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My understanding is that Northern Europe has a much more robust system of using Long Acting Injectable Antipsychotics (under court order if nessecary) and various group home options or Assertive Community Treatment teams that have nurses visit patients daily. They are also quicker to use lithium and clozapine when indicated. They also do much longer hospital stays when needed than our revolving door policies here. Also they don't have meth and fentanyl epidemics yet. We know that the longer psychosis goes untreated/the more times someone goes off the meds, the harder it is to treat, and that what happens in the first few years of someone developing a psychotic disorder makes a huge difference in long term outcomes. An American might develop psychosis in their mid 20s, end up committed for a few weeks and placed on antipsychotic pills until they're no longer floridly psychotic, and then go home, not follow up with doctors/refill meds, and end up on a cycle of this with more and more brittle symptoms until they're homeless and have no real chance of recovery. The same person in Northern Europe would likely be hospitalized for longer initially, started on an injectable that only needs to be given once a month, and they leave the hospital with fewer residual symptoms. They're then followed by an ACT team with a nurse visiting to check on them and make sure they're eating and keeping housing, and ensuring that shot goes in their arm every month. They don't necessarily fully recover, but a lot of them end up being able to do some kind of schooling/employment/volunteering and they are either stable enough to keep housing without being evicted for disruption, or are shuffled into staffed group homes. |
In Europe such a policy might make sense, but in America where being dumped on the street is rather common the situation is different. Also, in America the general social situation is quite different from life in Finland.