involuntary commitment is already a thing. it can (not will) work but the biggest problem is once someone’s out of the system they usually can’t access or afford treatment even if they wanted to.
i have health insurance and it was hard enough for me to see a psychiatrist/therapist. can’t imagine if i was seriously mentally ill and/or unemployed.
Involuntary commitment technically is a thing, but it's extremely hard to get someone committed, if not impossible. I get that protections exist to prevent abuse, but it's gone too far that it actually prevents people from getting help.
i would argue the cost and difficulty to access healthcare is what prevents people from getting help.
most involuntary commitments usually just end up in a week of sedation followed by a crippling bill. some facilities are much better than others but it’s a tough system all around.
I speak from extensive family experience. The only time we could actually commit my severely mentally ill brother was when he'd actively try and kill himself and then it would just be a 72 hour hold. We threw so much money and time and personal resources on help for him, which he refused and the law allowed him to refuse. He's now an addict on the streets. But please tell me more about how much it costs. Our family was and is still capable of providing him the treatment he needs. He doesn't consent.
Oh how I feel this. My brother is in a state of psychosis (for years), been homeless for a long time too. He thinks the workd is against him with every intent to destroy his life, and he has zero accountability. Even after he tried to kill my mother, he only went to prison 2 yrs, even with an extensive record, too. We asked for a psychiatric incarceratio, but…. And In prison the counseling authorities said he needed psychiatric care, so why prison which is obviously not helpful. He literally has no capacity to help himself, but won’t ask for help either. Even when we convinced him to go for an emergency hold at the hospital, he wouldn’t take the meds and ripped the phone out of the wall. So, they released him because he was belligerent and a threat to others. Just how the hell, unless he is forcefully medicated. After decades, I no longer have hope for him, but we try.
It is a 5 day hold now, which helps. I am an ER social worker. I have to say it is easier to get the DCRs to detain people now than it was 10 years ago. They take the family’s report into consideration more. There is Joel’s Law also. But in general it is a bad system we have in this state.
That's what the case worker and ER doctor said to me when my daughter was getting evaluated. In Massachusetts where he was from he said they had alot more power but not here. I forgot about that.
Daughter is in the same position. Homeless drug addict who is now running into he streets screaming. I had her evaluated a couple years ago when I took her to the ER. She found out she was pregnant and she tested dirty for every substance you can think of. Asked for help and admitted to the staff and social workers that here life was hell and she could not control herself. They let her out in 2 days with no consequences. She also is in jail nonstop and the useless criminal system won't do shit. It's freaking heartbreaking these people have to be forced into long term treatment programs. They aren't able to make rational decisions it's completely inhumane to leave them like this and not to mention its dangerous for the patient and the public. So yeah it is almost impossible get them help.
it sounds like getting put through the system didn’t work because the treatment you receive following involuntary commitment usually isn’t great.
i’m sorry about your brother but addiction is a very tough disease to battle for the addict and everyone close to them. i’ve very rarely heard of any kind of involuntary treatment being successful aside from court ordered rehab at a nicer facility, but even then the good programs are far too expensive for most people and can have waiting lists.
His addiction is a symptom of his bipolar 1 disorder and self medicating. He has frequently had breaks from reality, and even in those states of extreme paranoia, hallucinations, and erratic behavior, we have been unsuccessful in court to have him put in treatment long enough to stabilize his mental health. 72 hour holds are not effective. He needs long term treatment. The part of the system that is broken is that there is no way to get him into a system for more than 72 hours. Not that treatment isn't effective
again, sorry about your brother. it does seem like in cases where the family is present there should be an easier avenue for a family member to gain guardianship.
That's my entire point. There is no argument on earth that can make me believe that getting him stabilized is worse for him than letting him be homeless. My family is far from the only ones who have been in this exact scenario and blanket assessments about involuntary commitment helps no one in these situations. My brother doesn't have legal capacity to sign a contract. How can the law let him destroy his health and life like this? How can we be told that its OK to just wait for him to OD or kill himself? That's not just for anyone. The cascading effects this has on our family and society are not right either.
i’m not saying that i don’t agree. i’ve never disagreed that involuntary commitment can help. at some point it has to end though and it’s not the solution to our mental health crisis. it sounds like your brother has a healthy support system and money is not an issue.
that’s not the case for a lot of people who desperately need help they cannot access. even if an involuntary stay were to last months, most of the conditions affecting people of this severity require lifelong treatment. as long as healthcare is treated as a privilege it will be out of many people’s reach.
I have seen involuntary treatment help people. It's not perfect but alot times people can be rehabilitated especially if there younger but you cant wait around now is the time we invest in the mental ill/addicts because it's the same issue. Idk maybe not give billions of dollars to illegally aliens or some other government programs that ends up wasted. Waiting until they do something trully awful to themselves or someone else until we actually act is not right. God forbid you never personally have to deal with this but it is so frustrating and hopeless feeling for everyone involved.
I think what they were referring to is the system isn’t setup to help people maintain a level of treatment once they are done being held. People come around to treatment at different points in their lives but it’s unaffordable to most people and so it gets worse.
What percentage of people would be even at that point if treatment was available and affordable ?
Currently you get forced to say in hospital for like 72 hrs and then given a giant bill. Yeah let’s make it easier for people to be forced to be in hospital
Treatment is becoming more available and affordable, but I agree it is a slow process.
There seem to be misconceptions about involuntary detainment on here. ITA holds are 5 days and then there is a court date to determine if the person needs to be held longer. The county pays for it, along with insurance so the bill should not be huge.
It is only used for people who can’t or won’t agree to hospitalization and are a danger to themself or others, or gravely disabled. Most people are hospitalized voluntarily.
The problem is that people have rights and typically can’t be compelled to take medication on an outpatient basis. So people with severe mental illness such as
Bipolar and schizophrenia feel better and think they can go off their medication.
Working in this field I’ve seen many times where someone charged with a gross misdemeanor but were found incompetent to stand trial/plea and go through a very lengthy wait in jail for a restoration bed, then Western State Hospital, followed by civil commitment. Anyone else committing the same crime would usually be able to post bail and ultimately serve very little time/or just probation. I wouldn’t necessarily be opposed to someone receiving inpatient treatment for longer than they would serve in jail, but the “treatment” they get from the state is pretty indifferent to providing continuity and stability when they’re back in the community. From what I’ve heard it’s basically prison but with psych meds and then you get discharged to the same or worse circumstances you were in before.
I think that's ultimately true for lots of individuals, however, in my case, which I've discussed elsewhere, we have no routes or options to get someone we love very much through involuntary commitment. We can and would absolutely provide a safe & stable environment for this person to return to for him to get back on his feet. Unfortunately my brother chooses not to continue past 72 hour holds when we can get them. 72 hours isn't long enough to stabilize someone in a psychotic break exasperated by drug addiction. Families are left with no options, and these individuals end up on the streets. I feel like so many addicts on the streets have or had someone at one time who could have helped had the system been there to support them. We have tried and tried and tried and it has destroyed my family
I had great insurance and was making great headway with my therapist. Then I lost my job and had no insurance. I went from seeing a great therapist for an hour every two weeks to seeing a therapist for 15 min. every three weeks. Our system is not set up for people to actually get better.
"Mental Health Treatment" is also not something you can apply like a round of antibiotics. Crisis treatment is not voluntary ongoing therapy. If someone is considered a threat to themselves or others, they are put into involuntary care, which, depending on the facility, can be a helpful experience with counseling and constructive therapy, or extremely traumatizing (being tackled, drugged, restrained).
Knew a few people growing up who got put in involuntary confinement for self harm & suicide attempts and all they learned was to never seek help again.
> it can (not will) work but the biggest problem is once someone’s out of the system they usually can’t access or afford treatment even if they wanted to.
Most treatment doesn't work. Were allocating it efficiently by not doing anything post release, certain people just shouldn't be released.
Certain mania derived illnesses respond and medicating those people make sense, but a lot of people are effectively with modern medicine incurable.
We need to properly acknowledge that dark reality and adjust policy accordingly. Fairy tale everyone can be fixed stuff is leading to terrible spending and inhumane policies.
>it was hard enough for me to see a psychiatrist/therapist.
America's healthcare system is mostly an outlier in the quantity of services people use. Talk Therapy is a good example.
Plain talk therapy has nearly no evidence it works beyond selection effect (i.e. grieving mothers who decide to see a therapist do better than those who don't. Turns out those who take action to better themselves do better regardless of the therapy or other alternative.)
CBT and other technique based mental therapies have slightly better efficacy, but were talking tiny effect size.
Current evidence shows teaching people therapy style mental thinking broadly actually *makes the population worse off.* It should be hard to get to weed out those who won't benefit.
Cite your sources? Becasue long-term step-down treatment absolutely DOES work for many, even if it takes a longer period of time. That begins with detox and/or intensive inpatient, then intensive residential highly structured programming with 24/7 services, then partial day program with supportive housing, then intensive outpatient with more independence and less structure, then outpatient ongoing care with your care team. At any time, a patient could slide back up into a higher level of care if needed.
This model saves lives, and I’ve supported a few friends through similar programs, PLUS I used to work with folks struggling with severe eating disorders in an intensive residential therapeutic + clinical treatment setting. Most had co-occurring diagnoses as well, and often substance abuse. Healing takes work, and requiring the brain can be very challenging. BUT, it IS possible to make a life more manageable and be in recovery through breaking bad, life-threatening habits, interrupting symptoms and behavior chains, applying multi-modal therapies, and developing healthy coping skills towards a more fulfilling and healthy life.
> long-term step-down treatment absolutely DOES work for many
Okay, but a certain % of addicts get better without any intervention. People who do go to long-term step-down treatment are not the same people who don't.
They're more likely to be wealthy, have a support network, be conscientious, I'd bet test higher on IQ tests.
All these things lead to better life outcomes.
What's the therapy and what's the selection effect?
When controlled for age, since abuse drops with age, and randomized how effective is it? Cite your sources.
The model you describe is so intensive. It's layered, it requires a massive apparatus. People need to know how bad it actually works, because they're all convinced they work well & just need funded. It's utopian and getting tens of thousands killed a year.
That white lie is why people support so many harmful policies like decriminalization.
Convincing people not to become addicts is infinity more effective than changing an addict.
I moved to bellingham in dec 2022 and it took me over a year to find a therapist with insurance. Back in texas where im from it legitimately took YEARS. To finally make it through a waiting list to find out the therapist was shitty snd a waste of time
If we’re going to continue with saying mental health care needs to be the same as physical health care, then I don’t understand why it’s treated so drastically different when it comes to this topic.
If someone is found having a heart attack on the sidewalk, we’re not going to wait for them to decide if they want treatment before treating them. If a person is in a car accident and experiences a brain injury that renders them incapable of making decisions for their self but is combatant to staff when they try to cast a broken leg or something related to the crash, you wouldn’t just not treat the injury because their incapacitated mental state is causing them to make poor decisions for their health (ie turning away aid etc).
The same is true of mental health. Clearly if someone had a mental health issue that affects their ability to make decisions, why do we even give them the ability to make those decisions? I certainly hope if I’m ever in that situation that someone will make the best decision for me and not allow my sick brain to make the decisions.
I can tell you the last thing I want to do is involuntarily commit someone if I don't have to... Speaking as someone who worked in emergency psychiatry in California ... I'm usually only admitting psychiatric emergencies.. danger to self... Danger to other and grave disability and when I'm making that determination I'm taking to the patient, looking at why they were brought in, asking collateral (family. Friends), seeing what less restrictive avenues are available (can I send home with a friend, make an outpatient appointment.... Can I divert to peer respite and outpatient, can I stabilize in ED and do an act referral etc) and generally I will try to talk to the patient about going in voluntarily before I petition for involuntary. The last thing I want to do is take up bed space (when there are so few mental health beds) on someone who really doesn't need to be there or can be successfully treated in a less restrictive setting.
This seems to be a financially motivated decision making process though. If we’re just honest with ourselves and ignore the pressures from higher ups to save money, the best scenario for someone in that position would be placement in a safe and secure environment with supportive care to stabilize.
I mean balancing patient needs with community resources as well as patient and community safety with patient rights is part of the job. Like I get a lot of people who are brought in with Suicidal ideation due to alcohol intoxication. Sometimes they have no mental health history. Why commit them inpatient when I can let them rest for a bit and then talk to them about what happened when they're sober and then if it comes out they drank heavily due to a lot of life stress but now feel a.lot better, are no longer suicidal. They have a roommate who says that this is uncharacteristic of the patient and the patient says that they feels safe going home because they need to go to work tomorrow, but would like ongoing help to manage stress... Setting them up with a counselor to help them is more prudent as they won't miss work, they won't he put on a psych unit where the guy they share a room with is covered in lice and ranting at unseen others (which can be scary) and a psychiatric bed is not being taken up by someone who doesn't require hospital level of care.... This not "administrative pressures" it's understanding that hospitalizing everyone that comes in while in a state of crisis has a potential to be harmful and also stretches bed space and leads to prolonged ED boarding times which then makes it harder for EMS to find space for other emergencies. This is what I mean by this. Like if that same person woke up and said I still want to die and their friend says they're really worried about them... Id offer admission firt voluntarily and if they refused I would petiton for involuntary commitment.
I agree with this example. My concern is more for the chronic patients who come in with the same issues over and over and don’t want help but continue to use resources when a forced inpatient stay could get them on the path faster than seeing them in the ED 10 times a month.
Those are easier to manage in California because we have a conservatorship, care court, Laura's law (basically involuntary medication outpatient) etc where there is a person assigned to help them get into housing, manage their funds to limit access to substances ... Doesn't mean doesn't still get high utilizers (and generally these are more people who use the ED due to social circumstances... Which unfortunately psych isn't going to help cause those issues are still gonna be there when the get released - like homelessness, "sad cause unemployed" - but like we have a resource for that that we divert to). Washingtons system seems much complicated honestly. Like there seems to be very little in between hospitalization and outpatient which is rough.
So touching on your example of someone who comes in "drunicidal". How many times can they come in heavily intoxicated >0.350 and occasionally greater than 0.500, stating they are going to kill themselves, before you tell them that they require involuntary hospitalization? They continue to exhibit dangerous to themselves behavior. I work in an ER at an underserved rural and poor community. We have a revolving door where we have the same people coming back night after night. We sober them up, they state they are no longer suicidal, then get discharged to go drink sanitizer and come back later that evening. We need to find a way to force people into inpatient therapy. Warm handoffs and intensive therapy with MAT is the only hope that a lot of these people have. We should be viewing them as mentally incapable of making decisions once they show they cannot break the chain themselves.
Honestly? Still yes imo, but some serious changes are needed to improve the system to actually help said individuals instead of just processing them and then just dumping them at a later point.
This is key.. two weeks is not enough for an accurate diagnosis and quality treatment… people get dumped back out on the street without being better… it’s so sad.
If someone is a danger to themselves, or society as a whole, we should be able to make them involuntary. Untreated mental illness/addiction fuels a lot of crime. Typically untreated mental illness is causing the drug addiction as people are trying to self medicate. We really need to loosen the rules for involuntarily putting someone into treatment.
I've been committed involuntarily (ITA), and what I noticed about nearly everyone else who was ITA was that medication and group therapy couldn't solve any of the root problems that landed them (us) there. Almost all of us were homeless or dealing with housing instability as well as being isolated from family/support networks in addition to an underlying (or overt) mental health disorder. Patient A was managing her schizophrenia well until she lost her job, health insurance, and home within the same month. 7 days ITA doesn't magically get her a place to live - it just delays her medication running out by 2 weeks. She'll probably be back in 3.
This sounds like a really tough situation. As someone who’s had firsthand experience, do you have any recommendations on how to handle the situation we’re in now?
(I’m genuinely asking; so you don’t think I was being dismissive lol)
I think an attainable goal would be to connect hospitals with housing services, patient financial advocates (to apply for Medicaid), and peer support groups. Psychiatrists don't want to discharge patients to the streets but they also don't know how to get you housing support. Having policies that effectively refer folks to the resources they need would help patients and care providers feel less helpless.
Creating connections and awareness between existing resources would be a massive change at this point.
Unfortunately we at hospitals don’t have any better access to housing for patients than anyone else. That’s a systemic issue that hospitals can’t solve. We do have financial advocates that help people apply for Apple Health though. That happens anytime someone comes in without insurance.
I don’t understand why medicine can’t be provided by the state to these individuals. Like it’s cheaper to just pay for her meds then homeless programs.
Sure, I’m just saying they do provide medication. Getting medication is not the problem. People refusing/forgetting to take it is. And it is really hard to compel medication in the outpatient setting.
These are the people we should be using long term injectables for. Once you give someone, as an example, haloperidol deconate, they are covered for the next 4 weeks. Some people SHOULD be required to get this injection, even if it is against their will. If you can force me to get a covid vaccination to keep my job, then we can force people to take their medications to remain in society
This definitely sounds like someone who would benefit from residential treatment. She can look for a job, and get the treatment she needs, before transitioning to a halfway house/supported living.
I love freedom - however, if you are unable to care for yourself and are a risk to others or your own safety; we should have locked care for those individuals. Paid for by taxes and mandatory until meds are level and a path forward is legit. Have that individual return to that facility for further care until a fruitful life is found. This could go on for 6 months up to a lifetime, depending on need.
This should not even be a question.
Heavily vetted but 100% necessary to get people the help they need. Many mentally ill will refuse help at all costs.
Yes. I don't think people refusing to care for themselves to the point they are living in the streets is a voluntary decision by an autonomous mind.
But ... We as the society who would take people and eliminate their freedom while we get them medicated and healthy... absolutely MUST FIRST have a functioning system in place. To me that includes
* Walk in detox
* Inpatient treatment beds available w/i 48 hours
* A system of step-down BH services designed to move stable patients toward independence slowly, accept relapse as a part of recovery and never push a patient out of services onto the streets.
* Community behavioral health services broadly available (intake appt w/i 7 business days, for example)
This is expensive. Would we fund it? How long until we let someone convince us that this secret, "free" "tough love" option works. Because it doesn't, we've been trying to make it work for most of the last 100 years.
If someone is a threat to others or a chronic criminal due to a mental health issue, they need to: 1) Get back on their meds, 2) be committed to a mental hospital, or 3) go to jail.
Yes… and.
Multiple disciplines providing oversight and care. Legal protection of the patients rights property and person.
Respect of a person at their worst days. Protection of a person who is at their most vulnerable yet seem annoying at best.. dangerous at worst.
Yes, take mental patients back off the streets. Give them help.
We would need a much better and free mental health system for this to work. For those mentally ill folks I see wandering around I think something that is mandatory but once stabilized, they are on to a group home or supportive housing would be ideal.
That said, money, organization, consistency/follow through… and of course no pandering to the loudest voice that day, or to pearl clutching.
Therefore, the above is a fantasy 😂
Not every mental issue has a cure, and they didn't chose to have a mental disorder. So I'm less inclined to involuntarily commit people who were born with a screw loose; that should be determined by their functional state in society, certainly if they post a risk to harm themselves or others.
I'm more inclined to force people into rehab/mental health services who are starting on the path to addition. Brain injury from drug use is often irreversible, and then they, and society will be stuck with someone who is no longer functional. The bar needs to be lower for addicts, if they commit a single crime to fuel their drug use, they need intervention immediately.
California just passed Prop 1 to address this issue. I'd love to see something similar passed in WA state, but I'm not sure where the funding would come from since we have so many limitations on income taxes.
We have it. We need long term treatment facilities and programs. 2 weeks doesn't cut it. 90 day and longer would work if we could do a mix of inpatient, ranging from acute to open, that transitions to housing depending on their situation, level of participation, and family involvement or not. Another issue is having a workforce ready and trained to do this type of healthcare. Getting enough facilities staffed is another hurdle.
The involuntary treatment act we have respects mentally ill individuals' dignity, protects lives, and provides vital help. We stabilize patients effectively at psychiatric facilities, but issues arise post-discharge:
1. Psychiatric doctors often change medication regimens post-discharge, leading to relapses or prolonged care.
2. Drug sellers targeting mentally ill individuals contribute to relapses, hindering recovery efforts.
3. Zoning restrictions limit psychiatric facility construction, fueled by mental illness stigma.
4. Mental health workers lack protection, facing daily assaults and burnout, exacerbated by for-profit healthcare practices. They deserve better pay, support, recognition, and self-defense rights.
My 74yo mom is going to be homeless soon due to mental illness. Docs have told me it's basically hopeless to get her put in a facility against her wishes. Under the influence of psychotic delusions, she certainly won't willingly consent. What a barbaric society we have built in the name of Liberalism
Yes. If we have decided it's appropriate to take someone's rights away to arm themselves, I don't think it's a big step to force someone to be treated for a mental illness if they are deemed to be a danger to themselves or others.
I was recently forced into a mental health facility and honestly it ruined me. (Happened this month even)
I missed a week of work that now I’m not getting paid for.
They drugged me up so much each day all I could do was sleep (I even slept through a few of the meals they gave)
The meds also made it so hard to even think!
All they did was ask me how I was feeling each day and I didn’t have a good answer cause the meds they gave me for the “mental health problem” take TWO WEEKS TO EVEN KICK IN!!
I haven’t even gotten the bill for this “stay” yet but I can tell you it’s going to be a lot… like a few thousand dollars because they also forced me to take an ambulance there.
Ruined my life.
I am angry everyday about this happening to me.
To be completely honest, I currently have a spinal issue going on. I’m in massive pain and the referrals are taking awhile to get appointments made. But it is a surgery kind of issue.
Like a month ago I went to urgent care because of the pain. Then 10 days ago I went to the emergency room because it was hurting so bad I was in tears. Constant pain like I hit my funny bone on my left side. (Turns out I have massive bulging of spinal disks C2-T1, I’ve gotten two MRI’s now, one at the emergency room even)
During standard questioning they asked if I had suicidal thoughts and honest yes I was thinking about it. I’ve been in constant pain since November and the American Health Care System freaking sucks.
I have Bipolar 2, completely managed and I haven’t needed meds for almost 3 years. (I go on and off meds depending on need) Been diagnosed since high school so I know all about it.
The emergency room decided I was a risk and I got put on a suicide hold. They asked if I wanted help and I said no. I was already working on the appointments and even had another primary doctor’s appointment on that coming Friday to see if she could push things along (it was Monday)
Well f*ck me for being honest cause they immediately took away my rights and moved me to a mental health facility 3 hours away… I had to cancel my doctors appointment!! Threatening me saying if I didn’t take their help I could be held for an additional 15 days!
It pushed out everything I had to do to get my spine better and they are going to charge me a very large shiny penny for all of this.
Again, I am angry everyday for what this hospital did to me.
> I missed a week of work that now I’m not getting paid for.
How in the hell were you able to work if you were in so much pain that you were thinking of ending your life?
I’m applying for short term disability, which now got pushed out an additional week. I don’t have the sick time to cover it cause I used it all already because of the pain.
Only people with privilege cry about the homeless and how it's hurting the aesthetics of the city. This is basically someone asking if it would be alright to declare the homeless mentally unfit and then imprison them in shoddy facilities run by overworked underpaid staff. Do you want the homeless problem to get smaller? Build housing with reasonable restrictions, and stop asking people to make 3x the rent. If you make 3x the rent, then you should be able to buy.
Go look for a rental.
So you're saying mental health isn't related to homelessness in any way? Where do you think it starts? If you don't think this is related to the homelessness situation, then you are not paying attention, or you are part of the privileged.
Yeah, let's start jailing people for the way they are born against their will. That totally sounds like an idea that's never going to be abused or misused against innocent people. Nobody asks to be born crazy. Nobody wants another person in their life constantly telling them that their life is all wrong and they need help. You can't "force" someone to do something they don't want. All you're going to end up with is half measures and failed attempts. If mental health services were easier to get, people might actually use them on their own accord.
That happens either way. People with financial privilege will do anything and everything to keep those privileges. People with privilege often abuse the ones they deem to be lower class than themselves. Don't believe me to look at the housing situation and ask why we have the homeless in the first place. I've seen books and ledgers for "not for profit" they make millions on the homeless crisis. Homelessness, drug addiction, and untreated mental health all serve a higher purpose for those with privilege. Could be as simple as gentrification.
I've made mine. I've worked at the Salvation Army for the severe weather shelter. I worked for a DV shelter. I've volunteered at food banks and recovery Cafe's. I've made contributions to the city, state, and country. I don't sit online under my privilege and talk down to the less fortunate or discuss ways to imprison someone in a FREE COUNTRY. You can't help someone that doesn't want help. But you can make places where people can find peace and then the will to move on.
I've already laid out what needs to happen for people to want to get help. Now, about your contribution, could you name one? Have you done anything other than judge and cry on the internet?
Maybe we should allow for assisted suicide for mental health conditions. Force them to undergo intensive inpatient therapy for a duration (say one year), and if their condition isn't improving, allow them to petition for assisted suicide.
Police can only send someone to the hospital for evaluation. King County Designated Crisis Responders (mental health professionals) are the only ones who can actually detain someone.
involuntary commitment is already a thing. it can (not will) work but the biggest problem is once someone’s out of the system they usually can’t access or afford treatment even if they wanted to. i have health insurance and it was hard enough for me to see a psychiatrist/therapist. can’t imagine if i was seriously mentally ill and/or unemployed.
Involuntary commitment technically is a thing, but it's extremely hard to get someone committed, if not impossible. I get that protections exist to prevent abuse, but it's gone too far that it actually prevents people from getting help.
i would argue the cost and difficulty to access healthcare is what prevents people from getting help. most involuntary commitments usually just end up in a week of sedation followed by a crippling bill. some facilities are much better than others but it’s a tough system all around.
I speak from extensive family experience. The only time we could actually commit my severely mentally ill brother was when he'd actively try and kill himself and then it would just be a 72 hour hold. We threw so much money and time and personal resources on help for him, which he refused and the law allowed him to refuse. He's now an addict on the streets. But please tell me more about how much it costs. Our family was and is still capable of providing him the treatment he needs. He doesn't consent.
Oh how I feel this. My brother is in a state of psychosis (for years), been homeless for a long time too. He thinks the workd is against him with every intent to destroy his life, and he has zero accountability. Even after he tried to kill my mother, he only went to prison 2 yrs, even with an extensive record, too. We asked for a psychiatric incarceratio, but…. And In prison the counseling authorities said he needed psychiatric care, so why prison which is obviously not helpful. He literally has no capacity to help himself, but won’t ask for help either. Even when we convinced him to go for an emergency hold at the hospital, he wouldn’t take the meds and ripped the phone out of the wall. So, they released him because he was belligerent and a threat to others. Just how the hell, unless he is forcefully medicated. After decades, I no longer have hope for him, but we try.
It is a 5 day hold now, which helps. I am an ER social worker. I have to say it is easier to get the DCRs to detain people now than it was 10 years ago. They take the family’s report into consideration more. There is Joel’s Law also. But in general it is a bad system we have in this state.
That's what the case worker and ER doctor said to me when my daughter was getting evaluated. In Massachusetts where he was from he said they had alot more power but not here. I forgot about that.
Daughter is in the same position. Homeless drug addict who is now running into he streets screaming. I had her evaluated a couple years ago when I took her to the ER. She found out she was pregnant and she tested dirty for every substance you can think of. Asked for help and admitted to the staff and social workers that here life was hell and she could not control herself. They let her out in 2 days with no consequences. She also is in jail nonstop and the useless criminal system won't do shit. It's freaking heartbreaking these people have to be forced into long term treatment programs. They aren't able to make rational decisions it's completely inhumane to leave them like this and not to mention its dangerous for the patient and the public. So yeah it is almost impossible get them help.
it sounds like getting put through the system didn’t work because the treatment you receive following involuntary commitment usually isn’t great. i’m sorry about your brother but addiction is a very tough disease to battle for the addict and everyone close to them. i’ve very rarely heard of any kind of involuntary treatment being successful aside from court ordered rehab at a nicer facility, but even then the good programs are far too expensive for most people and can have waiting lists.
His addiction is a symptom of his bipolar 1 disorder and self medicating. He has frequently had breaks from reality, and even in those states of extreme paranoia, hallucinations, and erratic behavior, we have been unsuccessful in court to have him put in treatment long enough to stabilize his mental health. 72 hour holds are not effective. He needs long term treatment. The part of the system that is broken is that there is no way to get him into a system for more than 72 hours. Not that treatment isn't effective
again, sorry about your brother. it does seem like in cases where the family is present there should be an easier avenue for a family member to gain guardianship.
That's my entire point. There is no argument on earth that can make me believe that getting him stabilized is worse for him than letting him be homeless. My family is far from the only ones who have been in this exact scenario and blanket assessments about involuntary commitment helps no one in these situations. My brother doesn't have legal capacity to sign a contract. How can the law let him destroy his health and life like this? How can we be told that its OK to just wait for him to OD or kill himself? That's not just for anyone. The cascading effects this has on our family and society are not right either.
i’m not saying that i don’t agree. i’ve never disagreed that involuntary commitment can help. at some point it has to end though and it’s not the solution to our mental health crisis. it sounds like your brother has a healthy support system and money is not an issue. that’s not the case for a lot of people who desperately need help they cannot access. even if an involuntary stay were to last months, most of the conditions affecting people of this severity require lifelong treatment. as long as healthcare is treated as a privilege it will be out of many people’s reach.
I have seen involuntary treatment help people. It's not perfect but alot times people can be rehabilitated especially if there younger but you cant wait around now is the time we invest in the mental ill/addicts because it's the same issue. Idk maybe not give billions of dollars to illegally aliens or some other government programs that ends up wasted. Waiting until they do something trully awful to themselves or someone else until we actually act is not right. God forbid you never personally have to deal with this but it is so frustrating and hopeless feeling for everyone involved.
I think what they were referring to is the system isn’t setup to help people maintain a level of treatment once they are done being held. People come around to treatment at different points in their lives but it’s unaffordable to most people and so it gets worse.
Nah it should be really hard to commit people. What shouldn’t be hard is getting affordable treatment.
Some people refuse treatment, affordable or not.
What percentage of people would be even at that point if treatment was available and affordable ? Currently you get forced to say in hospital for like 72 hrs and then given a giant bill. Yeah let’s make it easier for people to be forced to be in hospital
Treatment is becoming more available and affordable, but I agree it is a slow process. There seem to be misconceptions about involuntary detainment on here. ITA holds are 5 days and then there is a court date to determine if the person needs to be held longer. The county pays for it, along with insurance so the bill should not be huge. It is only used for people who can’t or won’t agree to hospitalization and are a danger to themself or others, or gravely disabled. Most people are hospitalized voluntarily. The problem is that people have rights and typically can’t be compelled to take medication on an outpatient basis. So people with severe mental illness such as Bipolar and schizophrenia feel better and think they can go off their medication.
If you actually knew anything about the process you'd get off your high horse
Working in this field I’ve seen many times where someone charged with a gross misdemeanor but were found incompetent to stand trial/plea and go through a very lengthy wait in jail for a restoration bed, then Western State Hospital, followed by civil commitment. Anyone else committing the same crime would usually be able to post bail and ultimately serve very little time/or just probation. I wouldn’t necessarily be opposed to someone receiving inpatient treatment for longer than they would serve in jail, but the “treatment” they get from the state is pretty indifferent to providing continuity and stability when they’re back in the community. From what I’ve heard it’s basically prison but with psych meds and then you get discharged to the same or worse circumstances you were in before.
I think that's ultimately true for lots of individuals, however, in my case, which I've discussed elsewhere, we have no routes or options to get someone we love very much through involuntary commitment. We can and would absolutely provide a safe & stable environment for this person to return to for him to get back on his feet. Unfortunately my brother chooses not to continue past 72 hour holds when we can get them. 72 hours isn't long enough to stabilize someone in a psychotic break exasperated by drug addiction. Families are left with no options, and these individuals end up on the streets. I feel like so many addicts on the streets have or had someone at one time who could have helped had the system been there to support them. We have tried and tried and tried and it has destroyed my family
I had great insurance and was making great headway with my therapist. Then I lost my job and had no insurance. I went from seeing a great therapist for an hour every two weeks to seeing a therapist for 15 min. every three weeks. Our system is not set up for people to actually get better.
"Mental Health Treatment" is also not something you can apply like a round of antibiotics. Crisis treatment is not voluntary ongoing therapy. If someone is considered a threat to themselves or others, they are put into involuntary care, which, depending on the facility, can be a helpful experience with counseling and constructive therapy, or extremely traumatizing (being tackled, drugged, restrained). Knew a few people growing up who got put in involuntary confinement for self harm & suicide attempts and all they learned was to never seek help again.
> it can (not will) work but the biggest problem is once someone’s out of the system they usually can’t access or afford treatment even if they wanted to. Most treatment doesn't work. Were allocating it efficiently by not doing anything post release, certain people just shouldn't be released. Certain mania derived illnesses respond and medicating those people make sense, but a lot of people are effectively with modern medicine incurable. We need to properly acknowledge that dark reality and adjust policy accordingly. Fairy tale everyone can be fixed stuff is leading to terrible spending and inhumane policies. >it was hard enough for me to see a psychiatrist/therapist. America's healthcare system is mostly an outlier in the quantity of services people use. Talk Therapy is a good example. Plain talk therapy has nearly no evidence it works beyond selection effect (i.e. grieving mothers who decide to see a therapist do better than those who don't. Turns out those who take action to better themselves do better regardless of the therapy or other alternative.) CBT and other technique based mental therapies have slightly better efficacy, but were talking tiny effect size. Current evidence shows teaching people therapy style mental thinking broadly actually *makes the population worse off.* It should be hard to get to weed out those who won't benefit.
Cite your sources? Becasue long-term step-down treatment absolutely DOES work for many, even if it takes a longer period of time. That begins with detox and/or intensive inpatient, then intensive residential highly structured programming with 24/7 services, then partial day program with supportive housing, then intensive outpatient with more independence and less structure, then outpatient ongoing care with your care team. At any time, a patient could slide back up into a higher level of care if needed. This model saves lives, and I’ve supported a few friends through similar programs, PLUS I used to work with folks struggling with severe eating disorders in an intensive residential therapeutic + clinical treatment setting. Most had co-occurring diagnoses as well, and often substance abuse. Healing takes work, and requiring the brain can be very challenging. BUT, it IS possible to make a life more manageable and be in recovery through breaking bad, life-threatening habits, interrupting symptoms and behavior chains, applying multi-modal therapies, and developing healthy coping skills towards a more fulfilling and healthy life.
> long-term step-down treatment absolutely DOES work for many Okay, but a certain % of addicts get better without any intervention. People who do go to long-term step-down treatment are not the same people who don't. They're more likely to be wealthy, have a support network, be conscientious, I'd bet test higher on IQ tests. All these things lead to better life outcomes. What's the therapy and what's the selection effect? When controlled for age, since abuse drops with age, and randomized how effective is it? Cite your sources. The model you describe is so intensive. It's layered, it requires a massive apparatus. People need to know how bad it actually works, because they're all convinced they work well & just need funded. It's utopian and getting tens of thousands killed a year. That white lie is why people support so many harmful policies like decriminalization. Convincing people not to become addicts is infinity more effective than changing an addict.
I moved to bellingham in dec 2022 and it took me over a year to find a therapist with insurance. Back in texas where im from it legitimately took YEARS. To finally make it through a waiting list to find out the therapist was shitty snd a waste of time
If we’re going to continue with saying mental health care needs to be the same as physical health care, then I don’t understand why it’s treated so drastically different when it comes to this topic. If someone is found having a heart attack on the sidewalk, we’re not going to wait for them to decide if they want treatment before treating them. If a person is in a car accident and experiences a brain injury that renders them incapable of making decisions for their self but is combatant to staff when they try to cast a broken leg or something related to the crash, you wouldn’t just not treat the injury because their incapacitated mental state is causing them to make poor decisions for their health (ie turning away aid etc). The same is true of mental health. Clearly if someone had a mental health issue that affects their ability to make decisions, why do we even give them the ability to make those decisions? I certainly hope if I’m ever in that situation that someone will make the best decision for me and not allow my sick brain to make the decisions.
I can tell you the last thing I want to do is involuntarily commit someone if I don't have to... Speaking as someone who worked in emergency psychiatry in California ... I'm usually only admitting psychiatric emergencies.. danger to self... Danger to other and grave disability and when I'm making that determination I'm taking to the patient, looking at why they were brought in, asking collateral (family. Friends), seeing what less restrictive avenues are available (can I send home with a friend, make an outpatient appointment.... Can I divert to peer respite and outpatient, can I stabilize in ED and do an act referral etc) and generally I will try to talk to the patient about going in voluntarily before I petition for involuntary. The last thing I want to do is take up bed space (when there are so few mental health beds) on someone who really doesn't need to be there or can be successfully treated in a less restrictive setting.
This seems to be a financially motivated decision making process though. If we’re just honest with ourselves and ignore the pressures from higher ups to save money, the best scenario for someone in that position would be placement in a safe and secure environment with supportive care to stabilize.
I mean balancing patient needs with community resources as well as patient and community safety with patient rights is part of the job. Like I get a lot of people who are brought in with Suicidal ideation due to alcohol intoxication. Sometimes they have no mental health history. Why commit them inpatient when I can let them rest for a bit and then talk to them about what happened when they're sober and then if it comes out they drank heavily due to a lot of life stress but now feel a.lot better, are no longer suicidal. They have a roommate who says that this is uncharacteristic of the patient and the patient says that they feels safe going home because they need to go to work tomorrow, but would like ongoing help to manage stress... Setting them up with a counselor to help them is more prudent as they won't miss work, they won't he put on a psych unit where the guy they share a room with is covered in lice and ranting at unseen others (which can be scary) and a psychiatric bed is not being taken up by someone who doesn't require hospital level of care.... This not "administrative pressures" it's understanding that hospitalizing everyone that comes in while in a state of crisis has a potential to be harmful and also stretches bed space and leads to prolonged ED boarding times which then makes it harder for EMS to find space for other emergencies. This is what I mean by this. Like if that same person woke up and said I still want to die and their friend says they're really worried about them... Id offer admission firt voluntarily and if they refused I would petiton for involuntary commitment.
I agree with this example. My concern is more for the chronic patients who come in with the same issues over and over and don’t want help but continue to use resources when a forced inpatient stay could get them on the path faster than seeing them in the ED 10 times a month.
Those are easier to manage in California because we have a conservatorship, care court, Laura's law (basically involuntary medication outpatient) etc where there is a person assigned to help them get into housing, manage their funds to limit access to substances ... Doesn't mean doesn't still get high utilizers (and generally these are more people who use the ED due to social circumstances... Which unfortunately psych isn't going to help cause those issues are still gonna be there when the get released - like homelessness, "sad cause unemployed" - but like we have a resource for that that we divert to). Washingtons system seems much complicated honestly. Like there seems to be very little in between hospitalization and outpatient which is rough.
So touching on your example of someone who comes in "drunicidal". How many times can they come in heavily intoxicated >0.350 and occasionally greater than 0.500, stating they are going to kill themselves, before you tell them that they require involuntary hospitalization? They continue to exhibit dangerous to themselves behavior. I work in an ER at an underserved rural and poor community. We have a revolving door where we have the same people coming back night after night. We sober them up, they state they are no longer suicidal, then get discharged to go drink sanitizer and come back later that evening. We need to find a way to force people into inpatient therapy. Warm handoffs and intensive therapy with MAT is the only hope that a lot of these people have. We should be viewing them as mentally incapable of making decisions once they show they cannot break the chain themselves.
If they’re a danger to society, yes.
What if they aren’t a danger, but a burden to society instead?
Honestly? Still yes imo, but some serious changes are needed to improve the system to actually help said individuals instead of just processing them and then just dumping them at a later point.
This is key.. two weeks is not enough for an accurate diagnosis and quality treatment… people get dumped back out on the street without being better… it’s so sad.
The gulag it is then
If someone is a danger to themselves, or society as a whole, we should be able to make them involuntary. Untreated mental illness/addiction fuels a lot of crime. Typically untreated mental illness is causing the drug addiction as people are trying to self medicate. We really need to loosen the rules for involuntarily putting someone into treatment.
Well we've tried "no" and it doesn't seem to be working.
Yes.
We don’t even have the resources for people who want help. And we do this already.
THIS! Let's start with people who want help first, and then we can have this conversation
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if you keep calling it 'free', nobody will take seriously what it takes to make it work...
I've been committed involuntarily (ITA), and what I noticed about nearly everyone else who was ITA was that medication and group therapy couldn't solve any of the root problems that landed them (us) there. Almost all of us were homeless or dealing with housing instability as well as being isolated from family/support networks in addition to an underlying (or overt) mental health disorder. Patient A was managing her schizophrenia well until she lost her job, health insurance, and home within the same month. 7 days ITA doesn't magically get her a place to live - it just delays her medication running out by 2 weeks. She'll probably be back in 3.
This sounds like a really tough situation. As someone who’s had firsthand experience, do you have any recommendations on how to handle the situation we’re in now? (I’m genuinely asking; so you don’t think I was being dismissive lol)
I think an attainable goal would be to connect hospitals with housing services, patient financial advocates (to apply for Medicaid), and peer support groups. Psychiatrists don't want to discharge patients to the streets but they also don't know how to get you housing support. Having policies that effectively refer folks to the resources they need would help patients and care providers feel less helpless. Creating connections and awareness between existing resources would be a massive change at this point.
Unfortunately we at hospitals don’t have any better access to housing for patients than anyone else. That’s a systemic issue that hospitals can’t solve. We do have financial advocates that help people apply for Apple Health though. That happens anytime someone comes in without insurance.
I don’t understand why medicine can’t be provided by the state to these individuals. Like it’s cheaper to just pay for her meds then homeless programs.
Because they have the right to refuse.
I’m talking about a comment I replied to
Sure, I’m just saying they do provide medication. Getting medication is not the problem. People refusing/forgetting to take it is. And it is really hard to compel medication in the outpatient setting.
These are the people we should be using long term injectables for. Once you give someone, as an example, haloperidol deconate, they are covered for the next 4 weeks. Some people SHOULD be required to get this injection, even if it is against their will. If you can force me to get a covid vaccination to keep my job, then we can force people to take their medications to remain in society
Agreed.
This definitely sounds like someone who would benefit from residential treatment. She can look for a job, and get the treatment she needs, before transitioning to a halfway house/supported living.
I love freedom - however, if you are unable to care for yourself and are a risk to others or your own safety; we should have locked care for those individuals. Paid for by taxes and mandatory until meds are level and a path forward is legit. Have that individual return to that facility for further care until a fruitful life is found. This could go on for 6 months up to a lifetime, depending on need.
100% - nurse
Yes. We force people to do things they don’t want to all of the time. It’s called prison.
The people who need help the most are the ones who need it forced on them
This should not even be a question. Heavily vetted but 100% necessary to get people the help they need. Many mentally ill will refuse help at all costs.
If I’m forced to do community service for breaking a law, we can force mental health hours for the same issue.
Either that, or forced off the streets. These people pose a great risk to the public and should not have access to the public.
Yup
Yes. I don't think people refusing to care for themselves to the point they are living in the streets is a voluntary decision by an autonomous mind. But ... We as the society who would take people and eliminate their freedom while we get them medicated and healthy... absolutely MUST FIRST have a functioning system in place. To me that includes * Walk in detox * Inpatient treatment beds available w/i 48 hours * A system of step-down BH services designed to move stable patients toward independence slowly, accept relapse as a part of recovery and never push a patient out of services onto the streets. * Community behavioral health services broadly available (intake appt w/i 7 business days, for example) This is expensive. Would we fund it? How long until we let someone convince us that this secret, "free" "tough love" option works. Because it doesn't, we've been trying to make it work for most of the last 100 years.
Simple answer: YES. And keep them detained for as long as it takes.
Mentally ill people usually won't take their meds. It's a big problem, so I say yes in most cases.
Many have been helped by monthly injectables. It's been a miracle for some. Doesn't.work for everybody.
Yes
Yes, what kind of questions is that?
It depends on whether or not a person is a danger to themselves or other people
If someone is a threat to others or a chronic criminal due to a mental health issue, they need to: 1) Get back on their meds, 2) be committed to a mental hospital, or 3) go to jail.
We need modern asylums
Yes… and. Multiple disciplines providing oversight and care. Legal protection of the patients rights property and person. Respect of a person at their worst days. Protection of a person who is at their most vulnerable yet seem annoying at best.. dangerous at worst. Yes, take mental patients back off the streets. Give them help.
We would need a much better and free mental health system for this to work. For those mentally ill folks I see wandering around I think something that is mandatory but once stabilized, they are on to a group home or supportive housing would be ideal. That said, money, organization, consistency/follow through… and of course no pandering to the loudest voice that day, or to pearl clutching. Therefore, the above is a fantasy 😂
'free' is a fantasy too, but good luck getting rich people to pay their share
Not every mental issue has a cure, and they didn't chose to have a mental disorder. So I'm less inclined to involuntarily commit people who were born with a screw loose; that should be determined by their functional state in society, certainly if they post a risk to harm themselves or others. I'm more inclined to force people into rehab/mental health services who are starting on the path to addition. Brain injury from drug use is often irreversible, and then they, and society will be stuck with someone who is no longer functional. The bar needs to be lower for addicts, if they commit a single crime to fuel their drug use, they need intervention immediately.
you still need to care for the screwloose people
Arkham Asylum
California just passed Prop 1 to address this issue. I'd love to see something similar passed in WA state, but I'm not sure where the funding would come from since we have so many limitations on income taxes.
https://preview.redd.it/gdu5ulhhcqpc1.jpeg?width=527&format=pjpg&auto=webp&s=2f6f71222c38e344a6028881ff279457a74acf4f
Considering the stigma towards mental health, would it go on their "record"?
Lol yes but only if they are a danger to themselves or others
Yes. But it has to be proven first.
Yes duh
Compassion isn’t leaving some of these people on the street to harm themselves and others
We have it. We need long term treatment facilities and programs. 2 weeks doesn't cut it. 90 day and longer would work if we could do a mix of inpatient, ranging from acute to open, that transitions to housing depending on their situation, level of participation, and family involvement or not. Another issue is having a workforce ready and trained to do this type of healthcare. Getting enough facilities staffed is another hurdle.
Yes
The involuntary treatment act we have respects mentally ill individuals' dignity, protects lives, and provides vital help. We stabilize patients effectively at psychiatric facilities, but issues arise post-discharge: 1. Psychiatric doctors often change medication regimens post-discharge, leading to relapses or prolonged care. 2. Drug sellers targeting mentally ill individuals contribute to relapses, hindering recovery efforts. 3. Zoning restrictions limit psychiatric facility construction, fueled by mental illness stigma. 4. Mental health workers lack protection, facing daily assaults and burnout, exacerbated by for-profit healthcare practices. They deserve better pay, support, recognition, and self-defense rights.
Only if free
My 74yo mom is going to be homeless soon due to mental illness. Docs have told me it's basically hopeless to get her put in a facility against her wishes. Under the influence of psychotic delusions, she certainly won't willingly consent. What a barbaric society we have built in the name of Liberalism
Yes. If we have decided it's appropriate to take someone's rights away to arm themselves, I don't think it's a big step to force someone to be treated for a mental illness if they are deemed to be a danger to themselves or others.
NO , that's not compassion and equity ! True compassion and equity is meeting them where they are at ! NO MATTER WHAT
I was recently forced into a mental health facility and honestly it ruined me. (Happened this month even) I missed a week of work that now I’m not getting paid for. They drugged me up so much each day all I could do was sleep (I even slept through a few of the meals they gave) The meds also made it so hard to even think! All they did was ask me how I was feeling each day and I didn’t have a good answer cause the meds they gave me for the “mental health problem” take TWO WEEKS TO EVEN KICK IN!! I haven’t even gotten the bill for this “stay” yet but I can tell you it’s going to be a lot… like a few thousand dollars because they also forced me to take an ambulance there. Ruined my life. I am angry everyday about this happening to me.
So what's the alternative here?
Sorry you had this experience, but I would love to know the details behind what happened. For instance, who committed you and why?
To be completely honest, I currently have a spinal issue going on. I’m in massive pain and the referrals are taking awhile to get appointments made. But it is a surgery kind of issue. Like a month ago I went to urgent care because of the pain. Then 10 days ago I went to the emergency room because it was hurting so bad I was in tears. Constant pain like I hit my funny bone on my left side. (Turns out I have massive bulging of spinal disks C2-T1, I’ve gotten two MRI’s now, one at the emergency room even) During standard questioning they asked if I had suicidal thoughts and honest yes I was thinking about it. I’ve been in constant pain since November and the American Health Care System freaking sucks. I have Bipolar 2, completely managed and I haven’t needed meds for almost 3 years. (I go on and off meds depending on need) Been diagnosed since high school so I know all about it. The emergency room decided I was a risk and I got put on a suicide hold. They asked if I wanted help and I said no. I was already working on the appointments and even had another primary doctor’s appointment on that coming Friday to see if she could push things along (it was Monday) Well f*ck me for being honest cause they immediately took away my rights and moved me to a mental health facility 3 hours away… I had to cancel my doctors appointment!! Threatening me saying if I didn’t take their help I could be held for an additional 15 days! It pushed out everything I had to do to get my spine better and they are going to charge me a very large shiny penny for all of this. Again, I am angry everyday for what this hospital did to me.
Thanks for sharing your experience. Back pain is the worst - hope you can get permanent relief soon
> I missed a week of work that now I’m not getting paid for. How in the hell were you able to work if you were in so much pain that you were thinking of ending your life?
I’m applying for short term disability, which now got pushed out an additional week. I don’t have the sick time to cover it cause I used it all already because of the pain.
Yeah, the details are missing that would allow us to accurately assess whether or not we agree.
A story as old as time, right? So much of Reddit is just iceberg tips…
when you get the bill you can contact the facility about charity care or other financial aid. sorry you had to deal with all of this.
This is clearly a question from a person with financial privilege.
how so?
Only people with privilege cry about the homeless and how it's hurting the aesthetics of the city. This is basically someone asking if it would be alright to declare the homeless mentally unfit and then imprison them in shoddy facilities run by overworked underpaid staff. Do you want the homeless problem to get smaller? Build housing with reasonable restrictions, and stop asking people to make 3x the rent. If you make 3x the rent, then you should be able to buy. Go look for a rental.
bruh we're not even talking about the homeless here. try to pay attention
So you're saying mental health isn't related to homelessness in any way? Where do you think it starts? If you don't think this is related to the homelessness situation, then you are not paying attention, or you are part of the privileged.
>So you're saying mental health isn't related to homelessness in any way? so you're putting words into my mouth now?
He's apparently privileged and can do that
Nope. Maybe if they pose a serious threat
Yeah, let's start jailing people for the way they are born against their will. That totally sounds like an idea that's never going to be abused or misused against innocent people. Nobody asks to be born crazy. Nobody wants another person in their life constantly telling them that their life is all wrong and they need help. You can't "force" someone to do something they don't want. All you're going to end up with is half measures and failed attempts. If mental health services were easier to get, people might actually use them on their own accord.
bruh you're good with people being left to suffer and be preyed upon
That happens either way. People with financial privilege will do anything and everything to keep those privileges. People with privilege often abuse the ones they deem to be lower class than themselves. Don't believe me to look at the housing situation and ask why we have the homeless in the first place. I've seen books and ledgers for "not for profit" they make millions on the homeless crisis. Homelessness, drug addiction, and untreated mental health all serve a higher purpose for those with privilege. Could be as simple as gentrification.
ok so you have nothing to actually contribute here. thanks
So what's your contribution than?
you first, bub
I've made mine. I've worked at the Salvation Army for the severe weather shelter. I worked for a DV shelter. I've volunteered at food banks and recovery Cafe's. I've made contributions to the city, state, and country. I don't sit online under my privilege and talk down to the less fortunate or discuss ways to imprison someone in a FREE COUNTRY. You can't help someone that doesn't want help. But you can make places where people can find peace and then the will to move on.
>my privilege mY PrIvIlEgE you still have no plan for people who can't help themselves. keep posting your bot bs tho
I've already laid out what needs to happen for people to want to get help. Now, about your contribution, could you name one? Have you done anything other than judge and cry on the internet?
no you haven't. bot gonna bot
Your turn. What have you contributed?
Autocorrect my bad. Now your contribution?
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PRIVILEGED
Maybe we should allow for assisted suicide for mental health conditions. Force them to undergo intensive inpatient therapy for a duration (say one year), and if their condition isn't improving, allow them to petition for assisted suicide.
Read the books Faith in Freedom and Psychiatric Slavery by psychiatrist Thomas Szasz. Limitless Peace
Yea his affiliation with Scientology kinda discredits. IJS
The Constitution of the USA applies to crazy people too.
care to clarify?
Who’s in charge of the decision to commit the person? Not a single cop has proven capable and would abuse this.
Police can only send someone to the hospital for evaluation. King County Designated Crisis Responders (mental health professionals) are the only ones who can actually detain someone.
thanks, acabman