Homelessness has been a problem in San Francisco for most of my life. I was a high school intern working in City Hall over the summer of 1990, as Mayor Art Agnos struggled to resolve the giant homeless encampment that had taken over Civic Center Plaza. Agnos eventually cleared the plaza but he wasn't able to solve the larger problem, and neither have the four mayors who succeeded him.
Although there have been homeless folks on our streets for decades, a number of factors �" development in areas of the city where the homeless were formerly concentrated, the rise of the tents, the spread of opioid and meth addiction, the loss of facilities for the treatment of the mentally ill �" many San Franciscans sense that the situation on our sidewalks and other public spaces is worse today than ever before.
San Franciscans are rightly horrified by the misery we see on our streets. Sick and addicted people are living in encampments and on our doorsteps, and people suffering from severe mental illness have been abandoned to wander our neighborhoods, each in their own private hell.
We need an independent voice in City Hall who is laser-focused on solving this crisis, who will go beyond rhetoric and isn't afraid to hold the bureaucracy accountable. I will be that person, because for me, it's personal.
I was 11 when my mother's mental illness started her spiraling down a path that led her into repeated hospitalizations, and, eventually, homelessness. I had to grow up fast, finding myself housing, getting myself on Medi-Cal and to doctor's appointments, and finding my way through middle school and high school.
As an adult I was able to secure a guardianship for my mother, and find her the long-term care she needed.
I've experienced firsthand how sick people can fall into homelessness and what it takes to get them off the streets, and I know that with hard work from our elected representatives, San Francisco can end the tragedy that's playing out every day on our sidewalks and in our parks, plazas and transit stations.
Here are my top three priorities for homelessness in San Francisco:
1. Get severely mentally ill people off the streets and into care.
Leaving mentally ill people on the streets is dangerous and immoral. San Franciscans are a compassionate people but we're not qualified to deal with people suffering from psychotic breaks on our sidewalks.
During the last eight years the number of emergency psychiatric beds at Zuckerberg San Francisco General Hospital was cut from 88 to only 44 beds. That means that hundreds of mentally ill men and women have been released directly on to the streets with little to no support, many of them still in hospital clothes.
As supervisor I will work to dramatically expand our capacity to care for people with severe mental illness. That means investing in more public psychiatric beds, requiring private health care providers in the city to shoulder their fair share of the burden, and establishing new facilities for longer term in-patient care.
2. Support sobriety.
Every person who has a friend or family member who's gotten clean will tell you when an addict is finally ready to end the cycle of addiction, there isn't a moment to lose.
Unfortunately, a homeless person who's hit rock bottom and walks into a hospital in San Francisco is shown the way to a two-week waiting list and sent right back out the door. The city spends millions of dollars a year on emergency treatment for chronic alcoholics and drug addicts who pass out on the streets but hasn't fully invested in getting people sober. That needs to change.
3. End the cycle of chronic homelessness.
Not everyone who needs care is going to seek it voluntarily. There are people like my mother, who are unable to make the decisions that can save their lives �" and these people can't be just left on the streets to slowly die alone.
We need to do a far better job of tracking the so-called frequent flyers, who are regular users of emergency medical services, and who are regularly revolving in and out of our jails. And we need to use that data to secure public guardianships for individuals who simply cannot be left to care for themselves.
We are a city of tolerance in a nation of laws, and no one wants to revive the horrific mental institutions of the past. But San Francisco should be leading the charge to change state law to allow us to secure treatment for individuals who may resist it, but are clearly incapable of caring for themselves. Converting our streets and jails into the mental institutions is neither humane nor cost-effective and it's making our neighborhoods unlivable.
Too often politicians focus on aspects of homelessness that score them political points but shy away from addressing the inconvenient reality of a growing chronically homeless population. While focusing on youth and families is admirable and important, City Hall's failure to bring in the thousands of sick adults on the streets has left everyday San Franciscans fed up with half-answers and false starts. We simply cannot continue to spend this much money and have so little to show for it.
As Mayor Ed Lee's administration enters its final years, it's time to bring fresh minds to the homeless problem and create a plan to end street homelessness for good. But that means bold new leadership in City Hall that will demand solutions �" I'm ready to do that work.
Rafael Mandelman, a City College of San Francisco trustee, is running for District 8 supervisor in the June 2018 primary.