The mayor's mind games: "Mental Cruelty" (June 13, by Peter Byrne) was a fine piece, exposing the mayor's success at withholding crucial services from our mentally ill population. It looks once again as if Brown is shortsighted and heartless, although it may be simply that he's preoccupied. It surely takes much time and energy to lavish public funds on greedy cronies and to keep checking yourself out in the mirror.
Brown might try to defend himself by pointing out that he isn't the only sleazeball in charge of a municipality who is ignoring citizens in need. It seems that ever since Reagan shut down the hospitals, cities have been competing with one another to be the least attractive to victims of mental illness. Institutionalized NIMBYism. It's a doomed policy here, though, since persons with mental illness like S.F. for the same reasons most everyone else does, and so they stay without regard to the nonsense of Brown and his ilk.
Of course, we can complain about the mayor all we want, but we're still the ones who elected him, overwhelmingly. We might want to recognize that one important measure of a society's worth is how it treats its most vulner-able members, and that we fail that test, miserably.
A case for better care: My family and I have some experience with mental health issues. Your article is right on in pointing out that intensive case management or outpatient care for those affected by mental illness is a much more cost-effective and kind way to deal with the challenges they face.
One of my sons was in residential care for a year and a half, at a monthly cost that exceeded $5,000. Because he finally received an accurate diagnosis and treatment with appropriate medications, he has been home now for close to three years. We receive support (case management, in-home or community therapy, etc.) from East Field Ming Quong in Los Gatos. Their services have proven to be extremely beneficial in helping my son and family to maintain stability, and in working toward my son leading a normal and independent life.
Without their services, I have no doubt my son may have required further hospitalization and residential treatment, at a much higher cost, and with much less contact with his family. Plus, while most residential care units are no doubt well run, my son was subject to extreme abuse at the hands of other patients due to negligent supervision from the staff at the residential care unit.
As a "recovering" bipolar person, responsible single father, and parent of three (two of whom are being treated for mental illness), I would add my voice to others in support of strengthening outpatient programs for the mentally ill.
The finest lockup in town: In the recent excellent overview on the state of the city's mental health system, Mr. Byrne alludes to the fate of people when outpatient centers close. He said their fate would then be to be "thrown into the overcrowded county jail or the locked psychiatric wards at S.F. General." By implication, these were equivalent options and neither of them good. But we on 7B, one of the acute inpatient units at S.F. General Hospital, give care utterly different to what is available in the jail system. We try to practice psychiatry at its biomedical best, but we are also interested in the personhood of our patients. In the recent past, [Mayor Willie] Brown and [San Francisco Director of Health Mitchell] Katz painted us as the problem in the mental health system, because we try to give the best of care and therefore won't treat our patients like cogs on a medical production line. With the closure of private psychiatry units in this city, we are even more overburdened and try to maintain our moral calling intact against increasingly difficult and demoralizing odds. We support money being directed to the outpatient system, but not at the risk of cutting needed inpatient services that, although not perfect, are not, and I repeat not, some kind of draconian civilian equivalent to being thrown in the city jail.
Dr. Alastair Donald
Unit Chief, Unit 7B
Acute Inpatient Unit
San Francisco General Hospital
Support your local drug addict: Matt Smith should do his homework before repeating clichés about drug treatment ("Getting the Treatment," June 13, on Proposition 36, which substitutes drug treatment for prison sentences). Research shows that coercion is by no means necessary for addiction treatment success. It doesn't improve outcomes, according to the National Institute on Drug Abuse. In fact, the data show that incentives work better to get people clean than "tough love," and that empathy and respect beat the confrontational approach favored by providers hands down. Arizona's program has already saved taxpayers millions -- and convinced many formerly skeptical drug court officials. It isn't Prop. 36 that ignores the reality of addiction -- it's the ideologically blinded treatment lobby.
How to write a letter to SF Weekly: Matt Smith's piece on Proposition 36 and Peter Byrne's article "Mental Cruelty," concerning San Francisco's mental health budgeting policies, are a real contribution to public education about two critical community issues. I hope they are widely read, distributed to persons who may be able to take action, and retained for future reference. Thank you to these authors and SF Weekly.
Caution -- please clap safely: I, for one, think Matt Smith is brilliant. He says so many things about the politics in this city (specifically about the idiotic Board of Supervisors) that others are afraid to. The article about the NIMBYers ("Axing Permission," May 30), and his recent one on deconstructionist theory ("Warning: Deconstruction Ahead," June 6), had me up on my chair clapping.
Personally, I would love to kick all the supervisors (absent Gavin Newsom) from here to Tuesday. How a bunch of unreasonable, less-than-average individuals managed to win office, I know not. Please, please keep writing about the sad state of politics in this city and be the voice of reason where there are so few.
In last week's Matt Smith column ("Et Tu, Mom?"), Assemblywoman Carole Migden's name was misspelled. And in a story on outdoor dining ("Get Up, Get Out, Eat Somethin'") in last week's Summer in the City guide, the name of Primo Patio Café was also misspelled.