Yesterday afternoon I was going for a bike ride through San Francisco when I witnessed an unconscious man lying in the middle of the sidewalk on Mission St. No one seemed to know what to do. I always carry Narcan (Naloxone) with me because I’ve seen this scenario before. Thankfully, I was able to reverse the potentially fatal overdose and when the paramedics arrived, he agreed with them to go to SF General Hospital for follow up care. 

When the whole world seems like it’s on fire, and many places are literally being bombed into rubble and flames, it can be overwhelming to walk our streets and not know how to find solutions to suffering in our own cities. We can feel lost in the chaos, lost in the fog.

When I got home I tried looking for detailed information about the city’s current street outreach team protocols, and got an error message saying, “We can’t find that page.” Maybe it got lost in the fog.

Last month, I left the job I had for two and a half years as a street based social worker and therapist at the Harm Reduction Therapy Center. It’s a wonderful organization, but like so many community based organizations it has experienced funding cuts from the city. I left the job due to the combination of funding cuts and programmatic cuts (cutting off most foot-based street outreach), in addition to my need to change my schedule. But, as I reflect on the last few years of witnessing the homelessness and overdose crisis on the streets, the main takeaways have been simple: folks who are suffering on the street seek care that is accompanied by compassionate, relationship-based programs. Many folks respond best to a harm reduction model in which city services (shelters or substance use treatment) involves meeting the person where they are at without judgement. Listen to their voice first, get to know their responses to their traumas, and how they are processing it all, without mandating them to immediately go into a program. Yes, some folks respond to abstinence-based programs, but that should be their choice. 

Last year I witnessed the city use a ramped-up enforcement-first approach under Mayor London Breed. It has expanded under the new mayor Daniel Lurie. This has meant SFPD and the Department of Public Works (DPW) moving people off of the street, oftentimes using aggressive and violent means. Preliminary data for 2025 shows an increase in overdose deaths in the first three months with this strategy.

Whether or not we agree with someone having a tent on the sidewalk, do we want our city workers to take away people’s tents before they can retrieve their medications and personal belongings like phones, photos, clothes, or diaries? I spoke to one person who claimed that DPW took her tent despite, her pleas, while her cat was inside it.

More housing options, more types of shelters, more health outreach teams, clinics, harm reduction, and safe-use sites are needed. More rehab beds are needed to deal with the waitlists. 

Looking at these issues as we walk outside, or as we follow the news, we end up absorbing a lot of secondary trauma as well as an overall sense of negativity. Staying socially conscious shouldn’t come at a cost that drains us, depresses us to the point of impairing our functioning.

Looking for answers shouldn’t leave us lost in the fog. For those who are marginalized, social injustice can take away the self-care tools that once helped them stay afloat. And for those less afflicted by systems of oppression, and even for those more privileged, trying to do things in solidarity with the marginalized can be paralyzing.

How do we get over that paralysis, especially during these Trumpian times?

We need to remember to take care of our soul, body and mind. Without coming across as a self-help author, I merely want to share points from conversations I’ve had with other social workers and therapists. One of the biggest factors for my moments of burnout, and I’ve seen this with coworkers too, is when the constant tension of the work and the traumatic injustice takes you away from the things that keep you grounded, and the values that got you involved in this work. We tend to absorb the stress, anger and numbness that we see around us to the extent that it becomes difficult to distinguish our own emotions and response from the responses we have absorbed around us.

We often think of the mind (how to make sense of what we’re experiencing) as the key to fixing our well-being. But body movement is such a good technique to calm and slow the mind down, wipe away the static, and to give you a clearer bird’s eye view of what you’re going through. It can be anything from rigorous exercise to breath work while you’re sitting. The spiritual is the foundation of all of this. It can be understood as what is transcendent, symbolic, and poetic in your life. Both the believer in the Divine and the atheist can focus on the root values of what you feel and think this world should be, and what the purpose is.

With that said, let’s look again at where we are in SF. Streets are being cleared by SFPD, DPW, and ICE’s actions are joining the terror. Our tax dollars are used to police people more and more while federal agencies cut social services and increase military activities.

Continue to speak out, protest, stay up to date, and organize. But as Kendrick Lamar said, don’t let it kill your vibe and take you away from your roots.

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