[HN Gopher] People with severe mental illness have been failed b...
___________________________________________________________________
People with severe mental illness have been failed by a
dysfunctional system
Author : fortran77
Score : 253 points
Date : 2023-04-11 13:30 UTC (9 hours ago)
(HTM) web link (www.theatlantic.com)
(TXT) w3m dump (www.theatlantic.com)
| Hackbraten wrote:
| https://archive.is/bdOgl
| waynesonfire wrote:
| Reading or watching the news, you're sold the narrative that the
| world is doomed and falling apart. Some people are not equipped
| to deal with such a reality. Most are powerless to change the
| reality but instead internalize the message. Everyday, Lester
| Holt talks about how many tens of millions of people are under
| some weather distress due to severe climate. This is just but a
| sliver, one of countless examples, that contributes to a persons
| misery. And with sufficient resentment and misery, you awake the
| daemon within.
| PuppyTailWags wrote:
| On one hand I want to be sympathetic to the author here, who has
| personal stake in preventing the severely mentally ill from
| murdering people. At the same time, the author doesn't at all go
| into the deeply personal and often traumatic reasons the mentally
| ill may resist being forcibly hospitalized in the way the author
| suggests should be done to them. The author doesn't go into cases
| like Brittney Spears's conservatorship, forced to take medication
| and have an IUD inserted and have her estate taken over by her
| parents under spurious claims of being unable to care for
| herself. The author doesn't go into how little oversight there is
| over ensuring the safety of patients once they're in the
| healthcare system, many of which go on to develop medical trauma
| due to rape, assault, etc.
|
| There has to be some kind of middle way where people who are
| deeply sick can have healthcare even if they are resistant and
| also heavy guardrails in place to prevent them from being abused
| while they're vulnerable.
| woeirua wrote:
| When it comes to mental illness, people should avoid commenting
| on specific cases because the details matter and only the
| professionals involved in those situations actually know enough
| about the state of these individuals to know whether or not
| treatment is warranted. I know "Free Britney!" is all the rage,
| but the Court does not order conservatorships lightly.
|
| No one is arguing that asylums were perfect places. Far from
| it. There was a reason they were shut down in the 60s, but the
| alternative that we were promised never materialized either and
| the result is that we have severely mentally ill people
| wandering the streets now, left to their own devices. The
| results are all too predictable.
| PuppyTailWags wrote:
| > I know "Free Britney!" is all the rage, but the Court does
| not order conservatorships lightly.
|
| This is an assumption, and there's very limited oversight to
| this. That's the problem. The reason with Brittney was
| originally freed was that it was found she was
| inappropriately in conservatorship for years longer than she
| needed to be, and that all of the parties that should've been
| advocating for her were actually paid for by her estate
| through her parents, effectively making it so that anyone who
| advocated too hard for her wellbeing was eliminated from her
| circle. It's unknown how many more people are in this
| situation and, perhaps worse, we don't even know how many
| conservatorships exist!
| teeray wrote:
| The judicial system should, ideally, serve this function since
| both arguments for and against compulsory care can be
| represented and a judgement can be made.
|
| The problem is that it is so costly financially and temporally
| that we can manage one judgement in years for a case rather
| than the greater re-evaluation frequency that is probably
| required for mental health.
| jonhohle wrote:
| Replacing one dysfunctional system for another doesn't seem
| like the best option.
| marcinzm wrote:
| The judicial system is far from perfect even when the people
| involved are free to find their own representation or are
| able to freely do their own research. Someone who is not
| allowed to even access their own finances or sign legal
| contracts will naturally have a much harder time finding good
| legal representation. Someone in an institution even more so.
| ada1981 wrote:
| The challenge is you then have someone whose specialty is law
| making psychological / spiritual / developmental
| determinations.
| dclowd9901 wrote:
| Why are we acting like there aren't objective evaluations for
| "dangerously mentally ill?" Everyone here is talking about how
| the justice system fails at this. Well yeah, it's the justice
| system. They shouldn't (and wouldn't) be there in the first
| place.
|
| This is a psychological problem and it would be dealt with by
| people who have domain knowledge. We're not talking about
| hungry DAs with a political agenda or overworked public
| defenders not doing their job. We can and should evaluate
| people to determine the extent of mental illness and
| mandatorily treat them. Anything outside of that is passive
| misanthropy.
| woeirua wrote:
| As the article makes so plainly clear though, we cannot wait
| until someone is objectively dangerous for two reasons: 1 -
| it leaves very little time to actually intervene before
| something bad happens, and 2 - it removes our best chance to
| actually help someone. The mentally ill need to be treated
| when symptoms first start manifesting if we want to actually
| solve this problem.
| Pet_Ant wrote:
| > we cannot wait until someone is objectively dangerous ...
| it leaves very little time to actually intervene before
| something bad happens
|
| I mean that feels like it's dangerously treading close to
| "pre-crime". I feel like it doesn't take much to extend
| that logic to poor rural children whose mothers are raising
| them in urban gang-run areas. I mean I can see the germ of
| the idea, but it's ripe for abuse.
|
| https://en.wikipedia.org/wiki/Pre-crime
| woeirua wrote:
| CPS can already take children out of homes in spite of
| the fact that no one has died yet in said situation. That
| is for good reason. Failing to act before a crime has
| actually been committed in many of those situations would
| lead to unnecessary deaths.
| dragonwriter wrote:
| > CPS already takes children away from their families in
| spite of the fact that no child has yet died in their
| home, for good reason.
|
| It does so, in theory, based on indicia of objective
| danger (and is not without deep and serious problems in
| when it _does_ act, as well as when it does _not_.)
|
| It very much does not support the position of taking
| action when there is neither crime nor objective danger.
| dragonwriter wrote:
| > we cannot wait until someone is objectively dangerous for
| two reasons
|
| We cannot _not_ wait until someone is objectively dangerous
| before using state power to constrain their liberty in the
| interests of other people's security, because any other
| course of action is arbitrary tyranny.
|
| > The mentally ill need to be treated when symptoms first
| start manifesting if we want to actually solve this
| problem.
|
| If we need to force people into treatment at the moment
| symptoms of what _might or might not_ be mental illness
| that _may or may not_ eventually lead to objective danger
| to other people start manifesting to solve the problem,
| then the cost is simply too high and we _shouldn't_ solve
| the problem.
|
| Not all dangers in society have a mitigation that is a net
| benefit. Just because it would be beneficial _in hindsight_
| in the specific cases where we know _from later events_
| that it _would have developed_ into a manifest harm does
| not mean that you can ignore the cost of all the cases
| where that _isn't_ the case that you would have to sweep
| into the dragnet in order to apply a "when symptoms first
| start manifesting" rule as opposed to a "objective danger"
| rule.
| woeirua wrote:
| You're going to have tyranny either way. Either you have
| oppression of the mentally ill by the government, or
| oppression of society as a whole by the severely mentally
| ill who takeover public places when they become homeless,
| commit murders etc. The rights of a few do not always
| supersede the rights of the many.
|
| I'm not saying we should involuntarily commit everyone
| who shows some symptoms of mental illness. I'm saying we
| should aim to treat those people _before_ it becomes
| necessary to commit them.
| Jiro wrote:
| >We cannot not wait until someone is objectively
| dangerous before using state power to constrain their
| liberty in the interests of other people's security,
| because any other course of action is arbitrary tyranny
|
| Not true. There are nonviolent crimes that are still
| crimes and that you can still jail people for, and which
| the homeless commit lots of.
| A4ET8a8uTh0 wrote:
| Some cases are easier than others. A guy shouts a list of
| conspiracies at a passing cars is probably not as dangerous
| as a guy who talks about thinking of hurting himself and
| others. Key word is probably. As I understand it, there are
| guidelines.
|
| << We can and should evaluate people to determine the extent
| of mental illness and mandatorily treat them.
|
| Risky business man. I think you would need to lock up 100% of
| human population, because the question is always about the
| line of where they fall on the 'unacceptable' spectrum, who
| is making the decision and the societal impact of
| 'mandatory'.
|
| As always, the devil is in the details.
| bnralt wrote:
| We definitely need protections for people who are
| institutionalized. But we also need protection from the members
| of society who are being victimized by mentally unstable
| individuals. Many large cities seem to have no interest at all
| in the latter, to the point where there's a class of unwell
| citizens that the laws no longer apply to. Many are threatening
| people daily, violently assaulting people, committing frequent
| theft, using the streets as a bathroom, etc., mostly with
| impunity, and law-abiding citizens are told to just live with
| it.
| PuppyTailWags wrote:
| I never said anything at all to disagree with what you said.
| People who are mentally unstable should be treated as if
| they're undergoing a health crisis like diabetic shock or
| sepsis or something like this. I am merely pointing out that
| the article has a major blindspot that weakens it, in that it
| doesn't adequately acknowledge that the healthcare system
| might actually be causing more harm to already unstable
| people due to the medical staff abusing them, and there needs
| to be additional guardrails or something similar to prevent
| further harm.
| hitekker wrote:
| The article describes how the author's best friend murdered
| his fiance in a psychotic episode, while his support
| network stood around and praised him for his individual
| spirit.
|
| The GP distinguishes between psychotics, who require
| institutionalizing, the mentally unwell, who need guidance,
| and their victims, who are dead. You glossed over the first
| and last category, so it's fair for the GP to point out
| that ideological blindspot.
| A4ET8a8uTh0 wrote:
| Sadly, yes. I have all the sympathy, but it stops the moment
| it gets too close to my nose ( or that of my family ).
| Anecdotally, my wife works in an environment that sees severe
| mental cases in a relatively well to do area and the numbers
| and stories make me mildly uncomfortable ( mostly because I
| think those are much worse in poverty stricken areas ). And
| then you have to remember people may be hesitant to just have
| their name added to the system ( and general distrust and
| lack of understanding of the rules governing it ); not to
| mention the social stigma that goes along with it.
| fineIllregister wrote:
| > There has to be some kind of middle way where people who are
| deeply sick can have healthcare even if they are resistant and
| also heavy guardrails in place to prevent them from being
| abused while they're vulnerable.
|
| The only guardrails that work to prevent abuse are community
| connections and the right to refuse.
|
| In clinical treatment, many human rights abuses are normalized
| to the point where people being abused believe _that 's just
| what treatment is_ without someone outside the system to
| provide perspective (and usually abuse will continue without
| someone to advocate alongside the person being abused).
|
| It's just an obvious matter of course that people who can't say
| "no" will become objects to the treatment provider. Without
| some counteracting force, providers will manipulate people in
| their care to satisfy their own incentives and convenience.
|
| If people don't want treatment, we should ask what's wrong with
| the treatment, rather than forcing people into it. It's rarely
| helpful and makes things even harder down the line.
| at_a_remove wrote:
| My aunt didn't want treatment because her parents were trying
| to control her. So much so that she had her daughters up on
| the roof trying to disconnect the power lines so her parents
| and her ex-husband couldn't send control messages through the
| wires.
|
| Sometimes people don't want treatment because _they 're
| insane_.
| jschveibinz wrote:
| We just endured a pandemic in which we (100% of Americans)
| were compelled to comply with public health directives. The
| disease killed 0.3% of the population. I wore my mask, and a
| majority felt that compliance was the necessary and humane
| thing to do.
|
| But some-as much as 45% of the adult population-felt very
| uncomfortable with having to comply, for whatever reason. But
| the rule was firm, and those who wouldn't comply were shamed
| for their obstinance.
|
| Over the same period, roughly 0.1% of the population died
| from drug overdoses, and roughly the same number are homeless
| with mental illness.
|
| As a society, and morally and ethically sound individuals, we
| have to be consistent about what is best for public health.
|
| Dangerous people living in squalor on public streets using
| dangerous drugs or failing to take the necessary medications
| to alleviate mental health disease is a public health
| problem-not an individual rights matter. It's not fair to the
| people having to live near them, and it's not fair to our
| society.
| vkou wrote:
| > We just endured a pandemic in which we (100% of
| Americans) were compelled to comply with public health
| directives.
|
| Nonsense. Absolute, utter nonsense. I'm not sure why we are
| all of a sudden rewriting history.
|
| 100% of Americans were _asked_ to comply with a range of
| public health directives. Actual enforcement and compulsion
| of the public ranged from non-existent (In most of the
| country) to symbolic (In a few coastal cities).
|
| A significant fraction[1] loudly, and very prominently
| refused to comply. _They got their way._
|
| An even bigger fraction complied in an incredibly half-
| assed manner. As of today, a mere _16%_ of the US
| population has had an updated booster vaccine. Only 70% of
| the population has _completed_ the first vaccination series
| (But hey, 81% got their first shot, so at least that 's
| something...)
|
| [1] Much of that same fraction, of course, has no issue
| with inflicting involuntary mental health treatment -
| because _it 's directed at other people_.
| ifyoubuildit wrote:
| > 100% of Americans were asked to comply with a range of
| public health directives.
|
| This seems a bit of a rewrite itself. A large portion of
| the american work force was told get in line or find a
| new way to feed and house your family.
|
| Some people like to helpfully point out that's
| technically not forcing anything, but it's certainly a
| little bit more than politely asking.
| mrguyorama wrote:
| Many of those people even COMPARED WEARING A MASK AGAINST
| THEIR WILL TO THE HOLOCAUST.
| itsoktocry wrote:
| > _I 'm not sure why we are all of a sudden rewriting
| history._
|
| Because history was being re-written in real-time, so
| people stopped being compliant.
|
| People started the pandemic voluntarily washing products
| they brought into their homes for crying out loud. Your
| facts agree: 81% got the initial vaccine, because people
| thought it would mean something.
| hotpotamus wrote:
| I saw far lower than 100% of Americans actually comply with
| public health directives, and if those who think being made
| to wear a piece of cloth over their face or take a
| vaccination is an unacceptable loss of freedom, I can only
| imagine the violation of being held against their will and
| forced to take psychotropic medication. I actually don't
| really disagree with your premise, but it (like solving
| most any problem) does not seem possible in modern America.
| robotresearcher wrote:
| First, I agree that mental health and homelessness are
| serious public health problems.
|
| We didn't mask and isolate because 0.3% of Americans died.
| We did it so that only 0.3% of Americans would die.
|
| I'm not sure how the response to the drug epidemic and the
| infectious respiratory pandemic could be 'consistent'.
| jschveibinz wrote:
| Please allow me to clarify. First, it is not clear that
| wearing masks had much if any of an effect on reducing
| deaths during the pandemic. The science is not
| definitive. Isolation was probably a much stronger
| factor; but again, not necessarily causative.
|
| With respect to how the drug epidemic and the pandemic
| are compared: my point was that a majority of people were
| compelled to comply in the case of the pandemic for the
| greater good, so it is not unreasonable to compel a small
| minority of people to comply for the greater good. In
| both cases, those who are compelled to comply are
| theoretically receiving advice and services that are for
| their own good according to science and common sense.
|
| I also recognize that "homelessness" is a catch-all
| phrase that is abused, and that roughly half of the
| homeless are not suffering from mental illness or drug
| addiction. So the solutions to these problems are
| distinct.
|
| My only appeal to those reading this is to consider the
| big picture and to consider solutions that are best for
| all of society. This is a democratic approach.
| habinero wrote:
| I just want to make sure I'm understanding you correctly.
|
| Are you equating wearing a small piece of cloth --
| something all of us are already legally required to do
| outdoors -- with jailing and forced treatment of the
| homeless?
| mixmastamyk wrote:
| Are you equating abject neglect of society's
| responsibilities of caring for our fellow humans with
| freedom?
| habinero wrote:
| Of course not. I'm pointing out people upset with a small
| mandated inconvenience are completely fine with the
| imprisonment and forced medication of others.
| mixmastamyk wrote:
| [dead]
| magicalist wrote:
| That question only makes sense if you beg the question
| and assume that the only way to fulfill "society's
| responsibilities of caring for our fellow humans" is
| "jailing and forced treatment", otherwise it's just a
| rhetorical bit with no substance.
|
| The GP's question was obviously baiting but also follows
| logically.
| mixmastamyk wrote:
| That's your/gparent's phrasing, not mine. I've actually
| worked in a mental hospital, and it was 100x better and
| more humane than the freedom to die from the elements
| and/or eat from garbage cans while yelling at no one in
| particular.
| kerkeslager wrote:
| This is a particularly uncompassionate take, particularly
| with you lumping homelessness into this.
|
| The vast majority of homeless are not homeless by choice.
| Homeless people turn down _shelters_ because shelters aren
| 't homes, and are often legitimately worse than being
| outside. Programs which have offered the homeless _real
| homes_ , with privacy, the ability to safely store
| belongings and keep pets, and the ability to decorate,
| cook, and sleep in quiet, have not had any difficulty
| filling those homes, but these programs are few and far
| between (none exist in the US, that I know of).
|
| The solution to homelessness is homes, period. Not
| shelters, homes. Nothing else will work. Mental health
| treatment is utterly ineffective when the patients are
| suffering the ongoing trauma of homelessness, and any
| system which places mental health as a prerequisite to
| having a home _will not work_.
|
| As such, whatever forceful mental health treatment you're
| proposing as a solution to _your_ fear of the homeless, is
| not going to actually solve your problem. If the homeless
| are removed from the streets and forcibly medicated, they
| 'll end up in the same spot doing the same thing as soon as
| they're dumped back into the world without any real help.
|
| If you actually want a solution that works, you're going to
| have to grow a little compassion and start trying to
| actually help the homeless instead of only thinking about
| how to keep yourself safe from the homeless.
| jschveibinz wrote:
| I have thought about this a great deal, so please
| consider my thoughtful response. Compassion is about
| everyone and everything. I am extremely compassionate and
| I live to reduce suffering for the greatest number of
| people, and animals. It is possible to err on the side of
| providing accommodation to a few, while causing grief for
| the many. This is a calculus that is hard to make, but it
| is necessary nonetheless.
| neon_electro wrote:
| Whose grief? Quantified how? Compared against what
| benefit provided by the "accommodation to a few"?
| briffle wrote:
| > As such, whatever forceful mental health treatment
| you're proposing as a solution to your fear of the
| homeless, is not going to actually solve your problem.
|
| I have a 70 year old family friend that owns a farm, 4th
| generation of his family to own the farm. it butts up to
| the Freeway. His farm is less than 1/4 a mile outside a
| large (~200k) city limits on the west coast.
|
| He has an encampment of 30 or so homeless people living
| on his land. (A spot set aside for nature by the county,
| so its wooded, not actively farmed). this is about 200
| yards from his house. In a typical day, 15 or so semis'
| and old motorhomes pull over along the freeway offramp,
| to buy/sell meth. They cut down the trees, set fires to
| warm themselves, wander trough his property, have stolen
| countless tools, scrap metal, diesel fuel, etc from him.
| Basically a large tent/tarp city, with human waste,
| needles, stolen bikes/cars, (well, stolen everything) Its
| also caused a huge influx of rats, coyotes, and other
| scavengers.
|
| The County Sheriff has told him they no longer respond to
| trespassing and vandalism calls, and to just file a
| report. (they are overwhelmed with them) His 68 year old
| wife will no longer ride her horse on that half of the
| farm, she is scared of them, and if their dogs charge at
| her horses again they might spook them and cause her to
| get really hurt.
|
| One time, before they said no more trespassing calls, the
| sheriff did tell them to leave, they moved their camp
| from the trees, to right alongside the freeway, which is
| owned by the state dept of transportation. they couldn't
| do anything then, since it was state land, and they moved
| back the next week.
|
| once they do clear out, because its private property, he
| is solely responsible for the cleanup costs, including
| the human waste, needles, stolen abandoned cars, etc. He
| could also be fined by the state for cutting down trees,
| etc, in an area that is supposed to be set aside for
| nature. (even though he did not do it)
|
| I understand your ideas, And I am all for building them
| all homes. I am all for compassion, empathy, and helping
| out those that are less fortunate, and need help. But if
| it was funded, today, 100%, that would be 12-18 months to
| build the homes.
|
| There are solutions that need to be done now. And there
| are solutions that need to be done long term as well. We
| should be doing all the things, not just waiting for the
| one perfect thing to be put in place.
| kerkeslager wrote:
| Who is proposing that we wait, doing nothing, for a
| perfect solution to be put in place? I'm certainly not.
| I'm very in favor of harm reduction.
|
| All I'm doing is addressing the only solution which is
| actually going to _solve_ the problem in the long run.
| There remains a persistent refusal to talk about giving
| homeless people homes. Literally not a single response to
| my post has seriously engaged with the idea.
| majormajor wrote:
| Does "free homes for the homeless" possibly work in the
| US without becoming "free basic homes for everyone"? It
| is _ludicrously_ easy to attack politically otherwise (
| "you're working two jobs to make rent for you and your
| family, and now they want to give these people a free
| home that's new and nicer than your crappy old
| apartment!"), and you know the American right would rip
| it to shreds, given they already see social
| security/medicare as too expensive. EDIT: there's also
| the issue of "they don't wanna do things that way, so
| we're gonna give them nicer things; meanwhile, all the
| rest of you should keep following the laws kthx." We need
| to figure out how to reintegrate people into society
| _without_ giving up on the ideas of that society in the
| first place.
|
| From what I've looked up, places with much more
| established shelter programs and capacity than SF have
| fewer problems than SF. It makes zero sense to refuse to
| even start there. Personally, I would start with shelters
| and with programs to try to _prevent_ homelessness in the
| first place; the input funnel is the key variable here,
| because as you mention, everything else becomes much
| harder after that.
| kerkeslager wrote:
| > Does "free homes for the homeless" possibly work in the
| US without becoming "free basic homes for everyone"?
|
| No. Free basic homes for everyone is exactly what I want.
|
| > It is ludicrously easy to attack politically otherwise
| ("you're working two jobs to make rent for you and your
| family, and now they want to give these people a free
| home that's new and nicer than your crappy old
| apartment!"), and you know the American right would rip
| it to shreds, given they already see social
| security/medicare as too expensive.
|
| Easy attacks have easy solutions. Nobody should have to
| work two jobs to make rent, and tiered aid should exist
| for people who aren't already homeless such that that
| isn't necessary (in addition to addressing income
| disparities). Nobody is proposing we give the homeless
| free new homes and give the barely-homed nothing.
|
| > there's also the issue of "they don't wanna do things
| that way, so we're gonna give them nicer things;
| meanwhile, all the rest of you should keep following the
| laws kthx."
|
| I'm not even sure this narrative is coherent. Is the
| implication that the homeless are lawbreakers and
| therefore deserve to be punished... with homelessness?
|
| > We need to figure out how to reintegrate people into
| society without giving up on the ideas of that society in
| the first place.
|
| No, we don't. Which idea exactly are you talking about?
| If there is some idea of our society that is opposed to
| the idea that humans deserve to have their basic needs
| met, I'm pretty on board with changing the idea of our
| society.
|
| > From what I've looked up, places with much more
| established shelter programs and capacity than SF have
| fewer problems than SF. It makes zero sense to refuse to
| even start there.
|
| Who's refusing to even start there? You won't hear any
| perfect solution fallacies[1] from me.
|
| But I'm fully on board with imperfect solutions when
| better solutions aren't available, but your post seems to
| be arguing that we shouldn't even try the better
| solutions, because people might object. It's a weird
| circular argument: we're opposed to trying giving people
| homes because people might be opposed to it? We need to
| change minds, which is why I'm having this conversation.
|
| [1] https://en.wikipedia.org/wiki/Nirvana_fallacy
| 72f988bf wrote:
| > Programs which have offered the homeless real homes,
| with privacy, the ability to safely store belongings and
| keep pets, and the ability to decorate, cook, and sleep
| in quiet, have not had any difficulty filling those
| homes, but these programs are few and far between (none
| exist in the US, that I know of).
|
| This one is close to what you're describing:
|
| https://www.lihihousing.org/tinyhouses
|
| (Consider donating!)
|
| These tiny house villages are real tiny homes, providing
| privacy & dignity.
|
| And you're right about people preferring anything over a
| shelter:
|
| "Some of the people we spoke with told us that if given a
| choice between staying in a nearby homeless shelter or
| spending their nights in a tent, they will choose the
| tent"
| (https://www.krem.com/article/money/economy/boomtown-
| inland-n...)
|
| A tiny house in a small-by-design village is a better
| solution than a tent in a large encampment or shelter.
| kerkeslager wrote:
| That's exactly what I'm proposing, and I'm overjoyed to
| see that happening in the US! Thanks for bringing it to
| my attention!
|
| I'm going to do more research on their finances, but if
| nothing bad comes up I'll probably move a bunch of my
| donation budget to them.
| falcolas wrote:
| In support of this:
|
| Somewhere around 53% of homeless people are employed,
| part or full time.
|
| 40% of people were employed in the same year they became
| homeless.
|
| Definitely feels like a safety net issue and not a
| "homelessness is entirely a mental illness issue".
|
| https://bfi.uchicago.edu/insight/finding/learning-about-
| home...
| bnralt wrote:
| > Homeless people turn down shelters because shelters
| aren't homes, and are often legitimately worse than being
| outside.
|
| I keep hearing that homeless avoid shelters because of
| how dangerous the people are there[1]. And that's a
| legitimate point. But then people completely wipe that
| point from their memory when they say "Just move these
| people to apartments, there will be no problem."
|
| If other homeless are saying that many of these
| individuals are too dangerous to be around, we shouldn't
| be surprised if people who live in apartments feel the
| same way.
|
| [1] https://www.npr.org/2012/12/06/166666265/why-some-
| homeless-c...
| freeone3000 wrote:
| Apartments have doors that lock and walls that isolate.
| That is the point. Shelters _do not_.
| neon_electro wrote:
| "...that shelters are dangerous places, that they're full
| of drugs and drug dealers, that people will steal your
| shoes, and there's bedbugs and body lice."
|
| From your [1].
|
| The reasoning is that dangerous people exist in homeless
| shelters NOT because those people are homeless, but
| because people can exist who want to take advantage of
| homeless people, whether those people are homeless
| themselves or not.
|
| Your conclusion that homeless people living in apartments
| can cause the same reaction based on their previous
| homelessness and no other quality isn't a logical one.
| kerkeslager wrote:
| > I keep hearing that homeless avoid shelters because of
| how dangerous the people are there[1].
|
| Well, I didn't say that. That's part of the problem but
| it's not the whole problem.
|
| In the interview you quoted, the word "dangerous" is used
| once:
|
| _PIRTLE: Part of the reason was, you know, the paranoia
| and the fear of large groups of people that comes along
| with schizophrenia, but part of the reason was, and I
| think this is more generally the case with people, is
| that you hear a lot of terrible things about shelters,
| that shelters are dangerous places, that they 're full of
| drugs and drug dealers, that people will steal your
| shoes, and there's bedbugs and body lice.
|
| And yeah, unfortunately a lot of those things are true._
|
| It's a bit of a stretch to call that evidence of your
| position, but I'll grant the point and move on I guess.
|
| The interview also says:
|
| _PIRTLE: Oh yes, there 's - I don't want to say that all
| shelters are like that. There's a lot of very good
| shelters in this country. But there are a lot of big
| warehouses that are just places where we stick people at
| night and we really don't have any regard for how they
| live there._
|
| ...and:
|
| _PIRTLE: I spent most of my time homeless out on the
| street. It wasn 't until the very end of my homelessness
| that I ended up in a shelter. And I found out that a lot
| of what I was afraid of was true. I never found out what
| a body louse was until I got into the shelter. You know,
| I had my shoes stolen, just like people said you get your
| shoes stolen, although I will say that there were three
| people in the shelter who offered to give me a pair of
| shoes after that happened.
|
| So there is a sense of community there. I don't want to
| give the impression that everyone in the shelter is bad.
| But you have a lot of people with a lot of problems, and
| so when you cram them all together, you just have one big
| problem. That's why I'm a big fan of smaller, scattered-
| sized shelters, where people can get more focus on what
| they need to get help._
|
| Note that the "danger" here isn't "you're going to get
| murdered", it's theft--a predictable consequence of not
| having any place to store your personal belongings when
| you can't actively protect them.
|
| And then there's this part which bears reiterating: _But
| you have a lot of people with a lot of problems, and so
| when you cram them all together, you just have one big
| problem._
|
| Do you see why maybe putting people into apartments might
| actually be a partial solution to this problem?
|
| And you'll note, I'm not actually saying we put them in
| apartments right next to pre-existing tenants. My actual
| suggestion would be to build new housing, and repurpose
| or rebuild unused office and retail space. There's
| clearly a shortage of housing, and that shortage is being
| maintained because it serves to inflate housing prices,
| making a few people rich. If there's anything there
| should be an excess of, it's basic needs like homes.
|
| So it starts to sound like you're responding to a straw
| man argument I didn't make, based on an interview that
| you read very selectively.
| bnralt wrote:
| > In the interview you quoted, the word "dangerous" is
| used once:
|
| If you're familiar with the situation, you know that
| homeless frequently talk about the dangerous nature of
| shelters as a reason why they don't want to stay there. I
| hope that any discussion about the issue would at least
| be aware of that. The article I picked was just the first
| one that come up on Google in case people were new to the
| situation and didn't know much about it, but there are
| plenty of others you can find with even a quick search:
|
| > Likewise, respondents said they found it hard to
| coexist with others battling mental health issues at the
| shelters and that it sometimes led to issues such as
| fights, which made others feel unsafe.[1].
|
| **
|
| > But shelter beds seldom keep pace with need. And some
| people, like Carver, avoid shelters even when they are
| available. They say they feel unsafe and uncomfortable in
| the shelters, or they impose rules they can't follow.[2]
|
| **
|
| > They refuse to go back because they feel unsafe in
| them. Whether due to mere paranoia caused by an
| individual's unfortunate battle with mental illness or is
| a legitimate take on the reality of the conditions within
| the homeless shelter itself, the feeling of unsafety is
| as real as it gets. Some individuals site witnessing
| violence, drug solicitation, or theft as reasons it is
| unsafe to stay.[3] __________________
|
| > And you'll note, I'm not actually saying we put them in
| apartments right next to pre-existing tenants.
|
| That's the way it is being implemented cities trying the
| "housing first" approach, though, and with predictable
| results (long time residents having to move as there's a
| sharp increase in crime and violence in the building).
|
| [1]
| https://www.desmoinesregister.com/story/news/local/des-
| moine... [2]
| https://www.theguardian.com/society/2022/nov/02/unhoused-
| peo... [3] https://caufsociety.com/why-the-homeless-
| refuse-help/
| kerkeslager wrote:
| > If you're familiar with the situation, you know that
| homeless frequently talk about the dangerous nature of
| shelters as a reason why they don't want to stay there.
|
| If you're familiar with the post you're responding to,
| you know that I didn't disagree with that. How many times
| are you going to continue accusing me of this straw man
| argument? I've already told you that's not what I'm
| disagreeing with.
|
| You go on to quote a bunch of support for my assertion
| that shelters aren't homes. People herded into warehouses
| like cattle and forced into close proximity with no
| privacy get into fights? Why is that surprising to
| anyone?
|
| > > And you'll note, I'm not actually saying we put them
| in apartments right next to pre-existing tenants.
|
| > That's the way it is being implemented cities trying
| the "housing first" approach, though, and with
| predictable results (long time residents having to move
| as there's a sharp increase in crime and violence in the
| building).
|
| There are a bunch of reasons why that's happening: among
| them a refusal to re-purpose office and retail spaces
| which would be farther from existing residential areas,
| and intentional poor implementations of these programs by
| political interests so they can say they don't work.
|
| Failures of a poor implementation vaguely related to what
| I'm actually suggesting, aren't actually criticisms of my
| suggestion.
| habinero wrote:
| I don't think I would call any of this take "moral" or
| "ethical", and in the future, I would suggest refraining
| from using those words to refer to yourself.
|
| Homeless people are rarely dangerous. They don't want
| trouble because they know the moment that happens the cops
| will descend on them for a bit of fun. They are easy prey
| for others.
|
| It's also disingenuous to suggest that mental illness is
| the sole cause of homelessness, or that mental illness can
| always be alleviated with meds. Neither are true.
| falcolas wrote:
| Agreed. Over half of homeless people are employed. And
| many (most?) of those can't afford housing (and
| everything associated with housing) with their wages from
| that employment.
|
| Wages in comparison to the cost of living is an issue we
| also talk about, but we never connect the two.
| jvanderbot wrote:
| These arguments make logical sense, but fall flat to me,
| after spending a few years watching severely mentally ill
| people take over neighborhoods, rob, break in, and assault
| the people living there. Near my home, a large man lived
| nearby that began attempting to sexually assault women
| walking to the gym or nearby shops. It became a running joke,
| as nobody would do anything about it. I was regularly
| accosted by clearly mentally ill people who would defecate
| anywhere and yell at anything.
|
| That experience made decide that we're too sympathetic.
|
| For an extreme example, look up the echo park protests. Echo
| park was a great place to take my kids until it was overrun
| by homeless and bodies started appearing. And in the name of
| sympathy and such, protestors attempted to prevent the
| clearing of the park.
|
| https://abcnews.go.com/US/police-protesters-clash-sweep-
| echo...
| PuppyTailWags wrote:
| You see I feel like I'm some bizarre moderate where I can
| understand both the people who want Echo park cleared and
| also the people who are protesting the clearing of Echo
| park. It's not safe for the rest of the community for them
| to be there, but neither has the community provided any
| reasonable other option for them! I've heard of stories
| where people have tried to get housing only to be told they
| wouldn't be allowed unless they got rid of their PTSD-
| specific service animal or some other nonsense that is most
| definitely illegal but they're fucking homeless dude, where
| are they going to get any legal rep or otherwise to fight
| it? But at the same time they literally shouldn't be
| allowed to collectively endanger the community by accosting
| others or anything like that. It's a bad situation all
| around and I think I'm living some kind of crazy town where
| I sympathize with everyone and think there should be a
| solution that benefits all parties.
| jvanderbot wrote:
| That's not being moderate, that's being idealistic.
| You're saying, quite correctly, that there should be a
| better way, but in reality, people are dying in the
| streets next to a bus stop that kids use. The immediate
| problem (chaos) is absolutely a symptom of a larger
| systemic issue, but allowing that fact to impede
| solutions to the the very real immediate problem is not
| productive. You can do both. But to do so we have to do
| something.
| kevingadd wrote:
| "We have to do something, and this is something, so we
| have to do this". :/
|
| Clearing doesn't work! We do sweeps all the time in SF
| and Seattle etc and it doesn't get rid of the
| homelessness problem, it just deepens the problem by
| throwing out the few possessions those homeless people
| have and removing any remaining stability they have. They
| will still be homeless.
| jvanderbot wrote:
| What you said is true globally, but not locally. To those
| who live near the affected area, clearing is one of the
| best immediate options.
|
| But what you said is also wrong: We can do both. We can
| evict unlawful camps where they infringe on the rights of
| others, and we can prepare better solutions. We don't
| need to stop one to wait for the other, no matter which
| one you do first.
| shkkmo wrote:
| Just doing clearing without solving the other side of the
| issue is an example of the classic "tragedy of the
| commons" where people make decisions that benefit a few
| people greatly while having a larger negative impact that
| is distributed among a much larger group of people.
|
| While we can do both, we need to start with preparing
| better solutions FIRST, because if we do clearing first
| we make the problems we need to solve with the better
| solutions worse.
| jvanderbot wrote:
| > we need to start with preparing better solutions FIRST
|
| Disagree. Keep the peace first. That's basically where
| we'll not agree, I think. and that's ok. No sense arguing
| without further depth.
|
| FWIW, I'll claim without evidence that if your daughters
| couldn't leave their house for fear of the man under the
| bridge raping them, then you might change your answer. It
| absolutely changed my answer.
| shkkmo wrote:
| > if your daughters couldn't leave their house for fear
| of the man under the bridge raping them, then you might
| change your answer. It absolutely changed my answer.
|
| Quite possibly as I don't pretend to be a saint who
| always puts society ahead of myself. (Edit: this is the
| heart of the tragedy of the commons, everyone is making
| rational choices we can be sympathetic with but the end
| result is that things end up getting worse for everyone
| over the long term.)
|
| However, I would do it with a heavy heart since I know
| that while I am protecting my (hypothetical) daughters, I
| am doing so at the cost of putting someone else's
| daughters at risk instead while also making the overall
| situation worse.
| jvanderbot wrote:
| I respect your (hypothetical) altruism.
|
| This isn't tragedy of the commons, because the whole of
| humanity does not end up worse with these actions. I'm
| not convinced that clearing an encampment makes the
| average wellbeing across humanity go down. These
| arguments turn a blind eye to the harms to surrounding
| people and the homeless involved.
| PuppyTailWags wrote:
| But I never _agreed with_ impeding the forceful solution.
| I merely said I find it _sympathetic and understandable_
| to do so. You 're misunderstanding me in the exact way
| where I think I'm in some crazy land where I think
| everyone is acting sympathetically but no one else seems
| to be capable of believing this. I firmly understand the
| absolute need for the community to try and protect its
| housed people, but I also acknowledge the very same
| community is doing so because it has no protection for
| its unhoused people.
| UncleOxidant wrote:
| > after spending a few years watching severely mentally ill
| people take over neighborhoods, rob, break in, and assault
| the people living there.
|
| I've been thinking lately that the modern zombie genre
| might be influenced by this. Sort of a metaphor for what's
| happening in a lot of cities.
| kerkeslager wrote:
| > The only guardrails that work to prevent abuse are
| community connections and the right to refuse.
|
| These _aren 't_ the only guardrails that work to prevent
| abuse, and each has their limitations. Independent oversight
| and advocacy also work: in family court custody
| disagreements, the court appoints an advocate for the child,
| who has access to inspect living arrangements and gather
| other information to determine if the child is being abused
| or neglected by one or both parents. Of course these systems
| have limitations also, and the reality is that ALL these
| systems ideally would be in place.
|
| As usual, the underlying problem is greed. For-profit
| healthcare means that healthcare providers will cut cost and
| fight regulation on anything they can get away with, and that
| means that oversight is lax and independent patient advocacy
| is absent. Until we stop trusting corporations and assuming
| that amoral profit-seeking will lead to good results, these
| problems will not be fixed.
| retrac wrote:
| > If people don't want treatment, we should ask what's wrong
| with the treatment
|
| This reasoning works with most illnesses, including most
| mental health problems. But it sort of falls apart with
| psychotic illness. A common symptom of schizophrenia is a
| denial of any illness, or ill-functioning. In extreme cases,
| an individual may show no appreciation of the fact that e.g.
| being socially isolated and with no income will probably
| quickly kill them. I'm usually the advocate for the agency of
| people -- I do point out the opposite in another post in this
| thread, that many people with schizophrenia are aware of
| their illness and impairments, because many are. But many are
| not. Even with truly perfect treatments with no side effects
| that completely cleared delusions and clouded thinking, many,
| because of their illness, would choose not to take such
| treatment.
| shkkmo wrote:
| The awareness can also wax and wane within a single
| individual. A friend of mine has been forcibly hospitalized
| several times and the trauma inflicted severely impacted
| his desire to seek treatment during his more aware periods.
|
| When I finally got him to reach out to care providers
| (since as just a friend, there was no way to setup
| inpatient care as an intermediary) they made it so
| difficult for him to enroll that no only did that moment of
| clarity pass without getting treatment, it also burned up
| whatever status as an ally that I still had with him.
|
| So while changes to commitment laws absolutely can be part
| of a solution, they must be paired with deep introspection
| into the despicable failures of our mental health system to
| provide appropriate care. Otherwise we risk inflicting
| additional trauma that will make managing future crises far
| more difficult.
| baremetal wrote:
| >When I finally got him to reach out to care providers
| (since as just a friend, there was no way to setup
| inpatient care as an intermediary) they made it so
| difficult for him to enroll that no only did that moment
| of clarity pass without getting treatment, it also burned
| up whatever status as an ally that I still had with him.
|
| That is tragic. There is no ready alternative when health
| care providers fail.
| outside1234 wrote:
| These are all problems and we need a better solution that
| includes some sort of oversight over the care of these folks.
|
| But the solution can't be that severely mentally ill people
| can say NO to treatment and then are allowed to basically
| threaten anyone on the sidewalk 24/7 and/or camp because they
| refuse housing.
|
| This is just not working and the 98% of the rest of us have
| had enough. There needs to be a way to get them help, with
| oversight from someone that advocates for them, but without a
| mechanism where they can just say no. They are mentally ill
| and not competent to make these decisions.
| account42 wrote:
| > There needs to be a way to get them help
|
| Cool it with the doublespeak. If you don't let them say NO
| you are helping yourself and not them. This is hardly the
| first time I have seen calls to "get them help" when really
| it's all about getting rid of undesirables.
|
| > because they refuse housing
|
| That too should result in us investingating _why_ they
| refuse that housing rather than forcing it (or worse) upon
| them.
|
| > They are mentally ill and not competent to make these
| decisions.
|
| And that kind of thought has lead plenty of abuse.
| l33t233372 wrote:
| > That too should result in us investingating why they
| refuse that housing
|
| We're talking about people with severe mental illness.
| They are not able to reason effectively and rationally.
| habinero wrote:
| That's flat out not true.
| l33t233372 wrote:
| I'm not sure what you mean. Not being able to reason
| effectively is basically the definition of severe mental
| illness.
| habinero wrote:
| That's a frankly stale misconception based on old
| prejudice and Hollywood tropes. It's unmoored from
| reality.
|
| Mental illness is not a monolith and it does not present
| the same way for different people.
|
| It also doesn't mean you lose any ability to reason or
| understand what's being done to you.
|
| I would highly recommend you refrain from commenting on
| this topic until you can correct your broader
| misunderstandings. Sharing misinformation and FUD helps
| nobody.
| l33t233372 wrote:
| > Mental illness is not a monolith and it does not
| present the same way for different people.
|
| I agree. Of course it isn't. However, saying that people
| affected by severe mental illness are able to think
| clearly and rationally is almost definitionally false.
|
| If their ability to think clearly and rationally were not
| afflicted, they wouldn't be experiencing a mental
| disorder.
|
| Further, just saying that I have misunderstandings, am
| spreading FUD, and should stop commenting without
| yourself providing cogent reasons why I am mistaken helps
| nobody.
| sp332 wrote:
| I get it, there are people you want to disappear so you
| never have to look at them again. Declaring these people
| mentally ill and letting sanitariums kidnap them off the
| street for profit is very appealing.
| outside1234 wrote:
| Definitely not saying that. We just can't continue
| pretending that the current approach is working. They
| need treatment.
| [deleted]
| throwaway22032 wrote:
| In extreme cases mental illness manifests in violent
| behaviour, suicidal behaviour, etc.
|
| Most of us, including those of us with mental illness (which
| is effectively everyone to some degree), don't want to live
| in a society in which antisocial individuals are permitted to
| "refuse" to be treated. Their victims do not have that same
| privilege.
| bolanyo wrote:
| How do you know that 'most of us' feel that way?
|
| I definitely do want to live in such a society.
| throwaway22032 wrote:
| The rule of law, and non-elective incarceration for
| violent behaviour, are about as old as time itself.
|
| You can remove the laws if you like, societies will
| simply begin self-organizing around removing antisocial
| elements (or removing themselves from the situation e.g.
| downtown decay).
| habinero wrote:
| I just want to point out that we have several people in
| this thread talking about the blatant tyranny of being
| asked to wear a small face covering...
|
| ...while simultaneously advocating for the state to
| imprison and forcibly medicate others.
|
| It's also interesting that you value "a nice downtown"
| more than "liberty".
| throwaway22032 wrote:
| On the one hand, we have a perfectly functioning member
| of society being forced to wear a mask, when they don't
| even have a disease, for the sake of overly-anxious
| individuals.
|
| On the other, we have someone who might decide to live in
| a random place in a tent, shit in the street, swing
| bricks in socks around on the trains etc.
|
| I'm far more worried about the degenerates on my route
| from the train station than I ever was about coronavirus.
| vkou wrote:
| > I'm far more worried about the degenerates on my route
| from the train station than I ever was about coronavirus.
|
| And I'm personally far more worried about the _'
| degenerates'_ who might get my immunocompromised
| grandfather sick, than the people I meet on my way to the
| bus stop. You probably would be too, if you were sick, or
| lived in a 'better neighbourhood', or were better at
| analyzing long-tail risk[1].
|
| Unlike the people refusing to vaccinate, he doesn't have
| a choice in his condition. He gets to live with the
| selfish, ignorant decisions made by others.
|
| [1] Contagious, preventable diseases maim and kill vastly
| more people every year than <mentally ill people who are
| refusing to take meds>[2], but for some reason, you're
| more scared of the latter than the former.
|
| [2] The solution to them is a pinprick, and sometimes a
| day of discomfort. The solution to mental illness is
| often a lifetime of meds that make you either want to
| crawl out of your skin, or feel utterly dead on the
| inside, or be completely disembodied, or just plain make
| you suicidal. There's a good reason people refuse
| medication for their issues. There's no good reason for
| why people refuse to get vaccinated.
| throwaway22032 wrote:
| No-one is proposing that all mentally ill people
| (effectively all people) are forcibly medicated.
|
| Only those that are an acute danger to themselves and
| others, degrading the world around them on a non-
| statistical basis.
|
| The alternative is to imprison them.
|
| You are engaging in a strawman here.
| habinero wrote:
| Valuing a nice walk over human freedom, autonomy and
| dignity sure is an interesting choice for a person who
| claims to be moral.
| throwaway22032 wrote:
| Dignity sure is an interesting choice of word to use to
| describe ferals.
| vkou wrote:
| > Most of us, including those of us with mental illness
| (which is effectively everyone to some degree), don't want
| to live in a society in which antisocial individuals are
| permitted to "refuse" to be treated. Their victims do not
| have that same privilege.
|
| You're making an excellent case for mandatory vaccinations.
| throwaway22032 wrote:
| In the case of mandatory vaccinations, the victims are
| few whereas the requirement is placed on many.
|
| In the case of acute mental illness, the victims are many
| whereas the requirement is placed on few.
|
| The situations are not comparable.
|
| I think a more reasonable analogue would be that I am
| making the case for mandatory isolation for sick
| individuals.
| vkou wrote:
| > In the case of mandatory vaccinations, the victims are
| few whereas the requirement is placed on many.
|
| > In the case of acute mental illness, the victims are
| many whereas the requirement is placed on few.
|
| No. Mentally ill people harm far fewer people than
| preventable infectious diseases do. COVID killed over a
| million people in the US in three years, and seriously
| injured many, many more. How many deaths can you
| attribute to mentally ill people, that you'd like to
| forcibly treat in that time? A few dozen? A few hundred?
|
| And the 'requirement' is _far_ more onerous and invasive
| in the latter case. If mental illness could be cured with
| two shots and a day of discomfort, you might have a leg
| to stand on. It can 't be, which is _why_ mandating
| treatment is rife with abuses, and obvious moral and
| medical problems.
|
| > The situations are not comparable.
|
| They aren't comparable because the ROI of mandating
| vaccinations is _much_ better than the ROI of mandating
| mental health treatment.
| throwaway22032 wrote:
| There's about as much logic in what you're saying as "we
| lock up criminals, therefore we should require everyone
| to be vaccinated".
|
| Regardless of the merits of vaccination, it's nonsensical
| to make this sort of analogy, and I have better things to
| do than engage with this.
| vkou wrote:
| It's an entirely apples to apples logical comparison. The
| problem is that you don't like what the 'mandate unwanted
| medical treatment for the benefit of society' garden path
| leads down towards.
|
| You simply choose to not quantify the very real harm that
| unvaccinated people inflict on people around them. You
| assign it a value of zero, by calling it 'statistical'.
| It's illogical and irrational to do so, though. The harm
| is real, it's quantifiable, and people are suffering and
| dying from it.
| woeirua wrote:
| The problem is that there is no perfect treatment for severe
| mental illness. We cannot cure it. Many of these drugs have
| major and serious side effects, which is why so many people
| stop taking them.
|
| So the only question then is what will you do with these
| people? Do you let them continue to deteriorate under their
| own agency to the point where they become violent? That's not
| humane to their (inevitable) victims. Do you commit them
| involuntarily? That's not humane to the patient themselves.
|
| Unfortunately, someone's human rights are going to be
| trampled in this scenario, the only question is _whose_.
| mullen wrote:
| > Do you let them continue to deteriorate under their own
| agency to the point where they become violent? That's not
| humane to their (inevitable) victims. Do you commit them
| involuntarily? That's not humane to the patient themselves.
|
| The Law should take care of this person. If someone is
| violent, then they should have caught the attention of law
| enforcement and thrown in prison or put into a mental
| institution because they are violent. The problem is that
| The Law is not acting on the violent people who are
| homeless.
| throwaway8689 wrote:
| Involuntary admission is not automatically inhumane, but
| you do need to be admitting people to well-run hospitals
| and have a system in place to protect everyone from
| malicious admission. Both of those things cost money.
| kerkeslager wrote:
| > The problem is that there is no perfect treatment for
| severe mental illness. We cannot cure it. Many of these
| drugs have major and serious side effects, which is why so
| many people stop taking them.
|
| > So the only question then is what will you do with these
| people? Do you let them continue to deteriorate under their
| own agency to the point where they become violent? That's
| not humane to their (inevitable) victims. Do you commit
| them involuntarily? That's not humane to the patient
| themselves.
|
| > Unfortunately, someone's human rights are going to be
| trampled in this scenario, the only question is whose.
|
| It's true that we don't have perfect cures for many mental
| illnesses, but as a society we aren't even treating mental
| illnesses close to the best of our abilities. I'm not ready
| to give up treating mental illnesses and start trampling
| human rights when we haven't even _tried_ giving people
| effective and affordable healthcare.
|
| There's a narrative that we're trying to help people and
| they're not accepting help, and that's possibly true in a
| minority of cases, but in the vast majority of cases our
| society is just not doing anything for people that could
| reasonably be expected to work, and then we're blaming them
| for it.
| secondcoming wrote:
| > If people don't want treatment, we should ask what's wrong
| with the treatment, rather than forcing people into it. It's
| rarely helpful and makes things even harder down the line.
|
| This is ridiculous.
|
| Some people who are mentally ill cannot make informed
| decisions for themselves. If the voices in someone's head
| prevent someone from getting treatment, it's not the
| treatment that's the problem.
| mixmastamyk wrote:
| Yes, either these folks are competent to make decisions, or
| they are not. A significantly binary decision.
|
| Deeming them competent to make treatment decisions but not
| to face consequences for their behavior has been an
| absolute disaster.
| shkkmo wrote:
| > Yes, either these folks are competent to make
| decisions, or they are not. A significantly binary
| decision.
|
| Except it is not binary. "Competence" is an arbitrary
| threshold we place upon a spectrum and where people fall
| on that spectrum can vary significantly over time.
|
| > not to face consequences for their behavior has been an
| absolute disaster.
|
| They face lots of consequences, life in poverty on the
| street is extremely harsh and it punishes bad choices
| severely.
| mixmastamyk wrote:
| The law is reasonably clear in this area, with
| established precedent and procedures. Used to be
| followed.
|
| Not the consequences I'm referring to, rather law
| enforcement.
| anon291 wrote:
| > If people don't want treatment, we should ask what's wrong
| with the treatment, rather than forcing people into it. It's
| rarely helpful and makes things even harder down the line.
|
| This statement only works under the assumption that the
| person is thinking logically. We don't ask those who are
| unable to exercise reason for their decisions. As an example,
| my infant broke her finger recently, and needed stitches and
| bandages and a cast. If it were up to her, she'd take the
| bandages off and play in the mud. Luckily, she has parents
| who know better despite her kicking and screaming. If only
| some adults were so lucky
| VonGuard wrote:
| SF's favorite game is to send ambulances out to a guy sitting
| on the street, screaming insane things, covered in his own
| feces and trying to punch people. Ambulance shows, guy says
| "No!" and so everyone says "Oh, this person is doing just
| fine, leave them alone." And everyone leaves, and the guy
| goes back to covering himself in his own filth and shouting
| at people. Definitely a great outcome for all involved.
|
| If the people advocating for the homeless and mentally ill
| have a better solution than leaving them on the streets to
| rot, then I would like ot hear it. Because 100% of the
| solutions proposed in SF amount to "Leave them alone, they
| are fine." So fucking sick of it. It is VERY clear when
| someone needs help, but our society would rather let them
| suffer in the streets than do anything. Anyone who tries to
| help or suggests getting them off the streets is a fascist.
|
| Homeless advocacy in the Bay Area amounts to "Maintain the
| status quo, do nothing to help. Punish those who try to take
| back their own homes and streets from people covered in filth
| and perpetually addicted to drugs and violence." SFFD former
| captain who was beaten senseless this past week in SF is
| literally in the hospital while 2 of the 3 people who beat
| him with a crowbar remain on the streets. Even when these
| people are violent, we do nothing. KRON4 interviewed one of
| his attackers on TV! Guy's still in his camp on the streets,
| still angry and dangerous. Attack is even on camera!
|
| We live in a society where those who follow the laws are
| constantly punished for minor infractions like parking
| tickets and zoning violations, while people who do not
| participate in society AND completely flout the laws in every
| way are not only allowed to do so, there is a huge section of
| our population that encourages and protects their right to do
| so.
|
| It is supremely infuriating to watch the Bay Area be so
| completely backwards and so utterly dogmatic as to ignore
| problems and constantly attack people for not being
| progressive enough. We literally have conservatives
| disassembling democracy across this nation, and the Left's
| favorite game to play is "Can we castigate more progressives
| for not passing the acid test."
| hattmall wrote:
| You worry about conservatives destroying Democracy but all
| of the most desirable places to live for people who aren't
| rich enough to afford private segregation are conservative
| areas. Are there any liberal areas where it's actually nice
| to live if you are poor or of moderate income? As in not
| wealthy enough to afford, doormen, gated communities and
| private schools?
| majormajor wrote:
| It's hard to answer this question if we don't have any
| examples of what you think of as conservative "nice
| places to live." The affordability bar varies wildly even
| in red states, and you also have red state/blue city
| stuff going on a lot.
|
| So I'll turn the question back like this: what do you
| think are nice places to live _that have demonstrated
| effective solutions to affordability and mental health
| problems at scale in a relatively dense city with high
| property prices from high demand_?
|
| In my experience, the way this is "fixed" in a city like
| Phoenix is a combination of: "be able to sprawl outward
| further and further without yet getting completely
| blocked by geography so there's always somewhere to put
| new construction to keep costs down" and "have inclement
| weather that pushes the homeless out so we don't have to
| be the bad guys ourselves as much" - but these are
| basically the opposite of the most common proposed "if
| only the government could get it together" fixes for SF:
| denser construction and confinement. Those tools are
| likely necessary for a city like SF, but _it 's not like
| there are Republican cities showing how to get it done_.
| jrumbut wrote:
| Massachusetts (and most of New England) is great. I own a
| large house with a mortgage that's cheaper than a shared
| studio in San Francisco and I never worry about locking
| the door.
|
| Neighbors are all friendly, well behaved kids roam the
| street unsupervised, it feels the same way it did 30
| years ago here. It's deep blue territory. The weather is
| terrible and the Red Sox have gone off the rails, but you
| can't have everything.
| hattmall wrote:
| Ok, so can you be more specific that's a large reason,
| but my understanding was it's very expensive there? So
| what is an average home price like, and is there any
| significant diversity diversity? Massachusetts as a whole
| looks to be as much as 80% white.
| jrumbut wrote:
| There is a huge range, parts of Boston and the NYC
| suburbs that extend into CT might compete with San
| Francisco on astronomical prices (and real estate market
| absurdities) and parts of Maine will compete with
| anywhere in the US for cheapness.
|
| The average is not as meaningful here because there are
| places all along the scale (except in Boston, again, kind
| of crazy there, but there are commutable suburbs with
| fairly reasonable prices).
|
| No place is going to have the same diversity, fun, or
| nice weather like San Francisco. Certainly not in New
| England. That why it sounds like studios are going for
| $2500 or more there and I have a 3bed2br house for less
| than half that here.
|
| The cool thing is I'm 15 minutes from downtown Worcester,
| 45-60 to Boston and Providence, and 2.5 hours to NYC. I
| find that I get out in one city or another about as often
| as people who live there, but am also able to take more
| trips internationally because I'm not spending a fortune
| on housing. But if you're the kind of person who really
| is taking full advantage of what a place like San
| Francisco has to offer then it probably does make sense
| to live there.
| Mezzie wrote:
| > Are there any liberal areas where it's actually nice to
| live if you are poor or of moderate income?
|
| Lots of the Great Lakes Region. I live in a liberal area
| where the average house price is ~150-200k and I rent a 2
| bedroom, ~1000 sq. ft. apartment in the middle of the
| city within walking distance to things for $950.
| hattmall wrote:
| Ok, that realistically is the kind of answer I am looking
| for. Thanks, can you give any more specifics because
| great lakes region is pretty large.
|
| Though I also think you may benefit from a bit of the
| weather being inhospitable to most of the poor and
| homeless.
|
| Also what is the diversity like?
| Mezzie wrote:
| Mid sized cities in the region are very habitable,
| diverse, and reasonably priced. Indianapolis, Columbus,
| Cincinnati, Lansing, Green Bay, Springfield, etc. The big
| cities are harder but still better than the coasts, $$
| wise. I think Milwaukee is reasonable, though.
|
| Diversity will vary a lot. The manufacturing cities are
| pretty diverse: My city is about 60 percent white and 40
| percent POC.
|
| They do lean more towards 'working class' liberal than
| 'professional' liberal. More 'rah rah unions' and less
| Ibram Kendi. Though if you're in a university city or
| capital, both are decently represented. If you meant
| other than racial, I haven't had a problem being gay in
| any of those areas since the mid-00s and a lot of those
| cities have small but thriving immigrant populations and
| the cities are small enough that there is political
| diversity coming in from the burbs/rural areas.
|
| I feel like those areas are more diverse than the big big
| cities I have lived in. (Boston, Seattle, Vancouver).
| pnathan wrote:
| > SF's favorite game is to send ambulances out to a guy
| sitting on the street, screaming insane things, covered in
| his own feces and trying to punch people. Ambulance shows,
| guy says "No!"
|
| Roughly - without the violence - a friend watched this
| precise scenario last fall in Spokane, WA. If the person
| had been within hospital grounds, the paramedics & security
| could have restrained them under grounds of inability to
| make choice, given them medications, and maybe helped them
| some. But, since the person was a block away from the
| hospital, there was no ability to say, "buddy, you have
| feces all over you and are laying with flies all over.
| we're gonna take you in, hose you off, launder the clothes,
| then see what we can do for your mental state". That would
| have been the kindest thing to do.
|
| The crux is that certain "out of your mind" states require
| external intervention, and there is no legal way to apply
| that in many jurisdictions today. Note that some
| jurisdictions require a trial-like apparatus for
| involuntary holds after some 24/36? hour period - I don't
| that's inappropriate at all. Being able to see a guy laying
| covered in filth and take him in to help should be legal;
| at least for 24 hours. The indigent will have their debt
| forgiven - hospitals know they don't get blood from a
| turnip.
|
| It is true that some medications don't work for everyone,
| and some medications produce horrific side effects. So
| there is some % of people for whom the best medication
| regimes today do not work. That has to be considered and
| reflected through. It's also true that there's high
| correlation with addiction and homelessness. That all has
| to be considered and addressed.
|
| Considering institutions. As I've had a good friend for a
| long time with mental illness who has been in wards, the
| quote from the article is very true.
|
| > I disliked the hospital, but even with its heavy locked
| door, I knew it wasn't a branch of the "carceral state"
| devised by a power-mad society to torment him.
|
| And this has to be understood by everyone who thinks
| through this. Mental wards in the United States today are
| not, conventionally, torture chambers for mad doctors. They
| are restrictive and often frustrating, for reasons that a
| little thought should reveal. Aberrant nurses and arrogant
| & high-handed docs exist there, but they are not,
| systemically, the norm. It is not a horror movie.
|
| TBQH, I don't think the vast majority of mental health
| writings online by non-experts touch on severe mental
| illness in anything approximating a realistic way.
|
| The status quo is really quite unacceptable. My druthers
| would be to re-institutionalize and keep a very high legal
| and regulatory scrutiny on the institutions. Other
| solutions might work well too. But a key cornerstone of
| improvement will have to come to changing the shape of the
| law for involuntary holds and medication for people in high
| crisis.
| notch898b wrote:
| >The indigent will have their debt forgiven - hospitals
| know they don't get blood from a turnip.
|
| Lol I was taken involuntarily to the hospital. When they
| gave up billing me they simply turned it over to
| collections to let them deal with squeezing the blood
| from the turnip. (not mental though, fraudulent
| accusation by federal agents I had drugs up my ass and
| then dragged there in handcuffs).
| fineIllregister wrote:
| > Mental wards in the United States today are not,
| conventionally, torture chambers for mad doctors.
|
| I've worked on an inpatient psychiatric unit, and while
| the doctors might not be "mad", it absolutely is torture.
| The most obvious example is sleep deprivation, which is
| definitely torture. This is done in the name of "helping"
| the person (by checking on them), but makes things so
| much worse.
|
| > My druthers would be to re-institutionalize and keep a
| very high legal and regulatory scrutiny on the
| institutions.
|
| This does not and can not work for reasons outlined in my
| original comment. The system claims to be helping but
| shuts down any feedback mechanism that would suggest
| otherwise. There's just no way to square that circle.
| Dylan16807 wrote:
| > I've worked on an inpatient psychiatric unit, and while
| the doctors might not be "mad", it absolutely is torture.
| The most obvious example is sleep deprivation, which is
| definitely torture. This is done in the name of "helping"
| the person (by checking on them), but makes things so
| much worse.
|
| Checking on them how often?
|
| Is it worse than a normal hospital?
| pnathan wrote:
| Figure every 15 minute someone looks through the door to
| make sure you didn't harm yourself. Mileage might vary by
| ward and illness.
|
| Some wards are noisier than others.
|
| I've heard of a camera in-room as well. Better for
| disturbance, worse for privacy.
|
| Note that these people in acute inpatient wards are in a
| serious crisis: attendants _have_ to make sure they
| aren't hurting themselves.
| PuppyTailWags wrote:
| You might benefit from looking at personal experiences of
| what a psych ward is like. There's a furry comic called
| Fresh Meat about the partially fictionalized experiences
| of a teenaged girl in for attempted suicide, where one of
| the beginning sections she is forced out of bed from a
| dead sleep in order to be transferred to another ward by
| being shoved out of bed and then when she's asked not to
| be touched the nurse tells her there's much worse that
| can be done to her besides touching. She is also withheld
| food and water until she signs a consent form that allows
| her to be kept indefinitely, but also she cannot leave
| the facility on her own will because she's in a
| psychiatric hold.
| fineIllregister wrote:
| If someone is punching people, that's a legal issue. That's
| not really something the medical system has tools to
| address.
|
| To the rest of your scenario, no one says they're "fine".
| Just that the person has the right to choose no medical
| treatment. You also have that right. If a doctor says you
| will certainly die without treatment, you can say no. The
| doctor doesn't write in the note that you are fine, just
| that they offered and you did not want it. It's not a
| "game", it is the ethical and legal requirements of the
| role.
|
| You assume your proposed intervention will "help", but what
| is your basis for that claim? What signals should they be
| looking at to guide the course of treatment? For doctors,
| the answer can be vital signs, tests, but those don't help
| here. Usually, they're looking at patient input.
|
| > If the people advocating for the homeless and mentally
| ill have a better solution than leaving them on the streets
| to rot, then I would like ot hear it.
|
| Properly funded, voluntary community treatment. It is
| possible to design services such that people want them;
| I've seen it (yes, even people experiencing psychosis). You
| have to train providers in engagement skills and actually
| empower the person receiving services. Traumatizing them
| with regards to health care is not going to help.
|
| Fixing it requires and robust social safety nets at the
| federal level. A municipality cannot do it alone.
| spaced-out wrote:
| >Just that the person has the right to choose no medical
| treatment. You also have that right. If a doctor says you
| will certainly die without treatment, you can say no. The
| doctor doesn't write in the note that you are fine, just
| that they offered and you did not want it. It's not a
| "game", it is the ethical and legal requirements of the
| role.
|
| The issue is that the people we're talking about don't
| have the mental faculties to make these decisions. Do you
| think someone in the state they're in, barely even aware
| of where they are, unable to even speak or stand up
| straight, would be allowed to sign a legally binding
| contract? Of course not, any court would throw out any
| contract they signed because they're obviously not
| mentally able to make decisions like that. Same goes for
| decisions about their health.
| [deleted]
| dionidium wrote:
| > _You assume your proposed intervention will "help", but
| what is your basis for that claim?_
|
| This question causes pause because people are afraid to
| state the obvious: it helps _society_ first and foremost
| and then we can work on the individual once we get them
| off the street. If somebody is in the process of robbing
| a bank we do not ask whether stopping the robbery is best
| for the bank robber.
|
| This is what _basically everybody_ believes, but a very
| small minority that 's extremely good at moral blackmail
| (and well represented in this thread) knows exactly what
| to say to make this morally normal and obvious position
| seem somehow nefarious.
|
| The mentally ill drug addict has failed to live up to
| their societal obligations in basically every sense (even
| if through no fault of their own) and must _first be
| removed_ from the street before anything else can happen.
| ABCLAW wrote:
| >Ambulance shows, guy says "No!" and so everyone says "Oh,
| this person is doing just fine, leave them alone."
|
| No, no one says 'this person is doing fine'. It's 'we're
| medical staff and we can't arrest people - they are clearly
| withholding consent, we can't do anything else'.
|
| I've stayed with distressed homeless people trying to hurt
| themselves while social worker teams, cops and medical
| staff came to the scene; if the homeless individual doesn't
| want help and is not an active danger to others there's
| very very little that can be done to forcibly detain them.
|
| > If the people advocating for the homeless and mentally
| ill have a better solution than leaving them on the streets
| to rot, then I would like ot hear it.
|
| Fund shelters and support groups well enough that trying to
| get off the streets and get help doesn't require that you
| bunk next to someone who has a shiv and is experiencing a
| massive heroin withdrawl event while you try to sleep.
| There's a reason homeless people dodge a lot of so called
| 'help'. It's because the help is often worse than the
| alternative.
| baremetal wrote:
| I've befriended and fed a certain individual in south San
| Jose who would stand on a the corner of Bernal and Santa
| Theresa and yell at the air. Anyone familiar with the
| area knows who I am talking about.
|
| He is extremely lucid most of the time. And a very
| grateful and warm hearted individual. But he cannot for
| the life of him access any services, food stamps or
| healthcare or anything. The police can't even help him.
| They all know him. No one seems to be able to help him.
| I've fed him and been his friend, I don't know what else
| I can do.
|
| He has no ID nor way to get ID.
| bolanyo wrote:
| > If the people advocating for the homeless and mentally
| ill have a better solution than leaving them on the streets
| to rot
|
| The comment you are replying to put forward exactly such a
| solution: that treatment should be helpful enough and
| sufficiently respectful of users' rights, that people who
| need it don't refuse it.
| pc86 wrote:
| You can't reason the person smearing shit on themselves
| and screaming at people into treatment.
| cwmoore wrote:
| The eagerness to reason from the headline anecdata on
| this topic is a signal that it is not just the mentally
| ill who exhibit severe thinking problems.
|
| No, you can't reason with that one person at that moment.
| Get them sedated, cleaned up, new clothes and a haircut,
| and then ask them what is going on with them.
|
| For each one like that there are another 10,000 people in
| various forms of quiet desperation.
| [deleted]
| [deleted]
| UncleOxidant wrote:
| > Get them sedated
|
| Kind of tough to get them to that first step willingly.
| Got any other ideas?
| cwmoore wrote:
| <del>Willingly was your idea.</del> As for other ideas,
| some are in the comment.
|
| What about the 10,000 who might be willing if society
| offered them treatment options even a sane person would
| accept?
|
| EDIT: because sibling comments are willfully ignoring my
| point
|
| EDIT2: public disturbances are frequently halted with
| police arrest, not whatever willingness could be brought
| about ahead of time with better systems in place
| pc86 wrote:
| Willingly wasn't necessarily their idea, that's the whole
| point of this thread - getting people into treatment by
| their own choice vs. forcing them:
|
| > > > ... treatment should be helpful enough and
| sufficiently respectful of users' rights, that people who
| need it don't refuse it
| cwmoore wrote:
| The list of people who need help is so much longer than
| any one causing an event that makes it into the
| newspapers or anecdotes.
|
| Why is it such a fantasy that treatment options should be
| appealing to the people committing themselves to them?
| smcg wrote:
| presumably, in order to obtain consent. non-consensually
| committing someone raises issues that must be addressed
| to prevent abuse.
|
| I live in a state with 72 hour minimum emergency
| involuntary committal. (further requires a court order)
| this is a compromise that addresses the above concern.
| ideally it is enough for the patient to get on a routine
| of taking meds and making sure there aren't adverse
| reactions from them.
| UncleOxidant wrote:
| We used to fairly easily commit people to asylums. There
| was lots of abuse of this power. Mental institutions were
| very bad places (see One Flew Over the Cuckoo's Nest).
| Finally the pendulum started swinging the other direction
| starting in about the 50s (in the 60s JFK called for
| reform) and culminating in the 80s when Reagan
| effectively emptied the mental institutions (but more for
| budgetary reasons than any concern for the mentally ill).
| And now we've reached the other extreme where we're too
| afraid to violate the civil rights of the mentally ill so
| we let them stay on the streets because that's what they
| "want" to do.
| dragonwriter wrote:
| > culminating in the 80s when Reagan effectively emptied
| the mental institutions (but more for budgetary reasons
| than any concern for the mentally ill).
|
| "Reagan" getting credit or blame for this is largely
| misleading. There were a number of drivers..
|
| Deinstitutionalizations was an important goal of the
| Community Mental Health Act of 1963.
|
| Subsequently, a series of federal court rulings in the
| 1970s which restricted involuntary commitment and
| required paying patients federal minimum wage for doing
| work in and for institutions (like the prisons, mental
| institutions were slave institutions - on top of their
| myriad other problems - in all but name) undercut both
| the pipeline and the financial underpinnings of the
| system of institutionalization.
| cwmoore wrote:
| I think too many basically sane people are close enough
| to losing their minds at all times that they would fear
| for their own civil rights. The mentally ill on the
| streets are only a small sample of a spectrum.
|
| I understand the history well enough to note that a wide
| swath of (also) expensive alternatives have not been
| tried yet, or the basically sane people mentioned above
| would be willing to undergo treatment that works.
| [deleted]
| afthonos wrote:
| That's...not a solution. That's a goal.
| [deleted]
| jquery wrote:
| Longtime resident here (15 years). It's easy to become
| frustrated with the complex and persistent issues of
| homelessness and mental illness in San Francisco. However,
| it's important to acknowledge that there are numerous
| groups and individuals who are passionately working to
| create positive change in the lives of those affected.
| They're offering essential services, advocating for policy
| changes, and developing programs to tackle the systemic
| issues that contribute to homelessness and mental health
| challenges. It's simply not true that homeless advocates
| and organizations just want to maintain the status quo.
|
| Second, it is not a question of punishing those who follow
| the law, but rather addressing the systemic issues that
| contribute to homelessness and mental illness. By focusing
| on parking tickets and zoning violations, you're missing
| the bigger picture of societal inequality, lack of
| affordable housing, and inadequate mental health care. This
| isn't about passing a "progressive acid test", it's about
| practical solutions that work and are politically feasible.
|
| Lastly, your comment oozes contempt for people who are
| struggling with addiction and mental health issues.
| Labeling them as "people covered in filth and perpetually
| addicted to drugs and violence" is not only dehumanizing
| but also incredibly counterproductive. We must work
| together to find compassionate and effective solutions,
| rather than resorting to name-calling and finger-pointing."
| jstarfish wrote:
| > SF's favorite game is to send ambulances out to a guy
| sitting on the street, screaming insane things, covered in
| his own feces and trying to punch people. Ambulance shows,
| guy says "No!" and so everyone says "Oh, this person is
| doing just fine, leave them alone." And everyone leaves
|
| The flip side of this is forcibly transporting people to
| hospitals and slapping them with $10-15k bills for a
| glorified taxi ride.
|
| Homeless can't pay that, so small wonder they're left
| there. But you or me? _No sir, you 're unable to make
| decisions for yourself; we absolutely need to take you in
| for evaluation._
|
| Your wallet is biopsied on the way to the hospital, where
| the _real_ fun starts.
|
| Be very afraid of an America with forced medical "care."
| blackguardx wrote:
| There is a public hospital called SF General where people
| who can't afford medical care are treated.
| DesiLurker wrote:
| I dont know why you are downvoted but bad faith
| compliance is absolutely a thing. whats to stop city from
| sending such a patient to nearby private hospital in the
| name of 'medical necessity'. who decides who needs to
| forcibly hospitalized? if you fall into a puddle and
| somebody calls an ambulance would you rely on the
| ambulance driver's judgement to decide if you need the
| $10k ride to hospital?
|
| with healthcare you always have to think about bad faith
| operators because there is zero transparency and no free
| market there.
| jstarfish wrote:
| > if you fall into a puddle and somebody calls an
| ambulance would you rely on the ambulance driver's
| judgement to decide if you need the $10k ride to
| hospital?
|
| In the US, the fire department shows up first and
| administers first aid. Private transport to the hospital
| is arranged after that if needed.
|
| The problem is all the advance-fee bullshit. You're
| billed $1000 per minute starting with your occupation of
| a gurney, and that doesn't guarantee you will receive any
| sort of treatment once you get to the hospital. If you're
| not destined for a trauma ward, you'll sit in a room for
| six hours, be discharged without even a diagnosis (or the
| lolworthy "mild concussion"), and have incurred a debt
| equal to the cost of a new car for the experience.
|
| These days, you don't even get a bottle of Oxy as a
| consolation gift-- you get _nothing._
|
| It's exploitative even when _good_ faith operators are
| involved.
| nobody9999 wrote:
| >would you rely on the ambulance driver's judgement to
| decide if you need the $10k ride to hospital?
|
| $10k for an ambulance ride? Is there any documentation
| for that claim, or is it just hyperbole?
|
| According to the San Francisco Fire Department[0], an
| ambulance ride is ~$2400 (which includes lifesaving
| services), plus $46/mile[1.61km].
|
| By my calculation, an ambulance would need to transport a
| patient ~165 miles (266km) to make an ambulance ride cost
| $10k.
|
| For some perspective, It's ~160 miles from San Francisco
| to Fresno[1].
|
| I'd expect that San Francisco EMTs don't deliver patients
| to Fresno, or even outside the San Francisco city
| limits[2]. Since San Francisco is 46.9 sq miles (121 sq
| km) in area, a $10k ambulance ride is incredibly unlikely
| at best.
|
| N.B: I do not live in the Bay Area. It took less than 30
| seconds to confirm the costs above via DDG. Not sure how
| GP (and others) came up with a number 400% higher.
|
| [0] https://sf-fire.org/services/ambulance-billing
|
| [1] https://www.distancecalculator.net/
|
| [2] https://en.wikipedia.org/wiki/Nota_bene
|
| Edit: Added Nota Bene[2].
| teachrdan wrote:
| This comment is hopelessly obtuse. Most Americans can't
| even afford a $1000 emergency expense; the $2400 expense
| you cite is already unaffordable. Add in any ER fees the
| hospital charges -- which can easily be part of what GP
| refers to -- and you'll probably get to that $10K figure
| anyway.
|
| Don't believe me? Here's what happened right here in SF
| when a bicyclist with a broken arm was taken to the local
| public hospital, SF General:
|
| "A few months later, Dang got a bill for $24,074.50.
| Premera Blue Cross, her health insurer, would only cover
| $3,830.79 of that -- an amount that it thought was fair
| for the services provided. That left Dang with $20,243.71
| to pay, which the hospital threatened to send to
| collections in mid-December."
|
| > came up with a number 400% higher.
|
| A moment with a calculator would show you that the number
| GP uses is _300%_ higher, not 400% :)
|
| https://fortune.com/recommends/banking/57-percent-of-
| america...
|
| https://www.vox.com/policy-and-
| politics/2019/1/7/18137967/er...
| nobody9999 wrote:
| >This comment is hopelessly obtuse. Most Americans can't
| even afford a $1000 emergency expense; the $2400 expense
| you cite is already unaffordable. Add in any ER fees the
| hospital charges -- which can easily be part of what GP
| refers to -- and you'll probably get to that $10K figure
| anyway.
|
| I didn't say there weren't problems with the system, or
| that most folks (let alone homeless folks) could afford
| such things, but 400% more than the published cost?
| That's hyperbolic and, more importantly, incredibly
| imprecise.
|
| I see you disagree with that. I agree that you disagree
| with me. Have a lovely day.
|
| Edit: removed extraneous text.
| brightball wrote:
| > We literally have conservatives disassembling democracy
| across this nation, and the Left's favorite game to play is
| "Can we castigate more progressives for not passing the
| acid test."
|
| I have to say, a rant like that about how things are in SF
| ending on that note caught me off guard. You explained in
| detail all of these problems and closed out that you're
| worried about conservatives?
|
| I have to ask...why?
| majormajor wrote:
| The "left" as practiced in SF fails to get anything done
| and lets things fester and worsen through neglect.
|
| But... the evangelical/nationalistic right, on the other
| hand, comes out and says exactly all the things they
| want. Less healthcare, less regulation of the powerful,
| more cops for the less well-off, more weapons, less
| sexuality that they don't like, etc. "Fixing mental
| health" isn't in that list. "Building more housing" isn't
| even on that list. There are a LOT of people with good
| reason to be scared of those moves.
|
| Tell me which of these I should think is more feasible:
|
| 1) Working with democrats to add some practicality to how
| to get to the desired outcomes I support?
|
| 2) Trying to convince the right that they should change
| almost all of their goals?
| NoMoreNicksLeft wrote:
| I might be accused (by some) of being on the right.
|
| It's not that I don't want to "fix mental health". Who
| wouldn't want to wave that magic wand and be able to
| justifiably claim to be the savior of what I sometimes
| read is as high as 20-40% of the population of our
| country?
|
| That said, I feel like it's a problem that can't
| reasonably be solved by anyone. Not because they're
| unwilling or incompetent, but that the science just isn't
| there. Everyone today wants to solve infectious disease,
| after all. And we actually manage (sometimes) to
| accomplish that. But if the year were 800AD and you
| complained that those in charge weren't solving the
| perplexing miasmas and dark humors that were making
| people sick with the black death...
|
| You'd have been a fool. No one knew how to deal with
| those things then. And no one knows how to do something
| about mental health now. There seem to be medications
| that sometimes help some people, but when they don't work
| (or when they do!) no one can give a straight explanation
| why. The psychologists fail to give us a working theory
| of the human mind such that we can (even hypothetically)
| understand why someone is schizo. Or depressed. Or has
| OCD.
|
| Don't get me wrong. I am not blaming the left for not
| fixing this. It's just intractable. Everything I see
| suggests it's likely to remain so into the indefinite
| future.
|
| Both sides should stick to "building more housing" if you
| ask me.
| splitstud wrote:
| [dead]
| VonGuard wrote:
| The point of SF's progressive movement is to fight back
| against conservative policies with an example of what
| progressive politics can accomplish. It's not exactly
| working out now is it? SF itself is the city where all of
| the beautiful progressive ideas come together in harmony
| and make a heavenly place. It is absolutely incorrect in
| that assessment of itself. Spend 5 minutes at a city
| council meeting and you will see exactly what I mean.
| Same thing happens in Oakland. The city spends an awful
| lot of time commenting on what's going on in conservative
| areas and passing rules and laws that seemingly address
| those things but are really just talk. And then they
| continue to ignore the real problems of crime and
| homelessness. Oakland and SF love passing support
| statements for people having issues in other states, but
| can't get their own Police Departments to even show up to
| do their jobs. Priorities are entirely wrong.
| [deleted]
| colpabar wrote:
| There are a lot of people on the left who have never ever
| liked conservatives or republicans but who are extremely
| frustrated at what the left is doing. They seem to be
| failing on a lot of things, and conservatives seem to be
| succeeding, but whenever we criticize the left or suggest
| something other than what the current thing is in
| progressive circles, we're called fascists.
|
| More importantly though, it kinda sucks you focused on
| the tribal aspect of the comment because it was full of
| other things to engage with.
| brightball wrote:
| It was simply the part that surprised me the most. I've
| heard so much of the rest of the topic that the poster's
| mindset was the newest information from my perspective.
| throwaway22032 wrote:
| I'd guess that the idea is that left wing politics in a
| lot of places has gotten bogged down in ridiculous
| notions of "just do whatever you want, everyone has
| kindness within them" and lets that override the normal
| concerns about cohesion and wellbeing in society.
|
| You can have socialism, redistribution, a progressive
| society etc., whilst also recognising that no, you can't
| just park your tent wherever you want and bother people.
|
| You can support the fact that people might have
| unorthodox sex lives in private whilst also believing
| that people who parade the fact that they "have multiple
| genders" are attention seekers.
|
| The best way that I can describe the feeling I have is
| that effectively, there's no "upper bound" for
| compassion/empathy in the modern left-wing framework and
| that crashes and burns when it hits the real world.
| [deleted]
| danans wrote:
| > Because 100% of the solutions proposed in SF amount to
| "Leave them alone, they are fine."
|
| The mayor actively supports changes to state
| conservatorship law that would allow authorities to force
| people into treatment.
|
| https://www.sfgate.com/politics/article/san-francisco-
| treati...
| notch898b wrote:
| >We live in a society where those who follow the laws are
| constantly punished for minor infractions like parking
| tickets and zoning violations, while people who do not
| participate in society AND completely flout the laws in
| every way are not only allowed to do so, there is a huge
| section of our population that encourages and protects
| their right to do so.
|
| At the end of the day it's inconvenient to punish homeless
| for crimes. They have no money, they're often infected with
| disease, and they are often unpleasant to deal with.
| Meanwhile when I did absolutely nothing wrong, federal
| officers bragged to me what a great vacation it was to drag
| me to the hospital for the better part of a day on a
| fraudulent and fabricated search for "drugs" because they
| said it was better than doing their normal beat, and it
| paid great overtime. People say you should be polite to law
| enforcement, but the fact is being
| unpleasant/unpolite/filthy works.
|
| Like most humans, a frightening amount of law enforcement
| boils down to they did it because it was easiest. Dealing
| with mentally ill people at their worst moments is not
| easy, extorting a well to do professional for going 5 over
| the limit is much easier.
| DannyBee wrote:
| We used to force hospitalization, and one result was the states
| would force hospitalize people to avoid having to pay for their
| benefits/etc. They would lock people up and forget about them
| forever.
|
| There are plenty of examples of institutions that destroyed
| tons of people (some of whom were not even actually ill)!
|
| My older brother, who is mildly bipolar (functional but can't
| really hold a job long term) was sued by the state of new
| jersey when he was a teenager to hospitalize him, because they
| didn't want to pay for school/etc.
|
| The judge scolded them in the end, but that was a huge time
| spend, money spend, and emotional painful thing for my family
| that lasted years.
|
| There are of course no perfect systems, but one of the
| practical problems is that there is no real part of the system
| that actually cares about the mentally ill, and is actually
| incentivized to do that.
| lumb63 wrote:
| An ounce of prevention is also worth a pound of cure. More
| important than investing resources into helping those with
| mental illness is preventing people from developing mental
| illness in the first place.
|
| Traumatic experiences like you mentioned can be reduced by
| better education about what to look for in healthy
| relationships, or providing accessible resources to catch
| issues early before they become major issues. Other, more
| subtle, issues like neglect, poor home life (often due ti
| poverty, difficult family situation, etc.) would require more
| pervasive changes to address, but if prevent issues in society
| on the back end due to reduced incidence of mental illness, not
| to mention the improvement in quality of life for those
| affected, we should seriously consider those options.
| PuppyTailWags wrote:
| I fully agree that we should be working on preventing ACES
| and other environmental effects that specifically have proven
| out to have causal effects on mental illness. But psychosis
| cannot be eliminated altogether, and if someone is psychotic
| I would both like them to be allowed back into health even if
| they do not give informed consent _and also_ I would like
| them to not be raped, assaulted, or otherwise abused.
| lumb63 wrote:
| Definitely agree. It's not either or, and both issues
| should be given attention; however I think reducing the
| incidence of mental illness is more fruitful than
| correcting the negatives of it after the fact.
| vkou wrote:
| Indeed. Its strange how people have no issue with forcing
| medical treatment (which carries serious side effects) on the
| mentally ill, while at the same time, opposing mandatory
| vaccinations (which carry vastly less serious side effects, and
| are incredibly effective at reducing injury and death from
| infectious diseases).
|
| It's obvious why this hypocrisy is present. Mentally ill people
| are 'scary' and forcing treatment on them makes _them_
| uncomfortable, and _me_ comfortable, it 's an easy sell. But
| when medical treatment is forced on _me_ , all of a sudden, my
| body autonomy becomes the most important thing in the world,
| and I'm dipping into horse paste and counting each myocarditis
| case. (And conspicuously neglecting the consequences of not
| vaccinating.)
| chaostheory wrote:
| This incident, others like it, and the homelessness problem
| squarely falls on Reagan and the Kennedy's for making it near
| impossible to commit people to mental health care for those that
| need it.
| bjoli wrote:
| Isn't this the same old discussion that was recently ignited
| again by the Mr beast's glaucoma video? The US is a country where
| some people just can't afford not to be blind (or mentally ill).
|
| Their largest hope is for a millionaire influencer/Deus ex
| machina to appear and pay ther treatment.
| ixtli wrote:
| the media apparatus regularly turns these into feel-good
| stories as well. its irresolvable imo
| Cthulhu_ wrote:
| Wasn't there a guy that started a new pharmacy with affordable
| medication? And some states have started doing things like
| price caps for insulin.
|
| It's coming, but it requires capitalism to be kept in check by
| government. Vote with your... er... vote.
| 93po wrote:
| this? https://costplusdrugs.com/
| jonhohle wrote:
| How is capitalism kept in check if anything when
| bribes^H^H^H^H^H^Hlobbying ensure the most resources and
| connected will always fall on the beneficial side of any
| legislation?
|
| With the exception of several dozen conglomerates that should
| be kept in check, deregulating, imho, would do more for
| competition then allowing those conglomerates to direct even
| more restrictive regulation.
|
| The reason insulin is expensive isn't due to the cost to
| manufacture. No startup will run to disrupt a market that's
| price capped, entrenched, and has government backed pharma
| ready to squash any new entrants.
| giantg2 wrote:
| There are other options depending on the circumstances, such as
| Medicare, Medicaid, CHIP, pharmaceutical assistance programs,
| etc.
| kevingadd wrote:
| Getting onto the assistance programs and staying on them if
| you're disabled in any way is a huge ordeal even under the
| best of circumstances. I can only imagine how hard it is if
| you're homeless or severely mentally ill. I don't think it's
| adequate as-is.
| bjoli wrote:
| That is just individualizing a societal problem. A sick
| person has already qualified for care. The U.S. has, by FAR,
| the highest healthcare spending in the world, yet some people
| are to poor to not be blind. Chances are that these people
| don't have the social capital to know how to go about getting
| medicaid (...) or may be disqualified because of other
| reasons.
|
| Cataract surgery takes, what, 10 minutes and has an average
| ROI of about 40000% (taken out of my posterior), which is
| what makes it extra clear that it is a failing of society.
| Broken_Hippo wrote:
| Which are hard or stressful to get qualified for if you have
| your mental abilities with you, and you might not qualify for
| any of it (CHIP is for children, isn't it?).
|
| They can be almost impossible if you don't, and it isn't like
| someone is going to walk you through it.
|
| And most of these programs aren't going to do anything if you
| aren't already in crisis mode - disability might be the
| biggest offender here. You have a 24 month wait for medicare
| at that point, nevermind that you are obviously out of work
| at that point. You might qualify for medicaid, sure, but
| might not.
|
| And to be fair, most of my knowledge on this is personal: My
| ex was on disability for mental illness. I don't know how
| well he got along after we split.
| giantg2 wrote:
| "and you might not qualify for any of it (CHIP is for
| children, isn't it?)."
|
| Which is why I said depending on the circumstances.
|
| "They can be almost impossible if you don't,"
|
| The example give was glaucoma, so I was speaking to that.
| If one has mental issues, they could use an advocate
| (friend, family, or charity). If their impairment is too
| severe for that, they could have a guardian created by the
| court (still room for abuse here, but less so than acting
| without the extra step of a court).
|
| "and it isn't like someone is going to walk you through
| it."
|
| There are charities that do this very thing.
|
| Much of my knowledge also comes from personal experiences.
|
| The real point of discussion on this topic is somewhat
| hidden. The question is at what point should someone be
| considered a ward of the state - where they no longer have
| the capacity to decide things for themselves, and what
| restrictions the state should place on them
| (institutionalization, vs outpatient treatment, etc).
| zdragnar wrote:
| Depending on the state, there are social workers whose
| sole job is to reach out to and guide homeless people
| towards these and other programs.
|
| The experience related to me by one of these people is
| that the mentally ill homeless tend to not trust social
| workers, believing (wrongly) that they'll be
| institutionalized if they accept any help at all.
|
| The sad result is that they only way many of these people
| will get any health care is if they are, in fact,
| institutionalized, because they refuse every other effort
| to get it.
| nisegami wrote:
| A huge factor you're overlooking here is that a lot of the time
| there simply is no effective treatment.
| bjoli wrote:
| So these people should just stay ill as decided by fate? You
| can't decide your genes or luck or whatever, and you
| shouldn't be granted treatment just because you happened to
| have money. Social mobility stinks in the U.S., meaning the
| best thing to do to ensure you will get healthcare is to have
| rich parents.
| jsorrel wrote:
| >Their largest hope is for a millionaire influencer/Deus ex
| machina to appear and pay ther treatment.
|
| I try not to live for savior fantasies like that, but as a
| person with PTSD that's accomplished a number of remarkable
| things to overcome an unfortunately adverse background, having
| an isolating disorder that requires a complex arrangement of
| financial stability, social acceptance, safety, and
| mentoring/nurturance which would be easiest to attain and
| maintain with a big pile of cash... I feel trapped. I worked at
| a game developer when I was 16, my peers went off to achieve
| great things, and I can't stay stable enough to not lose
| everything on an annual basis so I can have the money to get
| the help I need to be stable.
|
| Ultimately it's on me to figure out, but it's hard to see so
| many resources squandered in this world to fruitless,
| meaningless, or even harmful ends and know in my heart that I
| could make the world a better place if I were the one "wasting"
| them pursuing my basic humanity enough to thrive.
| ada1981 wrote:
| I relate to this deeply
| jsorrel wrote:
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| swayvil wrote:
| [flagged]
| justrealist wrote:
| There is no obviously easy path from giving money to improving
| mental health given our current legal framework. You can
| sometimes fix around the edges, but the core constraint, for
| most people, is not one of resources.
|
| If someone is severely mentally ill and does not want
| treatment, you can't simply throw millions of dollars at them
| and make them _want_ to be committed for treatment or rehab.
| Until they are on the brink of death, there is no legal
| recourse.
| swayvil wrote:
| It's safe to say that your average homeless maniac would
| lunge at the offer of free housing/food/cleaning-service.
|
| (which would _vastly_ lower their stress level, which, in the
| majority of cases, converts non-functional to functional)
|
| It only takes a pile of money and an army of zero-skill
| workers.
|
| So yes, there is an easy path.
| jjulius wrote:
| >It's safe to say...
|
| Genuinely curious - what makes it safe to say that?
| tristor wrote:
| > It's safe to say that your average homeless maniac would
| lunge at the offer of free housing/food/cleaning-service.
|
| You say that it's "safe to say", except that it isn't true.
| There are many many services for the homeless, and these
| services legitimately help transitory homeless people, but
| those who are chronically homeless usually cannot stand
| (mentally/emotionally) or follow the strictures of these
| services, things like not engaging in drug and alcohol
| abuse, or being required to follow-through on mental health
| treatment. If your solution is basically paying people to
| care for mentally ill homeless people without /any/
| restrictions on the behavior of said people (e.g. no
| required treatment, no restrictions on drugs/alcohol), then
| you're asking for people to literally risk their lives to
| care for people who do not have the mental capacity to even
| appreciate it, without any of the necessary power to help
| make the situation any better. It's a fruitless exercise.
| Those strictures are in place, because they must be in
| place to make it socially meaningful to help at all.
|
| As long as we expect that homeless people will undergo
| treatment in return for free housing/food/service, there
| are /many/ chronically homeless that will either refuse or
| relapse. They certainly are not "lunging at the offer".
|
| > an army of zero-skill workers.
|
| Dealing with mentally ill people and drug addicts in a safe
| manner is not "zero skill", even if the other base service
| you're doing may be.
|
| > So yes, there is an easy path.
|
| There is only an easy path if you can forcibly
| institutionalize people and forcibly treat them. Which...
| is kind of the point of the entire article.
| swayvil wrote:
| If it was as bad as you say, you couldn't go out your
| front door without getting assaulted. There would be
| constant rioting. I don't think it's that bad. I think
| you are exaggerating the number of the truly deranged.
| tristor wrote:
| Most people who are mentally ill don't want to harm other
| people. The fact that they sometimes do, however, is
| indisputable. I would encourage you to do some research
| on homelessness in America and specifically on the
| chronic homeless. I've worked off-and-on with the
| homeless community for several years, and homeless people
| are not out to get anyone, they need help, it's just that
| providing that help is not nearly as simple as you make
| it out to be. Mental illness is so difficult to deal with
| partly because of its insidiousness, rather than what you
| are apparently imagining as "the truly deranged".
| Addiction is a big challenge as well, and the causative
| relationships are anything but simple and
| straightforward. Many people abuse substances to self-
| medicate for underlying mental health problems. Being
| homeless can create mental health problems as a
| consequences of the traumas associated with it.
|
| Trying to wrap up complicated issues with a bow and
| dismiss them as simple is not a realistic or informed
| viewpoint. Do some research and then get back to me.
| swayvil wrote:
| Offering a non-solution that coincidentally agrees with
| the #1 most popular billionaire's agenda bears a rather
| suspicious stink as well.
| tristor wrote:
| Offering simple "solutions" that don't actually take into
| account any of the complexity of the problem space and
| don't actually solve the problem, but sound pithy and
| coincidentally reduce the solution to "throw someone
| else's money at it" bear a rather suspicious stink as
| well.
| blog0r wrote:
| "There are many many services for the homeless"
|
| the services don't do anything though. much like in
| general healthcare there is no incentive to helping
| people, its just a method of transferring wealth from
| poorer taxpayers to rich people using taxes.
|
| helping homeless people really wouldn't be that hard its
| just that people with the power to make a difference
| aren't even aware there is a problem. for example you
| think there are services to help the homeless but there
| really aren't. there are just people who receive money
| and say they help the homeless but they don't, and you
| don't know any better because you don't know any homeless
| people.
|
| insitutionalizing a violent mentally ill man is not in
| the same category as "helping the homeless". its about
| equivalent to locking up a person who says in a
| therapists office yeah obviously I'm mildly suicidal like
| almost everyone else. it has nothing to do with helping
| people it's just a way to make money and police the
| culture
| tristor wrote:
| > the services don't do anything though
|
| You're right, in some ways. It's not that there aren't
| services that are trying, it's that chronic homelessness
| and transitory homelessness are nearly completely
| different problem domains, and the solutions to
| transitory homelessness don't do anything for chronic
| homelessness. Most of the programs are focused on helping
| the transitory homeless, or at least implementing
| solutions that only help the transitory homeless.
|
| There /are/ services focused on chronic homelessness,
| although they are not as common, but as I mentioned, they
| require participants in those services to agree to the
| rules and follow-through, things that commonly fail. Most
| of the severely mentally ill homeless people /aren't/
| violent, however they're not capable of consistently
| following a treatment plan or instructions. Most of the
| chronically homeless are basically /socially
| incompatible/ with the surrounding society, often due to
| their mental health problems, but at some level it's hard
| to separate what is a mental illness from what is a
| personality.
|
| The "people in power" don't care about homelessness, but
| it's far more cynical than you're being, fixing
| homelessness doesn't move the needle for any of the
| things they care about, so they simply don't care. It
| doesn't even register for them, other than a visible
| inconvenience in some cities.
| justrealist wrote:
| > obviously I'm mildly suicidal like almost everyone else
|
| I think you need more help than you realize.
| gitfan86 wrote:
| I wonder what the right ratio of complainers to doers is in a
| society. If 100% of people were doers, there would be no
| accountability due to no one focused on critiquing systems. On
| the other hand if 100% of people were professional critics
| nothing would get done other than a brunch of people asking why
| nothing is getting done.
| jondwillis wrote:
| Replace "mental" with any other word and it would be true.
| Navigating the US healthcare system is perplexing and depressing
| for anything but the most trivial of conditions, for everyone but
| the most wealthy.
| swayvil wrote:
| The role of USA healthcare is to fake it. To provide the
| appearance of healthcare without actually providing it.
|
| In collusion are a swarm of insurance and medical businesses.
| Parasites and illusionists.
| mrguyorama wrote:
| Strictly speaking the US healthcare system mostly works for
| those who are well off enough and have good enough insurance,
| at least until a catastrophic or chronic condition.
|
| But the way it is unavailable to many people and useless to
| many more means it should not be considered a functional
| system.
| davidgay wrote:
| > the US healthcare system mostly works for those who are
| well off enough and have good enough insurance, at least
| until a catastrophic or chronic condition.
|
| As the proud owner of several chronic conditions which are
| treated just fine(*) by US healthcare, I can infirm this
| statement (and I'm very, very far from being a fan of US
| healthcare...).
| logicalmonster wrote:
| This is a field I don't know much about, but I think a part of
| the problem from an American perspective is that you can't easily
| force anybody to take medical treatment against their will.
|
| As a society, our values seem to be prioritizing personal freedom
| over safety and security.
|
| Personally I think that's the right choice, but your values will
| decide if that's the best possible tradeoff.
| hackernewds wrote:
| if you are deemed a harm to society due to mental health
| concerns, you can totally be force admitted to a mental health
| institution in America, and denied basic guaranteed rights - if
| you have committed (or have the potential to) crimes - such as
| the right to bear arms (yes it does happen in America), and the
| "right" to privacy (registering in a sex offenders registry)
| [deleted]
| cleandreams wrote:
| Living in SF for 30 years I am over, over, over severely mentally
| ill people killing themselves and harming others. No, they don't
| take their meds. The consequences mean they do need involuntary
| hospitalization. This has to be done with checks and balances but
| it has to be done.
| tiahura wrote:
| If someone requires mental medication there should be a
| presumption that they shouldn't be out loose.
| loeg wrote:
| > If someone requires mental medication there should be a
| presumption that they shouldn't be out loose.
|
| This is obviously excessively reductive. I don't think my
| friends and colleagues on adderall and setraline should be
| locked up when they are perfectly functional members of
| society.
| AtlasBarfed wrote:
| Our healthcare system is functioning as design,mental or
| physical. It is a cartel profit extraction system with impossible
| barriers to entry.
| [deleted]
| calibas wrote:
| I watched as a schizophrenic friend of mine was teased and
| provoked by the local police. To me, it's common sense and common
| decency that you don't provoke someone who's mentally ill, but
| the police just treated him like an ordinary criminal. It's
| almost like they wanted him to act out so they'd have an excuse
| to arrest him.
|
| That's when I started to realize that crime, drug use and mental
| illness are closely connected.
| mxmbrb wrote:
| Hell, that's a damn book of an article. A short warning would
| have been apreciated.
| acuozzo wrote:
| the warning == theatlantic.com
|
| Do they post any articles which are not the length of a
| novella? :-)
| hoseja wrote:
| Freddie DeBoer writes a bit about this.
| kritiko wrote:
| Yes, Freddie's review of the book that this article was
| excerpted from was previously discussed on HN.
| giantg2 wrote:
| I find it hard to believe that expanding government power to put
| people in custody without a crime being committed is really the
| answer. Especially since the current laws would allow for a
| mandatory screening if the person commits a crime ("overt acts
| would almost always fall in that category or be rife for abuse).
| I think NY has already used mental health as an excuse to take
| away rights even when there was no danger to themself or others
| (retired NY police having firearms seized for having mild
| symptoms of depression with no risk of harm to themself or
| others).
|
| There's a ton of background in this story, but very little about
| what the solution is, at least in detail.
| bigtex88 wrote:
| Going into public and throwing filth at people, accosting them,
| and generally endangering the safety of other citizens is
| implicitly a crime by virtue of "Every civilized society in the
| history of man has cleaned up this behavior".
|
| We don't need to wait around for a court to indict a person for
| "being a crazy homeless person". That's insanely reductive to
| the point of absurdity.
| dragonwriter wrote:
| > Going into public and throwing filth at people, accosting
| them, and generally endangering the safety of other citizens
| is implicitly a crime
|
| In the US, there is no such concept as "implicit crime", but,
| yes, some of those things are just plain explicit crimes.
|
| > We don't need to wait around for a court to indict a person
| for "being a crazy homeless person"
|
| If you are going to treat it as a crime, then, yes, it has
| all the procedural safeguards generally applicable to crime.
| loeg wrote:
| > Going into public and throwing filth at people, accosting
| them, and generally endangering the safety of other citizens
| is implicitly a crime
|
| It's not just implicit -- assault is explicitly a crime,
| everywhere.
| tomjakubowski wrote:
| [dead]
| giantg2 wrote:
| "We don't need to wait around for a court to indict a person
| for "being a crazy homeless person". That's insanely
| reductive to the point of absurdity."
|
| They would be arrested based on the crime they commit, such
| as assault. Then the court would make a determination on
| their insanity plea.
|
| Adultery and sodomy have been crimes in most civilization of
| history too. That doesn't mean we convict people based solely
| on the spirit of the law, nor ignore the principle of
| innocent until proven guilty.
| woeirua wrote:
| I understand the civil liberties concerns, but you really want
| to treat severe mental illness as soon as possible. Earlier
| treatment is linked to better outcomes, lower costs, and a
| significantly higher chance of being reintegrated into society
| as a whole.
| luxuryballs wrote:
| And if they don't want to be treated?
| woeirua wrote:
| Not an option because severe mental illness affects us all.
| We already have a similar principle for other diseases that
| negatively affect others, e.g. tuberculosis.
| dionidium wrote:
| We're not nihilists so we _treat them anyway against their
| will._
|
| _" If the rule you followed brought you to this, of what
| use was the rule?"_
| johndevor wrote:
| Don't forget that the third world has 2x better outcomes with
| regards to schizophrenia. Probably due to the fact that they
| have more familial support and/or less reliant on meds.
|
| https://thecorrespondent.com/407/people-not-pills-what-
| the-w...
| lotsofpulp wrote:
| The alternative to this is 3 (or whatever number) strikes type
| laws where successive crimes, even small ones, are punished
| more severely.
| dionidium wrote:
| We're quite literally to the point where something like a
| 20-strike law, which sounds like parody, would actually be
| quite useful.
| giantg2 wrote:
| That could be one option, but still has room for abuse. Maybe
| a homeless person shoplifts some candy three time. That's a
| felony in many states. Maybe they have a mental condition
| that causes them to shoplift, or maybe they were hungry. Now
| it's up to someone's opinion, who is likely overburdened, to
| decide which one it is. Either way, it's likely to result in
| custody, but one of those ways might involve mandated
| medication and a lifelong (mis)diagnosis. At least in this
| case it would be going through the court, and under the
| current laws should require some input on the part of the
| defendant to seek an insanity plea.
| notch898b wrote:
| It does seem frighteningly easy to lose everything and be
| locked up.
|
| See https://en.wikipedia.org/wiki/Rosenhan_experiment . After
| just one episode of telling professionals that they "heard
| voices", patients were diagnosed and forced to take medication
| despite never again showing symptoms or evidence of illness.
| Once admitted and diagnosed, the pseudopatients were not able
| to obtain their release until they agreed with the
| psychiatrists that they were mentally ill and began taking
| antipsychotic medications,
|
| Even if they weren't ill... the only way to get out was to lie
| and say they were.
| 35208654 wrote:
| The Rosenhan experiment is now widely believed to have been a
| hoax.
| kelseyfrog wrote:
| It sounds like a great opportunity for the field to put
| their skin in the game and replicate it.
| monknomo wrote:
| Not only is there a good chance this was a hoax, but it was
| an experiment under a different mental health regime, one
| with institutions and a much lower bar to commit people.
|
| It is much different today
| throwaway646465 wrote:
| This is an interesting recent addition to the Wikipedia
| article.
|
| From the summary:
|
| > In 2019 and 2023, historians of psychiatry published
| evidence that the experiment is a hoax.
|
| And following the link:
|
| > In The Great Pretender, a 2019 book on Rosenhan, author
| Susannah Cahalan questions the veracity and validity of the
| Rosenhan experiment. Examining documents left behind by
| Rosenhan after his death, Cahalan finds apparent distortion
| in the Science article: inconsistent data, misleading
| descriptions, and inaccurate or fabricated quotations from
| psychiatric records. Moreover, despite an extensive search,
| she is only able to identify two of the eight pseudopatients:
| Rosenhan himself, and a graduate student whose testimony is
| allegedly inconsistent with Rosenhan's description in the
| article. In light of Rosenhan's seeming willingness to bend
| the truth in other ways regarding the experiment, Cahalan
| questions whether some or all of the six other pseudopatients
| might have been simply invented by Rosenhan.[11][12] In
| February 2023, Andrew Scull of the University of California
| at San Diego published an article[13] in the peer-reviewed
| journal History of Psychiatry in support of Cahalan's
| allegations.
|
| Still - it's scary how many rights you lose once you've been
| declared unwell. We might just want to start using more
| recent evidence since that experiment has come under
| question.
| loeg wrote:
| This concern isn't really a problem for the homeless mentally
| ill that are the target of these schemes because they're
| already committing small crimes all the time.
| giraffe_lady wrote:
| It's basically impossible to be homeless and not commit
| crimes as a matter of course, which is intentional. This will
| absolutely be used punitively against homeless people.
| HideousKojima wrote:
| The homeless mentally ill though, specifically, are the
| ones usually committing extra crimes beyond mere vagrancy
| and squatting. I.e. the ones taking shits on bus seats and
| getting into drunken fights in public.
| ada1981 wrote:
| Compared to the ones who are successful, who dump toxic
| waste into oceans or start proxy wars.
| HideousKojima wrote:
| You're right, we can't make any efforts to make our
| streets safe and free of crazed, violent hobos until
| we've gotten rid of all polluters and warmongers first.
| giraffe_lady wrote:
| Seeing now how y'all talk about homeless & mentally ill
| people where you think they can't see you, they are right
| to hate us.
| HideousKojima wrote:
| If they didn't shit on bus seats I would have no reason
| to talk about them shitting on bus seats.
| loeg wrote:
| I agree with you, except for the "punitively" judgement.
| notch898b wrote:
| I had a homeless stint. I did day labor for money and
| parked my tent in places where it was legal for me to stay,
| or where I hadn't been trespassed and wasn't marked, thus
| it would not be illegal unless someone asked me to leave
| and I didn't. In many states camping on property isn't
| illegal unless you've been trespassed, it is posted, or it
| is gated off etc.
|
| Plenty of homeless people who don't commit crime, you just
| don't notice them because they aren't bothering anyone.
| throwaway8689 wrote:
| Thanks for mentioning this. There are a lot of people who
| are homeless solely for economic reasons and are mostly
| unnoticed.
| micromacrofoot wrote:
| There's also a lot of substance addiction in
| homelessness, and treatment centers aren't really located
| in places where it's legal to camp.
| giantg2 wrote:
| Most treatment addiction treatment centers, especially
| the more effective ones, are in-patient facilities.
| micromacrofoot wrote:
| I was thinking more of outpatient methadone clinics
| kevingadd wrote:
| It's unfortunate that some jurisdictions are doing
| everything they can to make it illegal to be homeless
| anywhere, because I agree, lots of homeless people aren't
| bothering anyone.
| giraffe_lady wrote:
| I was on and off homeless for over a decade so I have my
| own experiences and opinions of this.
| giantg2 wrote:
| Then this policy change should be moot since they should be
| getting psychiatric treatment if their public defender is
| pleading insanity or looking at competency. Or are wr just
| adding more broken policy on top of an already broken system?
| loeg wrote:
| If prosecutors do not decline to prosecute, there is a
| process for diverting defendants who cannot be made
| competent to stand trial. (Note that this is also pre-
| trial, without being convicted of a crime.) But if no one
| is trying to determine if you're competent to stand trial,
| you wouldn't encounter that.
| stainablesteel wrote:
| i also find it important to note that therapy is becoming more
| and more a religious practice
|
| there are different flavors of therapy, and some may use more
| empirical methods than others, but there's a lot of
| infiltrating ideology and opinions that fight over what is and
| isn't science, and therefore what is and isn't empirical
|
| but if none of this is truly empirical, the therapeutic aspects
| are religious
|
| so locking people up for what are essential religious
| violations is way beyond illegitimate control
| goldforever wrote:
| [dead]
| LeonTheremin wrote:
| [flagged]
| anon291 wrote:
| Schizophrenia can be managed, not treated. Lost in all the talk
| about mental healthcare and drug addiction are two important
| topics.
|
| (1) Medicine does not have an answer for all mental illness. Many
| are incurable, and only manageable.
|
| (2) Sometimes even the management is not good enough.
|
| My uncle is extremely intelligent. Also has schizophrenia. Like
| Michael... extremely intelligent, PhD (received after diagnosis),
| etc. It's been many years. He has kids and grandchildren, etc.
| But... he still breaks from time to time. He's even attempted
| flat out murder. There's no answer really. His wife (my aunt) can
| get him to calm down, as can his children. But, it's still there,
| despite everyone's best efforts.In my view, short of completely
| numbing his personality and individualism, I can't see how anyone
| can 'fix' it.
|
| Further lost in our conversation as it pertains to drug abuse is
| the importance of not creating the problem to begin with.
| Schizophrenia is no joke. Several commonly available (some
| decriminalized) drugs can induce schizophrenia. We must do what
| is necessary to ensure this never happens. The mind is a terrible
| thing to lose.
|
| EDIT: Also, having also worked at Bain, I do not suggest anyone
| work in management consulting if they want their sanity.
| Invictus0 wrote:
| Curious to hear your Bain war stories.
| anon291 wrote:
| Well unlike Michael, I left after six months. I thought the
| job was a lot of BSing (and I decided to work at Bain after
| my SW eng interships which I felt did not move fast enough
| and had a lot of wasted time; I can be very type A and
| demanding for constant stimulation). There was a lot of time
| spent basically making things up to satisfy customers. There
| was also huge pressure to spend ungodly sums of money as an
| associate, because everyone's posing to one up the others
| (I'm talking about.. let's go do a birthday in Cabo every
| other weekend). So I had decided I didn't like it, but wanted
| to last at least a year.
|
| Anyway, my colleague / mentor who's supposed to be helping
| me, instead tells me that I need to do better at making
| things up for customers essentially. It's quite the intense
| conversation. I can feel I'm not his favorite associate.
| Anyway, he ends his criticism by telling me not to jump out a
| window (we're on the 33rd floor).
|
| Well, a week later, an associate at Goldman Sachs (which had
| an office in the same building) does indeed jump out a
| window.
|
| A week later, I resigned.
|
| All in all, it was very enlightening. I got to see how the
| rich really live. And most importantly, I realized they're no
| different than anyone else, just willing to sacrifice more.
| As my actual boss told me... family was for when I turned 30
| (I was engaged already at the time I joined Bain). I recently
| began listening to 'Woke Inc' by Ramaswamy, and he has
| similar experiences at Goldman Sachs. Including the fake
| philanthropy stuff.
| DaveExeter wrote:
| >Several commonly available (some decriminalized) drugs can
| induce schizophrenia.
|
| I don't think this is true. Some drugs can have effects that
| superficially resemble schizophrenia and then doctors
| mistakenly "diagnose" schizophrenia.
| anon291 wrote:
| No. drugs like LSD can cause schizophrenia after they are
| stopped or even after one dose in susceptible individuals.
| DaveExeter wrote:
| And I think that is the myth.
| kritiko wrote:
| https://pubmed.ncbi.nlm.nih.gov/30442059/
|
| "Cannabis use doubles the risk of developing psychosis in
| vulnerable people."
| DaveExeter wrote:
| That's just the thing. Psychosis can be a symptom of mental
| illness or it can be a symptom of smoking cannabis.
| anon291 wrote:
| I think the question is whether or not smoking cannabis
| increases your future risk of psychosis. If it does, then
| it ought to be highly controlled, if not outright banned.
| If it does not, but can cause psychotic like symptoms
| during its use, then regulations should be made that it
| can only be indulged in in appropriate places.
| Gatsky wrote:
| I think schizophrenia could be prevented... most people
| manifest psychosis in teenage or young adult years. There is at
| least a good decade before it develops where something could be
| done, maybe. Just worth thinking about, at least.
| avisser wrote:
| This is inline with what my wife thinks. She's a psychology
| PhD who studied schizophrenia in young adults.
|
| The way she phrases it is that the current best guess is that
| schizophrenia is a developmental disease.
| anon291 wrote:
| Knowing that it is a developmental disease does nothing to
| prevent / treat it. There are many diseases that we can
| recognize as developmental, yet do nothing to prevent
| (autism for example).
| pessimizer wrote:
| You're using "does nothing" to mean "doesn't
| automatically solve" here. Understanding how something
| develops gives you places to look to attempt a treatment.
| You don't stop sending firetrucks because some houses
| have burned despite firetrucks.
| anon291 wrote:
| I'm not denying that. I'm just saying we need to
| formulate our laws such that they recognize that some
| diseases are untreatable. That means proper asylums where
| those who are not responding to treatment can safely
| live.
| qikInNdOutReply wrote:
| Another nuance lost is, that there are many millions for which
| the sickness is a gift.
|
| What becomes a conspiracy theory of the government following
| for one, becomes a thriller book for another, that switch to
| differentiate between hallucination and reality that artists
| have and patients dont have. My brother was quite the creative
| powerhouse, before the sickness took him.
| anon291 wrote:
| My dad and his siblings are very smart (graduate degrees,
| doctors, all of them). However, the way my dad tells it, my
| uncle was exceptionally smart growing up, and I wonder if it
| was due to pre-schizophrenia traits (or pre-diagnosis... who
| knows).
|
| Despite being asian, my dad was always 'afraid' of smart
| children. In his mind, schizophrenia was caused by lack of
| rest and relaxation. He always encouraged my brother and I to
| relax, and not work too hard. Apparently, it is now known
| that schizophrenia is correlated with sleep disorders as
| well.
|
| I guess we are lucky in that my uncle has never been able to
| do anything wrong. He did attempt murder I suppose (in
| paranoid delusion), but luckily his brothers stopped him. I
| suppose it helps living near family and having a lot of
| siblings. Nowadays he's mostly limited (due to old age) to
| gathering apostles on the internet for his new religions.
| Probably the best outcome you can hope for.
|
| I believe the biggest lesson from this article though, is
| that it is dangerous when we legislate based on hope. The
| 1950s and 60s saw the beginnings of the desire to eliminate
| asylums due to civil rights concerns. The 'solution' was a
| technology that at the time didn't exist, but which they
| hoped would exist after the law was passed. It is dangerous
| to create law while ignoring current reality, and depending
| on hope.
| qikInNdOutReply wrote:
| >I believe the biggest lesson from this article though, is
| that it is dangerous when we legislate based on hope.
|
| Could not agree more. Self-hypnosis and can do rhetoric is
| a real poison when it comes to mental health. Its also very
| comon though, as humans can not really percieve mentally
| different people. We percieve other as flat copies with
| mirror neurons. So every person somebody else sees, is
| always "similar to me".
|
| https://en.wikipedia.org/wiki/Mirror_neuron
|
| If that does not work out, the brain evaluates the persons
| actions result. If its nothing we regard as valuable, we
| classify the person as "stupid/lazy/etc", if it has good
| outcomes, we classify the person as "brilliant/genius/etc".
|
| This inability to even percieve the other and the behaviour
| they are locked in eliminates alot of the possibilities for
| help. "I would never do that, unless im lazy. I would think
| really hard and snap out of it." is way to often the
| conclusion.
| tyingq wrote:
| I'd add a third point about misdiagnosis. Schizophrenia is
| maybe more straightforward, but there are other debilitating
| mental illnesses that are often diagnosed incorrectly. I
| suppose, though, that just leads back to your 2 points, making
| it more likely that the medication/management don't help.
| jwestbury wrote:
| > diagnosed incorrectly
|
| This is a tough one, because mental illness is not generally
| well-understood. Yes, we have diagnostic criteria, but
| they're all quite fuzzy, and very few kinds of mental illness
| take an obvious form like most physical illnesses. You can
| test for cancer and be certain; you can't test for depression
| or anxiety or PTSD or obsessive-compulsive disorder and be
| certain. Most mental illnesses exist on a continuum where,
| even if we could accurately identify their traits with any
| consistency, we would still be left to decide "are you
| depressed enough to be diagnosed?" I suppose in that sense,
| it's not unlike, say, prostate cancer, where the question is,
| "Is this bad enough to be worth treating?" But, generally
| speaking, you either have cancer or you don't; but with
| mental illness, there's no such binary, at least none that
| we've usefully identified for the vast, vast majority of
| forms of mental illness.
| tyingq wrote:
| Yes, I agree...that's deeper into my feelings about it. By
| "misdiagnose", I mean there's quite a lot of slapping
| labels onto people and handing out the drugs that go with
| the label. And all done with "high confidence" language to
| the patient. There's sometimes the missing honesty about
| what an imperfect world it is.
| kayodelycaon wrote:
| > Michael's friends and family and his supporters at Yale had
| thought intelligence could save him, allow him to transcend the
| terrible disease that was causing his mind to detach from
| reality.
|
| This is such a bad misunderstanding of how schizophrenia works...
| intelligence does not help if the underlying hardware powering it
| breaks at a fundamental level.
| tokai wrote:
| Premorbid IQ do predicted social function after the first
| schizophrenic episode.
|
| Here's some random papers, there are many more out there:
|
| https://www.sciencedirect.com/science/article/pii/S092493381...
|
| https://www.sciencedirect.com/science/article/pii/S092099640...
|
| https://www.nature.com/articles/npjschz201543
| qikInNdOutReply wrote:
| https://de.wikipedia.org/wiki/John_Forbes_Nash_Jr.
|
| I would argue quite High IQ, still got nowhere regarding
| normal life due to the problem most of his adult life. Was
| kept on campus out of respect for his archivements. Finally
| returned to a state of being able to use his IQ with high
| age.
|
| The intelligence can do nothing once the hardware goes,
| except weave more elaborate conspiracies and paranoid
| fantasys.
| retrac wrote:
| Schizophrenia is not an all or nothing. It's not like one
| resistor fries and suddenly they're hearing voices
| completely indistinguishable from reality. Some people have
| partial or even significant insight into their illness.
| That is to say, they are aware and appreciate that their
| thinking is disordered, or that the voices are actually
| internal, and they have coping methods. Some methods of
| coping like reality testing seem like they can be taught,
| and it does seem likely to me that having a lot of general
| intelligence would make such a thing more effective.
| kayodelycaon wrote:
| From my experience (and those on a bipolar discord
| server) coping mechanisms can definitely be taught. Most
| of them are rather simple in concept but almost all of
| them are absolutely exhausting to use.
|
| Trying to work full time while using coping mechanisms
| had me sitting in a chair, unable to function, after 5pm.
| I serious started to ask myself if living was worth
| living if that was all there was to it.
| tokai wrote:
| I don't get your point. Nash outcome was very very good. He
| stayed out of hospitals and didn't take his medicine, after
| his initial stints with hospitalisation.
|
| >The intelligence can do nothing once the hardware goes,
| except weave more elaborate conspiracies and paranoid
| fantasys
|
| Why do you write this when I post evidence of the opposite?
| Do at least have some kind of backing to your statement.
| qikInNdOutReply wrote:
| Nashes work declined greatly with the full onset of the
| sickness and never fully recovered.
| tokai wrote:
| That your only work declined is a very good outcome for
| an illness with as bad outcomes as schizophrenia. Like if
| you shattered both your legs, but ended up walking again
| while not able to compete in the olympics 100 meter
| sprint, would be a good outcome.
| PurpleRamen wrote:
| The linked german wikipedia descibe Nash's illness quite
| different from the english wikipedia. With the german
| article being less specific about the illness and
| outcome.
|
| Though, both are somewhat clear that the illness took him
| 20+ years of his life, which might be not a good proof
| for high IQ helps with mental illness.
| tokai wrote:
| I wouldn't know, the link is dead.
|
| edit: No his outcome was good. He didn't die from it, he
| didn't spend his life locked up. It's absolutely
| ridiculous to argue the effect of IQ on outcomes from
| this one example tho. I posted several studies, that
| between them cites numerous studies, all based on data
| collected on 1000s of persons. A German wiki articles
| angle on Nash's illness is seriously a waste of
| everyone's time.
| PurpleRamen wrote:
| The url has a dot at the end, which is missing in the
| link.
| kayodelycaon wrote:
| From personal experience, intelligence helps with self-
| awareness and finding strategies for dealing with mental
| illness. It does not help control it.
|
| Once psychosis take hold, it's in the driver's seat. I can be
| fully aware I'm trying to hurt someone and know that it's
| wrong and be unable to stop myself from acting on my
| delusions.
|
| It feels like I'm outside my body, watching it do things I
| have no control over.
| fortran77 wrote:
| Isn't that a one of the points of this article, that
| intelligence didn't save him?
| kayodelycaon wrote:
| It does. It's a very long (and very good) read. Most people
| aren't going to finish it in time to comment.
|
| So I decided to start the discussion early for everyone else.
| :)
| starkparker wrote:
| This is just an ad for a political policy that doesn't address
| any of the problems, would not have helped the author's friend,
| and if it were the only policy enacted might not have saved the
| murder victim's life.
|
| Adams's proposal to involuntarily hospitalize people did nothing
| to address these problems that don't _only_ affect New York City
| 's chronically homeless:
|
| - Hospital staffing or capacity for triaging, assessing,
| treating, and making committal decisions on chronically mentally
| ill patients; police can't directly involuntarily commit people,
| a doctor has to do it[1]
|
| - Lack of training for first responders, and especially police,
| to compassionately handle people suffering from acute mental
| illness; his proposal added a video call hotline. It also leans
| on NYPD's existing specialized training section, which is only a
| four-day program, has a stated primary goal of handcuffing the
| person, and hasn't stopped police from following protocol instead
| of killing mentally ill people.[2] It _also_ was apparently
| announced without any coordination with NYPD, who by their own
| admission found out about the new policy only when Adams publicly
| announced it.[2][3] NYPD in turn started implementing the policy
| without rolling out the training Adams mentioned, and directed
| officers to its legal team for advice instead of the hotline.[3]
|
| - An existing shortage of first responders, much less specially
| trained responders,[2] much less _effectively_ trained
| responders.[4]
|
| - An existing shortage of in-patient beds and supportive housing,
| a shortfall that the state government is attempting to address
| independently of Adams. In-patient psychiatric hospital bed
| capacity dropped 20 percent from 2014 to 2022 with only 5,000
| statewide, which left the handling of mentally ill people in
| places like NYC to understaffed and undertrained ERs.[5]
|
| Adams didn't respond to any of these fundamental shortfalls in
| his November proposal until three months later, with new
| proposals that didn't have budgets, didn't propose expanding
| fundamental mental health care infrastructure, and instead
| focused on clubhouse models for employing functionally mentally
| ill people without addressing the acute or chronic mental illness
| targeted by his involuntary hospitalization proposal. The only
| part of this new proposal that was even funded at the time it was
| announced was the other third of it, exclusively focused on
| substance abuse.[6]
|
| 1: https://www.washingtonpost.com/made-by-
| history/2023/03/13/ne...
|
| 2: https://www.nytimes.com/2022/12/05/nyregion/mental-health-
| pl...
|
| 3: https://nypost.com/2022/12/08/nypd-moves-ahead-with-eric-
| ada...
|
| 4: https://www.npr.org/2021/07/23/1019704823/police-mental-
| heal...
|
| 5: https://www.nytimes.com/2023/01/10/nyregion/hochul-mental-
| he...
|
| 6: https://www.politico.com/news/2023/02/23/adams-mental-
| health...
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