Is forced treatment for the mentally ill ever humane?

https://www.economist.com/united-states/2022/12/19/is-forced-treatment-for-the-mentally-ill-ever-humane

by MoSattler • 4 years ago

113 242 4 years ago

economist.com

kelseyfrog• 4 years ago

https://archive.vn/Togvj

hprotagonist4• 4 years ago

Well, should you be allowed to stop a suicide?

readthenotes1• 4 years ago

I have a relative who had to be taken to the hospital after scraping invisible mites out of their eyes with a razor blade. They asked them if she would like some antipsychotic medication and of course they said no.

As a result, my question is, is it ever humane to not force treatment on the mentally ill

ajb2• 4 years ago

Obviously it can be. See lobotomization and ECT just for starters (yes, I know ECT is supposed to be better now, don't really buy it)

raverbashing• 4 years ago

You are asking the right questions

A lot of homelessness is due to different mental illnesses (not discounting the societal issues, and of course the drugs then make it worse)

I really feel society sucks at dealing with the action/inaction assymetries

andrewclunn• 4 years ago

When societies will intervene to stop suicide while simultaneously allowing for government sanctioned assisted suicide, it means that the morality or "rightness" of an act is only now defined by whether the proper paperwork was filled out.

polygamous_bat• 4 years ago

... it means that the morality or "rightness" of an act is only now defined by whether the proper paperwork was filled out.

I do not understand your point. How is that any different than, say, driving my car down the highway? The same act can be fine if I have a driving license and not fine if I do not.

kbenson• 4 years ago

Sometimes, paperwork is there to force some other condition to have been met, such as time and review and notification of others. So, it it more "right" to make people that want to commit suicide take a bit of time to consider whether that's actually the decision they want, and not something being influenced by a temporary situation, whether external or internal (such as a hormone imbalance that ebbs and flows)? I think yes, generally, even if edge cases exist.

fellowniusmonk• 4 years ago

It's moral to have an unsubscribe button, it isn't moral to require me to fax in an unsubscribe form after signing up with one click.

It's moral to ensure charges go before a court quickly, it's immoral to allow a person to languish in jail for decades without trial.

Time and effort are a components of everything including morality. To dismiss time and effort as trite or irrelevant in nearly any situation seems abusurd.

itishappy5• 4 years ago

I don't think those are fundamentally equivalent categories.

Assisted suicide is (to my knowledge) aimed at end of life patients with terminal outlooks. People who have little chance of improving their outcome.

Self inflicted suicide is a much broader category including bullied high schoolers and unlucky stock traders. People who's current situation might look grim but who could potentially change that situation.

I won't comment on the morality of either, but there's more at play than just bureaucracy.

shanebellone8• 4 years ago

Absolutely not. I believe there is a legal argument in favor of bodily autonomy which includes the right to death.

"Life, Liberty and the pursuit of Happiness."

Life is inextricably linked with death. If you have the right to live, you must also have the right to die. That belief is largely entrenched in our medical system too but stops short of doctor assisted suicide.

hprotagonist4• 4 years ago

Does your right to die permit you to inflict trauma on others by, say, stepping in front of a train in a moment of crisis? Eating a 12 gauge and leaving your family to discover your meat splattered on the floor? etc.

Am I allowed to stop that suicide? "Whatever affects one directly, affects all indirectly."

tshaddox• 4 years ago

Should you be allowed to treat someone who is unconscious? Forcibly remove someone from a burning building or vehicle?

anon2916• 4 years ago

Life is inextricably linked with death.

Sure

If you have the right to live, you must also have the right to die.

This is a non-sequitur. In fact, in so far as all human rights descend from the one in question being alive in the first place (since the dead have no rights), it makes no sense of a right to die. In the same way a right to liberty involves no right to sell one's liberty. Just like your freedom, you do not own your life. We know this because you cannot sell either your life or your freedom, thus you don't own it. Thus, despite having a right to it, you don't have the right to rid yourself of it.

Here's another example. My children have a right to live in my house and receive support from me. They have no right to either sell my house or not receive support from me. Although they have a legal right to my money and protection, they cannot dispose themselves of it.

Life and freedom are similar. They are something we enjoy and have a right to, but not something we own.

That belief is largely entrenched in our medical system too but stops short of doctor assisted suicide.

Choosing to not undergo therapies that may or may not lengthen your life is not morally equivalent to actively choosing death.

guerrilla11• 4 years ago

Absolutely not. The only possible justification for any of these authoritarian interventions is self-defense. Anything short of that is infringing on their autonomy over their body and not something you should be advocating for especially considering you could be in that exact situation. In addition, suicide is not necessarily irrational, so definitely not.

mythrwy• 4 years ago

Looking around at insane and drugged up street people (for instance) intuitively I say "Yes definitely, and it should be more widely practiced!".

Then I remember how the definition of mental illness has changed over the years and think how it might change in the future, and now I'm not so sure.

TulliusCicero• 4 years ago

Seems like the threshold should probably be whether it's substantially interfering with their ability to interface with the rest of society, especially in terms of breaking laws. Many people in the situation you describe no longer seem capable of regulating their own behavior.

gernb• 4 years ago

There's a mentally ill person who lives outside my apartment. Every day/night she screams at the top of her voice about random things. I feel very sorry for her but at some point she needs to be moved and taken somewhere. She has no right to subject the entire neighborhood to her rants. All of our collective santity outweights her issues. It's not that different than a repeat criminal. Reguardless of reasons, at some point they're too much of a net negative to society. Dealing with them in some humane way is ideal but those 2 things are separate concerns IMO.

Meaning there are 2 issues

(1) Save everyone else from someone's distruptive behavior

(2) Deal with the person in the best possible way

You can solve (1) and not solve (2). Being not able to solve (2) perfectly does not invalidate the need to solve (1)

horsawlarway• 4 years ago

Yup - I think it's very important to point out that there are two different problems to solve here.

1) What sort of behaviors is a community willing to tolerate

2) What does that community do with people who are unable to stay within the confines of tolerated behavior

The problem is that asymmetrical answers to the two questions can create a strange grey-zone, where problems linger.

For example - if you murder someone, I don't think many people are going to argue against you spending some time in prison. The response is in line with the severity of the action.

But... if you say, consistently piss in the elevators of your local metro (even though public bathrooms are available), most folks aren't sure prison is the right answer. Ideally - we'd just keep you out of the metro entirely - but setting up that system is very expensive when we're dealing with a very small number of bad actors.

On the flip side - that small number of bad actors is doing considerable damage long term. They're making metro usage far less pleasant, driving down ridership, increasing cleaning costs, reducing public health, and requiring additional staff in attempts at monitoring. Each other member of society is only inconvenienced a relatively minor amount, but they're impacting a very large number of them by degrading a public and shared service.

The same is true of those who camp/sleep outside of businesses, or scream & rant in public spaces, or do drugs in public spaces. They are actively harming the space they are using at large, and are unwilling to stop or unable regulate themselves.

So what do we do with those people? What is a proportional action that we can take that prevents the damage this person is causing at scale?

Prison/Jail rarely work - because the damage of each individual occurrence is small, they are usually out very quickly.

Providing housing can resolve problems in some cases, but there are people who are actively unwilling to stay in publicly provided housing (for a variety of reasons - although the most common I see is consistent drug use, closely followed by serious mental illness).

Meds can definitely help - but the category of people creating these disturbances generally have trouble consistently taking meds (again - for a variety of reasons including access to services and payment, but not the least is active, personal resistance)

So... if we've ruled out (as in - tried and failed) self medication + housing + prison... where do we go?

Because at that point - I'm not really convinced that forced treatment and care are really unreasonable responses. It is far more cost effective to gather these folks in a single place and confine them there than it is to allow them to roam and attempt to stop their problem behavior at the place it occurs. It's the difference between 10 guards, a large facility home, and medical staff - versus thousands of required staff spread over a city.

tracerbulletx• 4 years ago

We need to do the best we can with the information and morality we have, we've become paralyzed into inaction by fear of doing anything wrong and the ghosts of atrocities past.

Baeocystin• 4 years ago

I fully agree that this is a genuinely difficult, multi-factor problem with no easy answers.

I also think that there are a lot of 'low-hanging fruit' level of options available, that seem to be disregarded in today's all-or-nothing environment. Specific example: During my short, ~10-block drive to the 101, I pass a good half-dozen regulars who are either screaming at the aether, wandering erratically through traffic, flinging things at passing people/cars, or in one case literally rolling around on the onramp between cars. This is not an exaggeration, or hyperbole.

These people need to be in an institution. Maybe with treatment, they can recover. Maybe they will be there for the rest of their lives. Maybe some form of halfway-house works best. But I can't think of any good-faith argument that leads to the status quo being the best choice for either them or society at large. Surely we can come to a societal agreement about what to do for this level of dysfunction?

LexGray• 4 years ago

That question would be is forced denial of treatment for the mentally ill ever humane. I question how many mentally ill people on the street are there because they were given a choice to avoid treatment or if they were driven there by circumstances. The cognitive disruption of most mental health treatments would make most any sane person question their value versus quality of life.

I do agree that mental illness definitions are a problem. Even forcing treatment on just those who are a danger to society makes me leery given that hostile social posts are now a social danger.

bell-cot7• 4 years ago

An old friend has a niece with a life-long, major mental illness. When off her medications (I've lost count of how many times, over the years), she goes "on the run", and phones home to various family members (often many times per day) with angry rants - which very often include threats of great bodily harm and/or death. Her grip on reality in that state is rather poor - asserting that Bugs Bunny and the CIA are conspiring to create a brain controlled army of polar bears with space lasers would not be unusual.

When on her medications, she is a relatively pleasant & rational person, usually able to hold an entry-level job.

Her family do not want to throw her in jail for all the threats (I'm not asserting that they could, if they wanted to), she really does not like the side effects of her medications, and (under the current system) neither confining her to a long-term mental health facility, nor reliably forcing her to take her medications seem to be available options. (Her family has talked to lawyers about their options more than once.)

What would be the "humane" thing to do? In composing your answer, please recall that her family are also humans, and - barring a premature death - she is likely to outlive most of them.

Edit: Thank you for all the replies, but my 4th-paragraph question was intended to be rhetorical. My point is that the case-by-case reality, even from the PoV of a well-to-do family that really seems to care about the mentally ill person, is often agonizingly difficult.

brodouevencode3• 4 years ago

It's certainly tough for sure. I think the ultimate question is what is considered "humane". Locked up in a straight jacket in a padded room for having slightly depressive thoughts is certainly not, but also allowing someone like in your story to spiral out of control and act out their trauma is arguably equally as inhumane. I wish I had a good answer for you.

jimbob45• 4 years ago

Assuming her threats and behavior would eventually result in her being tossed in jail, the choice seems to be between her imprisonment and her being forcibly medicated.

I don't have an answer for you. I think you've come up with a potential plot for a very interesting Star Trek episode though.

bell-cot7• 4 years ago

Her family's guess is that she'll be killed in some violent altercation while "on the run". Probably one for which she bears most of the "responsibility". And they pray that she won't get any innocents maimed or killed before that happens.

(Star Trek: My guess is that such an episode, if it had any serious depth, would be vetoed in the script stage - due to being an extremely painful subject for too many viewers.)

Pxtl• 4 years ago

I've already read a science fiction story or two about this scenario - a dangerously schizophrenic guy goes off his meds and then murders someone during mania. He gets charged with criminal negligence because he knew how dangerous he would be without his meds. One of Niven's short stories, he loved to write about the ethics of schizophrenia.

pcurve2• 4 years ago

What a dilemma. Is she aware of how she acts when she's off medication? Has she seen herself act this way on video?

runnerup11• 4 years ago

That won’t help. There’s hundreds of thousands (nearing or exceeding a million) people like this in the USA alone. If that worked, it would be widely practiced.

These mental illnesses break the ability of an individual to choose to do what’s best in terms of medication, treatment, and lifestyle. The illness makes one not want to be properly medicated.

Someone can be consistent with their treatment and lifestyle for many months, but it just takes one trigger and a couple days off medications to lose all progress.

kayodelycaon9• 4 years ago

I doubt this would work. When a neurotypical person is confronted with their actions, you usually get one of four results:

1. Justify what they did.

2. Dismiss it.

3. Ignore it.

4. Deny it happened.

Note that change their behavior isn't on that list. :(

bell-cot7• 4 years ago

My understanding is that she is relatively aware. I don't know about the video part.

tensor• 4 years ago

I have a high school friend who is the same way. It's beyond traumatizing for his friends and family. Many of them live in fear. Same story, neither confining him nor forcibly medicating him are options, so he roams around, unable to hold jobs, randomly threatening various people.

I worry that one day he'll end up being shot by police or something. It's awful.

kayodelycaon9• 4 years ago

I don't have any answers here, but I want to provide some context for the drugs in question.

I'm on antipsychotics. They are nasty drugs. Absolutely brutal. The worst of the side-effects for me are the sexual side-effects and motor-control issues. If I get dehydrated or my blood sugar gets low, I can lose the ability to walk.

Within the first hour of taking my meds, I can't stand without losing my balance. I lose both my inner ear and kinesthetic senses. I don't know where my feet or hands are. I can only walk by having my eyes open to see if I'm level and feeling where the pressure is on my feet.

During the day, I have medication that helps this but I still trip on uneven surfaces or drop things.

The sexual side effects, I can't orgasm. Combined with the hypersexuality a manic episode creates, it is unbearable. Fortunately, I'm on yet another drug that makes this less of an issue.

The only reason I can tolerate this is the alternative of going crazy is so terrifying, I'll do anything to prevent that from happening. If anyone wonders why people don't stay on their meds... this is a big reason.

asveikau4• 4 years ago

My brother was on antipsychotics for about 20 years. His compliance was poor. He is homeless now and without treatment.

Growing up he would tell me how terrible the medications were. I believed him, and still do to an extent. However he also identified with his illness and thought the drugs were taking away his special powers. That was a symptom. For those reading who have less experience, they sometimes call that anosognosia or lack of awareness.

In the end it's a very existential thing. It's easy to wonder about identity. I had a few people in my life with this sort of illness. I developed a model where medicated, treated, and stable, that is the "normal" them, their identity. However, these people got offended by this, and engaged in behavior I would describe as identifying with symptoms. Acknowledging symptoms, no matter how evident, was tantamount to personal attacks.

I think we all have issues with this in our lives. Self awareness and identity is a difficult problem. It's only when it falls far outside of norms, into extremes, that we call it a disorder. It can be very tricky to draw those lines.

bell-cot7• 4 years ago

+100 (if I could).

And similar for being sane enough to be so intent upon staying that way.

citizenpaul• 4 years ago

I've often been confused by reports like the OP that the person refuses meds then proceeds to descend into some sort of pure madness. How can that madness be better than the meds? Why do you think they prefer the madness? You seem to resist it do you know any reason why?

I've known three people one directly and two indirectly that were lunatic level if they were off meds and all refused meds consistantly.

1. Was a guy I worked in the same dept during an early job. His thing was to start telling people that government agents were in the elevator to control your mind or something and ending out emails about it and corning people to warn them. Funny thing was it was a government job so there were government agents in the elevator pretty much anytime someone was in the elevator. He resisted because he didn't like the meds.

2. My friends brother in his 30's would not take his meds and his parents had to sneak them in his food. If he missed enough doses he would eventually go raving mad into the woods and eventually be found passed out somewhere by emergency responders usually naked and injured. He resisted because he didn't like the meds.

3. My brother in laws brother was paralyzed and brain damaged from a car wreck. Yet when off meds he would run off in his wheelchair into dangerous traffic or be found passed out(and injured) from exhaustion of crawling because he went somewhere a wheelchair couldn't go and just crawled for miles. Again he didn't like the drugs.

thehappypm• 4 years ago

I have a super bad phobia of doctors and needles. Like, I literally pass out during a physical exam or a dental appointment in an uncontrolled panic spiral

50 mg of Zoloft later I am 100% panic attack free. But even 50mg of Zoloft (which is essentially the lowest dose of a very safe drug, and I am a large male) has side effects I dislike, and accidentally missing a dose makes me feel absolutely awful.

I can hardly imagine what serious drugs do to you and the implications of them.

profstasiak• 4 years ago

do u mind sharing drug and dosage? Sounds really extreme. I am working as a healthcare provider but never knew sideffects can be that harsh. I guess clopazine right?

23B1• 4 years ago

I think what's really important about your comment is that there might not be an answer to some problems. This is something that most people struggle with – and certainly publications (even the respectable Economist) love these sorts of conundrums because they pluck at the tragedy-strings of most humans.

Sometimes there simply is no solution to a problem, a very hard concept to grapple with as participants in a community, society, or civilization.

pyuser583• 4 years ago

The side effects of medications can be horrific. I’d rather be dead than deal with extreme nausea.

However … eventually she’s going to make contact with the criminal justice system. This can very productive. Authorities can make plea deals/pre-prosecution agreements that require medical compliance.

I’d advise the family to move to a jurisdiction with lots of resources. A wealthy suburb should work.

Then wait for her to commit a crime and make report it.

I too have a relative who has psychotic episodes. I’ve had wonderful experiences with the criminal justice system (in rich suburbs).

toast02• 4 years ago

However … eventually she’s going to make contact with the criminal justice system. This can very productive. Authorities can make plea deals/pre-prosecution agreements that require medical compliance.

Depends on the law enforcement. My aunt would ocassionally get arrested, but they'd never charge her with anything, just bring her to the hospital for an involuntary psych hold, and she'd find her way back home after that. I don't think they ever found meds that worked for her and that she'd take consistently for more than a couple weeks. (This was in San Pedro, CA, which doesn't fit your suggestion of a wealthy suburb)

squirrel• 4 years ago

Read books on schizophrenia by Dr Xavier Amador for an interesting perspective on gaining compliance without necessarily agreeing on what the problem is. Excellent videos on YouTube also.

Dma54rhs• 4 years ago

I've been forced to be on antipsychotics. They are nasty and I compare it to sexual conversion therapy. I totally understand the society is not ready for that discussion but it does irk me the supposedly compassionate people are quick to mentally sterilize you.

sshine• 4 years ago

It’s a controversial topic that the side effects are so bad that some choose to go psychotic instead. But it doesn’t change the picture that all the stories on this page tells you how much each side sucks and how much the other side sucks more.

Melatonic2• 4 years ago

I am hoping these kinds of things are the perfect candidate for future biotech implants. Having to take ap ill everyday can be difficult to regularly remember even for the totally sane. What if we had some type of implant that could somehow recognize when someone was going through a major mental episode and then dispense some medication to help them? Or even one that simply regularly released the medication throughout the day and then periodically had to be refilled?

Seems like the side effects of a lot of these harsh meds might be tempered by a slow release vs all at once with a pill. I am not a medical professional though so I could be completely wrong here.

TylerE3• 4 years ago

I dunno why docs don’t hand out pill organizers like candy. Make life so much easier. Only have to open the pill bottles once a week, and I easily tell if I’ve taken a dose or not. One I bought on Amazon was maybe $6 or something?

zaknil• 4 years ago

When off her medications

Sure. The problem is that most (probably all) of these drugs give severe withdrawal symptoms when abruptly discontinued by a patient. You'd have to spend a lot of time to slowly wean her off all(!) drugs to know if they're helping or harming. Nobody does that.

mjthrowaway1• 4 years ago

This is my reality as well with a family member. The only real option is to move to a state that has more effective mental health laws. The self-destruction that takes place during episodes isn’t fun for the niece either. Similar to my situation the government doesn’t make conservatorship easy to obtain. The practical solutions (10 day forced stays with up to 180 days involuntary) are nowhere to be found. Instead the govt thinks the best option is for the person to go bankrupt, burn all social relationships, and put themselves on the streets for a few months every other year.

yupis• 4 years ago

Thanks

p0pcult2• 4 years ago

Surely some of the answer also depends on what constitutes the "treatment," no?

armchairhacker• 4 years ago

The way I see it: forced treatment is humane when the person being treated consents afterward. e.g. stopping someone in a bad mental state from suicide or anorexia, so that they thank you when they improve. Of course it’s not possible to know whether the person will consent beforehand, so you have to predict (and if you get it wrong, you messed up).

In most cases this is what real-world suicide prevention leads to, because if a person is adamant on killing themselves they usually find a way. The exception is really sick people who want to kill themselves, but can’t because they have limited autonomy. That would be covered by euthanasia and is one of the reasons why it is very important ethically.

For other mentally ill people, forced treatment is still only ok if they may actually get better and thank you later. If someone is dirty, homeless, and senile, but they don’t care, putting them into a retirement home does not make them happy so it does not actually benefit them. If someone acts sane only when they get medication but they hate it, giving them the medication does not benefit them, it benefits others.

In these cases forced treatment may still be practically necessary and morally ok to benefit society (we don’t want dirty homeless people begging on the street, so we outlaw public indecency and soliciting, and some illnesses make a person dangerous). But I think that we need to understand that forced treatment is not to benefit the mentally ill themselves, but us, and also take their feelings into account. e.g. force homeless people out of the streets and into homes, but give them autonomy, and if their homes decay and they sit around all day and don’t care, let them.

EDIT: Should also add that nursing and caregiving are jobs which give people power over other, vulnerable people. Many of the doctors which take care of mentally ill and disabled people are genuinely amazing people who honestly don’t deserve the bad connotation, but some apply to these jobs to take advantage of their power over others. So when forcing treatment on someone, we really need to ensure that those in charge of the treatment have said person’s best interests at heart, and need to be monitored and held accountable. This is something which is unfortunately lacking because the people who are exploited or in danger of being exploited and thus care the most can’t really advocate well, so the burden falls to beaurocracy which cannot adequately manage.

loeg• 4 years ago

Always nice to see a counterexample to Betteridge's law of headlines.

pcurve2• 4 years ago

I guess it's a question of humane from whose perspective? If I were ever in a position where I'm not able to make sound decision ono my behalf and I don't have anyone around me to do so either, I would be OK with governmental entity intervening.

"Democratic mayor of New York City, instructed police and first responders to hospitalise people with severe mental illness who are incapable of looking after themselves."

I consider this humane and sound.

AnimalMuppet• 4 years ago

The problem comes with "incapable". What about marginally capable people? Where are you going to draw the line?

The solution to that might be to not have a binary line. The less capable they are, the more we can choose for them, but it's not all or nothing. (No, I don't have any idea what the details look like...)

lotsofpulp• 4 years ago

In that quote, “hospitalise” might mean to drop them off in an understaffed hospital emergency room so that they can be temporarily sedated or whatever and then released within whatever timeframe protects the various entities from liability.

I doubt “hospitalise” means to house them in a properly staffed psychiatric care facility under the care of qualified professionals.

bell-cot7• 4 years ago

Like ~any government policy, the reality depends mostly upon the competence, honesty, good will, and resources of the people & agencies actually implementing the policy. (Vs. the Official Rules, as written down by politicians & bureaucrats.)

Folks who really don't trust the government of NYC on the "competence, honesty, good will, and resources" angles may have plenty of evidence to support their distrust.

xyzelement3• 4 years ago

The question feels very complex when framed like in the article. In reality I think it's two separate but connected questions that society should be able to answer based on its dominant values.

1. Do we have and enforce laws about things like people setting up tent cities in neighborhoods, open air drug use, public defecation and attacking pedestrians.

Your politics can determine how you feel about this. My personal take is that yes we should have and enforce such laws.

2. What do we do when people are violating these laws due to mental illness? Do we just prosecute them and lock them up in regular jail or do we institutionalize and treat them like the mentally ill?

To me it seems like treating mentally ill transgressors as such is right. The alternative to treat them like regular criminals seem worse.

I think most people can follow this kind of argument. The real debate is around the first point, where do we draw the line about legal and illegal behavior.

runnerup11• 4 years ago

Also, where should people be homeless? Literally I cannot pay rent next month and have no one willing to take me in.

Where should I go? AFAIK there are zero legal options for me when I’m unable to pay for an apartment. I do not own a car.

If I insist on being an upright citizen and following the law…do I just show up to a police station on January 1st and turn myself in for vagrancy and hope they throw me in jail?

pigeons• 4 years ago

What part of the world do you live in.

Retric• 4 years ago

Homeless shelters are a short term solution. Various housing programs are available depending on location, but tend to be really slow.

dilap2• 4 years ago

I think you meant this as a rhetorical question, but I'll go ahead and answer it anyway.

The practical answer is you do become homeless, but not out in the open -- you'll set up a tent somewhere somewhat hidden (maybe in the middle of a park, for example), and hope nobody notices it. Every so often your camp will get discovered and cleared out, which will be inconvenient.

It certainly seems pretty mean-spirited to harrass the homeless in this way, but it does have the benefit of (mostly) preserving the beauty and safety of public space.

chaostheory3• 4 years ago

Homeless shelters exist for this purpose.

There’s also HUD or similar entities if you’re not in the US. There are also private nonprofits like churches that help with homelessness

p0pcult2• 4 years ago

Do you have a cryptocurrency address? Can I help?

anon2916• 4 years ago

Literally I cannot pay rent next month and have no one willing to take me in.

Well in most cities in the United States, there are numerous open spots in rent assistance or shelter programs. For example, in my city of Portland, there is a lot of money spent tackling this problem. In fact, each night, the city has empty rooms available for anyone, but they go unused. Unfortunately, part of the problem is the narrative pushed by the media that America has no social welfare. We have quite a lot. Unfortunately, the narrative we don't prevents people from seeking it out.

This is similar to how narratives about COVID swamping hospitals led to so many people not seeking medical intervention that they died or let a preventable illness go untreated. And it's what caused so many hospital closures.

Moreover, if you cannot pay the rent next month, you can contact your local st vincent de paul, and they will often cover it for you: https://www.svdphouston.org/

Below you said you are simply going to be late, and able to resume making payments in January. If that is the case, there are numerous programs available that will help you to make your rent so you don't take the credit hit. Again, if you lived in my city of Portland, I know several charities that will simply pay your rent no questions asked, not even expecting the money back. Please contact your local social services agency or one of these charities. Many have funds that go unused each month.

nonameiguess• 4 years ago

I happen to live in downtown Dallas, near enough to homeless encampments to walk past them pretty frequently. Tents all over the place near highway overpasses. There was a tent set up behind the Dallas Police Memorial across the street from city hall for about six months. The exact same tent, which never moved. The main branch public library, also across the street from city hall, and a bridge near me where there is a large bus depot, are nearly refugee camps. You can't walk six feet without stepping on someone if you try to go by them when it's dark.

My take on this is what else are they supposed to do? Unless they're all killed, they have to live somewhere, and if they can't hold jobs and/or can't obtain real housing, what option is there other than to live on the street? I don't see how this can be made illegal. You're arresting people simply for existing and not being able to pay rent. What is this supposed to help? These are at least thousands of people in one city, hell, one neighborhood. If they were all sent to prison, there'd be no space left for real criminals.

As for shitting on the street, again, what else are they supposed to do? If there aren't public toilets available to use anywhere, that doesn't change the fact that they're animals with digestive systems that require them to defecate on a regular basis. Hell, with all the walks I go for early in the morning, I have three times in the past six months had to shit on a sidewalk, not because I'm some belligerent lawbreaker or even because I don't have a toilet, but simply because I couldn't get home fast enough when it came on and there was nowhere else to go. It's not even a matter of whether businesses with toilets will let you use them. There aren't even any businesses open at 4:30 in the morning.

I don't even see how this is a matter of politics so much as practicality. There are simply so many people that having the police, courts, and prisons try to deal with all of them would leave them unable to effectively do anything else they're supposed to do. I doubt it even works as a deterrent. Prison isn't any worse than how they're already living and the inability to reintegrate into society means nothing if they were already unable to integrate into society in the first place.

As it stands, sleeping in public and setting up camp in these places is illegal, but they may as well pass a law saying eating is illegal. How can it possibly be enforced? People can't just not sleep and shit, and if they don't have the right to occupy any private space, public space is the only space left.

Edit: I can see someone else already said something similar and got immediately downvoted with the response that they should go to a shelter. Okay, as far as I can tell, the people are sleeping where they are right now because it's within walking distance of aid facilities that are all located downtown. This includes shelters. But these shelters don't have anywhere near enough room for all of these people, and they aren't faced with a "temporary" problem. I've lived here long enough to see the same people and recognize them over the course of years. Some of them have clearly lived on the street for decades.

anon2916• 4 years ago

In olden times, people used to be sent to poor farms, where they were given shelter, labor, and food. Yes, there were abuses. But these are fixable ones that we should have tried to solve, rather than get rid of the program entirely. Such situations help people get back on their feet by providing meaningful employment, training in labor, stability, an address, etc. I don't see why this is so verboten to mention these days.

I'm thoroughly unconvinced this is a problem of shelter space. I don't know about Dallas, but in Portland, OR we have hundreds of beds going unused every night, and despite best efforts to fill them... we still have tons of street campers.

Tiktaalik5• 4 years ago

The laws themselves are unjust.

In NA we don't build the housing we badly need, making it arduous and illegal to build in most places, which has spiked the price of having a home, making it unaffordable to many, and then we've turned around and made it illegal to not have a home.

That there are so many people "breaking the law" is a self created problem by refusing to build homes for people to live in.

souplesse2• 4 years ago

While this might seem pedantic, is it actually illegal not to have a home?

xyzelement3• 4 years ago

// In NA we don't build the housing we badly need, making it arduous and illegal to build in most places, which has spiked the price of having a home, making it unaffordable to many

As a capitalist who believes that everything is driven by supply and demand, I agree that enabling more build would drive down prices.

But that's completely irrelevant to the topic here. We're talking about people so severely mentally ill that "forced treatment" is a consideration. These aren't the people who are going to be buying/renting houses in a normal way regardless of availability and cost.

We're talking about people where the options are street life, incarceration, or institutionalization.

LarryMullins2• 4 years ago

Such laws should be enforced, they are good laws that benefit almost everybody. If somebody has a mental illness that renders them unable to comply, they should be permitted to receive treatment in lieu of legal punishment. If they prefer not to be treated, treatment should not be forced on them but they should instead face the normal legal punishment for their crimes.

And of course, funding/supporting programs and regulations that reduce the scope of the problem is a good investment. This likely entails providing housing to people to preempt the issue of those people trashing up public parks. But the laws against that sort of behavior will still be necessary because some people will choose not to avail themselves of those programs and will behave antisocially no matter how much help you try to give them.

outside1234• 4 years ago

What about the rest of us that have to endure them shouting at us in the streets?

Yes - it is humane for them AND for us.

throwayyy479087• 4 years ago

The general public isn't part of the Blessed Set of Protected Minorities so we don't count. What counts is the disadvantaged, and the more disadvantaged they are the more we're required to turn a blind eye to disruptive behavior. Homeless people, being at the bottom of the stack, are allowed to do basically anything and criticism of this fact will get you fired and cancelled.

Ironically, this seems like true freedom to me - do whatever you want to whoever, with no fear of consequences. Just have to deal with the lack of dignity and resources.

kneebonian• 4 years ago

Interesting prespective on forced treatment for the mentally ill here:

https://slatestarcodex.com/2016/03/07/reverse-voxsplaining-p...

ravenstine• 4 years ago

No, but neither is allowing the mentally ill to remain ill. There's no win to pontificating over this issue. The only way to win is to get lucky when treating someone's mental illness and they happen to respond to it.

blurri• 4 years ago

To get lucky treating someone's mental illness if they allow you to treat them you mean?

zozbot234• 4 years ago

Tangentially related: ACX "in partial, grudging defense of the Hearing Voices movement": https://astralcodexten.substack.com/p/in-partial-grudging-de...

AIUI, the blog author points out that if you really want to comprehensively replace institutionalized, forced treatment, some sort of self-organized peer support is the best reasonable alternative - one that, arguably, has barely been tried. Related: Prison and mental illness https://slatestarcodex.com/2016/03/07/reverse-voxsplaining-p... - My Brother Ron https://slatestarcodex.com/2016/03/31/book-review-my-brother...

djaouen• 4 years ago

As a mentally ill person myself, I don’t want to have to deal with being accosted when I go out just to buy food. If these policies get people off the streets, I think that is a good thing!

bnralt• 4 years ago

What's interesting is that once someone gets past a certain age, people almost universally agree that it's OK to confine them against their wishes if they are unable to take car of themselves. You don't hear many people saying that dementia patients should be able to leave whenever they want.

trynewideas3• 4 years ago

As someone who's cared for someone with a declining mental state, dementia patients should be able to leave whenever they want.

The problem is that the rest of the world doesn't want to - not can't, but finds it inconvenient - to deal with the ramifications of supervising or caring for people in public, strangers, who can't help themselves.

It's much easier to detain inconvenient people than change the rest of the world around them such that it wants to share the burden of caring for them.

tacotime• 4 years ago

Someone in my family, who is now in a memory care facility, has dementia. We tried to avoid it as long as possible, but when we got a call from the police saying that she was found wandering around barefoot in the snow next to a busy road in the middle of the night while hallucinating about “people coming to get her”, it felt like it was time to reconsider. She’s on meds that control the hallucinations now, but it would still be unsafe for her to leave unsupervised, no matter how much our culture changes. How do you help a stranger who doesn’t know where or who they are, and can’t hear too well to start with? She sure does still remember me and can dance to the Beatles, but I would not be comfortable trusting her welfare to a group of even the most compassionate strangers.

belval• 4 years ago

This is a very emotional topic so I want to avoid being too critical of that opinion, but at the same time, it's much much deeper than "doesn't want to". Dementia patients depending on their state are a danger to others and themselves. Their limited ability to understand what's happening around them means that they can get aggressive.

Even if not aggressive, they will just "get lost" and try to drive or "go for a walk" in the middle of the night in their pyjamas. I suppose from the way you phrased it that in your case it was mostly harmless and you just disliked getting weird looks, but a lot of dementia patients are actually incompatible with society and need to be detained or given anti-anxiety medications.

ww-picard-do• 4 years ago

The general public is not trained to recognize or assist people with dementia. Allowing people with dementia to wander around city like NYC seems like a bad idea.

mixmastamyk8• 4 years ago

Many folks fully don't believe mental illness among younger people is as serious as it is. Maybe they have never seen it up close. Somehow the frailty of old age legitimizes it.

mullen• 4 years ago

This is why we can't have nice things in this country. It's always comes down to some rhetorical discussion about edge cases and possibilities of how a tiny fraction of people might be negatively impacted, so let's not do it.

Let's frame it this way, "Is it humane to allow people be a slave to their mental illness and living on the streets?" The answer is clearly, "no". Allowing the mentally ill to live on the streets betters no ones life and causes many issues for everyone. If people with a mental health issue can not or will not take care of themselves, then someone else has to do it (IE: The Government).

It is humane for everyone if the mentally ill are forced to get treatment or confined if they refuse it.

guerrilla11• 4 years ago

It is humane for everyone if the mentally ill are forced to get treatment or confined if they refuse it.

Definitely not, unless they're actively harming you because self-defense is always justified. Short of that it's none of your business.

mixmastamyk8• 4 years ago

You may have misunderstood what humane means in this context. It is definitely society's business that our fellows don't live eating out of garbage cans while swearing obscenities at no one in particular on the sidewalk. Encampments also breed rats, disease, drugs, and prostitution.

It was never acceptable to allow this and we no longer have the excuses of the old days—that we don't have the resources to help them.

https://www.theatlantic.com/health/archive/2019/03/typhus-tu...

goatlover3• 4 years ago

It’s everyone’s business when it turns into homeless camps in well trafficked public places other people would like to use. Which is why cities like NY and LA have decided that some chronically homeless do need to be involuntarily committed.

vkou• 4 years ago

It is humane for everyone if the mentally ill are forced to get treatment or confined if they refuse it.

Are there any other situations when we can forcibly act to protect you from yourself, or is mental illness the only situation where this is permitted? Should society be allowed to forcibly restrict you from engaging in other forms of self-damaging behaviour? Smoking, drinking, gambling, being stoned all day erry day, riding an ATV without a helmet..? Not getting vaccinated against a deadly, contagious respiratory disease, because you think the vaccine[1] is a 5g chip created by Bill Gates as part of a secret mass eugenics program? Not allowing a doctor to operate on you or your child, because you believe that a blood transfusion is a sin?

There's a wide, wide spectrum of a gray zone here, and that's why drawing a hard line through it is not the clear-cut easy moral answer that you think it is. It's precisely why society tends to draw soft lines through it, leans towards encouraging and discouraging over compelling, and why it won't intervene in response to most forms of self-harm.

[1] That's a pretty big one. If we're going to forcibly medicate people for their own good, universal vaccination seems to be a much more obvious place to start. Debilitating side effects of vaccines are negligible compared to those of brain pills, and the overall ROI, both personally, and to the people around you is fantastic.

notwokeno• 4 years ago

You have to take any idea to its logical conclusion before it's implemented because that's what's going to happen sooner or later.

WarOnPrivacy• 4 years ago

I was my ex's caregiver for decades. Today she lives in a local homeless community and her wellbeing is often at risk.

Could she have had a different outcome through forced treatment? Yes and no.

The technical answer is No because the treatment she needs doesn't exist here (extended-term, inpatient, safe). There's nothing to commit her to.

If the treatment she needs existed, could I have committed her against her will? Probably not. It would require LEO assistance and (due to reality) husbands are generally considered to pose a heightened risk of gaslighting.

rr808• 4 years ago

Does anyone know of numbers of who used to be locked up in asylums etc? It seems to have been more common and I have no clue about how often it happens now. Reagan closed the mental hospitals?

jl6• 4 years ago

Implicit in the question is that we even understand what the right treatment should be. Once upon a time, doctors would have enthusiastically recommended lobotomies. Would we have nodded along?

I think the ethical conundrum lessens if there actually is a clear, proven, effective treatment. We often make decisions on behalf of people who aren’t able to make the right choice for themselves, and I don’t think a pathological commitment to individual liberty should constrain us in cases where there is the possibility of dramatically improving someone’s wellbeing.

mixmastamyk8• 4 years ago

It's 2022 not 1922 or earlier; no one is advocating medieval treatments.

trynewideas3• 4 years ago

This is an imminent question in Portland, Oregon: the mayor wants to relax the requirements to civilly commit a person against their will despite a lack of hospitals that can receive or treat them,[1][2] another of his suite of tactics to address homelessness that's included perpetual weekly sweeps of dozens of homeless encampments,[3] asking for $27 million to build city-run open-air camps,[4][5] and trying but failing through those policies to secure additional state funding for city-run shelters.[6]

None of these tactics have been strategic - housed and homeless people alike in Portland who want mental health resources can't access the limited inventory of them, so expanding involuntary commitment without funded services will only add to that resource stress. Sweeps without a variety of funded shelter options just move the problem of camps from one part of the city to another while destroying what little the campers own, at a contractor cost of $4.5 million per year. The city-run camp proposal has been derided as "concentration camps", and the $27 million price tag would pay for a year of stable housing for nearly 2,500. State legislators cited the sweeps and camp proposal as reasons why they were giving $25 million in funding to the separate county leadership instead of the city, and put conditions on the funding that explicitly prevented its use for sweeps or involuntary camps.

All of this happened _before_ the proposal to expand involuntary commitment criteria, which would at worst facilitate abuse or harassment of people with mental illnesses - housed or not - and at best fail to solve the underlying lack of treatment resources available to anyone, much less the involuntarily committed.[7]

1: https://www.opb.org/article/2022/12/12/portland-mayor-ted-wh...

2: https://www.wweek.com/news/2022/12/07/mayor-ted-wheeler-want...

3: https://www.oregonlive.com/politics/2022/12/portland-has-dra...

4: https://www.columbian.com/news/2022/nov/18/homeless-vote-in-...

5: https://www.kgw.com/article/news/local/homeless/multnomah-co...

6: https://www.oregonlive.com/politics/2022/02/no-direct-fundin...

7: https://www.themarshallproject.org/2020/11/08/when-going-to-...

guerrilla11• 4 years ago

It amazes me that this place gets a reputation of being libertarian when the vast majority of comments here (and on similar subjects) are extremely authoritarian. The libertarian stance is that if someone isn't harming you then you have absolutely no justification to impinge on their freedom. This is fundamental liberal and libertarian theory common to all branches of both.

goatlover3• 4 years ago

So what does a libertarian society do with people who do the following in public: defecate, shoot up, litter, block sidewalks with tents, harass passerbies? Do you arrest them for breaking the law? Allow them to continue doing so? Or would there be no such laws because it’s not harming anyone under a libertarian view?

How does a libertarian deal with the chronically homeless?

guerrilla11• 4 years ago

How does a libertarian deal with the chronically homeless?

Obviously you house them, feed them, offer them treatment, etc. with the least amount of friction possible. If they refuse and aren't literally hurting anyone, then nothing.

You don't need to over-complicate this.

mixmastamyk8• 4 years ago

An unwise comment on the surface; there are at least thousands of folks here. Further, those that are hn libertarians typically are most concerned with low taxes and possibly property values.

Even so libertarianism has to take the real world into account at some point to be a useful -ism. That means your freedom ends where mine begins.

qwerty456127• 4 years ago

Some times it is. It really depends on the condition, specific case and the way you treat them. To me it seems obvious that at least in some cases it is, even if not in many. May be hard to tell in advance though.

There are cases when a person is not in the mood (to put it mildly) to accept help but really needs it and will sincerely appreciate it once a relief comes.

The opposite question is also valid by the way: is it humane to leave the insane to struggle and roam the streets untreated?

MopMop• 4 years ago

"Her grip on reality in that state is rather poor - asserting that Bugs Bunny and the CIA are conspiring to create a brain controlled army of polar bears with space lasers would not be unusual."

The angry rants are a reaction to loss of bodily autonomy, spiritual wellbeing and mental liberation. If you are on these kind of antipsychotics for the most part of your adult life it's ordinary to not be in touch with your feelings or anyone elses and it's ok to be delusional cos if you don't ever know what it feels like to be mentally liberated then how else could you know how it feels to be free.

Tiktaalik5• 4 years ago

Doctors don't support involuntary treatment because it's not effective.

Effectively it trains people to distrust the health system, and to not seek medical care because they'll be locked up and bad things will happen to them. This leads to worsening health outcomes.

We just passed through years of pandemic where everyone was eager to listen to the experts in the medical profession and that saved countless lives. It's sad and disturbing that when it comes to other health care issues, the politicians are now tuning out the same experts because they don't like what they're hearing.

mullingitover3• 4 years ago

Doctors don't support involuntary treatment because it's not effective.

I think there's a difference between making an informed decision to decline treatment versus not being in a state of mind that allows you to make any rational decisions. People on the street with mental faculties in a state of failure are not really able to make that choice, and treating someone in that state as if they're making a voluntary choice is farcical.

HDThoreaun• 4 years ago

What other choice is there for people who have continuously refused treatment? Should we just accept that these people will live in tent encampments?

Tiktaalik5• 4 years ago

I'm sure we can concoct some elaborate edge edge edge case where there are no other options, but broadly I think the medical establishment much rather prefers the situation where some dysfunctional person is regularly coming to check in with a doctor, even if it means they have to handhold some person every step of the way through life as they make mistake after mistake.

The alternative, where someone is whisked away to internment for a few months, bounces back right after into the same broken lifestyle, and subsequently never trusts the medical system ever again and never goes to see a doctor again is less desirable.

With the former there remains always new opportunities for someone to take positive steps forward to recovery as they are always in contact with a system that can help them.

With the latter we burn a bridge one and done.

LatteLazy• 4 years ago

Given the very low efficiency of most mental health "treatment" this remains a mostly theoretical question. Until psychology and physiatry sort themselves out and become sciences were really just talking about locking people up...

ThinkBeat• 4 years ago

We had asylums where we locked up mentally ill peopl. They were treated in a most horrible way in general. I have seen pictures and documentaries and a lot of them were nightmares.

Then we tore down the asylums and set the inmates free. Good job.

You are free. Live your lives in happiness. Nobody will force treatment up on you.

In fact getting treatment is close to impossible in the US.

Many people without treatment get progressively worse.

A lot of start using alcohol or other drugs to try to manage their lives. For most people that does not turn out all that well over time. They had added a component that will give them even more problems.

Now prison is full of people with mental illness who ought not to be there. They have become the new asylums.

The prison cannot provide the care and treatment required.

This is not progress.

What was needed before, and is needed now is appropriate treatment for each person.

Some can do well with speech therapy. Some need to be tied to a bed. A lot.

Between those extremes there is a near infinite palette of mental problems. No two people are the same, even if they are given the same diagnosis.

(Diagnosis in itself is a difficult thing to get right, and requires observation / follow up over a long period of time. Not just when they are having an episode. )

Treatment of mental illness is almost universally a part of healthcare with low funding.

77pt772• 4 years ago

I have seen pictures and documentaries and a lot of them were nightmares.

Try reading the actual reports. Seriously, you can find that online.

selectodude2• 4 years ago

care to share?

at_a_remove• 4 years ago

Reframe the question in terms of what it really is: Is forced treatment for the mentally ill more humane or less humane than letting them "do their thing?" Is it more humane for the people who are forced to interact with them?

A lot of ethical questions could use a "trolley-fy" process in which the status quo is simply presented as another track, and then another process by which that question is re-embedded within its actual context -- the mentally ill are not off wandering some other plane of existence, they may be screaming in your alley, tonight, around three a.m.

nitwit005• 4 years ago

The reality is, we provide (admittedly crappy) mental health care in prisons, so we already have a program of forced treatment. We just wait until a serious crime has happened.

Almost any non-prison option would be better than the current way of doing things.

LarryMullins2• 4 years ago

I think the prison-solution, as crappy as it is, is better than doing nothing at all. But it should certainly be possible to do better.

nimbius• 4 years ago

Many liberals blame Ronald Reagan for the government’s abandonment of mentally ill Americans.

Thats a fascinating stretch of the truth. Most sociologists, public health professionals, and public policy researchers can directly link "Reagans army" to the mans policies quantitatively. its less of a blame game and more of a fact of life the thatcher/reagan neoliberalist push essentially relegated the mentally ill to freeway underpasses and drug store parking lots. Those that didnt wind up screaming at stop signs or dancing nude through the streets instead have gone on to commit some of American societies most horrific mass shootings.

Many administrations in California have had opportunities to reverse Reagan

in '67 sure, but by 1981 his federal cessation of funding for ANY state mental health services would have made the effort near Sisyphean. Alex Barnard doesnt do much to shore up the Gippers legacy outside of the prescriptive myopia that we should ignore the past and just look to the future now because $add_reason_later.

Treat mental illness just like real illness and stop pretending its some special category of sorta-problem we cant do anything about because, surprise, we havent invested any money into its research, treatment, or cure since Dutch decided to gut funding 41 years ago before slipping into Dementia himself.

malcolmgreaves• 4 years ago

San Francisco is what happens if you answer “no” to this question.

smm11• 4 years ago

It's never humane, those who suffer mental illness rarely prefer treatment. But pit bull terriers who kill kids are put down.

faeriechangling• 4 years ago

Yes, obviously, I have seen a number of mentally ill children, all their treatment was forced as mentally ill children are not competent to make their own medical decisions. There is a huge body of ethics and law on the issue of forcing treatment upon others.

As to this specific case, the forced treatment of homeless people with mental health problems, from what I've heard on the people with boots on the ground a lot of people have severe brain damage from things like fentanyl overdoses who simply can't take care of themselves, and I've heard tons of people who have been disturbed by people with mental health problems disrupting public order as people go about their day to day lives. How much should one value freedom, how much should one value order, and how much should one be a consequentialist? How cost-effective is forced treatment anyways?

77pt772• 4 years ago

Yes, because it's done by humans to humans.

Is it moral? No.

jwatt• 4 years ago

On a related note, the interviews with homeless people on the YouTube channel Soft White Underbelly were a real eyeopener to me. I highly recommend it, but some of them are extremely hard to watch.

https://www.youtube.com/@SoftWhiteUnderbelly/videos

ineedasername• 4 years ago

It's a poorly formed question, and journalism in general is not a good venue for exploring the actual multiple questions that must be answered to get at the ostensible question in the title, much less the answers to those questions.

An adequate addressing of the topic would need to start, at minimum, with defining with great specificity the following terms as applied to this problems:

Force (which mechanisms, legal, physical, social, etc)

Treatment (Chemical? Talk therapy & its many varieties? Simple protection from oneself, or others from the subject?)

Mentally Ill (As classified by the DSM-V? Some other formal source? Who makes the diagnosis, what if there are competing diagnosis from different practitioners? Does the State get a say in this definition?)

Humane (A vague concept whose specific definition, often also a bit vague, will vary by context: In the US it is considered humane to euthanize animals in pain that cannot be cured, or with terminal conditions, or some combination thereof. Doing so to humans, even with their consent, is highly controversial. And yet suicide hangs silently over many discussions of mental illness, and too often mental illness is resistant to treatment to the point of torture for the person experiencing it, even with their full & willing consent to any treatment that might help their cause. Further there is the same question of who decides what humane gets to mean, both in general and as applied in specific circumstances.)

This barely scratches the surface, all I've done is identify items in a short headline that need defining, and each of those could take countless person-hours of discussion & debate and still not be settled in a meaningful way in which most parties agreed.

StanislavPetrov• 4 years ago

Ultimately whether it is humane or not is irrelevant. If you are trapped on a lifeboat with a bunch of people, and one of them is mentally ill and threatening the safety and survival of the other people on the lifeboat because of an ability to regulate their own behavior, the people on that lifeboat are justified in taking whatever action necessary to ensure a safe environment. Society is that lifeboat. We should do everything possible to offer mentally ill people the resources they need to help themselves and to integrate themselves into society. But if that fails, and they are unwilling or unable to integrate into society, and their behavior causes a safety risk and/or a significant disruption to society, then society is completely justified in using whatever measures are necessary to ensure they aren't a danger to others. It is simply absurd to suggest (as many do today) that profoundly mentally ill people should be allowed to roam free and manifest their mental illness in ways that are harmful to other people because it it "inhumane" to stop them.

hackermeows• 4 years ago

One of the primary problems with this is who gets to decide what is metal illness ? Is being gay a mental illness , I’m sure there a whole subset of the population including some doctors who thinks it is. Is being overly religious a mental illness ? There is so much potential for abuse here it just doesn’t make sense to force anything on anyone, unless they are a direct threat to others

MissLaeti• 4 years ago

House them first, then treat them accordingly. It should be better for them. Of course it’s more expansive than just incarcerate them in psychiatric centers and feed them with nasty treatment just because they are a disgrace in our society. Maybe it’s time to think about them as humans, not as a social problem.

Capitalism is more of a social problem than psychotic homeless people.

BrandoElFollito• 4 years ago

I was discussing about that topic some time ago and was left wondering what the proportions of various mentally ill people actually are in the rought 3 categories:

- dangerous/"seriously impacting" for others (→ locking up in an asylum)

- need to be forced to take some treatment / learning so that they can function in the community

- the rest

I genuinely do not know the ratios, but have the feeling that the 1st one is really marginal, the 2nd quite a lot and the 3rd the bulk of people

Konohamaru• 4 years ago

...is it just me or is the number of cases of severe mental illness growing in the U.S.A.?

niemal_dev• 4 years ago

It is truly unfortunate to see how ignorant and misinformed most of these answers are. First, to understand what is a mental illness we have to deduce strong neuro-biological evidence of the problem and after-so we can proceed with an effective measure, a treatment, that is actually a treatment.

Currently, any kind of psychiatric label is equivalent to archaic prophecies. There's no credible scientific evidence to back up any kind of mental illness diagnostic. It is a facade.

Each and every medication supplied by psychiatrists is not a treatment. It is an inhumane process of complete eradication. Dopamine is a product of hormones among others and it is the core fuel of the brain. Dopamine is the resource with which you anticipate time. Dopamine is the resource with which you can memorize and have a cognitive function as a human being. Dopamine is the reason you have an imagination. Dopamine is the resource that transforms into energy for you to move your body. Shutting it down is nothing but a legal modern euthanasia.

You justify pills for an effective measure, when science itself tends to look towards the gut-microbiome and the inflammation reaching all the way up to the brain. Exact causes are still unknown, but: there are other things one should be treated with, and they are not pills. The ketogenic diet has completely cured people who have been diagnosed as schizo-affective (schizophrenia that is actually worse). People who have been diagnosed as bipolar have also seen tremendous benefits from the ketogenic diet and have been cured. There are many supplements one can use to optimize the overall neuro-biology along with daily routines that reinforce it.

But guess what? No psychiatrist actually pursues those choices, the biggest majority of them are "Here's your pills, next. You don't want them? Let me call the police.". Seeing people treating family members like that is also disheartening. Ignorance got us blind, blind to the madness we as society reinforce and blind to the actual truth.

Calling that a human process is completely ignorant, there's no way for you to know how it is like unless you have studied neuro-biology or you have been under the influence of a dopamine antagonist (commonly known as anti-psychotics).

And let me tell you something, there's nothing worse from seeing your lifetime go by and you being completely unable to live because you got no brain fuel. The worst possible prison is in our brains. Sometimes we build it ourselves, and sometimes other people do. Anti-psychotics is other people. That's how the real trauma occurs. That's how many innocents get "treated" from the society and the psychiatric community.

Is forced treatment for the mentally ill ever humane?

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