By Mallory Moench
San Francisco Chronicle
SAN FRANCISCO — BART police call it “Hofstein’s Hotline” — a glass case hanging in the department’s substation at Powell Street plastered with pictures of homeless, mentally ill or drug-addicted people whom Senior Officer Eric Hofstein is trying to save.
Right now, he’s fixated on helping a woman he met at the station the day after Christmas. She was gaunt and disoriented, with the leash of her dead dog wrapped around her. He helped her call relatives who live outside the Bay Area. They’d been anxious since the 28-year-old stopped communicating in September, her previously medicated schizophrenia and paranoia seeming to spiral, and felt helpless as they called many city agencies to check on her.
Since then, Hofstein has tracked down where she lives and twice talked with her — first through a crack in the door, and then getting her to open it.
“Most cops don’t go through the academy to be a social worker. I learned that if we say we go through the academy to help people, well, this is helping them,” said Hofstein, who at 54 has the stocky build of a boxer. “They come here (to BART) when they’re desperate, when they’re cold, when they’re hurt.”
BART, a transit agency with its own police force, is on the front lines of the Bay Area’s colliding crises of homelessness, drug addiction and mental illness, which have been worsened by the pandemic. And Hofstein is dealing with the fallout daily. In a count one day last November, half of BART train cars held at least one homeless person. Last year, nearly 40% of BART police 911 calls for service were for well-being and medical assistance.
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Hofstein, a father of four, understands the pain of parents who’ve lost contact with children: His oldest child, who has bipolar disorder, fell out of touch with the family years ago. As an officer, he’s spent the past six years patrolling downtown stations and helping families in crisis navigate San Francisco’s complex web of social services. He’s currently in touch with 26 families, he said.
His boss, co-workers, union president and board directors praised him as intense but compassionate. His former partner, Dave Touye, said Hofstein’s “moral compass points true north all the time.”
Amid national turmoil over policing, BART leadership has debated the role of law enforcement. Some elected directors argue that the system should have more trained officers and secure fare gates so police can reduce time spent on quality-of-life issues and focus on crime-fighting. Others want unarmed social workers to handle such calls under the department’s new bureau of progressive policing.
Hofstein believes that “only a cop” has the needed combination of investigative skills, connections with social services and power to initiate psychiatric holds.
“It’s a balancing act between public safety and quality-of-life issues,” he said.
[READ: Outcomes improve when law enforcement and mental health services combine forces]
Hofstein moved to California from the East Coast in 1987 and worked as a security and jail guard and emergency medical technician before settling into policing. When he joined BART in 2015 and met a woman who had fallen “into the abyss,” he fixated on helping people.
“I became a constructive nuisance,” he said. “I have a talent in life. My gift is I can annoy the s— out of anybody.”
Hofstein channels what he calls his obsessive compulsive tendencies into building rapport with those in crisis, tracking down loved ones and hounding city agencies to get them help.
He clings to successes: A schizophrenic homeless man who used to call 911 every day is now housed and medicated for his mental illness. An 89-year-old Australian woman with dementia who was sleeping on the trains is now in a nursing home. A violent and mentally ill young man was reunited with his mother.
Losses haunt him, such as a text in December from the parent of a young woman found dead from an overdose. It was the fourth young person he’s lost, he said.
“You take this stuff home with you,” he said. “It has a toll.”
On patrol last week, Hofstein and his partner, Nathan Young, ran into some of the regulars whom they hope to get off the streets. At Powell Street, they greeted a homeless man who had emigrated from Iran and graduated with a master’s in nuclear engineering from UC Berkeley. At Civic Center, they saw Michael Lehman, a former high school basketball player who said he became homeless and fell back into drug use a year and a half ago after his mother died.
Lehman called Hofstein “a good person,” adding “we kind of butt heads a little bit, because he does care.”
On the Civic Center platform, Hofstein and Young intercepted a young man just as he threw material he used to smoke fentanyl, a powerful opioid, onto the tracks.
“You gotta be really careful with that s—,” Hofstein said. “I can’t have you down here doing drugs. But, cop hat off, we’re losing a lot of kids out here.
“We want to get you connected to services,” Hofstein added. He asked the young man if he wanted to use a phone to call anyone in his family, but he shuffled away, holding up two pairs of shredded pants and clutching a blanket.
It can take multiple interactions over years for someone to accept care. Yet help isn’t always available when people need it, Hofstein said, citing a lack of adequate 24/7 social workers and crisis response in the city.
The city’s Behavioral Health Access Center, designed as an entry point to the system, is open only during business hours, though the city wants to expand to nights and weekends, said Angelica Almeida, the director of justice-involved behavioral health services. A city street crisis response team that started in November, comprising paramedics, mental health professionals and peer counselors, plans to run daily with 18 staff by March, but now only has three people working weekday shifts.
There are few services other than hospitals available at all hours. The Dore Urgent Care Clinic, which offers 24/7 voluntary non-emergency psychiatric care, is one of the few options, program director Annie Le said. But it has only up to a dozen overnight beds and 48 for long-term programs. Before the pandemic, San Francisco estimated it had 4,000 homeless who were mentally ill and addicted to drugs.
Almeida said that growing the street crisis response team, adding psychiatric care beds and making sure people are getting the right level of care are all part of the city’s multi-year plan to improve mental health services. Many of those plans have been delayed due to the pandemic.
“We’re always looking at ways to enhance our services,” she said.
Hofstein said it can be hard to navigate multiple aid agencies — and get them to agree. He said he and his former partner spent a year pestering a slew of city departments and writing multiple psychiatric holds to get the 89-year-old Australian woman into care at Laguna Honda Hospital.
When someone shows up at an emergency room, Hofstein wants to see wraparound services across departments. He has proposed creating an app for cops, doctors and social workers to share information about their cases. Federal guidelines around patient privacy have often stymied the sharing of information that could make treatment easier.
Hofstein said he referred a couple dozen people to the city-run Law Enforcement Assisted Diversion Program, or LEAD, a collaborative effort that directed nonviolent drug addicts to treatment and social workers instead of jail. LEAD ended in only a few long-term solutions for his referrals, he said, while “political bias” from different agencies could get in the way of working with police. The three-year pilot program, funded by grants, ended in October.
Almeida said the program was beneficial, but that the new street crisis response team aims to reach people before they have contact with officers.
In a city with a budget of $13.1 billion, Hofstein wants more accountability. Lately, he’s been frustrated with the case of the woman who wears the leash of her dead dog.
On Monday, her great-aunt pleaded for a mental health assessment in a letter to the heads of the San Francisco Homeless Youth Alliance, which runs the transitional housing where she lives, and the city’s Human Services Agency, which oversees the social worker handling the case. The great-aunt said she was told by the agencies that they were limited from legally entering the young woman’s room and needed evidence, for example feces on her face, to build a case for a higher level of care.
The Youth Alliance couldn’t discuss the case due to patient privacy. Neither could Jill Nielsen, deputy director of programs for the Department of Disability and Aging Services, who formerly investigated similar cases.
Nielsen explained that social workers investigating reports of self-neglect cases can call police to write a psychiatric hold if they determine a client is a danger to themselves or others or unable to provide for their own food, clothing and shelter. If workers don’t think the case is that extreme, they follow up to connect a client with social services to keep them safe “in the least restrictive setting possible.”
“There’s a lot of nuance,” she said. “Sometimes the persistence and determination of getting to know people makes all the difference.”
San Francisco will have to carry on without Hofstein. He’s taking a retirement incentive package from BART, which is seeking to reduce spending due to the pandemic, and moving to Georgia in March. As he prepares to leave, he’s been handing out his personal cell phone number to families who count on him.
“If you invest yourself that deeply emotionally, that hook goes both ways,” he said. “You’re as hooked to them as they are to you.”
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