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Glossary of Terms



NHMH Salutes the Passing of American Scientist Dr. Paul Greengard, a Pioneer in Brain Research and Mental Health Treament. We owe Dr. Greengard a great debt for his incredible, break-through work, and his amazing life of service.

San Francisco's Fragmented Mental Health Services Are Literally Killing Its CitizensSan Francisco’s fragmented city services are harming – and killing – the most vulnerable,S.F. Chronicle, Michael Cabanatuan Sep. 27, 2022 “A small number of San Franciscans — almost all of them unhoused — are responsible for overly heavy use of both the city’s medical and legal systems — but the systems’ fragmented approach is failing, according to a new study. The study, from the nonpartisan California Policy Lab and the Benioff Homelessness and Housing Initiative at UCSF, shows that a small group of people are repeatedly cycling in and out of both the county’s health and criminal legal systems each year and represent a disproportionately high amount of utilization of these systems.The systems provide fragmented care that fails those who use it, the study’s authors said, and one finding backs that up: Nearly one in four of the people with heavy use of both systems in 2011 were dead by 2020, “reflecting how vulnerable these individuals are and how high the stakes are for improving the systems that support them,” said co-author Dr. Hemal Kanzaria, medical director at Zuckerberg San Francisco General Hospital and an associate professor of emergency medicine at UCSF.The study underscores what health care workers and public hospital officials told city leaders in July — that far too many people struggling with severe mental illness and addiction cycle through San Francisco’s overburdened emergency rooms, failing to get long-term help, and at a high cost to the city. For instance, just five people in the past five years accounted for 1,781 ambulance transports, possibly up to 2,000, at a cost of $4 million.The study’s authors called for a more coordinated approach, such as connecting people released from the emergency room or jail with housing and continued care. “Our research highlights the need for coordinated, evidence-based interventions to address these individuals’ complex needs, promote stable housing, and prevent poor health outcomes including untimely death,” said co-author Dr. Maria Raven, chief of emergency medicine at UCSF Medical Center and co-lead of the Benioff Homelessness and Housing Initiative program on adults with complex needs.The study looked at 10 years of data from 270,000 people who used the city’s acute medical care or legal systems between 2011 and 2020. It narrowed its focus to two groups of people who had interactions with both systems in the same year, one from 2011 and one from 2020, to investigate trends among frequent users of city services.The study is unusual, researchers say, because it links data from multiple agencies to see how people are using critical city services including mental and physical health care and housing over a several-year period.Among the study’s findings, according to the Policy Lab:• About 24% of the 2011 group continued their high use of both systems the following years but their use declined each of the following years. • Between 80% and 90% of the people in the 2011 and 2020 groups had substance use problems and many also had chronic mental and and physical health issues. • More than 90% of the individuals in both groups had been booked into jail for a felony and a misdemeanor. • The research team determined that many of the people in the 2020 group were in San Francisco in 2011 and had contact with both health and criminal legal systems in the prior 10 years. For example, 30% of the 2020 cohort was booked into jail in 2011.” Michael Cabanatuan is a San Francisco Chronicle staff writer, email: ... See MoreSee Less
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