San Francisco is dealing with the harsh reality of a homelessness crisis that’s gone from bad to worse. In 2017, more than one in 100 homeless Americans lived on the city’s streets.
Tired of feeling helpless, Jacob Savage and Neil Shah created an app called Concrn that lets people send an alert whenever they see a person experiencing a mental health crisis, homelessness, or an issue with substance abuse. The app’s dispatcher sends a civilian response team trained in empathy to help get that person back on their feet and connect them with relevant support services.
We recently shadowed a Concrn responder on their shift. Here’s what it was like.
On any day in San Francisco, you may see a person raving incoherently, shooting up drugs, or tumbling into the streets. You might inch past to avoid them or offer your pocket change.
If a bystander takes action, they might call the police, assuming these trained keepers of the law know how to best handle trauma in the streets. But that’s not always the case.
Over a recent nine-year period, 58% of the city’s police shootings involved mentally ill people.
Created in 2014, Concrn is a “mobile alternative to 911,” according to the app’s founders.
If you see someone on the street who’s experiencing a crisis, you can use Concrn to request a “compassionate responder” on the scene. You snap a photo of the person in trouble, write a brief description of what’s happening, tag their current location on a map, and carry on.
Someone like Matthew Dudley might respond.
At age 11, Dudley came to San Francisco on a one-way bus ticket to live with his dad. The family bounced between different residential hotels and never maintained a permanent address.
His background is part of what makes Dudley one of Concrn’s top responders. He brings empathy to every encounter with the homeless, treating them with dignity instead of pity.
Dudley’s shift starts at Boeddeker Park, where he played stickball as a kid. The park was once known as “Prison Park,” because its iron fence provided cover for drug dealers and muggings.
He carries a neighbourhood map, where he marks past incidents, as well as a list of shelters and soup kitchens. Dudley knows the closest place to get a free meal at any time of day.
When a bystander makes a report, a dispatcher at Concrn’s offices will review the report and assign a pair of responders to track down the person and see how they can help.
People often hear Dudley coming before they see him. That’s because most days he travels with a Bluetooth speaker that blares Motown’s greatest hits when he arrives on scene.
Unfortunately, the speaker’s battery was dead, and Dudley left it at home the day we met.
The music “sets a tempo” for the interaction, Dudley said. It might start a conversation with the person he wants to help or distract them from their current emotional state.
Other times, the responder might only stand and listen. Neil Shah, executive director of Concrn, said it’s about “creating a safe space for the person in crisis to just experience what they’re experiencing without judgment, without fear of being attacked, just to know that we’re there.”
After the situation has been de-escalated, the healing work begins.
The responder might walk the person to a shelter and help them register for the waitlist. They might connect them with mental health clinics, food banks, and drug counseling.
A successful encounter, according to Shah, is a “warm handoff to another service provider based on what that person needs.” But the outcome isn’t always so productive, Shah said.
A person living on the street has their guard up at all times, according to Shah. They might not be willing to go with a stranger or accept help, because their situation makes it difficult to trust people.
“Sometimes the outcome of an interaction is not resolving the issue right then,” Shah said. “These are people that are chronically homeless, and we see them all the time. We have a good interaction with them the first time, the next time, or the time after that – they may be willing to get help.”
Substance abuse is rampant in the Tenderloin, and during his shift, Dudley pointed out local landmarks like “Pill Hill,” a popular spot for drug-dealing where he often responds to reports.
Concrn responders carry injections of a drug known as Narcan (when Concrn has the funding to stock them). A single injection can reverse an opioid overdose and even prevent death.
Dudley has only had to use the injection on a person once. He said the man was ungrateful because he had spent money to get high and claimed that Dudley unfairly took that high away. Dudley had a pastry in his bag that he then offered to soothe the man’s hunger pangs.
“He cussed and fussed, but he ate the doughnut,” Dudley said.
Dudley added: “You’d be surprised how many people are crazy because they’re hungry.”
In the last two years, Concrn has received 2,800 reports, which works out to about five to 10 reports a day. Short on staff and funding, the group can only respond to about 60% of alerts.
Most of Concrn’s funding to date has come from grants. Shah said he hopes to someday reach profitability by licensing software to other organisations and municipalities.
Concrn is currently seeking a board member who will coach the team on developing its product, according to Shah. He aims to have an app feature that crunches the data from reports and predicts what neighbourhood spots and times of day are likely to produce an incident.
“None of us are techies,” Shah said.
Concrn was recently awarded a grant from a major healthcare provider, which Shah declined to name, that will allow the non-profit to recruit and train homeless people as “apprentice” responders, after they have experienced a mental health crisis or issues with substance abuse.
These new recruits will shadow Concrn responders on shifts and accompany people in crisis to routine meetings with their case managers or mental health care providers. In return, Concrn will reward them with free hygiene products, gift cards, and access to housing subsidies.
Toward the end of his shift, Dudley spotted a man with a swollen face and hands — tell-tale signs of heroin use — lose his balance and tumble into the street. He fell unconscious.
Dudley stood over the man to protect him from cars and began to dial 911. If there’s a threat of violence or physical distress, Concrn responders will seek out the police or emergency services.
An ambulance that happened to be passing by pulled over and loaded the man, now awake and swatting away the emergency medical technicians, into the vehicle. Dudley continued down the footpath.
Like all Concrn responders, Dudley completed 100 hours of training before he started volunteering. He now trains other responders and gets paid by the hour for his service.
In his spare time, he meditates and volunteers with another non-profit in the Tenderloin. “You gotta find that peace inside you, because you won’t find it out here,” Dudley said.
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