Social Work in the Tenderloin is Not Hopeless

Last week, Vice put out a widely-circulated interview with a Tenderloin social worker under the alarming headline “Social Work in the Tenderloin Will Kill Something Inside of You.” While the popular reaction was shock and dismay to the conditions as they were described, it was hard to ignore the rejection of assertions the piece made by the social worker and the larger Tenderloin community.

In an effort to better understand both the work San Francisco's social workers do and the city's poverty problem, we reached out to Brian Brophy, an attorney at the AIDS Legal Referral Panel (ALRP) who advocates for clients facing difficulty accessing government-funded health care, mental health services, dental care, transitional and supportive housing, money management, food assistance, case management, hospice, social support, and emergency financial assistance.  Brian also happens to be the talented photographer behind The Tens, a project noted for its honest documentation of SF's more impoverished and vibrant communities.

Uptown Almanac: Vice's interviewee describes their “average workday” a grim experience, starting with a consuming stench of feces and urine, followed by 20+ voicemails left by paranoid addicts, followed by blood, vomit, begging, seizures, and—of course—paperwork.  Has this been your experience at all?  What does your “average day” look like?

Brian Brophy: I don't work in the Tenderloin, and neither did the person interviewed for the Vice article, although the article made it come off as though she did. Many of my clients (and her clients) do live and/or access services in the Tenderloin. Anyone who works, volunteers, or otherwise spends time in the Tenderloin knows that bad things go on, that it can be a difficult place to raise a family, stay safe, and become and stay sober. I have seen many of the behaviors that were described in the article. Those things should be talked about, but my problem with the Vice article is the way it presented these issues. It presented it as a spectacle, as something that only goes on with people it makes out to be freaks. It dehumanized the people who live there in general, and specifically dehumanized people with mental health and substance use issues.

I have had my fair share of disturbing events that I have witnessed, heard about, or talked to clients about. These things happen, I'm not pretending they don't, but the Tenderloin is far too complex to let it be defined by these events alone.

Vice made social work in the TL sound pretty hopeless.  Based on your strong reaction against the article on Twitter, I'm guessing you disagree with that.  How is this work important, and what good is being made in the client's lives?

The main reason people are homeless is because there is a lack of affordable housing. Other contributing factors include a lack of funding for effective mental health and substance use services. The Tenderloin is an incredibly diverse neighborhood. Many seniors live in the neighborhood, many veterans, people from many different races and ethnicities, families, and immigrants, and people who would be fit many of these different categories. There's a widely quoted figure that more than 3,500 children live in the Tenderloin.

My take on doing work providing direct services to the poor is that you don't do it to change the world, you don't do it to make yourself feel better, and you don't do it expecting gratitude from anyone. People do it because it needs to be done. There would be a catastrophe if local organizations didn't provide the services they do and I don't see the federal government taking any significant steps to reduce this need.

We all have successes and failures. Not every client we work with is a success story. But people at these agencies help to ensure as many people as possible are housed, are receiving medical care, are receiving food, and other necessities of life. No one owes me any gratitude and I do not expect it, no matter what the outcome of my work.

I have met amazing people who live in the Tenderloin: talented musicians, artists, writers, people who do everything they can to provide for themselves and their families, and people who care for others in the community. I am always impressed with peer advocates, people who have dealt with many of the difficult issues that others face in the Tenderloin and are now offering their guidance and support to others. I sat down with a group of teenagers at a meeting in the Tenderloin last week and was blown away by their insights, the complexity of their ideas far surpassed what I had at their age. They are facing great challenges, but still were hopeful, had goals, and motivation.

Is drug usage as rampant as its made out to be?  Is reality really as dire as the picture she painted?

For Vice to make an issue of out of substance use is disturbing on a number of levels. One, they pretty much glorified and celebrated Cat Marnell's use, among others. Two, people who use drugs are not necessarily bad people. It is not a character flaw. It is an issue of mental and physical pain, self-medication, and of addiction. Addiction is a disease and it deserves to be treated and viewed as such.

Is drug usage rampant? It's hard to say what percentage of people are actively using. I would guess that it's less than a third, but that's just a guess. I would guess a higher percentage are doing blow at most of the “cool” bars in the city than are using in buildings in the Tenderloin. But, yes, many people are using heavily in the Tenderloin. You cannot walk through the Tenderloin without being offered morphine, roxy, oxy, Valium, etc. Imagine trying to get clean in that environment. I'm in the process of quitting smoking, and though that doesn't compare to coming off meth or a narcotic pain addiction, if I was offered a cigarette every time I walked out of my apartment, I would fail, no doubt.

Vice was pretty down on not just social work, but the Tenderloin as a whole, calling it “a fucked place.”  They also seemed to link the homelessness and poverty with it being a “black neighborhood.”  What's your stance on the link between the amount of SROs and mentally ill with the state of the neighborhood?  Do patients really feel they are better off in the streets than in the SROs?

The Tenderloin is not “a fucked place.” It is a place where bad things can and do go down, but those things are a result of factors local and national, social and economic. One of the things that upset me the most about the article was the statement that the Tenderloin is a predominantly black neighborhood. The fact that Vice published that without even Googling the actual statistics is surprisingly unsurprising. The article talked about the Tenderloin. It talked about the Tenderloin being a bad place, where people have no hope or ambition, and it linked that with being black.

The Tenderloin is not a predominantly black neighborhood. The Tenderloin is somewhere around 10% African American. The homeless population in San Francisco includes a higher percentage of African Americans than the housed population, but while there are many homeless people in the neighborhood, the Tenderloin is nowhere near “predominantly black.” In addition to linking all the negativity in the Tenderloin with black people, that statement serves to show that this person really didn't know the makeup of the community she was hired to serve.

I have visited clients in a number of single-room occupancy (SRO) hotels. I have also worked with clients on issues that arise in these hotels. Some of my clients are in recovery from substance use and have to deal with people dealing outside and inside these buildings. I have had a number of clients allege that staff at some of the SROs are either facilitating or actively taking part in selling drugs. I have been in a tiny room in an SRO on Sixth Street that had no natural light, no cooking facilities, and a bathroom that you could not turn around in. Some SROs are better than others, but some that might seem decent have problems you might not notice in a quick go-through, like noise, broken windows and plumbing, lack of adequate heat, no common space, and infestations. Bed bugs are a huge problem, difficult to get rid of, and cause enormous stress. I have had clients who have been physically assaulted in their buildings and neither management nor police took their complaints seriously. The reason most of the people who you see hanging out on the sidewalk in the Tenderloin are there is because they have nowhere else to go to socialize with friends.

My problem with linking mental health issues with the Tenderloin is it makes it seem like mental illness is restricted to a certain area. Mental health is an issue that the entire city, the entire country, needs to take more seriously. People are poor for many reasons. Some poor people have mental health issues, some have substance use issues, some don't. Some have physical health problems that make them unable to work or fall into debt due to medical bills. But many poor people, including many poor people in the Tenderloin, are working. They stay in the city because there are jobs here, and as bad as Muni can be, there are better transportation options here than in many other areas. The Tenderloin is a complex place and isn't the exclusive home of the mental health treatment problems of this City.

One of the most powerful parts of the Vice interview came at the end of a long bit about the interviewee's loss of “ego” and idealism.  After asserting the job broke her and her convictions, she made a bold claim: “For the most part, people do not want help. They want money or they want drugs or they want death.”  Is there any truth to that?  What's your experience with your clients been like?

Yes, people do want money. It costs money to pay for rent, to be healthy, to get food, to pay citations, to get an identification, to have necessary dental surgeries. Yes, some people want drugs. They are addicted. I can't even imagine the pain someone must be in who needs to get a fix. Is this any different than society at large? People want money; people want drugs; people want their fucking flat screen TVs or their reservations at Flour & Water.

Do people want death? I have clients who have faced death. People who have watched their friends die as a result of substance use, as a result of violence, who have lost an entire community as a result of the AIDS epidemic. People who become suicidal suffer from depression or are living with schizophrenia or a number of other mental health issues. Substance use, which many use to try and cope, complicates and worsens depression. But people, for the most part, want to live, want to have hope, want to be respected as human beings.

Finally, do you think social work in the TL kills something inside of people?

It is difficult work. I know people who do social work who face much greater challenges than I do in my job, people who have done this work for decades. If you feel something is being killed in you, it is time to re-evaluate, and most likely to get out of the work you do. I have seen many of the clients served by my organization succeed, become housed, quit using, enjoy life. I have had clients unleash frustration at me and sometimes the same ones later thank me. I have seen some stumble and get back up, and whose lives take turns for worse.

Not only is it difficult work, it is not high-paying. Not only are our clients being priced out of the city, we are as well. The tech boom is doing a lot of good for a number of people, but these people need to become connected to their communities. The Vice article only serves to further the separation.

Editor's note: For another thoughtful response to Vice's piece, take a look at Dregs One's take on the Tenderloin and social work.

[All Photos by The Tens]

Comments (41)

Good article. I work in the TL sometimes and its very harsh but there is definitely good people and a positive sense of community.

A great opportunity for people to get up on their moral high horses.

Yes, the people have “dignity”. But then there are a lot of other people with a serious lack of it. Criticize bros for drunk and boorish behavior on Santacon and St Pat’s, sure, yet for some reason find aggressive/unsanitary behavior from homeless or transient people above reproach or at worst criticized with a huge asterisk? Yes there are mentally ill and substance addicted folks who need and deserve help out there, but how come it is immoral to just treat them like you’d treat your peers and say what the fuck man. You are shitting on a door step, and really, you don’t have to be doing that. To say nothing of the actual violent crime, which again is excused as if people living in the T/L are children who can’t be helped from committing burglary and assault.

I grew up in subsidized housing in another city and it just looks different when you actually come from a background like that, you want the suburb / nice neighborhood people to understand, but you also want the bad shit to be called out. A lot more of the situations you see on those streets are due to choice than medical, so don’t paint with a broad brush, yes, but also, BAD shit is BAD, whether it’s done by people living in crap neighborhoods or people jumping in uber cabs.

I don’t disagree that aggressive/unsanitary behavior is an issue in the Tenderloin, but there is a difference between the behavior of people who choose to participate in events like Santacon and people who are homeless. For one, most of the people involved in events like that do not live in the neighborhood where they are causing these problems. Another is that solving the problem associated with large events is much easier to address than the systemic issues that do underlie many of the problems in the Tenderloin.

I do think that more should be done to address the livability issues in the neighborhood,. I have been to community meetings in the Tenderloin where these issues are raised, but fines and imprisonment will not solve these problems. There are other ways to address these issues, but we choose not to do so because many San Franciscans take the view that the Tenderloin is “fucked” and that is what I was responding to. If someone is assaulted in the Marina or Pacific Heights, it is huge news and resources are dedicated to address it. If it happens in the Tenderloin, people say, well, that’s the Tenderloin. The vast majority of people in the Tenderloin do not engage in and do not deserve to be forced to live with the challenges because they live in a neighborhood that is low-income. Too often, the solution of dealing with problems in neighborhoods is to push out all the poor people. I do not want to see this city become Giuliani-fied.

I don’t want to see the T/L become like Manhattan either, and I know where you are coming from. Thank you for your perspective. But, I think what you want is for the poor people to magically “win” against the rich people without essentially acting like rich people themselves (i.e. acting selfishly, in their own best interests).

I guess I feel the same way about it as I do my old ‘hood , I left because I knew it was a pit and people that could have pulled themselves up chose not to or just were afraid to stand out from their friends. People inside the neighborhood are the ones who need to take action and fix things. But they don’t. They are too busy pointing fingers at other people to call the cops when someone is robbed or assaulted. Or to bust their asses going to night school to get a better job. So the people who do own property that could have invested in their own neighborhood get tired of it, and move out, and sell to massive developers from outside who don’t give a damn, and it winds up being developers who are the only ones who can make the changes. By using bulldozers and wrecking balls.

When you think about it, whether a social worker is an immature drama queen flexing for Vice or a veteran seasoned person who really does “get it”, it’s pretty much irrelevant and not worth getting upset/indignant about.

As a privileged, highly-educated, middle-class white woman, I won’t pretend to understand the experience of the people with whom The Tens works, but this interview helps me to strive for compassion and a better understanding. Thanks to both of you.

As a privileged, upper-class white man who started life as, quite literally, a dirt farmer on welfare, I do understand some of the experience of the people with whom The Tens works. It is a hard life, but to say that the fact that it’s hard excuses them from responsibility for their actions is often to both dehumanize them and to ignore a rather serious social issue.

Agree, have worked in the social work field for 10 years and personal responsibility for clients is as important as compassion. These are not blank slates being acted on by outside aggressors or the environment ( unless they are children or perhaps have II) it is a combination of environmental factors (poverty etc) and the Choices that they have made. We can do as much good by getting them to take responsibility for and change those choices as to get them housing (therefore changing the environment). The client is always full of agency.

You say “a place where bad things can and do go down”, she says “a fucked place”. It’s all semantics.

Agree. Other than the question of the racial makeup of the TL, I don’t see much actual disagreement between Brian and the Vice article. It’s a question of perspective rather than factual dispute. Brian and the article’s informant both see the same things, Brian just chooses to accentuate the positive and remain hopeful. That’s fine, but I think it’s also understandable to be overwhelmed by the often grim nature of the place and give up hope.

I won’t speak for Brian on this one, but I think there’s a pretty significant difference. Saying someplace is “fucked” implies finality–that what ails it is unsolvable; that social work is ultimately a pointless exercise.

To paint a rosy picture would be dishonest. Anyone who has ever walked through the TL knows it’s not idyllic. But to claim it’s all blood and piss and drugs and death is obviously BS, and dehumanizes disease, mental illness, and San Francisco’s widespread poverty.

My impression was that she was essentially saying her brand of social work is ultimately pointless, at least in terms of ending the cycle of homelessness, drug/alcohol addiction, and crime that she interacts with daily. I think most people involved in social work have had that thought cross their mind at some point. At the very least a feeling of helplessness. Without any sort of concerted economic, and social policy commitments, by both federal, state, and municipal government, it won’t change much. How could you not feel levels of extreme frustration at that prospect?

Yes, the Tenderloin is the way it is because of many overlapping laws and policies – services are not the solution, & lack of services is not the cause. As for social work being pointless, I guess it depends on the worker’s motivation. Mother Teresa never tried to clean up Calcutta, just to help the people living there.

We are currently solving the TL problem.

Of course, we’re solving it by slowly gentrifying it and pushing those folks to Oakland. But it solves the issue for us.

Oh Kevin, just when I thought you couldn’t possibly be any dumber, you go and do something like this… and totally redeem yourself!

Appreciate The Tens perspective on the TL/white nihilism and love that KevMo gave it a space.

Her piece did present the Tenderloin as a spectacle, but a certain subset of the Tenderloin IS a spectacle. It seems to me most people have a problem with that piece because she didn’t give an all encompassing picture of the Tenderloin. Well that’s not really what they were asking her for. It’s Vice magazine. What did you really expect? People don’t pick up a copy of Vice to read an in depth analysis of all of the social, and economic disparities that cause inequality and homelessness in the Tenderloin. You guys really need to stop taking yourselves so seriously.

Also it seems like lately UA is trying to reinvent itself as the blog police? You should change the name from Uptown Almanac to “Hacks Criticize Other People’s Work”.

Holy shit, actual JOURNALISM! Nice job!

Not only was this a nuanced interview, even the comments are (thus far) perceptive and well-reasoned.

What the FUCK happened to Uptown Almanac?

I know! And I don’t mean to jinx it, but we haven’t even had to moderate this thread yet.

just unsubscribed from the vice email list. it hasn’t been interesting in years. this article was good enough reason to dump ‘em.

there is a great scene in the Page One documentary where David Carr schools the Vice editors on their brand of journalism….something along the lines of ‘we’ve had journalists embedded in war zones for decades, don’t think you’re special because you put on your safari hat and took pictures of poop’. Seems like their main purpose with all of this stuff is just to appear edgy, which I guess isn’t much of a surprise for Vice.

Nice article Kevin and props too to Brian.

A great article. Thanks. I posted on his picture page a while ago, about how compassionate, well framed and ‘humanly’ beautiful his pictures
are. In that he does not come across as some cartoon giggling voyeur, but as a person documenting with an artistic and ethical vision.
Now I know why he is such a good photographer. He knows economics, he respects DIGNITY of all peoples, and he has an edge to him.
When I was at a book store on 6th street for two years, I was amazed at the deep rooted dedication of social workers that would come in and hang out, or bring ‘clients’ in. Whereas I have no patience with anyone with any mental problem, they would have this calming common sense nearly mechanical way of dealing with bad situations. Like walking human hearts. These are the underpaid angels of the city. They are even a notch above public school teachers. AND they can’t afford to live here. Those of ‘us’ of the bottom third still living here, really do know
our allies and enemies. And we keep score. “I met an angel on Turk street, she gave me a meal and bandaged my feet, we don’t need no jesus here…..not with all these angels so near…”

Great response, but gotta keep a bit more reality in this. You refer right off the bat to the “poverty problem” … yes, that is a huge piece of the problem but it is simply NOT the root cause. The root cause is substance abuse and mental illness - which are both compounded by poverty.

If otherwise well meaning people in this city would get off their high horses for a minute we could help a lot more of these people get their lives together. Specifically I’m calling for involuntary treatment and if necessary institutionalization. Exactly the kind of thing that the ACLU will lose their mind over is exactly what we actually need.

Once you pass the point where you’re regularly taking a dump in the middle of Market street, once you’ve passed the point where you are taken regularly to the emergency room at taxpayer expense for passing out on the sidewalk, then you need to be institutionalized - period. The government should pay for it as it’s cheaper than dealing with you on the street.

Harsh, perhaps, but I am 100% convinced this would be a better solution to the current do-nothing approach.

Of course long-term care for mentally ill homeless people would be good for everyone involved. I doubt many would disagree. Even if mandatory institutionalization for the most troubled cases isn’t the nicest thing to do, letting people die on the street and eat garbage is fucking inhumane.

But what can you do? The thing about long-term care is you can easily estimate the costs. Americans tend to look at simple numbers like that and freak out. “It’s going to cost x million! That’s so much money!” What Americans are NOT very good at is looking at how much the status quo costs and comparing the two.

Even if we did manage to set up long term care facilities, you can bet your ass it would be the #1 item on the chopping block during the next round of budget cuts. We can’t even agree to fund our schools, do you really think we would be willing to fund caregivers?

I know that sounds negative and hopeless, but there’s a reason this situation hasn’t changed for decades. Wish someone would prove me wrong though.

Thank God for that. You’re talking about imprisoning innocent people without a trial, a release date, or a lawyer acting in their client’s best interests. I think we need to vastly increase funding for mental health and substance abuse services, and if these resources were available very few people would refuse to take advantage of them. However, I’m disgusted that anyone would think that their right to a clean, pretty neighborhood outweighs someone else’s right to not be incarcerated and forced to take psychiatric medications (which lead to wonderful side effects like kidney damage and permanent nystagmus [Lithium] or tremors, sedation, and massive weight gain [most atypical antipsychotics). Read about the abuses in the Washington, D.C. group homes, which went on until 2006, or the use of electroshock treatment to discipline autistic children, which continued up until 2011. Don’t be so sure these people would be better off if they were trapped in mental institutions.

Group homes link: http://www.washingtonpost.com/wp-dyn/content/article/2006/05/30/AR200605…
Electroshock link: http://www.theguardian.com/world/2011/may/25/electric-shock-autism-treat…

Thanks. The line about the TL being predominantly black really stuck in my craw. Also, having lived for 10 years on sixth street, I’m glad you brought up the kids. There are so many kids around there.

What are some ways city transplants in the tech industry can get involved with the Tenderloin, a neighborhood they may rarely walk through?

A good start is to stop thinking that you are in the Tenderloin if you are at Hemlock or anywhere on Polk gulch

Totally! I’m sick of hearing people describe the Hemlock as “in the Tenderloin.” Post and Sutter doesn’t have a whole lot in common with Turk and Jones.

This is a good question. There are the obvious ways, like volunteering with St. Anthony’s, Project Open Hand, or Glide, tutoring kids in the neighborhood, writing to your supervisor, the mayor, other elected officials. I am sure there are much more creative ways that tech people can get involved though.

End capitalism and you instantly end homelessness and poverty……but really great piece Kevmo and Brain. When I lived in Little siagon(Larkin and Ellis) I was very close to the TL(In my world the TL is Market-Hyde -Ellis) The majority of the crack sales were conducted by people who did not live in the area or even the city(Look at the numbers of arrestees during drug sweeps)…Also I Have to agree that most of the blow in this town is being done by people in much nicer bars in this city/country,but that is by design,along with maximum minimum sentences that far out weight creme(crack) compared to blow convictions. End the unjust war on drugs that has been racist since its conception.

If they couldn’t end capitalism in corrupt shit holes like Russia and China, how are we gonna end capitalism in the U.S.?

Conversely, if you think they DID end capitalism in corrupt shit holes like Russia and China, how come they DIDN’T end homelessness and poverty?

Ahhhh…. GOT you there!

Capitalism is not self sustaining. So,in the short term you are right,we are not prob gonna end it. But in the long run,it will/is destroying itself.

Anyone trying to pretend the TL isn’t fucked is in denial. There’s a reason those blocks are so bleak and the streets reek of shit and piss and people get stabbed there- and that reason is that the TL is fucked.

I think your blog is great. You write about very interesting things. Thanks for all the tips and information

You say people are homeless because a lack of affordable housing? Whose fault is it when you cant afford something? the producer or the consumer? Lets be real here if I cannot afford something I can only blame myself for not having enough money or not working enough. Your article is enabling the behavior that takes place in the tenderloin, it’s not their fault, its the government or the system right….. In the end these people suffer their own misery not the system. The tenderloin is the way it is because the people who live in it simply don’t care. You go to neighborhoods where the people care and YOU CAN SEE IT WITH YOUR OWN EYES.

I think All Homeless people must go back where they Coming from.. I Am working hard and all my Tax dumb on them to using.. How come Homeless people not working , doing any thing just doing drugs, alcohol..And enjoy housing, well fare , food stamps..and fuck up every where…. they LIKE PARADE AND DRINKING I really want city must do something like remove 6th or The tenderloin „more hotel„ shopping malls, make it healthy living area…

I think All Homeless people must go back where they Coming from.. I Am working hard and all my Tax dumb on them to using.. How come Homeless people not working , doing any thing just doing drugs, alcohol..And enjoy housing, well fare , food stamps..and fuck up every where…. they LIKE PARADE AND DRINKING I really want city must do something like remove 6th or The tenderloin „more hotel„ shopping malls, make it healthy living area…

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