Crisis at Midnight: Who can You Call?


root - Posted on 31 December 1969

the case for 24 hour mental health services

by Leroy Moore/PoorNewsNetwork

What would you do if you were in psychiatric crisis in the middle of the night? Well, unfortunately based on the current city policies and available services you would have to wait until the morning. The only choice for people in psychiatric crisis in the middle of the night is to be taken by police to San Francisco General Hospital or to jail. The City’s answer doesn’t provide needed services, peer support or medical crisis intervention. According to California’s chapter of Alliance of the Mentally Ill, the second leading cause of violent death for people with psychiatric illnesses is police shootings, Idriss Stelley, a young brother who was shot by police after his girlfriend called for help at the Metron Theater is one example. In addition, 1 in 4 police calls are responses to people in psychiatric crisis. Having the police respond to health issues often results in trauma for the individual in crisis. To add to this situation San Francisco has the highest involuntary detention for psychiatric evaluation rate in the state. This points to the need of an after hours crisis drop-in clinic. Mental health experts and advocates agree when individuals do not get help until they are in crisis, it is far more expensive. As a city we are playing catch up from the days of deinstitution where people with mental illness and others with disabilities were supposed to transfer into the community but state cuts led to leaving people on the streets.

In the 1999 report, Locked Out: The Voices of Homeless People with Mental Illness authored by the Coalition on Homelessness, the number one problem in receiving mental health treatment and services was a lack of access to San Francisco’s mental health system. The report states that one third of those who tried to get mental health services did not get them because of bureaucratic roadblocks. According to homeless people with mental illness and their advocates these roadblocks in receiving mental heath services are too cumbersome, and it takes too long to get through paperwork, and experts you have to see before you get treatment this makes no sense during a crisis. Homeless people with mental illness explain it is first important to erase the bureaucratic process and the unnecessary waiting time. The Coalition on Homelessness and its allies are embarking on a campaign to create an after hours drop-in crisis clinic this will add a sensitive peer friendly environment where homeless people with mental illness can come in time of crisis or even before to receive not only medical treatment but peer support and other services in a home-like non-threatening center. We are pushing that this will happen without the red tape that too many homeless people with mental illness have grown accustom to before any services are rendered

We all know that the economy is sagging and the city is pitching pennies these days however the pennies that are requested for the after-hours-drop-in-clinic would lead to a decreased reliance on San Francisco Psychiatric Emergency Services and save the city money. It will also relieve some strain from San Francisco General Hospital. The push for the after hours drop-in-clinic has received a positive response from community leaders, day drop-in centers, disability organizations, families, some city departments and some political leaders. Although we are consistently told that the city’s economy has fallen, a group of advocates, mental health experts, community and advocacy organizations and consumers are coming together to work on what this after-hours drop-in-clinic would look like with the goal of helping people in psychiatric crisis get the services they need. This will provide a road back to recovery as well as an entry into the mental health system.

To get involved please call Jennifer Friedenbach at the Coalition on Homeless at (415) 346-3740

By Leroy Franklin Moore Jr.
Executive Director of Disability Advocates of Minorities Organization, DAMO

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