I was in SF yesterday for a play. Incredible numbers of unhoused in the streets in the rain.
Sometimes, in our town, we'll notice that someone did not pick up after their dog. What we saw yesterday on two occasions were people who didn't pick up after themselves.... kinda startling. They also have workers on many street corners helping keep the unhoused and often mentally ill organized so that folks going to plays or shopping or going to their houses remain un harassed.
I guess we've drifted from catalytic converters to drifters ... but, although not a native, SF was always my favorite city of all time. Something about it is charming and fun, with really nice vistas and lots of fun places and restaurants to visit. But in the last decade it slipped badly for the reasons you cite above, and now I can't even get my wife to join me on business trips. IMO, it's sad when a misguided spirit of acceptance and accommodation results in sustaining a pathetic and unhealthy existence for deeply troubled individuals.