Citywide Case Management — Mental health service in City and County of San Francisco, CA

I’ve been navigating UCSF Citywide and the broader San Francisco “support” system for years, and at some point you realize it’s not just one bad experience—it’s a pattern. My case manager, Stephen Joey Irwin, was paired with me and openly shared that he is a gay white man. This is not about his identity—it’s about power, role, and how this dynamic actually played out. As an immigrant woman, a mother, and someone navigating trauma, custody issues, and instability, I needed support that reflected that reality. Instead, there was a consistent disconnect. Even in conversations where it was acknowledged that he understands what it’s like to be criminalized, there was no meaningful recognition of what it means to move through these systems as a woman and parent—especially within family court and child welfare contexts. Over time, I felt increasingly dismissed. I requested a new case manager and trauma-informed, gender-responsive care. When I expressed grief, anger, and unmet needs, the response wasn’t support—it shifted into defensiveness and distance. I was treated like the problem for speaking up. At the same time, this is someone who has access to my personal history, my vulnerabilities, and highly sensitive information I shared in good faith. I also raised concerns about the use of AI tools and Meta glasses during interactions without my consent. When trust breaks down in that context, the impact is not small—it’s more destabilizing. What’s even more concerning is that both this case manager and supervisor, Alison Murphy, have acknowledged that this program does not fit my needs and has not been as helpful as it should be, often citing “scope” and “policy.” And yet, I remain in it—without a clear transition plan, without adequate support, and without accountability. The referral itself has never been clearly explained. I was referred from Compass, where I was initially offered support—including legal support—and then that support was withdrawn without explanation. Shortly after, there were shifts in staff and administration, and I was moved into another system that also does not meet my needs. This isn’t just about one program. UCSF Citywide operates within a larger network that includes HSH, HSA, CPS, and the family court system. These systems are interconnected, but when something breaks, there is no clear ownership of the outcome. You are passed between programs, given referrals, and left to navigate complex, high-stakes situations alone. For someone dealing with domestic violence, family separation, and legal instability, that lack of support has real consequences. At times, I have even been told I am “duplicating services,” while simultaneously not receiving the level of support required to stabilize my situation. I have asked for basic things: consistent case management, meaningful help navigating services, advocacy, acknowledgment of my rights, reassignment when needed, and support that reflects my situation as someone living with PTSD. What I’ve received instead is vagueness, delay, deflection, and silence. At some point, you have to ask whether these systems are designed to help people—or to manage them. Because from where I’m standing, you can be in the system for years and still be completely on your own, while programs continue to operate under the appearance of providing care.

Nice atmosphere for socializing case management and mental health agency offers home visits a place where you can pick up your prescriptions go to meetings for substance free abuse for mental health or bingo cooking classes another socializing and case management activities. Staff of all types of experience a safe place to go sit eat and watch some TV even take showers. Case management AIDS in housing healthcare communications transportation amongst

I came to CityWide as a broken man, and now I’m home, surrounded by all the amenities and wonderful things they offer. With this case management group, it feels like heaven. They prepare delicious hot meals twice a day, five days a week, using quality food from Costco. If you’re living with a mental health disability, you’ve truly landed in the right place. The staff is cordial, gracious, kind, helpful, and loving. Thank you, CityWide!

Very coveted