This episode contains mentions of suicide. If you or someone you know is in crisis, call or text 988.

Starting August 14, San Francisco will remove peer specialists from its 911 response. These peer responders, equipped with both training and personal experience with issues like homelessness and addiction, say the decision is a regressive step in the city’s approach to mental and behavioral health emergencies.

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Episode transcript

This transcript is computer-generated. While our team has reviewed it, there may be errors.

Ericka Cruz Guevarra: [00:00:57] Hey, just a quick note before we get started. This episode includes mentions of suicide and addiction. Please take care while listening. I’m Ericka Cruz Guevara and welcome to The Bay, local news to keep you rooted. It was early one morning outside of a cafe in San Francisco when Chantel Hernandez-Wood, who was homeless and in the throes of her addiction, was told she had to move. She wasn’t sure what her next move would be or where she’d go next, when about a block up, she saw a red van and made a decision that would change her life forever.

Chantel Hernandez-Wood: [00:01:47] So I walked up there and I knocked on the window and I said, ‘I need help.’

Ericka Cruz Guevarra: [00:01:56] It was San Francisco’s street crisis response team who respond to 911 calls alongside peer counselors, people who’ve had personal experience with homelessness, addiction, or mental illness.

Chantel Hernandez-Wood: [00:02:17] And they took me to a sobering center. And from there I was placed in a detox and there I, I was in a 90 day program. And while I was sitting there in the 90 day program, I thought, you know, I’d really love to do what they were doing. They went above and beyond to help me get off the streets.

Ericka Cruz Guevarra: [00:02:40] Today, Chantel is a peer counselor herself, working alongside emergency responders to help people suffering on the streets of San Francisco. It’s a program that’s been going on since 2020.

Chantel Hernandez-Wood: [00:02:57] When someone says, I know how you’re feeling, I know what you’re going through, everybody can say that, but I really know what that feels like to be that individual.

Ericka Cruz Guevarra: [00:03:08] But this program is about to change. Starting August 14, peer counselors will no longer accompany emergency responders on 911 calls. And advocates worry that without the firsthand expertise of peer counselors, more people will fall through the cracks. Today, what the end of peer support could mean for San Francisco.

Sydney Johnson: [00:03:40] You’ll probably remember, in 2020, following the killing of George Floyd and several other police brutality incidents, there were protests all over the country.

Ericka Cruz Guevarra: [00:03:52] Sydney Johnson is a reporter for KQED.

Sydney Johnson: [00:03:56] Calls for defunding the police. And, you know, those protests were happening here in the Bay Area. Even though San Francisco never defunded the police, there was a lot of interest in creating these sort of alternatives to having law enforcement and police respond to certain 911 emergencies. And one of those was the street crisis response team. These folks would drive around in red vans and they would respond to 911 calls for mental health emergencies. This could be happening on the street, someone having a psychiatric breakdown or potentially a domestic dispute up in a penthouse. It really ran the gamut. The teams were made up of EMTs, behavioral health clinicians, and peer responders. Peer responders were one of the more unique elements of this alternative response idea because they are not sworn officers, they did not arrive in uniform. They have lived experience, you know, with incarceration or potentially having gone through a mental health crisis themselves, substance use disorder. Having these types of experience that they’ve lived through. Was the expertise that the peers were bringing to these emergency responses also. And that group, the street crisis response team has been operating in San Francisco for about the last five years.

Ericka Cruz Guevarra: [00:05:40] Yeah, I remember the context of this time, I mean, just going back to 2020, like so many conversations and examples of, I mean really one too many people in the midst of a mental health crisis ending up in either jails or the emergency rooms and not necessarily getting the help that they need.

Sydney Johnson: [00:06:01] Yeah, I mean, I think this was something that San Francisco had been talking about. How do we take some responsibilities off of the plate of police officers? And so there was also this thinking not of just how do we offer people who are going through crises potentially someone that they might relate to a little bit more in these scenarios, but also how do we make this whole system more efficient by pulling some of these responsibilities off of law enforcement’s plate. Maybe if there’s someone who’s trained in de-escalation, maybe we don’t have to send police in for backup. And actually, that was one of the outcomes of this program.

Amelia Harmon: [00:06:40] We’re a team for people that are crashing out and the crash out could look any type of way. If you have less money, you’re going to crash out more. That’s just the way it goes.

Sydney Johnson: [00:06:49] Amelia Harmon manages many of the peer responders for this program, which is part of the fire department. The street crisis response team falls under the fire department umbrella.

Amelia Harmon: [00:07:01] I’ve responded to panic attacks and first episode psychoses in penthouses. I have responded to, you know, the craziest wildest condos in Knob Hill, where people all of a sudden, like, fell off their medication and now their husband is calling on them because they’ve never seen them act like this before and they’re pulling out their hair. I’ve respond to calls in the marina where I literally just had to play with a woman’s baby while she was having a panic attack because her husband walked out on her.

Sydney Johnson: [00:07:26] In a lot of circumstances, first responders have a lot calls that they have to respond to. And they might be like: OK, there’s not a life and death situation happening here. We got to get to the next spot. And so something that Amelia has talked about that these peers can offer is just a little bit more of that human touch of making sure that people have what they need, even if the crisis has started to deescalate.

Amelia Harmon: [00:07:52] But on many, many calls, it really is the peer counselor that the people will disclose to, because in my capacity as a peer counselor, I can tell someone that I was suicidal. I can them how complicated it is to be recovering from depression, but still being suicidal, and managing the symptoms of how often I think about killing myself per day. And if I showed improvement of what that looks like, and I could show that to someone that’s currently struggling, that would help them accept the services.

Ericka Cruz Guevarra: [00:08:18] How is training for these peer responders different from a typical emergency first responders?

Sydney Johnson: [00:08:26] I mean, you can take classes at San Francisco City College to be a peer responder, but you’re not necessarily getting the training of how to actually stop bleeding in a bullet wound. That is its own sort of set of training, but they are trained in just working with vulnerable populations and basically kind of learn how to translate what they’ve experienced into a bigger context of what did I need in those situations.

Chantel Hernandez-Wood: [00:08:59] You know, when someone says, I know how you’re feeling, I know what you’re going through, you know, everybody can say that, but I really know what that feels like to be that individual.

Sydney Johnson: [00:09:12] I spoke with one of the peer responders. Her name is Chantelle Hernandez-Wood, and she is formerly unhoused and struggled with alcoholism in the past. After going through her own recovery journey, she became one of these peer responders

Chantel Hernandez-Wood: [00:09:29] It’s just surreal because I’m working on the same team that helps me when I needed help the most.

Sydney Johnson: [00:09:41] And so Chantel said there were just experience after experience where she would kind of be that first line of, how do we help you? And kind of breaking it down like, hey, I’ve been here before, too.

Ericka Cruz Guevarra: [00:09:55] And I imagine really the goal being to get people access to the help that they need. And that being really the measurement of success for many of these peer responders. I mean, it’s been about five to six years since this program has been around. It sounds like anecdotally, there is this sense, at least among the responders themselves, that they have a really important role to play. But do we know how effective this program has actually been at getting people help?

Sydney Johnson: [00:10:25] There was a study that NYU did in 2024, so it’s been about two years, taking a look at San Francisco’s street crisis response team and these sort of alternatives that came up after 2020. And it really hails San Francisco as a model in this. And this study from NYU, you know, did say that their investments are showing positive results. It said that they the street crisis response team responds to roughly 29 calls a day in an average of 16 minutes each, and that in the vast majority of those calls, the police are not called upon for backup, which would save police resources and indicate that some of this care can be provided without police presence. So that’s pretty high marks for a program that was relatively new and in some regards experimental. Now, fast forward, the city has been really chipping away at this program.

Ericka Cruz Guevarra: [00:11:34] Coming up, why San Francisco is taking peer support counselors off its streets and what it means going forward. By the way, if you want to support the work that we do here at KQED, consider becoming a KQED member, which you could do at donate.kqed.org/podcasts. We’ll be right back.

Ericka Cruz Guevarra: [00:12:41] I mean, we are talking now because these peers are being removed from the street crisis response team in San Francisco. Why?

Sydney Johnson: [00:12:52] “Why?” Is a very difficult question. I’ll back up actually to just say how this first got on my radar, actually. Amelia Harmon, who we chatted about earlier, she received information at a fire department commission meeting that the fire department was moving to pull peers off of these 911 response teams and that August 14th would be their last day. You know, she manages these people. She had not heard about this. No one had communicated this to her directly. This was a complete surprise to her. That’s what she says. It was a completely surprise. They hadn’t heard that the program was, you know, not performing or meeting expectations. She has, for the last several weeks, gone and spoken at multiple public meetings, the Health Commission, the Police Commission, Board of Supervisors.

Amelia Harmon: [00:13:47] Hi, good evening supervisors. My name is Amelia, District 9, speaking in my individual capacity.

Sydney Johnson: [00:13:53] Trying to tell people in positions of power, like, this is happening, and ask them, did you know? Like, is there a reason why? Like is anyone concerned about this?

Amelia Harmon: [00:14:05] From frontline workers to directors. No one that I spoke to had heard it anywhere else. They count on the non-uniformed peer support backed by our traditional first responders when they call 911 for their people, our people. One person on foot door to door.

Sydney Johnson: [00:14:24] Ultimately, this was a decision from the fire department. And when I reached out to the fire department to ask about it, they said that this was very carefully considered decision. They are not getting rid of the street crisis response team, that the street crises response team will still exist. But they are moving peers off of these rigs. And when I tried to push a little bit more on why, the reasoning that I was given was that it has been difficult scheduling with the peers themselves. They are not stationed at the firehouse or with the paramedics. There has to be sort of. An arrangement for a pickup along some of these routes. But yeah, it ultimately has come down to the fire department just deciding that this was not working for their vision for the program.

Ericka Cruz Guevarra: [00:15:20] Yeah, it’s interesting that the reasoning is not something like this program isn’t working. It’s just sort of like an administrative issue. So then what does that then mean for, I mean, who is doing the work now of this sort of non-emergency emergency response in San Francisco?

Sydney Johnson: [00:15:40] Yeah, I mean, the city and the fire department is simultaneously working to expand and develop trained paramedics who have this additional layer of training in many of the things that the peers and behavioral health specialists brought to these rigs. Things like trauma informed responses, you know, extra training in how to direct people to certain social services. But you know what is different about the community paramedic versus the Dear Responders, is, you know, it’s subtle, but it’s important. This is what Amelia had to say about it.

Amelia Harmon: [00:16:17] They come in uniforms and they come in steel-toed boots, and that matters.

Sydney Johnson: [00:16:20] They may not necessarily have the lived experience that a peer brought also, which was kind of at the core of what these peer responders were offering to people who were in crisis.

Ericka Cruz Guevarra: [00:16:34] And again, that’s just not an experience that you can sit in a classroom and do a two hour training. Right. And I mean, I guess I wonder what someone like Chantal or Amelia worry that the city will really miss when it moves away from prioritizing this firsthand experience to help deal with some of the city’s most pressing issues.

Sydney Johnson: [00:16:58] Yeah, I mean both of them are pretty gutted.

Chantel Hernandez-Wood: [00:17:02] Like I’ve been blindsided.

Sydney Johnson: [00:17:03] Chantel talked to me about this.

Chantel Hernandez-Wood: [00:17:05] It’s just an incredible disservice to the community.

Sydney Johnson: [00:17:08] The rollout of this has been confusing, and a lot of people seem to not know what’s going on. But Chantal just said there’s been so many times in which she’s seen people on the street who specifically reached out to her in these moments.

Ericka Cruz Guevarra: [00:17:27] It sounds like they’re worried that this is just gonna mean that fewer people are gonna get help when they’re in crisis in San Francisco.

Sydney Johnson: [00:17:34] Yeah, I think that’s that’s kind of one of the biggest fears that both Chantel and Amelia have is that if peers are no longer in these on these 911 calls that there will be people who fall through the cracks. You know, when I spoke to Chantell, I asked her, what is your plan after August 14th? You know? What are you going to do after you’re no longer going to be on these 911 calls? And You know, they still don’t know what’s going to be sort of their new offering or position or even if there’s going to be layoffs. But one thing that’s been suggested, I guess, maybe unofficially, is that these peer responders would be shifted to respond to 3-1-1 calls, these non-emergency sort of like handling like, you know, we need unhoused people to move. It’s very different from a 9-1 call. And Chantel just said that feels like. Very different from the expertise she’s been developing over the last few years in kind of these more emergency kind of healthcare sort of driven settings. And so if that is what she’s offered, she’s going to look for something else.

Ericka Cruz Guevarra: [00:18:46] I mean, Sydney, it does seem like so much of the context that we’re living in has changed since 2020 and these conversations around these alternatives to policing, defunding the police. It feels like the conversations really swung in the opposite direction in San Francisco.

Sydney Johnson: [00:19:04] Yeah, it probably has swung in the opposite direction in a lot of places in the country. Yeah. But when you think about the conversations that were being had in 2020 and 2021 about, you know, having these alternatives to policing or, you know, even having hearings in City Hall about what defunding the police would look like, you know, Even though that didn’t happen, it was, you know, still something that city officials were talking about and considering. We are so far from that now. You know, the police budget has only increased. There has been a huge push towards public safety, you know, just as a rallying cry in San Francisco. Within the conversation of public safety. You know homelessness and drug use and mental health often gets wrapped into that. And, you know sometimes unfairly, sometimes not. But I think what we’ve seen is also more arrests for people who are refusing shelter or who are using drugs outside. Obviously, these peer responders were not only handling street-level issues, but I think that moving them off of these 911 calls does signal a return to the more traditional policing approach that we saw. Before these conversations were had.

Ericka Cruz Guevarra: [00:20:41] Well Sydney, thank you so much for sharing your reporting with me. I appreciate it.

Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.