The psychiatric emergency room at San Francisco General Hospital is licensed for 18 beds, but on Monday morning there were 26 patients crammed in just about every corner of the small, drab facility. Three men sat in the tiny waiting area in their stocking feet. All patients must remove their shoes because laces can be used as nooses and shoes can be hurled as weapons, a nurse explained. A man in bare feet and hospital scrubs spoke in animated gibberish and twirled like a ballerina in the reception area. Another man, clutching his belongings and looking frightened, whispered to a nurse that he was being followed. A few patients moaned from their gurneys in the hallway, and one hid under a blanket, a human form in light blue.

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