> And you must give those institutions some power to intervene sometimes against the will of those they are intervening with. And I have no illusions. Involuntary commitment to mental health care and drug treatment and community involvement are often ugly but Americans make it clear over and over that even though vagrants and homeless are generally not a problem that much affects those other than the vagrants and homeless themselves we will never collectively tolerate their presence.
It might be worth reviewing why Americans turned so harshly against involuntary commitment to mental health care institutions. It was a parade of horrors that made Abu Ghraib look like Disney World. Convincing people that we'll get it right, reliably, at massive scale this time around is something of a daunting task.
Oh I 100% agree. We deinstitutionalized for good reason. I will say two things however. Medical ethics and legal protections have come a long way since then. You wouldn't see doctors straight up experimenting on people at least not with legal sanction and the state now has an obligation to provide people attorneys. So using your own lawyer to get aunt Elsa committed while she just at the mercy of the system wouldn't be so easy.
But I would hope that with knowing what we do now about mental illness we would have many layers of intervention before we get to that level.
Imagine if theirs a kid getting into trouble regularly at school because of their mental health status. Rather than wait until that turns into a violent episode that gets the kid in jail or committed the court could assign that kid a mentor. Someone they have to spend 10 hours a week with and who they can call on for anything. That can change the trajectory of a kid's life. We know this because the number one difference between people with mental illness that succeed and those that fail is whether they have a support network.
Court mandated mentoring, support networks and counselling before, not after a major incident are all relatively low touch interventions that would be hugely beneficial. And we do some of this now. It just mostly comes after the criminal justice system has already begun to see the person as a criminal because it usually follows a significant crime.
Of course this cuta against the American psyche. We want to have 100% all our rights with no government intervention until we've proved we shouldn't. Then the government should have radical powers to shape our lives.
But maybe if we could come to see government more like the way doctors see medical treatment. The more unobtrusive it is the more we should allow. And the more intrusive it is, the more we should be nervous of its application.
> Medical ethics and legal protections have come a long way since then. You wouldn't see doctors straight up experimenting on people at least not with legal sanction and the state now has an obligation to provide people attorneys. So using your own lawyer to get aunt Elsa committed while she just at the mercy of the system wouldn't be so easy.
I completely disagree as a person who suffered involuntary treatment for 2 months and was drugged against my will for a psychological disease I didn't suffer. I'm a transgender woman that was going to university getting bullied constantly. One day it turned into an incident where the bullies fabricated a story to campus police and where my account of the situation wasn't listened to. Anyhow, I ended up with a psychiatrist that didn't ever treat gender dysphoria but believed it just has to be schizophrenia. They billed my insurance provider $58k USD. Needless to say, I also don't pass as a woman because of the religious abuse in that community and with unaccepting parents. I've never been able to save 58k to pay for surgeries unrighteously classified as cosmetic towards the illness gender dysphoria. Anyway, I tried to find legal representation for the wrongs and nobody in any civil rights institution for victims would help.
It might be worth considering that when the problem is "How do we help the mentally ill and destitute among us?" and the answer is "Fundamentally reformulate how Americans relate to their government", some might see a measure of disconnection between the two. Certainly it's a big ask that offers little in the way of obvious gradual steps.
In the past families would look after their own disabled members. Of course this is easier in large non-nuclear families. But maybe something like more like community centers in every town rather than imposing "Insane Asylums" run by scary officials would help?
To be clear, by institutions I don't mean monolithic asylums. I mean institutions in a broad sense. The way the fire department is an institution. I mean something much more akin to networks of social and the community centers you mention.
It might be worth reviewing why Americans turned so harshly against involuntary commitment to mental health care institutions. It was a parade of horrors that made Abu Ghraib look like Disney World. Convincing people that we'll get it right, reliably, at massive scale this time around is something of a daunting task.