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I mean, it really depends where you go...

In SF there used to be a lady who would chase people who came off the ferry from Oakland. She was never arrested (as far as I know) and the police essentially ignored it.

In Illinois, where I live now, there’s a “homeless, mentally unstable” person who is in the corner. Of course, if you watch he’s also collecting “tips” and dropping brown bags... which the people who tip pick up. They also have cell phones and all the “homeless” get together at dusk to head out (I assume to their house).

The reality, is people see what they want you to see. The media, SF city government, etc. American cities aren’t particularly bad (thinking of gypsies in Paris or China’s slave.. I mean migrants), but they allow the “homeless”.

The mentally unstable that are out there, are left there (for what ever reason). Either defunded government agencies, but more likely, they chose it. I’ve worked in shelters and they choose that life. The U.S. is a free society, in that, you have opportunity to do what you want. More often than not the beggers (somewhere along the line) made a choice. Now, they either can’t get out of it or don’t want help.

> It seems like you can’t walk down a single city block in the US without seeing someone...

This is so exaggerated I think calling it hyperbole would be an understatement. For those living outside the US reading this: this comment is not accurate, any more than it’s accurate to say that everyone in the US owns a gun and wears it on their hip- it’s just a charicature.

I mean, yeah, I exaggerated a bit. I completely understated how absolutely horrible it is in some places like Portland, with people completely lining the streets in some points in downtown. When I lived in Portland, Old Town Chinatown felt like an apocalyptic scene from Escape From New York. The east side isn’t so bad, but downtown, man, nobody would believe it unless they saw it themselves. I think the problem is worsened by other cities sending their troublesome people to Portland on buses.

"Exaggerated a bit" isn't saying that every block in every city in the entire country has homeless people that are either violent, mentally ill, or using the sidewalk as a bathroom. Whatever point you were trying to make is lost through your "why is the USA the only country where every city is a homeless dystopia?" hyperbole.

My exaggeration was in my understatement. America isn’t uniformly bad, but some cities are far beyond having merely one strange person per block. The downtown cores of many west coast cities really do have wide regions that resemble cinematic wastelands.

Maybe your experience is different, I don’t know, but it’s a scale far beyond anything I’ve witnessed anywhere else. Some cities are less severe than others.

This stems from the ideal many Americans have of "rugged individualism" for lack of a better phrase.

This manifests itself on the societal level where we don't want to pay for a broad social safety net (for example the end of the article mentions mental health diversion funding being cut).

It also manifests itself on a personal level. We want to respect people's liberty and not commit them to a psychiatric ward unless it appears they're an imminent danger to themselves or others (that's also mentioned in the article).

I'd also say other wealthier nations hide the problem. For example if you're out at 3am in London there's a fair amount of people "sleeping rough." I imagine at 6am or whatever cops come out and tell people to move along, whereas in the U.S. this is illegal [0].

As for why poorer countries have less mental illness? I'd say some of it has to do with wealth. Drugs are expensive and many countries have much harsher "zero-tolerance" laws in place that might reduce easy access to drugs (thus driving up the price). For non-drug induced mental illness there could also be problems unique to American culture such as high loneliness rates, weak social circles and a belief in the individual that contributes to illness.

0: https://www.nytimes.com/2018/09/05/us/-homeless-sleeping-on-...

The rich don't want to pay for anything, and the poor think that one day they will be rich so they don't want the rich to pay for anything either.

It's very hard in America to send people to treatment against their will, so they end up on the streets.

This. In the Bad Old Days, the US had the habit of over-institutionalizing people. The pendulum has now swung. We replaced a system that was inhumane and lacking in nuance with a system that is inhumane and lacking in nuance.

By American do you mean Canada also; Vancouver for example has some very similar Seattle/Portland problems (well, it is nearby).

I’ve personally encountered mentally ill in Switzerland, China, Japan, Thailand, India, and so on, and they don’t seem so different worlds over. Just how they are managed (in Switzerland, they will be given a place to sleep, even if it’s a bunk in a hostel with unfortunate other guests like me). China will try to keep the hidden/out of the cities, especially when sensitive events occur, and they know they will get a beat down by the police if they are too extreme.

I think you find your question offensive because it is poorly framed. I think a much better question is “what is wrong with our mental health infrastructure in America? Why is it so awful that we feel we must ask what is wrong with the mentally ill?”

To your point at not seeing mentally ill people in poor societies: I bet if you really follow this logic, you can figure out where these people are in those societies. Jail, other captive institutions, too ill to be in public, violence, institutional or personal, and death are all valid

I don't know if a study has been done, but there is a social aspect to mental illness. In different cultures, the mental ill & crazy behave the same way.

Mental illness is not "STUPID", they still mostly know what is right and wrong and will often do the right things to keep safe and avoid pain. In other parts of the world, homeless folks have less protection and can easily be assaulted and abused so they know to behave to stay safe.

In the US homeless folks know their rights and they take advantage of that.

I've got this impression too, you're not alone. I think one reason it might be that way is because of American culture.

Americans stereotypically love to share their thoughts and opinions, even unprompted with strangers. It might be that mentally ill Americans simply share more of their mental illness-influensed thoughts with the world, while people from other places deal with their mental illness more privately, like they're used to doing with normal thoughts.

The other comments here are also likely accurate, America probably also simply has more people with untreated mental health issues due to their laws and their (lacking) health care system.

Lack of strong family ties. People blame lack of public facilities and health care, but at the root of it all, it’s the missing safety net that family provides. This is the number one difference between some of those incredibly poor places and America.

Sorry, no The issue is the people who run the country you were born in are making all of the decisions.

If you're homeless because you came out of prison, you will have had your right to vote deprived of you.

Family has nothing to do with it.

We live in a country where the government is separating children from parents at the border for the "crime" of seeking asylum.

The government has a lot of capacity to undermine and outright destroy strong family ties. Or to support and nurture them with policies like maternity leave, as most of the world does.

The US is the only wealthy developed nation without a good maternity leave policy.

Family has a lot to do with it. You can't neatly and cleanly separate other social stuff from family. It all interacts.

You grow up in a particular kind of family/social fabric, so you think that matters. You take those values with you to your government job or position as an elected official and perpetuate those values, for good or for ill.

In many cases people on the streets had strongly family ties, up until their mental illness began to manifest and their family was no longer able or willing to continue supporting them. People get kicked out of their houses because of violence, financial hardship, or any of many other difficult reasons. It's not simply a matter of people lacking compassion.

Take the case of the late Terry Davis for instance. He was living with his parents for years, but their relationship deteriorated as his illness progressed and in the end he died homeless. I don't think you can rightly blame his parents for that.

True story: in one of my neighborhood boards, a young woman claimed to be homeless. She and her 8 year old are living with her grandmother in a tony part of town. The city counts her as homeless because she doesn’t have utilities in her name and is living with a relative.

This is bizarre to me. I grew up with three generations under one roof. We were a family and none of us were considered ‘homeless’.

The definition has becoming so broad to include so many different kinds of people that the cynic in me feels like the homeless activists and non profits and govt bloat benefits from inflating the numbers somehow with their ‘census’ taking..

Could it be because they're left alone in the US?

Well, what cities do you visit in America?

New York, Seattle, Philly, Portland, Pittsburgh, Nashville, Denver, Boise, Harrisburg, St Louis, and quite a few more.

I’ve lived in towns of about 15,000 that had the problem as well.

>I’ve seen this nowhere else in the world.

I find it hard to believe that their are not other homeless people in other countries not "tripping" on drugs.

In most countries I've been to it's not nearly as easy to get ahold of the quantity and diversity of drugs as you can in America.

In Latin America, for example, it is seriously hard to get ahold of anything but marijuana and cocaine, even for young hip people in-the-know with the right people.

Only in a few small markets in Europe like major cities in the UK and cities with liberal drug use policies like Amsterdam do you get comparable drug accessibility. And even then it's still a far cry from what's available in the US.

Besides street drugs, there are prescription drugs, and even there the US is exceptional in the availability of prescription drugs available via the black market.

Do you really think most many mentally unstable homeless are tripping? If so, on what? Psychadelics, speed...?

What makes American cities so particularly bad and absolutely full of people who seem to be bad movie caricatures of mentally ill homeless people?

It may be partly rooted in the origin story for the country. America was founded by Europeans who were so incapable of going along to get along in Europe that they were willing to face quite harsh conditions to start over elsewhere.

Arguably, "the pioneer spirit" is not well suited to a more settled life. Modern America is still living with that spirit, but the Wild West is now also settled and we are running out of things to channel it into, plus it seems to come with some inherent social challenges that much of the world doesn't seem to have a good answer for.