ed: In 1800s, Sanitariums were built by dedicated people to provide humane care for our mentally ill. They commonly provided the best care we knew how.
In the 1900s, the committed directors, orgs and philanthropists who long resisted degrading pressures died off. Govs eventually took over.
Pols/Public weren't as dedicated to safe treatment and spaces. Funding dwindled and the quality of care fell off, often to dangerous levels. The 1980 MHS act was passed to curtail the downward spiral but it was repealed in 1981 by the following administration. The sudden reversal ended improvements before they took root and MI care was disrupted at every level. By 1990, our mentally ill had swelled the ranks of America's homeless.
There's been little improvement since. State institutions are over capacity. Many are among the worst spaces in America and the better ones aren't much better.
This EO was written with the knowledge that we have no safe quartering available for mental health patients.
This bill was also written with the knowledge that will always be space for them in prisons.
I guess we're going to pay to house them ... ominously?
xenospn · 16h ago
I rarely, if ever agree with anything this administration says or does, but I don’t see how letting people rot on the street is the preferable alternative to keeping them somewhere where they at least can get some form of help or have access to a bathroom.
WarOnPrivacy · 16h ago
> but I don’t see how letting people rot on the street is the preferable alternative to keeping them somewhere where they at least can get some form of help or have access to a bathroom.
What you envision would require that we now have an excess of mental health capacity. There isn't. Now repeat that for thousands of municipalities.
There is an extreme shortage of available long term care.
There is never a shortage of space in prisons, not even when there is. It is where we have always put our MI - because anything else is inconvenient.
All of these things were known when this EO was drafted.
jfengel · 14h ago
Confining people so that they cannot leave is our primary form of punishment. We're so horrified by it that we wrote it into the Constitution that you can't be deprived of your liberty except by due process of law.
Even if the conditions are pleasant. (Prisons aren't supposed to be cruel, though apparently we've decided to tolerate that.)
It does sound compassionate to force them into a place with a bathroom and a door, but if they can't go see their families, look for a job, or go for a walk, maybe it isn't as compassionate as it appears at first glance.
(And that is on the assumption that the facilities are less unpleasant than our prisons. I strongly doubt that.)
techpineapple · 15h ago
I'm not confident that the alternative will be more humane (yes, I would in fact prefer to rot on the street than be in some of our institutions, even ones that aren't prison. Source: Masters in psychology and did my internship at a low-mid level nursing home)
But I do agree that the current situation is not good, and that reflexively defending the current system is stupid.
bell-cot · 15h ago
N = 1:
An old friend of mine has a mentally ill niece in her 50's. The family would love it if they could force her into hospitalization when needed.
Their current reality - the niece goes off her meds at least once every couple years, and skips town. They get to play amateur detectives yet again, trying to figure out where she's gone this time - mostly based on the angry rants she leaves on their answering machines. (Death threats are par for the course. Best not to think about how she's making ends meet when living on the street.) Eventually (so far) they've always managed to find her, and cajole her (typically with local law enforcement help) into returning home and getting back on her meds.
But her family is getting older. And what there is of a "next generation" doesn't seem too interested in taking up this cross.
WarOnPrivacy · 15h ago
> An old friend of mine has a mentally ill niece in her 50's. The family would love it if they could force her into hospitalization when needed.
My mentally ill ex needs long-term inpatient mental healthcare. As her caregiver of 25y, I got to know every bit of the mental healthcare system. Intimately.
Long-term inpatient mental healthcare exists for the wealthy and that's it.
In the 1900s, the committed directors, orgs and philanthropists who long resisted degrading pressures died off. Govs eventually took over.
Pols/Public weren't as dedicated to safe treatment and spaces. Funding dwindled and the quality of care fell off, often to dangerous levels. The 1980 MHS act was passed to curtail the downward spiral but it was repealed in 1981 by the following administration. The sudden reversal ended improvements before they took root and MI care was disrupted at every level. By 1990, our mentally ill had swelled the ranks of America's homeless.
There's been little improvement since. State institutions are over capacity. Many are among the worst spaces in America and the better ones aren't much better.
This EO was written with the knowledge that we have no safe quartering available for mental health patients.
This bill was also written with the knowledge that will always be space for them in prisons.
By design, we are in the 1700s again.
refs: https://www.nursing.upenn.edu/nhhc/nurses-institutions-carin...
https://projects.tampabay.com/projects/2015/investigations/f...
What you envision would require that we now have an excess of mental health capacity. There isn't. Now repeat that for thousands of municipalities.
There is an extreme shortage of available long term care.
There is never a shortage of space in prisons, not even when there is. It is where we have always put our MI - because anything else is inconvenient.
All of these things were known when this EO was drafted.
Even if the conditions are pleasant. (Prisons aren't supposed to be cruel, though apparently we've decided to tolerate that.)
It does sound compassionate to force them into a place with a bathroom and a door, but if they can't go see their families, look for a job, or go for a walk, maybe it isn't as compassionate as it appears at first glance.
(And that is on the assumption that the facilities are less unpleasant than our prisons. I strongly doubt that.)
But I do agree that the current situation is not good, and that reflexively defending the current system is stupid.
An old friend of mine has a mentally ill niece in her 50's. The family would love it if they could force her into hospitalization when needed.
Their current reality - the niece goes off her meds at least once every couple years, and skips town. They get to play amateur detectives yet again, trying to figure out where she's gone this time - mostly based on the angry rants she leaves on their answering machines. (Death threats are par for the course. Best not to think about how she's making ends meet when living on the street.) Eventually (so far) they've always managed to find her, and cajole her (typically with local law enforcement help) into returning home and getting back on her meds.
But her family is getting older. And what there is of a "next generation" doesn't seem too interested in taking up this cross.
My mentally ill ex needs long-term inpatient mental healthcare. As her caregiver of 25y, I got to know every bit of the mental healthcare system. Intimately.
Long-term inpatient mental healthcare exists for the wealthy and that's it.