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Comment by okareaman | Hacker News Reader

I was once homeless in California, strung out on drugs and alcohol, unable to quit or even think about getting treatment for that and my bipolar disorder. It is my opinion that we need to go back to locking people up and forcing them into treatment for their own good. It is inhumane to leave helpless people out on the street because of some abstract concept of personal rights. I understand the motivation of mental health advocates who argue that the government has no right to force people into treatment, but it really is counter-productive. I wish I had been locked up for my own good. I was rescued by the good people at the veterans administration.

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I'm not going to pretend I know a solution to this, but wasn't part of the reason it became hard to involuntarily commit people because it was being abused? Like, fathers were getting their daughters committed for being "too promiscuous"?

If that's a serious risk, I don't know that the "solution" to this problem by committing people is worth it.

That said, it's a hard problem. I know it's extremely hard for people without a yuppie income to get mental health treatment in the United States. I know before I got a high-paying desk job, I realized I had some form of manic depression, wanted treatment, but also could not afford to see a therapist because my health plan did not cover mental healthcare and my job didn't pay particularly well. It became this chicken-egg problem: it was hard to find a better job because of the depressive episodes, but I couldn't treat them without getting a better job. I can only imagine that stuff like schizophrenia and drug addiction (which I luckily have not suffered from) is exponentially more difficult to deal with.

Is mental health treatment not covered in a lot of health plans?

I'm not a fan of involuntarily committing people. But I do want to make it as easy (and as cheap) as possible to get good mental treatment if they need it. I've seen the results of good therapists, and it is no less impactful than a good surgeon.

In a sister reply apparently it's not hard to get mental health treatment in California, so I won't speak to that. Where I lived (and currently live) in NYC, it was hard for me to find cheap therapy, as it does not appear they require mental health plans in the insurance (though I'm not a lawyer, so maybe there's more recent legislation).

There are free clinics for it, and of course those are good things and the doctors there are doing the lord's work, but they're extremely backed up. I looked to make an appointment at the time, and the soonest one was four months away. Compare this to the two-day wait I had when I finally did manage to get better insurance.

> there's more recent legislation

California decided it liked Obamacare and the idea of Medicare for all, so I think that's when they made Covered California available for people who couldn't otherwise afford it. It might actually save money because there are less emergency room visits.

> Like, fathers were getting their daughters committed for being "too promiscuous"?

That's a really old-fashioned concern. It used to happen in the 50's and 60's, but patient rights have come a long way since then. The most anyone can do in CA is 5150 a relative, which is a 72 hour hold. That's not done more often because in 3 days and they're out on the street again, refusing to take meds. Mental health pros need to be able to hold someone longer and force a 30 day injection of psych meds. Paranoid schizophrenics usually won't take their meds because they don't trust the system naturally. They are unable to make a rational choice (obviously) So we just abandon them and ignore them.

> extremely hard for people without a yuppie income to get mental health treatment in the United States

Not in California. Impoverished people have access to basic free health care with Covered California. The mental health people I talked to at the local hospital were very well qualified. Too bad I was too screwed up to listen to them.

My gf has Covered California insurance and it is terrible. In particular, 1) very few doctors are in network, so she can't see the specialist she needs and 2) the customer service is a joke; when she calls she spends an hour on hold, and the reps never have any idea what's going on. Would not recommend (she is self-employed, so her options are limited).

And what we have now is a perverse setup where you get locked up after you commit some crime, but get locked up in a prison where little help is provided.

I'm not from the States and that's probably why I have this impression that the States talk a lot about respecting their veterans yet do very little to actually support them. I mean, stuff beyond thoughts and prayers.

I think the VA does a good job. There are veterans who are on the street and there are veterans who commit suicide everyday. People look at that and think we don't do enough for veterans. There is another explanation and that is sadly, some veterans can't be helped, like a friend of mine who shot a kid in Iraq and couldn't get over it. He was on a suicide mission with drugs and alcohol. He didn't stay in treatment with me and I lost track of him.

Appreciate your speaking up with an unpopular opinion; I fear coerced treatments because individuals vary more than medical practice allows for.

For example, there's people for whom opioids do not provide any pain relief; but try getting a doctor to understand that you're one of those people. You'll get the opiate pills prescribed anyway, and noted as a foolish drug seeker to boot.

There's always going to be issues like this. They can be solved. We shouldn't let smaller issues cloud our judgement about the larger issue, which is that woman screaming at the trees was someone's daughter. That man sprawled out naked and drunk in the bushes was once someone with friends and family, all gone now because no one can help him. The state needs to step in and take care of these people, against their will at least until they are well enough to decide for themselves.

"California homeless are crazy" narrative is tiring and excuse. They are still people and need basic life necessities: toilet, shower and food. Periodic showers improve mental health, there are studies to prove it! After that is solved, we can focus on other issues. And frankly California invented drug culture, it glorifies drugs, why shame homeless?

If Jordan can accept 3 million people, so can California.

The functional people who become homeless usually don't stay homeless because they are able to take advantage of services. There are some new methods being tried by providing temporary tent cities for these people with showers and such. A strict no drugs or alcohol policy in the tent city. When people speak of "The homeless problem" it's usually in regards to the chronically homeless who are addicted and/or mentally ill who won't stay in these regulated tent cities.

"functional people"? What sort of language is this? Far right BS!

People are people. It is illegal to scan people for drugs on job interview. Taking dump and shower should not require drug scan.

I think one can be generous here and assume the treatment centers mentioned in their comment would have running water, and access to e.g. food.

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