Housing first is an approach conceived in the U.S. but for political reasons not as widely adopted as it should be. 99pi did a fascinating podcast series about the homelessness problem in oakland and how housing first fits into the picture. My preconceived notions of why people are homeless were definitely upended. https://99percentinvisible.org/need/
Santa Clara County recently did a random assignment intervention to offer chronically homeless people free housing. There was no measurable difference in health outcomes (in fact, those provided housing died at higher rates). I am not convinced the housing first is as great as its proponents claim it is, though it does have an intuitive appeal (by definition, it’s the solution to homelessness! But what if homelessnes…
Finland has slashed homelessness; the rest of Europe is failing
281–290 of 360 posts
Re: Finland has slashed homelessness; the rest of Europe is failing
#282Earlier quoted context omitted.
Inpatient mental hospitals used to be in every state. They housed not only the mentally ill but also the chronically homeless and other outcasts. As the advent of antipsychotics and antidepressants reduced their population, these hospitals were an obvious target for budget cuts throughout the 80s and 90s. They money for the community health centers that were supposed to replace them never materialized, and thousands…
I would add that you are missing a major component for why mental hospitals went away-- public opinion changed. The public was made aware of abuses and such abuses were also dramatized in One Flew Over The Cuckoos Nest. There was pressure to shut these down. Separately, I will add that we need these hospitals back desperately. I don't know who will sign up for this tough job, but we need a place for the mentally ill…
Re: Finland has slashed homelessness; the rest of Europe is failing
#283Earlier quoted context omitted.
Inpatient mental hospitals used to be in every state. They housed not only the mentally ill but also the chronically homeless and other outcasts. As the advent of antipsychotics and antidepressants reduced their population, these hospitals were an obvious target for budget cuts throughout the 80s and 90s. They money for the community health centers that were supposed to replace them never materialized, and thousands…
I'll never forget this fact because there is a King of the Hill episode (10:13) where a mentally-ill, homeless man named Spongy exclaims "Ronald Reagan kicked me out of my mental hospital!" and Hank bashfully tries to justify it as part of winning the cold war.
Re: Finland has slashed homelessness; the rest of Europe is failing
#284Earlier quoted context omitted.
I was taken political prisoner three times in the Broadlawns facility ran by Polk County Iowa - currently helping Federal Medicaid claw back the fraudulent $20k hospital bill. Lynchpins of the rampant political corruption is nepotism between Chief Justice Susan Larson Christensen/ brother 4th District Chief Judge Jeff Larson and Hon Mary Tabor/brother Chief Deputy Attorney General Eric Tabor. What you speak of does e…
> What you speak of does exist, it's Medicaid I can't say that in-patient mental health care (for non-wealthy) is available nowhere in the US. But it is scarce enough that you may have the only example. I am excluding 72hour-hold facilities because they are more like an extended Dr.s visit, than any sort of rehabilitation.
I saw several women that were domestic abuse victims - their family labeled them as crazy because Iowa doesn't really have any emergency shelters to speak of.
Re: Finland has slashed homelessness; the rest of Europe is failing
#2852) Placation will make it worse. Living under a bridge near other homeless people is the problem. Efforts to decriminalize "the unhoused" make the problem worse. Look at Portland, SF, Austin, and ever other city that tries this. It gets worse EVERY TIME. STOP DOING THIS.
To solve the problem:
1) Hold humans to a high standard. No, you can't live in the park. That isn't an option. No you can't do drugs. No you can't rob the walgreens. No you can't stand in my front yard at 2:00am screaming. Doing these things will result in your spending your time locked in jail.
2) Get a job. Places like Albuquerque have program where anybody can show up in the morning and get work doing things like cleaning the parks, cleaning the sidewalks, picking up trash, etc. This is good. More of this.
3) Our understanding of human psychology does not need "disruption". People who spend their time depressed and doing drugs while living in a ditch are going to develop serious stress related mental health issues. People with structured 9-5 jobs which result in them having a house and food, and something to work towards are universally more mentally healthy. And it isn't the house and the food making them more stable, it's the structure.
The efforts to fix this stuff: closing the mental health facilities, letting people sleep in their own filth, letting people commit petty crimes: these things make the problem WORSE. Stop it. This stuff might make you feel good, but it is at the expense of the people you are exploiting for your good feelings. Stop being so selfish and accept that the solution to this problem isn'g going to be happy and fun and worthy of instagram posts.
Re: Finland has slashed homelessness; the rest of Europe is failing
#286Earlier quoted context omitted.
I would add that you are missing a major component for why mental hospitals went away-- public opinion changed. The public was made aware of abuses and such abuses were also dramatized in One Flew Over The Cuckoos Nest. There was pressure to shut these down. Separately, I will add that we need these hospitals back desperately. I don't know who will sign up for this tough job, but we need a place for the mentally ill…
Odd that "One Flew Over the Cuckoos Nest" could have such an effect, but we have all kinds of movies and TV shows now depicting how terrible prison is and that doesn't seem to have a similar (but opposite) effect.
There's lots of movies and shows that take place in prisons, but th prison itself is usually just the setting. The film is rarely making a statement about incarceration itself. Also, we have a much more fragmented high volume media culture, so it's not clear that film and TV can effect cultural change like they used to be able to.
Re: Finland has slashed homelessness; the rest of Europe is failing
#287Earlier quoted context omitted.
> Psychiatrists are mostly doing medication management because that’s where they’re most effective. I think it's money: insurance will shell a lot more $/hour if they do 15 minute medication appointments instead of hour therapy + medication appointments.
Integrating counselling and medical doctoring is a strange idea, and it's somewhat weird that it's even as much of a thing as it is. Drug-focused psychiatrists are certainly going to be a thing so long as med school is so costly and med schools conspire to keep the supply of doctors low.
Why? It doesn't seem any different to me than surgery + physical therapy for a non-brain-oriented medical problem.
Re: Finland has slashed homelessness; the rest of Europe is failing
#288Note that the "homeless" people in Finland are mainly people who refuse to accept support from the social welfare, this is because they prefer to get drunk instead of spending it on food and rent. The social welfare eventually suggests a different system for such people: pay the rent for them and give a special card that can be used for anything except alcohol and cigarette. If the people keep refusing that other opt…
> Such people are very rare in Finland in reality however, Given the severity of Finnish winters, I'm not surprised. Try a similar approach in, say, Hawaii or the Bahamas, and see how many homeless you'll see roaming around.
Re: Finland has slashed homelessness; the rest of Europe is failing
#289Re: Finland has slashed homelessness; the rest of Europe is failing
#290Earlier quoted context omitted.
With that kind of spending, how can it be that homeless people have trouble finding shelters? Sounds like a lot of that money is going to middlemen and outsourcing companies than the actual people that need it.
Lots of reasons. A short list includes: * Shelters not allowing pets - many would rather remain homeless than give up their dog * Shelters not allowing drugs * Social services officers looking too much like cops (many homeless have had bad enough experiences with cops to keep them away from anyone cop-like) * Spending on 'discomfort' measures (eg deliberately-hostile architecture to discourage people from being homel…
This is strange. I'd guess that free therapy, or at least government-subsidized mental health initiatives, would be pretty popular on the left. That leaves me with the right. But therapy doesn't really seem like something that's easy to get jealous about. Are people going to get mad at articles about "therapy queens" that see a dozen therapists per week?