San Francisco is falling apart. The city is the wealthiest metropolitan area in the United States, but also has become a haven for tent encampments, drugs, trash, and violence—conditions that are even more desperate and disordered than slums in many developing countries.

Progressive political leaders insist that this stark contrast is the result of capitalism, racism, and predatory housing development. San Francisco’s elected officials preach unlimited “compassion,” but their policies have resulted in a system of incredible cruelty, with record-high levels of homelessness, addiction, and overdose deaths.

Earlier this month, I released a short documentary exploring the contradictions of San Francisco’s homelessness policies. Press the “play” icon above to watch it.

The city now spends more than $1 billion per year on homelessness—including shelters, permanent housing, law enforcement, and medical programs—but the number of those living on the streets has risen 32% in the past decade.

As I demonstrate in the film, the core problem is that the city’s political leaders cannot grasp the true causes and consequences of widespread street homelessness.

Despite good intentions, the city’s policies amount to a regime of extreme permissiveness: The San Francisco Board of Supervisors insists on a policy of free housing for the homeless and, at the same time, the city’s district attorney, Chesa Boudin, has decriminalized public camping, drug consumption, prostitution, and other “quality-of-life crimes.”  

The result is sadly predictable. According to the San Francisco Chronicle, the city’s policies have created an “influx of about 450 chronically homeless people a year,” who migrate to neighborhoods such as the Tenderloin District because they have become a “sanctuary for people who are unwilling to participate in programs designed to get them off, and keep them off, a life in the streets.”

No matter how many “permanent supportive housing” units the city builds, it never can keep up with the rate of migration—dooming these policies to failure.

As homelessness has compounded over the years, the outcome is astonishing: according to the Department of Public Health, San Francisco now has a population of 18,000 homeless individuals, 4,000 of whom suffer from the “perilous trifecta” of homelessness, addiction, and mental illness—which is enormously costly in terms of services and street disorder.

As journalist Erica Sandberg told me: “If our problems could be solved with money, our problems would have been solved a long time ago. It’s not the funding, it’s policy.”

Fortunately, there is a better way. As I explain in a recent Heritage Foundation report, we have a promising alternative to San Francisco’s permissive approach to homelessness.

Rather than focusing on “housing first,” a policy that shelters the homeless while leaving them trapped in a cycle of addiction and mental illness, the most successful homelessness programs prioritize “treatment first.” This approach provides housing, but requires participation in a rigorous program of drug treatment, psychiatric care, and employment training.

According to a three-decade study at the University of Alabama at Birmingham, the treatment first approach can deliver strong positive outcomes for the homeless. In one trial program, 44% of men were stably housed and 53% of men were stably employed after 12 months—breaking the cycle of homelessness and setting them on a path to self-sufficiency.

The lesson from San Francisco is clear: A policy of permissiveness is a road to ruin. Policymakers must focus on the human aspect of homelessness—addressing addiction, mental illness, and unemployment—if they want better outcomes.