This problem has been nearly intractable. Consider my husband’s experience. His late father, who suffered from mental illness in the early 1980s, was one of many who lived without a home in Golden Gate Park for stretches of time. Eventually, he was able to relocate to a more affordable small town and live out a modest but essentially safe life, thanks in large part to Social Security Disability benefits. Just recently, as my husband was walking along Geary Blvd., he was briefly assaulted by a person in psychological distress, a man in just the kind of despair his own father experienced decades ago.

You have probably experienced the complex combination of feelings that emerge during such an interaction: uncertainty, fleeting shock or anger, fear for one’s own safety, empathy for the person in distress, a sense of hopelessness that this extraordinarily wealthy city can’t take care of the most downtrodden, and perhaps a worry that small tokens of compassion — money, or food — are simply exacerbating the situation rather than helping. You aren’t alone, and nobody has the “right answer” for how to feel.

You might yourself have also experienced the anxiety and uncertainty of losing your home and family, or nearly so. The chronic shortage of reasonably affordable housing in San Francisco means thousands of us are right on the edge, worried that our landlord might sell the building, or that we might not make our mortgage. Each year, approximately 8,000–9,000 people are born in San Francisco. Each year, we build between 1,000 and 4,000 new places to live. The housing shortage we as a City are creating is a recipe for displacement, eviction, and, yes, homelessness.

The potentially good news is that consensus is slowly forming around a compelling strategy to reduce chronic homelessness in San Francisco, and it bears a number of important characteristics that are based in research and driven by lessons from cities across the United States. Among these:

We know better now that homelessness impacts a broad variety of people, and that there are whole families with kids in SFUSD schools experiencing homelessness that is unrelated to opiate, amphetamine or alcohol addiction. And we know that chronic homelessness is immensely difficult and painful, and leads to shortened lives.

There are more compassionate and less expensive alternatives to calling 9–1–1 when a homeless person is in (non-emergency) distress — if there’s anything you take from this article, I hope it is that you remember to call 3–1–1 and ask to refer your report to the San Francisco Homeless Outreach Team (“SF HOT”).

and ask to refer your report to the San Francisco Homeless Outreach Team (“SF HOT”). The recent creation of a Department of Homelessness and Supportive Housing, with newly appointed Director Jeff Kositsky, is the right step towards increased accountability for the various city budget items that go towards supporting the homeless and also better tracking of individuals in our programs. A recent study commissioned by Board President London Breed has demonstrated the opportunities for cost savings in these two important ways.

The Housing First movement — the concept that it is more cost effective to deal with the causes of homelessness once the person is already housed — is gaining traction over time. Of course, in San Francisco, such a program is much more costly than in, say, Salt Lake City, simply because housing is more expensive. But with the successful launch of San Francisco’s first Navigation Center, we seem to be finding new ways of helping people that are more cost effective and more humane than a simple handout.

The rate of homelessness is tied inextricably to housing availability. That the west coast of the United States is facing both a housing shortage and a homelessness crisis is no coincidence. Leasing units for supportive housing is initially quite expensive. I don’t want us to be a City that, on one hand, puts enormous barriers in front of modest infill of affordable units in empty lots, and, on the other hand, allows people to spend months living in tents on the street.

We know that the number of sheltered and unsheltered homeless people in the Richmond District alone can be measured in the hundreds. We are beginning to understand that most people without homes in San Francisco were San Francisco residents before becoming homeless — though not all were, and we have to be careful that we aren’t solving problems for other cities and towns that need to pitch in on this with us.

Allowing people to live in psychological, financial, or addictive crisis in tents on our sidewalks is poor public policy for too many reasons to list here. On June 21st, Supervisors Farrell, Tang, Cohen, and Wiener placed an initiative on the ballot for the November election to guide a more humane city policy around removing encampments and — importantly — providing shelter or housing options to those encamped. This is a welcome move.

The trick for San Francisco is that we, at times, seek out deep partisan divisions even where there are none, demonizing those who hold different views. This is a political problem. We need to acknowledge both the immense human tragedy of homelessness — the total collapse of income and family and the need for government to respond with care — and also that there are a nontrivial number of homeless men and women who engage in inappropriate and illegal street behavior that is unacceptable in a civil society. Simply put: we need to better control the symptoms of the tragedy if we hope to have as a City the political capacity to treat the underlying problem. This is the political reality, and we have to work on this within the confines of political reality.

Recently, and counter to the emerging consensus, we saw an attempt by some on the Board of Supervisors to “require the city to provide bathroom and garbage services to homeless camps of more than 30 people” and “if the city can’t offer permanent or temporary housing … it must provide sanitation services at the camp until housing is available.” [SF Chronicle 4/13/16] To reiterate: sustained, spontaneous public camping on sidewalks is not an appropriate public policy solution for the homeless crisis; it is neither humane nor safe (particularly for those living there) nor politically viable.