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Comment by humanrebar | Hacker News Reader

> In one case, a homeless man in Sacramento, California, living under a bridge received 190 citations from police (almost all related to sleeping outside and camping) and wound up being assessed $104,000 in unpayable fines. When he died of cancer in 2016, there were thirty-seven warrants out for his arrest. Whose definition of public safety does any of this serve?

On the flip side, the government is powerless to address chronic mental health issues without a paper trail. We all know that poverty and mental health issues are deeply entwined. The government can't just compel mental health care on a whim. They need evidence. Evidence like trespassing citations, public intoxication arrests, and citations for defacating in public. Evidence like 911 calls when a senile resident continues to forget to turn off the oven.

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>On the flip side, the government is powerless to address chronic mental health issues without a paper trail. We all know that poverty and mental health issues are deeply entwined.

Only in the absence of a civilized public welfare system.

I'm arguing for one of those, actually. But even though I'd like to see more resources focused on these problems, we can't just spend our way into good mental health care. When people are in danger or harming others, care and treatment sometimes has to be compelled. People have a right to their day in court, so some amount of evidence has to be gathered so judges can objectively rule on the relevant questions.

I don’t think camping and sleeping under bridges are dangerous or harming others. I’m confused how this example shows your point, since your point is about dangerous people, and I’m not sure if people who sleep under bridges are necessarily dangerous.

Camping and sleeping under bridges harms everyone because of all the waste that ends up in watersheds. I've helped out with cleaning up riverbanks a couple times after illegal encampments were removed. Those places were like disaster areas and toxic waste dumps.

I live in Michigan, where PFAS are being found in water supplies all over the state. Companies did and still do dump poisonous chemicals into the environment, and day by day certain alphabet soup agencies give them more and more license to do so. We can talk about some garbage along a river bank after we prosecute large companies for knowingly poisoning entire swaths of land and bodies of water for decades, considering the scale on which they can harm people and the resources they have to avoid doing so.

But its only poor peoples' communities that get the brunt of the pollution. That's because their local governments can't fight against it, whereas richer communities can delay, fight, and stop.

Do poor communities deserve this?

Missing the point? My point is that a little trash on a riverbank pales in comparison to the large-scale environment destruction being committed every day by giant companies. Provide the homeless with food and shelter instead of worrying about some minimal pollution.

There's no trash removal for these people, and they're shut out of all public bathrooms. What do we really expect?

i-5 in Seattle is absolutely trashed from Northgate to Downtown because Jenny Durkan and previous mayors have raided homeless encampments out of view, away from other homes, spending millions of dollars to displace them instead of just giving them garbage cans and a few porta potties. They end up on i5 and in tent camps downtown and it looks like a dump.

I'm not familiar with the situation in Seattle, but in areas where homeless shelters have open beds then I really expect people to use them instead of wrecking ecologically sensitive areas. And in the cleanups I helped with, there were multiple public garbage cans within a couple blocks.

https://www.npr.org/2012/12/06/166666265/why-some-homeless-c...

Yes, it's not the camping, it's the lack of services that is toxic.

If we did a profiling we'd see that companies (from factories to hotels) do 99% of the pollution of rivers.

Humans have been living camping-like near rivers for millennia. It's not as homeless people shit is toxic...

My point is about helping sick people. Some of them are dangerous and should get extra attention for that reason. Many are just too sick to pay bills, show up to work reliably, get hired, etc. The government could decriminalize lots of things, but it's hard to show that someone is a danger to themselves if the government refuses to keep certain kinds of records for reasons of privacy and compassion.

In my (American) experience, few governments show any sign of wanting to address mental health in a serious way. They seem to care more about appearing to address mental health than actually getting anything done. It's easy to end up with bullshit like "resilience training" for schoolchildren when there's a critical shortage of psychiatrists and hospital beds.

Given the constant flow of mental health scandals, I'm not entirely sure what is worse: no mental health or mental health.

Just a few days ago an institution for mentally ill women got convicted for recording (and then discussing with the "patients" on their "evalution") what was said when they met with a lawyer.

Ok. So an investigation that was done earlier on the year was made public that already complained about this. When the press read that they published another few details:

* one patient was isolated and "fixated" (tied spread eagle to a bed) for 13 days because she bit her nails

* another patient had that done to her for over 2 months. The reason ? Nobody bothered to write anything down.

* several patients died without a clear reason

And ... no worries, the government agency responsible for it will "do a thorough review" of the system. Comments by the management on the issue are expected by the end of the year ...

Also, I seem to have no problem finding desperate pleas of patients on fora and on youtube about how they get incarcerated in such institutions for idiotically small reasons.

Mental health, when it does exist, seems like it's more a way for government employees to torture people who make a dumb legal mistake (like asking for help from a government psychiatrist) than it was ever meant to help anyone.

The people working there were on TV. Maybe it's just me but the impression I got was that these were incredibly dumb and definitely not the sort of people that can be trusted with the care over others. And, in case you're wondering, the psychiatrist on staff ? There is no psychiatrist on staff, one comes for 2 days per month. I'm sure it saved the government some money.

Is this really what you want to do to the homeless ? It does not seem like an improvement to me.

Yeah, there's a whole other dimension of this where facilities and processes become oriented toward controlling and containing patients rather than empowering them. But I think it has the same root causes as the broader lack of motivation among authorities to seriously engage:

1) Mental health treatment represents a legitimately difficult set of problems with no known recipe for success in the general case.

2) Mentally ill people are routinely dehumanized and otherwise marginalized.

First of all, NO. I DO NOT understand. Nothing justifies treating people like this, and certainly not what was used at this facility. Week-long solitary confinement for nail biting ...

And let's not pretend this facility is a huge negative exception. It's not. It just got caught recording client-lawyer confidential conversations because they boasted about it in court. Yes, they actually boasted in court that they did this and used it in the case. That's how they got caught. Then the inspection report fell into the hands of the press and this patient treatment stuff leaked. In other words, this is a random sample.

And what does the government do about this ? They ask the management to come up with ideas by year-end. Clearly nobody cares or wants to see improvements.

So the problem that this is exactly what is being proposed here as the solution to mental health problems ... I feel like it would be more humane to just round up all mentally ill patients and shoot them.

Let's please not pretend that torturing them for a decade or two before they accidentally die in such a "fixation" is more humane, because it's not, it's far, far worse. Solitary confinement for weeks is torture, constantly living under that thread is also torture.

Needless to say, when you check your find the same ("internment") is done to their kids, even if the only thing against them is that one of their parents has some mental health problems. Doesn't matter if the parent recovers. Doesn't matter if they are 16 or even 18 years old (mental health "care" lasts until 25). There was a story of a 21 year old student ripped out of independent living (well, a student dorm she paid for herself) and studying at university because her mother got interned.

Leaving them to rot on the streets, again, is a far more humane approach than mental health care.

We cannot seriously suggest this as a solution until massive improvements are made to the system, starting with a minimum complement of actual mental health professionals. The system doesn't have that, nor are there any plans to change it, so ... it is not humane or reasonable to suggest mental health services as a replacement to letting them live on the streets.

I'm not saying it's justified at all. I'm not saying that I know what the solution is. I'm saying that these are all expressions of the same underlying set of attitudes rather than merely being poor policy. The reason there aren't 24/7 protests outside mental hospitals and politicians of every stripe calling for radical reform of the mental health system is the same reason that city councils pass "sit-lie" and "anti-camping" laws instead of providing needed services to the homeless. At a societal level, the desire is largely to make these people just go away, or at least to approximate that by keeping them so beaten down that they're afraid to engage in any noticeable behavior. Lip service is sometimes given to fundamental rights and humane treatment, but the attitude expressed by the behavior of our institutions is often closer to animal control than to a welfare system. When it comes to the mentally ill, the average person seemingly doesn't know the difference between treatment and abuse, and might not even care to know. As long as there's any room for doubt and someone with the right letters after their name says "it's for their own good", the conscience goes back to sleep.

>The government can't just compel mental health care on a whim. They need evidence. Evidence like trespassing citations, public intoxication arrests, and citations for defacating in public

These are not signs of mental illness, and should not be considered reasons to imprison someone in a mental health facility and/or forcibly drug them.

I agree with you, but couldn't they be indicators of mental issues? In the same way that me stumbling doesn't mean I'm drunk, but the likelihood of someone stumbling goes up when they are drunk.

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