As someone who works in psychiatric medicine, I am not opposed to this in theory, so long as cases are handled appropriately. I have strong doubts this will be successful given the current and intended resources.
Most homeless people on the street are indeed severely mentally ill and are not receiving treatment. They are not in the state of mind to make reasonable decisions. In a place like NY, especially in the winter, living on the street dose poses significant risks to self. On average homeless people live almost TWENTY years less. Many suffer from severe substance use disorders which is also a form danger to self in some jurisdictions. And while many of these individuals are not violent, there some that are.
I think people assume involuntarily institutionalizing someone is inhumane, but I would argue the opposite is true. The goal is to get them into treatment, get them to a point of stability, provide them the resources to allow them opportunity to have a better life with as much independence as possible.
Unfortunately with mental illness, people are so sick that they cannot see a way out.
But for this system to work, there must be enough public resources to support this population. And the quality of care must be appropriate for individual needs, not a one size fits all model.
ER’s are already overcrowded with psych patients. Some ER’s might as well be psych units. I suspect what we will see though is a system with no continuity. People will be dropped off at the hospital, admitted for a few days and given antipsychotics, and as soon as the person starts to stabilize the hospital will have to discharge them as they no longer meet the necessary criteria to hold them. Longer term psych programs or housing support will not have beds available and these people will be discharged back onto the street or a shelter. Having no support, these people’s conditions will relapse and the cycle will begin again. That’s how the system operates as it is even with those who do pose an explicit danger.
Another problem is that it’s just not mental illnesses like psychotic disorders that requires treatment. More often than not, there is concurrent severe addiction and trauma involved, which are very difficult conditions to treat independently. Combine all of these and its exponentially more difficult and a lot of programs are not adequately equipped to handle such cases. Addiction treatment in particular is very resource intensive and accessibility has long been a problem, let alone dual-diagnosis programs that handle the more complex problems.
Thanks to media, many people have very interesting conceptions of mental health hospitalizations- like 1950’s asylums with people being given ECT against their will and being abused by staff. That’s not the case. It is true there are some pretty awful psych programs, but a lot of that has to do with funding.
The civil liberties issue is not that people are being involuntarily committed, it’s that they’re not being committed. I would much rather these people have every opportunity to get help, live in a safe environment, and hopefully achieve successful management of their condition and independent living than see them sleeping over a subway grate to keep warm in freezing weather while strung out on drugs next to the garbage can they eat out of- at risk of being beat up by some delinquent kids or robbed of the little they have by another homeless person.
Ideally involuntarily commitment would not be necessary, but that’s not the nature of the diseases involved. But in what world is alternative considered humane?
Honestly, the belief of “caring” by not caring is ridiculous and is used by politicians to underfund and excuse themselves of the failures of the social systems.
Here’s a good article to read:
https://news.harvard.edu/gazette/st...entally-ill-homeless-not-entirely-outrageous/
www.huffpost.com
