I'm not sure what you're pointing out in particular. The homelessness or the fighting? Homelessness is caused by poverty, not by drugs. People fight, with or without drugs. If you don't want to see people fighting in public places, you need a police force patrolling the streets that will actively break up fights, or you need a culture where people will intervene in fights they're not involved in and break them up. It would appear San Francisco has neither.
>At some point you have to be pragmatic and realize that some mental illnesses can't be fixed with more freedom.
I'm fine with a world with more than the absolute minimum number of mentally ill people. Put another way, there are things that are not worth sacrificing in order to have fewer mentally ill people.
>A responsible society provides said structure for those people who need it, and lets the ones who don't be free as you claim they should be.
Well, correct me if I'm wrong, but I believe the goal of a society is to organize efforts in order to accomplish tasks that would not be possible by individuals or smaller groups. "Providing structure to those who need it" seems more like the responsibility of a hospital, not of societies in general. While a society that works like a hospital (rather than merely containing them) is conceivable, I think asserting that one that doesn't is irresponsible is going too far.