Editorials

[Editorial] Governor Newsom, Compassion Means Taking People Off the Streets

What’s keeping beds empty as streets are overflowing are both a lack of inspections to ensure that shelters meet basic federal health codes, and the inability to compel individuals to receive treatment. The first issue is one that can easily be remedied by requiring more frequent inspections, but the second requires that we fundamentally rethink our approach to homelessness, mental health, and substance abuse.
A homeless woman in San Diego sorts through her belongings. Photo: Gregory Bull/AP

On January 8, Governor Newsom issued an executive order authorizing the use of government land, trailers, and vacant state buildings for the rapid development of homeless shelters. However, without any kind of mechanism to allow public officials to bring people indoors for proper treatment and care, such efforts to increase the number of shelters will be wasted and only perpetuate the state’s homelessness crisis.

With over 150,000 people living on the streets of California, one would assume shelters are operating at full capacity. Yet in Los Angeles County, where ⅓ of California’s homeless live, shelters have an average 74.6% occupancy rate during winter, with some shelters’ occupancy as low as 40%. In a system with 16,600 beds, that’s over 4,200 empty beds per night, or enough to house over half of San Francisco’s homeless population

What’s keeping beds empty as streets are overflowing are both a lack of inspections to ensure that shelters meet basic federal health codes, and the inability to compel individuals to receive treatment. The first issue is one that can easily be remedied by requiring more frequent inspections, but the second requires that we fundamentally rethink our approach to homelessness, mental health, and substance abuse. 

During the 1960s, Americans were becoming increasingly concerned that mental health institutions were not only subjecting patients to deplorable conditions, but holding healthy individuals against their will, as best demonstrated in novel, play, and later Oscar-winning film One Flew Over the Cuckoo’s Nest. In 1967, California governor Ronald Reagan signed a bipartisan bill making it vastly more difficult to involuntarily hospitalize substance abusers and the mentally ill; the following year, the number of mentally ill individuals in California’s justice system doubled. As president, Reagan worked with a Democrat-controlled congress to repeal the 1980 Mental Health Systems Act, which effectively ended federal involvement in treating the mentally ill, to disastrous effect. 

Considering that a recent California Policy Lab paper found that 84% of unsheltered homeless report physical health problems, 78% report mental health conditions, 75% report substance abuse issues, and 50% report all three, allowing people to continue to choose to fall apart on the streets is not compassion, but a death sentence; Mayor Kevin Faulconer, under whose leadership San Diego was the only county in the state to experience a reduction in unsheltered individuals last year, was absolutely correct when he said, “If you think someone who is addicted to drugs and sleeping in a canyon is going to turn their life around without an intervention, you’re not being honest.” 

San Diego mayor Kevin Faulconer, one of the state’s last remaining high-profile Republicans, has made homelessness his top priority. Photo: Office of Mayor Kevin J. Faulconer

Furthermore, given that 81% of unsheltered homeless have spent at least one night in jail in the past six months, it should come as no surprise that 20% of jail inmates and 15% of those in state prisons have a “severe psychiatric disease,” making our incarceration centers the largest mental healthcare providers in our country; the seriously mentally ill need treatment and care, not the criminal influence and terrifying confines of our overcrowded prisons

By opening up state properties for the rapid development of homeless services, Governor Newsom is off to a good start, but now it’s time for the state legislature to create a statewide definition for “gravely disabled,” a term that is interpreted differently by each county, and is what allows the state to institutionalize the mentally ill, or, even better, place them under conservatorship, which allows individuals to remain free but under the care and observation of an appointed caretaker. 

Assemblymember Chen and Senator Moorlach wrote such a bill, AB-1572, earlier in 2019, which defined “gravely disabled” as a condition in which a person, “as the result of a mental health disorder is incapable of making informed decisions about, or providing for, the person’s own basic personal needs…without significant supervision and assistance” and is thus at risk of harm to his or her self. The bill also would have increased the level of service required by county mental health departments, created a $20 million grant to ensure conservatorship programs could meet the demands of an expanded caseload, and reaffirmed the state’s constitutional requirement that it must reimburse local agencies and school districts for certain costs mandated by the state, including those pertaining to mental health. 

The bill sadly died in committee, but the ideas behind the proposal remain sound. If reintroduced and passed, the bill could reduce the number of state hospitals required to service the increased number of those who are “gravely ill” by creating a broader pathway to conservatorship, while still placing those in most urgent need of care into mental health institutions, not prisons or the streets. Governor Newsom, California set national precedent in 1967 by reforming its mental health system in the name of compassion. Now, that well intentioned, but ultimately misplaced compassion has created the greatest homelessness crisis this country has ever seen. Today, we ask that you cease the needless suffering of our society’s most vulnerable by supporting legislation that will take our mentally ill off the streets, out of our prisons, and into the gentle, loving care they deserve.

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