> lots of mentally ill people don't get proper treatment, yet are still a huge burden on the health care system.
I'm not saying you're right or wrong, but why do you believe that?
I'm not saying you're right or wrong, but why do you believe that?
I'm having difficulty finding the source, but I've read that individual "frequent fliers" have consumed hundreds of thousands of dollars of emergency services without receiving substantive care that would improve their situation.
Just an anecdote, I don’t see any late night “urgent care” places anymore. If they were sufficiently less expensive than ERs, it seems like insurance companies would incentivize them to have longer hours. Otherwise, after 9pm, you have to go to ER.
Two main reasons: you need to use personnel, equipment, and rooms that can offer the highest levels of care. And you need to pay for having a facility staffed to handle worst case loading (with triage) 24/7.
You also tend to have pretty exhaustive testing on the "emergent" side to make sure everything is immediately OK prior to discharge.
Further, tacking on “serious chronic mental disorders” is basically a non-sequitur and could’ve been replaced with “diabetes” or “broken legs” or “tooth pain”.
If your local urgent care can’t find a doctor or NP willing to be on call late, they can’t stay open late. Given the shortages, expect the problem to get worse.
> With a budget of more than $330 million, the San Francisco Fire Department responded to more than 136,000 incidents last year — about 28,000 of them fires and other nonmedical calls for service, plus just under 12,000 false alarms.
https://www.nytimes.com/2015/08/27/us/san-francisco-firefigh...
The police and emergency responders can be called, but are unable to take any action to help a clearly mentally ill individual unless they are a danger to themselves and others. The same is true for doctors/hospitals/emergency rooms.
It is common for an individual to have 20 or 30 public service calls before they are admitted and start to receive guided treatment. Even individuals with caring and attentive families can and will fail to be treated, with damage to their mental state, or at a minimum long costly delays to their recovery.
read about "5150 hold" and the criteria required:
https://en.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%80...
I don't blame the police, they followed the law. But in a case like that, where a person seemed very dangerous (and ultimately was), had a history of severe mental illness, was off their meds.. it seems like you need a way to intervene before the ill person does something dangerous.
1) very temporary ‘fixes’ to what are almost always conditions caused by some kind of chronic situation - often bad environments, toxic families, serious psychiatric and drug problems, major life events which don’t just go away, ongoing manipulation or emotional abuse by someone near the person, etc. often many of these things all at once.
2) very traumatizing on their own with severe long term legal and monetary consequences. Practically speaking, people lose a significant amount of rights they never get back (including the right to own firearms [https://www.atf.gov/file/58791/download], the right to adopt kids, hold many jobs, etc.) the moment they get a 5150. Getting a 5150 is one of the few ways one could lose custody of their child for good, at least in California. If someone has a legitimate history of psychosis or other serious mental health conditions, that’s all probably a good idea and legitimate! there is also a history of abusive folks using things like 5150’s to abuse and target folks they are trying to control (like abusive parents, ex spouses, etc).
Getting thrown in a psychiatric hospital against one’s will is not a pleasant or comfortable situation for anyone, let alone someone going through a psychotic episode. But the best society has come up with so far, and definitely better than them stabbing random strangers on the street (or themselves), or being thrown in genpop. Usually, anyway.
It’s a short term ‘fix’ for what is often (but not always!) a serious long term problem. Which is better than nothing!
Emergency and Long term involuntary commitment has a long and storied history of being seriously abused to steal people’s assets and manipulate/control folks who clearly were not crazy or a danger to themselves or others by any real definition.
It’s also a necessary tool when attempting to manage serious mental health issues in the population.
In both of these cases though, do you really want to set the bar so that it doesn’t require a clear, documented by a third party and actual/present danger to someone before it gets used?
Because I guarantee if you do, it will be used by angry spouses, controlling parents, political/business opponents or leaders, etc. against sane people all the time. More than it already is, anyway.
Which is often.
SF has a serious problem. Actually using 5150’s more isn’t likely to help though as most of the people getting them likely already have gotten them before. It’s a revolving door.
They get screwed up enough to warrant an emergency hold. They get help, temporarily stabilize, and within a week are back to the same situation. Eventually, they go psychotic again, and rinse repeat until they die or figure out how to get out of the cycle. Many die.
Unfortunately the police will tell you bluntly: "It's not against the law to be crazy"
More unfortunately, medical personnel have told me that unless a treatment regimen with appropriate medication starts, the brain will deteriorate and chances of a full recovery disappear.
Unless there's a separate medical system for the homeless/ mentally ill - I just don't see how it'd work. The American healthcare system is fucked, and cannot be unfucked for just the homeless (who can't pay). Most people are happy to ignore the state of affairs until there's an untreated schizophrenic hanging out in front of their favourite Avocado Toast joint.
Unless mental illness is criminalized, police have no business detaining the mentally ill or forcing them into treatment.
This doesn't require a separate medical system, it requires prompt intervention/treatment at the beginning of the illness, not after many many visits.
I fully agree. The same goes for cancer, dental health and countless other diseases and ailments. The solution is having a stronger social safety net - but America appears not to want that, so here we are.