[gexla]

Right, it's an issue that requires intensive care to address mental health issues. The human resources required for this is always going to be a bottleneck. Much more so than housing shortages or funding for programs that are largely self service (if you can navigate the system, you may not be homeless for long.) Building, staffing, and funding such an institution seems like it would be extremely difficult.

[joshtbradley]

SF is currently spending $100K per homeless person. I agree, it will be extremely difficult, and that the human resources may be a bottleneck. But that's enough for an average person to live in SF, go out sometimes, and pay for therapy. There must be a way to deploy those funds effectively.

[sharts]

$100K per homeless and yet each homeless person doesn’t receive anywhere close to $100K of services.

[seanmcdirmid]

$100k/year, and ya, public orgs non-profits that get the money aren’t very efficient. What is worse is that much of that money goes to chronic cases with drug addiction and mental illness, the people who are just struggling to pay rent (much cheaper than $100k/year) and wind up living in their car often get ignored until they become chronic cases that are no longer easy to help.

[joshtbradley]

As Buffett says “Show me an incentive and I’ll show you an outcome.”

I’m not one to think in conspiracies. But here is a clear, structural issue. The reward to NGOs should be granted upon reintegration, not upon crises.

[bix6]

I’ve heard that this is an over simplification and conflates a bunch of factors.

The big question I have is how do you help people who refuse to be helped? That’s an ethical dilemma not necessarily a $ question.

[joshtbradley]

I'm sure it is a conflation, but it is directionally correct. We are burning money and making zero progress.

The ethical dilemma is deep. Is forcing someone into an asylum—where they can be sheltered, monitored, and treated—more ethical than giving someone the self-determination to self-destruct on the street?

I don't have the answer, I'm not Kant. But it's a question we have been unwilling to face because it is deeply unsettling. It goes against our liberal instinct.

[mlrtime]

I think the only way is to give up a bit of freedom for the person's best interested AND societies.

This never works though because once you decide to do this, it is abused. So to prevent abuse, you use law enforcement. What I mean is that we decided freedom is more important than forcing treatment. And since there are no other levers, law enforcement is left to deal with the problem.

[fragmede]

The question is what do you do in the face of abuse of the system? Do we shut everything down and walk away and pretend it didn't happen and let's just not talk about it, like an emotionally immature six year old child that pooped in the living room? Because that doesn't make the problem go away, but that's what we did.

You set up a system to help people that could be abused, and then you set up oversight committee, external auditors, regulators, board of trustees, ombudsman, inspector general. A giant pile of bureaucrats and bureaucracy. And yes, abuses will still happen. You get it all on camera, in writing, you find the abuses of the system and you close those down. New abuses happen, you find those loopholes and close them down. The problem is there's no will to do that. The systems broken, so we just threw it out and the people that it was helping got fucked. Instead of like, hey the systems broken, lets fix it.

So instead we got people living in tents with no running water, no sewage, no electricity.

[parpfish]

the human resources required to make it work are a bottleneck, but even if we had the resources we need to build a humane modern asylum system, there'd be a whole slew of civil liberties issues