I found my father living on the street • Hacker News Board

Re: I found my father living on the street

#41

Post by SpaghettiCat » Thu, Nov 05, 2015, 1:22 PM UTC

bsder wrote: post #38

SpaghettiCat wrote: post #6

What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover?

> What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover? What gives you the authority to institutionalize him? This isn't a snide question. It's a very difficult question that leads to a whole raft of difficult questions. How do you force a person to take their medication? Why should you do it for this particular person but not that par…

> What gives you the authority to institutionalize him?

A government has the duty to provide for the welfare of their people. It's every government's goal to make their people healthier.

> How do you force a person to take their medication?

In a psychiatric institution you could for example inject the medicine into them.

> Why should you do it for this particular person but not that particular person?

If a person's mind is gone so haywire that they're destroying their own body, that they don't have adequate control of their mind (as is the case with schizophrenics), that they don't eat or even respond to human communication, and they have been diagnosed with a mental disorder then you should institutionalize them until their mind regains control.

> Who is responsible for the cost of doing so?

Taxpayer

Re: I found my father living on the street

#42

Post by s_kilk » Thu, Nov 05, 2015, 1:24 PM UTC

eli_gottlieb wrote: post #37

s_kilk wrote: post #13

Earlier quoted context omitted.

On my darker days I sometimes think we live in a hell-on-earth. In our fiction we describe whole worlds where the Damned are left to shamble around and fend for themselves, cut off from the warmth of humanity. We depict hell as a plane of the existence where the Lost are cut off from all that is right and good in the world, pitched overboard into un-ending darkness and despair. It's hard not to draw parallels.

Well maybe if we stopped declaring people Useless or Sinners and deliberately pitching them overboard ...

My point exactly :)

Re: I found my father living on the street

#43

Post by Gatsky » Thu, Nov 05, 2015, 1:25 PM UTC

SpaghettiCat wrote: post #6

What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover?

Institutionalisation can be avoided. Properly staffed and trained community mental health services could have intervened while he was still living in his apartment, and probably kept his lease going while getting his treatment back on track.

It's a crying shame to let yet another mentally ill person end up in crisis. He could have easily died or been severely injured.

Re: I found my father living on the street

#44

Post by chrisseaton » Thu, Nov 05, 2015, 1:37 PM UTC

SpaghettiCat wrote: post #41

bsder wrote: post #38

Earlier quoted context omitted.

> What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover? What gives you the authority to institutionalize him? This isn't a snide question. It's a very difficult question that leads to a whole raft of difficult questions. How do you force a person to take their medication? Why should you do it for this particular person but not that par…

> What gives you the authority to institutionalize him? A government has the duty to provide for the welfare of their people. It's every government's goal to make their people healthier. > How do you force a person to take their medication? In a psychiatric institution you could for example inject the medicine into them. > Why should you do it for this particular person but not that particular person? If a person's m…

But people have rights. They have a right to not live in an institution if they don't want to. You want to disregard that right, because you think you know better for them than they do. Many of these people aren't dangerous and don't have infectious diseases, so there's no public health need to lock them up as you're suggesting.

Re: I found my father living on the street

#45

Post by mattchew » Thu, Nov 05, 2015, 1:50 PM UTC

SpaghettiCat wrote: post #6

What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover?

The kind that has prior experience with what forced institutionalization actually means. (Hint: it's not about "helping" people.)

Re: I found my father living on the street

#46

Post by vidarh » Thu, Nov 05, 2015, 1:57 PM UTC

SpaghettiCat wrote: post #6

What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover?

Many other good answers, but here's an anecdote:

In Oslo, near the university, there used by a "cave dweller". A by all accounts bright student who at 25 decided to stop washing himself. He was soon thrown out of his student accommodation because of the smell. He then decided to take up residence under a tarp in a makeshift "cave" in a hillside next to the university where he stayed for the following two and half decades. In 1987, he was refused the opportunity to take his astrophysics exam because of the smell, and later given a blanket restriction on participating in any exams unless he washed first.

He was repeatedly institutionalised against his will, but in 1988 he won a supreme court decision that made it clear that his unorthodox lifestyle was insufficient grounds for forcing him into mental health institutions. He later sued the University of Oslo over lost income due to the exam ban, but lost.

It may seem obvious that this guy had mental problems. The problem is that in court and during psychological examinations he was fully coherent and defended his choices with references to traditions of asceticism and spiritual beliefs. He understood what he was doing. (EDIT: This does not mean that he necessarily didn't have mental problems, but that he was coherent enough to be able to justify his decisions sufficiently that the court found he was competent to make his own decisions about whether or not he needed treatment)

This poses a challenge, because it can be superficially extremely hard to distinguish actual mental illness from "crazy" lifestyle choices that the person making them are perfectly happy with.

The guy mentioned above was very bright and able to get the resources he needed to protect what he saw as his own best interests in court (all the way to the supreme court 3 times, with one win), but most don't.

Many of these people are mentally ill and need treatment, but we also need to protect those who aren't, and especially those who aren't yet are not resourceful enough to mount vigorous legal campaigns to protect their choices.

At the same time setting the bar high means there are potential high costs and lots of resources involved in helping people that makes it harder to help those who need it out of a concern for e.g. distinguishing resistance and refusals grounded in mental illness from resistance and refusals from people who are mentally competent.

Getting the balance right is hard.

Re: I found my father living on the street

#47

Post by treehau5 » Thu, Nov 05, 2015, 1:58 PM UTC

huuu wrote: post #12

SpaghettiCat wrote: post #6

What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover?

Unfortunately you would be amazed and ashamed. In the USA it's estimated that one third of the homeless people suffer a serious mental illness. I live in the Netherlands and I think the numbers are the same here. Ofcourse there is help but most homeless people move around a lot so it can be difficult to track them and help them. Also: having worked with homeless people I know for sure they will get some kind of menta…

One third? I think it is much higher, simply for the fact that you almost have to be mentally ill in some form of fashion to continue to live on the street. It's an awful place and I wish it upon no one.

Re: I found my father living on the street

#48

Post by DanBC » Thu, Nov 05, 2015, 1:58 PM UTC

SpaghettiCat wrote: post #41

bsder wrote: post #38

Earlier quoted context omitted.

> What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover? What gives you the authority to institutionalize him? This isn't a snide question. It's a very difficult question that leads to a whole raft of difficult questions. How do you force a person to take their medication? Why should you do it for this particular person but not that par…

> What gives you the authority to institutionalize him? A government has the duty to provide for the welfare of their people. It's every government's goal to make their people healthier. > How do you force a person to take their medication? In a psychiatric institution you could for example inject the medicine into them. > Why should you do it for this particular person but not that particular person? If a person's m…

What you're asking for is that people who have the ability to chose (where to live; what medical treatment to have) are denied that choice.

> In a psychiatric institution you could for example inject the medicine into them.

Schizophrenia is a lifelong illness. Do you keep someone imprisoned for the rest of their life so that you can forcibly medicate them against their will?

Re: I found my father living on the street

#49

Post by DominikR » Thu, Nov 05, 2015, 2:00 PM UTC

SpaghettiCat wrote: post #41

bsder wrote: post #38

Earlier quoted context omitted.

> What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover? What gives you the authority to institutionalize him? This isn't a snide question. It's a very difficult question that leads to a whole raft of difficult questions. How do you force a person to take their medication? Why should you do it for this particular person but not that par…

> What gives you the authority to institutionalize him? A government has the duty to provide for the welfare of their people. It's every government's goal to make their people healthier. > How do you force a person to take their medication? In a psychiatric institution you could for example inject the medicine into them. > Why should you do it for this particular person but not that particular person? If a person's m…

> A government has the duty to provide for the welfare of their people.

You state this as if it is an universal principle. It is not. Why don't you and everybody else provide for your own welfare?

> In a psychiatric institution you could for example inject the medicine into them.

Some countries deem persons with certain sexual preferences as mentally ill. (homosexuals) How would you feel about imprisoning them in a psychiatric ward and injecting some "medicine" against their will to "treat" them.

You may find this example not applicable because it is obviously wrong to do that but I can tell you this much:

No matter how much you feel that you are sitting on the moral high horse and know it all, in a hundred years people will analyze how we acted this very moment and conclude we were a bunch of backward barbarians.

Let's not revert back to the backwards behavior our precursors deemed morally right a hundred years ago.

> If a person's mind is gone so haywire that they're destroying their own body, that they don't have adequate control of their mind (as is the case with schizophrenics), that they don't eat or even respond to human communication, and they have been diagnosed with a mental disorder then you should institutionalize them until their mind regains control.

Which could be translated for many into: Imprisonment for life.

>> Who is responsible for the cost of doing so? > Taxpayer

And if it's not sufficient we'll just raise taxes and steal even more. Simple solution.

Re: I found my father living on the street

#50

Post by reverend_gonzo » Thu, Nov 05, 2015, 2:00 PM UTC

SpaghettiCat wrote: post #41

bsder wrote: post #38

Earlier quoted context omitted.

> What kind of society lets a mentally ill man roam the streets, deteriorating, instead of institutionalising him and helping him recover? What gives you the authority to institutionalize him? This isn't a snide question. It's a very difficult question that leads to a whole raft of difficult questions. How do you force a person to take their medication? Why should you do it for this particular person but not that par…

> What gives you the authority to institutionalize him? A government has the duty to provide for the welfare of their people. It's every government's goal to make their people healthier. > How do you force a person to take their medication? In a psychiatric institution you could for example inject the medicine into them. > Why should you do it for this particular person but not that particular person? If a person's m…

> If a person's mind is gone so haywire that they're destroying their own body, that they don't have adequate control of their mind (as is the case with schizophrenics), that they don't eat or even respond to human communication, and they have been diagnosed with a mental disorder then you should institutionalize them until their mind regains control.

This is a very fine line. What if someone refuses to eat food, or communicate, as part of a protest or a religious fast or any other personal reason? Who are you do to decide what they're doing is wrong?

If they are not endangering anyone else, it gives you no right to interfere.