I really hope in a few decades people will realize that the warning signs were fucking BLARING with the mental health care system in the US. The carceral approach to mental health care is evil. It is shockingly easy to reach out for help, falling for the 988 ad campaign, and end up in hell. The approach to mental health care is punishment-based, not treatment based. Not about helping anyone, just torturing and drugging into compliance. It’s about giving sadists and underpaid, undertrained “behavioral techs” free access to a vulnerable population. No one advocates for the mentally ill, and many of them can’t advocate for themselves.
$11,000 in debt
That was a lot of action for a one-night stay.
When I was stupid enough to reach out for help last year, they joked about how the legal three day hold only counted for business days, so they could hold me for a full week. They really do not like doing one day stays.
They threw away my grievance forms - I was physically assaulted by staff, had vape smoke blown in my face. I ended up losing my job because I disappeared without being able to communicate and they didn’t give me work release forms.
It was really my final straw with the entire system. My mother used troubled teen facilities and hospitals when I was a child to punish me for speaking up about her alcoholism and sexual abuse - I’ve never seen the system work.
Sorry you experienced that. I hope there’s something to eventually counter all that you’ve dealt with.
Universe doesn’t care, but we do.
Oh my god that’s awful
Shockingly easy to reach out for help, but those most in need of it are incapable or unwilling to do so, so what then?
See my other post above.
If you look at his other comment you start to see why people don’t reach out. I’ve never been in custody, I’ve always known that no matter how bad it is, inpatient care rarely helps. I’m rare in that I know someone who has been helped by it, but I know multiple people who were hurt by it.
Forcing people into inpatient care is dangerous for the sane and insane alike. There’s a long history of pathologizing dissenters and locking them up for it. But also locking people up against their will, in a system that those who volunteered for it often regret doing so, is not conducive to improving mental health.
You have to improve the system, fix it so a traumatized veteran would rather be receiving care than living on the streets. Once reaching out becomes the thing that those who’ve recovered from mental illness recommend doing rather than recommending against, then we can begin discussing ways to push the unwilling towards treatment.
Yeah, “disrupting bipartisan orthodoxies”, like “a country should have a functioning economy”, “nepotism is bad” or “crime should be punished”.
You can just remove the word mental there.
It must be said that the USA DOES NOT have a healthcare system, as that implies some kind of structure, regulation, standards, etc.
The USA has a complex overlapping patchwork of insurers, whos goal is to maximize profits.
What we call patients in the civilized world are just paycheques in America. The only system that exists is one to squeeze every drop of blood from the stone, and when the stone is utterly broken, squeeze their insurance for more.
That is a system, but it is not healthcare
“paternalism”
I’m a father myself and if my kid was out on the street, you can bet your ass I would be too, because as long as I have a roof, so do they.
How did paternalism come to mean patronizing those who are less capable and treating them like subhuman chattel, instead of treating them like someone we love in our care?
They just want to criminalize homelessness and throw them in jail. That’s it. That’s all this is.
I think largely it stems from the targeted infantilization of disabled people throughout most of Western history. Adults who are stripped of rights and treated like children for the convenience of a society that doesn’t feel like helping them (see: institutions) tend to start seeing parental roles in their life as sinister, because they tend to make decisions on their behalf and remove any personal agency they may otherwise be afforded.
Combine this with fundraising efforts that once again, treat disabled people as pitiable, helpless, and childlike, all to raise money that never actually goes towards helping them (see: telethon), and you have a system ripe to force people who want an actual life to push away offered help and become radically independent.
That, and unfortunately, an attitude like yours is relatively uncommon. Being patronized and dehumanized by their parents seems to be a much more familiar experience to most than being loved by them.
“I can’t be crazy because I’ve never been to therapy!”
“I just keep all my shit stuffed so deep down it eventually seeps from every pore. Punishing strangers via harmful policy I unleash on society gives me a sense of calm and control. Namaste.” 🧘🏼♂️
Trump signs an executive order to make it easier to remove homeless people from streets
A Look at the New Executive Order and the Intersection of Homelessness and Mental Illness
Well, what do you do for people like this?
60 years old, homeless for 10 years, living unsheltered on the side of a major freeway, leg infected to such a degree she had to have a foot amputated, leg then re-infected, other people keep stealing her wheelchair, but she refuses services, sitting in the dirt, feet away from 55mph (88.5kph) traffic, in 101° (38°C) heat.
“Vicky is known to our outreach workers, as well as teams who work with the city, all of whom have been attempting to provide services or engage for several weeks. At times, she has informed those teams that she has not been interested in care. But they continue to check in and try to work with her.”
Universal Health Care means Universal Mental Health Care too, and until we can get people off the street and into care for their own well being, we will continue to see situations like this.
At what point do you tell someone “you’re incapable of caring for yourself, we’ll do it for you.”?
Never, you can bring a horse to water but you can’t make it drink. You can give a person help but its up to them to take it. Even humanitarianism requires consent.
Leaving someone to die at the side of the road is not humanitarian.
Forcing someone to undergo potentially mind-altering medical treatment (because they absolutely will drug someone who fights against being there) and probably abuse (just check the stats) at the hands of the system isn’t humanitarian either.
This is one of those situations where all you can really do is make sure the options are as good as they can be, so people want to choose to get help, and we are not even remotely doing that.
Severely mentally ill people don’t want to choose help, that’s a function of being severely mentally ill. Leaving the decision making to people fundamentally incapable of making a decision actively harms them.
If the system was actually helpful to people, and severely ill patients still didn’t want help, you might have a point. Right now though, the system doesn’t help most people, it harms them actively, so we don’t actually know how many people would still refuse quality care.
And let’s be serious here, the number of people so mentally ill they can’t be trusted to make a decision about whether or not to take offered help…? Really really small percentage. We definitely shouldn’t be structuring the entire system based on edge cases, even if those edge cases have a legitimate need for that sort of inhumane treatment (a premise I strongly question).
That’s an argument to fix the system, which I 110% agree with. That doesn’t mean we shouldn’t get people the help they need.
Neither is forcing them to accept care they don’t want.
That’s still better than letting an amputee sit in the dirt, feet away from freeway traffic, unprotected in 100° heat.
At some point there needs to be a competency hearing and the person cared for even if they can’t or won’t ask for it. ESPECIALLY if they can’t or won’t ask for it.
The alternative is going “Welp, too bad they died, nothing we could do.”
This is something you and I aren’t going to agree on. From my perspective its an issue of consent. From yours (it seems) and issue of wellbeing. Our heirarchies of needs seem to value personal agency at different levels. I consider it to be a core need, and from that perspective I would never (given the power to do so) exert my will to care for someone as a ward of the state or whatever org I represent without the consent of the individual to be cared for.
I also recognize what you’re saying, that at a certain level of incompetence a person should no longer be able to advocate for themselves and should be required to accept care.
I personally believe that if a person can communicate, they can communicate consent. If a person is completely unable to communicate, it may be a good idea to give them a period of investigative and protective custody to determine their safety, but from their perspective that could be a kidnapping.
I’m not saying your perspective is wrong, but this is a situation that needs to be handled with extreme nuance and care by professionals.
On competency evaluations:
I’d need a large panel of Psyches from the same and similar communit(y/ies) as the JD (john doe/ jane doe) to all agree they are incompetent before I’d be comfortable allowing their consent to be violated in the manner of state endorsed internment in medical or mental facilities. If the medical community agrees, and the people around the JD agree, then and only then should the JD be given care without their consent.
I think the difference in our opinions are less than you think it is, you argue from a point of personal autonomy, and I get that, my argument is they have already lost their autonomy due to mental illness.
So if they have no autonomy already, society needs to error on the side of making sure they get appropriate care, especially when the alternative is utter destitution and death.
I agree with you it is a major dilemma when you have a situation where someone is stuck in a pattern that is essentially self harm and a cry for help, but they refuse help. I’ve actually been dealing with an ongoing similar situation for an immediate family member.
I’m the last one that they have contact with. I’ve spent my life begging them to get help. I say this not as a judgment for any other person’s situation, but in my case it felt like starting from a very young age, I spent most of my life trying to save somebody who was supposed to be the adult in the situation, but emotionally they were an angry child lashing out at every one who activated them. It didn’t matter what I did or how hard I tried, I just never could help them or convince them to get help.
It took me going to therapy to even realize that it didn’t matter how many times I kept throwing a life preserver, they were just going to keep batting it away. That was part of their mental health issue and the continuous cycle. In my case they preferred to just have someone drown with them because they were too scared to get help/hear the truth I guess.
Anyway, it got to the point it became detrimental to my own physical and mental health. I still do what I can, but I basically had to just accept that I’m an adult now with my own life and other responsibilities, and I couldn’t keep doing this to myself or my family for somebody who I was essentially enabling by dropping everything and rushing to their rescue over and over.
It absolutely breaks my heart to think about it, but the honest answer is, it’s a shitty situation and there isn’t a good answer at the moment. However, if there is a solution, it’s not going to be a cheap or easy one.
Even in the case of my family member, I feel safer with them taking the risk of being on the streets than I would if they were locked away in institution that has an incentive to keep people mentally ill forever with no oversight for human rights, and no standard of care.
I talked to a case worker not that long ago who said she had a patient who had been in a full blown state of psychosis for months with no help. I know how frighteningly fucked the medical system (which was never great to begin with) is in this country right now. There is no help or even getting better for most health issues. Mental health was always at the bottom of a broken healthcare totem pole even before Trump 2.0.
It’s just another continuous cycle where conservatives yanked funding and fired everyone or got them to quit from rather than keep banging their heads against a wall trying to help people with resources that no longer exist.
Now people are just shuffled from place to place with no chance of actually getting anything resembling help until they’re sent to the ER for an actual life and death emergency. If they survive, they’re just released back on to the streets. It’s a very expensive and worthless cycle, and the people that caused it love to claim it’s evidence that Medicaid is unsustainable. Soon they’ll probably be claiming it’s also evidence it would just be cheaper and better for everyone if they could just lock people up and throw away the key.
That’s what’s so absolutely fucked about all this. It’s not that they want people off the street because they want to help them. They’re making it easier to just lock people away for life, while simultaneously making more cuts for mental health, substance abuse, and housing assistance than ever before.
It’s their same approach to solving crime. It’s not a solution to just lock all poor people up so that there aren’t any more people desperate enough to commit crime. It doesn’t solve any of the complex social issues that are driving crime, addiction, or mental health problems, and often the people making these policies have an added incentive due to their own investments in the entire fucked up system they’ve created.
The more you jam pack private prisons/detention centers/institutions, the more their stock goes up. And it’s so fucking sneaky and evil how many fucking different ways they’ve figured out how to capitalize on the problem and prey on people who need help instead of actually just trying to help them.
It’s not even just private prisons anymore. Now it’s also the fucking transportation companies to and from the prisons. It’s the pharmaceutical companies that manufacture the expensive patented medications that doctors are pressured to prescribe to patients when they’re institutionalized.
I literally wouldn’t be surprised to learn that there are oligarchs hedging their bets on Trump’s executive order to make it easier to lock people up for mental illness. They’re probably buying up stock in hospital beds and whatever company makes straps to keep people restrained.
They think that there’s nothing wrong with this. That they’re just being smart/good at business by backing the policy that’s destroying lives, and that they’re actually “helping people” by taking them somewhere else where society doesn’t have to see them or think about them. Out of sight. Out of mind.
I think that the day we start locking up these callous, wealth hoarding, manipulative, narcissistic, predatory psychopaths away from the rest of society and forcing them to get treatment, maybe we can start talking about locking up everyone else against their will for obvious mental health problems they refuse to address.
That’s what it really is. The same old saying that a poor person with mental illness is a burden to society while a rich person with mental illness can be an eccentric. Except the eccentrics have been allowed to take over the government, and they’ve started capitalizing on their ability to do harm to others. The “eccentrics” who claim that their callous and unemotional behavior is what makes them so great at the game of life, even as they continue to pose the most obvious threat to society compared to the “crazy people” they want to lock away.
You have them evaluated and tell them to either get help or prepare to receive help.
Wanting to live off-grid is one thing but choosing to live on the sidewalk in front of my house is not acceptable.
Yup!
