Just blocks from the streets where he used to live with his 50-pound backpack with tent, camp stove and guitar, is Bill E.'s studio apartment. Here, hand towels are folded tidily over a bathroom railing with cleaning products lined up neatly. In his kitchenette, a coffee maker and toaster jostle for space on a modest food prep area next to a gleaming sink and two-burner stove.
Missing is the bric-a-brac of sentimental value that most of us accumulate: family photos, vacation mementoes, cards from loved ones, artwork. Its absence is evidence, perhaps, that Bill has made a break from a tumultuous past marked by uncontrolled schizophrenia, drugs and alcohol, a fleeting marriage and 10 years of living on the San Francisco streets hand to mouth, while he struggled with hepatitis C and crippling neuropathy.
"I'm grateful to a lot of people, San Francisco has been very kind to me," says Bill, 58, who grew up on his family's farm in Stockton, California, and worked as a Marine reservist until voices drove him to a psychotic break leading to his first hospitalization.
Mostly, Bill is grateful for Citywide Case Management, a 43-year-old program located in the city's Mission district, serving clients with serious mental illness. The majority are unhoused and approximately 75% have substance use disorder. Citywide may be the only program in San Francisco that recognizes that transforming the lives of the city's most vulnerable residents requires more than a door key and a doctor's appointment - it requires a tightly integrated team to take on the facets of their daily life, like ensuring bills get paid, food is available, therapy is accessible and medications are managed.
'I Know I'm Not Alone Anymore'
Bill credits his social worker, Robyn Miles, LMFT, one of 188 full-time Citywide employees, with "using her magic to turn my life around," and refers to his care worker who visits his apartment on weekdays as his best friend. His days are spent tinkering with his computer equipment, preparing meals and chatting with his care worker. "I'm back and I'm happy because I know I'm not alone anymore, and I'm here in my favorite city," he says.
Citywide is a testament to the 150-year partnership between Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) and UC San Francisco.
The program cares for approximately 2,000 clients a year and is staffed by UCSF employees, who include peer counselors and employment specialists, and overseen by the UCSF Department of Psychiatry at ZSFG. It partners with the State of California, the San Francisco Department of Public Health and other city departments in programs that they fund.
