Thread by @ShellenbergerMD

The decision by SF Mayor @LondonBreed to shut down open drug scenes is right, but SF lacks shelters, rehab clinics, group homes, and hospital psych beds. SF can’t solve this alone. We need a single state agency, Cal-Psych, to centralize care at facilities statewide at a low cost

Cal-Psych would be able to purchase shelter space, psychiatric beds, board and care facilities, and treatment facilities from across the state.

michaelshellenberger.substack.com/p/why-californ…

Cal-Psych would do as much as legally, ethically, and practically possible to establish voluntary drug treatment and psychiatric care. It would also work with the courts and law enforcement to enforce involuntary care through assisted outpatient treatment and conservatorship.

Experts agree: “Extending this approach to severe mental illness would mean a new bargain: The state would force treatment only when a person has been offered and turned down a full suite of alternatives.” @avb_soc

sfchronicle.com/opinion/openfo…

When I spoke to @GavinNewsom advisor, Dr. Tom Insel, he agreed on vision. But, he said, “Everybody says the same thing to me. ‘You’re going to have to change the constitution because the way that we got to where we are was through a series of ballot measures.’”

But that’s not as daunting a challenge as it may seem. Cal governors raise money and pass ballot initiatives all the time, I pointed out. In fact, in the last 20 years, several major measures put on the ballot by former Governor Brown contributed to the state’s addiction crisis.

Why hasn’t Newsom been pushing ballot initiatives?

Insel didn’t criticize Newsom directly, but when I read the transcript from our interview I was struck by how often he returned to one theme in particular.

“It’s been really hard to get any real leadership,” Insel said. “I don’t think money is the problem. I think it’s the leadership. . . . we need state leadership . . . We have to create state leadership. . . . I don’t think it’s a money problem. I think it’s a leadership problem.”

Today’s @sfchronicle asks what happens if @LondonBreed can’t deliver? The article left out crucial context. SF lacks shelters, psych beds, rehab, & group homes bc progressives diverted $ from those things to fund expensive “Housing First” housing instead

sfchronicle.com/sf/article/May…

And all of that happened under the watch of @GavinNewsom @JerryBrownGov

As SF Mayor, Gavin defunded shelters and diverted money into expensive “Housing First” housing at the behest of the unholy alliance of progressive advocates & developers

ACLU blocked $ for psych beds

Can’t we just leave this to churches & charities?

No. That’s the status quo. That’s what we’ve done for last 50 years. That’s what led to the chaos, misery, and deaths

Aren’t I just proposing more handouts?

No. We need carrots and sticks.

- Shelter First, Housing EARNED through abstinence, work, etc

- Rehab as ALTERNATIVE to incarceration, not optional

- Voluntary offering of good psych care at first but mandatory if you break law

Always think carrots and sticks, rewards and consequences. They must exist at every level in a functioning system and they must be protected from “soft doctors” who constantly want to remove accountability out of excess/unbalanced empathy, over-involvement, or laziness

It is tempting to think that @LondonBreed can just arrest the drug dealers & solve the problem but we have many people with mental illness & addiction that need shelter, hospital psych beds, rehab, & group homes that don’t exist, & for those she’ll need help from state & feds

After 6 months of campaigning, & 2 months after pub of “San Fransicko,” we’ve broken through to mod Dems that they need to crack down or face political defeat, but we still need to persuade the public of the broader Cal-Psych agenda, and empower or elect officials to implement it

If Republicans or independents were to embrace Cal-Psych it would be potentially game-changing since it would allow them to marry a traditional tough-on-crime policy with a more liberal approach to mental illness and addiction, and the reverse could be true for Dems

It has been a remarkable, inspiring, and educational experience for our work on drugs & crime to break through at the exact same moment our work on nuclear has broken through. In both cases, real-world crises, partly created by progressives, have given moderates the upper hand.

For more info please consider listening to my recent podcast with @sullydish

It is well-edited and I have become more succinct in the two months since my interview with @joerogan

Plus, a lot has changed in two months!

podcasts.apple.com/us/podcast/the…

And please consider reading “San Fransicko,” which I wrote precisely bc this is a big and complex topic that requires 400+ pages and 1,100 end notes to fully unpack

amazon.com/gp/product/006…

Here’s my 2.5 hour interview with @joerogan ! 😅

open.spotify.com/episode/5NxzDE…