There are a lot of reasons for San Francisco residents and visitors alike to spend their money in the city this holiday season, Mayor Ed Lee told reporters gathered at a press conference at the Museum of Ice Cream on Monday morning.

The small businesses that sell locally made items not found on Amazon or in the aisles of Walmart. The fantastic restaurants. The whimsy of the colorful city, where tickets are sold out to the pink-emblazoned pop-up museum with a sprinkle pool, and Unicorn Snot Lip Gloss is for sale in the gift shop for $6.50.

But there are also a lot of reasons not to visit San Francisco. That’s been made abundantly clear to me over the past week as locals and tourists have filled my in-box with responses to my column about the highs and lows of hosting my in-laws from England.

While the cable cars, the Golden Gate Bridge, the food, the beauty and the eclectic neighborhoods draw visitors from around the world, the open-air injection-drug use, sprawling tent encampments, rampant mental illness, car break-ins and dirty streets are, sadly, becoming just as well-known.

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Richard Robertson of Edmonton, Alberta, last week brought his 9-year-old daughter, Anna, to the city for her first visit. The highlights? Walking along Ocean Beach, the views of the bay from the piers and the clang of the cable cars.

The worst moment came when he, his wife and Anna — clutching a stuffed animal — were walking south on the Embarcadero to the Ferry Building for an early dinner.

“A topless and obviously drugged-up, crazed female seemed to emerge from out of nowhere, approached my daughter and extended her two middle fingers right into her face and started screaming ‘F— you!’ at her,” he wrote.

Robertson said his family was in shock and didn’t know what to do. He was also stunned that the incident sparked no response from anybody on the busy sidewalk.

“Streets filled with drug-induced lunacy and people with other severe mental health issues should not be ignored and swept under the rug by the citizens of San Francisco and its civic leaders,” he wrote.

It’s hard to argue with that. And for those “compassionate” advocates who have a live-and-let-live approach: What results is your method accomplishing for those mentally ill and drug addicted people?

Robert Donoghue was in town last week from Boylston, Mass., for his granddaughter’s first birthday. On Wednesday, he went to the Legion of Honor to see the Klimt and Rodin exhibit before heading to the airport for his flight home.

Two hours later, Donoghue realized his rented Jeep had been broken into in the museum’s parking lot, and $8,000 worth of electronics, medication and other items had been stolen from the rear cargo area.

“We went to the museum immediately and reported it. Their response was, ‘This happens all the time.’ They didn’t even come down to look, nothing,” Donoghue said. Museum staff gave them the phone number for the Richmond District police station, which didn’t pick up until the fifth try when Donoghue was already at the airport.

“I will never step foot in San Francisco again — never ever,” he said.

A spokeswoman for the Legion of Honor said the parking lot is on Recreation and Park Department land and that the museum has asked for signs to be installed warning drivers about break-ins, but that none exist now.

Pat Frankenfield lives in Palo Alto and visited the city in September to see “An American in Paris” at the Orpheum and spend the night at the Donatello Hotel near Union Square. The walk between the two after the show was full of people sprawled across the sidewalks blatantly injecting drugs.

“What is wrong with city leaders?” she asked. Excellent question.

Cynthia Fitzgibbon, who now lives in South San Francisco, regularly hosts friends from all over the world. Pals from Germany were recently walking on Market Street when they were followed and screamed at by a clearly deranged person.

Fitzgibbon herself has recently seen blatant drug deals South of Market, an out-of-his-mind person ranting and throwing trash at people standing in line to ride the cable cars, and a man drop his pants to defecate right in front of her 6-year-old granddaughter outside the Curran Theater.

“There are so many good points about the city — it’s so unique and so beautiful,” Fitzgibbon told me. “But I think when it gets really not OK is when you’re fearful, when you’re accosted or when you encounter really dirty situations.”

That’s certainly a reasonable expectation in a world-class, wealthy city. So what is its leader doing about it?

Mayor Lee — after touring the goofy Museum of Ice Cream but before eating ice cream and playing pingpong with its co-founder, Manish Vora — said he is working hard on these issues.

“Mid-Market is still a work in progress,” he said. “It’s not perfect, but it’s getting better and better.”

A harm-reduction team launched in July is aiming to improve 100 blocks in the Mid-Market, Tenderloin and South of Market neighborhoods through increased foot patrols, more street cleaning, and mental health and substance abuse outreach.

Just how bad is the problem? So far the team has collected 38,438 needles and 199,740 pounds of trash. It’s made 885 referrals to services such as substance abuse treatment or homeless shelters, and has made 2,026 arrests.

Certain spots, including the wide sidewalk expanse outside the Burger King at Eighth and Market streets, are noticeably better. But there’s obviously a long, long way to go, especially after dark when the injection drug use gets even worse. But Lee said he encourages his family’s visitors to go to the Orpheum and other institutions in Mid-Market at any time of day.

By the way, diagonally across the street from the Museum of Ice Cream on Monday morning sat another familiar San Francisco site: Megan Doudney, the homeless mom who gained notoriety over the summer for panhandling on Market Street with her newborn baby.

She’s still staying in a shelter at night and still panhandling during the day with her daughter, who’s now 5 months old and has her first tooth. Police officers walking past stopped at the alarming sight, but couldn’t do much other than buy her diapers and formula.

Doudney said her shelter stay ends Dec. 12, at which point she plans to visit her mom in Nebraska and then maybe take a road trip. She said she’s thinking of going to school to study early childhood psychology.

Nothing seems certain for Doudney and her baby girl. But credit where credit is due: The baby appeared healthy, chubby and happy.

San Francisco Chronicle columnist Heather Knight appears Sundays and Tuesdays. Email: hknight@sfchronicle.com Twitter: @hknightsf