The greatest minds are often ostracized
Psychotic Assaults Prestigious Psychiatrist at APA Convention San Francisco

From SF CHRONICLE, May 23, 2003

Members of the nation's largest psychiatrists' association meeting in San Francisco, were shocked when a prominent member of their group was assaulted by a man police said is homeless and has a hx of mental problems.

The apparently random attack near Union Square this week was a graphic illustration of San Francisco's homeless problem for attendees of the American Psychiatric Association's annual convention. Many of them said they were surprised by the legions of people living on the street.

"It seems to be tragically representative of what's happening these days," said Marcia Goin, president elect of the APA. "Those who need psychiatric care don't have it readily available."

The victim was Dr. Geetha Jayaram, an associate professor at John Hopkins University School of Medicine and "scientific program chair" for the conference. Knocked unconscious during the assault Sunday, she spent the week recovering at SFGH.

Police arrested Aaron Hull 33, no local address and a hx of being detained for psychiatric evaluations...scheduled to appear in court to determine if he is competent to face charges.

The irony of the attack was not lost on the association's members, many of whom said they'd been noting the large numbers of homeless people on the streets ever since they arrived...

"It's kind of shocking," said James McNulty, head of the National Alliance for the Mentally Ill. "I've been walking around the hotels and up the hill to Fisherman's wharf. It was very disheartening."

Long before the attack happened, the APA had planned a news conference to publicise past and future threatened cuts to what the group's leaders called the nation's crumbing mental health system." More than 27 million people with mental health problems are facing "personal health care disasters" they said, because of Medicaid and state funding cuts to mental health programs.

"Imagine what it would be like to have heart disease and be told, "Sorry, there is a budget crisis, we can't afford your beta blockers." McNulty said at the news conference. "Can you imagine the outcry?"

McNulty, who lives in Omaha said he had "never seen greater contrast between degradation and great wealth" than in SF on his current visit.

"If you think things are bad in SF now, wait till the cuts happen," he said. "And I'm not just talking like Chicken Little."...

...Jayram had come to the convention, which drew about 19.000 participants, to speak, among other topics, about outreach to indigent mentally ill people in India.

Jayram's husband said he had been walking with his wife on Sunday morning when he saw a man "talking to himself" as he paced on a sidewalk near Post and Grant streets.

Police said witnesses told them the suspect was making loud comments and yelling at Jayaram and her companions. Jumar said the suspect passed them and then was about 20-30 yards away when he suddenly approached Kayaram from behind and stuck her...don't know if the assailant used his first or a weapon.

Kumar said he was concerned that so many people who appear to need mental health treatment are wandering around the streets in San Francisco.

"I don't think proper treatment is being given to these people," said Kumar, who is not a psychiatrist. "as far as I'm concerned it's a scary situation...It is like a free ward for them. The whole place is like that. I, for one, will not want to come here again."

Mental health advocates and psychiatrists cautioned against stereotyping the mentally ill, saying that although they are more like to be homeless, most aren't violent...

CUTS IN HOUSING, TREATMENT

"You have the federal governments cutting housing and the state cutting treatment, and you end up with all these mentally ill people on the street, said Paul Boden, head of the Coalition on Homelessness. "You have all these people wandering around with no housing or treatment."

P.J. Johnston, a spokesman for Mayor Willie Brown, said the city if faced with a "vexing paradox" because it is inundated with people seeking mental health treatment "partly as a result of the fact that we do more than anyone else" to help people...

"It's ironic to see the number of homeless mentally ill on the streets here, " said...a psychiatrist at ...NYC...moments after they attended a symposium on relative merits of a new generation of anti-psychotic drugs. "It's striking, and I'm from NYC."

email: Kaatherine Seligman at kseligman@sfchronicle.com

Budget cuts mean less psychiatric treatment.

This week's attack on a visiting psychiatrist by a suspected mentally ill homeless man underscores the problems facing San Francisco, where mental health experts say the pending budget reductions can only mean more sick, homeless people will be wandering the streets.

"If people were concerned about homelessness before, they need to be a lot more concerned about homelessness now." said Jonathan Vernick, executive director of Baker Places, which provides residential treatment for the mentally ill and the drug addicted.

Baker Places' Westside Lodge, the city's largest residential mental health facility, faces a 1.9 million dollar cut as SF struggles to close a $347 million budget deficit. The program would lost 20 of 36 beds, and it's entire day treatment program serving 80 people would disappear.

Many of the patients come from SFGH's acute care unit for people who were a danger to themselves or others. Vernick says if the hospital can't find them a bed in a residential program--a real probability because mental health facilities are full now--the hospital must keep them longer at a greater expense.

"And they are going to end up in a shelter or a hotel where they probably can't sustain themselves." Vernick said. "there's a good chance they'll end up back in psych ER. It's a revolving door."

The full extent of SF's budget cuts won't be known till Willie Brown presents his fiscal year 2003-2004 budget plan to the board of Supervisors on June 1. But as bits and pieces have leaked out of the last few months, social service experts say the picture is bleak.

No one knows exactly how many homeless people live in SF, but the official estimate is 8,000 to 15,000 people who are homeless or on the verge of homelessness. An estimated 30% are thought to suffer from mental illness, and about half are addicted to drugs or alcohol.

The potential SF budget cut that has generated the most public outrage is the possibility of the closure of the city's only locked psychiatric program the 147 bed Mental Health Rehabilitation Facility at SFGH.

The program might be saved, however, it the city's largest public employee's union agrees to accept a 7.5 percent pay cut.

Meanwhile, the Lee Woodward Counselling Centre for women, which treats about 100 women a year for mental illness and addiction, could lost its entire 500.000 budget.

And the HAIGHT ASHBURY FREE CLINIC is bracing for a $2 million dollar cut into its $15 million dollar budget. The effect could be a 25%reduction in jail psychiatric services, the elimination of a 24 hour drop in clinic for homeless women and the elimination of a program helping addicted mothers.

email Ilens Lelchuk at ilelchuk@sfchronicle.com