As the teenager of liberal, civic-minded parents in the mid-1960s I spent every other Saturday afternoon volunteering at Napa State Hospital. Those mornings I piled into my Dad’s Mercury with two friends and drove the 45 minutes or so to the hospital gate.
Those were the days before patients had to be some version of Hannibal Lecter to be admitted so security was light. A name and destination were all we needed to pass through the gate and wind around a neatly landscaped road to a unit at the back, where we parked. Walking on to the lightly guarded ward, we left purses and jackets at the nurses’ station and entered a large, sunny day room for an afternoon filled with mostly the same women as two weeks ago. I don’t remember their names all these years later but one was always at the piano and another wanted to show off her artwork. Several had books for us to read to them, a few others sang songs or talked to either themselves or to the air in front of them. It strikes me now that the patients we saw were all women, probably because we were young teenaged women ourselves. Pre-lithium, most of the patients were ambulatory and able to do these things, except for the catatonics, of course, who sat scary and motionless in their wheelchairs, staring straight ahead, around the edges of the room.
The Napa State Hospital patients seemed really alien to us back then. In those halcyon-seeming pre-Reagan, pre-homeless days you didn’t have to kill somebody to become a patient. The schizophrenics, the paranoids, those off their rockers for other reasons or unable to care for themselves, were routinely housed there and at other state hospitals around the state. They weren’t out on the street where they live today, without the benefit of shelter, regular food, and basic hygiene. Today, in our modern, enlightened times, they live among us, present while invisible to many passersby who avert their eyes as they step around or over them on the sidewalk.
If given actual competent resources, some can be saved. My brother is living proof of it. After living at the Salvation Army on Harrison Street for two years he became homeless, the beginning of a long two-year journey of waiting in line every evening for a shelter bed, sleeping on his backpack so nobody could rip it off, and being rousted at dawn to somehow fill the hours on the street before the overnight shelters opened again. It all changed one day when he was assigned an actual, competent case worker and got on a list for subsidized housing. He went in faithfully to check his progress on the waiting list, watching his name creep up from somewhere in the hundreds where he started out. Two years later, as his next of kin, I got an urgent call from his case worker that she had housing for him but couldn’t find him. She said she needed to reach him right away. He didn’t have a phone, of course, but I was finally able to reach him through an agency on Market Street that worked with him and knew him.
Today he lives on the second floor of a 3-bedroom flat in the Outer Sunset, which he shares with three others. He shares a bedroom with a roommate. He’s also, finally, working nearly full time as a paid peer counselor. He’s never been happier or more productive. He’s one fewer person living on the street. And he could only do all this because he lives in San Francisco where real resources are available. If he were living in the East Bay, even in Berkeley where he used to live, it would have been a different story and he would probably have had to live on the streets forever. It’s sort of like health care. We have to take the long view (which will require money) and prepare to take our lumps in the short term. Crying poor in the face of this need, which is everywhere, will never solve anything. Cities and counties need to step up and look squarely at the reality of the homeless in their own communities and actually do something about it.
Seeing my brother pretty regularly over the past few years I can understand why some San Franciscans are sick and tired of seeing the homeless camped out on the sidewalks where they have to walk every day. In the dozens of times I walked with my brother from the Salvation Army on Harrison up 8th to our favorite vegetarian restaurant on the corner of 9th and Market, there’s nothing I haven’t seen, smelled, or stepped over: people shooting themselves up, people being shot up by others, syringes on the sidewalks, crack pipes, defecation, urination, total nudity, open acts of auto eroticism, you name it. I get that these activities, ranging from the mildly annoying to the repulsively gross, upset everyone, including most of those doing them.
I’m no Pollyanna; I know that not everyone wants to change or is capable of changing. But one thing is for sure. There’s absolutely no doubt that cycling the homeless from the streets through a judicial system to back on the streets never works. Never. It has an even lower success rate than governments chasing greater prosperity through budget and tax cuts.
So isn’t it at least worth trying to provide honest, meaningful resources to get at least some of the homeless off the streets and doing something meaningful? Even if only 10 percent turn their lives around, isn’t that better than nothing?
I recently went to a presentation by one of San Francisco’s housing deputies. She said everybody’s on board with the easy stuff. Food is donated, clothing is donated. Going with my brother to one of the city’s donated clothing pick-up sites was a real eye opener. Over the years he has collected all kinds of designer clothing; unworn shoes, high-end silk shirts and all the rest of the stuff rich people in San Francisco toss out (and write off on their taxes). There are lots of places to eat, especially for seniors like my brother. The hard, intractable piece is the housing. It’s the housing, Stupid.
The sad truth is that there’s no instant fix, for any community. Bureaucratic libs afraid to change anything for fear they’ll be criticized (or ostracized when it comes time to dole out the next political job) only make matters worse. Solving this will take, in this order: real case managers capable of separating those with the desire to change from those who can’t or won’t; public commitment to identify unused buildings and/or real estate that can house those in the first category; real employment people who understand the local job market; and, most importantly, regular contact with case managers, preferably every week, to help navigate the inevitable paperwork involved in moving from the street to subsidized housing, which communities must commit to and pay for. There should also be public, dorm-like housing for those at least marginally interested in helping themselves. Residents should be required to contribute to their communities in exchange for that housing. This could include everything from building or outside maintenance and landscaping to food procurement and preparation, and everything in between. The alternative is to keep doing what we’re doing and keep seeing what we’re seeing, with the same sorry results.
And those who are truly beyond help? The state hospitals should be expanded to accommodate them, just like they used to. Turning the walking wounded out on the streets to fend for themselves should never be an option for a country as rich as this one.