An involuntary commitment program would be better than the nothing we have now. About a year ago, in my neighborhood, a well-meaning mom took in a 'troubled' kid whose own family had kicked him out. One afternoon, her husband and two sons came home to find her dead, stabbed multiple times. There should have been some place his own family could have committed him for treatment and for the safety of others.
My son knows a woman who is schizophrenic. When she was on her meds, she was absolutely fine. She's my age and when we lived next door to each other, she and I would socialize. When she was off her meds, she was a danger, primarily to her parents with whom she lived. Her delusion was that "they" were poisoning the water, so she would shut off all the water in the house. Eventually, when things got bad, her parents would call my H to turn the water back on and take her to the hospital. Finally, she was placed on a monthly injection that keeps her symptoms in check. If she doesn't show up at the clinic to get the shot on schedule, a social worker and nurse go to her home to give it to her. This system has worked for years. She is able to live on her own and work in a sheltered environment. It seems to me that if there are meds available, at least for some conditions, that are long term, that might be a treatment of choice. This woman once told me that after a year or so of refusing to go for the shots and having someone come to administer them, she realized that she felt so much better on them that there was no point in refusing.
Of course, some meds, like those for bipolar, can make a person feel less than themselves and not want to take them. I had a bf for many years who was bipolar. Even though he knew that the meds allowed him to function, he would complain about how they made him feel. Three times while we were together, he stopped taking them and eventually wound up hospitalized. He was never violent but I always worried that his delusions and false beliefs would make him a target and/or get him hurt. Finally, he decided that taking the meds was just the better way to live and he became compliant. I last saw him about 10 years ago and he looked fine.
This is a very sad situation. I do believe that the state should be able to direct that people comply with their meds if they want to be out on the street, although this should perhaps be limited to people who are known to be violent when off their meds. It's such a hard thing. I see so many homeless people on the streets (I work in midtown Manhattan) and I often wonder how much some of them might benefit from being on a regular medication program, like my former neighbor. I am not really certain how there is the authority to go and give her the meds if she doesn't show up, it might have originally been part of the disposition of a criminal case against her for assaulting her mother.
The big downtown LA library does have metal detectors.
And I think homeless and violently mentally ill homeless are two separate problems. Many of the homeless around here don't want to go to shelters. They can't drink there or do drugs. They can't bring their dogs. So they sleep in the canyons, start cooking fires and nearly burn down Bel Air and Malibu. In San Diego, they spread hepatitis.
But the homeless are also being preyed upon by the violent homeless. There have been several multiple homicides in homeless encampments in Southern California in the last few years.
TomSrOfBostonRegistered UserPosts: 15,596Senior Member
I have seen on social media discussing this murder in Winchester that as people have tried to mention the mental illness of this young man, others have denounced them for blaming his act on mental illness. They accuse posters of trying to stereotype the mentally ill as violent. Mental illness is not synonymous with violence of course but to some even linking the two in this situation gets posters blasted for being insensitive. To these advocates for the mentally ill we are not even supposed to mention the link.
If we are not even supposed to mention mental illness how are the potentially violent mentally ill supposed to get help?
It is a conundrum. The vast majority of mentally ill people are not violent and are a danger only to themselves. However, we don't hear about the woman down the block who takes her meds and goes to PTA meetings or the man on the bowling team who is conscientious about getting his lithium levels checked so his meds can be properly titrated. Those people don't sell newspapers - the small minority of violent mentally ill get most of the press. This leads to a conclusion that all or most of mentally ill people are violent and leads to discrimination against all of them.
I don't know that the Florida shooter was ever diagnosed as mentally ill. I do think that the fallback position that people who do these acts MUST be "crazy" is too simplistic. Many of them may have anti-social personality disorders but those are not necessarily mental illness like bipolar or schizophrenia and some may just be mean or bad.
", an inordinate amount of the budget would be consumed by indefinite commitments in locked, secure settings which would result in a lack of treatment "
Already have this--it's called jail. It's cheaper than psychiatric care.
I think the main issue is simply cost. Both federal and state governments closed institutions because of the cost for long term care. We already know how expensive nursing home care is--now extend those costs to long term care for the mentally ill. Cheaper to lock them in jail or let them be homeless (it's estimated that a third to a half of homeless people are mentally ill).
Right now if someone is violent we lock them up in jail. But for how long? Unfortunately until an act is committed nothing much can be done by law enforcement.
And if you could easily say "so and so" needs locking up then who gets that final say?
The sad part is that there are people who would voluntarily commit themselves to get some help and even they don't have a place to go.
Well frankly only a sicko would go out and shoot up a bunch of people. Sometimes you have to put aside the PC stuff to solve a problem. I am vehemently anti gun but that is only a piece of the issues and simply allows a violent person to kill more people. That is a somewhat hard core statement probably more than I feel but the heart of the issue is mental illness. “Sicko” is not a polite word but that does not change the issue. And not all mentally ill people are violent or have the propensity to be violent so there is that issue too. We have come so far from the 60s in terms of diagnostics and medication and awareness I feel like there is a solution in the middle somewhere besides denial or over-concern about stigma.
AroundHereRegistered UserPosts: 3,601Senior Member
It's mainly a problem because as a country we refuse to invest money in it. Healthcare is for everyone remains extremely controversial and therefore hard to spend tax money on. Mental healthcare has even less money in its system than physical healthcare.
There is no reason besides unwillingness to spend money to make them better that mental health hospitals have been horrific.
There is actually a 911 call to police from the high school shooter asking for help about a month prior. It's very sad. They should've been able to send him somewhere.
Cardinal FangRegistered UserPosts: 18,314Senior Member
How many mentally ill people are we willing to lock up, in order to stop a murder? What are your criteria to lock them up? What percentage of the people you end up locking up would have committed a violent crime if they hadn't been locked up?
I get that ranting and raving people are unpleasant to be around. But we don't get to lock up people because they're unpleasant to be around.
It's mainly a problem because as a country we refuse to invest money in it. Healthcare is for everyone remains extremely controversial and therefore hard to spend tax money on. Mental healthcare has even less money in its system than physical healthcare.
Unless your idea of mental health care is locking people up, money is not the only problem. We don't know how to treat many kinds of mental illness. We can't cure most people with mental illness. For example, we don't know how to treat people like the Sandy Hook shooter or Eric Harris, the Columbine shooter.
TomSrOfBostonRegistered UserPosts: 15,596Senior Member
@doschicos Actually it was both. Liberals were glad that the "snake pits' were being closed. Conservatives were glad that the government would be saving money. Attempts to put the blame on one side will not solve anything but rather further the national divide.
Cardinal FangRegistered UserPosts: 18,314Senior Member
Because we don't have a way to deal with mentally ill people who commit violent crimes, they end up locked up in prison after they commit the crimes, and get no treatment, even if treatment would help them.
But still, we have to distinguish between mentally ill people who have committed crimes, and mentally ill people who have not committed crimes. If we want to lock up people who are dangerous, we need stringent criteria for dangerousness. Law enforcement in the past has not been good at distinguishing odd people, annoying people or non-white people from dangerous people.
doschicosRegistered UserPosts: 20,394Senior Member
edited February 2018
I think some were more in the improve the "snake pits" camp and provide other services actually rather than a dump them on the street approach. The dumping was hardly more humane than poorly run institutions. Let's look at history critically and the effects it has had since then if you truly want to understand the issues rather than reverting to "further the national divide" talk, which basically is an attempt to shut down conversation and retrospective analysis, IMO. This is something that happened almost 40 years ago and understanding the ramifications of it is important to finding solutions today.
Replies to: How Do We Deal with the Violently Mentally Ill?
Another thought would be to adequately fund & properly manage funds for the VA hospital system.
Free prenatal care. Free breakfast & lunch in public school systems for those in need.
Create homeless shelters with a strong social services presence.
Of course, some meds, like those for bipolar, can make a person feel less than themselves and not want to take them. I had a bf for many years who was bipolar. Even though he knew that the meds allowed him to function, he would complain about how they made him feel. Three times while we were together, he stopped taking them and eventually wound up hospitalized. He was never violent but I always worried that his delusions and false beliefs would make him a target and/or get him hurt. Finally, he decided that taking the meds was just the better way to live and he became compliant. I last saw him about 10 years ago and he looked fine.
This is a very sad situation. I do believe that the state should be able to direct that people comply with their meds if they want to be out on the street, although this should perhaps be limited to people who are known to be violent when off their meds. It's such a hard thing. I see so many homeless people on the streets (I work in midtown Manhattan) and I often wonder how much some of them might benefit from being on a regular medication program, like my former neighbor. I am not really certain how there is the authority to go and give her the meds if she doesn't show up, it might have originally been part of the disposition of a criminal case against her for assaulting her mother.
And I think homeless and violently mentally ill homeless are two separate problems. Many of the homeless around here don't want to go to shelters. They can't drink there or do drugs. They can't bring their dogs. So they sleep in the canyons, start cooking fires and nearly burn down Bel Air and Malibu. In San Diego, they spread hepatitis.
But the homeless are also being preyed upon by the violent homeless. There have been several multiple homicides in homeless encampments in Southern California in the last few years.
If we are not even supposed to mention mental illness how are the potentially violent mentally ill supposed to get help?
I don't know that the Florida shooter was ever diagnosed as mentally ill. I do think that the fallback position that people who do these acts MUST be "crazy" is too simplistic. Many of them may have anti-social personality disorders but those are not necessarily mental illness like bipolar or schizophrenia and some may just be mean or bad.
Already have this--it's called jail. It's cheaper than psychiatric care.
I think the main issue is simply cost. Both federal and state governments closed institutions because of the cost for long term care. We already know how expensive nursing home care is--now extend those costs to long term care for the mentally ill. Cheaper to lock them in jail or let them be homeless (it's estimated that a third to a half of homeless people are mentally ill).
Right now if someone is violent we lock them up in jail. But for how long? Unfortunately until an act is committed nothing much can be done by law enforcement.
And if you could easily say "so and so" needs locking up then who gets that final say?
The sad part is that there are people who would voluntarily commit themselves to get some help and even they don't have a place to go.
There is no reason besides unwillingness to spend money to make them better that mental health hospitals have been horrific.
There is actually a 911 call to police from the high school shooter asking for help about a month prior. It's very sad. They should've been able to send him somewhere.
I get that ranting and raving people are unpleasant to be around. But we don't get to lock up people because they're unpleasant to be around.
Unless your idea of mental health care is locking people up, money is not the only problem. We don't know how to treat many kinds of mental illness. We can't cure most people with mental illness. For example, we don't know how to treat people like the Sandy Hook shooter or Eric Harris, the Columbine shooter.
But still, we have to distinguish between mentally ill people who have committed crimes, and mentally ill people who have not committed crimes. If we want to lock up people who are dangerous, we need stringent criteria for dangerousness. Law enforcement in the past has not been good at distinguishing odd people, annoying people or non-white people from dangerous people.