Expanding on what officials called a promising start to San Francisco's new police-free mental health crisis teams, Mayor London Breed is proposing a sister division that would respond to lower-level "wellness" calls that traditionally have been handled by armed officers.
The street wellness response teams would represent the latest in the city's efforts to dial back police presence from calls for service that don't involve criminal activity — particularly those involving mental health and homelessness.
"We are continuing our work to make a significant change to improve how we effectively serve people in need on our streets," Breed said in a statement.
"Many calls to 9-1-1 or 3-1-1 about someone who appears to need help on our streets don't require an armed police response, and often the services and care people need would be best provided by a paramedic or outreach worker instead of a police officer."
Breed's proposal, announced Monday, comes as the city launches its fourth street crisis response team — trios made up of a paramedic, a behavioral health clinician and a peer health worker who respond to people in the throes of a mental health crises.
There is broad support throughout San Francisco City Hall for replacing police with people trained to handle psychiatric crises and other types of mental health emergencies.
The street teams were one of the key pillars of Breed's police reform blueprint released last year in the wake of the George Floyd killing and a national uprising over police brutality against Black people. The teams were also important elements of Mental Health SF, the sweeping proposal to overhaul the city's mental health care system, spearheaded by Supervisors Hillary Ronen and Matt Haney.
The wellness teams would work in tandem with their crisis team counterparts, but would tend to scenes where the need is less severe. This could include reports of a homeless person sprawled out on the sidewalk, someone with an obvious injury or calls from out-of-towners who haven't heard from an elderly relative in a few days and want someone to check in.
"Most of the people that are out in the street and exhibiting problem behavior are not having an acute behavioral crisis," said Simon Pang, section chief of community paramedicine at the San Francisco Fire Department.
Pang, who heads the department's street team efforts, said while the subject of a mental health call may have a history of mental illness or be in a social distress, many don't meet the threshold for the crisis teams, or require a psychologist or social worker on scene.
"What they need is someone to assess them to make sure there isn't an acute medical emergency that needs to be addressed, and have the ability to connect them to any resource the city has to offer," Pang said. "We can do that."
The initial five wellness teams would consist of a paramedic and homeless outreach team member, operate in 12-hour shifts, and handle about six or seven calls per day, according to the mayor's office. It's estimated to cost about $3.8 million in the first year and $5.8 million in the second year as the program scales up to 10 total teams by the end of 2022.
Breed will include these funds in her next budget proposal, which will be unveiled on June 1. If approved, officials plan to launch at least one team by January of next year and up to five teams by April 2022.
By April of this year, city officials said the street crisis response teams had responded to more than 700 calls since its soft launch in November, which began with just one team in the Tenderloin.
The vast majority of those calls, officials said, were dispatched from 9-1-1, meaning they significantly diverted what would have likely been a police presence. This amounted to about 19% of the dispatch calls for a "mentally disturbed person."
In 2019, San Francisco dispatchers fielded about 12,000 mental health crisis calls. Calls for well-being checks — the ones that will be handled by the new teams — clocked in at about 18,000 calls.
"I feel like this team that we're proposing is nimble enough that we could respond to any nature of these checks on well-being," Pang said. "People won't be alarmed to see our department member knocking on the door and asking is everything OK."
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