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Comment by throwawayacc2 | Hacker News Reader

I mean, you could say the same thing about jail sentences right? Presumably this forced treatment would be done via due process. Maybe in cases where a medical sentence is issued, half the jury are psychiatrists or neurologists or have some appropriate qualification.

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The due process necessary to put someone in prison is generally far more rigorous and affords the accused more rights than the due process necessary to institutionalize someone.

It's possible to construct a system that respects the rights of the mental health patient, but we have historically not been able to do so.

Before the 80s, we'd just throw people into madhouses and toss away the key. That system, and its myriad of abuses was torn down due to public backlash, and was replaced with... Nothing.

Your third paragraph seems to contradict the first paragraph. If there is no system to institutionalize people, then how can it be less rigorous than the system to imprison people.

Are you suggesting there hasn't been any involuntary psychiatric in-patient treatment since the 1980s?

There probably is, but as I understand, there are some Supreme Court rulings from 1970s to 1990s that make it very costly and/or require a high bar of proof that accused is a threat to themself or others.

The workaround to the very high costs of working within these rulings was imprisoning people for drug or other non violent offenses, which was much cheaper and easier.

There still is a system to institutionalize people that haven't been breaking any laws, but it's very short-term. If you're interested in checking it out, a failed suicide attempt can give you a peek into it. They are unlikely to keep you for very long, though.

The long-term system was largely shut down in the 80s, because of the aforementioned abuses. The bar to get someone thrown in the loonie bin was very low, and once you're there, good luck proving that you're sane, or that you're being abused and mistreated.

> There still is a system to institutionalize people

why are we talking of "institutionalizing" people? Compulsory treatment of someone experiencing an episode involves depriving them of liberty, while staff ensure they take their drugs, and doctors monitor their effects. Institutionalization generally means that you've been incarcerated so long that the institution is now your home, and it would be a struggle to live back in the world. Institutionalization was a large part of the problem with the old asylums.

At least one mentally-ill person I've known had been taken off the street several times; she was bitterly critical of the abolition of the psychiatric hospitals.

See my comment regarding 18 U.S. Code § 3553(a)(2)(D). Due process is superseded by 'treatment in the most effective manner' under Federal law, including losing your Constitutional right to be sentenced by a judge (a treatment provider, not a judge, determines the rules of your Court Ordered treatment imposed with the full force of the Federal Government).

To be clear, are you saying people who commit crimes should (in some cases) face forced treatment. OR. That mental illness itself should mean forced treatment?

Sentencing someone to a secure hospital rather than a prison for crimes is one thing. Sentencing them for not fitting in is another.

Sorry if I have misunderstood

The case I was thinking about is something like, let's say there's a obviously mentally ill guy thratening to kill people. I'm talking hobo smeared with shit, reeking like all hell, tattered clothes, broken bottle in hand, screaming obscenities and frightening people with death threats in parking lots. You know, regulard tuesday evening in LA.

I think the police should be allowed to arrest this man. A DA might decide to file this new mental health charge against him. Assuming the crazy person doesn't accept the plea deal he would be offered, voluntary commitment in a mental health facility, this goes to trial. If the trial finds the defendant guilty of being insane, he is forcefully commited to said mental health facilty.

Are there issues? Sure. Is it somewhat ok because it's done via due process? Maybe. Is it better then letting potentially violent crazies in desperate need of mental health treatment run loose? Absolutely.

You can already be arrested for the things your describing, they're crimes. And if the judge feels it's appropriate sent to hospital. If that isn't happening it's because cities (understandably) cannot pay for the enforcement or treatment. I don't think we need any change in the law for this.

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