[HN Gopher] Time to bring back asylums?
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Time to bring back asylums?
Author : sam345
Score : 39 points
Date : 2023-07-22 14:05 UTC (8 hours ago)
(HTM) web link (www.wsj.com)
(TXT) w3m dump (www.wsj.com)
| creer wrote:
| Mental health doesn't have to be done in the most stupid way
| possible. And yet could be much more present, available,
| temporary.
|
| An institutional system can be built with cross-checks,
| inspections, corruption fighting mechanisms, etc. By this I mean
| actual, independent, not powerless, not perfunctory, corruption-
| fighting, enforceable, etc. As opposed to the usual such cross-
| checks around here. This is a far broader issue that just mental
| health but simply (not) doing mental health on the street isn't a
| great solution.
| Spooky23 wrote:
| It's time to bring back a credible editorial board to the Wall St
| Journal.
| sam345 wrote:
| Explain ? Not a WSJ editorial board opinion. Also interested in
| when you think the WSJ board was credible and at what point it
| lost its credibility ?
| iancmceachern wrote:
| I've had this conversation with many friends. Totally agree. They
| need to be good, well run with compassion and care of course. But
| we indeed need them.
| orwin wrote:
| But they already exist, no?
| amanaplanacanal wrote:
| It's time to make money appear out of nowhere, ignore the long
| history of abuses in such places, and pretend the courts are
| going to do a 180 and suddenly allow what was unconstitutional
| before.
| spondylosaurus wrote:
| Meanwhile I've been reading this New Yorker piece this morning:
| https://www.newyorker.com/science/annals-of-medicine/reinven...
|
| Reinventing the E.R. For America's Mental Health Crisis
| (subtitle: _EmPATH units are advancing a radically new approach
| to psychiatric emergencies. It seems to be working._ )
| amadeuspagel wrote:
| Asylums still exist. What this person wants to bring back is the
| ability to lock people up and keep people locked up there with
| little recourse. A typical case from this time[1]:
|
| > [Cramer] frankly discusses the "regimented, often hopeless
| conditions of state mental hospitals", talks about a hospital in
| Alabama where "care was worse than simply inadequate: one
| psychiatrist for 5000 patients; astonishingly low funding for
| clothing, food and upkeep of the buildings", studies showing that
| institutions never actually got patients' signatures on the forms
| that were supposed to waive their rights to court hearings.
|
| > [He] describes the case of Edna Long, who was hospitalized for
| "public drunkenness" and "permanently hospitalized in 1952. As
| Ennis tells the tale, Long received no treatment during the next
| fifteen years, but was kept busy working at menial jobs in the
| hospital. After the death of her husband in 1960, the state
| hospital had her declared incompetent, and seized her assets to
| pay for her care. Then, they put what assets remained under the
| management of an attorney, who made a bit of money from reducing
| the value of her estate by 86% (according to Ennis, a common
| practice at the time in New York). Once Long had become too
| physically ill to continue working, the hospital suddenly found
| her "competent to manage her own affairs" and released her, to a
| life of elderly poverty. Most of the money that she and her
| husband had accumulated had been consumed by attorneys supposedly
| protecting her assets."
|
| [1]: https://astralcodexten.substack.com/p/book-review-san-
| fransi...
| iancmceachern wrote:
| Not really at all.
|
| In a sentence, we need a public infrastructure in place to care
| for the mentally ill that currently are forced to live on the
| streets of our major cities. We need a way to pay the people
| that do the work, buy the buildings, keep the lights on. We
| call this infrastructure asylums, whatever you want to call it
| we need it desperately.
|
| If you want to stop things like what you cited from happening,
| lobby to have rules and regulations surrounding these
| institutions that get you what you want. But it doesn't mean we
| don't need the 90% good they will do for fear of the 10% bad
| they've done in the past
| amadeuspagel wrote:
| Homeless shelters still exist too.
|
| It's not about what to call it, it's about whether people are
| forced to be there.
| uejfiweun wrote:
| Clearly HN does not seem to like this idea so much. But I do have
| to ask, what exactly do you propose as a solution to the massive,
| growing hordes of drug addicted zombies in west coast cities? You
| can't tell me that this problem doesn't exist, anyone who's been
| to a west coast city knows it's very real. The past 20 years of
| the "compassion" approach or whatever is clearly a total
| disaster. At what point do we just say "these people are a danger
| to society and they need to be off the damn streets?" Because
| that strikes me as the most realistic solution. We're not gonna
| be able to stop the illicit flow of fentanyl into our society.
| Danjoe4 wrote:
| Jail. Asylums circumvent due process as other commentators have
| pointed out. Jails should be staffed with a physician who has
| the discretion to transfer inmates to treatment centers.
| aschearer wrote:
| First, I reject the notion that there are "massive, growing
| hordes of drug addicted zombies in west coast cities." Having
| lived in Seattle for over a decade, now living in Olympia, and
| having visited San Franscisco, Portland, and other west coast
| cities plenty of times, what you're describing doesn't line up
| with my experience at all. If you drop the hyperbole perhaps we
| agree, but then why hyperventilate? It undermines your point.
|
| Second, assuming you're genuinely curious and not simply trying
| to spread misinformation my answer would be to greatly reduce
| inequality. In my corner of the world housing has exploded in
| price. Healthcare is also very expensive. I don't see "hordes
| of drug addicts" I see Hoovervilles. For some reason we're not
| moved to help the destitute like we once were. Perhaps it's
| because we view them as "drug addicted zombies." So much for
| "love thy neighbor."
| remarkEon wrote:
| I've lived in various west coast cities since 2011 and while
| a "horde of drug addicted zombies" roaming the streets is not
| literally true (like out of a zombie apocalypse film or
| something), you can't deny that there is a significant
| problem in certain areas of these cities. In the same way
| that hyperbolizing the descriptor undermines the point,
| imagining that it isn't a problem and just something you deal
| with is the other side of the same coin.
|
| >... my answer would be to greatly reduce inequality
|
| We've been screaming the same tune for over a decade at this
| point. Equality is a problem but it's a parallel issue. Doing
| the same policies, but louder, is not a good faith proposal
| because it's just repetition of what doesn't work. Many, and
| indeed I would posit most, do not want your or my help to
| live as a "contributing member of society". Some are so far
| gone they're not in the position to even make a choice.
| aschearer wrote:
| I didn't deny that homelessness is a problem, please re-
| read my comment.
|
| Perhaps I've been "screaming the tune" for a decade but in
| that time the cost of housing has gone up dramatically. In
| 2009 I rented a 2-br apartment in Capitol Hill for $1,600
| -- parking included. In 2019 I rented a studio apartment in
| the same neighborhood for the same -- parking not included.
| I can produce examples like this all day.
|
| My point is, we haven't successfully tackled the problem of
| inequality and affordability. In my opinion, we must tackle
| the root problem if we hope to resolve the issue long term.
| We can do that _and_ address the symptoms in parallel.
| However if I had to bet, my money is on housing continuing
| it's inexorable rise over the next decade, pushing further
| people into destitution.
|
| I've tried to respond in "good faith." Your turn.
| remarkEon wrote:
| We're clearly not talking about the same problem. There
| isn't a direct line from you not being able to find the
| same square footage for $1600 in 2019 as you did in 2009,
| and you winding up as a hopeless drug addict in Cal
| Anderson. I'm all for draconian policies to address
| rising housing costs (such a extreme excise taxes on
| vacant units, of which there are _a lot_ in Seattle and
| Portland), but that doesn't have anything to do with tent
| cities in the Puget Sound area. If Capital Hill suddenly
| had the same inventory of 2 bedroom units with parking at
| $1600 a month that it did in 2009, the broader problems
| do not go away.
|
| These people we're talking about will all be dead by the
| time any of yours or my pet ideas to increase housing
| supply come to fruition. And yet, in the here and now,
| there's a continuing escalation of health and safety
| issues that, again, don't go away if rents suddenly drop.
| aschearer wrote:
| I've advanced the position that 1) we should agree to
| tackle the root cause of the problem primarily but not
| exclusively and 2) we should identify and agree on what
| the root cause is. I'm not clear if you agree with the
| above.
|
| I've explained what I believe to be the root of the
| problem. You have not. I've explained some ways we might
| ameliorate the problem. You have not.
|
| It's difficult to have a conversation when the
| interlocutor won't state their positions and take a
| stand. Even more so when they accuse you of "screaming"
| and acting in "bad faith."
|
| I'm left to infer what you're thinking. I imagine it's
| that inequality is not linked to the rise in
| homelessness. (I disagree.) That people are more
| susceptible to drug addiction than before. (I'm very
| skeptical.) And that if we punish people more forcefully
| the problem will be resolved. (I doubt it, but that's not
| to say we can't protect our public spaces more
| vigerously.)
|
| If I pegged you wrong, I apologize and look forward to
| being corrected. If not, then let's agree to disagree.
| mlyle wrote:
| Homelessness is a huge problem that needs additional
| resources. Most of it isn't really visible.
|
| And then there's the huge sub-problem of people who are
| chronically homeless, drug-addicted, and visible.
|
| Large efforts at simply improving access to housing are
| likely to make a large dent in the larger homelessness
| problem, but may not be effective in addressing people
| with long-standing drug addiction and behavioral
| disorders. Many/most have behaviors that are incompatible
| with conventional housing.
|
| The solution for this subgroup is going to be a lot more
| complicated.
| aschearer wrote:
| Bringing back forced hospitalizion. Repealing child labor laws.
| Tolerating graft in the Supreme Court. Calling Secretary of
| States asking them to find some votes. Grabbing women by their
| genitals. Teaching the idea that slavery was benefitial for the
| enslaved. Wild that this is popular with people. Why does Murdoch
| keep pushing this stuff?
| monkmartinez wrote:
| > These days, the idea of compelled vaccination is pretty
| controversial, so the idea that we are going to take away
| peoples' liberty and force them to take psychotropic drugs after
| we've imprisoned them seems beyond belief.
|
| This is already happening. Compelled vaccination is completely
| different than a mentally disturbed member of our society roaming
| the streets unhinged. I have been party to several title 36[1]
| cases and it's very, very difficult to get dangerous people
| "petitioned". It requires coordination between disparate agencies
| like hospitals, Fire/EMS, Police, community mental health orgs,
| etc. None of them share a database.
|
| Once they are found to be incapable of living on their own, what
| do we do with them? Jail? Hospital? Half-way house/Assisted
| Living?
|
| I will tell you... They end up back on the streets and it isn't
| pretty. The underbelly of every American city is a nasty, grimy,
| horrific place. I need to retire.
|
| [1] https://www.azleg.gov/arsDetail/?title=36
| amadeuspagel wrote:
| Compelled vaccination -- forcing people to endure the pain of a
| needle and a few hours of feeling sore in their arm -- is
| indeed completely different from locking people up in mental
| institutions for decades.
| gretch wrote:
| This is a strawman - no one is complaining about the pain of
| the stab. It's 100% the juice inside the syringe.
|
| This is the CDC site on the history of vaccine incidents:
| https://www.cdc.gov/vaccinesafety/concerns/concerns-
| history....
|
| Bad things can and do happen and it doesn't do any good to
| pretend they don't.
|
| Of course the reward is far worth the risk with modern
| science, but some people are still afraid of shit like this.
| sbuccini wrote:
| You should write more on this topic.
| devilbunny wrote:
| There is no shortage of writing on this. The Supreme Court
| decisions of the early 1970s on mental health were well-
| intentioned but disastrous.
| wahern wrote:
| > The Supreme Court decisions of the early 1970s on mental
| health were well intentioned but disastrous.
|
| Those decisions still left much room for coerced treatment,
| so it's not clear how disastrous they were. Most if not all
| states and cities ended up with additional legislation,
| caselaw, and normative policies that made coerced treatment
| (including outpatient treatment) much more difficult.
| sbuccini wrote:
| I am very curious to hear the personal experiences of a
| frontline firefighter/EMT in Phoenix
| badrabbit wrote:
| A person does not belong to society or to the government. Sane or
| not, a person who chooses to not get mental, physical or
| preventive treatment (like vaccines) or other social manadates
| should not be compelled because humans lack the authority to do
| so.
|
| What should happen is they should be expelled from society.
| Expulsion was very common in historical societies. The famous
| version of this is leper colonies. The land of thr country
| belongs to them, so designate a place for them to live in
| isolation except for volunteers that wish to visit them and offer
| aid/help.
|
| People should be asked that in the event they are deemed by
| professionals to be incapable of making their own decisions that
| they delegate the power of decision making on their behalf to the
| courts or society.
|
| This is a pervasive issue, even things like not wanting to be
| dependent on tech for day to day survival is a person's right.
| Compelling a person to do anything means you have deprived them
| of liberty and subjugated them, and to do that, having a good and
| legitimate reason is not enough, you also need authority.
|
| In communist governments for example, people are subjucts of the
| state and the state assumes authority even over what people
| belief. But in the US at least, the government that derives all
| its power and authority from the governed has not been granted
| such unlimited authority over law abiding citizens, or authority
| to pass laws to manipulate peoples bodies, regulate their beliefs
| and convictions or imprison them when they have not broken a law
| "for their own well being and without their prior consent. The
| people did not consent to have their wellbeing and safety taken
| care of against their will. If insane people, unvaccinated
| people, naked people and other people are considered to place a
| burden to society or to cause harm in the future, simply forbid
| them from coming into contact with society and only enforce
| complelled measures when they persistently refuse to comply.
| veave wrote:
| There isn't much difference between expulsion and putting them
| in an asylum, no?
| lurquer wrote:
| [flagged]
| badrabbit wrote:
| There is, more space and freedom to do whatever they want
| there.
| krapp wrote:
| But clearly what they want is to remain within society,
| otherwise they would have simply run off into the
| wilderness on their own accord.
| badrabbit wrote:
| This will allow them to form a society that will tolerate
| their ways and appease existing mainstream society.
| Polygamy in utah is a good example.
| veave wrote:
| Most likely they will simply die of starvation.
| badrabbit wrote:
| They can take what they want with them, farm the land,
| fish, build houses, cities,etc...
| kelseyfrog wrote:
| There is from a sociological perspective. It's the difference
| between therapy and nihilation[1].
|
| The section on therapy and nihilation comprises just a few
| paragraphs, but the general gist is this. Therapy prevents
| immigrations from reality and nihilation prevents
| contamination of reality. They are, of course, both machines
| of universe maintenance. However just because they share a
| telos, doesn't mean there isn't much of a difference. There
| is a vast difference between the experience of being
| subjected to either therapy or nihilation depending on the
| social and material particulars of each.
|
| 1. Berger, P.L. and Luckmann, T. (1966) The Social
| Construction of Reality: A Treatise in the Sociology of
| Knowledge. Doubleday & Company, New York.
| mplewis wrote:
| Uh, what the hell?
| klyrs wrote:
| This is pretty normal for Wall Street Journal. When they
| suggest anything that looks like socialized health care, it's
| gonna be the bizzaro version that does more harm than good to
| the patients, but gets the homeless off the streets they want
| to make money on. I haven't bothered to read the article, but
| there's good money to be made if these institutions are
| privatized.
| sam345 wrote:
| ? Author not editorial board: David Oshinsky directs the
| Division of Medical Humanities at NYU Langone Health. His
| books include "Bellevue: Three Centuries of Medicine and
| Mayhem at America's Most Storied Hospital" and "Polio: An
| American Story," which won the 2006 Pulitzer Prize for
| history. Wikipedia:
| https://en.wikipedia.org/wiki/David_Oshinsky
| klyrs wrote:
| Are you saying that the editorial board doesn't choose who,
| and what, to publish? Because I didn't say "this article
| was written by the editorial board" which is what you seem
| to be arguing against. I said that this article is
| consistent with WSJ's agenda.
| hotpotamus wrote:
| I wonder how much of an increase in taxes the folks at the WSJ
| would be willing to pay to bring back asylums? The longer I live,
| the more the quote "the past is a foreign country: they do things
| differently there" comes to mind. I don't really understand what
| the asylums were like, but I see that old America that they
| resided in as a very different place that believed more in public
| investment. These days, the idea of compelled vaccination is
| pretty controversial, so the idea that we are going to take away
| peoples' liberty and force them to take psychotropic drugs after
| we've imprisoned them seems beyond belief.
|
| None of that is to say I don't think it's probably the right
| answer, rather that I just don't see it happening in modern
| America.
| amadeuspagel wrote:
| This old america did not believe in public investment enough to
| ensure humane conditions in asylums.
| neonate wrote:
| https://archive.ph/d948j
| sam345 wrote:
| No paywall: https://archive.is/RK7dH
|
| Author David M. Oshinsky is per Wikipedia an American historian,
| director of the Division of Medical Humanities at NYU School of
| Medicine[1] and a professor in the Department of History at New
| York University.
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