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I found my father living on the street

bbc.co.uk

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Re: I found my father living on the street

#101

Post by Thimothy »

Man, so many comments, so many musings about individual freedom and whatnot, and I have yet to see one that mentions the actual, and IMHU perfectly logical, criteria that mental care institutions use to decide whether to intern someone against their will:

"Is this person a serious danger for himself/herself or other people?"

Note that it's not the institution the one to make the decision, but a judge. And, also, taking completely someones freedom away is a very extreme measure that will only be considered for really extreme cases, there are a lot of middle grounds, from compulsory regular visits to the doctor to home visits from the doctor. But all of this, is not usually necessary because most of the people that are mentally ill, know that there is something wrong with them and will voluntarily seek treatment.

It's at least peculiar than when people from the US are asked about mental healthcare, their visceral reaction is "OMG!!! THEY ARE GOING TO TAKE AWAY MY FREEDOM!!!". So much fear, so little idea about how an actual mental care system works.

Source: exGF psychiatrist in a western European country with a strong public healthcare network.

Re: I found my father living on the street

#102

Post by DanBC »

SpaghettiCat wrote: post #93
DanBC wrote: post #84

Earlier quoted context omitted.

Schizophrenia is not cured, but treated. So you risk getting into "revolving door" admissions to hospital. A person with a psychosis becomes ill, rejects medication, is detained against their will in hospital and given medication against their will (sometimes by force) until they "become well" enough to be let out of hospital. At which point they're free to decide to stop taking the medication. I'm not sure that this…

This already happens with homeless people: they become diseased, malnourished, get drunk and hurt themselves. Once the trauma has reached a certain degree that they require hospitalisation, they end up in hospital and released once they've recovered. Are you proposing we not help them at all and just let them fester and die on the streets? Surely not. The "revolving door" concept, as you call it, is the middle-ground…

No, I'm saying that you can't force people to take medication against their will apart from a few situations.

If you want to provide MH treatment to people it's much better to start with children and young people and better drug and alcohol services, both of which would reduce the amount of homeless people, and also to provide better voluntary MH treatment for homeless people.

People aren't arguing with you because you want to provide MH treatment. People are arguing with you because you want to force that treatment on people against their will.

Re: I found my father living on the street

#103

Post by ska »

onion2k wrote: post #17
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 mentally ill people are still in a position where they can still make decisions for themselves, but their illness means that they choose things that are ostensibly bad for them eg refusing help to get off the streets, help with addiction, stopping them committing suicide, etc. That means society has to decide between forcing people to do things against their will or respecting their decision even though it's wha…

  and choosing to let people do things that are bad for them doesn't mean there's anything wrong with the society.
True, but the discussion doesn't end there. For example: ".. and leaving them to suffer with the consequences of their actions " vs. " ... and supporting them through the negative consequences if it doesn't go well" are very different responses, and certainly do reflect on the society in question.

Re: I found my father living on the street

#104

Post by ska »

DominikR wrote: post #15
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?

Mentally ill persons enjoy the same rights that other citizens enjoy and have their own free will. As long as a person didn't commit any crime and is no risk to society or oneself you cannot institutionalize him or her. In any case I would refrain from making such broad generalizations about a society. Some societies prefer strong individual rights and others prefer a strong state that tells them what to do.

   Some societies prefer strong individual rights and others prefer a strong state that tells them what to do.
That sounds like a false dichotomy. It isn't a choice between institutionalizing people or leaving them to fend for themselves entirely. Whether private or public, the choices made on this spectrum absolutely do reflect on the society making them.

Re: I found my father living on the street

#105

Post by nickff »

DominikR wrote: post #34
nikolay wrote: post #30

Earlier quoted context omitted.

I doubled a mentally ill person has anything resembling "free will"...

You can very objectively prove that a person is missing a limb but often you cannot prove that a person is mentally ill. Often persons will be categorized as mentally ill just because they deviate in their beliefs or lifestyle from the mainstream culture. And yes, mentally ill persons HAVE a free will, don't tell me they don't as this would be equal to declaring that they are not human beings but just a lump of meat.…

What you are describing seems similar to Szasz's ideas of mental illness (, but please correct me if I am wrong).[1]

[1] https://en.wikipedia.org/wiki/Thomas_Szasz#.22Myth_of_mental...

Re: I found my father living on the street

#106

Post by kweks »

Turukawa wrote: post #3
nekgrim wrote: post #2

Beautiful story. Not very relative to HN I think, but it's good to see the world throught other points of view, sometimes. Thanks for this post.

There's an idea by the writer, almost lost in the article, that I thought is brilliant: "When he was in hospital without any documents or ID I came up with the idea of medical bracelets for homeless people. I bought about 100 waterproof USB wristbands which can hold important information and I've given away about 60 so far." There are any number of people made homeless through mental illness. They are often lost in t…

I work with homeless people, people in precarious situations, people without ID, immigrants without papers, etc.

I've discussed this very concept multiple times, from multiple angles, with a few organisations.

This issue becomes a real issue of when the person becomes gravely ill, or dies. Most of the time, it's impossible to trace the person's history - contacting next of kin, working out their path until their demise.

This is a real problem to solve.

However, the practical aspects are that this device needs to be non-identifying, and needs also to be non-exploitable by third parties (in particular: police).

Many people without papers are already in a situation that's difficult enough as it is, but this would be made even more difficult by giving police / other authorities a tool to trace, track, and punish.

Likewise, many people in these situations do not WANT to be found, or do not WANT to carry papers.

The conclusion that I had come to would be that these devices are completely encrypted, and provide no form of external data (ID, etc); and a 'read only' industry facing interface would be exposed.

Services, such as hospitals, or indeed police, etc - could lodge requests to a system with this data. The system would register this information, but give nothing back.

The organisation trusted with this information (could be a recognised charity that works with homeless etc) - would be able to, if requested, or required, or at the person's death, be able to access this information.

The end result being, a person holding one of these cards would be able to have a medical history, and be able to build up a map of their lives.

Such things already exist: social security card, etc.

It's a tough problem to crack, once you start to consider the human element.

Re: I found my father living on the street

#107

Post by eli_gottlieb »

s_kilk wrote: post #42
eli_gottlieb wrote: post #37

Earlier quoted context omitted.

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

My point exactly :)

Dear Lost and Damned Denizens of Hell,

You can leave any time you're willing to stop calling us nasty names and accept our help. Or hell, even stop calling each-other nasty names and accept each-other's help. It's not like you're actually damned in any strictly metaphysical sense. It's just that you've got two primary tools, your intellects and your social abilities, your brains and your hearts, and you vilify the fuck out of both of them in favor of fists and fire!

Sincerely,

The Other Place

Re: I found my father living on the street

#108

Post by duggan »

SpaghettiCat wrote: post #77
ashworth wrote: post #66

Earlier quoted context omitted.

But who decides who has control over their mental faculties? Who decides who is competent? The state? The family? The physician? Can you imagine scenarios where the state, or the family, or the physician are incompetent, selfish, or malicious in determining the competence of a person? I believe there are MANY such scenarios. This isn't a hypothetical for me... like the author of the article we're discussing, I've had…

> But who decides who has control over their mental faculties? Who decides who is competent? The state? The family? The physician? Who is the most competent to make this decision? The medical professional. Of course government (advised by medical professionals) will set the policy which will constrain the possible decisions. > Can you imagine scenarios where the state, or the family, or the physician are incompetent,…

> Who is the most competent to make this decision? The medical professional. Of course government (advised by medical professionals) will set the policy which will constrain the possible decisions.

This has gone poorly quite often throughout history, which is why it's a tough question. Homosexually was officially considered a mental illness in America until 1974.

Re: I found my father living on the street

#109

Post by nikolay »

chris_wot wrote: post #72
nikolay wrote: post #30

Earlier quoted context omitted.

I doubled a mentally ill person has anything resembling "free will"...

I have quite bad depression. That's a mental illness, and I have free will. My brother-in-law has very bad schizophrenia. I can assure you, he has free will. You speak about mentally ill people like they are subhuman. They aren't - they are people with the capacity for agency and they have rights. And they should be treated with more respect.

Are disabled people subhuman, because they don't have free mobility? Never said anything like that - only that your illness affects the reasoning, i.e. the will as well. It doesn't have to be all the time as there are different mental conditions affecting people differently at different times.

Re: I found my father living on the street

#110

Post by dragonwriter »

SpaghettiCat wrote: post #53
chrisseaton wrote: post #44

Earlier quoted context omitted.

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.

These people don't have control over their mental faculties; they aren't competent enough to make a choice for what is best for them in the same way that minors aren't allowed to go truant or to consent to sex with an adult. If you are all there in the head, by all means live on the streets, stay filthy, don't eat and ignore people, but this man has a brain disease that makes him lose control of his mind. If he was f…

> These people don't have control over their mental faculties; they aren't competent enough to make a choice for what is best for them in the same way that minors aren't allowed to go truant or to consent to sex with an adult.

Which people? "Mentally ill" people aren't a homogenous group, and the fact that someone is mentally ill and living on the street does not imply that they are incompetent to make personal decisions due to their mental illness. The relation between mental illness, poverty, physical illness, etc. is complex.

There aren't simple answers, and this person isn't these people.

> If he was forcefully taken to the hospital, forcefully given medication, and recovered he would exclaim "Thank you for saving me! I had a disease in my brain that lead me to believe in crazy things: to be paranoid of police and even medical personnel. I spent 2 years on the streets suffering like this with no place I believed could help me, but you cured me."

Would he? He was medicated, functional from the point of view of the broader society, and living in an apartment and stopped taking his medication. Was it because the medication wasn't the best medical science could identify and he was still incompetent though he would be better off with other medication? Did he accidentally stop taking medication and start a downward spiral where he became out of control? Or was he, as he seemed, competent -- but voluntarily decided to discontinue the medication?

> If I had a mental disorder that made me go crazy--so crazy that it doesn't even enter my mind that I need help--I would hope that my government would restore my sanity (as I am unable to do so).

And that's great, but its a mistake to project what you think you would want onto other people as their preferences.

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