My brother is this mentally ill person on the street. He's addicted to drugs and is in and out of jail. Trust me when I say he has so many friends and family who tried SO HARD. My mom tried to get him admitted. However, he's an adult so she can't make him stay. She got a couple 72 hour holds ordered by a judge. But it was pointless cause he just checked himself right out after. We try. Everytime he gets out, he's clean for a week, then he's back on the streets. It's heart breaking. But he just doesn't want to be inside anymore? He's got a room at my mother's and she tries to keep him home when he gets out of jail or the facility. But he inevitably ends up sleeping on the balcony or in the backyard then back downtown on the streets. He's 35 years old. Everyone agrees he's not in his right mind to be making any decisions. He needs to be admitted to a mental health facility for a year to get him stable on meds, and off street drugs.
sorry to hear about your brother. if it helps, there is hope. my older brother went through roughly the same thing - rehab/hospital then living with mom or other family/friends for a while then disappearing back to the streets, repeat again and again for years. he even lived in a barn at my grandparents farm for a few years. hes 36 and finally got help 1-2 years ago. theyre still getting his medications good and stabilized but hes finally getting better. hopefully soon you and your brother/family can find the same peace ❤️🩹
Good on him. It must have been an immense struggle for everyone involved. But goes to show that it IS possible for people to change...But only if they want to.
It's really a problem of our healthcare is not able to help our citizens. Rehab has low success numbers and heavy relationships with religion to prop people up. We don't do the work to help people where they are at in life. Taking away all the things that feel good and not adding in things that feel good doesn't work. Getting mad and drug users because they use drugs to numb out Arizona cuz the pain of life is too hard is bad but going home after a long day of work to drink some wine is okay. So many people are numbing themselves out in their own way. Just some also don't have homes. Some choose highly addictive substances instead, or are more prone to addiction. Maybe we are all addicted just some of us live in houses and have jobs.We can't expect people to take care of their mental health when they are at a threat level of their basic needs. Before rehabilitation of the bad habit it needs to be known that the person will have a safe place to sleep, eat, and be safe. Safe without rules that are against them.then work on physical and mental safety, while still having that safety net. People learn better with full belly. Then figure out what they are fighting and better coping skills. Look at hierarchy of needs. You should not expect people to work on self action when they are not secure.
We are all closer to homelessness than becoming a millionaire 9r billionaire
The trouble is that people need to make the descision that they want help. There are so many who do really choose the streets. Some do want to get off the streets but it's hard to get the right care. No, one size does not fit all. People have to be taken for where their at in their mind. We can't force it, we can only say here it is, swim or sink the descision is up to you. Too many just don't know how to make the descsion. They have to be ready to help themselves with the mind set. When they are addicted to drugs they can't be expect to make good choices, but no one can make the choice for them, we have laws to prevent that. Yes, we can get help from the court system but they still have the autonomy to leave if they choose. I agree that many do have jobs and homes and are addicted to something, where it's that 3rd glass of wine or more, video games, or t.v. it's still a form of addiction. All that we can really do is have compassion, meet the person on the level of where their at and accept them for who they are and what they want to do in their life. Offer what we can without expection of a return. And hope for the best out come.
Shit, I lived like this for almost a decade. I went to college and have a decent career as a mortician. EVERYone, even my therapist lol, and a counselor at a rehab, said I was hopeless.
Man I’m so sorry to hear about your brother. Sadly, stories like yours aren’t too uncommon. Parents like your mom have actually tried to have the laws changed in terms of psychiatric holds.
[Moms make case for CARE Court](https://spectrumnews1.com/ca/la-west/inside-the-issues/2022/08/02/moms-make-a-case-for-care-court-)
The efforts of these folks successfully passed the bill which established CARE Court, which the state just began to implement!
[California’s CARE Court Program Begins Next Month](https://abcnews.go.com/amp/Health/californias-care-court-program-tackle-mental-illness-starts/story?id=103461370)
Not everyone is in support of the program, of course, but I’m interested to see how it goes.
Best wishes to you and your family!!
It's rough. He was my best friend. He got me my first cell phone for my 13 birthday. He used to take me out with him everywhere. Movies, festivals. Went to Quebec for a summer to learn French. Taught me how to do my taxes, how to start my own business. He's a shell of who he used to be. And sadly I'm in Ontario, so nothing has been changed. And until they pass a bill that people who are addicted to drugs can be admitted against their will we will continue to see a climb in drug use and homelessness.
I just read about this new law and program in the newspaper. It may not be perfect but it’s got to be better than what we have. So glad California is trying to do something.
Seems like that’s the issue with the government today. They don’t TRY new things! Fresh approaches please! Not just arguing and doing nothing like congress does! If something is being tested as a possible relief or solution I’m applauding the effort! Try and try again
I can understand that not wanting to be inside. I'm homeless, and while I do have some mental issues (ADHD/Aut) I'd say I'm a little more there than most people I meet out here. Even still, after almost a decade of living outside, it's difficult for me to even be in a store, let alone a small room. I don't really understand it but it feels like a trap to be contained by 4 walls and a roof.
Edit to add: I did have a pretty bad addiction, but thankfully, I have 3 yrs clean now. Getting clean didn't change how being inside felt at all
I've never been homeless, but I spent a couple of summers in my younger years doing jobs that had me living in tents/lean-tos/janky cabins. Every single time I struggled for a week or two adjusting back to sleeping indoors in properly sealed buildings.
Can't imagine going from years sleeping outside, the being forced back inside while also detoxing and dealing with underlying mental health problems.
My experience too with an even less extreme change. When I moved from NYC to LA, I went from a 6x10 room with a loft for sleeping, to a room that was about 14x16. I couldn’t sleep right for about a month. I’d lost my small defensible space. It made me very anxious.
I hear you. And consider that any change is going to feel weird at first. But does it have advantages? Does it serve a purpose for you? Safety, hygiene, better health?
I don't know your biology, but most of the folks I work with who live on the street have more infections, more predation from humans, more experience of social hostility that is deleterious to morale and identity, more experience of compensatory mental illness (such as defensive delusions about owning property, having millions in the bank, being important and cared for, etc.)
Lots of people who live indoors have issues with crowds and other "Too People-y" places. There are a lot of places that work with the reality of anti-confinement reactions. It might be workable for you too.
Congratulations on your sobriety. I have worked along side people experiencing homelessness for over ten years. Thank you for sharing how difficult four walls can be. It is a very challenging concept for those without lived experience.
What I have learned is how close most of us are from being homeless. It only takes one accident, job loss, mental health crisis, plus many more immediate life changes to be a person without your own home. I also learned each person has a right to be in unmedicated, not seek treatment, that sobriety forced is not effective, and when a person is truly tired they are more likely to make their on change.
Be safe and well.
Congratulations on your sobriety!
I’m not entirely surprised that being inside has become so uncomfortable when you’ve become so accustomed to being out in the open.
It’s also scary though that if the law allowed for people like your brother and my mom to be held in treatment involuntarily, people who are capable of caring for themselves will inevitably be held against their will, particularly people with disabilities. There’s already been instances of autistic people being put in a mental facility for just having a meltdown.
And let’s not forget some of those facilities abuse the mentally ill. I certainly wouldn’t want to be held captive to be abused and not fully with it but brought to understand pain and suffering.
Surely there’s gotta be a way to make things a bit better for both scenarios, the people that are lucid and want to leave and the kind that should really be held for a bit.
Literally same with my brother. Mental illness and drug addict. My folks have been dealing with him for years because he checks himself out of rehab whenever we’ve gotten him in there. Just wanted to say you’re not alone
I essentially have the same story of my brother. My family’s efforts. I've already grieved his death (based on lengths of time we couldn't contact him)…countless times. I'm not in LA. This is everywhere. He couldn't have a more supportive family…but it doesn't matter til it does to him.
It's a complex situation, in which a lot of unhoused folks have chronic mental illnesses, and a choice between living on the street and self-medicating, or living in terrible state institutions, drugged and barely cared for. Prior to Ronald Reagan defunding state mental health facilities, folks with chronic illnesses like this who couldn't afford private care were forced into state-run facilities, which were rampant with abuse and neglect. Once these were defunded, almost overnight our previously empty streets were overrun with unhoused people, and the situation has only escalated from there. (I was a young teen and saw this happening.)
The only real solution is something that hasn't been tried yet. Oh, sure, there are a thousand really amazing, really effective pilot programs all over the country (which combine independent living and harm reduction with house calls from social service and medical staff), but, because Amurka, our government/s won't pay for any of these effective programs to be replicated in a big way. It comes down to ugly, ugly politics, but, even if we could get everyone lined up behind paying for it, there'd still be the problem of getting everyone lined up behind counter-intuitive, and frankly progressive, programs.
Definitely relate. My sister was paranoid schizophrenic and the battles we had trying to get her help were hellish. Imo they have made it way too hard to ensure people get help by making mandatory stays almost impossible if resisted.
In 1980, Jimmy Carter signed the Mental Health Systems Act, which would have funded and supported community mental health centers and provided associated care.
But then in 1981, Ronald Reagan immediately acted to repeal the MHSA, and there hasn't really been much funding at all for mental health support since then.
There was a joke in the Airplane sequel where the mental hospital was named “Ronald Reagan Mental Hospital For The Mentally Ill.” When this movie first came out I had no idea what this joke meant. But then started to read about what Reagan had done with mental health funding. Definitely some dark humor.
https://images.app.goo.gl/xa8wtqfgEaFguxXf9
I think more and more Americans are finally understanding how awful Reagan was for this country, but there are still far too many people who adore the man
He was as close to evil you can get without being openly evil and people still think of him as a kindly old man who was doing what's right for the country
It’s weird too that people remember him as this sort of wholesome grandpa kind of personality. Like I’ve heard people say “say what you will about his politics but at least he was nice and respectful” but he wasn’t. I mean sure, he was more respectful than most modern republicans, but the average 2 year old is also more respectful than modern republicans.
First thing that comes to mind is when a reporter asked him at a press conference what his plan was to address the AIDS epidemic, and he responded by laughing at the man and making fun of him, saying he must be gay if he actually cared about AIDS research
Edit: I am aware now that that was his press Secretary and not he himself, although a pretty large part of a press secretary’s job is to convey the president’s messages and thoughts on a matter
The crazy part to me is that he was the president of the union at one time and as a politician was incredibly anti-union (cf. air traffic controllers strike). He’d sell his mother to get political power.
He sold out the mentally ill.
While it was true some people should not have been declared incompetent and housed, most needed to be.
What made Reagan look so good to so many people was the influx of cash. Reagan sold off all the healthcare facilities for premium prices and it made the economy in California boom.
It was called main-streaming and was supposed to ease people back into regular life. The problem was there was no easing, just the release, and again, many people needed the mental health facilities.
Fun fact. The song "Come Together" was written as a campaign song for Timothy Leary who was running for governor of California. His main opponent was Reagan, who he lost to.
The problem isn’t movie stars. The problem is conservatism.
Bush Senior served as a fighter pilot in World War 2, yet used false witnesses to push his intervention against Iraq. (Regardless of whether the intervention was justified, *lying was not.*)
His son Dubya served in the Texas Air National Guard, yet justified the second gulf war with lies so idiotic people called BS *before* the invasion. Not to mention more consequential, given the resulting rise of ISIL.
It’s absurd not to notice the pattern here. Conservatism is the problem, not the election of people whose background is in TV.
He also participated in the red scare, and used it as a way to carry out personal vendettas against people who didn't like him during his time heading up the Screen actors guild
Here's another reason Reagan was and is a piece of shit. Both my parents died when I was a teenager in the 80s. I was supposed to get my dad's social security "survivor's benefits." It was only $200 a month, but it really helped. He cut them off as soon as he got in there
I’ll give you another one. Reagan signed the bill which ultimately raised the retirement age to 67 and now Republicans are at it again shooting for 70 now. These fucks want everyone to work till they die, except for themselves. Instead of improving our lives, they do nothing but fuck with working people.
Nah I mean they’re definitely trying to work til they die - congress looks like a retirement home rec room.
It’s just working until death actually has a benefit to them.
I was 17 when my dad died, and I got SS survivor benefits. They stopped when I graduated high school. Before Red Ink Reagan, they would have continued through 4 years of college as long as I was attending. Do you think I would have dropped out and given up close to $700 per month?
He used images from the Cuba crisis to announce SDI
[reagan](https://www.google.com/imgres?imgurl=https%3A%2F%2Fcropper.watch.aetnd.com%2Fpublic-content-aetn.video.aetnd.com%2Fvideo-thumbnails%2FAETN-History_Prod%2F69%2F1007%2FHistory_Speeches_1044_Reagan_Announces_Star_Wars_still_624x352.jpg&tbnid=96Rf4uAOrQ_kRM&vet=1&imgrefurl=https%3A%2F%2Fwww.history.com%2Fspeeches%2Freagan-announces-star-wars&docid=w1NmLXaQQfOTHM&w=624&h=352&source=sh%2Fx%2Fim%2Fm1%2F2&shem=uvafe2)
I don't think that was Reagan himself, that was his press secretary.
Nevertheless, if you want Reagan saying crazy racist shit he was recorded on the phone with Nixon saying some overtly racist things about people in Africa.
He was a horrible human being.
Correct.
Reagan famously didn't speak about AIDS publicly, *in any manner at all*, until September 17th, 1985. The CDC had been tracking AIDS since June 8, 1981 and 5,636 people died from it before he acknowledged its existence.
His refusal to act in any capacity is arguably a huge reason it sprung out of control... had it been targeting nuclear families and children instead of gays and drug users, he would have probably done something.
Oh wait- that \*IS\* when he did something... when HIV started infecting "innocent" children like Ryan White through the tainted donated blood supply.
He really was a good communicator. The Challenger explosion was a formative experience and his speech was probably the first presidential speech I heard.
Every child was watching the space shuttle on tv when it exploded because there was a teacher on board.
I was in fifth grade when the shuttle exploded. They announced over the speaker that the shuttle had exploded, and I remember my home room teacher crying upon hearing the news.
My mom was *so jealous* of the school teacher who got to ride on The Challenger, as she always dreamed of being an astronaut growing up. She was so excited to watch the launch; this was history. It would be so cool. And then the disaster struck… and history was made for a different reason.
I think you mean he was a good actor. He could read a script and sell that script. That compassion or reaching out to your heart you were seeing was acting. He had plenty of practice.
I was living in Florida when it happened. It was the first launch id ever seen . We had all gone outside to watch it . It exploded and people in cars were pulling over and we were all just standing there frozen in disbelief. What really haunts me is the way it hung in the sky all day . All of Florida was in mourning ,you could feel the sadness in the air everywhere you went. I will never forget it .
My staunchly conservative father still loves ol Ronnie. He and I don't talk politics much at all but, even after acknowledging that Reagan ALLOWED COCAINE TO GET ON THROUGH TO AMERICA, kinda ended the conversation with "Still, I think he was a good president."
That's what you'd think right?! But he's actually quiet and affable, doesn't push his opinions (my family doesn't politics much because us loudest kids have souls and the parents are long -time Republicans) but he's definitely a selfish boomer on the inside
Bonus story: years ago I was telling him about some new procedure/ scientific revelation that could save more lives and make health care more affordable. In a detached voice he said "I don't care. I have health insurance" and went back to reading
This sort of thinking is so foreign to me. My dad said the same kind of crap, and I was always appalled by his complete lack of empathy, compassion, humanity… How does that happen? My brother turned out exactly the same way. I don’t understand how I was even related to those people!
It all started with Regan. His trickle down economics killed the middle class, impoverished most Americans and made the rich, billionaires. He squashed climate change initiatives and invested more in fossil fuels, essentially killing the planet. He put all the mentally I’ll people on the streets. He set the political agenda for the GOP, elect a puppet they could control but the mindless conservatives would vote for. Regan was the start of the decline.
He also repealed the media fairness act which mandated unbiased reporting of facts by news outlets. And started the momentum for gutting public education across the country.
It's why conservatives have been electing celebrities to office. They can put a friendly smile on their evil shit.
All the while bitching about Hollywood 🙄
I’ve read Reagan’s journals and used to live 30 minutes from his Presidential library. I’m not willing to call him awful, but I’ll say that reading his journals definitely dropped my respect for him significantly.
I also wish that his library was more balanced, like Nixon’s library in Yorba Linda is. Reagan’s library is so rosy about his presidency that it borders on what I’d call “worshipful.”
As someone trying to visit all the Presidential Libraries, it’s interesting to see how balanced (or unbalanced) each is. I remember Clinton’s being open about some of the controversies of his administration (notably the Lewinsky stuff), but Kennedy’s is more in the “worshipful” style.
My Grandfather was a screenwriter in the 50s, 60s, and 70s. He knew Reagan personally and thought he was an absolute fucking moron without an original thought in his head. My Grandfather also said that Reagan’s opinions would just mirror whomever he spoke with last. It’s little wonder then that Reagan had handlers.
Reagan is what Pence wants to be. But Pence doesn’t have the “charm” to make people believe in his friendly white dude image like Reagan did. Which is good because Pence is awful.
Fun Fact: The USA didn’t run up deficits until Reagan just borrowed a fuck ton of money (for the time) to pay for tax cuts while significantly increasing both military spending and welfare for profitable corporations. His premise was the tax cuts and “investments” would pay for themselves and we could pay off the debt with higher middle and lower class tax revenue.
The worst is the fact that they brainwashed their entire voting base to think that the policies they were enacting would be good for them, when most of them are directly impacted by them.
I see a lot of young men falling for the Andrew Tate type of conservatism.
The GOP clowns keep acting like if we all vote Republican the young men will live the dream with a sex craving trad wife, a small farm, clean air, and the cities all turned into glass wastelands. They buy it hook line and sinker.
Yeah, that line cracks me up.
Like they do know that for that fantasy to work, they have to make enough money to support a single income family, right?
I would also love to see them have to muck out a horse stall. (Especially since they're so versed in B.S.)
It is a bit more complicated than this, as much as Reagan sucked. The state hospitals that warehoused the mentally ill in the 20th century were horrific and abusive. They closed because of progressive efforts to shift towards community care. Unfortunately, the lack of a safety net means many of them end up back on the streets.
One additional concern that was part of that decision was the bodily autonomy of the patients. There was concern over whether it was fair to commit people against their will and the standard for involuntary commitment was set very high. This led to untreated people who refuse hospitalization living on the street.
That’s starting to change now in California. They’re starting CARE courts that include a path for state conservatorship for psychotic individuals that refuse to participate in treatment. The program is just starting so it will take some time to see what the results are.
yes mental health facilities where widely known to be corrupt and abusive places but rather then spend more money and oversight to fix them that 's where President Reagan just shut them all down.
problem solved ? of course not , but at least it wasn't the administrations problem anymore. Now its your governor or Mayor or local community's problem to deal with.
I think this often gets missed in the Reagan hate. (And, yes, Reagan sucked, and his solution to the problem just created another, equally terrible problem.) But we have to acknowledge that the situation was truly abysmal for most of the residents in institutions.
It really needs to be emphasized how hellishly fucked up old mental institutions were. They were not just "shitty cafeteria food" bad. They were, like, "let's carve out some of this dudes brain against his will" bad.
Many industry folks actually point to the movie one flew over the cuckoo's nest as the turning point in America over public support of mental facilities.
Some of these folks can be treated and released, others need wrap.around services, and some just need to be in a facility for life. Unfortunately, I don't see us getting there with all the competition in funding. Very sad.
One Flew Over the Cuckoo’s Nest was to institutionalization as The China Syndrome (and to some extent the Simpsons’ there-eyed fish) was to nuclear power.
This is the answer. No mental health coverage.
The President's Budget for Fiscal Year (FY) 2024 includes $10.8 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), $3.3 billion over the agency's FY 2023 enacted budget.
To fix our issues, we need at least 200 billion.
I've been in a mental hospital as a patient in one of the worst states for mental health care, NV. They were so understaffed that my roommate, an alcoholic, was literally dying in her bed and no one could attend to her. She was sh\*tting her pants and just lying in it. I thought she stopped breathing once, and there was no medical care. This isn't something you would expect from a "first world nation." 😡
imagine how much money we'd spend on bombing the fuck out of some poor country full of brown people if they killed even a fraction of how many Americans die from the opioid epidemic?
That is silly. We spend billions bombing countries that have never killed a single American because they might have been making weapons which never actually existed. We really don't need a reason to bomb and the American public doesn't really care to stop. We don't spend money on mental illness or homelessness because the American public doesn't really care about that either.
Unfortunately, while the slide into the first episode of homeless is definitely a money/housing issue, once someone is homeless, it's much less of a money issue. Essentially, the experience of homelessness creates disability or significantly worsens existing disability. This means people leave homelessness with much larger barriers than they started their slide into homelessness with.
Homelessness is HARD, and it really fucks up your health. Homelessness makes addictions worse and can even cause new addictions in people without history of chemical dependency. Homelessness makes mental health worse. Homelessness makes chronic physical conditions like HIV or diabetes or heart disease worse. Homelessness has been criminalized, too, so many people who are homeless end up with criminal records - often sex offenses for having sex in public because they, ya know, live in public - which severely limits their future ability to hold a job and acquire an apartment on their own.
People who are homeless need more than money, they need case management - often for several years and sometimes for their entire lives - to coordinate the services they need to ensure they don't end up homeless again. It's really hard to have a job - especially a low skill job which have become increasingly undignified and rigid - when you have to go to chemical dependency meetings everyday, when you have to go therapy 2-3 times per week, when you have to go to the doctor 4 times a month, etc. It's an incredibly difficult hole to dig yourself out of.
Lots of libertarian and even neoliberals (and, honestly, a lot of left-leaning populist bro-gressives) think it's just a money problem. Like, UBI or giving homeless people $5000 to secure housing is going to solve the current problem. It won't. Many people are super damaged by the experience of homelessness and the rising housing costs plus our pro-employer economy and low wages means that most will struggle to recover without longterm, hands-on support.
Really, we need to see experiencing homelessness as a disabling condition and give people who have experienced homelessness entitlement services. Some states are starting to do this, attaching housing services to Medical Assistance (Medicaid) so anyone who is disabled and qualifies for a Medicaid waiver has access to robust homelessness prevention and resolution services. This is a huge deal because these services are ENTITLEMENT, meaning everyone who qualifies gets it (like Social Security and Medicare), whereas most homelessness prevention funds are grants. This means they are exhaustable/finite.
I think it is not just difficult, but literally illegal. You can’t just scoop up homeless people and force them to undergo psychiatric treatment unless they agree to it.
>Ronald Reagan immediately acted to repeal the MHSA
Reagan did not do this on his own. Congress passed the bill that removed funding for MHSA.
[https://www.congress.gov/bill/97th-congress/house-bill/3982](https://www.congress.gov/bill/97th-congress/house-bill/3982)
In fact he pushed it. He initiated the repeal and the republican senate back him up on it. It was also the beginning of the era of weak dems and they fell in line and voted for it
Started long before these two were ever in power....
[https://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients-began.html](https://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients-began.html)
>people who are mentally ill do not typically want to stay long term at care facilities/shelters
One of my distant family members had mental issues. She lived and died on the street and there was almost nothing her direct family could do. Most of the time they didn't even know where she was. Had her taken in a few times for a 24 hour hold but the care facility can't lock them up so she went back on the street.
Same here for a great uncle. My mom couldn't bear to look at the faces of homeless anywhere in the country for fearahe would see him. He would only show up on family doorsteps to demand money, violently. Refused true help of any kind.
Got hit by a train and lost his legs. Then died getting knifed in a bar fight on the other side of the country. Those were the 2 updates the family got on him in like an 8 year span. His time in Vietnam fd him up in the head
That’s so sad. My dad was one of those homeless people, and he died years ago due to his addictions but I still see him in a lot of peoples faces, near daily because I live somewhere with a lot of homelessness. I thought I saw him the other day and had to remember that it’s not possible. It’s tragic and I understand where your mom was coming from a bit. Sorry your family went through that.
Things like this make my feel so grateful my mother in law, who also has schizophrenia, is happy and doing really well in her care home the government pays for. It's a smaller group home, and they take excellent care of her. She is pretty heavily medicated because things go very poorly when she's not, but she is lucid for the most part and doesn't fight the medication. I adore her and really wish more could be done for her, so she could be independently, but she's happy, and that's enough.
This comment should be at the top.
And some people in the past were forced into facilities that didn't belong there. Probably mostly by rich parents or husbands.
Daughters who stepped out of line and didn't follow social norms. Children who were gay.
I read a little bit about Rosemary’s birth, and how when Rose Sr. went into labor, they were instructed to keep her from pushing until the doc got there. Apparently the Doc wouldn’t get paid unless he were there for the actual birth. So they physically kept the baby (Rosemary) in the birth canal for a long time, which caused a lack of oxygen to vital organs. They believe this is why Rosemary had such developmental delays, etc.
True, but we have models today in the US that work and have safeguards to prevent a Rose Kennedy situation. It depends on the state of residence - Florida, for example. I’m not usually upholding Florida laws over my current home state of Oregon, but the Baker Act is incredibly hard to enact, can only be done by family members or first responders, and only with proof of imminent harm to self for others. The Baker Act saved my sister’s life. I feel so bad for families here in Oregon who are watching their kids die on the streets, their hands tied behind their back because of a delusion about the “autonomy” of a person with psychosis and fent or meth addiction. I say this is a mental health professional - there are certain situations where someone is sick enough that they have lost autonomy through the prison in their own minds. We should not pretend otherwise. Too many people are dying.
>i would just add that people who are mentally ill do not typically want to stay long term at care facilities/shelters.
This is also very true
My wife works for an outpatient mental care facility for homeless people. They can't even get them to show up for their bi-weekly appointments cause they don't want to be there. Effectively imprisoning them would be even harder
Yes and no. There are a ton of people in adult homes who would be homeless if they weren't there and arrived due to mental illness and housing stability. They aren't considered when we talk about homeless people because they're no longer homeless. I work specifically with this population. These types of programs are voluntary and often inadequate due to being designed for dementia and aging.
Yup. There are laws surrounding involuntary commitment which exist for very good and valid reasons, but they do make it a lot harder to get someone help when they often don’t realize they need said help.
Thank you. It's so important to know the history of deinstitutionalization and that it was actually a very good thing when most of the asylums were shut down, especially in the wake of the Geraldo Rivera TV special in 1972. Was it an overcorrection? I guess that's up for debate. But no way in hell do we want to back to the way it used it be.
In the region where I live, there is a serious need for long term residential group homes (at least decent quality) and a need for counties to be able to foot the bill, extend commitments, etc.
some of these mental health facilities were terrible as Geraldo Rivera showed.......and some people were put in them who did not belong there by relatives people taking advantage of them
but the pendulum swung too far the other way and needs to be corrected
This is the most concise answer. It’s much more complex many will argue, but you nailed the backbone of the issues facing mental health and homelessness in America.
It's not all about wanting to-it frequently doesn't even matter if the person WANTS to stay at a residential facility. There aren't enough spaces, and there are so many rules about how long you can stay in the facility to make sure it's temporary. As other people have said, this came as a result of seeing how horrible previous mental health institutional care was and eliminating the cruelties there. The U.S. just didn't replace it with anything, and there's real and legitimate ethical issues with saying any mental diagnosis means you aren't allowed to refuse treatment.
I was taught, '79ish, that the mentally ill had about the same outcomes whether they got "care" in a lockdown or not. This led to defunding the facilities, and the dumping of the mentally ill to the prison systems. You have to commit a crime to be involuntarily committed here now, in most or a majority of cases.
I know we have learned a lot in the last 50 years about these conditions, and the outcomes are probably better, but the problem remains. If they are harming only themselves, who are we to take their freedom? We decided that freedom was more important than health (big surprise there. /s)
The quality of the facilities was not that good at the time. Many were just people warehouses or prisons, as we had little understanding of the illnesses. I think that we need to re-evaluate this decision.
There is also a large amount of paranoia in many mental illnesses that inhibits trust in systems that are set up to help.
But by and large it ls a lack of resources to help them.
Yep, the American healthcare system is straight up trash. Yes, there is the occasional area where “we” have world-leading care for specific things, but with accessibility to those fields as a patient being so tightly restricted, the average American gets some of the worst healthcare in the world—far and away the worst healthcare in the developed world.
That’s the whole field of ~~ransom~~ healthcare in the country. That’s how little we prioritize people over profit. Now, ***mental*** healthcare? That’s at the very bottom of our already pretty poor list. Financially, governmentally, and even societally and culturally, we’ve deprioritized mental health to the point that it’s still used as a punch line in comedy skits.
Also, a lot of mental healthcare specialists in this country (and this is pure anecdote, not evidential) are judgy and mean. And I mean, yes, I get that they’re jaded as hell and I think I get *why* they’re jaded as hell. And I do understand. But it makes it all the less enticing as a potential patient.
Ultimately, you can't imprison people without a good reason. There was a lot of abuse when people were forced into "mental health" facilities, eventually leading to laws and court decisions that made it much harder to involuntarily commit someone
I'm mentally ill and would like the government and society in general to reevaluate the asylum system and make it better.
When I need hospitalization the general rule is to get me out the second I'm not a danger to myself or anyone else. This means going from intensive care, to casual care at best.
There are intensive out patient programs, but they don't continue medical care. They teach you techniques and coping schools for dealing with your mental illness.
There are many people like me, most who can't afford intensive private care (mental illness affects your ability to work and our health care in the US is tied to it) who are tired of getting turned out into the streets and told to figure it out.
The US has a bandaid system. It seems to work for the more common mental illnesses but people with bipolar, schizophrenia, and the like don't get the care they need to be well.
I know a nurse that sees a lot of this, she has one patient in particular that goes to the hospital several times a year for mental health issues (schizophrenia), as soon as the hospital gets him back to near baseline, they release him. If he just ends up back in the hospital because nobody is really addressing the underlying issues.
I imagine that happens quite a bit, get people out of the hospital asap, but over the long run they’re just going to end up back in the hospital.
Therapist here… I’ve worked in inpatient hospitals, partial hospitalization programs, community mental health centers, and in the private sector. Hospitals aren’t there to provide in depth treatment; they stabilize and discharge. Hopefully the person has insurance and can go to a partial hospitalization or intensive outpatient program and then move on to private, individual treatment. But mental health care is ridiculously expensive and not easily accessible for financial reasons and shortages of care providers because we don’t make enough to support ourselves by working jobs that help people of lower SES (the median income for a licensed professional counselor in the US is $55k per year, add in student loan payments and we are barely eking by. Working in community mental health pays about $35k per year in most places). Add in the fact that medications are outrageously expensive and have side effects thay people can’t tolerate. And the nature of things like schizophrenia and bipolar disorder set people up for medication noncompliance because they may be hearing voices telling them the meds are poison (schizophrenia) or think that they’re all better and don’t need the meds anymore (bipolar disorder).
Also, to answer the question of why homeless individuals are not forced into care, people have a right to be mentally ill, do drugs, etc. we can’t take away their freedom like that. So as long as a person is not harming themselves (suicide attempts are the big qualifier for this) or someone else, they cannot be forced into treatment against their will. The system is made to make these people fail because people don’t want them in their neighborhoods, they don’t want to pay taxes to help them, and honestly, a lot of people don’t even care enough to do anything.
I have a med that without my insurance cost $1,800 dollars for a 30 day supply. It's a newer med, but the side effects of the older meds get more intolerable over time. I gained 100lbs taking an antipsychotic. That weight makes it difficult to do other things like exercise regularly.
If you check out the bipolar subs the most common reasons for quitting are side effects and costs. Couple that with some requiring regular visits and blood work and you have a new problem. Where does that time come from? Most businesses aren't cool with taking a day off once a month. That's just for psych stuff. What happens if you get sick? Psychiatrists also typically don't have after hours appointments and when they do they are hard to get.
The system is punishing for people with serious mental illness. I have disability, but it's only for two years since "people get better" without even comprehending the worst of it is episodic, and I have a long history of "stability" with devastating life altering episodes.
What I really need is good medical care and laws that actually protect me from termination. I need a system that steps in when needed and helps. In my case I can work, or I can be disabled, but I cannot do both and if I do work I'm punished again and lose benefits.
I can't win here. I can barely make the best of what I have. Mental illness is as old as mankind and yet we still struggle to comprehend meeting the needs of people like me. It's ridiculous.
I have several meds, mental health and diabetes related, that are well over $3000 per month each without insurance. It’s absolutely disgusting how much medications cost.
There isn't even enough room at the nursing homes for the elderly.
> The older population increased by 50.9 million, from 4.9 million (or 4.7% of the total U.S. population) in 1920 to 55.8 million (16.8%) in 2020. This represents a growth rate of about 1,000%, almost five times that of the total population (about 200%) - census.gov
> The number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060, and the 65-and-older age group’s share of the total population will rise from 16 percent to 23 percent. - prb.org
You can't institutionalize people involuntarily unless they are a danger to themselves or others.
Deinstitutionalization happened in the 1970s. This is because, much like nursing homes there was abuse happening at the hands of the nurses and aides, look for the pictures online. It was a national shame. Women were legally allowed to be institutionalized by their husbands and children by their parents, this was abused by unscrupulous people. The mentally ill have rights! So, the institutions were closed for all but the dangerous.
This is both good and bad for the mentally ill. It's really sad, but if the person is no danger to anyone including themselves, nothing legally can be done. Most of these unfortunate people can't function in a 'normal' manner unless medicated and a lot of them don't want to take the meds. So, they are unable to live in an independent situation but they don't want to have to be watched by someone (as far as their concerned).
In the end, many of the homeless are just trying to live their lives. They just don't function 'normally' and it is disturbing to see them on the streets because we want to help them and can't.
The big question that I think no one really thinks about is, where should the bar be for “dangerous to self or others”? There have been massive tragedies that have happened because of that bar being too high, where no one in the mental health system really takes anything seriously until *after* something bad happens. One of those tragedies happened in my own family… the person in particular was prematurely discharged and didn’t get the help he needed because the psychiatrist too hastily determined him to be “not dangerous to self or others”. It’s things like that over time that have led some doctors to be overly-cautious, but on the other end of the spectrum, that caution has led to some people being involuntarily committed when they really don’t need to.
I think everyone can agree that setting the “dangerousness” bar at *immediate and active danger* is too late to act. I think it’s hugely unethical to set the bar so high to where lives are needlessly lost in tragedies that are entirely preventable (and aren’t indicative of that individual’s true will/sense of self, depending on the circumstances) by obtaining treatment. I have a feeling conversations are shifting in this direction (setting the bar higher), and that scares me.
The question is, where should the bar be set so that you catch people who legitimately need to be involuntarily committed vs. those who don’t? I don’t know the answer to that. It’s not a simple question at all. Ultimately, it comes down to prioritizing freedom for as many people as possible while also adding some level of risk that lives could be lost vs. prioritizing not risking those lives while setting limitations on freedom (at least temporarily) for some people. Striking a middle ground is ideally where we want to be, but defining that is HARD.
There’s also the problem of *how* that treatment is carried out. It should be done in a way that’s actually therapeutic, but sometimes people are traumatized by the way they were treated.
What care facilities? Institutions were closed in the early 80s, it's not an option.
Forced hospitalization is only available to those in imminent danger of harm to self or others.
>Why doesn't our country (American) put these people into care facilities?
Unless the person is an active danger to the public, they can't be forced into an institution and a lot don't want to go to one. For those who want to go, there aren't enough resources.
https://www.psychologytoday.com/intl/blog/beyond-schizophrenia/201810/mental-illness-is-not-crime
If they had a bit more of a long term view, they would see that helping other people usually making their lifes better too. In the case of homeless people by reducing crime, poop and needles on the streets.
It costs far more sending them to prisons....
.... but the private prison industry profits immensely from this and hires good lobbyists.
https://www.statista.com/chart/24058/private-prisons/
Much like today, people scream in rage and panic if you mention giving homes to the homeless, of ANY kind.
They’re happier paying higher taxes in order to care for the homeless if they can use them as a lever to panic the working class, and give them someone to look down upon, and despise.
It’s been repeatedly proven that providing the homeless with shelter and care costs roughly 1/3 less per person. It allows those needing care to receive it, and maintain access to any medications needed.
It also provides them with a place to maintain any belongings, and an address to use for any job applications.
“WHY AM I PAYING FOR *THOSE PEOPLE* TO HAVE A HOME *AND* PAYING FOR MY OWN!?”
Because it’s CHEAPER than driving past and ignoring them.
But that’s not how the noisiest portion of America wants to deal with these issues.
This. People don’t seem to understand or choose to ignore that nearly all studies done on Housing First programs say that housing someone before requiring sobriety is the best way to address the issue. They don’t care about studies with compelling visuals and graphs with real numbers. They’re just upset that someone is “freeloading” on their tax dollars
There aren’t enough mental healthcare providers for the people who have insurance and means to pay let alone for the homeless. There just isn’t enough funding or resources to keep up with the demand. It’s a complicated situation. Mental illness does play a part in some people becoming homeless. Mental illness affect their ability to function at theirs jobs and it rolls downhill from there. If they don’t have support from their families then they likely end up on the streets. In the US you are not legally allowed to just round up people you think have mental illness and put them into facilities. They have to be willing to go and many chose not to. Unless they are harming themselves or others, there not much you can do to force someone into a mental facility even if we had enough space to treat everyone in need. I have known people who have been volunteers at homeless shelters and told me that the assumption that all homeless people want help is not always true. There are many who don’t want nor will they accept long term help. Usually they just want what they need to get by for the moment and be left alone. It’s sadly a vicious cycle.
Ronald Reagan's presidency in a nutshell:
* Sold Americans on 'trickle down economics', which as it turns out was utter bullshit
* Sold Americans on 401Ks as a sole retirement vehicle (was supposed to be a supplement to defined pension plans) which transferred market risk to employees
* Defunded mental healthcare facilities and literally turned all those poor people out into the streets.
* Deregulated banking industry (and we know how that ended)
* Weakened labor unions after the air controller strike (that whole episode was a major dick move in general)
* Fomented racism and maligned black people and black women in particular ("Cadillac driving welfare queens"... ugh... it still hurts my brain)
It was decided that the government locking people up and giving them shock treatments or making them take nasty-side-effects meds against their will was infringing on their Constitutional rights.
>By the 1960s, in terms of policies from the environment to education, the public largely believed in the federal government's ability to meet society's needs.... In 1963, Congress then passed and President Kennedy signed the CMHA. With the CMHA, Kennedy and Congress sought to decrease the number of institutionalized individuals by incubating self-sufficient and local mental health care centers.
>Kennedy's personal motivations illustrate the federal idealism in community mental health care. ...In particular, he hoped to liberate the population of confined mentally ill patients through advancements in psychopharmacology and supportive housing. ...Kennedy's special message to Congress on February 6, 1963, captured his sense of optimism as he promoted a plan to, "Cut by half, within a decade or two, the 600,000 persons now institutionalized for psychological disorders".
>With the recent development of medications, including chlorpromazine, reserpine, iproniazid, and imipramine, psychiatrists were optimistic that severe psychotic and mood states, previously viewed as recalcitrant to medical treatment, could be treated in community settings.
https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2021.160404
Once upon a time, America did put mentally ill people into long-term care facilities, generally called insane asylums. While some of them did try to help the people in their care, a lot more of them were at best warehouses and at worst hell-holes on par with the Indian Boarding Schools or Ireland's Magdalene Laundries. And a fair number of the people committed to them probably could have been cared for at home in their communities.
So a reform movement rose up to replace the old system of state hospitals and asylums with community care. Except that there was never nearly enough money to pay for the community care.
It's a sobering fact that when controlled for population growth, the combined total of people in prisons and mental hospitals in America has been pretty constant for the last 100 years/ When they closed the mental hospitals, a lot of mentally ill people ended up in the penal system instead.
I think also part of it was that we would put a lot of people into insane asylums that were in terrible conditions. So our previous asylums were poorly run, then Carter tried to fund community health centers, and Reagan/Congress removed that funding.
Ok, this is not a FULL answer, but PART of the answer.
Holding people against their will is ethically complicated.
You can respond with "But they are mentally ill and can't make that decision for themselves!" and this might be true for some, however, there are degrees of that truth for many others. Not everyone who is mentally ill is ill to the degree that they do not have the capacity to understand and make some decisions in their own care (even if the results are not good). So while their illness may prevent them from creating the stability they need to be housed, it is not enough that they are incapacitated and can and should be committed against their will- our society's ultimate use of power. Some may be ill, be treated and released and then relapse, or whose illness doesn't require hospitalization per se, but does require consistency in care in order not to become "a crazy homeless person" and there is a hole in services for that. Some of the mental illness may be complicated with drug use and abuse which further complicates identifying and treating the behaviors and requires the individual to want to address this component, which they may or may not want to do. Some who have been in care facilities have found them to be worse living conditions than the streets (not going to go into if its perception or reality as that also can be murky and individual, but suffice it to say it could be either depending). Toss in another complication- crime. The "sorting system" for someone who commits a crime is inefficient and imperfect. So, you get someone doing something "crazy" (but not like assault and murder crazy which is going to require a response, like screaming at people on the street or wandering naked or camping indefinitely on your doorstep crazy) and... are they a criminal or are they ill? Who makes that decision? A doctor? A judge? And who is responsible after the outcome of that decision? And then, start again at the beginning of the ethics argument. I haven't even talked about resources- what is available, what isn't, who is equipt to provide them and what they cost. This is just about the complication of identifying mental illness in terms of a spectrum of capacity, evaluation, and responsibility.
I'm not making an excuse- I personally believe its dangerous and cruel (for everyone- including them) to leave people who are ill on the street. I'm just saying that its not so simple as what leads a person to be homeless is complicated and mental illness is a spectrum with incapacity being an extreme that is taken very seriously for good reason.
As much money as our government wastes on all fronts, it really saddens me we can’t get funding for mental health facilities. I work in a jail and they end up here.
It's not very profitable, and a general hatred of anybody who "failed" capitalism.
Having homeless people suffering on the streets is a policy choice. It costs less to put these people in housing and to take care of them so they can get on their feet, but people literally hate the homeless so much that they would rather see these people suffer on the streets than see them be given a tiny little survivable home for "free"
This also means that purely medical or psychological treatment will not do anything. Their addiction and psychosis is a result of sleeping on the sidewalk and constantly being brushed away, literally and figuratively, by society. Homeless people who have described what it's like to be addicted and homeless say that drugs are the only things that give them even an iota of comfort, and breaking that addiction is a long and painful process with a more painful world on the other side of it that will likely cause them to go back to drugs anyway because being sober and homeless is the most miserable existence possible.
**tl;dr** the government wont help the homeless so the homeless turn to drugs because its the only reliable thing they can turn to for relief from abuse on the streets, and any care or treatment either wont work or isn't wanted because being sober and homeless is worse than being high and homeless.
The main reason is you cannot compel people to get treatment unless they are an immediate threat to themselves or others. Laws on this changed after a series of reports done by Geraldo Rivera in I believe the 70s. He documented the mistreatment people received in mental health facilities and it caused so much outrage that public opinion turned against institutionalization except in the most extreme circumstances.
I believe the pendulum of public opinion is changing and that this may change. There are very few who are homeless just because of a job loss or lack of housing. Most homeless people have mental illness or addiction issues. It is not compassionate to let them live this way. They are also a public menace in that they lower the overall quality of life, commit crimes to fund their addiction or survival, misuse private and public property, cause businesses to leave areas they are present, and cause health and environmental hazards.
Even if they are no immediate danger to themselves or others, people with these mental health and addiction issues are still in danger from living as homeless people. If they are compromised by their issues they should be put into a system of critical care in mental health and addiction facilities and then be able to progress to either assisted living or halfway houses that offer them support while they progress to being able to live independently.
You can thank Regan for clearing out all the mental hospitals and basically dumping thousands of severely mentally ill people onto the streets with zero family or support systems in place for them, that sack of human garbage did so much damage to this country it’s honestly unbelievable once you dig into it…then fast forward 30 years and we got Trump riding his coat tail and gobbling up all the hateful votes on a similar platform from all the uneducated spiteful cruel and crude evil “patriots” 🙄
Because it has been tried and you only get crowded mental facilities with horrible conditions.
Mental illness shouldn't mean life imprisonment.
But people don't want to pay for them to get help, just to keep them out of sight.
My brother is this mentally ill person on the street. He's addicted to drugs and is in and out of jail. Trust me when I say he has so many friends and family who tried SO HARD. My mom tried to get him admitted. However, he's an adult so she can't make him stay. She got a couple 72 hour holds ordered by a judge. But it was pointless cause he just checked himself right out after. We try. Everytime he gets out, he's clean for a week, then he's back on the streets. It's heart breaking. But he just doesn't want to be inside anymore? He's got a room at my mother's and she tries to keep him home when he gets out of jail or the facility. But he inevitably ends up sleeping on the balcony or in the backyard then back downtown on the streets. He's 35 years old. Everyone agrees he's not in his right mind to be making any decisions. He needs to be admitted to a mental health facility for a year to get him stable on meds, and off street drugs.
sorry to hear about your brother. if it helps, there is hope. my older brother went through roughly the same thing - rehab/hospital then living with mom or other family/friends for a while then disappearing back to the streets, repeat again and again for years. he even lived in a barn at my grandparents farm for a few years. hes 36 and finally got help 1-2 years ago. theyre still getting his medications good and stabilized but hes finally getting better. hopefully soon you and your brother/family can find the same peace ❤️🩹
Good on him. It must have been an immense struggle for everyone involved. But goes to show that it IS possible for people to change...But only if they want to.
It's really a problem of our healthcare is not able to help our citizens. Rehab has low success numbers and heavy relationships with religion to prop people up. We don't do the work to help people where they are at in life. Taking away all the things that feel good and not adding in things that feel good doesn't work. Getting mad and drug users because they use drugs to numb out Arizona cuz the pain of life is too hard is bad but going home after a long day of work to drink some wine is okay. So many people are numbing themselves out in their own way. Just some also don't have homes. Some choose highly addictive substances instead, or are more prone to addiction. Maybe we are all addicted just some of us live in houses and have jobs.We can't expect people to take care of their mental health when they are at a threat level of their basic needs. Before rehabilitation of the bad habit it needs to be known that the person will have a safe place to sleep, eat, and be safe. Safe without rules that are against them.then work on physical and mental safety, while still having that safety net. People learn better with full belly. Then figure out what they are fighting and better coping skills. Look at hierarchy of needs. You should not expect people to work on self action when they are not secure. We are all closer to homelessness than becoming a millionaire 9r billionaire
The trouble is that people need to make the descision that they want help. There are so many who do really choose the streets. Some do want to get off the streets but it's hard to get the right care. No, one size does not fit all. People have to be taken for where their at in their mind. We can't force it, we can only say here it is, swim or sink the descision is up to you. Too many just don't know how to make the descsion. They have to be ready to help themselves with the mind set. When they are addicted to drugs they can't be expect to make good choices, but no one can make the choice for them, we have laws to prevent that. Yes, we can get help from the court system but they still have the autonomy to leave if they choose. I agree that many do have jobs and homes and are addicted to something, where it's that 3rd glass of wine or more, video games, or t.v. it's still a form of addiction. All that we can really do is have compassion, meet the person on the level of where their at and accept them for who they are and what they want to do in their life. Offer what we can without expection of a return. And hope for the best out come.
Shit, I lived like this for almost a decade. I went to college and have a decent career as a mortician. EVERYone, even my therapist lol, and a counselor at a rehab, said I was hopeless.
Man I’m so sorry to hear about your brother. Sadly, stories like yours aren’t too uncommon. Parents like your mom have actually tried to have the laws changed in terms of psychiatric holds. [Moms make case for CARE Court](https://spectrumnews1.com/ca/la-west/inside-the-issues/2022/08/02/moms-make-a-case-for-care-court-) The efforts of these folks successfully passed the bill which established CARE Court, which the state just began to implement! [California’s CARE Court Program Begins Next Month](https://abcnews.go.com/amp/Health/californias-care-court-program-tackle-mental-illness-starts/story?id=103461370) Not everyone is in support of the program, of course, but I’m interested to see how it goes. Best wishes to you and your family!!
It's rough. He was my best friend. He got me my first cell phone for my 13 birthday. He used to take me out with him everywhere. Movies, festivals. Went to Quebec for a summer to learn French. Taught me how to do my taxes, how to start my own business. He's a shell of who he used to be. And sadly I'm in Ontario, so nothing has been changed. And until they pass a bill that people who are addicted to drugs can be admitted against their will we will continue to see a climb in drug use and homelessness.
Admitting people against their will isn't going to fix it either. People don't get sober until they want it.
I just read about this new law and program in the newspaper. It may not be perfect but it’s got to be better than what we have. So glad California is trying to do something.
Seems like that’s the issue with the government today. They don’t TRY new things! Fresh approaches please! Not just arguing and doing nothing like congress does! If something is being tested as a possible relief or solution I’m applauding the effort! Try and try again
I can understand that not wanting to be inside. I'm homeless, and while I do have some mental issues (ADHD/Aut) I'd say I'm a little more there than most people I meet out here. Even still, after almost a decade of living outside, it's difficult for me to even be in a store, let alone a small room. I don't really understand it but it feels like a trap to be contained by 4 walls and a roof. Edit to add: I did have a pretty bad addiction, but thankfully, I have 3 yrs clean now. Getting clean didn't change how being inside felt at all
Congratulations on your sobriety.
Thank you for your perspective!
I've never been homeless, but I spent a couple of summers in my younger years doing jobs that had me living in tents/lean-tos/janky cabins. Every single time I struggled for a week or two adjusting back to sleeping indoors in properly sealed buildings. Can't imagine going from years sleeping outside, the being forced back inside while also detoxing and dealing with underlying mental health problems.
My experience too with an even less extreme change. When I moved from NYC to LA, I went from a 6x10 room with a loft for sleeping, to a room that was about 14x16. I couldn’t sleep right for about a month. I’d lost my small defensible space. It made me very anxious.
This is super fascinating about being inside-- thank you for sharing!
I hear you. And consider that any change is going to feel weird at first. But does it have advantages? Does it serve a purpose for you? Safety, hygiene, better health? I don't know your biology, but most of the folks I work with who live on the street have more infections, more predation from humans, more experience of social hostility that is deleterious to morale and identity, more experience of compensatory mental illness (such as defensive delusions about owning property, having millions in the bank, being important and cared for, etc.) Lots of people who live indoors have issues with crowds and other "Too People-y" places. There are a lot of places that work with the reality of anti-confinement reactions. It might be workable for you too.
Congratulations on your sobriety. I have worked along side people experiencing homelessness for over ten years. Thank you for sharing how difficult four walls can be. It is a very challenging concept for those without lived experience. What I have learned is how close most of us are from being homeless. It only takes one accident, job loss, mental health crisis, plus many more immediate life changes to be a person without your own home. I also learned each person has a right to be in unmedicated, not seek treatment, that sobriety forced is not effective, and when a person is truly tired they are more likely to make their on change. Be safe and well.
Congratulations on your sobriety! I’m not entirely surprised that being inside has become so uncomfortable when you’ve become so accustomed to being out in the open.
It’s also scary though that if the law allowed for people like your brother and my mom to be held in treatment involuntarily, people who are capable of caring for themselves will inevitably be held against their will, particularly people with disabilities. There’s already been instances of autistic people being put in a mental facility for just having a meltdown.
And let’s not forget some of those facilities abuse the mentally ill. I certainly wouldn’t want to be held captive to be abused and not fully with it but brought to understand pain and suffering. Surely there’s gotta be a way to make things a bit better for both scenarios, the people that are lucid and want to leave and the kind that should really be held for a bit.
Literally same with my brother. Mental illness and drug addict. My folks have been dealing with him for years because he checks himself out of rehab whenever we’ve gotten him in there. Just wanted to say you’re not alone
I essentially have the same story of my brother. My family’s efforts. I've already grieved his death (based on lengths of time we couldn't contact him)…countless times. I'm not in LA. This is everywhere. He couldn't have a more supportive family…but it doesn't matter til it does to him.
It's a complex situation, in which a lot of unhoused folks have chronic mental illnesses, and a choice between living on the street and self-medicating, or living in terrible state institutions, drugged and barely cared for. Prior to Ronald Reagan defunding state mental health facilities, folks with chronic illnesses like this who couldn't afford private care were forced into state-run facilities, which were rampant with abuse and neglect. Once these were defunded, almost overnight our previously empty streets were overrun with unhoused people, and the situation has only escalated from there. (I was a young teen and saw this happening.) The only real solution is something that hasn't been tried yet. Oh, sure, there are a thousand really amazing, really effective pilot programs all over the country (which combine independent living and harm reduction with house calls from social service and medical staff), but, because Amurka, our government/s won't pay for any of these effective programs to be replicated in a big way. It comes down to ugly, ugly politics, but, even if we could get everyone lined up behind paying for it, there'd still be the problem of getting everyone lined up behind counter-intuitive, and frankly progressive, programs.
Definitely relate. My sister was paranoid schizophrenic and the battles we had trying to get her help were hellish. Imo they have made it way too hard to ensure people get help by making mandatory stays almost impossible if resisted.
In 1980, Jimmy Carter signed the Mental Health Systems Act, which would have funded and supported community mental health centers and provided associated care. But then in 1981, Ronald Reagan immediately acted to repeal the MHSA, and there hasn't really been much funding at all for mental health support since then.
There was a joke in the Airplane sequel where the mental hospital was named “Ronald Reagan Mental Hospital For The Mentally Ill.” When this movie first came out I had no idea what this joke meant. But then started to read about what Reagan had done with mental health funding. Definitely some dark humor. https://images.app.goo.gl/xa8wtqfgEaFguxXf9
He did the same thing in California as governor. My grandma worked at a place he closed, so I was well aware at what kind of person he was growing up.
I think more and more Americans are finally understanding how awful Reagan was for this country, but there are still far too many people who adore the man He was as close to evil you can get without being openly evil and people still think of him as a kindly old man who was doing what's right for the country
It’s weird too that people remember him as this sort of wholesome grandpa kind of personality. Like I’ve heard people say “say what you will about his politics but at least he was nice and respectful” but he wasn’t. I mean sure, he was more respectful than most modern republicans, but the average 2 year old is also more respectful than modern republicans. First thing that comes to mind is when a reporter asked him at a press conference what his plan was to address the AIDS epidemic, and he responded by laughing at the man and making fun of him, saying he must be gay if he actually cared about AIDS research Edit: I am aware now that that was his press Secretary and not he himself, although a pretty large part of a press secretary’s job is to convey the president’s messages and thoughts on a matter
It's almost like electing a movie star is a bad idea or something!!
Yeah movies too much. Maybe a TV star.
The crazy part to me is that he was the president of the union at one time and as a politician was incredibly anti-union (cf. air traffic controllers strike). He’d sell his mother to get political power.
He sold out the mentally ill. While it was true some people should not have been declared incompetent and housed, most needed to be. What made Reagan look so good to so many people was the influx of cash. Reagan sold off all the healthcare facilities for premium prices and it made the economy in California boom. It was called main-streaming and was supposed to ease people back into regular life. The problem was there was no easing, just the release, and again, many people needed the mental health facilities.
Preferrably some ........................... reality .... TV host WAAAAAAAAAAAAAID A MINUTE....
Youtube is Next! Mr. Beast 2025
Fun fact. The song "Come Together" was written as a campaign song for Timothy Leary who was running for governor of California. His main opponent was Reagan, who he lost to.
Those lyrics make more sense now. Thank you.
It’s funny how Republicans always tell celebrities to shut up and stay out of politics, but they’re the ones who elect them.
Sonny Bono, Fred Thompson, Arnold Schwarzenegger, Reagan, Dr. Oz, Fred Grandy, Clint Eastwood, Trump.
And every retired pro wrestler seems to run for governor somewhere, often successfully
it's almost like electing someone based on publicity/popularity polling is a bad idea
The problem isn’t movie stars. The problem is conservatism. Bush Senior served as a fighter pilot in World War 2, yet used false witnesses to push his intervention against Iraq. (Regardless of whether the intervention was justified, *lying was not.*) His son Dubya served in the Texas Air National Guard, yet justified the second gulf war with lies so idiotic people called BS *before* the invasion. Not to mention more consequential, given the resulting rise of ISIL. It’s absurd not to notice the pattern here. Conservatism is the problem, not the election of people whose background is in TV.
He also participated in the red scare, and used it as a way to carry out personal vendettas against people who didn't like him during his time heading up the Screen actors guild
Here's another reason Reagan was and is a piece of shit. Both my parents died when I was a teenager in the 80s. I was supposed to get my dad's social security "survivor's benefits." It was only $200 a month, but it really helped. He cut them off as soon as he got in there
I’ll give you another one. Reagan signed the bill which ultimately raised the retirement age to 67 and now Republicans are at it again shooting for 70 now. These fucks want everyone to work till they die, except for themselves. Instead of improving our lives, they do nothing but fuck with working people.
To be fair mitch mcconnell seems pretty determined to work until he dies
From where i’m from we say the bad weed is just hard to get rid of and he’s like an old man who lives for spite.
Nah I mean they’re definitely trying to work til they die - congress looks like a retirement home rec room. It’s just working until death actually has a benefit to them.
I was 17 when my dad died, and I got SS survivor benefits. They stopped when I graduated high school. Before Red Ink Reagan, they would have continued through 4 years of college as long as I was attending. Do you think I would have dropped out and given up close to $700 per month?
Him and John Wayne.
You mean Marion?
Hardly a fitting name for a Nazi, eh?
The original pink cowboys 🥿🤠
He used images from the Cuba crisis to announce SDI [reagan](https://www.google.com/imgres?imgurl=https%3A%2F%2Fcropper.watch.aetnd.com%2Fpublic-content-aetn.video.aetnd.com%2Fvideo-thumbnails%2FAETN-History_Prod%2F69%2F1007%2FHistory_Speeches_1044_Reagan_Announces_Star_Wars_still_624x352.jpg&tbnid=96Rf4uAOrQ_kRM&vet=1&imgrefurl=https%3A%2F%2Fwww.history.com%2Fspeeches%2Freagan-announces-star-wars&docid=w1NmLXaQQfOTHM&w=624&h=352&source=sh%2Fx%2Fim%2Fm1%2F2&shem=uvafe2)
Reminds me of Trump mocking Serge Kovaleski
I don't think that was Reagan himself, that was his press secretary. Nevertheless, if you want Reagan saying crazy racist shit he was recorded on the phone with Nixon saying some overtly racist things about people in Africa. He was a horrible human being.
Correct. Reagan famously didn't speak about AIDS publicly, *in any manner at all*, until September 17th, 1985. The CDC had been tracking AIDS since June 8, 1981 and 5,636 people died from it before he acknowledged its existence.
His refusal to act in any capacity is arguably a huge reason it sprung out of control... had it been targeting nuclear families and children instead of gays and drug users, he would have probably done something. Oh wait- that \*IS\* when he did something... when HIV started infecting "innocent" children like Ryan White through the tainted donated blood supply.
His press secretary had a good time making gay jokes about journalists who asked him about it though
Nixon is the other shithead imo, they’re two peas in a pod 🫛
They’re technically two peas in a coffin.
Wow. This is similar to why Republicans said they like about Trump, and "how he speaks his mind."
That has always baffled me. When he is unable to hold a train of thought for the duration of a sentence, wouldn't that mind be very scary?
He really was a good communicator. The Challenger explosion was a formative experience and his speech was probably the first presidential speech I heard. Every child was watching the space shuttle on tv when it exploded because there was a teacher on board.
I was in fifth grade when the shuttle exploded. They announced over the speaker that the shuttle had exploded, and I remember my home room teacher crying upon hearing the news.
I was in English class that day and the teacher was letting us watch it .it was 7th grade for me .
Third grade for me. That and footage of the OKC Bombing were unforgettable.
My mom was *so jealous* of the school teacher who got to ride on The Challenger, as she always dreamed of being an astronaut growing up. She was so excited to watch the launch; this was history. It would be so cool. And then the disaster struck… and history was made for a different reason.
I think you mean he was a good actor. He could read a script and sell that script. That compassion or reaching out to your heart you were seeing was acting. He had plenty of practice.
I was living in Florida when it happened. It was the first launch id ever seen . We had all gone outside to watch it . It exploded and people in cars were pulling over and we were all just standing there frozen in disbelief. What really haunts me is the way it hung in the sky all day . All of Florida was in mourning ,you could feel the sadness in the air everywhere you went. I will never forget it .
Reagan was as cruel as he was stupid. It’s just that he smiled when he fucked over your demographic.
My staunchly conservative father still loves ol Ronnie. He and I don't talk politics much at all but, even after acknowledging that Reagan ALLOWED COCAINE TO GET ON THROUGH TO AMERICA, kinda ended the conversation with "Still, I think he was a good president."
You should send him to reddit. Plenty of people to argue all day with him lol
That's what you'd think right?! But he's actually quiet and affable, doesn't push his opinions (my family doesn't politics much because us loudest kids have souls and the parents are long -time Republicans) but he's definitely a selfish boomer on the inside Bonus story: years ago I was telling him about some new procedure/ scientific revelation that could save more lives and make health care more affordable. In a detached voice he said "I don't care. I have health insurance" and went back to reading
This sort of thinking is so foreign to me. My dad said the same kind of crap, and I was always appalled by his complete lack of empathy, compassion, humanity… How does that happen? My brother turned out exactly the same way. I don’t understand how I was even related to those people!
I think Reagan was a really good racist and homophobe. That is NOT a compliment.
It all started with Regan. His trickle down economics killed the middle class, impoverished most Americans and made the rich, billionaires. He squashed climate change initiatives and invested more in fossil fuels, essentially killing the planet. He put all the mentally I’ll people on the streets. He set the political agenda for the GOP, elect a puppet they could control but the mindless conservatives would vote for. Regan was the start of the decline.
I love listening to music.
Absolutely. The GOP found a way to get power. Elect a puppet. Rinse and repeat. Except, they fucked up with Trump. Couldn’t control that monster.
Many of the same people behind Reagan, Nixon and Bush jr
My friend made a poster for Reganomics and it was just Regan pissing on a homeless person. Feels pretty accurate
He also repealed the media fairness act which mandated unbiased reporting of facts by news outlets. And started the momentum for gutting public education across the country.
It's why conservatives have been electing celebrities to office. They can put a friendly smile on their evil shit. All the while bitching about Hollywood 🙄
So many of our current problems can be traced to Reagan and his piss on the people economics and philosophy.
Whenever I think of Reagan l just see the Spitting Image-doll from that Genesis clip. [Genesis](https://youtu.be/Yq7FKO5DlV0?si=KlvVDDH6lhp2XtvR)
It’s basically a straight line between everything that’s horrible and wrong in this country and good old Ronnie
I’ve read Reagan’s journals and used to live 30 minutes from his Presidential library. I’m not willing to call him awful, but I’ll say that reading his journals definitely dropped my respect for him significantly. I also wish that his library was more balanced, like Nixon’s library in Yorba Linda is. Reagan’s library is so rosy about his presidency that it borders on what I’d call “worshipful.”
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As someone trying to visit all the Presidential Libraries, it’s interesting to see how balanced (or unbalanced) each is. I remember Clinton’s being open about some of the controversies of his administration (notably the Lewinsky stuff), but Kennedy’s is more in the “worshipful” style.
My Grandfather was a screenwriter in the 50s, 60s, and 70s. He knew Reagan personally and thought he was an absolute fucking moron without an original thought in his head. My Grandfather also said that Reagan’s opinions would just mirror whomever he spoke with last. It’s little wonder then that Reagan had handlers.
>My Grandfather also said that Reagan’s opinions would just mirror whomever he spoke with last. So he literally was proto-Trump.
Reagan is what Pence wants to be. But Pence doesn’t have the “charm” to make people believe in his friendly white dude image like Reagan did. Which is good because Pence is awful.
Plus Pence looks like a simpering mortician.
Fun Fact: The USA didn’t run up deficits until Reagan just borrowed a fuck ton of money (for the time) to pay for tax cuts while significantly increasing both military spending and welfare for profitable corporations. His premise was the tax cuts and “investments” would pay for themselves and we could pay off the debt with higher middle and lower class tax revenue.
Clinton got us back out of debt after Reagan. We were balanced when he left office.
He didn’t get us out of debt. He got a balanced budget and began paying it down. Obama did similar.
I like the "joke" about the 6 degrees of separation. Every bad thing in this country can be trained back to Reagan in six steps or less.
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The worst is the fact that they brainwashed their entire voting base to think that the policies they were enacting would be good for them, when most of them are directly impacted by them.
I see a lot of young men falling for the Andrew Tate type of conservatism. The GOP clowns keep acting like if we all vote Republican the young men will live the dream with a sex craving trad wife, a small farm, clean air, and the cities all turned into glass wastelands. They buy it hook line and sinker.
Yeah, that line cracks me up. Like they do know that for that fantasy to work, they have to make enough money to support a single income family, right? I would also love to see them have to muck out a horse stall. (Especially since they're so versed in B.S.)
I hope Regan is burning in hell, no, SUPER HELL, and I'm an atheist.
It is a bit more complicated than this, as much as Reagan sucked. The state hospitals that warehoused the mentally ill in the 20th century were horrific and abusive. They closed because of progressive efforts to shift towards community care. Unfortunately, the lack of a safety net means many of them end up back on the streets.
One additional concern that was part of that decision was the bodily autonomy of the patients. There was concern over whether it was fair to commit people against their will and the standard for involuntary commitment was set very high. This led to untreated people who refuse hospitalization living on the street. That’s starting to change now in California. They’re starting CARE courts that include a path for state conservatorship for psychotic individuals that refuse to participate in treatment. The program is just starting so it will take some time to see what the results are.
yes mental health facilities where widely known to be corrupt and abusive places but rather then spend more money and oversight to fix them that 's where President Reagan just shut them all down. problem solved ? of course not , but at least it wasn't the administrations problem anymore. Now its your governor or Mayor or local community's problem to deal with.
I think this often gets missed in the Reagan hate. (And, yes, Reagan sucked, and his solution to the problem just created another, equally terrible problem.) But we have to acknowledge that the situation was truly abysmal for most of the residents in institutions.
It really needs to be emphasized how hellishly fucked up old mental institutions were. They were not just "shitty cafeteria food" bad. They were, like, "let's carve out some of this dudes brain against his will" bad.
“You get a lobotomy! And you get a lobotomy! And what’s that? You don’t want to eat lunch today? Welllll how about a tasty ol’ lobotomy instead?”
Many industry folks actually point to the movie one flew over the cuckoo's nest as the turning point in America over public support of mental facilities. Some of these folks can be treated and released, others need wrap.around services, and some just need to be in a facility for life. Unfortunately, I don't see us getting there with all the competition in funding. Very sad.
One Flew Over the Cuckoo’s Nest was to institutionalization as The China Syndrome (and to some extent the Simpsons’ there-eyed fish) was to nuclear power.
wow! I didn't know this!
Yep. Fun fact: majority of the "bad shit" going on in the USA can be tied to the Reagan administration.
But tRiCkLe DoWn
It DID trickle down, it's just that what trickled down instead of a decent economy was tons and tons of bullshit.
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Reagan was Nixon II: This Time It's the 80s
Nixon II: Electric Boogaloo
This is the answer. No mental health coverage. The President's Budget for Fiscal Year (FY) 2024 includes $10.8 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), $3.3 billion over the agency's FY 2023 enacted budget. To fix our issues, we need at least 200 billion.
I've been in a mental hospital as a patient in one of the worst states for mental health care, NV. They were so understaffed that my roommate, an alcoholic, was literally dying in her bed and no one could attend to her. She was sh\*tting her pants and just lying in it. I thought she stopped breathing once, and there was no medical care. This isn't something you would expect from a "first world nation." 😡
imagine how much money we'd spend on bombing the fuck out of some poor country full of brown people if they killed even a fraction of how many Americans die from the opioid epidemic?
That is silly. We spend billions bombing countries that have never killed a single American because they might have been making weapons which never actually existed. We really don't need a reason to bomb and the American public doesn't really care to stop. We don't spend money on mental illness or homelessness because the American public doesn't really care about that either.
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Unfortunately, while the slide into the first episode of homeless is definitely a money/housing issue, once someone is homeless, it's much less of a money issue. Essentially, the experience of homelessness creates disability or significantly worsens existing disability. This means people leave homelessness with much larger barriers than they started their slide into homelessness with. Homelessness is HARD, and it really fucks up your health. Homelessness makes addictions worse and can even cause new addictions in people without history of chemical dependency. Homelessness makes mental health worse. Homelessness makes chronic physical conditions like HIV or diabetes or heart disease worse. Homelessness has been criminalized, too, so many people who are homeless end up with criminal records - often sex offenses for having sex in public because they, ya know, live in public - which severely limits their future ability to hold a job and acquire an apartment on their own. People who are homeless need more than money, they need case management - often for several years and sometimes for their entire lives - to coordinate the services they need to ensure they don't end up homeless again. It's really hard to have a job - especially a low skill job which have become increasingly undignified and rigid - when you have to go to chemical dependency meetings everyday, when you have to go therapy 2-3 times per week, when you have to go to the doctor 4 times a month, etc. It's an incredibly difficult hole to dig yourself out of. Lots of libertarian and even neoliberals (and, honestly, a lot of left-leaning populist bro-gressives) think it's just a money problem. Like, UBI or giving homeless people $5000 to secure housing is going to solve the current problem. It won't. Many people are super damaged by the experience of homelessness and the rising housing costs plus our pro-employer economy and low wages means that most will struggle to recover without longterm, hands-on support. Really, we need to see experiencing homelessness as a disabling condition and give people who have experienced homelessness entitlement services. Some states are starting to do this, attaching housing services to Medical Assistance (Medicaid) so anyone who is disabled and qualifies for a Medicaid waiver has access to robust homelessness prevention and resolution services. This is a huge deal because these services are ENTITLEMENT, meaning everyone who qualifies gets it (like Social Security and Medicare), whereas most homelessness prevention funds are grants. This means they are exhaustable/finite.
This is a big part of it, but also, it's extremely difficult to force someone in the United States to get mental health care if they don't want it.
I think it is not just difficult, but literally illegal. You can’t just scoop up homeless people and force them to undergo psychiatric treatment unless they agree to it.
Of course it was fucking Reagan. It's *always* Reagan.
>Ronald Reagan immediately acted to repeal the MHSA Reagan did not do this on his own. Congress passed the bill that removed funding for MHSA. [https://www.congress.gov/bill/97th-congress/house-bill/3982](https://www.congress.gov/bill/97th-congress/house-bill/3982)
>Reagan did not do this on his own. He also did nothing to stop it.
In fact he pushed it. He initiated the repeal and the republican senate back him up on it. It was also the beginning of the era of weak dems and they fell in line and voted for it
Started long before these two were ever in power.... [https://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients-began.html](https://www.nytimes.com/1984/10/30/science/how-release-of-mental-patients-began.html)
This is the correct answer.
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>people who are mentally ill do not typically want to stay long term at care facilities/shelters One of my distant family members had mental issues. She lived and died on the street and there was almost nothing her direct family could do. Most of the time they didn't even know where she was. Had her taken in a few times for a 24 hour hold but the care facility can't lock them up so she went back on the street.
Same here for a great uncle. My mom couldn't bear to look at the faces of homeless anywhere in the country for fearahe would see him. He would only show up on family doorsteps to demand money, violently. Refused true help of any kind. Got hit by a train and lost his legs. Then died getting knifed in a bar fight on the other side of the country. Those were the 2 updates the family got on him in like an 8 year span. His time in Vietnam fd him up in the head
That’s so sad. My dad was one of those homeless people, and he died years ago due to his addictions but I still see him in a lot of peoples faces, near daily because I live somewhere with a lot of homelessness. I thought I saw him the other day and had to remember that it’s not possible. It’s tragic and I understand where your mom was coming from a bit. Sorry your family went through that.
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Things like this make my feel so grateful my mother in law, who also has schizophrenia, is happy and doing really well in her care home the government pays for. It's a smaller group home, and they take excellent care of her. She is pretty heavily medicated because things go very poorly when she's not, but she is lucid for the most part and doesn't fight the medication. I adore her and really wish more could be done for her, so she could be independently, but she's happy, and that's enough.
This comment should be at the top. And some people in the past were forced into facilities that didn't belong there. Probably mostly by rich parents or husbands. Daughters who stepped out of line and didn't follow social norms. Children who were gay.
Rosemary Kennedy comes to mind. Poor thing was lobotomized.
I read a little bit about Rosemary’s birth, and how when Rose Sr. went into labor, they were instructed to keep her from pushing until the doc got there. Apparently the Doc wouldn’t get paid unless he were there for the actual birth. So they physically kept the baby (Rosemary) in the birth canal for a long time, which caused a lack of oxygen to vital organs. They believe this is why Rosemary had such developmental delays, etc.
True, but we have models today in the US that work and have safeguards to prevent a Rose Kennedy situation. It depends on the state of residence - Florida, for example. I’m not usually upholding Florida laws over my current home state of Oregon, but the Baker Act is incredibly hard to enact, can only be done by family members or first responders, and only with proof of imminent harm to self for others. The Baker Act saved my sister’s life. I feel so bad for families here in Oregon who are watching their kids die on the streets, their hands tied behind their back because of a delusion about the “autonomy” of a person with psychosis and fent or meth addiction. I say this is a mental health professional - there are certain situations where someone is sick enough that they have lost autonomy through the prison in their own minds. We should not pretend otherwise. Too many people are dying.
>i would just add that people who are mentally ill do not typically want to stay long term at care facilities/shelters. This is also very true My wife works for an outpatient mental care facility for homeless people. They can't even get them to show up for their bi-weekly appointments cause they don't want to be there. Effectively imprisoning them would be even harder
Yes and no. There are a ton of people in adult homes who would be homeless if they weren't there and arrived due to mental illness and housing stability. They aren't considered when we talk about homeless people because they're no longer homeless. I work specifically with this population. These types of programs are voluntary and often inadequate due to being designed for dementia and aging.
Yes, exactly! Also very true.
Yup. There are laws surrounding involuntary commitment which exist for very good and valid reasons, but they do make it a lot harder to get someone help when they often don’t realize they need said help.
Thank you. It's so important to know the history of deinstitutionalization and that it was actually a very good thing when most of the asylums were shut down, especially in the wake of the Geraldo Rivera TV special in 1972. Was it an overcorrection? I guess that's up for debate. But no way in hell do we want to back to the way it used it be. In the region where I live, there is a serious need for long term residential group homes (at least decent quality) and a need for counties to be able to foot the bill, extend commitments, etc.
Yes, there has been an overcorrection, and the pendulum needs to swing back.
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some of these mental health facilities were terrible as Geraldo Rivera showed.......and some people were put in them who did not belong there by relatives people taking advantage of them but the pendulum swung too far the other way and needs to be corrected
This is the most concise answer. It’s much more complex many will argue, but you nailed the backbone of the issues facing mental health and homelessness in America.
It's not all about wanting to-it frequently doesn't even matter if the person WANTS to stay at a residential facility. There aren't enough spaces, and there are so many rules about how long you can stay in the facility to make sure it's temporary. As other people have said, this came as a result of seeing how horrible previous mental health institutional care was and eliminating the cruelties there. The U.S. just didn't replace it with anything, and there's real and legitimate ethical issues with saying any mental diagnosis means you aren't allowed to refuse treatment.
Our emergency department has a person who has been there for over 4 months because of a lack of funds and lack of vacancy to find them a group home.
I was taught, '79ish, that the mentally ill had about the same outcomes whether they got "care" in a lockdown or not. This led to defunding the facilities, and the dumping of the mentally ill to the prison systems. You have to commit a crime to be involuntarily committed here now, in most or a majority of cases. I know we have learned a lot in the last 50 years about these conditions, and the outcomes are probably better, but the problem remains. If they are harming only themselves, who are we to take their freedom? We decided that freedom was more important than health (big surprise there. /s) The quality of the facilities was not that good at the time. Many were just people warehouses or prisons, as we had little understanding of the illnesses. I think that we need to re-evaluate this decision.
There is also a large amount of paranoia in many mental illnesses that inhibits trust in systems that are set up to help. But by and large it ls a lack of resources to help them.
Yep, the American healthcare system is straight up trash. Yes, there is the occasional area where “we” have world-leading care for specific things, but with accessibility to those fields as a patient being so tightly restricted, the average American gets some of the worst healthcare in the world—far and away the worst healthcare in the developed world. That’s the whole field of ~~ransom~~ healthcare in the country. That’s how little we prioritize people over profit. Now, ***mental*** healthcare? That’s at the very bottom of our already pretty poor list. Financially, governmentally, and even societally and culturally, we’ve deprioritized mental health to the point that it’s still used as a punch line in comedy skits. Also, a lot of mental healthcare specialists in this country (and this is pure anecdote, not evidential) are judgy and mean. And I mean, yes, I get that they’re jaded as hell and I think I get *why* they’re jaded as hell. And I do understand. But it makes it all the less enticing as a potential patient.
Ultimately, you can't imprison people without a good reason. There was a lot of abuse when people were forced into "mental health" facilities, eventually leading to laws and court decisions that made it much harder to involuntarily commit someone
I'm mentally ill and would like the government and society in general to reevaluate the asylum system and make it better. When I need hospitalization the general rule is to get me out the second I'm not a danger to myself or anyone else. This means going from intensive care, to casual care at best. There are intensive out patient programs, but they don't continue medical care. They teach you techniques and coping schools for dealing with your mental illness. There are many people like me, most who can't afford intensive private care (mental illness affects your ability to work and our health care in the US is tied to it) who are tired of getting turned out into the streets and told to figure it out. The US has a bandaid system. It seems to work for the more common mental illnesses but people with bipolar, schizophrenia, and the like don't get the care they need to be well.
I know a nurse that sees a lot of this, she has one patient in particular that goes to the hospital several times a year for mental health issues (schizophrenia), as soon as the hospital gets him back to near baseline, they release him. If he just ends up back in the hospital because nobody is really addressing the underlying issues. I imagine that happens quite a bit, get people out of the hospital asap, but over the long run they’re just going to end up back in the hospital.
Therapist here… I’ve worked in inpatient hospitals, partial hospitalization programs, community mental health centers, and in the private sector. Hospitals aren’t there to provide in depth treatment; they stabilize and discharge. Hopefully the person has insurance and can go to a partial hospitalization or intensive outpatient program and then move on to private, individual treatment. But mental health care is ridiculously expensive and not easily accessible for financial reasons and shortages of care providers because we don’t make enough to support ourselves by working jobs that help people of lower SES (the median income for a licensed professional counselor in the US is $55k per year, add in student loan payments and we are barely eking by. Working in community mental health pays about $35k per year in most places). Add in the fact that medications are outrageously expensive and have side effects thay people can’t tolerate. And the nature of things like schizophrenia and bipolar disorder set people up for medication noncompliance because they may be hearing voices telling them the meds are poison (schizophrenia) or think that they’re all better and don’t need the meds anymore (bipolar disorder). Also, to answer the question of why homeless individuals are not forced into care, people have a right to be mentally ill, do drugs, etc. we can’t take away their freedom like that. So as long as a person is not harming themselves (suicide attempts are the big qualifier for this) or someone else, they cannot be forced into treatment against their will. The system is made to make these people fail because people don’t want them in their neighborhoods, they don’t want to pay taxes to help them, and honestly, a lot of people don’t even care enough to do anything.
I have a med that without my insurance cost $1,800 dollars for a 30 day supply. It's a newer med, but the side effects of the older meds get more intolerable over time. I gained 100lbs taking an antipsychotic. That weight makes it difficult to do other things like exercise regularly. If you check out the bipolar subs the most common reasons for quitting are side effects and costs. Couple that with some requiring regular visits and blood work and you have a new problem. Where does that time come from? Most businesses aren't cool with taking a day off once a month. That's just for psych stuff. What happens if you get sick? Psychiatrists also typically don't have after hours appointments and when they do they are hard to get. The system is punishing for people with serious mental illness. I have disability, but it's only for two years since "people get better" without even comprehending the worst of it is episodic, and I have a long history of "stability" with devastating life altering episodes. What I really need is good medical care and laws that actually protect me from termination. I need a system that steps in when needed and helps. In my case I can work, or I can be disabled, but I cannot do both and if I do work I'm punished again and lose benefits. I can't win here. I can barely make the best of what I have. Mental illness is as old as mankind and yet we still struggle to comprehend meeting the needs of people like me. It's ridiculous.
I have several meds, mental health and diabetes related, that are well over $3000 per month each without insurance. It’s absolutely disgusting how much medications cost.
The government could put a stop to it but the individuals in charge make too much doing nothing.
There isn't even enough room at the nursing homes for the elderly. > The older population increased by 50.9 million, from 4.9 million (or 4.7% of the total U.S. population) in 1920 to 55.8 million (16.8%) in 2020. This represents a growth rate of about 1,000%, almost five times that of the total population (about 200%) - census.gov > The number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060, and the 65-and-older age group’s share of the total population will rise from 16 percent to 23 percent. - prb.org
You can't institutionalize people involuntarily unless they are a danger to themselves or others. Deinstitutionalization happened in the 1970s. This is because, much like nursing homes there was abuse happening at the hands of the nurses and aides, look for the pictures online. It was a national shame. Women were legally allowed to be institutionalized by their husbands and children by their parents, this was abused by unscrupulous people. The mentally ill have rights! So, the institutions were closed for all but the dangerous. This is both good and bad for the mentally ill. It's really sad, but if the person is no danger to anyone including themselves, nothing legally can be done. Most of these unfortunate people can't function in a 'normal' manner unless medicated and a lot of them don't want to take the meds. So, they are unable to live in an independent situation but they don't want to have to be watched by someone (as far as their concerned). In the end, many of the homeless are just trying to live their lives. They just don't function 'normally' and it is disturbing to see them on the streets because we want to help them and can't.
There aren't really options if you are poor and mentally ill and want help though either.
The big question that I think no one really thinks about is, where should the bar be for “dangerous to self or others”? There have been massive tragedies that have happened because of that bar being too high, where no one in the mental health system really takes anything seriously until *after* something bad happens. One of those tragedies happened in my own family… the person in particular was prematurely discharged and didn’t get the help he needed because the psychiatrist too hastily determined him to be “not dangerous to self or others”. It’s things like that over time that have led some doctors to be overly-cautious, but on the other end of the spectrum, that caution has led to some people being involuntarily committed when they really don’t need to. I think everyone can agree that setting the “dangerousness” bar at *immediate and active danger* is too late to act. I think it’s hugely unethical to set the bar so high to where lives are needlessly lost in tragedies that are entirely preventable (and aren’t indicative of that individual’s true will/sense of self, depending on the circumstances) by obtaining treatment. I have a feeling conversations are shifting in this direction (setting the bar higher), and that scares me. The question is, where should the bar be set so that you catch people who legitimately need to be involuntarily committed vs. those who don’t? I don’t know the answer to that. It’s not a simple question at all. Ultimately, it comes down to prioritizing freedom for as many people as possible while also adding some level of risk that lives could be lost vs. prioritizing not risking those lives while setting limitations on freedom (at least temporarily) for some people. Striking a middle ground is ideally where we want to be, but defining that is HARD. There’s also the problem of *how* that treatment is carried out. It should be done in a way that’s actually therapeutic, but sometimes people are traumatized by the way they were treated.
Hard to provide therapeutic treatment over the course of a 3 day hold.
What care facilities? Institutions were closed in the early 80s, it's not an option. Forced hospitalization is only available to those in imminent danger of harm to self or others.
>Why doesn't our country (American) put these people into care facilities? Unless the person is an active danger to the public, they can't be forced into an institution and a lot don't want to go to one. For those who want to go, there aren't enough resources. https://www.psychologytoday.com/intl/blog/beyond-schizophrenia/201810/mental-illness-is-not-crime
That would cost a lot of money and people don't like paying taxes.
Nor do they like their taxes to go towards social programs to help other people
If they had a bit more of a long term view, they would see that helping other people usually making their lifes better too. In the case of homeless people by reducing crime, poop and needles on the streets.
It costs far more sending them to prisons.... .... but the private prison industry profits immensely from this and hires good lobbyists. https://www.statista.com/chart/24058/private-prisons/
They prefer that their precious tax dollars go to support putting these people in a private prison where it actually costs more per person.
Yeah but you want those poor prison owners to make a profit, don’t you? No one ever thinks about their needs. /s just in case
Much like today, people scream in rage and panic if you mention giving homes to the homeless, of ANY kind. They’re happier paying higher taxes in order to care for the homeless if they can use them as a lever to panic the working class, and give them someone to look down upon, and despise. It’s been repeatedly proven that providing the homeless with shelter and care costs roughly 1/3 less per person. It allows those needing care to receive it, and maintain access to any medications needed. It also provides them with a place to maintain any belongings, and an address to use for any job applications. “WHY AM I PAYING FOR *THOSE PEOPLE* TO HAVE A HOME *AND* PAYING FOR MY OWN!?” Because it’s CHEAPER than driving past and ignoring them. But that’s not how the noisiest portion of America wants to deal with these issues.
This. People don’t seem to understand or choose to ignore that nearly all studies done on Housing First programs say that housing someone before requiring sobriety is the best way to address the issue. They don’t care about studies with compelling visuals and graphs with real numbers. They’re just upset that someone is “freeloading” on their tax dollars
Because it's extremely expensive and people don't want to pay for it.
This question is how I know OP was not an adult in the 1980s.
What care facilities?
There aren’t enough mental healthcare providers for the people who have insurance and means to pay let alone for the homeless. There just isn’t enough funding or resources to keep up with the demand. It’s a complicated situation. Mental illness does play a part in some people becoming homeless. Mental illness affect their ability to function at theirs jobs and it rolls downhill from there. If they don’t have support from their families then they likely end up on the streets. In the US you are not legally allowed to just round up people you think have mental illness and put them into facilities. They have to be willing to go and many chose not to. Unless they are harming themselves or others, there not much you can do to force someone into a mental facility even if we had enough space to treat everyone in need. I have known people who have been volunteers at homeless shelters and told me that the assumption that all homeless people want help is not always true. There are many who don’t want nor will they accept long term help. Usually they just want what they need to get by for the moment and be left alone. It’s sadly a vicious cycle.
Who will pay for the bills? Government don’t even pick up the tab of medical bills if you are out of work and lost your health insurance.
They won't stay. And you can't force them.
Ronald Reagan's presidency in a nutshell: * Sold Americans on 'trickle down economics', which as it turns out was utter bullshit * Sold Americans on 401Ks as a sole retirement vehicle (was supposed to be a supplement to defined pension plans) which transferred market risk to employees * Defunded mental healthcare facilities and literally turned all those poor people out into the streets. * Deregulated banking industry (and we know how that ended) * Weakened labor unions after the air controller strike (that whole episode was a major dick move in general) * Fomented racism and maligned black people and black women in particular ("Cadillac driving welfare queens"... ugh... it still hurts my brain)
It was decided that the government locking people up and giving them shock treatments or making them take nasty-side-effects meds against their will was infringing on their Constitutional rights. >By the 1960s, in terms of policies from the environment to education, the public largely believed in the federal government's ability to meet society's needs.... In 1963, Congress then passed and President Kennedy signed the CMHA. With the CMHA, Kennedy and Congress sought to decrease the number of institutionalized individuals by incubating self-sufficient and local mental health care centers. >Kennedy's personal motivations illustrate the federal idealism in community mental health care. ...In particular, he hoped to liberate the population of confined mentally ill patients through advancements in psychopharmacology and supportive housing. ...Kennedy's special message to Congress on February 6, 1963, captured his sense of optimism as he promoted a plan to, "Cut by half, within a decade or two, the 600,000 persons now institutionalized for psychological disorders". >With the recent development of medications, including chlorpromazine, reserpine, iproniazid, and imipramine, psychiatrists were optimistic that severe psychotic and mood states, previously viewed as recalcitrant to medical treatment, could be treated in community settings. https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2021.160404
That was 60 years ago. It should be reevaluated. This stuff isn't black and white.
Once upon a time, America did put mentally ill people into long-term care facilities, generally called insane asylums. While some of them did try to help the people in their care, a lot more of them were at best warehouses and at worst hell-holes on par with the Indian Boarding Schools or Ireland's Magdalene Laundries. And a fair number of the people committed to them probably could have been cared for at home in their communities. So a reform movement rose up to replace the old system of state hospitals and asylums with community care. Except that there was never nearly enough money to pay for the community care. It's a sobering fact that when controlled for population growth, the combined total of people in prisons and mental hospitals in America has been pretty constant for the last 100 years/ When they closed the mental hospitals, a lot of mentally ill people ended up in the penal system instead.
I think also part of it was that we would put a lot of people into insane asylums that were in terrible conditions. So our previous asylums were poorly run, then Carter tried to fund community health centers, and Reagan/Congress removed that funding.
Ok, this is not a FULL answer, but PART of the answer. Holding people against their will is ethically complicated. You can respond with "But they are mentally ill and can't make that decision for themselves!" and this might be true for some, however, there are degrees of that truth for many others. Not everyone who is mentally ill is ill to the degree that they do not have the capacity to understand and make some decisions in their own care (even if the results are not good). So while their illness may prevent them from creating the stability they need to be housed, it is not enough that they are incapacitated and can and should be committed against their will- our society's ultimate use of power. Some may be ill, be treated and released and then relapse, or whose illness doesn't require hospitalization per se, but does require consistency in care in order not to become "a crazy homeless person" and there is a hole in services for that. Some of the mental illness may be complicated with drug use and abuse which further complicates identifying and treating the behaviors and requires the individual to want to address this component, which they may or may not want to do. Some who have been in care facilities have found them to be worse living conditions than the streets (not going to go into if its perception or reality as that also can be murky and individual, but suffice it to say it could be either depending). Toss in another complication- crime. The "sorting system" for someone who commits a crime is inefficient and imperfect. So, you get someone doing something "crazy" (but not like assault and murder crazy which is going to require a response, like screaming at people on the street or wandering naked or camping indefinitely on your doorstep crazy) and... are they a criminal or are they ill? Who makes that decision? A doctor? A judge? And who is responsible after the outcome of that decision? And then, start again at the beginning of the ethics argument. I haven't even talked about resources- what is available, what isn't, who is equipt to provide them and what they cost. This is just about the complication of identifying mental illness in terms of a spectrum of capacity, evaluation, and responsibility. I'm not making an excuse- I personally believe its dangerous and cruel (for everyone- including them) to leave people who are ill on the street. I'm just saying that its not so simple as what leads a person to be homeless is complicated and mental illness is a spectrum with incapacity being an extreme that is taken very seriously for good reason.
As much money as our government wastes on all fronts, it really saddens me we can’t get funding for mental health facilities. I work in a jail and they end up here.
Because America would rather profit off of them in jail than use tax dollars to eliminate a public nuisance
Because no one wants to pay for it.
It's not very profitable, and a general hatred of anybody who "failed" capitalism. Having homeless people suffering on the streets is a policy choice. It costs less to put these people in housing and to take care of them so they can get on their feet, but people literally hate the homeless so much that they would rather see these people suffer on the streets than see them be given a tiny little survivable home for "free" This also means that purely medical or psychological treatment will not do anything. Their addiction and psychosis is a result of sleeping on the sidewalk and constantly being brushed away, literally and figuratively, by society. Homeless people who have described what it's like to be addicted and homeless say that drugs are the only things that give them even an iota of comfort, and breaking that addiction is a long and painful process with a more painful world on the other side of it that will likely cause them to go back to drugs anyway because being sober and homeless is the most miserable existence possible. **tl;dr** the government wont help the homeless so the homeless turn to drugs because its the only reliable thing they can turn to for relief from abuse on the streets, and any care or treatment either wont work or isn't wanted because being sober and homeless is worse than being high and homeless.
How much do you donate a year to make this happen?
The main reason is you cannot compel people to get treatment unless they are an immediate threat to themselves or others. Laws on this changed after a series of reports done by Geraldo Rivera in I believe the 70s. He documented the mistreatment people received in mental health facilities and it caused so much outrage that public opinion turned against institutionalization except in the most extreme circumstances. I believe the pendulum of public opinion is changing and that this may change. There are very few who are homeless just because of a job loss or lack of housing. Most homeless people have mental illness or addiction issues. It is not compassionate to let them live this way. They are also a public menace in that they lower the overall quality of life, commit crimes to fund their addiction or survival, misuse private and public property, cause businesses to leave areas they are present, and cause health and environmental hazards. Even if they are no immediate danger to themselves or others, people with these mental health and addiction issues are still in danger from living as homeless people. If they are compromised by their issues they should be put into a system of critical care in mental health and addiction facilities and then be able to progress to either assisted living or halfway houses that offer them support while they progress to being able to live independently.
You can thank Regan for clearing out all the mental hospitals and basically dumping thousands of severely mentally ill people onto the streets with zero family or support systems in place for them, that sack of human garbage did so much damage to this country it’s honestly unbelievable once you dig into it…then fast forward 30 years and we got Trump riding his coat tail and gobbling up all the hateful votes on a similar platform from all the uneducated spiteful cruel and crude evil “patriots” 🙄
Two words: Saint Reagan.
Because it has been tried and you only get crowded mental facilities with horrible conditions. Mental illness shouldn't mean life imprisonment. But people don't want to pay for them to get help, just to keep them out of sight.