Having Inadequate Mental Health Services is Insane

by Ken Katz

Last month, I reported that “Howard,” a homeless individual whose behavior on Lakeshore and Grand has long been extremely disruptive and destructive, was apparently hospitalized for several months and was now back on the streets. I predicted that, without supportive housing, his behavior would rapidly deteriorate, and that’s exactly what has occurred. One business owner on Grand said he’d exposed himself to her which has been an ongoing problem.  Abebe Lemma, the longtime Lakeshore BID Security Guard advised that Howard urinates and defecates in public during the day. Even more concerning is that he has blood in his urine and other obvious signs of being physically ill. A few days later, as I turned onto Wesley Way, I spotted Howard asleep on the sidewalk adjacent to the Wells Fargo parking lot, naked from the waist down and apparently writhing in pain.

My call to the OPD non-emergency number (510-777-3333) was picked up within a minute or two. When I explained the circumstances, my call was forwarded to the Fire Department Supervisor responsible for Medical Emergencies. She subsequently informed me that an OFD crew was on site and that Howard had refused services and walked away. A few minutes later, a member of the MACRO team called to say that they would try to make contact with Howard and, over time, build rapport to the point that he agrees to get the care he desperately needs. My concern is that, like Norman Allen (Splash Pad News November 2011), Howard is going to die a terrible death long before rapport is established.

Involuntary hospitalizations are a controversial topic but, in my opinion, shouldn’t be if properly administered. Coincidentally, one of the drawings that we included in the August “Event Calendar of the Month” was by Martin Martinez, a patient in the California mental hospital system for some thirty years until his passing in 1963. According to one account, there are now serious questions as to whether or not Martinez was, in fact, schizophrenic. Even if that were the case, it’s now become nearly impossible to obtain a court-ordered commitment in California as a whole and Alameda County in particular. That may partly be due to an overly strict interpretation of the requirement that any given individual has to be a threat to himself, to others, or gravely disabled and unable to care for themselves. Even if Alameda County does determine that a given individual is gravely disabled, there’s a critical shortage of public psychiatric hospital beds. According to this 2021 article from Bay City News, Alameda County has 349 beds. That’s approximately twenty-two beds per 100,000 population–slightly higher than the statewide average reported by the Treatment Advocacy Center, a non-profit that’s been lobbying for implementation of Laura’s Law statewide but far fewer than the 50 beds per 100,000 population that the Advocacy Center recommends.

Last month’s post also touched briefly on Governor Newsom’s proposal which passed the State Assembly on Tuesday and is almost certain to be approved by the Senate as well. Once implemented, it would make it easier to approve a conservatorship or involuntary hospitalization in California.  But as I cautioned last month, far more assisted living facilities need to be built, and what’s happening now to “Howard” is a perfect example as to why. I should add that these facilities need to be staffed by people who care and are adequately compensated and should be physical environments that are attractive. We want people in need to say, “Yes, we’d much prefer to live here than on the streets.” Which brings to mind, Carrera Guest House, the low-budget, psychiatric halfway house on 15th Street in a twelve-unit stucco apartment building where I worked as the Resident Counselor in 1968. One afternoon, we took several carloads of residents to the Oakland Zoo. When we returned, we learned that a guy who had moved in just a couple of days before had run around the block naked until the police picked him up and took him back to the Veteran’s Hospital, which apparently had a golf course, swimming pool, and better meals. The lesson learned: Let’s agree to spend less money long-term on cycling patients in and out of hospitals and far more for housing and support services that will make these individuals feel safe and at home.



10 responses to “Having Inadequate Mental Health Services is Insane”

  1. Jim Hopkins Avatar
    Jim Hopkins

    Thanks Ken. Your words reflect your commitment of many years to the well being of our neighborhood, and these, our neighbors. It seems like compassion and coercion would, by definition, be incompatible. Yet, the experience of those of us who watch people slolwly die while living on the streets suggests that this is not always the case.

  2. Cynthia Bragdon Avatar
    Cynthia Bragdon

    Hi Ken, I sent you an important email. Cynthia, Urban Indigo

  3. Hey Ken,

    Do you know the backstory of the individuals who have been living under the lakeshore underpass for the last several years?

    They camp next to Splash Pad and close to the Farmer’s Market (and across the street) and the situation is increasingly unsanitary with garbage and human waste strewn across the sidewalk.

    Do you know of any plans by the city or county to move these individuals to temporary or permanent housing? The status quo is problematic for all involved.

    Thank you for your work in the community.

    1. Zachary, Thanks for your input. We don’t know the circumstances regarding the homeless individuals who are encamped under the freeway — other than the guy next to the curb between the two pillars. He’s been there for years and isn’t inclined to talk. Unfortunately, we don’t know of any immediate plans to move him or any of the others and would be surprised if there are, since this is a nearly city-wide crisis of enormous proportions. As far as the health issues are concerned, anybody who see feces or other hazards should phone in a complaint to the Public Works Call Center: 311 or (510) 615-5566 and, if possible, make a follow-up call if the issue hasn’t been addressed.

      1. As far as I know, Armchair AL, as I call him, is the only regular resident under the overpass by the parking lot. The dilapidated tent appears unoccupied. There is a youngish man who occasionally sleeps there on blankets. I walk that way twice a day and have seen no human feces on the sidewalk. There is another regular across Grand under the mural.

      2. Addendum: the dilapidated tent near Armchair AL is still occupied.

  4. Nancy M Friedman Avatar
    Nancy M Friedman

    Wonderfully written, compassionate piece, Ken. It’s great that CARE might be soon passed, but it sounds like it will be 2024 before anything associated with it will come into being, in particular, programs to help the mentally ill through supportive housing and other services. There is a young man who lives two blocks from me who is clearly disturbed, so far housed with a family member but it’s unclear how long that will continue. In the kind of society we wish to live in, there would be day treatment programs for him to participate in, so that he has some structure, can continue learning, and perhaps be employed at some point. At the present time, he roams the streets and harasses people periodically.

    1. Nancy. Thanks for the compliments. There’s a middle-aged gentleman who lives in the family home on the Oakland/Piedmont who was in that very situation until 10-15 years ago when his father passed. Not taking his medications and isolated, his condition quickly deteriorated and he began harassing and physically threatening just about anybody. It took a lot arm-twisting by neighbors and the co-director of the Lakeshore BID but he was apparently assigned a conservator six months ago and hasn’t been seen since. If you’re on good terms with the family member, suggest that they look into assigning a conservator in advance.

  5. Janis Clark Avatar
    Janis Clark


  6. Gabe Ets-Hokin Avatar
    Gabe Ets-Hokin

    I wonder how many nude laps around the block I’d have to run to get arrested by the OPD today. I’m going to guess I’d be in marathon-level shape before they even came to investigate. Wonderful reporting, Ken! Thanks so much.