Blocks away from the upscale shops that line San Francisco’s affluent Union Square, lies the Tenderloin neighborhood, an area known for crime, homelessness and hard-core drugs.
Neil Shah walks these streets on a regular basis. As a compassionate responder for Concrn, a non-profit community-based crisis reporting service, Shah responds to reports of homeless people in distress. By downloading the Concrn mobile app (free on both Android and iPhone), the general public can use their smartphone to report non-emergency crisis situations involving the homeless.
“When people witness an incident involving a homeless person, their first reaction is often to call 911,” Shah said. “The problem is emergency response personnel aren’t equipped to provide the mental health support and follow-up care that many of the homeless population needs.”
Retraining the public to call Concrn, rather than 911 in a non-emergency situation, is a task in itself, yet Concrn strives to do much more. Founded by local entrepreneur Jacob Savage, the non-profit also trains crisis responders to complement the city’s existing resources and reduce strain on 911 and law enforcement. A recent report found that in 2016, the San Francisco Police Department received 57,249 dispatches for homeless related calls.
In addition, the 2017 San Francisco Point in Time count for the homeless found the city’s number of homeless residents to be about 7,500, with 41 percent suffering from an alcohol or drug addiction and 39 percent with mental health issues.
As Shah walked along Eddy Street earlier this month, through the heart of the Tenderloin, he carefully stepped over the discarded syringes and human feces that lined the sidewalk. He discussed a report he responded to earlier that week concerning a homeless man who was standing in the middle of a busy street talking to himself incoherently.
Shah engaged the man in conversation, and after talking to him for several minutes, persuaded him to leave the busy street and walk with him to a nearby shelter that had an available bed. There, the man would not only receive food and shelter, but information about mental health and other services that might help him ultimately leave the streets.
Other calls might involve responding to a possible overdose (all compassionate responders carry Narcan, a prescription nasal spray used to treat overdoses in emergency situations). Often Shah and the other responders are called to provide wellness checks on homeless residents who appear ill, or they proactively hand out free jackets when the weather becomes cold.
“When police are dispatched to these calls, they’re limited in what they can do,” Shah said. “If they give the homeless resident a quality-of-life ordinance, for something like urinating, defecating or drinking in public, or they enforce an anti-homeless law where a person is cited for sleeping or begging on the street, the resident typically just moves to another part of the city.”
For the 911 calls on homeless who are intoxicated or may be experiencing medical problems, Shah said they are typically taken to the hospital, and then released on the streets, often without receiving any follow-up care on how to manage their addiction or chronic health condition.
To break this cycle, Shah said Concrn works closely with other organizations such as San Francisco’s Homeless Outreach Team and Department of Public Health, to ensure residents get the ongoing care they need.
Concrn responders like Shah, who also serves as the organizations’ founding board member, are required to undergo a 20-hour training session, combined with 80 hours of shadowing a lead responder. The training teaches conflict resolution, de-escalation techniques and compassionate response. For Shah, 32, who struggled for years with his own mental health and substance abuse issues, the work is also deeply personal.
“I’ve been through treatment and am in recovery, but I know how isolating it feels to suffer from addiction and how difficult it can be to navigate the health care system and to find the right therapist and support services,” he said.
Concrn currently has a staff of 10 responders who dispatch in pairs to crisis calls. They are paid $17.50 an hour, and Shah said Concrn gets approximately 10 crisis calls each day. Many of the responders are in recovery or are formerly homeless, a few still live in shelters.
“Since the program first launched in 2015, we’ve logged in 3,500 crisis reports,” Shah said.
While Concrn would like to expand their offerings to more areas of San Francisco, increase their number of responders, and even make a version of their service available to other cities across California and the country, Shah noted the non-profit would require additional funding in order to accomplish their goals.
Alex Briscoe, a national funding consultant and principal of the California Children’s Trust, an initiative to leverage the power of behavioral supports and strategies to achieve healthy development and healthy equity for children in California, said Concrn provides many benefits to the city’s homeless population including peer to peer counseling during times of crises and helping residents access services including shelter and mental health services.
“Concrn opens up a public conversation about the homeless while also helping to fill some of the gaping holes in our fragmented safety gap,” said Briscoe, who serves on the non-profit’s Board of Directors. “While the service isn’t a replacement for adequate housing and mental health services, they do provide a much-needed empathetic presence to the homeless.”