AdviceSan Francisco

What to do When Someone is Having a Mental Health Crisis on the Street

mental-health-crisis-san-francisco

image from youtube

Justin Keller’s absurd, entitled, whiny, anti-homeless rant got me thinking about this.

Not long ago I was walking near Church and Market and suddenly there was a bunch of hubbub behind me. You know what I’m talking about, it’s not loud and raucous but there’s some kind of disturbance that sets off your Spidey-Sense and makes you turn around.

Just then, a butt naked African-American woman in her 40s, ran by screeching and then went into one of the local businesses. It was obvious from the scene and the way things went down that she wasn’t one of the nudists who hang out in the Castro (or at least used to before Scott Wiener banned it). She was absolutely having a mental health crisis and needed help.

But the question was: who was I supposed to call?

I knew for sure that I didn’t want to call the police. There’s the great quote by Abraham Maslow that says “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.” And unfortunately that’s often how it is with the American police. They are trained in ending crisis situations forcefully, but there isn’t enough training in how to deescalate them so that no one gets hurt or killed. While that is in the process of changing as we speak, I’d still rather involve people who already have the training.

Unfortunately I didn’t have the answer then, and as some of the business owners had begun making phone calls, I continued on to my way hoping they did know who to call. But I decided then to find out who I should call next time something like that arises. Below are the answers:

Mobile Crisis Team

The Mobile Crisis Treatment Team is made up of a diverse multidisciplinary staff providing psychiatric crisis intervention services for adults located in the City and County of San Francisco.

Phone number: 415-970-4000

Hours:

Monday through Friday 8:30 AM to 11 PM (last field visit at 10PM)
Saturdays and Holidays  12 Noon to  8 PM  (last field visit at 7PM)
[Closed Sundays]

Services Provided:
•    Emergency crisis assessment/intervention services conducted in the field
•    Early intervention before situation escalates to critical crisis point
•    Consultation services provided to consumers, housing/support systems, mental health providers, and other concerned parties
•    Assistance with linkage to outpatient mental health services
•    5150 evaluation capacity and determination of appropriate level of care
•    Short-term medication services may be available
•    Spanish, Russian, and Cantonese/Mandarin speaking staff (schedules vary)
•    Available to all adult residents (at least 18 years old), regardless of payer source

Concrn.org

As their site says “When 911 isn’t the best option, connect with the Compassionate Response Network”

Also from their site: We are a compassionate social service network that connects people in need to volunteer responders trained in crisis intervention and mediation.Concerned citizens can download our mobile app on iPhone or Android or call us directly to access our services. We make it easy for both witnesses and victims of nonviolent crises to create a report and directly dispatch our network.

We believe that this “Compassionate Response” model is more humane, harm-reducing, and cost-effective than a law enforcement approach to non-violent crises.

You can learn about their Tenderloin pilot program and download the app here.

311

If it’s not during the hours that the Mobile Crisis Team is open, and it’s not in the Tenderloin (which his where Concrn.org serves) call 311. Explain to them the situation and ask for them to send out the Homelessness Outreach Team.

Are there services that I’m missing? Please let me know in the comments

Thanks to Jenny Friedenbach and Amy Weiss for giving me this info.

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  • Robin Edgar

    Is there any equivalent of these for the South Bay? I live in Palo Alto and these moments are all too common and heartbreaking.

  • http://www.geekpinata.com geekpinata

    LOVE love love this post. Thank you.

  • Kristen

    These are all good for folks in immediate, but non-life threatening, crisis. It’s also good to familiarize yourself with the drop-ins and safe spaces in your area. If somebody is in a space to hear you and receive your help, letting them know that there are spaces in the immediate area where they can go and be safe, receive services, eat, etc, can be incredibly valuable.

    Also, please be respectful if people do not want your help. You don’t always know or can see what’s going on with somebody, their past, their traumas, etc, and no matter how “needy” somebody appears, they have the right to tell you to leave them alone, that they don’t want your help, your leftovers, your money, etc.

  • foobar

    If you’re going to cast your judgement and jump on the anti-Justin Keller bandwagon; calling his post whiny, absurd and entitled, then maybe you should consider how it makes you look describing someone as “butt naked.”

    http://public.wsu.edu/~brians/errors/butt.html

  • Miles_Long

    Dude, your story was an emergency. 911 should have been called. Those other agencies do not have the power or authority to handle a violent situation. The ability of those agencies to get there in a timely manner and address the situation isn’t the same as police.

    While those agencies have value, it’s best to call police in an emergency. A naked woman howling in a place of business is an emergency situation.

  • Alex Brideau III

    That’s interesting indeed. I had no idea of the history of the expression.

  • Sadie Stone

    Another possible resource, especially if it’s at night, is the San Francisco Night Ministry. They have trained clergy who walk the street every single night, and they also have trained crisis counselors available to call during the evening hours. http://www.sfnightministry.org/joomla30/index.php/about/what-we-do

  • Javier Acosta

    A hobo tripping on drugs is now “having a mental health crisis” God I hate liberals

  • CA-MD

    Wow, are you ever ignorant and insensitive. Please, feel free to come shadow for a day in the Emergency Department as see the mental health issues that homeless people face and the reality of homelessness, mental health, and drugs and the intersection between them. Maybe you’ll learn to actually find some empathy there too.

  • mathglot

    Wow, how very mean-spirited and self-righteous of you. Without knowing anything about the person involved, you’ve already condemned them.

    For one thing, people who make more money than you and are not using drugs can have breakdowns of various kinds in public. I have one friend who is an elite biz-school grad and is epileptic and may fall to the ground in convulsions on occasion, and another who sometimes becomes incapacitated by cluster headaches (go look it up). Either of them would need outside help from a stranger if they were unaccompanied at the time.

    As for your “tripping hobos” you do know that a lot of the homeless have diagnosed mental health problems, don’t you? Many of them may need to take maintenance doses of medication for life in order to remain stabilized, but that’s not always easy to do if you’re homeless. And yes, some of them are even taking illegal drugs and acting out on top of all the rest of the problems they have.

    If you want to condemn liberals for whatever your pet peeve is, why don’t you go find the right internet forum and go ahead and make your case in a cogent manner to your heart’s content. This article is about people having severe breakdowns in public for one reason or another in and who need immediate help, and what to do about it.

    How you get from a poor woman obviously out of control in public, to condemning liberals is beyond me. Where is your compassion? What would you do, just walk on by, not call anyone? What would you recommend other people do in that situation?

  • Ralph Furley

    Not in SF it isn’t. It’s barely worth looking up from your iPhone.

  • Erin

    Thank you! This is the first response to the Justin letter that actually serves to move the dialogue to a helpful place. I wish I knew of EBay counterparts.

  • blackalaureate

    we need this all over the country. the police are not the answer.

  • *9

    Thanks! Coming from a self-absorbed n self-righteous a-hole like U, it’s a fine, if unintended, compliment! Now get on back to yer trailer boy!

  • Miles_Long

    Among civil people living in a civilized society, that is concidered an emergency worthy of the attention of the authorities. If you allow the inmates to run the asylum then everyone lives in misery.

  • SteveZB

    Man relax. Sometimes sh!t happens in a persons life and they don’t know how to deal with it or don’t have anyone they can turn to. Ain’t a liberal or conservative thing. Sometimes a person just needs help.

  • Monika Tippie

    This is a great list of similar resources in the East Bay http://www.askferc.org/help-in-crisis/age-18.html

  • DoYouEvenGameBro?

    The first time my mother ran down the street naked she had been raped, beaten, and left for dead. All the times afterwards were nightmares/PTSD. Thanks for being one of those judgmental jerks who assumed she was on drugs.

  • DoYouEvenGameBro?

    Yes, it’s an emergency. No, it’s not best to get the police. Like the writer said, officers are not trained for this type of situation. She would have been scared, and likely fought back. Things would have escalated. She would’ve been injured and likely would not have gotten the type of help she needed. In fact, that’s probably exactly what happened.

  • toofarinsideacar

    this isn’t an immediately available resource at this point but i’d suggest looking into Critical Resistance’s Oakland Power Projects. They recently put togetehr a workshop on this topic to help folks think abot alternatives and consider de-escalation skills.

    personally i dream of a non-police number to call for non-stigmatizing, non-punishing support + widely accessible and affordable peer-run crisis respite centers (look em up — they are rad) that folks could go to to “come down” or heal…dreams.

  • Monika Tippie

    I’m glad to know this now: “The standard expression is “buck naked,” and the contemporary “butt naked” is an error that will get you laughed at in some circles. However, it might be just as well if the new form were to triumph. Originally a “buck” was a dandy, a pretentious, overdressed show-off of a man. Condescendingly applied in the US to Native Americans and black slaves, it quickly acquired negative connotations. To the historically aware speaker, “buck naked” conjures up stereotypical images of naked “savages” or—worse—slaves laboring naked on plantations. Consider using the alternative expression “stark naked.””

  • toofarinsideacar

    some parts of the east bay do have an equivalent to the mobile crisis unit. Here are notes I took on the subject a few months back. (so I”m not swearing 100% accuracy):

    Alameda County Mobile Crisis Teams (MCTs)

    Berkeley and Alameda County crisis teams are made up of clinicians – for example, counselors or social workers – who typically show up with police(!!!). NOTE: It may be possible to request that the police show up around the corner or at a distance rather than coming straight to the scene. The MCTs are only available in certain location and at certain times. See below.

    In Downtown Oakland, South County, Fremont, Hayward, Dublin Pleasanton, Antioch…
    Hours: Vary depending on location. Phone line is 24/7.
    Phone: 1-800-309-2131 (Crisis Support Services) Operators/counselors can send out Mobile Crisis Team, if it is available at given time and place.
    Wesbite: http://www.acbhcs.org/

    In Berkeley or Albany…
    MCT delivers crisis intervention services at locations throughout the community (suicide, homicide, threats, drug abuse, evaluation for psychiatric hospitalization); consultation; and disaster and trauma-related mental health services.
    Hours: 11:30 a.m. – 10 p.m., 365 days per year
    Call: 1-800-309-2131 (Crisis Support Services) OR
    Call: 510-981-5254 (Leave message – call will be returned) OR
    Call Berkeley Police non-emergency dispatch, 510-981-5900, and specify that it is a mental health call and no one is in danger of violence.
    Website: http://www.ci.berkeley.ca.us/Health_Human_Services/Mental_Health/Mobile_Crisis_Team_(MCT).aspx

  • Ralph Furley

    “To the historically aware speaker, “buck naked” conjures up stereotypical images”

    This is a good reason not to burden oneself with historical knowledge. It enables one to listen for intent, instead of irrelevant subtext from generations long perished.

  • Candace Aylor
  • zoe

    She could also have escaped from somewhere or someone and been in dire need of help.

  • http://crissa.twu.net/ Crissa

    This sort of thing really should be built into our first responder system. After all, 911 can get you the specific police or help you want for other emergencies; why not this more common one?

  • http://crissa.twu.net/ Crissa

    Not really, since every word is loaded with historical use.

    It’s better to apologize and learn when one is offended – than go looking for offenses that are probably not there.

  • Anthony Barreiro

    San Francisco 311 also has an app, available for ios and android. Making a report via the app is faster than calling 311, but you don’t get to talk to a live 311 operator.

  • cupcake macfastlane

    Beware! In 2006 I met a couple in a bar one night and invited them back to my place for a drink when the bars closed. The girl stayed for a beer then demanded to go home so the guy gave her the car keys and cut her loose. I really hit it of with the guy and we stayed up talking till the morning. The girl was pissed that he didn’t come home with her, she called the Mobile Crisis Team which invaded my apartment at eight in the morning. They waited until someone came out of the building and let themselves in past security. I was living in a big apartment with several other people on the third floor so we didn’t always lock the front door. I looked up to find two guys in lab coats standing in my bedroom doorway, there to do a welfare check. The girl had reported the guy as suicidal which I can assure you, based on several hours conversation, he was not. These crisis teams are not held back by the usual civil protections, like having to have a warrant to enter your home. They are just there to help, WTF.

  • JD415

    You seem to have gone our of your way to include it–even using the clumsily politically correct phrase “African-American”– so I’d love to know why this woman’s race was relevant to the story.

    The common explanation when this happens is that it’s to “paint a picture” or something along those lines, yet I can’t help but notice that a detail like that isn’t included nearly as often when the story is about a white person.

    I’m sure some idiot is already preparing a mental draft of their response, wherein they rebut my accusations of racism, so let me make explicitly clear that I’m not calling anyone racist: I’m just wondering why that detail was relevant.

  • Rebecca Zenola

    In Michigan, the University of Michigan hospital has a pscyh ER. You can even call and talk to someone for about 20 mins. That is in Ann Arbor. Safehouse is in Ypsilanti, it’s a domestic violence program with 24 hour call center. Women only. They have counselors who can talk about options.

  • suzy

    this is great! thank you! I’m curious if there’s anything for us over in nyc, does anyone know of any extra resources?

  • Mikey Burger

    anyone have simular resources for new york?

  • Denny Smith

    Javier, your Internet Coward’s Mask is no more convincing than all the other Internet Cowards, trying to find meaning in life by posting ugly remarks just to stir up anger. There really is meaning to be found in life; but you’re pursuing a dead end. Try using your heart and brain, Instead of this cynical, and tedious, “vomit-and-post” strategy.

  • pailhead

    What happened after 4 hours, when the emergency team showed up?

  • Abrasax

    You’re a piece of shit and probably a coward bitch with a mouth like that

  • Abrasax

    Except it’s not irrelevant subtext from generations long perished. It’s common knowledge. I would rather understand the words I use, wouldn’t you?

  • Abrasax

    It’s for shock value and drama, part of the way black bodies are exotified and gawked at in a racist society. It wasn’t relevant to the story and a detail like that is almost never included when the story is about a white person.

  • Jay101

    So I’d love to know why this person’s gender was relevant to the story.

    So I’d love to know why this life form’s species was relevant to the story.

  • DayWalker

    Yes, that totally jumped out for me as well. A naked, screaming woman tells me all I need to know.

  • *9

    Thanks for proving my point!

  • Jan

    Is it possible it’s also there to underscore the danger this woman would have been in if the police were called? Like, considering how often African-Americans in crisis get shot by the police?

    Nah, better explanation is that the author of this piece is simply a racist shitbag. As am I, probably, for posting this comment.

  • Ralph Furley
  • Abrasax

    Really you think that’s what the author’s intention was? So why didn’t he just come out and address that issue? Nope, that wasn’t clear from his writing at all and if you’re going to be an apologist for the racism of others at least come with a stronger debate.

  • Abrasax

    Wow, he’s cute! Thanks for the photo :)

  • Catherine Anderson

    Actually, he did….he just may not have phrased it as “cops are racist jerks.” Instead he more eloquently said “I knew for sure that I didn’t want to call the police…They are trained in ending crisis situations forcefully, but there isn’t enough training in how to deescalate them so that no one gets hurt or killed. While that is in the process of changing as we speak, I’d still rather involve people who already have the training.”

    This is an article about how to help the homeless and mentally ill community. If he had taken it there, it would have detracted from the simplicity and purpose of the article. You’re sitting here maligning someone who wanted to help the woman, who thoughtfully considered why he DIDN’T want to call the police, and who published an article to try and help the rest of us to help the unfortunate.

    Would you be this bothered if he had described her as a half naked Asian woman? Yes, racism exists. Yes, terrible things have been done to and said about minority communities. Yes, we all have a duty to stop such things from happening. However, labeling those who are actively trying to help as racists for describing a situation and not digressing from the topic at hand to racism is taking a step backwards.

  • Abrasax

    Oh please. There was nothing and I mean nothing in his writing that covered police AND race. Not even subtly. Sure, he was clear about not wanting to call the police because ‘police brutality’, and he provided some useful info. Cool, kudos, bravo. That doesn’t change that he identified her as African-American without explaining how it was relevant to the story, transparently using it the way tons of authors use race when writing about people of color. Taking a step backwards? Taking a step backwards would be advocating for the homeless but making racist comments in the process. One good dead doesn’t absolve a bad one.

  • pailhead

    It seems like he was bothered by mere mention of race, nor which race it was. Gender, sure, it’s relevant to the story, could be the difference between that human being posing a physical threat (very large man) or not (petite woman), but what does race have to do with anything.

  • http://www.scoop.it/u/joseph-thomas2 jthomas09

    Actually, Native American warriors were called “bucks” by the colonists, and sometimes were naked, or near-naked, hence the term.

  • http://www.scoop.it/u/joseph-thomas2 jthomas09

    The people best trained to deal with someone who might be a danger to themselves or others are the EMT’s: call 911. The fact is we have nowhere near enough properly trained people in our mental health system (if you can call it that) to deal with the NON-screaming people who need help. I’m personally more concerned witht the alarming increase in the number of people without feet and legs struggling to get around. We need housing designed with rehabilitation facilities, community kitchen, and supprtive services “built-in.”

  • Jason Albertson

    As a former supervisor with the Homeless Outreach Team, a social worker
    for the San Francisco Department of Public Health, now a Psychiatric
    Emergency Responmse Team member in San Mateo County, I do not agree with
    your suggestion that in the absence of the Mobile Crisis Treatment Team
    the San Francisco Homeless Outreach Team should be contacted through
    311 to address the needs of individuals who are emotionally or
    behaviorally dysregulated.

    Let the HOT address homeless issues
    and assist people experiencing homelessness, not high end de-scalation
    and treatment support for disturbed individuals, who may or may not be
    homeless. The team is stretched thin, not qualified or resourced for
    crisis management and has demands on their time and effort that cannot
    support an additional service line.

    Responsibly,

    Jason M. Albertson, LCSW

  • JD415

    I guess that could be true. Thing is, when the music stops and we’re all out of excuses and rationalizations (no matter how reasonable each of them might sound in isolation), we’re still left with the pretty plain truth that somehow race always gets mentioned more often when the person is non-white, even when their non-whiteness isn’t relevant to the story.

    I don’t think Stuart is a racist at all. Not even a little bit; I simply don’t know him or his character well enough to level a serious accusation like that at him.

    On the other hand, we’re all a little bit racist in the sense that we’re more susceptible to making generalizations and having emotional blind spots when it comes to the out-group, and here I think he somehow made her race, which stands out to him as a non-black person, relevant in a way that left me, a black person, scratching my head. I just can’t see why it was mentioned. Usually when someone mentions my race, their motive is, um, questionable, so those kind of things always stick out to me.

  • Abrasax

    THANK YOU :)

  • Chris Courtney
  • NunyadangbusinessDOS

    This is a case of PC going too far. If all that was taken away from the article was “the author shouldn’t have mentioned her race”, congratulations, you missed the entire point. Way to make it about YOU.

  • pk

    Thanks for the feedback, but who do you recommend we call? Are you recommending to call the Homeless Outreach Team directly??

  • Jason Albertson

    I suggest calling the Mobile Crisis Team. The Night Ministry is also a good choice. Concrn will grow its response capacity as well. Again, I do not suggest calling the Homeless Outreach Team for situations that do not involve homelessness versus need for crisis intervention. HOT is capacitated, trained, and equipped to manage homeless individuals and is not a crisis or descalation team. Let them keep their core mission of outreach, engagement, and support for homeless individuals without tasking them with an entirely new area of operations. If Mobile Crisis Team is not available, then resources in SF are limited to Night Ministry and SFPD and Concrn.

    It is not a bad idea to call Mobile Crisis the next day and describe the event, the person, and the resolution, especially if you have a name and birthdate. That way, if the person is developing a pattern they have them on, sort of, an expect list.

    Jason Albertson, LCSW

  • pk

    Thanks so much for the detailed response. Valuable information.

  • Abrasax

    Hmm… I can’t find in my comments above the part where I wrote,”the author shouldn’t have mentioned her race”, but I’m having trouble… maybe it was you who missed my point. So please illuminate me, IF you understood the blog post so well; what was the entire point?

  • roy bot

    Please consider not using the photo of the man on the street yelling, or at least cropping/blurring it so that his face isn’t recognizable. It doesn’t matter where it came from, you should practice what you preach (i.e.; compassion for the mentally ill). As it is, the fact that you’re using it discredits your position.

  • roy bot

    “Inmates”!? So, a mental health diagnosis is the same as a criminal conviction, then? Sounds like you need to do some reading, and examine your ethos.

    In a “civilized society”, the authorities would try to help sick people instead of just immediately using (lethal) force against them. If our society was so “civilized”, they’d rarely reach that point because we made sure they had proper care before they got there.

  • roy bot

    Exactly, but in some circumstances they police may really need to be called (absolute last resort in most places, imo) – the problem then becomes _how_ the incident was called in.
    When I was sick and in crisis, people lied to the police, grossly exaggerating what happened because they thought it would help me get the help I needed more quickly (or just get locked away more surely). I had dropped a key at someone’s feet, they said I “threw a chunk of metal at them”. 5 minutes later the police came, and I nearly got shot while reaching for my ID.
    My point is ignorant, scared people can make the situation worse, part of why we need to work against the MH stigma and educate people better.

  • Miles_Long

    You are right, in a civilized socaity these people would be relegated to an actual insane asylum where they would be helped. But the ACLU argued against involuntary confinement and now they freely roam the streets.

    If you are criminally insane and not fit for society, yes you need to be locked away.

  • AJACs

    From talking to 311/911directly, my understanding us that the very same folks answer both phone numbers. Calling one or the other just changes what queue you are sent to. If you are going to call one or the other, then if it is not a dangerous situation, then call 311, if it is dangerous or you are not sure and it might be, call 911.