Jacob Savage almost became a cop. He spent high school and college going on police ride-alongs, wearing a uniform and a bulletproof vest.
But, he says, “eventually, you start to see the unfortunate reality of the system’s criminalization of mental illness, and how certain crimes, like substance abuse-related crimes, or even petty theft and things like that, are really just symptoms of untreated mental illness.”
So now, instead of wearing a blue uniform and a badge, Savage wears a purple T-shirt. On it is the name of the nonprofit he founded in 2014, Concrn. Concrn's dispatch line (415-801-3737), text line (415-881-8278) and smartphone app provide an alternative to calling 911 for mental health crises in San Francisco’s Tenderloin district.
Today, we’re at the corner of Jones and Eddy Streets. We’re getting ready to do what Savage calls street response: passing out harm reduction supplies, asking people if they need help accessing services, and most importantly, answering dispatch calls if they come in.
In those cases, Savage says, "we'll send a team of compassionate, trained responders to handle the crisis, to support somebody through a difficult circumstance."
That can be playful, like playing music or taking out some sidewalk chalk, or as simple as offering a bottle of water. But Savage says the key is meeting the client with compassion, calm, and respect. Other approaches, like the ones taken by law enforcement, can escalate the situation and make the client feel unsafe.
Savage is well-known in the Tenderloin. He wears a walkie-talkie and greets some of the homeless people we pass by name.
He carries a trumpet, which he’ll often just start playing in the street. It also helps to break the ice with people in crisis situations.
“You usually try to guess what their age is, and then think back to what was number one on the billboards when they were 21 years old. So if they’re 60, then they were maybe in the age of disco,” he says, and plays the hook to the Bee Gees’ “Stayin’ Alive.”
There’s a certain casualness surrounding Concrn’s approach to mental health crisis response. It’s really about connecting with their clients as equals, not just giving them medical attention. And since Concrn responders aren’t police or city officials - they’re just volunteers in purple shirts - people feel at ease around them. They trust them.
Jim Zelaya-Wagner, the director of San Francisco’s Homeless Outreach Team, says he supports non-profits like Concrn providing street outreach to the homeless. SFHOT does a lot of the same work as Concrn, but they’re a city agency.
“There’s no two ways about it,” he says. “We’ve got 30 outreach workers, and we’re looking at a city of 6,000 to 7,000 homeless individuals, based on last year’s count. That’s a lot of homeless folks. So, hey, the more people that can help, the better.”
San Francisco has the second-highest rate of homelessness in the country, and the majority of homeless individuals suffer from mental illness. The city does offer a number of mental health care programs already, but it’s not enough.
In late August the city’s new Department of Homelessness announced it’s developing a system to track the services each homeless person has been connected to, including jail, rehab, and housing agencies.
The system is supposed to help figure out what’s not working, but it won’t go into effect for another two years. For now, the reality of failed access to social services is in the streets, and that’s where Concrn is.
Back out on the streets near UN Plaza, we find a group of crack and heroin users shooting up on the sidewalk behind the Asian Art Museum. Blood drips down one man’s forearm from where he’s just injected himself.
Concrn distributes clean syringes so that people don’t share or reuse them, which can spread disease. They also pass out packets of dehydrated salmon, V8, saline, condoms, and Brillo, which is used as a filter in a crack pipe.
One young man is standing apart from the others. He’s leaning against a wall, and Savage doesn’t recognize him. So Savage goes up and introduces himself.
“We’re Concrn,” Savage says. “My name’s Jacob. We do mental health crisis outreach. Is there anything we can help you with today? Any resources we can connect you to? Hook you up with a 90-day shelter bed, or at least get you on the reservation system?”
The man says he's interested, but he's skittish. He eventually tells Savage his name, birthdate, and the last four of his social security number. I’m going to refer to him as Terrence to protect his privacy.
Terrence says he’s been on the street for a couple years. He mumbles a lot, and his train of thought is hard to follow. He doesn’t answer our questions directly, and it sometimes seems like he’s talking to someone who isn’t there. But he says he has family in Oakland, and that he’s 24.
We walk him the eight blocks to Glide Memorial Church, which operates a social services agency in the Tenderloin. The walk takes almost half an hour because Terrence keeps stopping to take hits of crack. We go inside the church and start the process of signing Terrence up for a shelter bed.
Savage tries to coax Terrence into getting his picture taken and his fingerprints scanned, so he can be entered into the system. But Terrence seems nervous, and after 15 minutes, he gets up and walks out. He says it’s just taking too long, and that he’s scared of getting robbed in a shelter.
He’s one fingerprint short of a full set, and Glide can’t register him for a shelter bed without it. Savage has seen this before.
“It’s difficult to get a lot of people services, and we have to be okay with the fact that we don’t have amazing access to what limited resources there are,” Savage says. “But we do have ourselves, at the moment, to make somebody feel cared for.”
Savage and his team at Concrn can’t help everybody. But they keep working to reach as much of the Tenderloin’s homeless population as they can.
When Concrn started, they had just two trained responders. Now that number’s up to 18. And if they keep growing, Savage dreams of expanding to other parts of the city.