2023-05-02 03:30:00
Victoria Solomon had been walking and shouting through the streets of San Francisco’s El Castro neighborhood for a decade, addressing no one in particular, or camping on the sidewalk, rejecting offers of help.
But not anymore. After being on the streets since he was 20 years old, Solomon became an expression of hope in a difficult part of the city.
A street counselor assigned to El Castro has managed what no one else could: persuade Solomon, 34, to move into transit housing and accept treatment for his mental health and drug use problems. After more than a month inside, Solomon seems like a totally different woman. Her eyes are clear, her calm demeanor.
The other day, as he walked his dog Chunx between Castro and Market streets, he marveled at the progress he had made.
“It was all thanks to Erica,” he said, waving to Erica McGary, the homeless health worker who made this street miracle possible and making her regular rounds on the sidewalk. “Other people tried to help over the years, but they wouldn’t listen to me. Erica yes. I have anger issues and she didn’t push me. She made the difference.”
The situation in El Castro, and not just for Solomon, has changed remarkably in the last five months. McGary helped lead a pilot project that demonstrates the strides that can be made to help people get off the streets, and also how excruciatingly difficult that task is. And how hard it will be to repeat it throughout the city.
The project began in August, focusing on 34 long-term homeless people who have resisted most relief efforts for many years.
Last August, El Castro merchants threatened to withhold municipal taxes if authorities did not take steps to help people they say regularly suffered psychotic episodes in public, smashed shop windows and harassed passers-by. According to municipal authorities, the El Castro camp was being planned before the merchants threatened to withhold their taxes.
Supervisor Rafael Mandelman, who represents El Castro, helped compile the list of people most in need of care, and a plan was put into action.
The plan, coordinated by the city’s Department of Emergency Management, has more than a dozen city teams and other agencies, including health and homeless departments, who will do everything they can to convince the 34 people to leave the street. Initiative leaders meet daily to coordinate strategies and check on each person’s progress.
In the last five months, eight other homeless people like Solomon have been moved from El Castro to housing or residential treatment centers. Seven more went to temporary shelters. And 19 of the total 34 agreed to receive regular treatment for their medical, behavioral and other needs in order to get off the streets. Under the law, there is no strict requirement that they go through with treatment, but simply getting them to commit was unusual and, so far, they have followed through, according to attendees.
This is remarkable progress for a population that in some cases resisted aid for more than a decade, and traders are noticing the difference with cautious optimism.
“I’ve noticed that some people have left,” says Martha Asten, co-owner for 50 years of Cliff’s Variety home and garden store on Castro Street. “These types of initiatives are cyclical and I have seen them come and go. We’ll see how this works. But we always have hope.”
Mandelman, who has long been frustrated by the situation on Castro Street, is also encouraged to “wait and see” not only by what the project means for his neighborhood, but for the rest of the city.
“I’m glad they do it instead of not doing it. I would love to see it expand as much as possible. But that can be difficult.”
Like the rest of the city, the neighborhood has long had support teams, from the Homeless Outreach Team to the more recent Street Crisis Response Team. la Calle), which are only two of the at least ten municipal teams that currently deal with the homeless. But these teams are all over the city and cannot be concentrated in one area for long.
This pilot project is progressing because it is focused on a small area, El Castro, with a handful of the same assistants on the ground daily, developing close relationships with regular homeless clients.
And deep down, the secret to the success of this latest initiative lies with Health Department counselor McGary and her two supervisors, Krista Gaeta, who is responsible for the Health Department’s outreach strategy, and Mark Mazza, her colleague at the Emergency Department.
McGary, who works for the city’s Department of Public Health’s homeless team, walks the sidewalks of El Castro five days a week and has gotten to know all the people experiencing homelessness. At 49, she radiates credibility to the street population as few can, after having been homeless and a drug addict. She has worked in shelters, prisons, the Homeless Outreach Team and health clinics, and when she chats with someone on the street, it shows that she means business.
“He’s someone who really cares, and when you’ve been here as long as I have, you can tell the difference,” says Desean Dixon, 38, who has been living outdoors for more than 15 years and resisted attempts to take him away. to a hostel. “At first, when he approached my tent, I pushed her away. But then I asked a couple of friends and they said it was fine. And he was”.
McGary has convinced Dixon to get on a waiting list for permanent housing, and in the meantime accompanies him to his medical appointments, which he has also resisted for years. Recently, he accompanied him to the Castro Mission Health Center for a complete checkup, something he had urgently needed for a few months, when he had been shivering with pneumonia in his tent. Dixon has persistent skin infections since he hasn’t been able to clean himself regularly, and he feared he would be diagnosed with diabetes and other complications from life outside and poor diet.
“Some of these questions are easy to answer, and I really don’t think you have diabetes,” Dr. Stephen Mazat said helpfully as Dixon sat stiffly in an exam chair. Dixon visibly softened.
“I’m a little relieved,” he said mid-exam. “I don’t go to the doctors because every time I did it seemed like something was wrong, and I don’t want bad news. Now I’m going to try to come more”.
That’s the kind of confidence that, combined with regular visits, can turn a homeless person like Dixon into a more houseable and healthier person, said Gaeta, who also went with Dixon to his doctor’s visit.
“If you treat people with dignity and respect, and show up every day so they know and trust you, you can make a difference,” he said.
“Many of the people here are hopeless and traumatized by many things. If you find out what they need and cover it, you may get somewhere, because (under federal and local law) you can’t force treatment or housing on them. They have to want to accept it.”
Individualized treatment is especially important if one takes into account that the increase in street teams in the last two years has generated many service calls on the street. But you may not be referring enough people to services to make much of a difference.
Street crews have fielded more than 14,000 calls since the end of 2020, most of them for homelessness crises, and according to municipal data, most of those calls appear to have resulted in the person continuing out in the open.
In line with the city’s broader “harm reduction” approach to addiction treatment and state conservatorship laws, individuals can only be coerced into treatment in extreme circumstances. To convince them to accept you, sustained and specific persuasion is crucial.
“People on the street instantly pick up if you’re serious about staying, if it’s true that you’re really going to help them,” says McGary. “I? I’m in my element out here. The objective is to get to know them, to work so that people receive the help they need”.
With Solomon, that meant buying cups of coffee, chatting, and conveying the idea that being inside could work, week after week.
At first, McGary put her in a shelter cabin, but that was just the beginning. McGary keeps track of everyone she helps, and after visiting Solomon and seeing that she wasn’t happy in the cabin, he moved her to a transitional hotel room.
Now Solomon and McGary are working with housing assistants from the homeless department to get permanent supportive housing. “Erica didn’t just leave me there,” says Solomon. She “she Followed up. She worries “.
Mayor London Breed praised the project’s progress in her State of the City address this month, saying without elaborating that she intends to “extend it to other neighbourhoods.” Mandelman also expressed hope for the success achieved so far.
But to expand the initiative will have to make a great effort.
The advantage of the El Castro project is that it focuses on a relatively small number of homeless people in a compact neighborhood, unlike other larger areas of San Francisco, such as the Tenderloin or the Mission District. Replicating this same citywide deployment success would likely require a significant increase in staff, energy and time, Mandelman said.
The supervisor said he would like the city to have more power to keep or force people with mental health problems on the street to receive care forcedsomething that has proven elusive on a large scale not just in San Francisco, but across the state.
“It seems like they are making progress, which is great. I’m glad they’re doing it. But we have to come up with interventions that are really scalable,” Mandelman said. “The El Castro project will be difficult to reproduce throughout the city.”
“And we still don’t know how this story will end. We have not yet ‘arrived’ at El Castro. When I walk around the neighborhood I see that there are still many people in various states of addiction and homelessness.
Jim Walton, who has lived in El Castro for 40 years, shook his head as he walked away from a conversation with a panhandler sitting in front of La Tortilla Mexican restaurant on Castro Street. The beggar was actually in a hostel near the Tenderloin, but he had come to this side of town because begging brought him more money.
“It’s gotten better lately, but honestly, the best solution to all of this? Not only for the residents, but also for the homeless themselves,” she says. “Go somewhere else, like Santa Cruz. It’s bad here.”
This story was originally published in the San Francisco Chronicle (USA), and is republished within the Program of the Human Journalism Networksupported by the ICFJ, International Center for Journalists.
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