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Oh hey, I've been to that shelter. I live in (and grew up in) Utah. My Aunt is severely mentally ill and homeless and relies on the Road Home shelter, I've visi

Oh hey, I've been to that shelter. I live in (and grew up in) Utah. My Aunt is severely mentally ill and homeless and relies on the Road Home shelter, I've visited her there a few times. They are doing good work, although being homeless is still pretty shitty, obviously. The hardest part is that the state could take much better care of her if she would allow herself to be diagnosed as handicapped due to her mental illness, but she doesn't believe that she's mentally ill. And of course forcing treatment on her is unethical and probably counter-productive. I don't really know where she's at now, we only have fleeting contact with her. EDIT: A sad/curious anecdote - at one time she was placed in an apartment. I don't know the details but it was probably using the programs outlined in the article. She lit the apartment on fire and ended up in the hospital. As I understand she believed that she owned the apartment complex and could not understand why the managers would not let her make decisions, so she lit it on fire.

humanrebar 10y ago
> And of course forcing treatment on her is unethical and probably counter-productive. Counter-productive is an empirical question, but why is forcing treatment always unethical? > ...She lit the apartment on fire and ended up in the hospital. ...for example. Do we need to wait for manslaughter charges before the government is responsible? Often people on the street are at least committing fraud (lying for food, bus fare, cash, etc.). I understand that people do what they need to for survival (at least on their terms), but there is an actual cost to that. For instance, if someone actually lost their wallet and needed fare home, they have to compete with people who say they haven't eaten in days but actually don't want professional help (and may even be unfit to make that decision in the first place). The information asymmetry is enormous in this sort of interaction. To reiterate, the people getting conned aren't the biggest victims here; it's the people who have to deal with a jaded audience and fraudulent sob stories when $20, bus fare, or a prepaid phone is legitimately their biggest need. Anyway, I'm willing to listen to counterpoints about this, but it just doesn't make sense to me that the government isn't responsible for people who can't (or won't) take care of themselves. I'm talking haven't showered in weeks; open sores on their feet, faces, and bodies; etc. Literally no other group has (or should have!) the power to require someone to get care. If we say it's not the government's job, we're saying it's nobody's job. I'm willing to hear other thoughts on this. My current conclusion is that the status quo is ethically unconscionable but politically impossible to do anything about, but maybe I'm missing something.
- grahamburger 10y ago
  I don't know. Honestly it seems unethical to me to compel someone to do anything if they haven't done anything illegal, and being homeless / not showering / having sores isn't illegal. There's a fine line between 'helping the mentally ill through compulsory treatment' and 'rounding up the homeless so we don't have to see them all the time' and it seems like whenever we try to do the former we end up doing some of the latter as well. In my Aunt's case, apparently they decided not to press charges about the fire. Maybe they thought they were doing her a favor, and insurance probably covered the damage anyway.
  - lobster_johnson 10y ago
    As you point out, she doesn't know she is ill; you (and we as a society) have the clarity to recognize it and help. I have dealt with a similar situation involving a family member. I later regretted not being proactive in intervening before it was too late. Years went by, and plenty of situations arose that could have lead to a serious intervention. Instead, nothing happened. In one instance, criminal charges were pending, but somehow they were dropped. Of course, there must be a very high bar against forced institutionalization; we don't want to return to the bad old days when people were locked up for all sorts of unjustifiable reasons.
    - vkou 10y ago
      In certain countries, society had the clarity to recognize that people who did not believe in the superiority of communism were mentally ill.
    - wyager 10y ago
      You are describing a way for the government to punish people without due process. "Oh that guy, he's a loon, let's lock him up." > we don't want to return to the bad old days when people were locked up for all sorts of unjustifiable reasons. What makes you think this would no longer be the case?
- Iv 10y ago
  > Counter-productive is an empirical question, but why is forcing treatment always unethical? Ask most people who were diagnosed as mentally ill by east-german authorities before 1990. Trust me, however nice they are today, you don't want an authority, a committee, or even "community standards" enforce any medical treatment on someone. > ...for example. Do we need to wait for manslaughter charges before the government is responsible? You need offenses to put charges forward. That's how justice works. You just don't jail people for things you suspect they will do.

humanrebar 10y ago

> And of course forcing treatment on her is unethical and probably counter-productive. Counter-productive is an empirical question, but why is forcing treatment always unethical? > ...She lit the apartment on fire and ended up in the hospital. ...for example. Do we need to wait for manslaughter charges before the government is responsible? Often people on the street are at least committing fraud (lying for food, bus fare, cash, etc.). I understand that people do what they need to for survival (at least on their terms), but there is an actual cost to that. For instance, if someone actually lost their wallet and needed fare home, they have to compete with people who say they haven't eaten in days but actually don't want professional help (and may even be unfit to make that decision in the first place). The information asymmetry is enormous in this sort of interaction. To reiterate, the people getting conned aren't the biggest victims here; it's the people who have to deal with a jaded audience and fraudulent sob stories when $20, bus fare, or a prepaid phone is legitimately their biggest need. Anyway, I'm willing to listen to counterpoints about this, but it just doesn't make sense to me that the government isn't responsible for people who can't (or won't) take care of themselves. I'm talking haven't showered in weeks; open sores on their feet, faces, and bodies; etc. Literally no other group has (or should have!) the power to require someone to get care. If we say it's not the government's job, we're saying it's nobody's job. I'm willing to hear other thoughts on this. My current conclusion is that the status quo is ethically unconscionable but politically impossible to do anything about, but maybe I'm missing something.

grahamburger 10y ago
I don't know. Honestly it seems unethical to me to compel someone to do anything if they haven't done anything illegal, and being homeless / not showering / having sores isn't illegal. There's a fine line between 'helping the mentally ill through compulsory treatment' and 'rounding up the homeless so we don't have to see them all the time' and it seems like whenever we try to do the former we end up doing some of the latter as well. In my Aunt's case, apparently they decided not to press charges about the fire. Maybe they thought they were doing her a favor, and insurance probably covered the damage anyway.
- lobster_johnson 10y ago
  As you point out, she doesn't know she is ill; you (and we as a society) have the clarity to recognize it and help. I have dealt with a similar situation involving a family member. I later regretted not being proactive in intervening before it was too late. Years went by, and plenty of situations arose that could have lead to a serious intervention. Instead, nothing happened. In one instance, criminal charges were pending, but somehow they were dropped. Of course, there must be a very high bar against forced institutionalization; we don't want to return to the bad old days when people were locked up for all sorts of unjustifiable reasons.
  - vkou 10y ago
    In certain countries, society had the clarity to recognize that people who did not believe in the superiority of communism were mentally ill.
  - wyager 10y ago
    You are describing a way for the government to punish people without due process. "Oh that guy, he's a loon, let's lock him up." > we don't want to return to the bad old days when people were locked up for all sorts of unjustifiable reasons. What makes you think this would no longer be the case?
Iv 10y ago
> Counter-productive is an empirical question, but why is forcing treatment always unethical? Ask most people who were diagnosed as mentally ill by east-german authorities before 1990. Trust me, however nice they are today, you don't want an authority, a committee, or even "community standards" enforce any medical treatment on someone. > ...for example. Do we need to wait for manslaughter charges before the government is responsible? You need offenses to put charges forward. That's how justice works. You just don't jail people for things you suspect they will do.