 years. Has severe mental illness grown significantly during that time? The bigger problem here is Stripe's argument is misleading. They're comparing cost-per-resident instead of cost-per-homeless-resident, when SF actually has a higher rate of homelessness than other cities. We actually spend less per homeless resident than NYC. Totally invalidates their argument that "if it's just a question of money this issue would already be solved."
- orf 8y ago
  > Has severe mental illness grown significantly during that time? Maybe? Who's to say it has not?
- smsm42 8y ago
  > Has severe mental illness grown significantly during that time? No, but protocols for involuntary commitment of people with borderline states may have. > They're comparing cost-per-resident instead of cost-per-homeless-resident It is pretty easy to derive one from the other, given homelessness levels, and given as SF is has one of the highest ones (slightly lower only than NYC) the conclusion seems to stay - expense level is very high. > We actually spend less per homeless resident than NYC Source?
  - abalone 8y ago
    > given homelessness levels, and given as SF is has one of the highest ones (slightly lower only than NYC) the conclusion seems to stay - expense level is very high. That doesn’t follow at all. NYC spends 10x what SF does on homelessness. SF spends $3.8K [1] on each homeless person while NYC is around 10x that. [2] [1] https://www.sfchronicle.com/bayarea/heatherknight/article/Businesses-must-contribute-more-to-city-s-13178743.php https://www.sfchronicle.com/bayarea/heatherknight/article/Bu... [2] https://www.wsj.com/articles/cost-of-housing-homeless-in-shelters-keeps-rising-in-new-york-city-1537377091 https://www.wsj.com/articles/cost-of-housing-homeless-in-she...
TarpitCarnivore 8y ago
Things like SRO's are vanishing in the city and they were at one point a way for lower income people to live off the streets: https://thebolditalic.com/life-inside-sf-s-vanishing-single-resident-occupancies-the-bold-italic-san-francisco-20bf7aa0b3c8 https://thebolditalic.com/life-inside-sf-s-vanishing-single-...

adamrezich 8y ago

Being born in 1991 I didn't realize this until recently but apparently we used to be better about this before these institutions shut down in the 80s-90s. I still don't really understand why this happened or how the resulting issues haven't been addressed.

aeternus 8y ago
Simply shutting them down probably wasn't the best solution, but those institutions were generally more geared towards locking people away than recover & treatment.
gumby 8y ago
> apparently we used to be better about this before these institutions shut down in the 80s-90s. I still don't really understand why this happened or how the resulting issues haven't been addressed. There are two explanations, idealistic and cynical; I'll let you decide what percentage of accuracy applies to each (neither were 0% or 100%). The idealistic justification was that the institutional option was pretty grim (think "one flew over the cuckoo's nest") and that many of those patients would do better at home or in halfway houses. The cynical explanation was that this was at the beginning of the huge anti-tax / anti-government wave that began with Reagan's election and continues today: closing the institutions cut government expenditure.
js2 8y ago
I found this via Google and it seems to cover the highlights: https://www.thebalance.com/deinstitutionalization-3306067 https://www.thebalance.com/deinstitutionalization-3306067
zapita 8y ago
> I still don't really understand why this happened Reagan and his failed economic policy. > or how the resulting issues haven't been addressed. The ongoing personality cult around Reagan and his failed economic policy.

kareemsabri 8y ago

Couldn't the money be used for mental health facilities? Toronto has https://en.wikipedia.org/wiki/Centre_for_Addiction_and_Mental_Health https://en.wikipedia.org/wiki/Centre_for_Addiction_and_Menta... - which I believe is publicly funded

core-questions 8y ago
One problem is that we don't really "commit" people the same way as we did decades ago. It's a lot harder to just declare someone unfit and lock them in an institution - and for good reason, but the unfortunate result is that mental institutions no longer serve the same function of cloistering these people away from the rest of society. The reaction to unacceptable conditions was correct and justifiable, but we've thrown the baby with the bathwater in the sense that now, mentally handicapped people are homeless all over the place...
- leetcrew 8y ago
  this is something i think about a lot, as one of my best friends from high school developed severe schizophrenia in his early twenties and has been living on the streets for several years now. his parents have plenty of money and would be willing to pay for pretty much any treatment program, but he completely refuses to try at all. they've had him involuntarily committed several times now, but he just walks out as soon as possible every time. the doctors say there is still a possibility of managing his condition, but that the time window is closing. on the one hand, it's really frustrating because it seems like his life could be greatly improved if he could be forced to undergo long term treatment. he might even be grateful on the other side. but on the other hand, living in a putatively free society, is there a point where you just have to take someone at their word that they don't want to do something? he doesn't seem to be hurting anyone but himself, and he claims to be happy.
  - cco 8y ago
    Depending upon the state a few ounces of weed could get him locked away for far longer than it would take to get his mental illness under control. That to me starkly calls out the hypocrisy.

snowmaker 8y ago

There is actually a severe shortage of shelter beds in San Francisco. You are right that mental health is a consideration, but the bigger problem is both simpler and easier to fix: the number of shelter beds (and other forms of supportive housing - including long-term housing) has decreased since 2004 and is woefully inadequate for the number of current homeless. For more reading on this topic I recommend this detailed analysis: https://medium.com/@josefow/the-one-stat-that-explains-sfs-street-homeless-crisis-e863329ba8ed https://medium.com/@josefow/the-one-stat-that-explains-sfs-s... Also Mayor London Breed's analysis and approach: https://medium.com/@LondonBreed/a-bold-approach-to-homelessness-a42121dc586c https://medium.com/@LondonBreed/a-bold-approach-to-homelessn...

abalone 8y ago

> the much larger problem is SF's... failure to provide institutionalized care for people with severe mental disabilities You can debunk this with a simple observation: Homelessness has grown significantly in the past 20 years. Has severe mental illness grown significantly during that time? The bigger problem here is Stripe's argument is misleading. They're comparing cost-per-resident instead of cost-per-homeless-resident, when SF actually has a higher rate of homelessness than other cities. We actually spend less per homeless resident than NYC. Totally invalidates their argument that "if it's just a question of money this issue would already be solved."

orf 8y ago
> Has severe mental illness grown significantly during that time? Maybe? Who's to say it has not?
smsm42 8y ago
> Has severe mental illness grown significantly during that time? No, but protocols for involuntary commitment of people with borderline states may have. > They're comparing cost-per-resident instead of cost-per-homeless-resident It is pretty easy to derive one from the other, given homelessness levels, and given as SF is has one of the highest ones (slightly lower only than NYC) the conclusion seems to stay - expense level is very high. > We actually spend less per homeless resident than NYC Source?
- abalone 8y ago
  > given homelessness levels, and given as SF is has one of the highest ones (slightly lower only than NYC) the conclusion seems to stay - expense level is very high. That doesn’t follow at all. NYC spends 10x what SF does on homelessness. SF spends $3.8K [1] on each homeless person while NYC is around 10x that. [2] [1] https://www.sfchronicle.com/bayarea/heatherknight/article/Businesses-must-contribute-more-to-city-s-13178743.php https://www.sfchronicle.com/bayarea/heatherknight/article/Bu... [2] https://www.wsj.com/articles/cost-of-housing-homeless-in-shelters-keeps-rising-in-new-york-city-1537377091 https://www.wsj.com/articles/cost-of-housing-homeless-in-she...

TarpitCarnivore 8y ago

Things like SRO's are vanishing in the city and they were at one point a way for lower income people to live off the streets: https://thebolditalic.com/life-inside-sf-s-vanishing-single-resident-occupancies-the-bold-italic-san-francisco-20bf7aa0b3c8 https://thebolditalic.com/life-inside-sf-s-vanishing-single-...