4 ms·

> places like CA attract homeless people from other places, because they have good services. California's winter weather is more survivable than most parts of

• eltoozero 10y ago
  This is getting downvoted with no explanation, rude if you ask me; The points are salient: I personally know a man in care who's been seemingly "kept stupid" with drugs while in an assisted living facility receiving treatment, and yes you can sleep outdoors most winter nights in CA, not comfortably but it's doable.
  • tcj_phx 10y ago
    > This is getting downvoted with no explanation, rude if you ask me; If I check my comments frequently enough I sometimes notice oscillations. That one was voted up once, then down twice, then I didn't check for a while. 2 people have since appeared to cancel out those two downvotes. After I posted that comment I thought about editing it to say something about how the nicer weather is "in addition to the state's services...". Perhaps some of the downvoters thought I was disagreeing with the comment I was replying to, whereas I actually meant to supplement his/her good points with my experiences. Edit: changed his to his/her.
• appleflaxen 10y ago
  Where is the data for the point about making psychotic chronic? Because there is peer-reviewed medical literature (meaning double-blind clinical trials) about their effectiveness in reducing symptoms, and "longer lasting symptoms" would have been a reportable adverse event that could/would have been seen. Additionally: to advance this model, you have to think that the people caring for these individuals (both families and doctors) are either unable to see that the treatments make it worse, or that they see it but are motivated by something other than the patient's best interests. My uncle had schizophrenia. In my experience, neither of these were true. Finally: these symptoms are chronic and intractable by nature, if you talk to people that have them. Look at the homeless people who are clearly mentally ill: they react to things we can't see all the time; not episodically. Asking iconclastic questions like Whitaker does is important; we need to have a discussion about it and make sure we're not completely off base, but when you look at a persons total ability to function and their global quality of life, antipsychotic medications are helpful.
  • SomeStupidPoint 10y ago
    Just to comment on a case I know personally: the person had semi-regular psychotic episodes, a few per quarter, but every day meds to prevent them definitely made him less smart and... "there" on the good days (in addition to stopping episodes). That's how he was treated until about 20, when he managed to convince a doctor he should just have an as-needed supply of fast acting ones. I know it's anecdata, but my experience is that there are a fair number of borderline cases where they can't hold it together sporadically, but the meds definitely lower the quality of the "good days" to fix that. Sometimes there's a fast acting med that can work; often there's not and patients are faced with a stark choice. I think we see a lot more homelessness in that group of people than we should, because we basically trap them there after one or two episodes, even though if we fixed it and got them some help (usually better coping techniques; occasionally meds), we'd see a lot less homelessness. I do think that meds have become a substitute for real coping technique teaching, and that in many of those cases, the caregiver isn't making the optimal choice for the patient, because they're optimizing cost or time invested, rather than long-term quality of life. There are obviously things like hardcore schizophrenia where that isn't the case, but even for more sporadic delusion disorders, it can be.