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“She has to agree to want treatment”—the challenge of serving the chronically homeless.

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Monarch Resort sign

Housing is one part of the solution for getting chronically homeless people into a stable setting. After opposition from the hotel owners and neighbors emerged, Pacific Grove city officials dropped an effort to transform this hotel into a Homekey site, which would have provided enough space for the city’s entire homeless population, including H.

Sara Rubin here, concerned about a local woman who I have never met—but I have met people with similar stories. 

Life is not easy for H. She is 85 and legally blind, and lives on Social Security checks that come each month. Those checks cover hotels for a time, but don’t last long. H.—the Weekly is using her initial only, to protect her privacy—is also known to have behavioral issues. She’s mean to people, including those who are trying to help her, and including multiple hotels that have kicked her out for verbally abusing staff or other guests. It means that partway through the month she ends up without a place to live, and on the street she might have a police interaction. 

More than once they’ve placed her under a 5150 hold, a reference to the California Welfare and Institutions Code that allows adults experiencing a mental health crisis to be detained for up to 72 hours in a psychiatric hospitalization. When it ends, she is on the street again, and the cycle repeats.

It has repeated at least twice in recent months, according to Anastacia Wyatt, housing program manager for the city of Pacific Grove, who has worked with H. Most recently, she was released from a 5150 hold on Friday, June 3. 

That is one week ago, and Wyatt and others who have worked with her haven’t seen her or heard from her since.

Her story—of bouncing around from temporary shelter to police to hospitalizations to the streets and then back again—is not uncommon among chronically homeless people. While many people without housing are grateful for any help they can get, there are people who are just difficult, whether due to mental illness, years of living on the street, or a combination. H. has refused numerous services available to her, and so far, at least, she’s been deemed able to make her own decisions—even if they are reckless decisions that endanger her. So she’s not a candidate for conservatorship, in which the government appoints a caretaker to make decisions on behalf of the “gravely disabled” conserved person.

“I don’t blame anyone,” Wyatt says. “But at the same time, where are the services? She is going to keep getting bounced around in our community. If we don’t solve her problems, she is going to cost us a fortune as a community, and not get what she truly needs. What do we do, let her stay on the street and let her die?”

In some ways, the collective societal answer is yes.

But there is momentum from Gov. Gavin Newsom and state lawmakers to give more power to the government in the treatment of chronically homeless people, including increasing conservatorships.

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There is a policy pendulum that swings when it comes to how much we protect the rights of people with mental illness and how much we choose to intervene. Images of One Flew Over the Cuckoo’s Nest come to mind as the worst-case, heavy-handed state intervention—depriving adults of any ability to make choices for themselves about their health and housing raises questions.

“I am conflicted,” says Monterey County Behavioral Health Bureau Chief Katy Eckert. “I do think it is a very serious thing to take people’s civil rights away—that is a grave concern to me. I also see that there are individuals who definitely need help, and so far what we have been able to provide has not been successful.”

In the case of someone like H., who has rejected or alienated most efforts to help her, it might be successful. Under current law, Eckert says, “She has to agree to want treatment, want help—or she has to devolve to the point where she meets the legal standard for us to be able to make her choices for her.”

There is no count of how many chronically homeless people there are in Monterey County who refuse services, but there are others like H. who for whatever reasons continue to reject them.

I think about someone like CeliaSue Hecht, a chronically homeless woman and writer who blogged extensively about her singular story and the broader challenges of accessing services. Hecht had medical (not psychiatric) issues that would place her in the hospital for periods of time that she was sheltered, but that also meant she needed a temporary home for her dog, CiCi. Hecht wanted reasonable things, but she could also be an unreasonable person, difficult for local service providers to work with and not the easiest to get along with. (Hecht was in regular contact with the Weekly, and a few members of our staff dog-sat for Cici during her hospital stays.) 

Hecht finally found housing, in CHISPA’s Junsay Oaks development in Marina, in December 2020, after years of living in her car. She died on April 6 this year, following a heart attack at age 72—and at least she had the dignity of a home when she died.

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Sara Rubin loves long public meetings, red pens and reading (on newsprint). She has been editor of the Monterey County Weekly since 2016, and has been on staff since 2010.

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