Governor jerry brown signed SB 1045 into law September 27th. This law allows for the expansion of conservatorship for people who have both substance abuse issues and psychiatric disabilities. The bill introduced by scott wiener (who claims to be gay but we don’t accept him as family), a politician in the pocket of the big developers, is a naked attempt to remove the houseless people from the streets of cities. Big developers are just itching to make every square foot of san francisco into condos for the techie wave of affluent gentrifiers. To that evil end they want to rid the city of street encampments, which interfere with their expansive views and latte laced daily routines.
SB 1045 allows for a five-year pilot project in san francisco, los angeles and san diego counties to set up expanded criteria for which people could be held against their will. The bill says that a person must have both severe substance abuse and psychiatric problems, be detained on a 5150 psychiatric hold eight times in a year, have tried all less restrictive treatment modalities, have not complied with Assisted Outpatient Treatment ( Laura’s Law) and be outside the purview of the law which currently provides for psychiatric holds and conservatorship in california, called Lanterman Petris Short (LPS). london breed, the mayor of san francisco, has indicated that she will introduce a plan to implement the pilot project immediately. The Homeless Action Coalition, Senior Disability Advocacy, LAGAI-Queer Insurrection, Gay Shame and other groups have begun a campaign to raise awareness and to lobby sf board members to fight this law. Susan Mizner, Disability Rights Program Director of the National ACLU stated, “Conservatorship is the biggest deprivation of civil rights aside from the death penalty.”
The law is wrong in so many ways. The bill itself has NO funding. So while setting up a new bureaucracy to strip people with mental health and drug problems of their civil rights, there is no provision in place to provide treatment or housing. This then leads one to speculate that the real plan is to build a new jail to incarcerate pesky houseless people in the name of all this heightened compassion. london breed stated in the SF examiner, “it is not humane to allow San Franciscans struggling with severe mental illness and addiction to continue to suffer on our streets.” This from the same mayor who is funded by developers intent on building condos everywhere.
It is clear to housing rights activists that the solution to homelessness, is to create enough housing for everyone. In fact throughout the bay area houselessness is rising exponentially as rents skyrocket and evictions abound in the wake of condo conversions. SB 1045 presupposes the falsehood that people living on the streets don’t want housing and services. The facts belie this insidious idea. In san francisco there are over 1000 people on the shelter waiting list and 8000 families waiting for public housing. There are 500 people requesting substance abuse treatment that is not available. Furthermore while knowing that people with psychiatric diagnosis are vulnerable to homelessness and substance abuse, in 2017 40% of people discharged from psychiatric emergency services in sf were given no referrals or follow up at all! This likely happens because emergency rooms are overwhelmed and there is just no real help to be had for those who need it in this profit driven world.
Along with the lack of services to implement this bill, the provision that requires eight 5150 detentions to trigger the law further emboldens and empowers the police, who most often initiate 5150 psychiatric holds. This means that cops will target certain people they want to get off the streets, further criminalizing those with psychiatric disabilities and substance abuse problems. We have repeatedly seen the horrific stories of police called to intervene with someone with mental illness and then promptly killing them. In san francisco 60% of people murdered by police have mental health problems.
It is also important to consider what conservatorship really means. It takes all the decision-making away from a person, about where they go, what they do, how they live. A conservator is assigned to the person by the courts and quite literally makes every important decision. We need only remember the history of forced sterilization, barbaric treatments such as lobotomies and hideous institutions in the not so distant past to challenge this idea. And in a racist, classist, sexist, ableist society, the rich, white, male able-bodied person rarely, if ever fears this kind of state control. This, in a world that has no housing or services in place to support depriving people of their civil rights, even if one agreed with this specious notion. The current conservatorship laws which have some civil rights built in (in the form of court hearings) are adequate. What is woefully inadequate are specific services that actually work for the people who need them, and housing.
In addition to being pushed by developers, the support for this bill is coming from desperate family and friends of people with psychiatric disabilities who correctly fear for the vulnerability of their people on the street in need of treatment. It is naive to think that the developers and politicians care one whit for the mentally ill. Rather their concern is the look of the city they want for their own profit. They are cynically and callously using the pain of friends and family of the psychiatrically disabled to push relentless gentrification.
My adamant opposition to SB1045 is informed by a history as a health care provider in mental health, as well as from living with my long term ex-lover of 15 years, who struggled with a severe psychiatric disability. When I was nineteen, I had a summer internship at chicago state hospital, an old archaic cook county mental institution on the outskirts of chicago. I was hired by some long-forgotten research project to observe various behaviors on a check list, exhibited by people institutionalized their entire lives in this county psych hospital. This job had a profound effect on me. I soon realized that lifelong institutionalization had robbed people of much of their agency, decision making and even basic social relationships that give pleasure. I read the charts of the patients and most of them were incarcerated because someone in their lives felt that they were acting strangely or too bizarrely to fit the norms of the current times. The charts would begin “patient’s husband said she was acting strangely.” In those days it was easy to “commit’ people. Certainly many queer people were considered bizarre and incarcerated. I spent that summer hanging out in the day room trying to befriend people who often had lost ability to even make eye contact. Some years later droves of people were discharged from state hospitals back to the communities, with the promise of community mental health services which never materialized.
After that job, still living in chicago, I became part of a radical psychiatry grassroots group trying to care for people with mental illness without hospitalization. We tried to set shifts to take care of people having psychotic breaks. It was really hard; we didn’t have enough resources.
I became an RN in 1981, working as a psych nurse at the alameda county psychiatric emergency services in the 1990s. I saw first hand just how limited services were. People, after getting a shower and a meal, were regularly put out on the streets of san leandro with bus tokens and a list of AA meetings. Only the most severely disabled were placed on longer term holds with court hearings and admitted, because there were never enough inpatient beds. Then there was the story of an old woman in her early 80s, a little confused and possibly psychotic, who had according to her been happily living in a park, until community members snitched on her and she was summarily brought to the bench in psych emergency. She desperately wanted to leave the hospital and return to the park she considered her home. She knew full well she had come to the end of the line and was now incarcerated. Where was the mobile service unit that could come to her with a shower, change of clothes and some meals?
In 1999 I became a nurse practitioner and went to work at the VA oakland mental health clinic as the psychiatric provider for the methadone and substance abuse programs. All my patients were dually diagnosed with both mental health and substance abuse problems. Many lived on the street. During my tenure, the VA started a program to house patients, in response to public outcry over all the houseless veterans. The VA set up a very successful program which got people off the street into good apartments using case management and advocacy to keep people in their apartments. Not so shockingly, it worked!
After I retired from the VA, I worked at san francisco general as a nurse practitioner in their large methadone program. Many people in this program are houseless, giving me first hand knowledge just how limited services are for people living on the street in san francisco.
Along with all the many experiences from my work life, I also loved someone living with a psychiatric disability. Saundra and I lived together for fifteen years. During that time she had multiple psych hospitalizations at Bellevue in New York. Before I knew her she had lived on the streets. She was diagnosed as schizoaffective, sort of a depressed version of schizophrenia. I remember terrible times, sometimes lasting months, in which she would be in bed in a near catatonic depressed state, hearing voices telling her she was bad and thinking stop signs had special ominous meaning for her. Often she wouldn’t let me take her to get help. Saundra was a gifted writer and artist a delightful funny person, and never wanted to give up her right to self-determination in spite of how hard her disability was.
Expanding conservatorship as called for by SB 1045 does absolutely nothing for people living with mental illness and substance abuse on the streets. It is a cynical political window dressing of a law. Politicians pretend to care about houseless people, but really want room for more private parklets to sprout in front of hanging fern bars in the mission.
As someone who has lived with and loved someone with schizoaffective disorder, and who has worked in many health care settings, it is clear that until we have a society which prioritizes real health care providing complete and accessible treatment for psychiatric illness and substance abuse, and housing for all, nothing is really going to change. If they want to do a pilot project, how about creating enough housing for everyone! We need an end to capitalism a complete transformation of how we live, nothing less than a revolution. Until that happens, we can’t really know what people need and make it happen!
STILL BLAMING CAPITALISM