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Comment by muh_gradle | Hacker News Reader

For those that are mentally ill, and especially if they are violent, you force them to get the psychiatric help that they need. It's an unpopular opinion. But frankly it's long overdue. For those that have the option to go to shelters, receive plenty of benefits (which SF most definitely provides) but prefer to be homeless, they need to be separated from major city areas where tourists, business people, and every day people want to live peacefully. I've seen enough of this the last few times I've been to SF and the bay area.

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For better or for worse, homelessness in America can largely be attributed to Regan-era changes in policy [1] that prevented people from being committed against their will to psychiatric hospitals. It was done in the name of human rights, but naturally there were ulterior motives.

It's time we reverted it.

About 10% of humans have been addicts across most cultures throughout most of recorded human history, and they desperately need help (even if they claim don't want it).

There should obviously be a ton of safeguards in place before committing someone against their will (e.g. 1 or 2 doctors should declare that the patient is unable to care for themselves and make rational decisions, assessment at regular intervals, ensuring the patient has the right to get a new doctor, etc.), but I don't think we'll be able to solve homelessness without it, because this is what we used to do differently prior to the homelessness epidemic, and this is what other nations have been doing.

[1] https://en.m.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%...

>About 10% of humans have been addicts across most cultures throughout most of recorded human history, and they desperately need help (even if they claim don't want it).

one can wonder why this trait hasn't been selected out by now (or some trait managing it hasn't appeared).

Anecdotally, while 9/10 people with obsessive traits may crash and burn and possibly end up homeless, 1/10 may succeed spectacularly by becoming obsessed with something healthy-ish, or something that benefits people other than themselves. (Even if it's at the expense of their family and friends).

How many addicts crash and burn before reproductive age?

It's not a genetic issue, it's an ecological issue. I imagine almost all humans can become addicted to something or develop mental health issues under the right (wrong) circumstances.

Same reason some young men play chicken with traffic. Paradoxically, it's likely a signal of fitness. A young man who can still manage sex successfully under the burden of multiple addictions probably has decent genes, cardiovascularly speaking. Probably why men are much more likely than women to take such risks, too.

It was a bipartisan initiative. Tying Regan’s name to it seems disingenuous.

But they are making rational decisions, in their own framework. And they are caring for themselves, as much as they care. Sure we could grab them up and throw them into institutions, and call the problem solved. I’d rather see us hold them accountable for any behavior that harms others, and leave it at that. Sleep on the sidewalk? Fine. Block the sidewalk? Not fine. Litter, endanger, defacate in public? Same penalty as anyone else. Looking at them as victims is degrading to them and paralyzing to society.

What are those penalties, and does this penal system actually work to change people's habits, or is it just part of a cycle, e.g. streets -> jail -> streets?

I think the idea of "There's nothing you can do for me given the current social-political reality" too often gets conflated with "This is all I want my life to be". And even if the person has truly given up on society, I don't think society should ever give up on the person.

> Litter, endanger, defacate in public? Same penalty as anyone else.

what penalty is that for people who cannot pay any fines?

The first step against mental institutions was by Kennedy who's family had bad experiences with the mental health system. Blaming this solely on Reagan is misguided. Reagan just went with the flow.

With respect to the Kennedy’s bad experience, are you referring to Rosemary’s involuntary commitment and subsequent lobotomy? That was pretty awful, was there something more?

No that's it. JFK held a vendetta against mental institutions. He signed legislation to rid the country of them and create community mental health centers which was the first step in deinstitutionalization.

> It was done in the name of human rights, but naturally there were ulterior motives.

what was the ulterior motive?

Saving a great deal of money for the state of California in the short term.

Wasn’t psychic ward “incarceration” also used to silence politically-incorrect dissidents?

> you force them to get the psychiatric help that they need

The problem is that there’s a long history of people labelling all sorts of things they don’t like as being a mental illness and using that as an excuse to use treatment as violence against them. We called homosexuality a mental illness until very recently and forced people to have violent treatment for it, for example.

If someone is having an episode and causing violence onto other people, we're not gonna look at this 20 years later and question if this isn't a mental illness. We absolutely know what the issue is here, and the situation that I described is not unheard of.

Given that causing violence onto other people is illegal, I suppose what you're talking about could be thought of as a change to the prison system so that it's designed to improve the (mental) health of people committed, rather than just being punitive.

As an addendum, I’ll also add that the psychiatric system was the main Avenue for suppressing dissidents in the post-Brezhnev USSR.

100% this -- is this really an unpopular opinion?

Yes, unfortunately it is and the way we handle this isn't exclusive to SF. Google Andrew Yang NYC homeless. Everyone is avoiding the elephant in the room and refusing to touch this issue.

I don’t know if it’s unpopular or not but it’s certainly not as simple as “you force them to get the psychiatric help that they need.” That’s not how it works at all. You can’t force people to heal or get better — they have to want it themselves. When people make these types of sweeping statements, it makes me really question if they’ve ever been in a situation where a loved one has been resisting getting help for years.

I know -- I meant more about making sure they don't make public places unsafe/unclean.

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