One Place at a Time: How Sobriety Centers Can Help the Homeless
After more than eight years of working in the light green building on Mission Street in San Francisco, Shannon Smith-Bernardin recognizes many of the faces that come through.
Located in the Tenderloin, a stretch of the city with the highest concentration of homelessness, the San Francisco Sobering Center provides a particular service—it is a safe place for homeless people and others who are found inebriated and in danger on the streets.
“Some are not looking for treatment,” said Smith-Bernardin. “They are intoxicated and not trying to get sober, but we keep working with them.” Some people come by so often she knows everything about them: names, birthdays, personal history.
In sobriety centers like the one in San Francisco, people are allowed to sleep and shower while medical staff is on hand tending to wounds or other injuries. Once sober, they are allowed to leave, but not before getting information about housing and health services available to them.
Founded in 2003 with the help of a doctor named Mitchell Katz, the center has provided resources for more than 44,000 people. Houston, San Antonio, Seattle, and several cities across the country have similar programs. Los Angeles has seen homelessness jump 12 percent in the last two years, and local fire and police officials are backing a push to open a sobering center on Skid Row, a downtown area with the highest concentration of homeless people in the city.
Lucky for them, Katz is now the director of the Los Angeles County Department of Health Services and has backed the opening of a center.
“There are many people in Skid Row that get picked up by an EMT and ambulances to the tune of 30 to 50 times a year,” said Marc Trotz, director of Housing for Health in the Los Angeles County Department of Health Services. Those pickups cost the city money, both in the emergency room and via court costs.
Most people that are picked up under the influence of drugs and alcohol do not require medical attention; they just need to sober up. Instead of them taking up a bed in the emergency room or staying in jail overnight, sobriety centers offer the police and fire department an alternative.
L.A. City Councilmember Joe Buscaino backs building the center, and understandably, as his district, which includes part of Watts and the South Bay, has seen homelessness jump 39 percent in the last two years.
In September, the city declared a state of emergency and allocated $100 million to help with homelessness. The sobriety center is still in the planning stages—currently, they are looking for a location. The goal is to have 20 to 40 beds.
“This is not an L.A. issue; this is statewide and a national issue,” Buscaino said. “The city needs to do a better job at fast-tracking these projects. We need to get to yes like yesterday.”
Across the country, there are more than 564,500 people who were homeless. About 69 percent are staying in residential programs, but 31 percent find themselves outside, according to Department of Housing and Urban Development estimates. The National Coalition for the Homeless, an advocacy group, says substance abuse is often a cause of homelessness.
Buscaino met with Katz and the police officers several months ago to discuss the creation of the center. He has also created a Homelessness Task Force to find other solutions to the growing number of tent cities and homeless individuals on the streets.
“We know these individuals on a first-name basis, and we are not giving up on them,” Buscaino said.
So far, his district has provided housing for 79 people who were homeless and has has built 311 affordable housing units.
“Contrary to the common narrative that people don’t want help, most of the people we encounter do,” said Trotz. “But they want to be treated well.”
That first point of contact is important. Creating a safe and welcoming environment allows health providers to engage with people, Trotz said.
In San Francisco, most who come through the center refuse services, but getting people into interim housing is still the ultimate goal. The point is to use those savings and invest them in creating permanent support housing.
“We have as many wins as we have losses,” said Smith-Bernardin. “A lot of our clients are nice people just in really rough situations.”
She remembers a Vietnam vet in his fifties who was repeatedly dropped off at her center by EMTs. He had a history of PTSD and alcohol abuse, which started after he came back from the war. One night, while talking with her and a case manager at the center, he had an active PTSD hallucination.
“He said we were getting attacked, getting killed,” said Smith-Bernardin.
But eventually, after years of the man coming to the center, Smith-Bernardin and her staff were able to get him into permanent housing through the Department of Veterans Affairs. She hasn’t seen him come back into the center in three years and hears he’s doing well in his new living situation.