Of Community and Quarantine

A fight over mental health treatment blurs the line between civilization and discrimination

On Harrison Street, just off Fourth, an empty two-story building has been echoing with the sounds of hammers and saws in recent weeks. Vacant for months, it was a little-noticed neighborhood blemish until February of this year when a huge banner was slung across its front: "Notice of Hearing for Mental Health Facility."

The announcement set off a neighborhood fight that one observer compared to the raging strife over school desegregation and left others equally shaken.

At issue, the South of Market Mental Health Clinic, which proposed in January to move from its longtime site at Jessie and Sixth streets to this building, at 760 Harrison, just four blocks away. The banner was then hung with the best of intentions, mandated by a little-known 1987 S.F. ordinance designed to ease neighborhoods' resistance to sharing space with the mentally ill. But the result has been just the opposite.

Face-offs between the stigmatized and the broader community are common in this era of reduced government dollars. But, ironically, the notification law exacerbates compassion fatigue. And it may even be illegal under newer federal anti-housing-discrimination guidelines.

The ordinance is very specific: Neighbors within a 300-foot radius of a proposed mental health or drug treatment facility must be notified. Hearings must be held by the Health Commission, which passes its recommendations on to the Board of Supervisors for final approval. Even then, community members may appeal to the commission and the board.

Social workers and legal experts argue that the ordinance violates the Fair Housing Amendments Act of 1989, which makes it illegal for landlords to discriminate against mentally and physically disabled people or agencies operating on their behalf. The FHAA also makes it illegal for cities to manipulate zoning rules or single out disabled residential facilities for special regulation.

"The ordinance ... implies there is a problem with our clients, and therefore a community review is needed," says Steve Fields. As executive director of Progress Foundation, a nonprofit organization that provides community-based housing for the mentally ill, Fields has been through the process a number of times.

"The toll it takes on the sense of community is pretty hard," he says. "You run into this unswerving opposition of people who don't want you there. People who've been through the system speak on our behalf, and they hear some of the most terrible things said about themselves. It's discouraging."

And not just for residents. Potential landlords are reluctant to wait out the lengthy review process. Jo Ruffin, director of the city's Division of Mental Health Services and one of the city's lead spokespersons for the city on behalf of the clinic's move, says an earlier site for the clinic had already been lost because of that. "The landlord couldn't put up with the amount of time it took," she says. (Clinic personnel begged off commenting for this story, out of fear they would stir up neighborhood animosities anew.)

"There are so many opportunities to slow down a project," Fields says. "Community attitudes have deteriorated rather than improved. People are more fearful, angry, and sophisticated in fighting."

The South of Market Mental Health Clinic has operated since the mid-'60s, providing counseling and medical services for approximately 80 people a day. The move was decided on in 1992, because the Jessie Street structure was deteriorating badly, and increased crime in the area threatened the safety of clients and staff alike.

But Harrison Street residents felt threatened, too -- by the new neighbor.
"This is predominantly a senior citizen community," says Jerry Clark, spokesman for the Yerba Buena Council, a community organization formed to oppose the clinic's relocation. "We don't want a flood of people in here who can't be helped."

Police statistics don't back up Clark's fears. Community perceptions "are a bigger problem than reality in these circumstances," says South Station Police Capt. Dennis Martell. "Our data showed no correlation between the high crime rate on Sixth Street with the existence of the clinic at its old location."

Such doses of reality have been lost in this debate. Relations between the two sides deteriorated rapidly over the course of six community meetings in March and April. Intended to provide information about the clinic and its clientele, they instead erupted into such vitriolic clashes that some participants remain upset to this day.

"Now I know what it must have been like being an African-American in front of a lynch mob," recalls Kinke Walker. "It was like a witch burning. I am a former mental health client with manic depression. I'm also an incest survivor, so I spoke as someone who received help. I was suicidal when I first entered the system. When I said I almost committed suicide somebody said I should have done it."

Don Hesse, a 20-year staff member with the city Human Rights Commission, which works to resolve conflicts between community groups, likened the meetings to "hearings at the school board regarding integration. I hadn't seen anything like it in 20 years. The behavior of the people was outrageous beyond any description. Clients of the clinic were mocked and hooted at. One woman who spoke of her schizophrenic son regaining his health and starting a family was told he should be castrated."

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