Behavioral health professionals and paramedics on Street Crisis Response Teams are handling non-violent mental health calls instead of police under a San Francisco Department of Public Health pilot program.<ins> (Courtesy San Francisco Fire Department via Twitter)</ins>

Behavioral health professionals and paramedics on Street Crisis Response Teams are handling non-violent mental health calls instead of police under a San Francisco Department of Public Health pilot program. (Courtesy San Francisco Fire Department via Twitter)

SF expands civilian response to mental health 911 calls

Program adds new Bayview team but falls short of goals

San Francisco is expanding a new program to the Bayview that aims to be an alternative to policing by having a team of behavioral health professionals and paramedics respond to certain 911 calls.

The Street Crisis Response Team will respond to non-violent reports of people in mental health crisis in the Bayview every day of the week beginning Monday from 11 a.m. to 11 p.m., according to the Mayor’s Office.

The Bayview team is the third to be deployed in San Francisco. Officials first launched a team in the Tenderloin last November, followed by a second team serving the Mission and Castro in February.

Board of Supervisors President Shamann Walton, who represents the Bayview, said he hopes the team can help “prevent and intervene before violence escalates.”

“If real connections are provided for people who would otherwise commit violent crimes, and they are connected to employment and services, this would be a great complement and piece of the work for our District 10 Public Safety Plan,” Walton said, referring to his anti-violence work in the neighborhood.

While officials are praising the expansion, the rollout falls short of the goals Mayor London Breed laid out last November when she announced that San Francisco would have at least six teams available 24/7 across The City by the end of March.

The Mayor’s Office blamed the delay on hiring challenges.

“The process of hiring behavioral health clinicians is a challenge in normal times, but it has been especially difficult during the pandemic because of the demands that COVID-19 has placed on the public health system,” Breed’s spokesperson Andy Lynch said. “Additionally, The City is looking for clinicians with experience handling these types of interactions.”

Lynch said Breed is still committed to establishing all six teams for 24 hour per day coverage and “are optimistic we can do this by the end of summer 2021.”

The teams are being rolled out as part of a pilot program with the Department of Public Health to reform The City’s system of care for those with mental health and substance use issues on the streets under the Mental Health SF initiative.

Supervisor Matt Haney, who represents the Tenderloin, said the teams are “making a difference.”

“I’ve heard and seen good things directly in terms of their impact,” Haney said.

But Haney said more teams are needed.

“The number of people on our streets who are in a mental health or drug crisis is huge,” Haney said. “Right now they’re doing great work, it’s just far too limited than it needs to be.”

Castro Supervisor Rafael Mandelman also approved of the effort, but said the teams haven’t been able to respond to every situation where it would seem appropriate.

“Either there aren’t enough of them or they are not working those hours,” Mandelman said.

The Tenderloin team operates seven days a week from 9 a.m. to 9 p.m., while the Castro team operates daily from 7 a.m. to 7 p.m.

The pilot was budgeted at $6.2 million for about half the current fiscal year and the proposed budget next year is $13.4 million, which includes about 60 full-time staff.

Each team includes a paramedic from the Fire Department, a behavioral health clinician with the nonprofit HealthRight 360 and a peer specialist with Richmond Area Multi-Services, or RAMS, a nonprofit mental health agency. Staff also includes people to coordinate care for those encountered on the street.

In its first two months, the Tenderloin team responded to 199 calls for service that police would have otherwise responded to with officers, according to DPH. The average response time was 15 minutes. As a result of the calls, the team interacted with 110 people and couldn’t locate 89. Nearly all were experiencing homelessness.

Seventy-four percent of those served by the team were assessed, underwent therapeutic de-escalation and “ultimately were able to safely remain in the community,” while 17 percent were transported by ambulance to emergency care and 9 percent were brought by the team to a behavioral health setting like sobering services.

The teams are dispatched to respond to 911 calls known as as “800-B” calls, the code for “mentally disturbed person calls” at the priority B level, meaning they do not involve weapons or violence. There were bout 10,000 800-B calls in 2019.

The Tenderloin team responded to 20 percent of all such calls made across the entire city in its first two months.

The pilot is expected to evolve. One discussion underway is for residents to be able call for the team without calling 911, as some may have concerns about calling the police.

Officials with DPH say they want to ensure they are able to successfully respond to all of the 800-B calls first before providing other ways to call for the team’s response.

There are also discussions about expanding the type of 911 calls they respond to.

As the pilot expands, some are concerned The City won’t have the adequate services in place to meet the need.

“My main worry is that there are actually the services, beds, therapists and treatment programs available for those they serve to access immediate help,” said Sara Shortt of the Community Housing Partnership, who sits on the Mental Health SF working group. “Outreach and de-escalation are important, but at the end of the day the teams will only be as effective as the resources they have to offer to truly address the mental health needs.”

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