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Comment by closeparen | Hacker News Reader

Being a tolerable neighbor involves skills, habits, and self control that are far from universal. Showing up to appointments and taking your meds every time is hard for yuppies with mild depression, let alone people with much looser holds on life. Inpatient mental health facilities are necesarily more coercive and less fun than the outside world. The mentally ill have civil rights too and can check themselves out unless their situation continues to meet a high bar for imminent risk of serious harm.

People in between “cannot manage own life” and “imminent danger to self and others” are a tricky proposition for the mental health system. It only takes a handful of such people wandering around your city center continuously (seriously, it’s the same dozen faces over and over in SF) to completely change the kind of place it is.

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> Inpatient mental health facilities are necesarily more coercive and less fun than the outside world. The mentally ill have civil rights too and can check themselves out unless their situation continues to meet a high bar for imminent risk of serious harm.

I didn't say kidnap and torture them like we did in the 70s. I said give them mental healthcare and housing.

People don't become junkies overnight, and a building full of single bed sized lockable (from the inside) rooms available to anyone without stable housing (without fear of the salvation army taking them off of HRT or abusing them) with a few social workers and mediators to teach those skills, a doctor, a vocational educator, and a therapist on staff 24/7 is both cheaper than policing and jail, and would go a long, long, long way towards preventing these problems in the first place.

There's absolutely no reason not to do this. It's cheaper up front than policing. It saves the same amount again on cleanup and maintenance of public spaces. It saves many times the amount of money again on reduction of crime and insurance. And it provides a portion again in people that become productive tax payers

For the ones that have already fallen to the bottom of the hole you need something more, but surely if it's doing so much damage to the entire city that out of the 300 billion gdp, the inhabitants can afford four dozen social workers and an apartment block to do nothing but try to find a way to help them.

The idea that this is even a question in the wealthiest place on earth is mindbogglingly callous and evil, and a sign of a very very sick and antisocial society that has nothing to do with the people that fell through the cracks.

Offering support to people who want it is important and necessary. I am willing to bet however that a decent sized city contains at least one and probably several people who do not very much like having their lives managed by teams of social workers (I wouldn’t!) and will instead avail themselves of their right to shit on the floor of the train station.

> do not very much like having their lives managed by teams of social workers

Then don't manage. Serve and support. Start by bringing a sandwich, a coffee and a smoke and listening for an hour every day, not by shoving them in a cell.

Yes, it's expensive, but if it is -- as people here and elsewhere say over and over again -- making an entire area of a city uninhabitable and causing millions in damage and enforcement costs then surely it's worth the cost? Why do people seem to constantly favour being callous and cruel over even being selfish, let alone humane?

Why is this such a uniquely American problem? Large, dense cities in the rest of the world don't face these issues.

Large dense cities in certain parts of Europe and east Asia don’t face these issues (and even then, there isn’t really the same concept of large and dense in most of Europe), but I would say chaotic unfriendly cities are the default in most of the world. In a sense, many American cities act as a bridge between these two worlds. It also doesn’t help that you can fall much farther in the US than other places before anyone even begins to notice.

Individualism and unusually strong civil rights? In other countries people similarly troubled would be involuntarily committed or cared for by family.

If the government picked people it didn't like from the streets and checked them into a mental hospital, it'd be strangely un-American.

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