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Comment by imperio59 | Hacker News Reader

Difference is, if your only tool is a hammer, everything is a nail.

If you send a mental health professional to all sorts of situations, their solutions will be mental health related (medication, treatment, commitment, etc...).

If you send a cop, their solutions will involve the criminal justice system (citation, fines, arrest, jail time, etc...).

One of these has a long history of strong checks and balances and improving itself over time (latest major improvement: body cams). The other one of these is primarily fueled by giant corporate lobbies who spend a lot on every single political campaign (read: Big Pharma).

Can you guess which one is now being touted as the "new solution for all our societal ills" despite having no track record of actually being able to fix any of these ills?

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> If you send a mental health professional to all sorts of situations, their solutions will be mental health related

Can you even say that with a straight face? Do you really think if these guys got sent to a robbery, they'd be all "the thief obviously needs Xanax!" instead of saying "This ain't one of ours, send a cop here please".

Cops have, for whatever reason, ended top being sent not just to criminal justice related incidents, but everything else as well, including mental health related incidents which they're manifestly untrained for and incapable of dealing with. But they "deal" in those situations anyway, in ways we're all tired of seeing from body cam footage and in the live crosses of news stories about police violence protests.

> One of these has a long history of strong checks and balances and improving itself over time

And yet "Some of those who work forces, are the same who burn crosses" is just as heavily quoted and relevant to 2021/01/06 as it was when it was written over 20 years ago... I do not agree with your claims about the relative track records of the two groups involved here.

Because there are a lot of cops, and they are on-call at all hours, they need training in all emergency situations.

That means they need to know enough first aid to deal with a heart attack until the EMTs get there. Likewise they should have enough psychology training to deal with the mentally ill until the experts can take over.

This is not reasonable. Everybody should know enough first aid to deal with a heart attack until EMTs get there. It's not that hard, the course only takes a couple of long days. Dealing with every variety of mental illness is orders of magnitude harder. Social workers have master's degrees, not a certificate from a 2-day course.

Just let cops figure out how to do their regular jobs right, rather than making them the first responders to an embarrassingly terrible social safety net.

We don't have a choice, cops will be first on the scene. If nothing else because until they arrive nobody even knows to call in someone else.

The police have more complete first aid kits than the average person, including such things as an AED. They also get a bit more than your standard firstly aid course.

>One of these has a long history of strong checks and balances and improving itself over time.

Sorry, it's hard to take you seriously if you make such a statement. It betrays serious ignorance of the background for why they started sending health care professionals over officers.

> Difference is, if your only tool is a hammer, everything is a nail.

Seems this program has a hammer and a screw driver for nails and screws.

> Can you guess which one is now being touted as the "new solution for all our societal ills" despite having no track record of actually being able to fix any of these ills?

Hyperbolic, no? One can certainly find people shouting from the halls on any issue. Doesn’t every startup need time and opportunity to create a track record.

> primarily fueled by giant corporate lobbies who spend a lot on every single political campaign (read: Big Pharma).

I wouldn’t be surprised if police unions and big pharma are within the same order of magnitude in political lobbying.

A couple of problems:

1. You have a pretty high opinion of our police if you think that police unions, donations, and endorsements don't have effects on political campaigns, that towns don't use both police fines and public prisons as a revenue source, and that the criminal justice system can't have comparably (or even greater) negative effects as involuntary mental health interventions.

2. You have a pretty low opinion of our current medical industry if you think that it hasn't improved itself over time. Our country used to lobotomize people and commit them for being gay. Things can and do get better over time. That doesn't mean there aren't still problems, there definitely are, but even in just my lifetime, the way the medical profession approaches mental illness has gotten much, much better. Absent some kind of better data, I am skeptical of the claim that our medical industry's problems are being solved significantly slower than our (also numerous) criminal justice problems.

3. It's possible that this will lead to more medical involvement, but I would be cautious about making strong claims about how much that will be the case and what changes that will have in people's outcomes. It's important to remember that prison is really bad. As just one example, being convicted of a felony removes 13th amendment protections, which is regularly exploited for both private and state revenue -- even in public prisons! What data do we have that indicates that mental interventions will increase at a drastic rate because of this, and what data do we have that says that involuntary incarceration is worse than our current prison system?

4. Denver hasn't gotten rid of its police, it's merely changed how it's using them and how quickly they respond to problems. So it's not that the only tool is a hammer, police officers can still respond to situations. I think it's early to jump to the conclusion that the city is going to start thinking that involuntary mental interventions are the only tool at its disposal. I don't see strong data that backs that conclusion up; in fact 35% of the calls to the STAR program came from police officers. Another way of looking at the data might just as plausibly be that the city was treating police officers as its only tool, and now it's striking a better balance and realizing that arrests weren't the only way to deal with every problem. That's the kind of thing that'll get revealed one way or another as we get more data.

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> despite having no track record of actually being able to fix any of these ills?

Finally, again, just an unrelated side note, but I know people who are extremely grateful to both psychological therapy and psychiatric help in managing conditions. If you're struggling with this, you don't need to do it alone. Professionals can help. The idea that the only thing a psychiatrist is ever going to do is turn you into a zombie with drugs is bullcrap. And it also ignores that non-psychiatrist interventions don't always need to involve drugs. Cognitive behavioral therapy can have amazing outcomes.

I get that you don't have a high opinion of psychologists or psychiatrists, but they do help people. I just want to make that point very clear.

Have you even read the article? This does not send psychiatrists or doctors but social workers with mental health education.

I don't know about the US, but I highly doubt that these people would have the authority to involuntarily commit someone. Apart from the fact that you have yet to demonstrate that increased health workers lead to increase involuntary commitment, as if that's the only thing psychiatrists etc do.

It's also ironic that you somehow think that sending someone whose only tool is a gun (I know this is somewhat over the top, but much less so then saying involuntary commitment is the only tool of mental health professionals) is the better solution.

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The suicide rate has been steadily increasing since 2000. The effectiveness of the mental health profession is falling at an alarming rate: https://www.macrotrends.net/countries/USA/united-states/suic...

The former does not implicate the latter. Total non sequitur.

The suicide rate measures death from mental illness. The death rate from mental illness has been steadily increasing. Therefore we are doing a bad job at treating and preventing mental illness. What other statistic would you like to use to measure how good of a job the mental health profession is doing? There have been several prominent speeches from professionals in the field who don't handwave away problems talking about the need for more analysis of what's gone wrong.

Literally every individual thing you wrote is wrong.

1. Suicide rate doesn’t “measure death from mental illness.”

2. The suicide rate isn’t “the death rate from mental illness.” (See #1)

3. What do you even mean by “we are doing a bad job”? Who is “we” there? Also, this “conclusion” you’re drawing is supported only by nonsense predicates (see #1 & #2).

4. The “mental health profession” isn’t responsible for moderating the suicide rate. Also literally every mention you make of “mental health profession” is fallacious because the suicide rate is not an actual metric for evaluating the efficacy of the “mental health profession”, so even addressing anything you’re saying about “measuring how good of a job the mental health profession is doing” would be legitimizing a nonsensical claim. This one covers how pretty much everything else you wrote here is wrong.

You just say the first proposition is false without any reasoning to back up why and without providing any better alternative. You're sticking your head in the sand and trying to ignore the problem by saying ignorance is better than any empirical approach to measuring the quality of the mental health profession.

It seems, by failing to provide any alternative, that you're saying that it is impossible to measure the effectiveness of the mental health profession as a whole? This decline is similar to how the economics profession has concluded that it is impossible to measure the success of any economic policy vs. any other because of all the confounding factors as Paul Romer has commented on extensively. This leads to methodological poverty. You can make up whatever policy or treatment you want. It's as good as any other whether it causes people to kill themselves at a higher rate or not or leads to lower or higher economic performance. It's all the same without metrics.

You’re ignoring the material conditions of people since 2000. The steady decline of that is more likely to do with suicide rates than failures of psychiatry.

While it might be valid to frame suicide as death from mental illness, how can you say that the death rate from mental illness has been increasing when we don't even really know the size of the population with mental illness. A lot of mental illness goes unrecognized.

I would argue that the problem is in recognizing mental illness and connecting those affected to the appropriate mental health professionals.

> If you send a cop, their solutions will involve the criminal justice system (citation, fines, arrest, jail time, etc...).

Shooting people. Choking them to death. Pinning them down till they freeze. I'll take my chances with mental health professionals, thanks.

> If you send a mental health professional to all sorts of situations, their solutions will be mental health related (medication, treatment, commitment, etc...).

> If you send a cop, their solutions will involve the criminal justice system (citation, fines, arrest, jail time, etc...).

The fact you list both of these out then say policing is the one with a "long history of strong checks and balances" (what does this even mean?) is appalling. It reads like authoritarian propaganda.

You're taking the classist and racist position, that force employed by agents of the state should be deployed against the poor & otherwise marginalized to prevent them from being a "burden to society." Also that employing people who are tasked with _helping_ instead of _enforcing laws_ should NOT be allowed to do that.

To be clear, you're not really making any falsifiable claims. It's just an endless appeal to emotion. "a long history of strong checks and balances and improving itself over time" is a bold claim about municipal agencies with their own regulations, city, and state laws to adhere to. Not to mention different missions, run by different organizations with different lines of reporting. Totally different cultures, etc. It's so vague but that's the beauty of it: you can make it mean whatever you want under scrutiny.

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