Support

A man screaming at the sky and tearing at himself. A young couple crouched over on the sidewalk, each searching for a vein, syringe in hand. A woman sleeping in her wheelchair at night on the sidewalk. We may witness this reality at our doorsteps, at the transit stations we use to get to work, at the parks we use for play. Yet what we are witnessing is merely a snapshot of homelessness – the one that is most stark.

These heart wrenching, and (yes) sometimes frustrating, scenes we witness on our streets are how we encounter the city’s chronically homeless -- nearly 2,200 San Franciscans who have been without housing for longer than a year and who also have a disabling condition. This is the population we largely encounter because the vast majority are unsheltered, literally living on the streets. While highly visible to us, these individuals with the greatest needs and challenges comprise less than 30% of San Francisco’s homeless population, causing a perception of homelessness that is limited.

Image courtesy of IDEO.org          

Homelessness is a traumatic experience. It is also extremely harmful to one’s physical health; people experiencing homelessness have mortality rates four to nine times higher than the general population.

Those living on the streets are also more susceptible to victimization. This is particularly acute for youth: 37% of homeless youth in San Francisco report being physically assaulted within the last year. Violence occurs not only at the hands of other homeless individuals, but also by the general public, which is an underreported phenomenon.

“I HAVE BEEN STABBED, HAD TWO HEART ATTACKS, LOST A LEG, I WAS SHOT."
- JOE, AS TOLD TO STORIES BEHIND THE FOG

While the humanitarian argument for helping those living on the streets is clear, it makes economic sense as well. Someone experiencing chronic homelessness costs San Francisco taxpayers, on average, $80,000 annually in police, ambulance, hospital and other emergency services. These costs fall dramatically once someone enters supportive housing.

Our Approach

 

The need for a rapid response to the emergency of homelessness is critical. Our approach is to ensure that the differing needs of individuals and families currently experiencing homelessness are addressed in a dignified manner while ensuring those resources are linked to a system that will permanently resolve their housing crisis.

A Better Shelter Experience

San Francisco’s shelter system is inadequately equipped to deal with the number of residents going unsheltered in our city on any single night. Nightly waitlists average over 1,000 individuals.

While there is good reason behind San Francisco’s approach, which has historically prioritized the creation of permanent supportive housing versus temporary shelter, the harsh realities of sleeping on the streets demand an immediate resolution.

Shelter that does not have a clear exit to permanent housing is an insufficient solution. But shelter that offers the lowest possible barriers to entry and stay, coupled with evidence-based wraparound services tailored to each person, can leverage a temporary fix to create a permanent solution. Critically, we must ensure that near-term housing solutions are dignified, empathetic and efficient - a better shelter experience than many encounter today. Including the voices of those experiencing homelessness in decision making around improving the shelter system is key.

Image courtesy of IDEO.org

Care for Addiction and Mental Health

Homelessness exacerbates complications like addiction and mental illness. And the longer someone remains homeless, the more complex these challenges become. Service providers have clients with increasingly complex and acute care needs and overloaded systems have sometimes perpetuated bad outcomes. For example, 38% of homeless people who were discharged from psychiatric emergency services last year in the city exited without a connection to another service, jeopardizing their health, and deepening distrust and alienation.

“Few people would say someone suffering from severe dementia has a human right to wander the streets.”

Dr. Matthew state, Chair, Department of Psychiatry, UCSF

 

We are interested in trauma-informed solutions that create connective tissue across the services and providers that an individual with serious mental health conditions or addiction may need to get housed and get well. We recognize that those with serious conditions may not have a linear path toward self-determination. Mental illness and addiction are often criminalized and involvement in the criminal justice system is common. Approaches that surround them with support throughout their journey and ensure warm handoffs as needs for services evolve can reduce a backslide into homelessness.

 

 

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