Time to bring back asylums? • Hacker News Board

Re: Time to bring back asylums?

#201

Post by david38 » Sun, Jul 23, 2023, 3:31 AM UTC

amadeuspagel wrote: post #11

Asylums still exist. What this person wants to bring back is the ability to lock people up and keep people locked up there with little recourse. A typical case from this time[1]: > [Cramer] frankly discusses the “regimented, often hopeless conditions of state mental hospitals”, talks about a hospital in Alabama where “care was worse than simply inadequate: one psychiatrist for 5000 patients; astonishingly low funding…

Pointing to the worst abuse of a system of the same name when that is clearly not the intent and claiming this is what the person wants is a lie.

It is possible to keep mentally ill in walled communities and those communities not resemble the above. There are activities which are known to help some of these people, such as gardening (plants are cheap, forgiving, rewarding, and have no real profit motive).

There are large numbers of mentally ill people who are given a bottle of pills and just released to fend for themselves. This became common after the development of certain medications and the government felt it was a lot cheaper than institutionalizing them.

Re: Time to bring back asylums?

#202

Post by Spooky23 » Sun, Jul 23, 2023, 3:32 AM UTC

sam345 wrote: post #23

Spooky23 wrote: post #4

It’s time to bring back a credible editorial board to the Wall St Journal.

Explain ? Not a WSJ editorial board opinion. Also interested in when you think the WSJ board was credible and at what point it lost its credibility ?

It’s become a joke post Fox acquisition.

Re: Time to bring back asylums?

#203

Post by swivelmaster » Sun, Jul 23, 2023, 3:32 AM UTC

bko wrote: post #169

m463 wrote: post #65

Earlier 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…

Do you have a source about California mental health spending being cut? Anytime i read a comment about spending being cut or austerity it never materializes when I look it up. I blame the media that reports "cuts in the future anticipated spending growth" as "cuts". So basically someone said spending on X will grow Y percent a year and someone else comes in and changes Y to slightly lower. Sure enough: > The chart be…

You’re not going back far enough.

https://calmatters.org/justice/2019/03/hard-truths-about-dei...

Re: Time to bring back asylums?

#204

Post by creata » Sun, Jul 23, 2023, 3:33 AM UTC

imgabe wrote: post #177

EatingWithForks wrote: post #170

Earlier quoted context omitted.

You cannot merely wave aside that your proposed solution is a solution that also already evidenced to have caused mental illness on a broad, demographic-specific scale , in the name of solving mental illness! That's patently ridiculous.

Which of the following statements are you advocating for: 1. There is never any reason to involuntarily commit someone 2. There are valid reasons, but there is no known diagnostic that can detect them. 3. There are valid reasons, and we can detect them, but there is no way to prevent people from involuntarily committing people for other reasons, even if we make laws and conduct audits to ensure that only valid reason…

Not the person you're replying to, but I'm curious: what's wrong with position (3)? That's kinda where I am right now.

Re: Time to bring back asylums?

#205

Post by imgabe » Sun, Jul 23, 2023, 3:34 AM UTC

EatingWithForks wrote: post #191

imgabe wrote: post #177

Earlier quoted context omitted.

Which of the following statements are you advocating for: 1. There is never any reason to involuntarily commit someone 2. There are valid reasons, but there is no known diagnostic that can detect them. 3. There are valid reasons, and we can detect them, but there is no way to prevent people from involuntarily committing people for other reasons, even if we make laws and conduct audits to ensure that only valid reason…

You are not addressing my concerns and are mostly creating straw men to avoid that I am pointing out the historical, real, already evidenced harms of the proposed solution.

You are the one creating strawmen by harping on abuses from 60 years ago when I'm specifically saying don't do that.

Are you just completely against the idea of human progress? Do you think we're incapable of fixing things that were bad in the past?

Both my parents were nurses who worked in psych hospitals. I can promise you people exist who need to be in there. People who are incapable of caring for themselves. People who in some cases already committed violent crimes. We need places to care for people like this.

Yes, abuses happened. So stop abusing people, don't stop caring for people who need care.

Prisons are sometimes abusive. People are sometimes put in prison for unjust reasons. People sometimes try to make bad laws to put people in prison for shitty reasons. So should get rid of prisons altogether and just let thieves and murderers do whatever they want? That doesn't seem to be working out so well in California.

At no point did I say there were never problems with institutions. I'm saying fix the problems instead of getting rid of institutions altogether.

Now, are you saying it's not possible to fix or what?

Re: Time to bring back asylums?

#206

Post by m463 » Sun, Jul 23, 2023, 3:39 AM UTC

bko wrote: post #169

m463 wrote: post #65

Earlier 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…

Do you have a source about California mental health spending being cut? Anytime i read a comment about spending being cut or austerity it never materializes when I look it up. I blame the media that reports "cuts in the future anticipated spending growth" as "cuts". So basically someone said spending on X will grow Y percent a year and someone else comes in and changes Y to slightly lower. Sure enough: > The chart be…

funding: https://en.wikipedia.org/wiki/Mental_Health_Systems_Act_of_1...

california: https://en.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%80...

"Some family of mentally ill individuals believe that the LPS act favors the individual's civil rights too much when weighed against their self-evident need for treatment. It can be very difficult for their family member to be placed on a 5150 hold or on a LPS conservatorship. The LPS Act requires a "grave disability" to provide oneself with food, clothing, or shelter. Thus an individual may indeed be highly symptomatic, displaying paranoia, delusions, mania, etc., but if he or she can present a cogent plan to care for food, clothing, and shelter, he or she may very well be released from psychiatric care"

Re: Time to bring back asylums?

#207

Post by kaitai » Sun, Jul 23, 2023, 3:41 AM UTC

amadeuspagel wrote: post #43

iancmceachern wrote: post #39

Earlier quoted context omitted.

Not really at all. 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. We need a way to pay the people that do the work, buy the buildings, keep the lights on. We call this infrastructure asylums, whatever you want to call it we need it desperately. If you want to stop things like what you cited from happening, lobb…

Homeless shelters still exist too. It's not about what to call it, it's about whether people are forced to be there.

A shelter is generally a place that you go to overnight, where you can't keep your stuff, you have to be out early in the morning and come back at a strict time in the afternoon or evening. Very different than an asylum which provides 24 hour care. Also, there are many homeless families (shelters don't serve them that well), but when it comes to mental illness it's not usually a family thing.

Re: Time to bring back asylums?

#208

Post by Spooky23 » Sun, Jul 23, 2023, 3:42 AM UTC

bko wrote: post #169

m463 wrote: post #65

Earlier 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…

Do you have a source about California mental health spending being cut? Anytime i read a comment about spending being cut or austerity it never materializes when I look it up. I blame the media that reports "cuts in the future anticipated spending growth" as "cuts". So basically someone said spending on X will grow Y percent a year and someone else comes in and changes Y to slightly lower. Sure enough: > The chart be…

The 1980s story around the closure of institutional behavioral health institutions was that the people in need of care would have that care delivered in the community.

If you look around, you’ll find a dearth of facilities in the community that can handle mentally ill, mentally disabled, and addicted people.

The expenses you reference are mostly Medicaid growth, of which a relatively small proportion is mental health related.

Re: Time to bring back asylums?

#209

Post by danShumway » Sun, Jul 23, 2023, 3:42 AM UTC

EatingWithForks wrote: post #173

soligern wrote: post #165

Earlier quoted context omitted.

Things can improve. We can learn from past mistakes and do it better. Have a high bar for entry, have stringent regulations that involve inspections every week etc. The solution is not to just throw up your hands and refuse to do anything about a clear problem and hope it goes away because we failed in the past.

We can't even bother inspecting our current critical inpatient mental crisis facilities. You cannot seriously claim we should be bringing back an evidently widely abused institution because we can regulate it, when we already have widely abused institutions that are not regulated. We had, in our most respected medical facilities, numerous women subjected to extremely painful ovarian harvesting with no pain relief and…

Absolutely this. The burden of proof here is on people proposing some kind of happy regulated system to prove that we are in any way as a society capable of building those systems. And it's not just that mental health and inpatient care in the US is under-regulated, under-funded, and abusable -- our society still has debates about mental health and still suffers from widespread stigmatization of people with mental health issues. We have not shaken off the social attitudes and beliefs that led to the original widespread abuse within asylums.

If someone is proposing forced asylums you have got to grapple with the fact that Florida legislature considers being transgender a mental disorder and that Florida is fully willing to try and weaponize social services and child protective services to attack families with transgender members. You can't just gloss over that, you have to understand how a state like Florida will immediately try to weaponize an expanded system of forced asylums.

"We'll just have strong standards that prevent abuse" -- how? A nontrivial number of states right now are actively trying to use medical standards to oppress or eliminate a minority group. I'm sure Texas is going to have great standards on when the State can lock someone in an asylum. /s

Re: Time to bring back asylums?

#210

Post by m463 » Sun, Jul 23, 2023, 3:48 AM UTC

creata wrote: post #87

m463 wrote: post #65

Earlier 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?

I have direct experience with this.

The police and emergency responders can be called, but are unable to take any action to help a clearly mentally ill individual unless they are a danger to themselves and others. The same is true for doctors/hospitals/emergency rooms.

It is common for an individual to have 20 or 30 public service calls before they are admitted and start to receive guided treatment. Even individuals with caring and attentive families can and will fail to be treated, with damage to their mental state, or at a minimum long costly delays to their recovery.

read about "5150 hold" and the criteria required:

https://en.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%80...