San Francisco’s Street Crisis Response Teams will undergo a major change starting this Saturday. The city is removing peer counselors from these response units, a role that has been part of the program since its inception in 2020. Moving forward, teams will consist solely of fire department paramedics and EMTs. This decision impacts 19 staff members who were employed by the nonprofit Richmond Area Multi-Services.
During a recent Fire Commission meeting, dozens of residents, former clients, and behavioral health professionals voiced strong opposition to the shift. Many speakers argued that peer counselors provide a unique level of connection born from lived experience that formal medical training cannot replicate. Del Seymour, a former paramedic who experienced homelessness and addiction, emphasized that no amount of classroom instruction can replace the perspective of someone who has survived similar hardships.
City officials framed the decision as a shift toward operational efficiency. Assistant Deputy Chief April Sloan stated that the new team structure aims to return the program to its core mission of handling behavioral health emergencies. The department also plans to adjust service hours, concentrating operations between 5 a.m. and midnight when most crisis calls occur. While fire department officials maintained that their paramedics receive extensive training in trauma-informed care and de-escalation, they did not provide data suggesting that the removal of peers would lead to better outcomes.
The funding for these peer counselors currently comes from the Department of Public Health rather than the fire department, and the contract remains active through the end of the year. Despite the lack of budget-related reasons for the change, the department is moving ahead with the new staffing model. The city asserts that behavioral health calls will continue to be handled by paramedics rather than police officers when the street teams are unavailable. However, many advocates remain concerned that the removal of these specialists weakens the city's approach to crisis intervention during a time of high need.