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Your sarcasm/examples are false equivalencies. US cities were at one point far less car centric than they are now. Do you think we should maintain the status quo there as well?
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Time to bring back asylums?
91–100 of 397 posts
Re: Time to bring back asylums?
#92Will the 1% also be institutionalized against their will to treat their undiagnosed hoarding mental illness?
Re: Time to bring back asylums?
#93Earlier quoted context omitted.
>In a sentence, we need a public infrastructure in place to care for the mentally ill that currently are forced to live on the streets of our major cities. Your feelings, whatever they are, that lead you to your opinions, political principles, or ethics, are inherently immune to being invalidated by others. However, it makes me nervous to read comments such as yours, because my first reaction is that I can't tell wha…
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Re: Time to bring back asylums?
#94I see a lot of misinformed takes in here and this is a very nuanced topic. However unless you actually work in services interacting with mentally ill and homeless people you likely have a very skewed idea of how things work. I know I certainly did before I became involved.
Washington state has what is called ITA (involuntary treatment act) which is used for holding people in mental health facilities temporarily. These people are placed there after a DCR (designated crisis responder) performs an evaluation on the person.
I work in an ED in a busy city hospital. We have a constant stream of psych patients coming in. Not all of them end up on ITA. Some times they just need to go through a 72 hr hold in the ED and detox and are fine to be released. Other pts coming in every week , they’re too unstable to live in a shelter but not enough of a danger to themselves or others to be sent to a mental health facility.
The social workers at the hospital are the ones who make these decisions to place pts on holds. They are not tyrants with power trips. These are people who have Masters in psychology and licensed in the state. They’re incredibly empathetic people working a job that is massively underpaid compared to their private sector colleagues.
Some of these pts are absolutely unable to care for themselves but again can’t get into shelters because they are behaviorally nondirectable so their only recourse is to live on the streets.
Pts get ITA and sent off to facilities but after 30 days they’re released back on to the street only to end up in crisis again and back in the ED to start the process again. We have one regular pt who cuts himself every time he gets released. His legs and arms are covered in scars. He isn’t capable of taking care of himself but he doesn’t stay sober enough to live in a shelter so he’s in the ED every week until something bad enough happens that he gets ITA and sent to a facility again, rinse repeat. There’s no where for most of these people. There is no long term facility for people who are not able to care for themselves and function in society.
When I worked at homeless shelters before the hospital I’m at it was a mess. There’s no help for people who want to get sober. You’re thrown into a barracks style room mixed in with sex offenders, users, elderly, mentally ill, there’s no separation and there’s no services to help people so you see them relapsing constantly. There’s usually encampments outside the shelters so those trying to get clean can’t even go outside without being triggered by the surrounding people using openly and selling to those living in the shelters. It’s really hard to be sober and get your shit together living in a shelter.
This is just a scratch of the surface. It’s so much more complex and nuanced than what you think.
Re: Time to bring back asylums?
#95Earlier quoted context omitted.
We’re clearly not talking about the same problem. There isn’t a direct line from you not being able to find the same square footage for $1600 in 2019 as you did in 2009, and you winding up as a hopeless drug addict in Cal Anderson. I’m all for draconian policies to address rising housing costs (such a extreme excise taxes on vacant units, of which there are a lot in Seattle and Portland), but that doesn’t have anythi…
I've advanced the position that 1) we should agree to tackle the root cause of the problem primarily but not exclusively and 2) we should identify and agree on what the root cause is. I'm not clear if you agree with the above. I've explained what I believe to be the root of the problem. You have not. I've explained some ways we might ameliorate the problem. You have not. It's difficult to have a conversation when the…
I replied to you also, and you chose not to answer.
> That people are more susceptible to drug addiction than before.
Maybe somewhat; but a bigger part of it is that what was a problem spread throughout the US was successfully exported by the rest of the country to a few west coast cities.
> And that if we punish people more forcefully the problem will be resolved.
No, I don't think anyone is saying that. But adding housing isn't enough.
Homeless shelters successfully use inability to stop using drugs during length of stay as a predictor of violent, antisocial, and destructive behavior. You can't just place these people in housing units without a lot more scaffolding, support, and treatment.
"Housing first" works very well for 85%+ of homeless people, but treating this like it's one homogenous problem isn't going to be successful. If you try to just cram the rest into housing, they're going to still end up disrupting streets and causing property damage.
> protect our public spaces more vigerously.
Chasing the chronically homeless and ill from place to place isn't what I want. That game of musical chairs is what we do now.
Re: Time to bring back asylums?
#96For anyone who wants to bring back asylums: first and foremost, you must imagine that you will be subjected to asylums as they existed. You could simply be protesting while black or female, considered insane for protesting and forcibly detained-- for which you can be raped and assaulted, and any reporting to the police of your trauma isn't taken seriously because you're considered insane. It's nonsensical to say we s…
> you must imagine that you will be subjected to asylums as they existed.
No you don't. Nobody is advocating for that. Nobody is saying we should follow the same broken standards that led to locking up people for protesting, or that we should allow abuse and rape.
Do you not think there is any middle ground between raping protestors and letting people with violent schizophrenia live in a tent on the street?
Re: Time to bring back asylums?
#97For anyone who wants to bring back asylums: first and foremost, you must imagine that you will be subjected to asylums as they existed. You could simply be protesting while black or female, considered insane for protesting and forcibly detained-- for which you can be raped and assaulted, and any reporting to the police of your trauma isn't taken seriously because you're considered insane. It's nonsensical to say we s…
Florida has laws on the books that let anyone go to a judge to get an order for forced treatment of someone else for claimed mental illness or addiction, like the Baker Act and the Marchman Act. With the Marchman Act, non-compliance with treatment can have legal consequences, as well.
From here[1]:
> What happens if the respondent isn’t compliant with the treatment order?
> It’s up to the judge but the idea is that non-compliance with a court order equates to contempt of court and is punishable by jail time. This is where the “teeth” or consequences are introduced for someone refusing to comply with the treatment plan. However, we have found that many counties do not enforce treatment orders with jail time.
Re: Time to bring back asylums?
#98Earlier quoted context omitted.
As someone with direct experience with someone that has a mental illness, there needs to be something better than the present system. I think something went right, then wrong with the treatment of mental illness in california. Years ago, when the laws were changed to allow mentally-ill but benign or even non-ill people to escape the "snake pits", lots of people could recover. But later state mental illness funding wa…
> lots of mentally ill people don't get proper treatment, yet are still a huge burden on the health care system. I'm not saying you're right or wrong, but why do you believe that?
Instead of getting the treatment they need, they end up tying up ER resources? Either because of continual crisis with no proper diagnosis, or just lack of health insurance to find/afford any other options
Re: Time to bring back asylums?
#99Earlier quoted context omitted.
> In a sentence, we need a public infrastructure in place to care for the mentally ill that currently are forced to live on the streets of our major cities. Maybe that's putting the cart before the horse? How about what is needed is changing the conditions in society, workplace, and culture, so that fewer people end up "mentally ill", and those that are environmentally or genetically mentally ill do not get broken an…
But there will still be some mentally ill people right? Not everything and everyone can cured. Just like we will always need jails.
Yes. Far fewer, and with lesser societal impact and harm, for which existing infrastructure would be more than enough.
Kind of how other first world countries (even nominally poorer ones) only have a tiny fraction of the problems with mentally-ill homelessness, crime, shootings, and so on.
Re: Time to bring back asylums?
#100Earlier quoted context omitted.
As someone with direct experience with someone that has a mental illness, there needs to be something better than the present system. I think something went right, then wrong with the treatment of mental illness in california. Years ago, when the laws were changed to allow mentally-ill but benign or even non-ill people to escape the "snake pits", lots of people could recover. But later state mental illness funding wa…
> lots of mentally ill people don't get proper treatment, yet are still a huge burden on the health care system. I'm not saying you're right or wrong, but why do you believe that?
ER visits are inordinately costly, but are generally the only way for homeless people to receive care (behavioral, chronic health conditions, etc).
I'm having difficulty finding the source, but I've read that individual "frequent fliers" have consumed hundreds of thousands of dollars of emergency services without receiving substantive care that would improve their situation.