Citywide Supports Clients with Serious Mental Illness

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