The Two Most Important Things SF Is Getting Wrong About Homelessness

This is a piece I wrote for TheVoiceSF. I’ll be regularly contributing to VoSF, along with some incredibly writers, so please check them out at the link.

There’s been plenty of “what we’re getting wrong about homelessness” lists over the years, and apparently our leaders aren’t reading them because the homeless population has dramatically increased over the last decade. After reading a few of these articles I realized that the problem wasn’t that they weren’t influencing policy, in fact the problem might be that they are. The biggest issue I noticed was that these articles represent homelessness as a monolith of purely economic origin. The truth is that people become homeless for radically different reasons, and homelessness due to poverty shouldn’t be conflated with much of what we’re witnessing in the streets of San Francisco. The city has been at the helm of radical leniency towards antisocial and self-destructive behavior, which has been devastating for those that are homeless due to addiction and/or mental illness. And the strategy of essentially providing them hospice care to slowly kill themselves in front of us over the last few years has become an utter disaster.

The drug addicts that are homeless are usually homeless because of their addiction, and nearly half of the homeless in San Francisco self-report drug abuse. These people don’t deserve assisted suicide via neo-harm-reduction (which is our current strategy), nor do they deserve long prison sentences; they deserve comprehensive care that our city is hopefully on the verge of providing. For those that are severely mentally ill, they too deserve a dignified level of care, but instead we provide them little more than the freedom to wither away in the public eye. As a former homeless drug addict that lived in the Tenderloin and on Skid Row in Los Angeles, I felt compelled to weigh in. And although there are plenty more “things we’re getting wrong” I could add, right now I’ve decided to focus on the two most critical misconceptions specific to San Francisco. These are the two most important things our city is getting wrong about homelessness when it comes to drug addiction and mental illness. 

Housing alone can’t solve the majority of homelessness in SF

This is a tough concept for some to grasp, and will likely get the most pushback from the devout housing-first fanatics. If someone is homeless it implies that they are without housing, so the obvious solution is to provide them a house, right? This is somewhat correct. In order to solve homelessness in SF, every homeless person will need to be provided a place to live. But a large number of our homeless people are severely addicted to drugs and/or mentally ill, so that place needs to be a medical treatment program. Once detoxed, transitional supportive housing with psych care, addiction treatment, life skills training, and job placement would set these people up for prolonged success. And with incremental steps towards self-sufficiency, they could get a second chance at a life worth living. A free studio apartment can’t cure severe mental illness and/or addiction, but it can help a homeless person that has simply fallen on hard times - and I’m all for that. But for those that are a danger to themselves or others, four walls and a kitchenette is nothing more than an oversized coffin. In fact, 44 people died from overdose in San Francisco’s permanent supportive housing system last December, and another 30 in January. Activists often say it’s safer for homeless drug addicts to be housed, and this is true, but what they’re leaving out is that it’s only safe if they're housed in a recovery environment that doesn’t enable their deadly disease. One would think that most of SF’s overdose deaths in 2023 happened to people living on the street, but the truth is that 74% occurred at a fixed address, the majority of which were concentrated in pockets of permanent supportive housing. A fellow contributor to VoSF, Gina McDee, analyzed every overdose death from the county medical examiner and determined that 542 people overdosed in SF permanent supportive housing since 2020. Of those 542 deaths, 121 occurred at the Tenderloin Housing Clinic, a nonprofit that doesn’t require or incentivize addiction treatment. Salvation Army, one of the only nonprofits that does, had only a single overdose death since 2020.

Given that I’ve purchased drugs, gotten high, and even overdosed in some of these SRO’s, I’m speaking from experience. These homeless addicts, like myself, have a disease defined by the subconscious drive to kill ourselves, and when the “solution” is no-strings-attached housing, none of the root problems are remotely addressed. On top of this, the city’s notorious leniency and resources to help homeless addicts self-destruct attracts many out-of-towners. Even Jeff Kositsky, SF’s former Homeless Czar, admitted this last year, “San Francisco attracts unsheltered people to our City due to a lack of real enforcement and the many amenities we provide to folks.” Therefore, this approach will never come close to solving the problem. The more we double-down, the more homeless addicts San Francisco attracts, and the cycle never ends. But those that are making millions off of the controlled suffering of thousands want it this way. Which brings me to the second thing San Francisco is getting wrong about homelessness.

Most of our current homeless nonprofits are doing more harm than good

As a person who heavily utilized homeless nonprofits for years, this topic is complicated for me. Most of these organizations truly meant well, but some of them ended up doing more damage than not. Of course the nonprofits that provided food were a godsend. You can’t really hurt someone by feeding them. And the needle exchanges I utilized may very well have prevented me from contracting HIV. But I got off the streets for good in 2016, and since then the situation has changed dramatically. Needle exchanges used to provide information about detoxes and treatment centers. In fact, I got into a detox once through a needle exchange on Skid Row. These were often nonprofits run by former addicts that were simply trying to prevent the spread of diseases and gently guide addicts on a path towards recovery. Once cities like San Francisco started dumping hundreds of millions of dollars into “harm reduction”, however, working at a needle exchange became more of a career path. Nowadays they often employ recent college grads with a penchant for radical politics and social justice, and pay them $30/hr to walk the streets and hand out tin foil to fentanyl addicts. We went from exchanging needles to prevent the spread of HIV to the Uber Eats version of free crack pipes. With fentanyl fully replacing heroin by 2019, and the fact that the majority of addicts favor smoking fentanyl over shooting it, the nonprofits had to adapt to keep the money train going. They switched from needles to tin foil and crack pipes, both of which pose almost no risk of spreading disease. And with this original goal of reducing harm (Curbing the spread of HIV and Hep C) thrown out the window, the neo “harm-reduction” movement lost most of its credibility with former addicts like myself.

 I used to have to dig through a garbage can and find a half-eaten burrito to get a piece of tin foil. Now it gets delivered to your tent by a kid with an Art History degree, funded by tax dollars. I wouldn’t mind this so much if it wasn’t taking millions out of the coffers that could be better spent on public detox and treatment. But the big picture is that we provide zero incentive to get clean and only incentivize homeless addicts to keep getting high. The embezzling tin foil-peddlers are obviously bad, but the damage they’re doing is miniscule in comparison to the free housing organizations. We’ve given these orgs hundreds of millions of dollars to build glorified crackhouses where dozens of people die from overdose each month on the taxpayers dime. It wasn’t always like this. Newsom signed SB 1380 into law in 2016, making it so housing nonprofits could no longer receive state funding if they attached sobriety/recovery requirements to housing. At the time, homelessness numbers in California had surpassed 120,000, and most housing nonprofits didn’t allow active drug abuse. SB 1380 was enacted so nonprofits would be forced to open their doors to everyone and lower the official homeless population. However,  the homeless population has climbed to a whopping 181,000 since SB 1380 was signed into law, and the overdose death rate in San Francisco has more than tripled. This measure not only failed to reduce homelessness, but it cultivated a billion-dollar industry in prolonging active addiction. And with terrible outcomes and increased public scrutiny, the hammer is finally starting to drop. 

Corruption is never completely avoidable, but corruption combined with no accountability of results and waves of overdose deaths is beyond contempt. In February, J&J Community Resource Center got nabbed for double billing, submitting false invoices, and seeking reimbursements from the city for cigars, alcohol, and motorcycle rentals. Shortly after, the nonprofit Homerise - one of the city’s largest “homeless housing” providers with tens of millions in public contracts - got caught misusing millions in taxpayer funds on huge pay raises and lavish spending that was earmarked to help the homeless. While maintaining a vacancy rate as high as 30% at some of their drug-infested properties, management handed out bonuses and maintained a whopping 118 company credit cards. 

The FBI has finally been called in to investigate the United Council of Human Relations (UCHS), one of the city’s many corrupt nonprofits, after discovering extensive criminal activity. We can only hope that this is the first domino out of many more to fall on a federal level, and San Francisco can soon start anew with a focus on mental health and addiction treatment. After several moderate measures passed in San Francisco last month, as well as Prop 1 on a state level, it’s become clear that the tax base is exhausted by radical policies. Our experiment with neo harm-reduction and housing-first for the mentally ill and addicted has failed; More importantly, those suffering from such afflictions have suffered the most. A new direction is far past due, and given the recent election results, the majority clearly agrees.