SAN FRANCISCO, CA — San Francisco Supervisor Aaron Peskin said Thursday he will be entering treatment for alcohol dependency.

In a statement, the District 3 supervisor thanked his friends, family, colleagues and staff for standing by his side as he confronted his personal issues.

“After serious consideration, I have decided to enter into alcohol treatment under the guidance of professionals,” he said. “I stand by my long legislative and civic record but must also take full responsibility for the tenor that I have struck in my public relationships — for that, I am truly sorry.”

He added, “I seriously take my duties and responsibilities as a community member and public official and remain deeply committed to the issues and legislative agenda that I have pursued on behalf of the people of San Francisco for two decades.”

Peskin was first elected to the Board of Supervisors in 2000 and served for eight years, then was elected to the board again in 2015. His district includes neighborhoods like Nob Hill, North Beach, Chinatown and the Financial District.

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The Posttraumatic Stress Disorder (PTSD) Research Program at the San Francisco VA Medical Center/UCSF is studying the effectiveness of using cognitive-behavioral therapy to treat people with insomnia and PTSD.

Eligibility

The PTSD Research Program is looking for individuals:

• Ages 18-65.
• Who have experienced a traumatic event.
• Are experiencing symptoms of Post Traumatic Stress Disorder (PTSD).
• Who are experiencing sleep disturbances.
• Are taking a psychiatric medication.
• And/or are in counseling.

The Study

Participants will have their sleep-wake activity monitored at home for a one-week period, followed by eight weeks of therapy with a trained clinician aimed at resolving problems falling and staying asleep, and improving the quality of sleep. At the end of eight weeks of therapy, sleep-wake activity will be monitored once more for one week. Participants are reimbursed for their time and efforts.

Getting Started

We will ask you some questions over the phone, and if you are a potential match for the study, we will invite you to participate in a clinical interview.

Contact Us

For more information, please call 415-418-4360/888-567-6337 or email us at:
sleepstudy@ncire.org.

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Thomas Martin, MD, spoke about how to increase response durability with ciltacabtagene autoleucel for patients with heavily pretreated multiple myeloma.

Thomas Martin, MD, associate director of the myeloma program at the University of California San Francisco, spoke with CancerNetwork® about the approval of ciltacabtagene autoleucel (Carbykti; cilta-cel) and how investigators can best utilize this treatment for those with relapsed/refractory multiple myeloma.1 This approval comes based on the results of the phase 1b/2 CARTITUDE-1 trial (NCT03548207) in which patients with heavily pretreated multiple myeloma and were given cilta-cel and saw durable responses.2

Transcript:

In this patient population, we must look into how we can make it a longer remission duration for everybody. The currently approved therapeutic idecabtagene vicleucel [Abecma] has a [median] progression-free survival [PFS] of 12 months. We would love for it to be longer than that, right? Maybe we need to do maintenance therapy. Maybe we need to see if we [give] treatment after we give the CAR T-cell therapy, something that can rev up the T-cells, make them last longer, and perhaps provide more of an anti-myeloma effect.

Cilta-cel has a longer PFS [with data recently] presented at the recent [63rd Annual American Society of Hematology Annual Meeting]. The 2-year progression-free survival rate was 60.5%, so people are getting 2 years or more of remission duration. Can we even make it longer by adding? That’s one avenue as to how to make it better for the people with relapsed, triple-class refractory [disease]. The other question for us is if we move it to earlier lines of therapy, will we be able to cure some patients with multiple myeloma? Will their remission duration be longer? If we do it in less heavily pretreated patients where their T-cells are healthier and when their myeloma isn’t as resistant, can we make it last longer? That’s a huge question, and that’s where a lot of the energy is now in proving those points.

References

1. US FDA Approves CARVYKTI (ciltacabtagene autoleucel), Janssen’s first cell therapy, a BCMA-directed CAR-T immunotherapy for the treatment of patients with relapsed or refractory multiple myeloma. release. Jansen. February 28, 2022. Accessed February 28, 2022. https://prn.to/3vskiZu

2. Martin T, Usmani S, Berdeja J, et al. Updated Results from CARTITUDE-1: Phase 1b/2 study of ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T cell therapy, in patients with relapsed/refractory multiple myeloma. Blood. 2021;138(suppl 1):549. doi:10.1182/blood-2021-146060

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San Francisco is allowing people to use drugs in an outdoor area of ​​Mayor London Breed’s new Tenderloin Linkage Center in United Nations Plaza, interviews and Chronicle observations confirm.

Several people told The Chronicle in interviews Tuesday that they had used drugs inside the fenced-in area bordering the center’s entrance on UN Plaza. In addition to the outdoor area, the city offers basic hygiene services, food, clothing and connections to services such as treatment and housing on the first floor of the seven-story building.

The mayor’s spokesperson, Jeff Cretan, said in an email that the “emergency initiative is about doing everything we can to help people struggling with addiction, and getting them connected to services and treatment. As part of that, the linkage center is serving as a low-barrier site to bring people off the street.”

The revelation that people are using drugs at the week-old site was first reported on the Substack newsletter of Michael Shellenberger, an author who has criticized progressive policies in San Francisco he sees as too permissive.

Addiction experts and advocates differ on whether allowing those who struggle with substance use disorder to get high at the site will help them get connected to treatment, with some saying it acknowledges a necessary reality on a journey to get help and others calling it counterproductive.

Shellenberger accused the city of running an “illicit drug consumption site” and a “supervised drug consumption area,” which is currently illegal under state and federal law.

Francis Zamora, a spokesperson for the Department of Emergency Management, which is running the linkage center, denied the city was operating a supervised consumption site. San Francisco is working to follow New York City in opening such a site which would provide medical supervision and clean supplies, despite its questionable legal status.

Even if city officials are turning a blind eye to illegal drug use, they’re unlikely to face legal liability, said Robert Weisberg, a Stanford law professor and co-director of the school’s Criminal Justice Center.

“Prosecutors have almost unreviewable discretion not to bring a charge,” Weisberg said. “I don’t think anybody would have standing to complain,” he said, because it would be hard for an individual to show he or she was injured by San Francisco’s actions or inactions.

Used syringes are seen littered along Hyde Street in San Francisco, Calif. Tuesday, Jan 18, 2022.

Stephen Lam / The Chronicle

Last month, Breed announced a state of emergency in the tenderloin in a bid to reduce overdose deaths and said she wanted to crack down on drug dealing and use in the neighborhood. She said people using drugs on the streets would be told that they had a choice of going to the linkage center or jail.

But the Department of Emergency Management and the Police Department said the day the center opened that social workers and public health workers were leading the outreach to get people to the center, but they were not being arrested for refusing to go, at least for now.

So far, police have not stepped up patrols and arrests in the tenderloin, although the mayor has indicated she still wants to do so when staffing and the budget increases.

Journalists are not allowed inside the linkage site, but a Chronicle reporter standing outside on Tuesday observed several people in the fenced-in area holding drug paraphernalia including foil and lighters used to smoke fentanyl and pipes used to smoke meth.

Three men with foil said they were glad to have a calm place to use drugs. Others were also appreciative, saying they could connect with the center’s services while taking advantage of a more private place to use drugs than the sidewalk.

Kayla Simpson, 28, sitting outside the center in UN Plaza, said she went in Jan. 18, the first day the center opened. While waiting in the fenced-in area, she said she felt the need to smoke, so she did.

“They were cool about it,” she said Tuesday.

Shellenberger, author of the new book “San Fransicko: Why Progressives Ruin Cities,” wrote that two people who did not identify themselves as journalists entered the site and took videos of people using drugs in the fenced-in area, while city contractors working at the site stood by.

When asked by The Chronicle what happens if someone tries to use drugs in the outdoor or indoor areas of the linkage center, and whether staff will allow the practice to continue, Zamora did not answer directly.

“This site is about getting people connected with immediate support as well as long-term services and treatment,” he said. “Part of being a low-barrier site means bringing people in without asking a lot of questions.”

Other city staff and nonprofit contractors interviewed at the center Tuesday gave a similar answer about a “low-barrier site.”

City homelessness department spokesperson Denny Machuca-Grebe said the area is not a supervised consumption site, “but if people overdose, at least they’re right next to staff that can help them.”

Since the center opened, staff members have reversed three overdoses, the city said. But those overdoses might be the result of someone using drugs prior to entering the site.

No one interviewed mentioned using drugs inside the building, only in the fenced area. People can come into the center and stay as long as they like; the center is open 12 hours a day now but will expand to 24 hours. Fentanyl users on the street said they sometimes need to use every hour to avoid symptoms of withdrawal.

Those who embrace the city’s harm-reduction policies said that allowing people struggling with addiction to use drugs at the center makes sense. Brooke Lober, director of harm reduction at St. James Infirmary, an organization that supports sex workers, said she wasn’t surprised by the reports people were using drugs at a drop-in center.

“They remain welcome there, and I think that’s how all services have to be if they are appealing to people if they use drugs,” she said. “The alternative would be to kick people out or otherwise send them on their way. The norm of these places is we are trying to meet people where they’re at.”

Lober said her organization does not support coerced services and has condemned the city’s law enforcement crackdowns and homeless sweeps.

dr Josh Bamberger, a clinical and family medicine professor at UCSF, said that allowing addicts to use drugs in a safer situation than on the street or the sidewalk is generally preferable, although he didn’t comment directly on the linkage center.

He said health care workers who help people addicted to drugs in street settings are in a similar, often “difficult” situation because users may want to get high in front of them to avoid getting sick from withdrawal. Outreach workers may offer medication-assisted treatment, such as Suboxone or methadone, but an addict may not want to accept on the spot, Bamberger said.

Tom Wolf, who was formerly addicted to drugs and is now a recovery advocate, said he visited the center Tuesday and was discouraged when he saw people using drugs inside the fenced area.

“I’m not saying totally prohibit drugs, because people will have it on them. I’m just saying don’t let them use inside,” Wolf said. “I respect what they’re trying to do there, but if you’re going to allow someone to come in with a bag of dope and use it, that’s not good. How is that going to work if you walk up to someone who just smoked and say, ‘Hey, do you want rehab?’ That’s not going to work. You’re messing with that guy’s high. How can you engage him at that moment?”

Keith Humphreys, an addiction medicine specialist at Stanford University School of Medicine who has advocated for more treatment options and supported the mayor’s promised crackdown on open-air drug markets, said the city should not mix active drug use with people seeking treatment.

“If you’re coming into a place that’s supposed to guide you toward the end of seeking treatment and recovery and there are people using drugs around you, that becomes an incentive to keep going,” he said. “It’s like trying to have an AA meeting in a bar.”

Some people who use drugs said there were few alternatives.

“It’s not like they’re advertising it, but what are you going to do when you’re waiting around and you need to use?” said Ray, who did not provide his last name, as he sat outside the center Tuesday. “If someone overdoses in there, they can help. What’s wrong with that?”

Ray said he had smoked in the fenced-in area at the linkage center on Monday and that staff members were “cool” with it. He went to the center to get rehab and housing and planned to return.

Trent, who also did not provide his last name, said in an interview in the plaza that he had smoked inside the fence on Sunday.

“They were very professional about it. That’s kind of like a safe site right now because it’s partitioned off. We need that,” he said.

He said he went inside looking for housing, rehabilitation services, medication to treat drug use and tools for harm reduction, and was hopeful he would get them.

“It’s very impressive,” he said. “I saw hopeful stuff.”

Chronicle staff writer Bob Egelko contributed to this report.

Mallory Moench is a San Francisco Chronicle staff writer. Email: mallory.moench@sfchronicle.com Twitter: @mallorymoench

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SAN FRANCISCO (KRON) – Two buildings on Florida Street in Mission and Dore Street in the South of Market neighborhood have been acquired to house people with mental illness and substance use disorders, the San Francisco Department of Public Health said Friday.

The buildings will be converted into cooperative housing for 26 adults as part of the city’s Cooperative Living for Mental Health (CLMH) program.

The mission building, located at 1140-1142 Florida Street, will accommodate 8 adults in separate bedrooms, with access to communal kitchens, bathrooms and a large garden.

The SOMA facility, located at 139-145 Dore Street, will consist of six three bedroom apartments that can accommodate 18 adults, with communal areas.

Conard House, a non-profit provider of residential and behavioral medicine, will own and operate the two properties in partnership with the Department of Health.

Police: Suspect runs over employees after duty in Palo Alto

The city says cooperative living enables people with mental illnesses and substance use disorders to live in community with access to care, services and treatment in spaces run by local behavioral medicine providers. The model can also help on the way to an independent life.

“These buildings are part of our long-term strategy to transform the way we support people with mental health problems and addiction problems,” said Mayor of London Breed. “We’re focused on a whole range of solutions that cover everything from improving roadwork to providing safe, supportive housing for our most vulnerable residents. All of this is part of our commitment to making San Francisco a safer, healthier place for everyone. “

The new buildings represent a 20 percent increase in the city’s residential supply capacity. 140 new beds will open in San Francisco in 2021, including the following:

• The 20-bed SOMA RISE Center, which opens this winter as part of the city’s response to the drug overdose crisis. It will provide a safe indoor space for people who have used methamphetamine or other substances, monitor their health while drunk, and connect them to other health and social services.
• An inpatient treatment facility with 10 beds, specially designed for the treatment of young adults with severe mental illnesses and / or substance use disorders, is being planned.
• Neighborhood-based psychiatric recreation facilities for people affected by homelessness to find shelter in a safe, supportive environment with access to ongoing care.

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San Francisco supervisor Aaron Peskin said Thursday he would seek treatment for alcohol addiction.

In a statement, the District 3 supervisor thanked his friends, family, colleagues, and co-workers for helping him deal with his personal problems.

“After careful consideration, I decided to start alcohol treatment under professional guidance,” he said. “I stand by my long legislative and civil history, but I also have to take full responsibility for the tenor that I have struck in my public relations – I am really sorry for that.”

He said, “I take my duties and responsibilities as a community member and officer seriously and remain deeply committed to the issues and legislative agenda that I have followed on behalf of the people of San Francisco for the past two decades.”

Peskin was first elected to the board in 2000 and served for eight years, then was re-elected to the board in 2015. Its borough includes neighborhoods such as Nob Hill, North Beach, Chinatown, and the Financial District.

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San Francisco is building 400 beds for mental health and addiction treatments – an 18% jump in capacity – as the city seeks to expand aid to needy residents, many of whom are homeless.

The new beds and facilities are in various stages of development. Of the 400 in total, 140 will be opened this year, while 260 are still being planned and designed without an opening date. The city currently has 2,200 treatment beds.

The new beds will support the work of the city’s new and expanding street outreach teams, which include mental health and medical experts who respond to people in a psychiatric or drug crisis.

The expansion – part of the city’s mental health reform efforts aimed at reshaping its behavioral health system – will likely not be enough to serve the city’s most vulnerable residents. Nearly two years ago, the health department identified nearly 4,000 San Francisco residents facing homelessness, mental illness, and addiction, and at the time promised to seek help as a priority to 230 of them.

The pandemic exacerbated the city’s drug crisis as the powerful opioid fentanyl caught on and overdoses skyrocketed. Pressure has risen on Mayor London Breed and the board of directors to deal with the ongoing crisis.

“This is an unprecedented addition to our care and treatment system for people with mental illness and substance use disorders,” Breed said in a statement.

The announcement comes as the city is investing money in its homeless and mental health services by raising a combination of federal and local funding, as well as funding through Proposition C, a controversial 2018 business tax that can now be used for free after years of tying one Legal action. Prop. C is funding the new expansion with approximately $ 30 million. Another $ 6 million will come from the city’s general fund and grants.

Deputy Health Director Naveena Bobba said the expansion will improve patient flow so that patients are treated in a timely manner.

“The investments we are making in expanding our inpatient care and treatment system will help us achieve our goal of rapid access to recovery-oriented care and treatment,” she said.

The expansion effort will be guided in part by recommendations from a 2020 report, efforts by Mental Health SF, and data that identified the types of treatment with the greatest need.

The 400-bed expansion includes the 20-bed SOMA Rise Center, which opens in the fall of 2021 and provides a safe indoor space – or a sobering center – for people who have used methamphetamine or other substances to maintain their health while drunk to monitor and link them to other health and social services.

An inpatient treatment facility with 10 beds is also being designed for young adults with severe mental illnesses or drug abuse.

“That’s huge,” said Jennifer Esteen, former psychiatric nurse for the San Francisco Department of Public Health and Service Employees International Union vice president of organizing. “We absolutely need this inventory.”

“We need that and more,” she added.

The health department is also negotiating the purchase of facilities for an additional 73 beds for people with mental health problems who need assistance with daily living activities, including some for the elderly. The department plans to create an additional 140 new beds to support people leaving dormitory drug use treatment – a final step before independent living.

The city most recently opened the new Hummingbird Place recreation center with 30 new beds in Mission in February after announcing the plans a year earlier.

“People who are mentally ill and addicted to drugs need immediate access to treatment and care,” supervisor Matt Haney said in a press release. “These treatment beds cannot arrive early enough.”

Emma Talley is a contributor to the San Francisco Chronicle. Email: emma.talley@sfchronicle.com Twitter: @ EmmaT332

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July 22, 2021

As part of the mayor’s budget investment, San Francisco will create over 400 new treatment beds, an expansion of 20%

San Francisco, California – London Mayor N. Breed and the San Francisco Department of Public Health (DPH) announced today that San Francisco is building over 400 new treatment beds for people with mental health problems and drug use. This expansion of treatment beds will give those in need more opportunities to receive appropriate services that suit their situation, while also providing San Francisco’s new Street Response teams with additional spaces for customers to interact with.

The expansion plans represent a 20 percent increase in the city’s home care capacity. 140 new beds will open in San Francisco in 2021 alone, with significant progress being made in closing the gaps in critical need areas identified in the 2020 Behavioral Health Bed Optimization Report have been identified. Since Mayor Breed took office, San Francisco has added more than 100 treatment beds across the San Francisco care system.

“This is an unprecedented addition to our care and treatment system for people with mental illness and substance use disorders,” said Mayor of London N. Breed. “We are responding with the urgency this crisis deserves while saving millions of dollars by removing bottlenecks in the system so that people can move to lower, lower cost care levels when they are ready, a lot of the time and effort, but we should see the benefits for years to come. “

These new treatment beds will allow San Francisco’s new Street Outreach teams, including the Street Crisis Response Teams and Street Wellness Response Teams, with additional seats to serve the clients they interact with. There are now five Street Crisis Response Teams in action in San Francisco, answering around 500 calls a month. Mayor Breed has raised funds in this year’s budget for five Street Wellness Response Teams that will begin responding to “wellness check” calls, which number around 17,000 annually.

The expansion efforts are based on recommendations from the Behavioral Health Bed Optimization Project report in 2020, as well as SF Mental Health Legislation in 2019 and usage data that identified the types of treatment with the greatest need. These new beds and facilities are in various stages of development, some ready to open in 2021 and others in the planning and design stages.

“Our biggest public health crisis after COVID is the thousands of people living on our streets with untreated mental illness and drug use disorders. Getting these sick people off the streets and putting them in proper treatment beds will save lives and make San Francisco a safer, “healthier place for everyone,” said supervisor Rafael Mandelman.

“People who are mentally ill and addicted to drugs need immediate access to treatment and care. The expansion of our city’s treatment beds and street crisis response teams through Mental Health SF will better ensure that services are available, accessible and effective, ”said Supervisor Matt Haney. “Fully funding SF for mental health was a top priority for us during this year’s budget process, and we have worked together to expand much-needed treatment beds, care coordination and street intervention. Those treatment beds cannot come soon enough.”

“This expansion of available treatment facilities is an integral part of the full implementation of the Mental Health SF. We need to create places for people in crisis, to get the much-needed supplies and to stop the revolving door that is bringing people back to the streets, ”said Supervisor Hillary Ronen.

“We are not only improving patient flow so that patients are cared for and treated in a timely manner, but we are also developing innovative treatment models that address the specific needs of the community,” said Dr. Naveena Bobba, Assistant Director of Health. “The investments that we are making in the expansion of our inpatient care and treatment system will help us to achieve our goal of rapid access to recovery-oriented care and treatment.”

Several innovative treatment and care programs are being developed to meet the diverse needs of people with behavioral health problems, including:

While nursing homes are closing due to rising housing costs, DPH is also in active negotiations to acquire facilities with at least 73 nursing beds to support people with mental health problems who need assistance with activities of daily living. Some of these will support the elderly. Crucially, DPH is also creating 140 new beds to support people leaving dormitory drug use treatment – a final step in skills building prior to independent living.

In May DPH, together with community partners PRC / Baker Places, the Salvation Army and the Tipping Point Community Hummingbird Valencia, opened a psychiatric recreation facility for the homeless in the Mission and Castro neighborhoods. It is now fully occupied with 30 overnight beds and 20 day beds.

For the latest update on expanding inpatient care and treatment in San Francisco, please visit: sf.gov/residential-care-and-treatment.

San Francisco also posted a daily update on available mental health and drug use treatment beds at: FindTreatmentSF.org.

This press release was produced by the San Francisco Office of the Mayor. The views expressed here are your own.

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Almost two years after approving a conservatory program for mentally ill residents with drug addictions who live on the city streets, San Francisco has only now brought the first person to justice.

In June 2019, the Board approved the controversial Housing Conservatorship pilot program, permitted under Senate Act 1045, approved earlier that year. However, the challenges of implementing the program, sponsored by Mayor London Breed and Supervisor Rafael Mandelman, have so far prevented anyone from staying. The pilot expires on January 1, 2024.

“It’s been almost two years since the board of directors debated fiercely and ultimately decided on SB 1045,” Mandelman said at a public safety and neighborhood services committee hearing on Thursday. “I said at the time that even if SB 1045 only helped one person, I believed it was worth doing. And I still believe that, but I didn’t think it would literally be just one person. “

He said the “purpose was to meet the needs of a relatively small population of unhodged people who cycle repeatedly through mental emergencies, our other emergency rooms, the prison, back on the road and again without ever having the longer-term assistance and support.” Get the care they need. “

Under the program, an individual with a mental illness and substance use disorder from The City can apply for a court-approved conservatory if they have a mental illness and substance use disorder for up to 72 hours for an emergency psychiatric evaluation.

Early last year city officials blamed the difficult process of establishing legal forms in the courts for the new program as the reason for the delay in implementation.

“In June 2020, the forms were finalized by the local courts so we could continue working on the cases,” Angelica Almeida, who oversees the health ministry’s outpatient treatment program and SB 1045 pilots, told the committee. “We weren’t able to move the cases forward until June 2020.”

Almeida said that by the end of January they had identified 63 people with double illnesses who had at least five 5150 in the past 12 months, of whom 16 had at least 8 and one was preserved.

She said she anticipated The City would eventually get “at least a handful more people” under the pilot.

Mandelman said SB 1045 was originally suggested as a solution to a certain type of problematic behavior he sees in his district.

“I know a number of these named people in my district who commit crimes, not because they are bad people, but because they have a mental illness associated with a substance problem, who are 5150 years old, maybe not eight times. but a lot, ‘said Mandelman. “One such person lit a fire in my district that burned three people from their homes last week.”

Jill Nielsen, assistant program director for the disability and elderly services department that oversees regulators, said the “eligibility criteria are way too tight” to get someone under the pilot. She noted that SB 1045 was originally introduced to allow a conservatory if a person had three 5150s within 12 months, not 8.

However, critics of the law have called for stricter protections against the conservatory under the pilot, including The City, which is doing more to provide volunteer services and housing “before we take away civil liberties.”

Nielsen said it remains to be seen what will happen if there is a controversial conservatory, but that the prosecutor “believes that a future controversial case could be quite complex and lengthy because of the” extensive requirements contained in the law ” .

“While we knew the housing conservation program would only serve a small number of people, it remains disappointing that we were unable to serve more vulnerable people at the time,” said Nielsen. “We are absolutely determined to expand the program and we remain committed to implementation and innovation to do whatever we can to ensure we use this tool.”

However, critics said the approach was still wrong.

“We know there are big problems with the Conservatory,” said Jessica Lehman, executive director of Senior and Disability Action. “It’s a major deprivation of civil liberties. We need to offer people housing and volunteer services sooner instead of having people in crisis for years and then say they haven’t made rational decisions.”

It refuted the characterization of 1045 supporters that the opponents of the bill had succeeded in making changes that made the pilot overly complex.

“It’s great that we have as many safeguards as we do,” said Lehman. “The people who have had multiple 5150s are disproportionately African-American men, and the city needs to work out a plan to eliminate these racial differences before proceeding.”

Dr. Grant Colfax, Head of the Department of Health, acknowledged the “multiple challenges” involved in implementing the pilot project, but stood behind them.

“DPH will continue to support the Housing Protection Agency,” said Colfax. “We need all the tools we have to help the most vulnerable in San Francisco.”

He promised improvements to the overall care system through Mental Health SF, a multi-year effort to reshape the city’s behavioral health system. The department recently appointed Dr. Hillary Kunins hired to lead the Mental Health SF.

“Our care system is expanding, lowering treatment barriers, and making it easier to access and move through the system,” said Colfax.

Mandelman said, however, that “expectations of SF mental health are very high” and he remains concerned that the city is “orders of magnitude away from responding to the fairly serious behavioral health and substance use problems on the street.”

jsabatini@sfexaminer.com

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