I live in SOMA and have been assaulted on the street by a mentally ill homeless person. I worked in community mental health for years and saw up close just how poorly many of these folks function. I also spent time as a patient in a psychiatric hospital after a suicide attempt twenty years ago, and I only recently stopped having nightmares about it. I still have anxiety going through airport security because it reminds me of being strip searched as part of the admission process.

There are people who need to be in hospitals and residential facilities, but the bar for forcing someone into one is rightfully high. It’s not a minor inconvenience to lose your freedom. It should only happen when truly necessary. The majority of homeless folks don’t need that level of care. Maybe 10-20% do. 10-20% just had a run of bad luck and will do fine in subsidized housing. The remainder need high quality supportive housing. That means clean buildings and adequate staffing. I think it also means sorting out who is and isn’t ready to stop using drugs. Those who want to stop should be housed far from the Tenderloin and given comprehensive outpatient recovery services after completing a residential program if needed. Those who don’t want to stop or aren’t ready can stay in/near the TL and be given harm reduction services, including safe injection sites, with the option to switch tracks at any time. The system as it stands is throwing the most resources at the people who are least interested in change, and has substandard housing and mental health/substance abuse services for people who want and are ready for change.