Reopen the mental hospitals?

[Pb]

John Ringo's drug theory- if you haven't read it, it is worth reading:

https://www.facebook.com/notes/john-ringo/a-theory-on-las-vegas/10155111388257055/

[230RN]

^ "Part of the issue with the homeless is liberal city leadership seems to not only tolerate their presence, but actively encourage and accomodate them. "

Well, I don't know how well it worked, but here's a typical hand-fluttering solution --"homeless parking meters" where you could nickel and dime your way out of guilt.



https://www.sfgate.com/news/article/How-homeless-meters-fare-elsewhere-3214609.php

One of these appeared on the sidewalk outside "my" building sometime around 2007 right near where a bunch of we smokers used to take our breaks.

Our jokes almost wrote themselves.

Terry

Pic credit in cited article.

[MechAg94]

So is the homeless guy supposed to put part of the change he gets in the meter near where he is sitting?  That is an intersting pay to play idea.

[230RN]

So is the homeless guy supposed to put part of the change he gets in the meter near where he is sitting?  That is an interesting pay to play idea.

Ayup.  That was indeed one of the jokes.

Terry

[KD5NRH]

They are ending up in places that absolutely not equipped to help them in any meaningful way. Mental hospitals won't fix everything, there are a lot of things that aren't "fixable", but they would at least be better equipped to handle the problems of these people.

IMO, the things that aren't fixable should be segregated from the ones that are; a lot of people who might voluntarily submit for inpatient treatment under the right conditions likely won't if they're going to be put in the same facility as people who fling poo or vote Green.  Among those committed involuntarily or under duress, (i.e. intensive anger management or other treatment as a "voluntary" alternative sentence) being lumped in with incurable drooling idiots and other Congressional candidates is likely to be counterproductive to the recovery process.

[KD5NRH]

Caffeine is an antidepressant. Just saying.

And you are (theoretically, at least) a mammal.  That doesn't mean you can hear, see or do parkour like an ocelot.

[Firethorn]

IMO, the things that aren't fixable should be segregated from the ones that are; a lot of people who might voluntarily submit for inpatient treatment under the right conditions likely won't if they're going to be put in the same facility as people who fling poo or vote Green.  Among those committed involuntarily or under duress, (i.e. intensive anger management or other treatment as a "voluntary" alternative sentence) being lumped in with incurable drooling idiots and other Congressional candidates is likely to be counterproductive to the recovery process.

There's segregation and then there's segregation.  I'd picture something like 3-4 floors, minimum.  The violent, the 'drooling idiots', the fixable, the 'mostly sane but subject to sporadic breaks from reality bad enough that they need to be in protective custody' could all be in separate areas.  Plus a floor or two for the medical professionals located in the same building for ease of providing treatment.

Could also be different wings, the building plan is open.

From what I've read, many of the hospitals were absolutely clean and up to date for their time.  A lot of the horror was the lack of medical knowledge at the time.  They couldn't make it better.

I've seen some before and after photos for the asylums.  They were not bad places at all, often very beautiful, until they were closed, abandoned, and exposed to the elements and vandals.  Hell, some of the latter were probably occupants from when they were open wishing that they were still open.

[KD5NRH]

There's segregation and then there's segregation.  I'd picture something like 3-4 floors, minimum.  The violent, the 'drooling idiots', the fixable, the 'mostly sane but subject to sporadic breaks from reality bad enough that they need to be in protective custody' could all be in separate areas.  Plus a floor or two for the medical professionals located in the same building for ease of providing treatment.

Considering the first two need a lot more attention from a much more dedicated class of mental health professionals, I'd go more for completely separate facilities.  Fixable and mostly sane get the vast majority of their treatment and monitoring from psychologists and counselors, whereas the more intense treatment for those with serious problems requires more time from psychiatrists and closer monitoring form nursing staff. 

Somewhat like the difference between a maximum security prison and a county jail, and in some cases more like an addiction recovery facility.  (Which is another purpose the lower-intensity facility would be well suited for, as it can address the root causes for functional addicts.)

On the security side, separate facilities would be helpful too; the "really crazy" aren't going to be getting weekend furloughs, whereas some of the least troubled might even be almost outpatient; allowed to go to work or other activities regularly.  Separating sites means those don't have to go through the equivalent of a prison release every morning, while also reducing the risk of a high-functioning psychopath from the high-risk side slipping into the line of low-risk voluntary admission clients heading out to spend the holidays with their families.

[Firethorn]

On the security side, separate facilities would be helpful too; the "really crazy" aren't going to be getting weekend furloughs, whereas some of the least troubled might even be almost outpatient; allowed to go to work or other activities regularly.  Separating sites means those don't have to go through the equivalent of a prison release every morning, while also reducing the risk of a high-functioning psychopath from the high-risk side slipping into the line of low-risk voluntary admission clients heading out to spend the holidays with their families.

I was thinking 'separate facilities' like how in some places, the county jail is attached to the county courthouse and in one case, the state capital. 

It might be one building, having some walls in common, but they are very much separate facilities.

[KD5NRH]

It might be one building, having some walls in common, but they are very much separate facilities.

Separate buildings on a single campus would be more practical from an access control standpoint; with no direct access between buildings, everybody goes in the front door of the place they need to be.  Unsecured or minimally secured low-risk/voluntary facilities would likely be more like group homes.  Maybe nearby, but off-campus.

[Jamisjockey]

   I'd venture to bet that every one of the mass shooters we've had in the last 10 years wouldn't meet the requirements to go into a mental hospital.

The idea of government deciding who is fit or not fit to enter society is abhorrent. 
https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union

[Scout26]

 I'd venture to bet that every one of the mass shooters we've had in the last 10 years wouldn't meet the requirements to go into a mental hospital.

The idea of government deciding who is fit or not fit to enter society is abhorrent.  
https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union

Yes, there will always be abuses.  But given that we're dealing with people on all sides of the equation, Due Process should get rid of most of the blatant abuses.

[TommyGunn]

Yes, there will always be abuses.  But given that we're dealing with people on all sides of the equation, Due Process should get rid of most of the balant abuses.

   "Balant??"   You must mean "blatant."  

[just Warren]

A person has to have balant in their life. Otherwise they'd go czray.

[just Warren]

I don't think it would be abhorrent to round up the chronically homeless and put them in an institution.

These people should not be wandering around free.

[KD5NRH]

I don't think it would be abhorrent to round up the chronically homeless and put them in an institution.

Disgustingly similar to what happened here in 2010: http://texannews.net/brandi-todd-mom-attacked-at-park-embraces-changed-life/

[Pb]

  I'd venture to bet that every one of the mass shooters we've had in the last 10 years wouldn't meet the requirements to go into a mental hospital.

The idea of government deciding who is fit or not fit to enter society is abhorrent. 
https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union

The fact is some people aren't fit to enter society, though.

They aren't going to decide to take themselves out voluntarily.

It is the job of the government to protect people from being attacked by others... including the insane.

[dogmush]

It is the job of the government to protect people from being attacked by others... including the insane.

Is it though?*

The job of the government is to secure our society from outside threats, and to provide a framework for dispute resolution short of duels.

Proactively protecting people from other individuals would seem to be a little micro for the government.  It would also seem to open the door to pretty dang invasive policies.

I've said before that a non-prison place for mentally ill folks to be cared for isn't a bad idea, but Jamis  is has a point that those places, and entry into them, end up being pretty abusive in actual practice.  Perhaps we need to take a hard look at some of our underlying assumptions.


*there is, of course, Supreme Court precident that it is not the job of the government to protect any one individual from another.

[MechAg94]

I am thinking back to past arguments we have had about the death penalty and the injustices that often happen when suspects are charged and run through the court system (not just death penalty cases).  IMO, determining whether someone is mentally incompetent is a much more nebulous question than whether they killed someone or robbed the gas station.  Due process is not 100% with something as straightforward as crime.  I think it could easily be a LOT worse with locking up people someone has defined as "crazy".  

Remember, it isn't the violent homeless guy mumbling in the alley that you should be thinking about.  It is the normal guy who pissed off the wrong people and suddenly has the system working against him.  It is the kid arrested for pot who gets committed for drug abuse because the judge gets kick backs from the people running the for-profit treatment center.  I can see some of these idiots trying to define all sorts of things as "crazy-think" and trying to add them as reasons to have someone committed.  

I think in this day and time we should not be giving BigGov more tools to use against us.  

[KD5NRH]

I've said before that a non-prison place for mentally ill folks to be cared for isn't a bad idea, but Jam is has a point that those places, and entry into them, end up being pretty abusive in actual practice.

In general, a large part of the issue has been that the people who decide whether someone can leave have a vested interest in one answer or the other, either because they make more money by keeping them in, or (as has been seen with a few drug rehab facilities) their insurance runs out and they're suddenly miraculously cured.  There needs to be a 2-3 layer system of independent review and/or appeal on any involuntary confinement, bringing in unbiased professionals, and holding the facility accountable if it's found to have held someone an excessive time, or kicked them out when they were still clearly far from ready to return to society.

At the same time, courts (and the state laws they're applying) need to reflect society's need to be protected from these people.  While I think the local court did all it could in the case of Brandi Todd's attacker, giving a maximum sentence without parole and maximum fine, without credit for time served in a mental hospital until he was deemed fit to stand trial, the simple fact is that a 20 year maximum sentence for AADW isn't nearly enough; hell, you can get the same for theft over $100k and theft over $200k opens a 99 year maximum.  While I don't necessarily disagree with the theft penalties, (after all, stealing $200k, or even $100k from most people means taking the product of several years of their labor - effectively retroactively enslaving them for the period they spent earning it) intentionally causing disabling, potentially fatal injury to someone should come with a strong possibility that you will never be allowed to return to society.

I think in this day and time we should not be giving BigGov more tools to use against us.

In general, I'd agree, but with proper independent unbiased review of its actions, and full accountability for all involved, abuse of the tool becomes far less likely.  In fact, by setting a precedent of review and accountability, one could then work to expand that to handle the abuses currently happening of government's existing tools.

[dogmush]

I'm not convinced unbiased mental health professionals exist.

You say, for example:

holding the facility accountable if it's found to have held someone an excessive time, or kicked them out when they were still clearly far from ready to return to society.

For every expert you trot out saying the release was too early, or too late the facility could find one to say the opposite. It's not like mental health is a binary solution set.

I'm pretty sure the idea of an unbiased, accurate mental health oversight board is fantasy.

[RoadKingLarry]

Add to the above.
My anecdotal experience with mental health types, psychologists and psychiatrists, has not left me with any respect for the profession.
To  a person they were what we call "book smart" but beyond that a barely functioning human being. Once the subject was outside of their specialty they were essentially useless.

[KD5NRH]

I'm not convinced unbiased mental health professionals exist.

As it stands, that's because they're largely unaccountable, even in the face of overwhelming evidence their assessment was completely wrong.  I can't find it right now, but there is or was an inpatient facility near Fort Worth that was notorious for "curing" severely depressed people within days of their insurance running out, until a few of them committed suicide within days of being released.  AFAIK, no one ever faced any serious repercussions over that, and I have no doubt they'd be more careful if they knew there was a real chance they could be facing manslaughter charges for releasing too soon, or some sort of false imprisonment for keeping them too long.

Add to the above.
My anecdotal experience with mental health types, psychologists and psychiatrists, has not left me with any respect for the profession.
To  a person they were what we call "book smart" but beyond that a barely functioning human being. Once the subject was outside of their specialty they were essentially useless.

IOW, same as university professors, who also lack accountability for even grossly incompetent actions.

[RoadKingLarry]

Started having issues with tramadol and a little depression linked to the hip replacement and all the SNAFUs associated with it.
Things in my head got really dark a few weeks ago.
I had recently learned of the potential connection here. 
I pitched that stuff.
I was never informed of any such side effects by my PCP,  nor was anything mentioned in the literature from the pharmacy.

[just Warren]

So I'm at my local library and they have a shelf of .50 cent books. And I found this on there: The precis is that mental hospitals can be more residential than prison-like.

His point is that most of the people in a mental health place are not violent but they are occasionally disruptive. So there is no need for these max-security dungeons. You can and should have a pleasant place for these folks to live. And someone up thread mentioned that some of them were not what is found in the popular imagination.

So if there was a proper intake and review process and the places were more like a fenced-in resort than a prison would that take away some of the resistance to opening up more institutions?