6 ms·

To help contextualize this so I understand the situation better, can someone compare and contrast what treatment for debilitating mental health issues such as s

To help contextualize this so I understand the situation better, can someone compare and contrast what treatment for debilitating mental health issues such as schizophrenia looks like in Finland vs. the US? The second issue is, In the last 10 years, the “Housing First” programme provided 4,600 homes in Finland. In 2017 there were still about 1,900 people living on the streets. In the US, there are something like half a million people living on the streets.

svantana 7y ago
The US has about 60x the population of Finland, so on a per capita basis the situation (sans programme) seems comparable.
- splitrocket 7y ago
  Correct, and generally speaking, economic of scale should apply to social sector programs. In theory, it should be 60x easier for the US to house everyone, simply because we have more resources to aggregate. Even when you compare per capita GDP, Finland's doing it with $50k, while the US is at $62.5k.
  - SpicyLemonZest 7y ago
    Is the US in fact spending less money on homelessness, though? My guess would be that it's spending a comparable amount on a per-person basis.
    - soulofmischief 7y ago
      The US citizen sees a fraction of their tax dollar ever actually reach the ground. The rest gets caught up in people's pockets on the way down. We would need to adjust for this but it's unclear how to create a heuristic.
      - _jal 7y ago
        Do you have evidence that there's more friction/graft in the US than, say, Finland?
        deleted 7y ago
        [deleted]
        soulofmischief 7y ago
        I don't, because I don't know how to calculate it. Like I said, we need a heuristic but I don't know how to go about it. But it's an important qualifier when we're trying to isolate this problem to just the economics of solving homelessness.
        pavlov 7y ago
        There's the established Corruption Perceptions Index published annually by Transparency International: https://en.wikipedia.org/wiki/Corruption_Perceptions_Index https://en.wikipedia.org/wiki/Corruption_Perceptions_Index Finland is ranked #3 while US is #22.
        yokaze 7y ago
        The keyword here is "perception". I am not convinced that the perception is deserved.
    - claudeganon 7y ago
      A great deal of spending in the US suffers the problem of direct versus some form of market disintermediation. So, instead of just building houses for people, we funnel it through myriad private or semi-private bureaucracies and suffer their corruption and graft.
      - SpicyLemonZest 7y ago
        That appears to be happening in Finland as well. The article says that state funding is funneled through "NGOs such as the Y-Foundation" who are responsible for actually getting the housing.
        claudeganon 7y ago
        Yes, it’s not a binary situation. But Finland also directly took over several private/NGO shelters and converted them to apartment blocks. In the US, this would be considered verboten in most major cities because of the challenge it poses to everyone involved in real estate speculation and development.
  - chimeracoder 7y ago
    > Correct, and generally speaking, economic of scale should apply to social sector programs. In theory, it should be 60x easier for the US to house everyone, simply because we have more resources to aggregate. People always like to rush to talk about economies of scale, completely forgetting that diseconomies of scale are also a thing. (And even that's all assuming that you think Finland's demographics are comparable to the US's and that causes of homelessness and poverty in Finland are representative of the causes of homelessness and poverty in the US.)
  - mkohlmyr 7y ago
    I'm actually not convinced on the surface of it that economies of scale apply to government. It seems to me like the larger the population, the more layers of government required to effectively deploy capital. If you assumed a similar per capita tax rate, but more government is required to deploy the taxes in a larger nation, the larger nation would presumably end up with less money deployed per capita. Of course I am neither a social scientist, economist or political scientist.
    - joshspankit 7y ago
      The simpler the program, the less layers you need. If the todo list for a homeless person is: - Assign open apartment - Digitally fill out form B12 - Deposit money Then there is very little work required. Where social programs have the highest overhead is where they do things like “Assess whether it’s ‘required’ based on binders 3 through 7” and “Continually check in with all other governmental arms to validate that they are meeting criteria”.
JanSt 7y ago
The US also has 60x as many people. 327/5,5*(4600+1900) = ~386.000 (at 1 person/home)
- ianleeclark 7y ago
  Why are you adding the 4600 and the 1900 together? Those 4600 have been homed.
  - TacticalTable 7y ago
    Homed by a process that the United States also doesn't have and would need. It would be dishonest to compare the rates without including the cases that Finland has already solved through a similar (but not as far reaching) program.
    - ianleeclark 7y ago
      > It would be dishonest to compare the rates No, I think it's perfectly honest to compare the rates of homelessness in a country that has worked to improve the situation versus a country that continues to let people die in the streets. It seems far more dishonest to compare the rates before the work was done, considering that work was done to reduce the problem. The reason that the US now has a roughly 5x rate of homelessness (and, let's face it, growing) vs a roughly 1.3x rate of homelessness is because the United States has no interest in fixing the problem.
    - raxxorrax 7y ago
      I still don't believe in fractional reserve banking.
  - SpicyLemonZest 7y ago
    They've been homed, but subsidies for the housing of previously homeless people are typically aggregated under homeless spending. (The US has a lot of programs like that as well.)
MuffinFlavored 7y ago
source for 500,000 homeless people in America claim?
- Someone1234 7y ago
  The US Government: > According to the US Department of Housing and Urban Development's Annual Homeless Assessment Report, as of 2018 there were around 553,000 homeless people in the United States on a given night, or 0.17% of the population. https://en.wikipedia.org/wiki/Homelessness_in_the_United_States https://en.wikipedia.org/wiki/Homelessness_in_the_United_Sta...
- splitrocket 7y ago
  The 2018 annual "point in time" count done by the federal housing administration: https://www.hudexchange.info/resource/5783/2018-ahar-part-1-pit-estimates-of-homelessness-in-the-us/ https://www.hudexchange.info/resource/5783/2018-ahar-part-1-...
gamblor956 7y ago
They never had Reagan, so they still treat mental illness there. More importantly, Finland allows for the involuntary commitment if the mentally ill. In the US, this is only allowed if the individual presents a danger to themselves or others.
- stjohnswarts 7y ago
  The government shouldn't be able to just walk around pointing fingers trying to put individuals in "therapy". Particularly the sort the is available at minimal budget government facilities.
  - AQuantized 7y ago
    Do you feel that is an accurate characterization of mental health care in non-US countries with different requirements for commitment, like Finland?
- pjc50 7y ago
  That's almost what the Finnish system requires: https://helda.helsinki.fi/bitstream/handle/10138/231986/compulsory_psychiatric_detention_and_treatment_in_finland.pdf?sequence=1 https://helda.helsinki.fi/bitstream/handle/10138/231986/comp... "The current Finnish Mental Health Act stipulates thefollowing criteria for compulsory admission: .a person should be found to have a psychotic illness,and .because of this psychosis, they are (.in need of psychiatric care as their condition would otherwise worsen [this is the main different criterion], or .a danger to their own health or welfare, or .a danger to the health or welfare of others) .no other mental health services are suitable or adequate (Finland of course has proper free at the point of use healthcare for all residents, a far more important point for mental health than involuntary commitment.)
  - gamblor956 7y ago
    The main different condition makes all the difference... That would describe more than two thirds of the homeless.
  - 7y ago
duiker101 7y ago
Why can't the issue be looked at a state level then?

svantana 7y ago

The US has about 60x the population of Finland, so on a per capita basis the situation (sans programme) seems comparable.

splitrocket 7y ago
Correct, and generally speaking, economic of scale should apply to social sector programs. In theory, it should be 60x easier for the US to house everyone, simply because we have more resources to aggregate. Even when you compare per capita GDP, Finland's doing it with $50k, while the US is at $62.5k.
- SpicyLemonZest 7y ago
  Is the US in fact spending less money on homelessness, though? My guess would be that it's spending a comparable amount on a per-person basis.
  - soulofmischief 7y ago
    The US citizen sees a fraction of their tax dollar ever actually reach the ground. The rest gets caught up in people's pockets on the way down. We would need to adjust for this but it's unclear how to create a heuristic.
    - _jal 7y ago
      Do you have evidence that there's more friction/graft in the US than, say, Finland?
      - deleted 7y ago
        [deleted]
      - soulofmischief 7y ago
        I don't, because I don't know how to calculate it. Like I said, we need a heuristic but I don't know how to go about it. But it's an important qualifier when we're trying to isolate this problem to just the economics of solving homelessness.
      - pavlov 7y ago
        There's the established Corruption Perceptions Index published annually by Transparency International: https://en.wikipedia.org/wiki/Corruption_Perceptions_Index https://en.wikipedia.org/wiki/Corruption_Perceptions_Index Finland is ranked #3 while US is #22.
        yokaze 7y ago
        The keyword here is "perception". I am not convinced that the perception is deserved.
  - claudeganon 7y ago
    A great deal of spending in the US suffers the problem of direct versus some form of market disintermediation. So, instead of just building houses for people, we funnel it through myriad private or semi-private bureaucracies and suffer their corruption and graft.
    - SpicyLemonZest 7y ago
      That appears to be happening in Finland as well. The article says that state funding is funneled through "NGOs such as the Y-Foundation" who are responsible for actually getting the housing.
      - claudeganon 7y ago
        Yes, it’s not a binary situation. But Finland also directly took over several private/NGO shelters and converted them to apartment blocks. In the US, this would be considered verboten in most major cities because of the challenge it poses to everyone involved in real estate speculation and development.
- chimeracoder 7y ago
  > Correct, and generally speaking, economic of scale should apply to social sector programs. In theory, it should be 60x easier for the US to house everyone, simply because we have more resources to aggregate. People always like to rush to talk about economies of scale, completely forgetting that diseconomies of scale are also a thing. (And even that's all assuming that you think Finland's demographics are comparable to the US's and that causes of homelessness and poverty in Finland are representative of the causes of homelessness and poverty in the US.)
- mkohlmyr 7y ago
  I'm actually not convinced on the surface of it that economies of scale apply to government. It seems to me like the larger the population, the more layers of government required to effectively deploy capital. If you assumed a similar per capita tax rate, but more government is required to deploy the taxes in a larger nation, the larger nation would presumably end up with less money deployed per capita. Of course I am neither a social scientist, economist or political scientist.
  - joshspankit 7y ago
    The simpler the program, the less layers you need. If the todo list for a homeless person is: - Assign open apartment - Digitally fill out form B12 - Deposit money Then there is very little work required. Where social programs have the highest overhead is where they do things like “Assess whether it’s ‘required’ based on binders 3 through 7” and “Continually check in with all other governmental arms to validate that they are meeting criteria”.

JanSt 7y ago

The US also has 60x as many people. 327/5,5*(4600+1900) = ~386.000 (at 1 person/home)

ianleeclark 7y ago
Why are you adding the 4600 and the 1900 together? Those 4600 have been homed.
- TacticalTable 7y ago
  Homed by a process that the United States also doesn't have and would need. It would be dishonest to compare the rates without including the cases that Finland has already solved through a similar (but not as far reaching) program.
  - ianleeclark 7y ago
    > It would be dishonest to compare the rates No, I think it's perfectly honest to compare the rates of homelessness in a country that has worked to improve the situation versus a country that continues to let people die in the streets. It seems far more dishonest to compare the rates before the work was done, considering that work was done to reduce the problem. The reason that the US now has a roughly 5x rate of homelessness (and, let's face it, growing) vs a roughly 1.3x rate of homelessness is because the United States has no interest in fixing the problem.
  - raxxorrax 7y ago
    I still don't believe in fractional reserve banking.
- SpicyLemonZest 7y ago
  They've been homed, but subsidies for the housing of previously homeless people are typically aggregated under homeless spending. (The US has a lot of programs like that as well.)

MuffinFlavored 7y ago

source for 500,000 homeless people in America claim?

Someone1234 7y ago
The US Government: > According to the US Department of Housing and Urban Development's Annual Homeless Assessment Report, as of 2018 there were around 553,000 homeless people in the United States on a given night, or 0.17% of the population. https://en.wikipedia.org/wiki/Homelessness_in_the_United_States https://en.wikipedia.org/wiki/Homelessness_in_the_United_Sta...
splitrocket 7y ago
The 2018 annual "point in time" count done by the federal housing administration: https://www.hudexchange.info/resource/5783/2018-ahar-part-1-pit-estimates-of-homelessness-in-the-us/ https://www.hudexchange.info/resource/5783/2018-ahar-part-1-...

gamblor956 7y ago

They never had Reagan, so they still treat mental illness there. More importantly, Finland allows for the involuntary commitment if the mentally ill. In the US, this is only allowed if the individual presents a danger to themselves or others.

stjohnswarts 7y ago
The government shouldn't be able to just walk around pointing fingers trying to put individuals in "therapy". Particularly the sort the is available at minimal budget government facilities.
- AQuantized 7y ago
  Do you feel that is an accurate characterization of mental health care in non-US countries with different requirements for commitment, like Finland?
pjc50 7y ago
That's almost what the Finnish system requires: https://helda.helsinki.fi/bitstream/handle/10138/231986/compulsory_psychiatric_detention_and_treatment_in_finland.pdf?sequence=1 https://helda.helsinki.fi/bitstream/handle/10138/231986/comp... "The current Finnish Mental Health Act stipulates thefollowing criteria for compulsory admission: .a person should be found to have a psychotic illness,and .because of this psychosis, they are (.in need of psychiatric care as their condition would otherwise worsen [this is the main different criterion], or .a danger to their own health or welfare, or .a danger to the health or welfare of others) .no other mental health services are suitable or adequate (Finland of course has proper free at the point of use healthcare for all residents, a far more important point for mental health than involuntary commitment.)
- gamblor956 7y ago
  The main different condition makes all the difference... That would describe more than two thirds of the homeless.
- 7y ago

duiker101 7y ago

Why can't the issue be looked at a state level then?