Homelessness and substance abuse are linked, and are associated with alarmingly high mortality rates. Mortality, a very scientific and dissociative way of saying people are dying in the streets, literally, before finding help with addiction. The average age a homeless person in San Francisco dies is 41. Seventy-eight percent of those who die on the streets are intoxicated at the time they die.

That is dark, difficult to hear, and incredibly saddening. But somehow that has not been enough for the city of San Francisco to help to it’s residents who are dying on the streets by offering comprehensive drug and alcohol rehabilitation to those who most need it, and saving the programs that DO WORK from complete elimination during budget season.

According to the San Francisco City Fire Division intervention, and diversion programs work. As Chronicle  columnist C.W. Nevius has pointed out, repeat ambulance transport and emergency care spent on homeless users is very costly to the city. One of such intervention programs, McMillan Drop-In Center, created beds for emergency response calls dealing with intoxication to bring people to detox, sign-up for drug and alcohol recovery programs, and receive counseling and social services support to further stabilize themselves. In one year this program brought 300 people into detox and recovery programs, and 750 people case management linking them with critical supportive services such as housing.

Through this program “a number of high-profile homeless inebriates have been engaged and housed,” according to the San Francisco Medical Society’s study of the program. The SF Fire Department, St. Francis Hospital, SF General and other partners were thrilled by the success of the project, saving money and more importantly helping increase health and stability of at-risk San Franciscans.

But that was not enough to save the service, and McMillan Drop-In Center was cut. A similar program, Buster’s Place, was initiated in the same rite and same location. This program too, was cut.

Emergency visits are costly. Critical care is costly. Without the preventative care, supportive services and case management that help people become stable and seek help before it becomes an “emergency”, these costs will continue. To see that this is a problem in hindsight takes no special talent. But, to take action and create and support (especially in difficult times of budget crises) programs that comprehensively address the dangerous problem of drug and alcohol abuse, that takes determination and compassion. Criticizing those the system has failed has no productive ends, criticizing the failing system can bring about powerful change that makes a stronger city and citizenry.

San Francisco has a lot of non profits. We’re a progressive city, one that pushes forward for needs, rights and liberties. Some, like St. Anthony’s, have been around for decades and have weathered troubled economic times not unlike the present. Others may have only recently sprung up and serve a need not as old as poverty, but just as critical (like HIV care or education).

Some suggest that perhaps there are too many non-profits in San Francisco. They may not be seeing the need that we do, here in the Tenderloin. There is no way we could do it by ourselves. That’s why St. Anthony’s partners with The San Francisco Food Bank, Project Open Hand and Glide Memorial to purchase bulk foods. That’s why we partner with Network Ministries to offer broader programming at the Tenderloin Tech Lab.

Some people walk around and see too many non profits. We see the tremendous need that can not possibly be served by one organization like St. Anthony’s.

Recently, C.W. Nevius posed the age-old ‘chicken or the egg’ question in his twice weekly column.  As so many people do, he wonders,  why is it that there is such a concentration of homeless services in the Tenderloin?

“The question is,” Nevius asks, “Do the homeless and low-income people flock to the Tenderloin because there are so many services, or have the charitable groups been drawn to the neighborhood because so many residents need help?”

As with any questions regarding social services, the answer depends on the person’s beliefs of who “deserves” services.   At St. Anthony Foundation, we firmly believe in each person’s right to eat, to have affordable health care, warm clothing, to have shelter and to have the opportunities to build employment skills, and find community to overcome addiction.

As service providers city-wide brace for impact of the budget crisis, it is becoming clearer that privately funded non-profits will fiscally weather the storm, but more and more of the clients who sought help from city services will be turning to us for help.

What tragically some people see as the “easy work” of feeding the hungry, mentioned in Nevius’ article, what they are missing is that the children and young adults who partake in service-learning will have a deeper understanding of the issues of homelessness and poverty.  That direct experiential learning will more greatly impact youth than any fifth period lecture on the economy, and they will carry those stories to the family members, and friends, continuing the dialogue.

It is through volunteering, through service-learning and education and that greater issues of homelessness and poverty are understood and approached with insight.  Not through columns written outside looking in, questioning whether or not we might scare the tourists.

“Who does that help?”

San Francisco columnist C.W. Nevius posed this question last Saturday in regards to the social services available in The Tenderloin.

St. Anthony Foundation has been serving the needs of the poor and homeless, transitioning families and individuals out of poverty, since 1950. Prior to that Franciscans friars were organizing bread lines, pictured above, on the same block of Golden Gate in San Francisco dating as far back as 1908. For over 100 years this tiny stretch of the Tenderloin has been helping the needy in whatever capacity possible.

Here are some of the folks who, in our lifetime, have benefited from these services:

“It makes you realize … that they’re in the same situation as you or I, but something went wrong somewhere along the way.” – Jesse, High School Volunteer at St. Anthony Dining Room

“Without St. Anthony Free Medical Clinic I’d be dead. It’s such a positive place. Once you walk into the Clinic you know everything is going to be taken care of.” – Tim, St. Anthony Free Medical Clinic Client

“Since I’ve been here at St. Anthony’s I have seen nothing but love, appreciation, kindness, and people that really want to teach you or give you the opportunity.” – Leroy, St. Anthony Employment Program / Tech Lab Student.

“Part of what I do today as a banquet waiter is what I learned volunteering at St. Anthony’s. It’s all about service with a smile.” – Muhamad, former St. Anthony Dining Room guest and current Volunteer

“Everything is so expensive. Some people have to work two jobs and they still can’t make ends meet. That is why organizations like St. Anthony’s are so important.”– Olga, Volunteer at St. Anthony Dining Room

“Every day, I see people I used to get high with. When they see me, it gives them hope. As I stay clean, I’ll be the encouragement for others.” – James, Fr. Alfred Center Graduate

“I chose St. Anthony’s for an internship because I wanted to know more about the people who were living in the Tenderloin. There I found a community of people helping each other survive in an area of town that is neglected.” – Kathy, Former Intern at St. Anthony’s Employment Program / Tech Lab

Today, San Francisco Chronicle columnist C.W. Nevius writes about the growing number of families entering homelessness during what has been one of the coldest Decembers San Francisco has seen in years.

The timing couldn’t be worse.

San Francisco is in the worst budget crisis it has seen in 70 years. According to City Homeless Policy Director, Dariush Kayhan, the number of families requesting assistance is currently up “50 percent more than we had one year ago.”

We’ve been seeing the numbers slowly increase for a year now. Families of all shapes and sizes are coming to St. Anthony Foundation for food, clothing, medical care and assistance in navigating through the already over crowded social service system.

Because St. Anthony’s doesn’t accept government funding of any kind we can respond quickly to emergencies like this. And because we are supported entirely by private donations we aren’t in jeopardy when the city is in financial crisis at the same time as it’s people.