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The debate over mental health policy needs to include those who use city services

San Francisco Examiner - 12/5/2019

By Eddie Stiel, Fancher Larson and Peter J. Sampson

San Francisco's long running community mental health crisis has become more visible as catastrophically high rents and evictions have forced many lower income people into homelessness, exacerbating their mental health issues.

As mental health "consumers," we know that we are almost entirely absent from efforts to address this community mental health crisis. In response, a group of us has organized to speak out and advocate for ourselves. We are Mad Mob SF.

The City's response to this crisis has been largely to criminalize homeless people with mental health challenges. Rather than implement and fund voter approved treatment on demand, the Board of Supervisors chose to expand conservatorships authorized by Senate Bill 1045 and Senate Bill 40, which will lead to long-term forced institutionalizations of conservatees. The Board of Supervisors' Budget and Legislative Analyst report on conservatorships documents that 23% of conservatorships last five to 10 years and 37% last more than 10 years.

City Hall is deeply dysfunctional in dealing with our community mental health crisis. Some examples of this dysfunction are the recent (thankfully reversed) effort to convert long-term psychiatric beds into short-term navigation center beds at the Adult Residential Facility of the Behavioral Health Center and the attempt to expand community mental health access through legislation that creates a Mental Health San Francisco program after an unfortunate City Hall battle between dueling potential ballot initiatives.

The struggle between Mayor London Breed and Supervisors Matt Haney and Hillary Ronen to arrive at mutually agreeable Mental Health San Francisco legislation drained resources from underfunded, stretched advocacy groups with little involvement from mental health "consumers." Although this compromise Mental Health San Francisco proposes a lower threshold 24/7/365 mental health clinic rather than the present reliance on law enforcement and emergency rooms, it remains unfunded.

The voices, involvement and ideas from mental health "consumers" are almost completely missing from these policy decisions, discussions and initiatives. Once again, that is why we formed Mad Mob SF.

In just a few meetings, Mad Mob SF has identified major shortcomings in the community mental health system, including a major deficit of psychiatric beds in San Francisco and a lack of equitable access to new treatments and to consistent therapy. We understand that early voluntary services, like trauma-based, peer-driven recovery services, can prevent mental illness from getting worse. And, of course, underlying mental health challenges is the lack of truly affordable housing.

We invite peers and mental health "consumers" to join Mad Mob SF to demand and get sufficient mental health care and services. Our next meeting is December 13, 2019 at Senior and Disability Action, 1360 Mission Street #400, San Francisco, CA 94103 from 2 p.m. to 3:30 p.m. Please contact Raia Small of Senior and Disability Action for more information, raia@sdaction.org, or 415-546-1333 x308.

Eddie Stiel is a founding member of Mad Mob SF. A Mission District resident of 28 years, Stiel has struggled with anxiety and depression for many years, including two hospitalizations in 1991 and in May 2019. Fancher Larson is a former patient and client and now a patients' rights advocate. Peter J. Sampson is a longtime depression survivor and a San Francisco resident since 1995.