As public health and medical professionals, we strongly oppose implementation of SB 1045 in San Francisco. We agree that we have a crisis of homeless people living and dying on our streets. But an expansion of involuntary conservatorship is the wrong approach and will do nothing to address the underlying drivers of psychiatric disabilities, substance abuse, and homelessness.
Conservatorship is a serious matter. It takes away every single one of a person’s civil liberties-- their ability to make decisions about what happens to their body, their pet, where they live, what they eat, how they spend their time and their money. Our government should not ignore the long and shameful history of institutionalization, involuntary sterilization, and other forced treatment of people with disabilities. As Susan Mizner, Disability Rights Program Director of the National ACLU stated, “Conservatorship is the biggest deprivation of civil rights aside from the death penalty.”
Current law under the Lanterman-Petris-Short Act was carefully constructed to balance safety and personal liberties, and centers on whether the individual is harmful to themselves or others, or cannot care for themselves due to their mental illness. This new law adds addiction to mental illness, and focuses instead on whether someone has been detained more than 8 times. It therefore moves the reason for the conservatorship away from medical and safety necessity to police intervention. It is police who 5150 individuals, and this law would give them great incentive to repeatedly detain people who are generating complaints, or when political pressure is applied. A punitive approach to mental health is both inhumane and ineffective.
SB 1045 has become a political strategy to address homeless people with mental health disabilities. This strategy relies on the false narrative that people choose not to get services, when in reality services are not available. There are 1,060 individuals on the single adult Shelter Reservation Waitlist and 8,000 households on the waitlist for public housing. When this data was last tracked, there were 500 people waiting to get methadone and substance abuse residential treatment.
San Francisco’s performance audit of Behavioral Health Services (April 2018) reads: “Clients accessing psychiatric emergency services often have dual mental health and substance use disorders and experience homelessness. Linking these clients to services on discharge is important, because without service linkage, these clients are at risk of not only decompensating mentally, but of also resorting to alcohol and substance abuse after being discharged.” And yet, of people discharged from psychiatric emergency services in 2017, nearly 40% were not offered any services. The conservatorship process is failing us now, because there are not adequate services or placements for the individual, and this new law does not change that. It just makes it easier to churn people through the system.
Implementation would be a much greater challenge than has been recognized by government leaders. Conservatorship is a serious commitment and responsibility, making government liable for providing extensive care for conservatees -- with the same level of resources that is currently not adequate to meet the needs of the community. Where is the housing going to come from when someone is conserved from the street? Where are the services coming from? Who will not get that housing or services because the conserved person does?
Implementation of SB 1045 encourages police action and criminalization of people who are homeless and mentally ill. To be eligible, people will need to be detained through a 5150 action eight times, which gives police an incentive to use 5150 on people with mental illness and substance abuse. In San Francisco, almost 60% of people shot and killed by police have mental health disabilities. In addition, being detained and then conserved could turn into a homeless person’s only option for accessing housing and services.
Before we take away civil liberties--in a city that prides itself on being a pioneer on civil rights--San Francisco needs to provide housing and voluntary mental health and substance abuse services. Proposition C, on November’s ballot, will provide much needed housing and services. Real solutions are available before we turn to involuntary conservatorship.
Sponsors:Senior and Disability ActionMental Health Association of San FranciscoDisability Rights Program, ACLUCoalition on HomelessnessIndependent Living Resource Center SFDisability Rights CaliforniaHospitality HouseSURJ SFNo New Jail CoalitionLAGAI Queer InsurrectionGay ShamePacifica Social JusticeGray PanthersWestern Regional Advocacy ProjectDo No Harm CoalitionPublic Health Justice Collective