Time to bring back asylums? • Hacker News Board

Re: Time to bring back asylums?

#261

Post by SamReidHughes » Sun, Jul 23, 2023, 6:39 AM UTC

If I were to make a system for taking homeless off the street, my idea would be:

1) Outlaw vagrancy, and arrest people for vagrancy, the crime specifically being living on the street instead of paying for their own upkeep, but the important part is...

2) They can get their freedom quickly by working some minimum wage job, provided by the city, like cleaning the highways or picking up trash, for a week. Then when they're released, they can still work that job, or they can get out of dodge.

This is a clumsy proposal and not fully thought through -- but there can be some mechanism that lets people who aren't totally deranged get themselves quickly released while directing the others to treatment.

An obvious criticism of this is, it's not hard to come up with counterfactuals. What if somebody is homeless with their family, and they get arrested for vagrancy. Now their kids are separated from them. Then what? What if they have a dog?

Re: Time to bring back asylums?

#262

Post by mixmastamyk » Sun, Jul 23, 2023, 6:47 AM UTC

SamReidHughes wrote: post #261

If I were to make a system for taking homeless off the street, my idea would be: 1) Outlaw vagrancy, and arrest people for vagrancy, the crime specifically being living on the street instead of paying for their own upkeep, but the important part is... 2) They can get their freedom quickly by working some minimum wage job, provided by the city, like cleaning the highways or picking up trash, for a week. Then when they…

I think that's starting at the wrong end. Need to get sick people help, addicts support, halfway housing available. Only much later would you start thinking about arresting folks who refuse.

Re: Time to bring back asylums?

#263

Post by vore » Sun, Jul 23, 2023, 6:51 AM UTC

SamReidHughes wrote: post #261

If I were to make a system for taking homeless off the street, my idea would be: 1) Outlaw vagrancy, and arrest people for vagrancy, the crime specifically being living on the street instead of paying for their own upkeep, but the important part is... 2) They can get their freedom quickly by working some minimum wage job, provided by the city, like cleaning the highways or picking up trash, for a week. Then when they…

This doesn't really solve any kind of housing supply problem.

If you're forced to live on the street because you can't afford any kind of housing, you're just going to get arrested and forced into a minimum wage job where you still can't afford housing. Then you're still not affording housing, aren't you now basically enslaved if you're just going to get arrested again and forced to work a minimum wage job?

Re: Time to bring back asylums?

#264

Post by nradov » Sun, Jul 23, 2023, 6:56 AM UTC

mlyle wrote: post #259

ec109685 wrote: post #231

Earlier quoted context omitted.

Why is an ER fundamentally so much more expensive than another office visit? Just an anecdote, I don’t see any late night “urgent care” places anymore. If they were sufficiently less expensive than ERs, it seems like insurance companies would incentivize them to have longer hours. Otherwise, after 9pm, you have to go to ER.

> Why is an ER fundamentally so much more expensive than another office visit? Two main reasons: you need to use personnel, equipment, and rooms that can offer the highest levels of care. And you need to pay for having a facility staffed to handle worst case loading (with triage) 24/7. You also tend to have pretty exhaustive testing on the "emergent" side to make sure everything is immediately OK prior to discharge.

Right, and ERs also charge high prices to insured patients in an attempt to recoup losses from treating uninsured patients (including those with serious chronic mental disorders).

Re: Time to bring back asylums?

#265

Post by SamReidHughes » Sun, Jul 23, 2023, 6:56 AM UTC

mixmastamyk wrote: post #262

SamReidHughes wrote: post #261

If I were to make a system for taking homeless off the street, my idea would be: 1) Outlaw vagrancy, and arrest people for vagrancy, the crime specifically being living on the street instead of paying for their own upkeep, but the important part is... 2) They can get their freedom quickly by working some minimum wage job, provided by the city, like cleaning the highways or picking up trash, for a week. Then when they…

I think that's starting at the wrong end. Need to get sick people help, addicts support, halfway housing available. Only much later would you start thinking about arresting folks who refuse.

I agree, maybe not the same way because instead of "helping" people, you could target much of addiction by arresting and hanging drug dealers.

But aside from that, getting these people help apparently requires forcing them into custody. I don't want the more functional people, or people parking their RVs in the wrong place, to get swept up in that.

Re: Time to bring back asylums?

#266

Post by SamReidHughes » Sun, Jul 23, 2023, 6:58 AM UTC

vore wrote: post #263

SamReidHughes wrote: post #261

If I were to make a system for taking homeless off the street, my idea would be: 1) Outlaw vagrancy, and arrest people for vagrancy, the crime specifically being living on the street instead of paying for their own upkeep, but the important part is... 2) They can get their freedom quickly by working some minimum wage job, provided by the city, like cleaning the highways or picking up trash, for a week. Then when they…

This doesn't really solve any kind of housing supply problem. If you're forced to live on the street because you can't afford any kind of housing, you're just going to get arrested and forced into a minimum wage job where you still can't afford housing. Then you're still not affording housing, aren't you now basically enslaved if you're just going to get arrested again and forced to work a minimum wage job?

It's not about housing. They can leave the west coast and live someplace cheaper.

Re: Time to bring back asylums?

#267

Post by [deleted] » Sun, Jul 23, 2023, 6:59 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…

[deleted]

Re: Time to bring back asylums?

#268

Post by vore » Sun, Jul 23, 2023, 7:01 AM UTC

SamReidHughes wrote: post #266

vore wrote: post #263

Earlier quoted context omitted.

This doesn't really solve any kind of housing supply problem. If you're forced to live on the street because you can't afford any kind of housing, you're just going to get arrested and forced into a minimum wage job where you still can't afford housing. Then you're still not affording housing, aren't you now basically enslaved if you're just going to get arrested again and forced to work a minimum wage job?

It's not about housing. They can leave the west coast and live someplace cheaper.

But... why? Why can't we also build more affordable housing as well instead of just making rich people enclaves? If you're forcing all the low income people to live in one place, that is clearly not good for class mobility at all.

Re: Time to bring back asylums?

#269

Post by 01100011 » Sun, Jul 23, 2023, 7:06 AM UTC

One problem with this line of thought: no one wants to fill the jobs needed to warehouse the mentally ill and socially incompetent.

As it is, we can't seem to staff health care jobs adequately and we think we can just magic up the workers who would take these demanding jobs. It's not even about funding. You can pay people insane wages but if they burn out quickly or just flat out refuse the working conditions you're stuck.

Re: Time to bring back asylums?

#270

Post by whyenot » Sun, Jul 23, 2023, 7:08 AM UTC

Santa Clara county, one of the wealthiest locations in California, has only 211 inpatient psychiatric care beds. Soon, the number will be reduced to 193. Based on population, it should have 960 beds{1]. Is it really any wonder that the current system doesn’t work all that well?

1. https://www.mercurynews.com/2023/07/02/this-should-be-a-wake...