Historical Opportunities to Serve the Unhoused

For all its damage, COVID-19 presented a unique opportunity to support one of San Francisco’s most vulnerable populations. Although it’s nearly impossible to make an accurate census, it’s estimated that there are roughly 7,000 – 8,000 unhoused individuals living in the city. For a multitude of reasons, it is uniquely difficult to ensure unhoused people have consistent access to medical, mental health, and social services. However, last year, with shelter-in-place orders in place and hotels standing mostly vacant, San Francisco was able to establish Shelter-In-Place (SIP) hotels to house 2,500+ of the most vulnerable of the unhoused, an already highly vulnerable population. Specifically, the hotels housed those who were 65 or older or had a preexisting condition. 

For the first time, a large percentage of the unhoused were concentrated in locations where they can reliably receive support. Like Disaster Service Workers from the RAMS CAAP Counseling Program, the Division of Peer-Based Services was also asked to deploy peer counselors to SIP hotels to provide behavioral health services. Starting in May 2020 with four Peer Counselors, nine peers are currently deployed and have served 200+ unduplicated individuals with 75+ people in person and 150+ people over the phone. Peer Counselors have both behavioral health training and lived experience with mental health and/or substance use issues they can draw upon in order to work effectively with clients. 

The nature of their support is broad ranging. Some need to be connected to Medi-Cal. Some need a cell phone. Some need help getting to medical appointments. Some need services in Spanish, Cantonese, or Japanese. Some just want someone to check in every couple weeks. Some want someone to talk to a couple times a week. Our peer team, in partnership with the RAMS Adult Outpatient Clinic and other Behavioral Health Services providers, have been able to fulfill these needs and serve as an integral support for people during a time that is, to varying degrees, lonely and isolating for us all. One team member stated that these services eliminate “the usual barriers and challenges around connecting with people, and we’re able to offer coordinated care and follow-up. We’re seeing a lot of folks flourish now that they have a connection with behavioral health services and peer support.” 

Here at RAMS, we’re incredibly proud of the commitment and flexibility of our peer team as they rose to the occasion to serve a highly vulnerable population. And we’re not the only ones. Last December, the Mental Health Services Act (responsible for many innovative mental health programs), acknowledged the team’s hard work by awarding them the Team of the Year award.