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Comment by EatingWithForks | Hacker News Reader

For anyone who wants to bring back asylums: first and foremost, you must imagine that you will be subjected to asylums as they existed. You could simply be protesting while black or female, considered insane for protesting and forcibly detained-- for which you can be raped and assaulted, and any reporting to the police of your trauma isn't taken seriously because you're considered insane.

It's nonsensical to say we should bring back asylums and then not seriously consider what asylums were at the time. Women who tried to fight for their right to vote were put in asylums and raped.

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> you must imagine that you will be subjected to asylums as they existed.

No you don't. Nobody is advocating for that. Nobody is saying we should follow the same broken standards that led to locking up people for protesting, or that we should allow abuse and rape.

Do you not think there is any middle ground between raping protestors and letting people with violent schizophrenia live in a tent on the street?

If they can be used as a punishment, they WILL be used as a punishment.

Not too long ago, BDSM was considered a mental illness. We'not talking the 1960s either.. this was 2010 when the DSM-4 had BDSM and similar removed.

Prior to 1980, homosexuality was also in the DSM-4.

The trend is obvious and troublesome: this is mainly a list of consensual actions that were listed as "mental health problems" and therefore could be treated against the will of the person. And it's easier to dismiss a 'sick' person since they're obviously out of their mind.

So yes, this is something you definitely will have if the asylum system is recreated and/or reformed. Person making different lifestyle choices others don't like? Committed, with no real say or due process.

Do you think they're suddenly going to put homosexuality and BDSM back in the DSM-4 and lock people up for it? I mean, you look at the current political climate and you believe that is a thing that could actually happen when the White House is hosting a Pride parade?

There are real people getting assaulted and murdered by the mentally ill right now. Not to mention the mentally ill themselves who are subject to violence on the streets and living in squalor. These are actual problems that are really happening and you're saying we shouldn't do anything to address them because of hypothetical problems you that you think might happen and that we could easily be aware of and prevent?

I have ZERO doubt that the Ron DeSantis' of the world would try to lock up LGBTQ people. It's honestly hard for me to imagine anyone not thinking that people like him would try to do it.

I’ll reluctantly back you up on this one. There are definitely people in power right now that would definitely lock up LGBTQ/Black/Women (honestly white males too) under false pretenses.

Still, we have to do something about the homeless problem. These handful of people ruin millions of peoples lives.

Did Trump do it? Is Ron worse than Trump?

On LGBTQ issues, yes. Ron is unquestionably worse than Trump. It's part of his current campaign strategy to call out that Trump is "weak" on LGBTQ "issues."

Trump and DeSantis are individuals and their political views can't be reduced to a single scale running from "good" to "bad". They have different approaches to politics and they have different areas that they care about and they approach their political goals using different strategies.

They're both bad candidates, but they're bad in sometimes different ways. And there are many, many issues where DeSantis is better than Trump (although that's not saying much, and it's not saying that DeSantis is good on those issues). LGBTQ+ discrimination in specific though is an area where DeSantis is worse.

This is just the personal impression that I get, but I think that most progressives feel that Ron is worse than Trump. The one exception is that Ron seems to be worse at politics than Trump so I could see some people viewing him as less of a threat.

>Do you think they're suddenly going to put homosexuality and BDSM back in the DSM-4 and lock people up for it?

Yes. A young woman was recently locked up for 90 days for terminating a pregnancy because she did not have access to legal abortion. There are people who basically want 'white sharia'.

I'm sick of the civic rainbow-religion. Get those flags and the moral authoritarianism out of my face. But let us not forget there really are people who think two guys shouldn't be able to hold hands in public or fool around in private.

> Do you think they're suddenly going to put homosexuality and BDSM back in the DSM-4 and lock people up for it?

Are you asking whether rights people enjoyed for decades can be rolled back? You can't think of a single instance of that happening?

Lots of things can happen, I’m talking about addressing problems that are happening and not letting hypothetical fearmongering get in the way of doing that.

What’s the point here? We should never do anything if even one person can come up with some possible hypothetical scenario where it turns out badly?

The point is _right now, as we speak_ there is a concerted effort to roll back rights and freedoms women and gay people have enjoyed for years; you should not give people doing this more tools to harm people.

There is also right now an epidemic of homeless people harassing, assaulting, and even murdering people and generally making major cities nearly unlivable. So when you create a false dichotomy between "treat mentally ill people who might murder you" or "lock up gay people", YOU are in fact giving tools to the people who want to lock up gay people. However much your average, non-gay person supports rights for gay people, I guarantee you they support not getting murdered more. So when you force a choice between "maybe, hypothetically, gay people get locked up" and "you might get murdered", people are going to choose the "don't get murdered" side. People, really, really don't like being murdered.

Instead, how about we don't force that choice on people? How about we offer the option "don't lock up gay people" and also, "don't let mentally ill people murder anyone"? Call me a crazy idealist if you must, but I really think we just might be able to do both things.

I live in a major city that is constantly described as having an epidemic of homeless people. I am far more annoyed by delinquent, housed teenagers than I am of the homeless population here. And more people die from reckless drivers than are murdered by insane homeless people-- in fact, a little girl was killed in a hit and run this year a few streets from me, and 0 murders by insane homeless people have happened in the meantime.

I'm pointing out that you must absolutely contend with the fact that marginalized people have historically been labeled mentally ill when they fight for equality, and that asylums have historically been used as a tool for this purpose. If your concern is to address homeless insane people, one of the major causes of insanity is being homeless for more than a few months, and yet our homeless shelters are still under-resourced and we are still creating more homeless people by seeing housing as an investment that must always grow, pricing out more and more people.

If anything, I am pointing out we must address the "false positive" issue, where the population of people who are under threat of being institutionalized as insane even though they are just a marginalized person reasonably reacting to their own oppression might be greater than the insane homeless we want to address. And that "we just won't do that because regulation" is a straight up delusional belief, with zero basis in actual reality, and is more or less saying you hate homeless people more than you care about marginalized people losing their rights.

> I'm pointing out that you must absolutely contend with the fact that marginalized people have historically been labeled mentally ill when they fight for equality

And I am pointing out that all people, marginalized or not, are currently subject to violence and harassment by the untreated mentally ill, right now. Not historically, currently.

If one party starts telling voters that they care more about hypothetical inconveniences for marginalized people than they do about people getting murdered right now, that party is not going to be in any kind of power for long and they will have no opportunity to protect anyone's rights.

Why are you calling the actual, historically factual sexual assaults of women in asylums to be "hypothetical inconveniences for marginalized people"? I guess that's what it means to be marginalized, that the harm done to you and how your life has been ruined is an inconvenience.

The only reason why the rape of women in asylums is historical is because we no longer have asylums. If you want to bring back asylums, justify how you're not going to also be bringing back raping women in them.

> we just might be able to do both things

Yes. But there is no easy solution. History shows that anything that involves locking up people because they might commit a crime will result in innocent people being locked up and abused.

Better not do anything then, certainly not try to figure out a better way.

The only safe choice is to oppose every proposal and offer nothing as an alternative.

Fix the root causes of the homeless crisis. Home affordability, employment, mental health treatment (with consent).

For some us states I have zero doubt they'd make such things eligible criteria for placement in a facility, regardless of thier presence in the dsm.

Just look at what's happening right now with them violating hippa to attack women trying to survive miscarriages...

I think when you look at history it doesn't predict the future, but it tells you what is possible.

What we had is possible, it did happen. Why? What was the system of alignments and incentives that led to that being the case, and how are we different now?

I do think that if you want to bring back asylums, a place to lock away people who are too expensive or are otherwise uneconomical to treat, you must have an answer.

Talking about taxation in America is a political death sentence. Privatization of public services is still extremely rampant. How are you going to get well run asylums if you can't tax or you have a for-profit model?

If you want nice things, we have to be getting less corrupt as a country, not more corrupt, and we are most definitely getting more corrupt. I absolutely do not want asylums as long as we are inching towards literal oligarchy, and we definitely are inching closer to it than farther away. Our supreme court justices openly take bribes, and our representatives think it's ethically okay to trade stocks. Our politicians are choosing to carve up districts to keep themselves in power, and some want to absolve the idea of voting altogether and just choose federal candidates from state legislatures.

Asylums are running when we can't even walk. The post office was in the process of being dismantled to create pretext to steal an election and you think we can run an asylum?

Do you really want an asylum in the context of Ron DeSantis's Florida and GOP rhetoric against trans people? That seems like a bad mix.

Those that fail to learn from history are doomed to repeat it.

>a place to lock away people who are too expensive or are otherwise uneconomical to treat

Asylums are where people are treated, as opposed to the streets where they're a threat to themselves and everyone around them.

> Do you not think there is any middle ground between raping protestors and letting people with violent schizophrenia live in a tent on the street?

I think we all do see such a middle ground, but think that it's really difficult to hit from a due process point of view. This is a parallel track, from the criminal justice system, to take away peoples' autonomy and rights to choose what happens to their bodies.

E.g. maybe we should be focusing on putting real treatment in jails (which tends to be pretty barbaric and ineffective at this point) and using the normal criminal justice system.

You cannot advocate to bring back an institution and then lie about what that institution was. The asylum institution was a way to label people as insane regardless of their sanity and then subject them to heinous mistreatment for which they had no recourse. Unless you directly address this, you are simply advocating for the re-implementation of institutional abuse.

You cannot interpret people's meaning however you want. If someone wants to "bring back asylums" it's entirely possible (and from the context here, very likely) that they want to bring "back" a version of asylums that never technically existed, but nevertheless both this new thing and the old thing are in the "asylums" category.

If you want to "bring back" something that never existed, you have to address what the thing actually was that you want to bring back-- and more importantly emphasize what will actually be different. You cannot merely lie about what that thing was you're bringing back, or handwave that its different now because the year is different. There is ample evidence that government officials will sexually assault people, traffic children, forcibly sterilize women, and starve/torture/kill/enslave men that they are responsible for in current day.

No two things at different points in time are identical, so it's technically impossible to bring back something that did exist. I mean, while we're stuck on semantics, let's just do the full thing, no?

It's rather obtuse to suggest anyone is arguing to take a Delorian back to 1955 and bring back asylums completely intact with nurse Ratched.

Yeah, how about full-service gas stations and Doowop hits too?

What sort of protections do you advocate putting in place to prevent that?

The medical community already has well-developed ethics and treatment rules.

The medical community also had ethics and treatment rules when asylums where common and they didn't seem to help much.

Even if the doctors themselves are moral, what prevents politicians from putting their thumb on the scale? We are already seeing them override physicians on gender affirming care.

What prevents politicians of finding a small number of immoral doctors who are willing to rubber stamp whatever they want?

Sorry to be harsh, but these hypothetical (and nearby) concerns are not important enough compared to the daily atrocities I see in downtown LA. There’s egregious harm happening now.

Also it’s not uncommon to discourage procedures for minors until they are able to lawfully consent. So your example is muddy.

Florida has laws on the books that let anyone go to a judge to get an order for forced treatment of someone else for claimed mental illness or addiction, like the Baker Act and the Marchman Act. With the Marchman Act, non-compliance with treatment can have legal consequences, as well.

From here[1]:

> What happens if the respondent isn’t compliant with the treatment order?

> It’s up to the judge but the idea is that non-compliance with a court order equates to contempt of court and is punishable by jail time. This is where the “teeth” or consequences are introduced for someone refusing to comply with the treatment plan. However, we have found that many counties do not enforce treatment orders with jail time.

[1] https://marchmanactflorida.com/faq/

Things can improve. We can learn from past mistakes and do it better. Have a high bar for entry, have stringent regulations that involve inspections every week etc. The solution is not to just throw up your hands and refuse to do anything about a clear problem and hope it goes away because we failed in the past.

We can't even bother inspecting our current critical inpatient mental crisis facilities. You cannot seriously claim we should be bringing back an evidently widely abused institution because we can regulate it, when we already have widely abused institutions that are not regulated.

We had, in our most respected medical facilities, numerous women subjected to extremely painful ovarian harvesting with no pain relief and it turns out a nurse was stealing pain medication from the patients for YEARS. You cannot seriously suggest bringing back yet another widely abused institution when our current institutions already abuse people to a horrific, systemic extent, as if it will solve anything.

Absolutely this. The burden of proof here is on people proposing some kind of happy regulated system to prove that we are in any way as a society capable of building those systems. And it's not just that mental health and inpatient care in the US is under-regulated, under-funded, and abusable -- our society still has debates about mental health and still suffers from widespread stigmatization of people with mental health issues. We have not shaken off the social attitudes and beliefs that led to the original widespread abuse within asylums.

If someone is proposing forced asylums you have got to grapple with the fact that Florida legislature considers being transgender a mental disorder and that Florida is fully willing to try and weaponize social services and child protective services to attack families with transgender members. You can't just gloss over that, you have to understand how a state like Florida will immediately try to weaponize an expanded system of forced asylums.

"We'll just have strong standards that prevent abuse" -- how? A nontrivial number of states right now are actively trying to use medical standards to oppress or eliminate a minority group. I'm sure Texas is going to have great standards on when the State can lock someone in an asylum. /s

Asylums are prison type 2, and I am already subjected to the possibility of prison for crimes. Most arguments against asylums is an argument against criminal prosecution, police and prisons in general. Make the standards the same then and only subject to committing an actual crime in the first place?

I frankly don't believe that the majority of people advocating for forced institutionalization are going to be satisfied by waiting for someone to commit a crime. I think the majority of people advocating for the return of asylums want the State to be able to commit citizens to asylums before they do anything criminal.

Like you said, prison exists. And I will happily advocate for prison reforms within the existing legal system that allow for better rehabilitation of prisoners, particularly better rehabilitation for prisoners who suffer from mental disabilities or illnesses. Prisoners should have more access to mental health services, and prisons should be focused on treating and caring for prisoners who are struggling with mental health issues. And of course, prosecution already exists today, so prison reform changes nothing about prosecution, it would merely improve conditions for people forced into that system who have mental disabilities. Call it what it is -- prison, and then lets make prisons better. Sure, I'm on board.

But wait. Is that what people are calling for, even in this thread? People here are advocating that the government should have the ability to forcibly commit someone to an asylum. Well, wait a second, don't they already have that ability? What ability are workers currently lacking? They can forcibly commit someone to a prison once they've committed a crime and have been prosecuted. That system already exists, we have sentencing for crimes. So what do they want?

The fact that people are talking primarily about needing the ability to forcibly commit people indicates that they don't believe that police or judges or the legal system has that ability right now. They are arguing that current abilities to imprison people are not enough. They believe the State should have more power to forcibly imprison people than it currently does and that under certain situations the State should have the ability to expand prison sentences, possibly even indefinitely.

Otherwise they'd just be talking about prison reform and this wouldn't be a debate at all. Nobody is against prison reform[0].

----

[0]: Well, okay, many many people are against prison reform, but nobody who is worth paying attention to when they talk about justice or human rights or care for the mentally ill is against prison reform.

>People here are advocating that the government should have the ability to forcibly commit someone to an asylum.

The state already has the ability to forcibly confine people. We just think that some people would do better in a hospital than a prison.

I think you should be honest that you're talking about putting people into a prison and then calling that prison a hospital.

And given the state of prisons in the US, I know what that "hospital" would end up looking like. And I think it's kind of weird and very vaguely gross to try and distinguish. There really aren't many reforms or programs for an asylum that aren't applicable to existing prisons -- normal prisoners deserve mental health services.

That people so intuitively understand that prisons are horrible places for people with mental disabilities should not spark you to try and create Prison 2.0 Deluxe Hospital Edition, it should spark you to try and make Prison 1.0 less horrible for everyone.

Politically it's much easier to sell "prison type 2: mental hospital edition" than it is to make "global prison: sweden edition", much like they have low security / high security prisons.

It's a classic case of perfect being the enemy of good, and it's a major reason why the USA has problems like this, because of it's vetocracy structure.

IMO the first step to prison type sweden would probably be getting rid of the drug war and dismantling the DEA, much of the 'load' comes from that.

> Politically it's much easier to sell "prison type 2: mental hospital edition" than it is to make "global prison: sweden edition", much like they have low security / high security prisons.

On one hand I agree that it would be a lot easier initially to sell the idea; on the other hand the public sentiment around prisons as they exist today and the unwillingness to treat prison residents as if they are human beings is a fundamental social problem that will corrupt attempts to build compassionate and helpful asylums.

I don't believe there's a shortcut; our prisons are horrible in part because society tolerates that. They will also tolerate abuse in mental hospitals, they will also very quickly dehumanize people who are committed to mental institutions. And very quickly you will find yourself in the position of needing to argue for basic human rights inside mental institutions and realizing that the same people who are antagonistic to prison reform are also going to be antagonistic to treating the mentally ill with dignity and respect.

That you feel that you can't really effectively argue for general prison reform to the general public is the canary in the coal mine. Your instincts are correct, you do not live in a society that cares about the rights of prisoners. Attempting to trick that society into caring about some of those rights by renaming prisons to hospitals... it's not going to work. The same people will vote and will have the same attitudes about segments of society that they would prefer please go exist someplace else where they can be ignored.

It's just going to be prison 1.0 with a different name on it. If you can't convince people to care about prison 1.0, you also will not have a defense when those same people stop caring about prison 2.0 for the same reasons.

Honestly, if anything having a different name on it will make it easier for the general public to ignore abuses in both asylums and regular prisons. The sentiment will be that asylums are "nice" so they're obviously caring for the sick people who don't know better, and mental health in prisons isn't a problem, those people go to asylums. And since asylums are nice, why do we have to wait for people to commit crimes? It's not like we're sending them to prison. And on and on...

I just don't think there's a marketing trick that can be done to get around that problem; it's reinforcing delusions people have about the justice system rather than correcting them. We have to actually do the work to change social views on prison.

And I think the distinction itself is kind of unhelpful for that effort. To be very clear, mental institutions and asylums are prisons. If saying that out loud rubs people the wrong way, it's because we know deep down that our current prisons are awful places and we all (myself included) desperately want to figure out some excuse to use so we can say that sympathetic human beings don't go there. Telling the general public "they don't deserve to be in prison, they deserve to be in a hospital" is in many ways just allowing people to feel less bad about the people who are in prison, it's a way to allow the general public to continue clinging to the idea that prison isn't about rehabilitation or treatment or safety. It's a way to allow the general public to shrug when people are sent to prisons because "it's just a hospital." But calling prisons a different word doesn't make them not prisons, it just makes us feel better about putting people into them.

> You could simply be protesting while black or female,

do you have any sources for the occurrence of such events in the latter part of the 20th century?

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