S.F. needs substance abuse counselors
It’s often said in San Francisco that it’s easier to buy drugs than to get drug treatment. For the former, just head to Golden Gate Avenue and Hyde Street in the Tenderloin with a few bucks, and you’re all set. The latter? Well, that’s more complicated.
One reason is there are far too few substance abuse counselors in San Francisco and throughout California. In fact, a decade ago the state labeled that workforce as “distressed,” because there were so few people entering the field. But it did little about it, and now the situation is dire.
Take HealthRIGHT 360, a health care provider for lowincome Californians that runs residential substance abuse treatment programs in San Francisco. It needs 63 counselors to be fully staffed. Currently, 22 of those are vacant. That means the nonprofit regularly has to turn away clients seeking help — and risk never seeing them again.
Assemblymember David Chiu, DSan Francisco, has new legislation he hopes will begin to address the crisis by bolstering the number of counselors trained to help people addicted to drugs.
His unfortunately numbered AB666 (“I pulled the short straw,” he said) would provide tuition assistance for people entering vocational
“Demand for substance use treatment far exceeds capacity.” Assemblymember David Chiu, DSan Francisco
programs, community college and universities to study behavioral health.
It also would waive fees for tests and certification expenses and ensure classroom materials are available in a number of languages. Chiu says the idea is to make it easier for people to enter the field, and that the changes could add more than 1,000 certified behavioral health counselors to the state’s workforce in the shortterm.
“Demand for substance use treatment far exceeds capacity, and an enormous part of that capacity issue is a lack of counselors and substance use clinicians,” he said. “It’s shocking and heartbreaking and compels action.”
Vitka Eisen knows the counselor shortage very well. She’s the president and CEO of HealthRIGHT 360 and said recruiting substance use counselors is always a daunting task. The average salary for the 22 open positions at the nonprofit is just $47,000, a paltry sum in an expensive city. She’s also competing with private medical providers and government agencies that pay better.
People stay in those jobs just two years on average, she said, because of the low pay and high stress. The lack of staff means not always being able to accept clients who are ready for help — and pushing them off for any time at all can mean never seeing them again.
“Every single thing you put up as a potential barrier is a reason for somebody to not come into treatment,” she said. “In order to see them today, you have to have enough people to per
form their intakes.”
And there’s no real pipeline to find new candidates, she said, adding that Chiu’s legislation could help convince more people to enter the field. Her hires right now tend to be people getting out of prison or in their own recovery who are seeking a job where their life experience is an asset rather than something to hide. But once they’re on
a better path, they often leave to return to school or for a better paying job, she said.
In California, about 2.7 million residents had a substance abuse disorder in the past year, but only 10% of them received treatment, Chiu said. There are fewer than 20,000 substance use counselors statewide, and just 700 doctors licensed with an addiction specialty.
This problem has been known for at least a decade, but California has done little to address it, said Pete Nielsen, president and CEO of the California Consortium of Addiction Programs and Professionals.
“There’s been nothing to expand the workforce, nothing to to create a universal career path,” he said. “Nothing to have a way for individuals to even get interested.”
He’s pushed for years for provisions like those in Chiu’s legislation with no luck, but he said the attention to spiking overdose rates during the COVID19 pandemic, brought on by isolation and despair, may finally get the idea across the finish line.
Chiu said this is clearly just one of many answers needed to address San Francisco’s skyrocketing overdose rate — the one that saw 61 peo
ple die in January alone.
“We have a moral obligation to end these tragedies on our streets,” he said. “We have to do things differently.”
The men on the San Francisco Board of Supervisors better watch their mouths over the next few weeks. Or at least watch how often they’re using them.
Supervisor Myrna Melgar is celebrating Women’s History Month by pointing out how often men talk versus women. In collaboration with the San Francisco Women’s Political Committee, she’s having someone watch every full board meeting and committee meeting during an undisclosed week in March and track the minutes taken up by men’s chatter versus women’s.
They’ll also keep track of the number of times somebody interrupts another speaker or asks to speak multiple times about the same topic.
They’ll average the numbers in accordance with each gender’s proportion on the board. There are seven men and four women, so if men talk for seven out of every 11 minutes, that would be about right. But here’s guessing they’ll talk more than that.
Melgar will present her findings at the end of the month, but won’t name individual mansplainers. She’ll just highlight the yammering by gender.
“We’re using this as a moment of reflection about gender privilege,” she said, adding she’s served on a number of boards and commissions and has seen men suck up the airtime over and over again.
“This is a universal experience for women,” she said. “We need to think about whose voice gets heard. We can all be trained to be active listeners, and it starts by just thinking about it, having that insight.”
She won’t divulge which week she’s conducting her study — for a very good reason.
“I want them to be on their best behavior for the entire month of March!” she said with a laugh.