Address wider direct, indirect public health, safety concerns

The recent incident involving a machete-wielding man atop a downtown building gives us pause. We don’t know all his circumstances, including whether he was homeless.

However, now that we have 50 years of experience with Welfare and Institutions Code 5150, maybe some issues need to be addressed regarding wider direct and indirect public health and safety concerns:

• Background: The mentally ill homeless must meet at least one of three criteria for being brought safely off the streets under WIC 5150 et seq: Danger to self, danger to others, or grave disability. Courts have viewed these criteria extremely narrowly. The two “danger” criteria are met when the danger is “imminent,” that is, the danger must be such that it will occur immediately unless stopped immediately. The “gravely disabled” criterion is met when the person cannot meet their basic survival needs because of mental illness and is in imminent danger of becoming gravely ill or dying if not immediately housed and treated.

• Public safety concerns abound about how the mentally ill homeless conduct their lives in the public commons. We know that they can become quite violent with little or no provocation — a public safety issue, not just for the person(s) attacked but for the mentally ill attacker who might himself be injured in any fight he might initiate. We also know that the mentally ill can appear quite odd and act quite strangely and erratically, which might provoke animosity or physical aggression toward him or her. It might also provoke bullying, teasing, and other forms of unwarranted unkind harassment or victimization.

• Public urinating and defecating are public health and safety issues. We know that the lack of hygiene and sanitation practices can become a public health issue. Eating out of dumpsters can lead to serious illness, which must be addressed by public health agencies or emergency rooms.

• Exposure to sexual assault for mentally ill homeless women can lead to physical and emotional harm and spread sexually transmitted diseases. It can also lead to victimization through forced (or voluntary) prostitution, which can spread sexually acquired and other diseases and be harmful to the persons having to resort to prostitution to survive — and to their customers. We know that those who recruit and employ such persons as prostitutes use violence against them to force compliance and strict obedience representing a safety issue for them.

• Public commons are being soiled. When food is openly discarded or left unattended we find increases in vermin and other feral animals that spread disease and may be dangerous. In one way or another, public health issues are also about public safety and their — and the public’s — right to be protected from harm. The history of medicine is replete with reports of sometimes serious diseases brought on by unsanitary practices in public places.

• The mentally ill homeless are defenseless against being assaulted, raped, stolen from.

• They set fires for warmth in vacant, derelict and abandoned buildings, which inevitably spread.

• Confrontational and intimidating panhandling is a public nuisance and safety issue.

• Public dollars must be spent on public clean-up activities made necessary by their unsanitary practices and illegal encampments rather than on more routine law enforcement activities.

• Police must spend time responding to the nuisance problems they cause rather than responding to true crisis calls reporting crime.

• The Public Works Department must spend time responding to their nuisance code violations rather than doing their work improving the safety and attractiveness of the public commons.

Yes, we know that America is built on the “pursuit of life, liberty and happiness.” Don’t we all have an ethical and social duty to protect the mentally ill homeless from the very direct and indirect public health and safety risks they are themselves creating? Maybe it’s time to think about the health and safety repercussions upon the mentally ill homeless and revisit WIC 5150 et seq and rethink them in the light of the real-world experience we’ve had over the last 50 years.