At an upscale salon near Union Square last year, she was one of the regulars. But she didn’t come for a haircut. She came every day to plant herself outside the front door, strip her clothes off and scratch herself violently.

“With nails the size of a tiger’s — it was so horrible,” recalled Bibbo Saab, the owner of Bibbo Salon on Sutter Street. He said the woman would scream at customers and defecate on the sidewalk, sometimes smearing her waste on the salon’s windows and, once, throwing it inside.

He called the police hundreds of times, he said, and each time the answer was the same. She didn’t want help, so there was nothing they could do. Saab considered closing his business. He said he grew so angry and desperate, he wondered if he, too, was going crazy.

“She got me completely out of my mind,” he said.

But it wasn’t Saab that was crazy. It was the state’s laws around conservatorship of the mentally ill that are so desperately broken.

Finally, some city officials are proposing solutions to San Francisco’s mental health and drug addiction crises. They’re realizing it’s not compassionate or humane to let people wither away on our sidewalks because they’re too out of their mind to accept help. And that it’s not fair to neighbors, businesses and pedestrians to allow the deranged, destructive behavior to go unchecked.

On Monday, state Sen. Scott Wiener will hold a news conference to promote his newly introduced legislation giving counties more control over conservatorship programs for the mentally ill and drug-addicted. Currently, counties can hospitalize people for 72 hours against their will if they pose a danger to themselves or others, or are gravely disabled. The county can go before a judge to seek a 14-day extension and then repeat the process every 30 days.

Wiener wants to expand the “gravely disabled” category to include those who are drug-addicted, many of whom can sober up and appear OK during the initial 72 hours and not qualify for the longer holds. But then they return to the streets and start using again. He also wants to ensure that conservatorships come with housing attached, adding a carrot to the stick.

“This is not about bringing people to jail or criminalizing people. This is about housing people and getting them healthy,” he said, noting he sees far too many examples every day. “I see this guy or this woman on the street who is clearly dying and clearly incapable of making decisions for themselves. Why the hell are we letting this person die on our streets?”

It’s a great question. Nobody wants to return to the days of harsh mental institutions in the style of “One Flew Over the Cuckoo’s Nest,” but the pendulum has swung too far the other way. Now, we’re in a state of total paralysis when it comes to getting clearly sick people the help they need.

Supervisor London Breed agrees. On Tuesday, she’ll introduce legislation to transfer the job of overseeing conservatorships from the district attorney’s office to the city attorney’s office as long as there’s no criminal element to the person’s behavior. Breed said the switch will make it easier to coordinate help with other city agencies, including the Department of Public Health.

“This is a public health issue and needs to be treated as such,” she said.

Breed’s legislation will also make permanent a new group of representatives from Public Health, the Department of Homelessness and Supportive Housing, the Police Department, BART police and Aging and Adult Services who meet regularly to discuss plans of action for dozens of the most severely mentally ill or drug-addicted people who are causing problems on the city streets. The idea was hatched by the late Mayor Ed Lee and has the support of Mayor Mark Farrell, who has pledged to find funding for the effort.

Breed pointed to an older woman who frequently walks naked past Rosa Parks Elementary School at O’Farrell near Webster as someone who desperately needs assistance.

“That’s somebody’s grandmother,” she said. “If that were you, wouldn’t you want somebody to help you?”

Uh, yes.

Public Health Director Barbara Garcia supports the proposals from Wiener and Breed. She said a major reason derangement on the streets has become so much more prevalent is because of the methamphetamine epidemic. The drug can cause behavior in people that looks like mental illness, including screaming incoherently and stripping naked.

She said more than 50 percent of people leaving the psychiatric emergency wing at San Francisco General Hospital have been under the influence of meth. The hospital has a new navigation center for homeless mentally ill people, and Garcia is hiring three new social workers to help steer people leaving the psych ward into voluntarily accepting help at the center.

These kinds of changes can’t come soon enough for Karin Flood, executive director of the Union Square Business Improvement District, which assesses extra property taxes to pay for services beyond what the city provides. There have long been homeless people and panhandlers in the shopping mecca, of course, but the derangement that’s so prevalent is newer, she said.

She’s working on a program to train retail workers on what to do when a severely mentally ill or drug-addicted person walks into a store ranting, making threats or picking fights. Outside, the same people sometimes throw bottles or walk into zooming traffic. For a while, Flood’s organization funded a social worker, but she decided the money wasn’t worth it because there was nothing the employee could do if the person declined help, which was usually the case.

For business owners and their customers, the havoc can be jolting. Flood said the team behind the Museum of Ice Cream on Grant Avenue was shocked by what she politely called the “antisocial behavior” in the adjacent alley, behavior the team hadn’t seen when it opened in Los Angeles or New York City.

“This is a huge, complex problem,” Flood said, noting that talking about it to me wouldn’t exactly be great for business. “We’re desperate enough to expose ourselves to look for solutions.”

Or, as Bibbo Saab, the salon owner, put it, “Union Square is being destroyed, and if you don’t take care of this, it’s going to destroy the city of San Francisco.”

He did finally find a solution to the woman who was wreaking havoc in his doorway — sort of. He told a local TV station, and a news story aired in late November, prompting visits from police brass and the mayor’s staff. The woman was hospitalized briefly, but she’s back in Union Square. She sleeps in nearby doorways at night, but she avoids Saab’s business during the day.

“At least she doesn’t meet her needs right in front of my salon,” he said, sounding pleased.

Sadly, these days that counts as success.

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