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Comment by 1024core | Hacker News Reader

Every time the topic comes up, people from across the country start commenting on SF's homelessness woes. I live in SF, and consider our homeless situation unique. There are lots of mentally ill people, who have been hanging around for many years, thanks to good weather and generous people (and the easy availability of some drugs). Most of these people are NOT your typical "lost my job, lost my apartment, and hence am homeless" types. Many of them are so mentally ill that putting them in a mental institution is the only option. They simply cannot take care of themselves.

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How many homeless people have you talked to? In my (anecdotal) experience just chatting with people, there are plenty of “lost my job and now I’m homeless” folks in SF. These tend to be a bit less visible than the mentally ill though.

More generally, many homeless people become mentally unstable or take up mind-altering substances after a while living on the street. It’s a really stressful, socially alientating situation, and in general the folks who end up homeless are those with less family/friend support. When you’re stuck feeling like a social outcast with no particular purpose, under the daily stress of figuring out how to eat, find a bathroom, sleep, shower, etc., it’s hard for even the toughest person to stay mentally sharp and optimistic.

> How many homeless people have you talked to?

Quite a few. Maybe close to 50 over the years, a decent sized sample. Some of them I got to know very closely. One of them did get an SRO room (I was really close to him), I helped him get settled in. Of course, about 2 years later he was back on the streets, because he wrecked his room.

> Of course, about 2 years later he was back on the streets, because he wrecked his room.

Do you have any insight as to why he would do that? This is a complaint I've heard many times and never understood why someone would wreck their own place they live.

Since I was close to him, here is how it went down. Initially, he was good: we provided him with curtains, sheets, clothes, etc. Then slowly, it started to go downhill: first he started eating in his room. This left crumbs, etc., which attracted cockroaches, etc. Then, despite a ban, he started occasionally smoking in his room. Then he started storing food, which attracted more insects. And since he didn't have a fridge, the food would rot. Finally (the last straw, from what I heard from the SRO manager), he set up a hot plate (an electric cooking stove) in his room; which, given that it was carpeted, was a _very_ bad idea. After repeated admonishments, he was eventually kicked out.

So most of those sound like symptoms of not having pretty basic needs met. A place to eat cleanly, food storage and preparation facilities. I suppose maybe all those could have been dealt with with more work (cleaning, groceries elsewhere) but that is pretty over the top to ask people to live like that.

sad to hear about his challenges. All of us could do well to imagine how much it would suck to be in his shoes.

I've talked to a lot of homeless people in SF, often involuntarily.

Anecdotally, roughly half seem to have severe mental problems and/or severe drug and alcohol problems (these often overlap.)

The most visible homeless and those we consider "the problem" certainly may be those who "cannot take care of themselves". However, the majority do not fit this category.

I may be naive but I think we should be tackling the homeless with mental problems first. While I certainly have more empathy to those who have "lost my job, lost my apartment, and hence am homeless", I am unconfident that traditional support services can put them back on their feet without drastic improvements to the housing crisis in San Francisco. Furthermore, the mentally ill make everyone (especially those homeless who have fallen on hard times) less safe.

> the mentally ill make everyone (especially those homeless who have fallen on hard times) less safe.

Statistics please.

Careful. Last time I did this, I got downvoted and detached to hell.

I actually really want to know what the statistics are. If it's "mostly" mentally ill people maybe deal with that problem first, if mentally ill is the corner case (a loud one), then maybe not.

You'd be hard pressed to find any, other than anecdata.

Yesterday, a small woman was assaulted (just pushed hard, luckily she did not fall) in front of me by a woman who was clearly off kilter (rambling to herself, shouting periodically to noone, etc.).

One day, a similarly off-balance gentleman started hurling obscenities at me and threatened to punch me. He was a foot away from me, and I was on the MUNI train, so nowhere to go. I stared him down as his spittle flew in my direction, and he walked away. Coincidentally(?) I came down with the worst throat infection a few days later.

And then another time a guy who had severely bad hygiene problems got on the N train, which was already crowded.... and then the train goes into the tunnel before Inner Sunset. I have never felt so nauseated in my life. As soon as the train got out of the tunnel, half the carriage emptied, with people gasping for air.

And then one time a mentally ill person (from appearance) got on the bus, stood behind a young woman and started slowly humping her. I would have done something, but he was huge.

And then there was this time a mentally ill guy was walking down the sidewalk, totally in his own world... but the asshole grabbed my crotch as I walked by.

In contrast, I have never seen such a thing being done by a non-mentally-ill person.

Make up your own mind.

Most severely mentally ill are not violent nor a danger to anyone, except perhaps themselves through neglect.

> A widespread belief that the afflicted are violent contributes to the stigma of mental illness and as such may interfere with their seeking and obtaining appropriate assistance. Debunking this misconception will likely lead to progress in helping troubled individuals [...] [1]

1. http://www.scientificamerican.com/article/deranged-and-dange...

Being yelled at, scared, (wrongfully) guilted, manipulated and lied to are violent and dangerous (in the negative effects on my life sense).

IMO it's violence and IMO the danger isnt in getting bruised/battered, but in losing the ability to carry out normal life for fear of what is "out there" on the streets. Safety isnt the only point, sure there maybe a low chance of issues, but safety is also about how people feel, do they feel secure? In this case I think its a resounding no, the behavior of many of these street people is outright disturbing and makes people, likely those least able of defending themselves, live with a burned of fear/insecurity.

There is no need for scare quotes around "the problem." When people regularly walk up to you on the street and start ranting obscenities at you for no particular reason, that is a problem, full stop, no scare quotes.

Source: it happened to me yesterday in downtown San Francisco. It's happened numerous times before. It's a problem.

I agree. I am a decent sized person, so feel comfortable in my ability to defend myself in need, at least enough to get away more or less unscathed, but I do feel for smaller people, women, children. They shouldnt have to be toeing a line of "Do I walk awkwardly to add a safe distance between people who look odd" and "Do I walk normal and maybe get attacked/accosted".

I suggest looking at the official data on this subject[1]. The vast majority of San Francisco's homeless people are, in fact, people who were living in SF and paying rent, lost one or more jobs, and subsequently became homeless.

I would also suggest you read the literature[2] concerning "putting people in a mental institution" against their will, because that practice has a long and sordid history and there are many, many good reasons we don't do it anymore.

[1]https://sfgov.org/lhcb/sites/sfgov.org.lhcb/files/2015%20San...

[2]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392176/

Thanks for sharing those links. I'll definitely look into them in more detail. At a cursory glance I'm not sure that the data necessarily contradicts 1024core's statement. A disturbingly high number of respondents cites having one or more health conditions, such as Drug or Alcohol Abuse (37%), Pyschiatric or Emotional Conditions (35%) and PTSD (27%).

At the same time, to your point, the number of people on the streets due to evictions has also markedly increased over the last years, so there are probably multiple things going on.

I'd imagine that (as usual) the problems are complex. For instance, respondents say they're on the street because they lost their job (25%) or because family or friends asked them to leave (12%), but it doesn't mention if there's an underlying reason for that. For example, some of these people might have lost their job due to substance abuse. I'm not saying that's the case for everyone, just trying to say that the situation is complex.

Similarly I'd imagine there's a vicious cycle where once you're living on the street it's difficult to break out of it. Living on the street makes it difficult to get a job, which in turn makes it hard to get a home. Substance abuse is probably more likely if you're living on the street, again making it more difficult to get a job and a home. If you have a mental illness and you voluntarily sought mental care, it's difficult to stick with it if you also have a drug addiction.

Again, thanks for posting those links. I also live in SF and I find the homeless situation tragic. It saddens me that very few people seem interested in discussing the problem beyond black and white opinions and simple soundbites.

> The vast majority of San Francisco's homeless people are, in fact, people who were living in SF and paying rent, lost one or more jobs, and subsequently became homeless.

Look closely. 70% claim to be so ... but only ~30% were actually paying rent. That's 21%, certainly not the vast majority. Also: if you got kicked out of a shelter, it counts as having been "living" in SF. :-)

Plus, this was a self-reported survey. Homeless people will often lie to get your sympathy. Case in point: the whole "I need to buy food" spiel. Most of the time that I have offered to do so, they hum and haw and ignore my offer. Some in fact take the food and throw it away. Very rarely do they actually eat the food. The point is: if the homeless think they can get more sympathy by claiming to be lifelong residents of SF, many will claim to be so.

Leaving people with severe mental illnesses who cannot take care of themselves in any sense to rot on the streets and fend for themselves is far more sordid (and has a far longer history.)

I agree, but that still doesn't make involuntary commitment a good idea

What's your third way solution, then?

i'm sorry but 'institutions' hardly seem like the solution when those places are where a number of people are coming directly from(o)

i think we need to acknowledge shelter as a basic right and determine a minimum for meeting that right's demands, then offer it to everyone with autonomy, only regulated by the respect for the rights of others

(o) http://thinkprogress.org/health/2013/09/11/2602391/san-franc...

> They simply cannot take care of themselves.

And no one else wants to, which is part of the problem.

Well, there's enormous amounts of charity that ensures noone starves to death, and there's enormous amounts of money spent by Fire departments/Police/EMT teams to handle emergencies, because those are deemed politically acceptable expenses.

But those are band-aid responses that can never ever eliminate the root cause. I'm convinced that the public would spend way less money over the long term, and the affected people would be vastly better off, if they were given proper long-term care and treatment.

SF spends $241M/year on the homeless. That is way more money per homeless than NYC does (which spends about $1B/year, for 10x more homeless).

According to the article, the City of San Francisco spends $242 million annually to do just that, and the City of New York spends over $1 billion to do just that.

It's not that nobody wants to. Apparently the ways they are trying to take care of them now are not particularly effective.

> Every time the topic comes up, people from across the country start commenting on SF's homelessness woes. I live in SF, and consider our homeless situation unique. There are lots of mentally ill people, who have been hanging around for many years, thanks to good weather and generous people (and the easy availability of some drugs). Most of these people are NOT your typical "lost my job, lost my apartment, and hence am homeless" types. Many of them are so mentally ill that putting them in a mental institution is the only option. They simply cannot take care of themselves.

Pretty much every coastal county along the West Coast and Florida has this "problem". It is not some unique snowflake SF problem. Yes, it may be 2-3x more common among the homeless but that isn't enough to consider them as anything other than people in need of help.

You are simply factually wrong about the "uniqueness" of your problem by any reasonable measure.

http://www.latimes.com/local/california/la-me-homeless-natio...

> Los Angeles city and county have the most chronically homeless people in the country, and nearly all of them sleep on the streets, according to figures released Thursday by the U.S. Housing and Urban Development Department.

http://www.samhsa.gov/disorders

> According to SAMHSA’s 2014 National Survey on Drug Use and Health (NSDUH) (PDF | 3.4 MB) an estimated 43.6 million (18.1%) Americans ages 18 and up experienced some form of mental illness. In the past year, 20.2 million adults (8.4%) had a substance use disorder. Of these, 7.9 million people had both a mental disorder and substance use disorder, also known as co-occurring mental and substance use disorders.

https://sfgov.org/lhcb/sites/sfgov.org.lhcb/files/2015%20San...

> The most frequently reported health condition was drug or alcohol abuse (37%), followed by psychiatric or emotional conditions (35%).

Homeless people are more like to be disadvantaged groups. [e.g. Poor people with one or more disadvantages, such as mental illness]

http://healthsciences.utah.edu/utahaddictioncenter/healthcar...

> 8.1% of the general population are illicit drug users of 1 or more times a month

http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-con...

> Adults (ages 18+): 16.6 million adults ages 18 and older3 (7.0 percent of this age group4) had an AUD in 2013. This includes 10.8 million men3 (9.4 percent of men in this age group4) and 5.8 million women3 (4.7 percent of women in this age group4).

Similarly, it isn't surprising that a good chunk of them have used drugs/alcohol as any addiction is a disadvantage economically. However, the general population has those problems too to a substantial degree.

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