This is nuts: A bizarre tale of the insanity that is SF's mental health system

Shortly before midnight on April 21, 2001, Jason Grant Garza walked into the psychiatric wing of San Francisco General's emergency room and said he was having a mental health crisis. A staffer there refused to admit him. When Garza insisted on seeing a doctor, he wound up strip-searched and thrown into jail. Now, after six years of legal wrangling and bureaucratic buck-passing, SF General has officially conceded that Garza was denied proper service. But Garza says he is still waiting for the help he needs and the justice he demands.

As I sat across from Garza on a recent afternoon, it wasn't hard to imagine a busy hospital worker or government official blowing him off rather than dealing with his frenetic energy. Diagnosed with a so-called "adjustment disorder," Garza was intense, to say the least. Running his hands through his wiry, gray-streaked hair and leaning over the table as he spoke, the 47-year-old Panhandle-area resident railed against "the system" for well over an hour. At one point, he likened his suffering to that of "a starving kid in Africa ... [except] the starving kid in Africa still has hope. I have none of that."

Garza's ire and his penchant for hyperbole might be exasperating at times, but his behavior also seems to bolster his main contention — that he needs help with his mental health, help that he claims a flawed public health care apparatus has failed to provide. He says his attempts to receive care and support have only exacerbated his condition, increasing his isolation and his sense of persecution. "I'm dead right," he said repeatedly. "And yet I've gotten nothing for it."

Garza declined to recount specific details of his story or be photographed. Instead, he referred the Guardian to a 2003 deposition he gave to deputy city attorney Scott Burrell. According to the deposition, his ordeal began shortly after his lover and "soulmate" killed himself in January 2001. That April, Garza became despondent over his loss and called a suicide hotline. The phone counselor directed him to visit SF General's Psychiatric Emergency Services.

Garza took a cab to SF General and told PES charge nurse Paul Lewis that he was "wigging out" and badly needed to see a doctor. According to Garza's deposition and other court documents obtained by the Guardian, Lewis asked him if he was suicidal. Garza is quoted in his deposition as responding, "If I was crossing the street and fell, I don't know if I'd get up." Lewis determined that this answer meant Garza was not suicidal and thus not in need of emergency care. He asked Garza to leave. When Garza refused, the hospital's institutional police escorted him out.

Garza did eventually get into the hospital that night, but not in the way he was hoping. After he was ejected from the premises, he stole back into the main lobby and called city police to help him receive treatment. But hospital cops returned instead and stuck him in a holding room. Sheriff's deputies arrived four hours later, early in the morning of April 22. They arrested Garza for trespassing and possession of marijuana, even though he had a prescription for medical cannabis in his wallet.

At the city jail, Garza finally got someone to acknowledge that he was experiencing a psychiatric emergency. He says he told jail staffers that he "didn't care if he lived or if he died," and as a result, he was stripped of his clothes and placed naked in a cell for his own safety. "That nurse [at the jail] classified me as an emergency," Garza told us. "So one says I'm in an emergency, and the other [at SF General] says I'm not.... At what point am I going to get any help?"

To recap: When Garza voluntarily tried to find care, he was told he was not sufficiently distressed.

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