I was pretty with it until 4 and 5. The premise that certain groups of people without housing "can't survive without the kind of assistance that money can't buy" is condescending and elitist at best.
No, there are a huge number of people that are on the edge w.r.t. mental health. Not quite capable of handling activities of daily living and/or their own finances. Or not 100% of the time, and that fraction of the time that they can't, their money evaporates, and/or relationships evaporate.
The crisis in mental health care in the US is shameful. It is true that in the bad-old-days people were over institutionalized. So the pendulum has swung, and now unless a person is very clearly dangerous to themselves or others, it is nearly impossible to get a person resistant to treatment the help that they really need.
We talk about people "falling through the cracks", but the "crack" is a mile wide. It is pretty hard to convince me that a cardboard box under a freeway overpass is better housing than the mental institutions of old. That said, I don't think many of the mentally ill need to be forced into an institution under the old model, but we really do need a mechanism to deal with ill people resistant to treatment.
Yeah man it’s serious. Someone asked me to help an individual recently and I’m struggling to figure out how to help. He is a programmer who suffers from schizophrenia. His hallucinations got out of control until he lost his job, his life, and his kids. Social workers pretty much forced the one person in his life who cares for him (his wife) to have him removed by the police. Now he hates her. Then he proceeded to miss his hearing so he was arrested. Now he is thrown in jail. I feel guilty but I don’t know how to handle this.
I feel for you. Lacking appropriate training, it is hard for us to actually help, even though we care. The first thing to remember is that whatever you say or do will be processed through the lens of his reality. He will try to fit it into the framework of his world. The eventual fit may be very skewed. It is difficult to know how to be helpful in that situation. Sorry I don’t have more for you.
> That said, I don't think many of the mentally ill need to be forced into an institution under the old model, but we really do need a mechanism to deal with ill people resistant to treatment.
This is the mission statement right here. Very well said.
There are quite a few articles/blogs/etc out there from psychiatric professionals who were practicing before deinstitutionalization, many of whom were champions of the reforms, but who in retrospect question whether it should have happened (or at least how it was executed and how ‘community mental health’ never really took off).
Maybe it’s time to revisit the concept of mental institutions, albeit a more humane model.
> Maybe it’s time to revisit the concept of mental institutions, albeit a more humane model.
There isn't a more humane model. If you're forcing people into an institution you're also going to be forcign them to take medication and if you're not very careful there's a bunch of other restrictive practice and other bad stuff that happens. The main ones would be use of rapid tranquilisation, use of prone restraint and supine restraint, and sexual assualt from staff and other patients.
A better model would be correctly funded assertive outreach teams.
There’s a guy on my psych floor right now that, at his best, is too psychotic and paranoid to hold a job for more than a few days. At his worst - where he usually is, because his paranoia includes medications, and he believes he’s completely healthy - he’s only loosely tethered to reality. It’s a good day if he’s clothed even vaguely appropriate to the season, and manages to eat actual food. It’s not uncommon for him to eat soap because an archangel tells him this will increase his potency with women. This isn’t funny, nor exaggeration: this is how an actual real person is living and suffering.
He’s not exceptional. Psychotic disorders do that.
That you think that /describing their existence/ is “condescending and elitist” speaks mostly to the ridiculously privileged bubble you live in.
This is absolutely blowing my mind right now because 20 years ago during a significant psychotic episode I also ate soap on the advice of a glowing angelic figure who also commanded me to store samples of my own semen in a freezer in my basement. I've long since accepted those experiences as crazy edge cases in a complex brain and tied every supernatural interpretation I had to actual rational events, and I'm sure this is just an insane coincidence, but damn if it doesn't make me pause for a second. I wonder if there's some strange cultural artifact I've forgotten that both I and this fellow were exposed to that would explain this synchronicity.
Yeah thank you for your comment -- there are tons of people out there who need that kind of help, I have known some of them as well (maybe not as closely as in your profession!) and the us mental health system is not adequate
My point wasn't articulated well in my first comment. I am worried more about painting homeless people with such a broad stroke. Getting a roof over someone's head is entirely different from getting them mental health services -- we need to fix both to actually solve the problem. And the specific language around "ruiners" in the post really struck a nerve with me... I think that everyone is deserving of some degree of help and shouldn't be thrown in prison like OP suggested.
That said, I don't appreciate the personal attack. While I did find reading about your experience helpful and appreciate you sharing, I think your comment at the end is part of what makes the internet bad. Look to some of the other comments critical of my post for some better examples.
Have you met someone with severe mental retardation? My neighbor required round the clock support, often by multiple people. You could've given that girl 5 million dollars, and she would have no idea how to use it to get support. There is nothing condescending about his statement.
Many years ago, I visited a group home for people with various psychiatric issues. My girlfriend was the "den mother", and I'd spend nights with her occasionally. So I got to know some of the residents.
Anyway, these people would have been on the street, if the state hadn't provided a place for them. I particularly remember a schizophrenic guy. In the right circumstances, on safe topics, he seemed pretty sharp. But then, he was well medicated.
I've had a college class on Homelessness and Public Policy. I spent nearly six years homeless.
It seems accurate to me, at least for America today. It's quite a tall order to ask society as a whole to change, though that would make life more manageable for some people currently unable to make their lives work.
It's a common misconception that humans without homes would be / are totally fine. Normal people who live in houses every day have no idea what living on the street does to someone psychologically. It's the jungle compared to our cushy lifestyles.
Sure, you can "survive", technically speaking. But living for days, weeks, years as an animal, fighting sometimes to the death for scraps, and god knows what else, it's definitely the comforts of friendship and human civility (that "money can't buy") that you're in the most need of.
There are many veterans out there who will tell anyone that they just don’t know what to do once they leave the forces. They need to have their entire weekly schedule planned out and someone to help them with that planning. Many ex-cons have the same problem, and you’ll find a similar issue with 18 year olds who are fresh out of school and pushed out their parents’s home.
This phenomenon, institutionalization, is a very real issue. For guys who have their whole life planned out daily for them and superiors to assist them with finding housing and dealing with medical care, having a load of freedom tossed at them when they’re over 40 is overwhelming. They’re not dumb. It’s just that humans have trouble adapting as we get older.
A considerable number of veteran support networks and veteran-oriented jobs exist to help people adapt to retiring during middle age.
The crisis in mental health care in the US is shameful. It is true that in the bad-old-days people were over institutionalized. So the pendulum has swung, and now unless a person is very clearly dangerous to themselves or others, it is nearly impossible to get a person resistant to treatment the help that they really need.
We talk about people "falling through the cracks", but the "crack" is a mile wide. It is pretty hard to convince me that a cardboard box under a freeway overpass is better housing than the mental institutions of old. That said, I don't think many of the mentally ill need to be forced into an institution under the old model, but we really do need a mechanism to deal with ill people resistant to treatment.
[edit: spelling]