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San Francisco District Attorney Chesa Boudin Hosts Summit “Public Health Is Public Safety: Behavioral Health Care in San Francisco”

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Rachel Marshall, (415) 416-4468 / Rachel.Marshall@sfgov.org  

San Francisco—Today, San Francisco District Attorney Boudin hosted a live summit, “Public Health is Public Safety: Behavioral Health Care in San Francisco.”  The event was held at Manny’s in San Francisco and was live-streamed for those who could not attend in person.  The event featured public health and criminal law experts, personally impacted people, and community leaders to explore solutions to the behavioral health crisis on our streets.  District Attorney Boudin moderated the event and delivered opening remarks, in which he emphasized the need for proactive solutions that treat behavioral health needs as public health ones.   

“My priority as District Attorney is ensuring that San Francisco both is and feels safe for all who live here.  To do so, we must address the crisis on our streets, where there are many people living with unmet behavioral health needs,” said District Attorney Boudin.  “I am proud to have hosted this important summit to develop solutions towards promoting public health approaches to behavioral health issues.”

Senator Sydney Kamlager’s Keynote Address

The summit’s keynote address was delivered by California State Senator Sydney Kamlager (D-30, Los Angeles).  She spoke of the intersection between behavioral health and the housing crisis and warned against stigmatizing those who are struggling.  The biggest mental health provider in Los Angeles, as in San Francisco, is the jail—and she described observing painful mental health struggles of people inside the jail. Senator Kamlager also spoke of her own personal experience with her stepchild who was diagnosed with autism at an early age.  

Senator Kamlager and District Attorney Boudin co-authored an opinion piece in CalMatters, published earlier today, about the urgent need across California to address behavioral health, substance abuse disorder, and housing crises by investing in treatment and housing.

“It was an honor to keynote the San Francisco District Attorney’s “Public Health is Public Safety” summit this morning,” said Senator Kamlager. “The Penal Code can no longer serve as the catch-all for responses in times of emergency. We must develop proactive solutions to address the behavioral health crises taking place on our streets. Thank you to DA Chesa Boudin for creating this space, and for helping chart a course forward that prioritizes public health and public safety.”

Panel Discussions Explored Behavioral Health, Substance Abuse, and Housing Needs

Following the keynote address, District Attorney Boudin moderated two panels.  The first panel, “Locked Up and Locked Out: The Intersection of Behavioral Health and the Criminal Legal System in San Francisco,” included numerous speakers with a wide range of experiences interacting with the legal system’s intersection with behavioral health.  Featured on the panel were: Demarris Evans, Managing Attorney, Collaborative Courts, San Francisco District Attorney’s Office; Dr. Marilyn Jones, Executive Director, Because Black Is Still Beautiful; Philip Jones, Peer Case Manager, Mentoring and Peer Support Project, San Francisco Department of Public Health; Lindsay Lasalle, Managing Director of Policy, Drug Policy Alliance; Tanya Mera, Director of Jail Behavioral Health and Reentry Services at Jail Health Services; and Mark Salazar, Executive Director, Mental Health Association San Francisco.

The second panel, “Care Not Cages: Towards a Public Health Response to Behavioral Health Issues,” focused on non-punitive, public health-centered approaches to treating behavioral health concerns. District Attorney Boudin also moderated this panel, which featured:  Angelica Almeida, Director of Forensic & Justice Involved Behavioral Health Services, San Francisco Department of Public Health; Nina Catalano, Senior Planner, Tipping Point; Vinny Eng, Director of Policy and Advocacy, Safer Together; Dr. Margot Kushel, Director, UCSF Center for Vulnerable Populations and Kristen Marshall, DOPE Project Manager, National Harm Reduction Coalition.  The panel addressed the urgent need for housing, the benefits of harm reduction approaches, and the need to develop alternative responses to people in crisis.

Discussion of Alternative Responses to Those in Crisis

Numerous panelists described the need for new approaches to those in crisis that do not involve police or criminal justice responses.  Angelica Almeida, Director of Forensic & Justice Involved Behavioral Health Services for the San Francisco Department of Public Health, described San Francisco’s Street Crisis Response Team, which offers a compassionate and trauma-informed response as an alternative to contact with police.  She explained that the program has responded to 2,000 calls to people in crisis, none of which have led to an arrest or contact with the criminal justice system.

Vinny Eng, Director of Policy and Advocacy of Safer Together, spoke of the importance of protecting communities and vulnerable people from police violence. “The greatest strategy to reducing police violence is reducing unnecessary police interaction,” he explained, noting that three people a day are killed by police violence.  “This is an incredible time to reimagine who are the holders of safety in our community.”

Discussion of Substance Use Disorders

Throughout both panels, substance use came up and numerous speakers brought up concerns about criminalizing drug use or substance abuse.   Lindsay LaSalle, Managing Director of Policy of Drug Policy Alliance, spoke of the misguided approach of the War on Drugs, which criminalized addiction.  “We have to acknowledge that the War on Drugs was implemented as a cover to criminalize certain groups.”  She also warned that someone should not need to be arrested to obtain access to treatment, and advocated for the decriminalization of drugs.

Kirsten Marshall, DOPE Project Manager or National Harm Reduction Coalition, emphasized that the War on Drugs perpetuated racial oppression.  She described the importance of harm reduction approaches, which emerged out of the AIDS crisis, to center the needs and health of the individual.  She also explained that, “We meet people where they are and we don’t leave them there if they don’t want to be left.” 

Discussion of the Intersection with the Housing Crisis

Numerous panelists explored the intersection of behavioral health and San Francisco’s housing crisis and inadequate support for unhoused persons.  Dr. Margot Kushel, Director of the UCSF Center for Vulnerable Populations emphasized the need for housing as a solution to many of the problems addressed at the summit. “Housing first is a response to homelessness that starts with housing. If you start the other way, it doesn’t work,” she explained. “It’s hard to get people engaged when they are worried about where they are going to sleep.” 

Nina Catalano, Senior Planner of Tipping Point, emphasized that housing is a racial justice issue—and pushed back on ideas that San Franciscans did not support navigational centers or housing in their communities. “Those voices may not be the loudest,” she explained, as she stressed that the housing crisis impacts all San Franciscans.

During the summit, District Attorney Boudin read a letter to him from a San Franciscan mother who wrote of her child who was arrested and struggled at length with behavioral health issues.  That mother identified herself at the conclusion of the program, leading to a discussion about harm reduction approaches and how to help those who need more support than just housing.  Dr. Kushel noted, “Housing first does not mean housing only.”

Panelists Discussed Personal Experiences

Some of the panelists described both personal and professional understanding of behavioral health crises.  Philip Jones, Peer Case Manager of Mentoring and Peer Support Project at the San Francisco Department of Public Health, described his personal struggle with behavioral health and substance use and how he was pushed into the criminal legal system as a direct result of those struggles.  He praised programs like Larkin Street, San Francisco Pretrial, Reentry Services, along with Behavioral Health Court.  “For me, in these circumstances, I could never get the proper help,” he explained. “I would be in the cycle, I’d get arrested for quality of life offenses. I’d be in custody for three to four days. I’d lose my housing.”  He explained that he could only get help when he was no longer afraid of losing housing, had an income, and was able to get help for his substance use disorder and behavioral health needs.

Dr. Marilyn Jones, Executive Director of Because Black Is Still Beautiful, also described her personal struggle with substance use disorder and incarceration.  She warned that, “You can’t move on to the next epidemic until you’ve fixed the response to the last one.”

Demarris Evans, Managing Attorney of Collaborative Courts at the San Francisco District Attorney’s Office, described the role of collaborative courts and particularly drug court and behavioral health court in helping people who are struggling.  She also noted her own experience with addiction, from which she recovered over 30 years ago.  “I like to let judges and prosecutors know that just because someone has experienced substance abuse, does not mean that they shouldn’t have the same opportunities,” ADA Evans explained.

The entire event can be watched at: https://www.facebook.com/SFDistrictAttorney.