Live data from Hacker News

Time to bring back asylums?

wsj.com

361–370 of 397 posts

Re: Time to bring back asylums?

#361
post #357

Earlier quoted context omitted.

I think you should be honest that you're talking about putting people into a prison and then calling that prison a hospital. And given the state of prisons in the US, I know what that "hospital" would end up looking like. And I think it's kind of weird and very vaguely gross to try and distinguish. There really aren't many reforms or programs for an asylum that aren't applicable to existing prisons -- normal prisoner…

Politically it's much easier to sell "prison type 2: mental hospital edition" than it is to make "global prison: sweden edition", much like they have low security / high security prisons. It's a classic case of perfect being the enemy of good, and it's a major reason why the USA has problems like this, because of it's vetocracy structure. IMO the first step to prison type sweden would probably be getting rid of the d…

> Politically it's much easier to sell "prison type 2: mental hospital edition" than it is to make "global prison: sweden edition", much like they have low security / high security prisons.

On one hand I agree that it would be a lot easier initially to sell the idea; on the other hand the public sentiment around prisons as they exist today and the unwillingness to treat prison residents as if they are human beings is a fundamental social problem that will corrupt attempts to build compassionate and helpful asylums.

I don't believe there's a shortcut; our prisons are horrible in part because society tolerates that. They will also tolerate abuse in mental hospitals, they will also very quickly dehumanize people who are committed to mental institutions. And very quickly you will find yourself in the position of needing to argue for basic human rights inside mental institutions and realizing that the same people who are antagonistic to prison reform are also going to be antagonistic to treating the mentally ill with dignity and respect.

That you feel that you can't really effectively argue for general prison reform to the general public is the canary in the coal mine. Your instincts are correct, you do not live in a society that cares about the rights of prisoners. Attempting to trick that society into caring about some of those rights by renaming prisons to hospitals... it's not going to work. The same people will vote and will have the same attitudes about segments of society that they would prefer please go exist someplace else where they can be ignored.

It's just going to be prison 1.0 with a different name on it. If you can't convince people to care about prison 1.0, you also will not have a defense when those same people stop caring about prison 2.0 for the same reasons.

Honestly, if anything having a different name on it will make it easier for the general public to ignore abuses in both asylums and regular prisons. The sentiment will be that asylums are "nice" so they're obviously caring for the sick people who don't know better, and mental health in prisons isn't a problem, those people go to asylums. And since asylums are nice, why do we have to wait for people to commit crimes? It's not like we're sending them to prison. And on and on...

I just don't think there's a marketing trick that can be done to get around that problem; it's reinforcing delusions people have about the justice system rather than correcting them. We have to actually do the work to change social views on prison.

And I think the distinction itself is kind of unhelpful for that effort. To be very clear, mental institutions and asylums are prisons. If saying that out loud rubs people the wrong way, it's because we know deep down that our current prisons are awful places and we all (myself included) desperately want to figure out some excuse to use so we can say that sympathetic human beings don't go there. Telling the general public "they don't deserve to be in prison, they deserve to be in a hospital" is in many ways just allowing people to feel less bad about the people who are in prison, it's a way to allow the general public to continue clinging to the idea that prison isn't about rehabilitation or treatment or safety. It's a way to allow the general public to shrug when people are sent to prisons because "it's just a hospital." But calling prisons a different word doesn't make them not prisons, it just makes us feel better about putting people into them.

Re: Time to bring back asylums?

#362

Earlier quoted context omitted.

The medical community already has well-developed ethics and treatment rules.

The medical community also had ethics and treatment rules when asylums where common and they didn't seem to help much. Even if the doctors themselves are moral, what prevents politicians from putting their thumb on the scale? We are already seeing them override physicians on gender affirming care. What prevents politicians of finding a small number of immoral doctors who are willing to rubber stamp whatever they want…

Sorry to be harsh, but these hypothetical (and nearby) concerns are not important enough compared to the daily atrocities I see in downtown LA. There’s egregious harm happening now.

Also it’s not uncommon to discourage procedures for minors until they are able to lawfully consent. So your example is muddy.

Re: Time to bring back asylums?

#363
post #32

Mental health doesn't have to be done in the most stupid way possible. And yet could be much more present, available, temporary. An institutional system can be built with cross-checks, inspections, corruption fighting mechanisms, etc. By this I mean actual, independent, not powerless, not perfunctory, corruption-fighting, enforceable, etc. As opposed to the usual such cross-checks around here. This is a far broader i…

> An institutional system can be built with cross-checks, inspections, corruption fighting mechanisms, etc. By this I mean actual, independent, not powerless, not perfunctory, corruption-fighting, enforceable, etc. It can be but not within capitalism. Even if it’s the Best Government Program Ever, eventually it will become public/private, and eventually private. And it will get worse and worse the entire time. Once i…

Okay, let's take that comment as an opportunity:

Which institutional system out there, worldwide, is a model of cross-checks, effective powerful independent oversight, corruption fighting, etc - enforcing not just lack of corruption (not just financial) but also efficiency in accomplishing its mission? Anyone? Anyone?

Some institutions used to have great reputation but I don't know that they were all that efficient. (UK Police, French electricity company). But for both of these I don't feel that it was because of good independent oversight anyway.

Re: Time to bring back asylums?

#364
post #50

Earlier 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…

I'm just repeating a commonly held belief, hence the upvotes. It's not as if I came up with this opinion out of thin air. >Your feelings, whatever they are, that lead you to your opinions, political principles, or ethics, are inherently immune to being invalidated by others. You don't know me. You can't possibly know something like this from one comment on the internet. It seems that others have said this to you in t…

>I'm just repeating a commonly held belief, hence the upvotes

That possibility ("a commonly held belief") indeed is the reason I thought it worth engaging.

I don't think I can see your upvotes, and discussing voting is against the guidelines.

>It's not as if I came up with this opinion out of thin air.

It would be unreasonable to assume you did. Yet that doesn't give me a hint where your opinions do come from, which is why I was - and am - asking.

>You don't know me.

That was the gist of my whole comment. It's unfortunate if the meaning of the whole thing was somehow inverted.

>You can't possibly know something like this from one comment on the internet

Something like what? You quoted a sentence that tried to communicate, in short, nobody can judge you.

My entire comment was a disclaimer or admission that I know nothing about you nor can I judge you, and a solicitation of information.

>It seems that others have said this to you in the past, and you are just parroting it to me

Every word I wrote was original to me and expressed my thoughts at least for one particular moment.

Do you think repeating beliefs that others hold is bad? I don't think it's good or bad in itself. By the repetition of an idea, you make it your own, and there is always a good reason for doing so...but that reason is unique to you and not made clear unless you choose.

Asking about your reasons may seem intrusive, like asking if you want to open yourself to bullying from all and sundry, but I strongly believe in this principle:

What convinces you of a thing is the best possible argument for convincing other people

Constructive dialogue on anything cannot take place without some willingness to treat discussion as more than a tactical game.

Not participating in constructive dialogue is everyone's right. The benefit to you, the carrot and not the stick, is that you might one day rightly convince someone, somewhere, in the world of something you believe in.

Who knows, you could be the first person to convince anyone of anything on the internet in the last half century.

Re: Time to bring back asylums?

#365
post #213

Earlier quoted context omitted.

Mental healthcare coverage in Canada is pretty abysmal. It's barely covered at all unless you're in a crisis situation, which is not very different from many US states.

That’s fair. Though to be clear the following are covered: * Family doctor or clinic visits for mental health * Psychiatrist visits * In most provinces, medications Talk therapy through a psychologist is what is generally not covered outside of work insurance. That’s a big gap, but also not quite right to say “not covered at all”.

[deleted]

Re: Time to bring back asylums?

#366
post #332

Earlier quoted context omitted.

Higher minimum wages are the last thing those people need. We're talking about the least productive workers. If minimum wage is $20 and their labor is only worth $10 then no one will hire them at all. They will remain dependent on handouts and never have the opportunity to gain real work experience. Under the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, medical insurers are already required to cove…

You, nradov, are the problem. Paying people a living wage is not a handout. Raising the minimum wage is not a handout. These people are working, hard, harder than you do, for way less. These people are being taken advantage of. It's not just fast food workers, it's bank tellers, it's farm workers, it's orderliness and custodians at hospitals, it's the backbone of our society. What do you get paid to do? I would argue…

Feel free to insult me if that makes you feel better but it won't solve anything. You can't force private employers to hire unproductive, unskilled workers at wages that make them unprofitable.

A better solution would be to eliminate the minimum wage entirely and instead expand the Earned Income Tax Credit. Basically have negative income tax rates for low income workers. This would cut unemployment and allow those people to start gaining some real job skills.

Re: Time to bring back asylums?

#367
post #65

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…

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…

>Now clearly mentally ill people - who needed help - were turned away unless they were clearly "a danger to themselves and others".

People talk as if this standard is the source of problems, but it's a fine standard. We just don't enforce it.

Eg, if a homeless drug addict overdoses and is brought back by the fire dept with narcan, this is clearly someone who is a danger to themselves. They should be treated no differently than someone rescued from a suicide attempt.

Fentanyl itself changes the imminent danger of being an opiate addict because there's no remotely safe way to use it. Any chronic user of Fentanyl is a danger to themselves.

Someone who is unable to maintain basic level of health on the street is the same. Do you have infected wounds festering? Teeth rotting out of your mouth? The government would take away a pet dog from someone in that state, but for a human doing it to themselves, no problem.

Re: Time to bring back asylums?

#368
post #278

Earlier quoted context omitted.

Thank you. These people that demand perfection are poison to any kind of progress, and one of the reasons the US is an increasing failure. Was recently in Asia, and the contrast was clear as day.

I'm not demanding perfection. I'm literally just asking "what would be different this time", and the only answer I'm getting is "we know better this time around". Seriously: the reason asylums were so prone to abuse in the past was not because the people running them didn't know better.

[dead]

Re: Time to bring back asylums?

#369
post #258

Earlier quoted context omitted.

There is also right now an epidemic of homeless people harassing, assaulting, and even murdering people and generally making major cities nearly unlivable. So when you create a false dichotomy between "treat mentally ill people who might murder you" or "lock up gay people", YOU are in fact giving tools to the people who want to lock up gay people. However much your average, non-gay person supports rights for gay peop…

I live in a major city that is constantly described as having an epidemic of homeless people. I am far more annoyed by delinquent, housed teenagers than I am of the homeless population here. And more people die from reckless drivers than are murdered by insane homeless people-- in fact, a little girl was killed in a hit and run this year a few streets from me, and 0 murders by insane homeless people have happened in…

> I'm pointing out that you must absolutely contend with the fact that marginalized people have historically been labeled mentally ill when they fight for equality

And I am pointing out that all people, marginalized or not, are currently subject to violence and harassment by the untreated mentally ill, right now. Not historically, currently.

If one party starts telling voters that they care more about hypothetical inconveniences for marginalized people than they do about people getting murdered right now, that party is not going to be in any kind of power for long and they will have no opportunity to protect anyone's rights.

Re: Time to bring back asylums?

#370

Earlier quoted context omitted.

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.

Focus on vengeance is a mental illness in itself; I’ll make sure you get on the list. ;-)
Post reply on HN