On the main drag of downtown San Francisco, a bearded man with a tattered t-shirt stumbles into the middle of busy Market Street, carrying a foldable lawn chair.
Two police officers patrolling the area look his way. “We gotta take care of that,” one officer says, but then turns to a man and a woman wearing what looks like typical start-up gear. “Unless you guys can.”
“Yeah, we can take it,” says Jacob Savage, the co-founder of Concrn, a crisis response nonprofit and app whose logo is emblazoned on his purple shirt.
Savage, along with a Concrn volunteer named Abby, catch up with the stumbling man and coax him to the sidewalk. The man tells Savage his name is Brett. Savage pulls out a pen and paper and peppers Brett with questions: Were there services they could help with? Did he need a shelter bed? Had he taken a TB test?
“The cops were concerned about you walking in the street,” he explains.
Savage and Abby are on a “shift,” which means walking around San Francisco’s Tenderloin neighborhood, which is the city’s highest density district for crime and homelessness. They’re monitoring their smartphones for any crises reported by users who turn to the Concrn app to hail civilian intervention rather than escalating a problem to gun-toting police officers. When there are no calls for their help, they spend their time checking in with members of the community and intervening when appropriate.
Abby calls 311, San Francisco’s help line. Good news—there’s a 90-day bed at Providence, a homeless shelter four miles away. Brett just needs to take a TB test—a Department of Public Health requirement—to get a place to sleep for the night. Savage also tells him how to get a California ID so he can start receiving social security benefits.
Savage writes this all down, and hands Brett a little slip of paper with his next steps. A few minutes later, Brett stumbles back into the middle of the street, and then past the Burger King, and then out of sight.
Concrn launched back in 2014 as sort of an aspirational crisis response service. It describes itself as an alternative to 911, helping “connect individuals suffering from homelessness, mental illness, and substance abuse, to the resources they need.” In its founders’ ideal world, denizens of the Tenderloin (and some day, all of San Francisco) report emotional and mental health crises via the Concrn App, and then responders, both of the paid and volunteer variety, spot the reports on their phones and address them as quickly as possible. One hope is that this will prevent the tragic fatalities that can occur when police encounter the mentally ill.
In practice, this works a little differently.
When I first met up with Savage outside The Hall on Market Street, he was holding a trumpet while in conversation with an intoxicated man. He later explained to me that music can be a great tool for de-escalation. But it’s not always the trumpet, he says. Sometimes, he brings a football, which is also popular: Everyone wants to play catch, right?
Savage is a charismatic guy, fluent in both the language of social work and tech. As we walked the streets of the Tenderloin, where Concrn’s resources are focused, it seemed like everyone was happy to talk to him, and quite a few people asked him to play the trumpet.
Getting to know the people in the neighborhood is a major part of the Concrn mission of “compassionate response.” Much like the philosophy of “community policing,” Concrn responders take the time to introduce themselves to residents, officers working the beat, and business owners of the Tenderloin. This way, when someone is in need of help, Concrn responders aren’t appearing as unfamiliar faces introducing themselves for the first time in a moment of crisis.
Savage grew up in Palo Alto, California, with the hope of one day becoming a police officer. He was well on his way, joining the local police cadet program as a high school sophomore. In college, however, Savage grew disillusioned with the profession, not wanting to be involved with the “perpetuation of incarceration.” Years later, he and a friend—inspired by the crisis intervention service CAHOOTS—crafted the idea of Concrn because they thought officers were too often deployed in situations where a social worker would be more effective. Police are trained to deter crime, but when someone’s having an emotional or behavioral health-related crisis, it’s sometimes addressed in an excessively forceful way.
“There’s only so much we can do, because they see us as a threat,” one cop said.
In the four hours we spend together, no crises are reported on the app itself. That’s an unusual day, Savage told me; generally, they receive between three and seven reports per day. It’s clear, though, that a major part of Concrn is simply walking the neighborhood, showing their faces.
Today, Savage is looking for one woman in particular. Last he saw her, she’d thrown a water bottle at a cop, and was in a pretty bad place. Savage spoke to a number of police around the Tenderloin throughout the afternoon; some said they recognized her when shown a picture, some didn’t. All received Concrn business cards, and were instructed to call if they spotted her, an odd twist on how these things usually go.
It’s something police seem genuinely appreciative of, at least anecdotally. After Savage sent the stumbling man on his way, we ran into the two police officers from before. They thanked Savage for his work, explaining those situations can be difficult because homeless folks are (understandably) distrustful of police.
“That was so great that you guys were there,” one cop said. “There’s only so much we can do, because they see us as a threat.”
Not all officers agree on this. In a San Francisco Magazine piece from August, Tenderloin Station Captain Teresa Ewins was quoted as being unsupportive of Concrn’s urging people to report crises to the app instead of the police.
“If they’re convincing people to do that, that’s not really the responsible thing to do,” Ewins said. “I don’t think it’s good for the community to not call the police during crisis situations. That creates a huge safety issue.”
Savage argues this characterization was unfair, and he specifies that Concrn wants emotional and health crises reported through their app, not crises of a dangerous or criminal kind.
“As long as a crisis isn’t associated with an imminent threat to health and safety, we feel we can respond and provide triage when necessary,” Savage says. “If you go to emergency first, you’ve gone to the maximum response. If we get there first, we can make that triage decision.”
Either way, there are some legitimate concerns to address. One is basic accountability. Consider Brett, who was given detailed instructions of concrete steps to improve his day-to-day life but no mechanism to ensure he follows through.
“People like that, I feel, are more receiving the service of positive human engagement than anything else,” Savage said. “I don’t think he’s gonna get his TB test, but we are gonna keep track of it.”
Keeping track means, simply, knowing where people hang out. The Tenderloin is small, Savage points out, and he often runs into clients multiple times in one day when out on a shift.
Another potential issue is scale. Right now, Concrn is staffed with 20 volunteer responders and 8-10 lead responders. No one’s paid yet, though Savage says they’ll soon be able to pay folks $17.50 an hour. Imagine a world where Concrn is deployed seven hundred times a day, not seven. How would they manage those requests? Could they match the responsiveness of a 911 call?
Savage thinks so. Savage sees an eventual world where the members of the community—first in the Tenderloin, and then in all of San Francisco, and then maybe one day even in Oakland—sign up as responders, monitoring the concerns of their own neighborhood.
“It’s all about mobilizing people in their communities,” Savage says. “It’s the only neighbor-to-neighbor response model. It’s called N-to-N; neighbor-to-neighbor.”
For now, they’re largely doing it the old fashioned way: establishing themselves as a neighborhood presence, and hopefully being available when a troublesome situation arises.
Like midway through the day on Monday, when one man looked to be in a bit of trouble. Savage talked to him for a bit, asking if he needed any help securing resources. He said no, but thanks anyway. A beat, and then he asked: “You guys just out here helpin’ people?”