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No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, which is an ero

No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, which is an erosion of civil liberties (incarceration without trial). Having known several friends who got committed and held against their will in psych wards when there was no good reason to, because their insurance was good, this is an issue. Notice they don't give any stats about outcomes, but the primary cited issue is "mental health" which is very vague and a subjective assessment. We should not create an extra judicial system that has no checks and balances. Otherwise we will head towards medical authoritarianism which could easily be abused by those in power (psychiatrists and others) for their own personal gain. See https://www.buzzfeednews.com/article/rosalindadams/intake https://www.buzzfeednews.com/article/rosalindadams/intake for an example of what I mean.

monadic3 6y ago
> No one is talking about the very big risk associated with this The left is. "Abolish the police"/"Abolish prisons" refer to an abolition of policing and the entire law enforcement/prison complex. Social workers (and, I suspect, other rapid response officials) are certainly part of this.
Benjammer 6y ago
Is the risk alone a "very big" risk? Or are you saying the difference in risk of this happening with a cop vs. a medical person is a "very big" difference? Are cops not also able to commit someone involuntarily? Why are you talking about objective "very big risk" without comparing it to the current situation and what is different about this? I did a google search for "can a police officer commit someone to a mental ward" and this is the first result, from harvard: https://blog.petrieflom.law.harvard.edu/2014/11/25/short-term-emergency-commitment-laws-require-police-to-assess-symptoms-of-mental-illness/#:~:text=In%20most%20jurisdictions%2C%20a%20police,short%2Dterm%20emergency%20commitment%20process https://blog.petrieflom.law.harvard.edu/2014/11/25/short-ter.... This says that a police officer is also able to commit someone in most jurisdictions. Why didn't you also mention this fact? FUD
- aaronbrethorst 6y ago
  I'd rather take my chances with a medical person than an amped-up dude carrying a firearm with basically no chance of getting fired (let alone imprisoned) if he shoots me.
- Flozzin 6y ago
  This is what I was looking for or I was going to post myself. Why is the risk of being involuntarily committed so much greater than having a cop do the same. Or a cop just throwing you in jail? The anecdotes of peoples loved ones being 'committed and only getting released when the money runs dry', seems far more preferable than their loved ones being thrown in jail and released when they can pay the bond. Or sit in jail and wait for a judge.
  - Benjammer 6y ago
    >being thrown in jail and released when they can pay the bond. Or sit in jail and wait for a judge. Or shot to death on site because the cop doesn't have (enough?) training to deal with a mental health episode without resorting to violence.
Ericson2314 6y ago
You do realize that jails (not prisons) already house people quite long due to various dubiously legal reasons? Also that we got rid of most asylums so the risk of being committed is quite low by the pigeonhole principle?
- imperio59 6y ago
  You can get thrown in jail for a long time but there is a long list of legal ways to appeal a conviction. Yes, people get convicted wrongly but that is pretty rare. 97% of people at the federal level who get indicted just take a plea deal, so the proportion of people sitting in jail unfairly (assuming they pled not guilty) must be fairly low, at least at the federal level.
  - tadfisher 6y ago
    This claim disregards those who take a plea deal because they believe they cannot win a federal criminal case, which is a superset of those who are actually innocent of their accused crimes.
    - ryanwhitney 6y ago
      Yeah. Oddly enough, the aforementioned “97%” stat brought me to an Innocence Project page[1] which leads with: > In nearly 11% of the nation’s 349 DNA exoneration cases, innocent people entered guilty pleas. Obviously a small and biased sample group, but guilty plea ≠ guilty. [1] https://innocenceproject.org/guilty-plea-campaign-announcement/ https://innocenceproject.org/guilty-plea-campaign-announceme... (2017)
  - giantg2 6y ago
    There are a large number of people who take a plea just because they can't afford the bail and it would take a year or two to get to trial. Or because lawyers are expensive and it's cheaper to plead guilty than to defend your innocence. I've recently had an issue with an incompetent trooper (1 successful complaint and one pending) and incompetent magistrate (complaint pending). It will cost between $100 (win) and $650 (lose) to go through the legal process and defend our innocence. It's been more than 6 months too. All this is over "leash law" violation. But it's great to see both the trooper and magistrate commit civil rights violations, and have the civil rights lawyer tell you that they are violations but that the system doesn't care unless you suffer serious financial damages. So much for a justice system.
faitswulff 6y ago
Police officers can end your life against your will with no trial, so I see anything being an improvement over that.
- imperio59 6y ago
  I understand the media loves to hype these things when they happen, and they are all tragic incidents, but when you take a look at how often that actually happens compared to other things that can end your life, you realize it's really not actually that big a problem, compared to say... Murders or violent crime.
  - faitswulff 6y ago
    Except murderers and violent criminals don't have essentially legal immunity.
    - dimitrios1 6y ago
      And this is the hyperbolic, overdramatic society we live in today, with no nuance or potential to see another side. Qualified immunity -- qualified meaning limited. Yes it is easy to abuse and has been abused, but rest assured cops have gone to jail for murder and involuntary manslaughter.
      - faitswulff 6y ago
        I'd love for you to show me how many of these officers went to jail for murder: https://www.statista.com/statistics/585152/people-shot-to-death-by-us-police-by-race/ https://www.statista.com/statistics/585152/people-shot-to-de...
        dimitrios1 6y ago
        I'd love for you to first show me how many of those shootings were justified.
        6y ago
iujjkfjdkkdkf 6y ago
Yes, from the title I had expected it to be about health officials ignoring the law in instituting covid related restrictions. We definitely don't need more power in the hands of unaccountable technocrats.
GavinMcG 6y ago
This isn't changed by an arrest being the first step. As an EMT I frequently transported people to hospitals (or from hospitals to psychiatric facilities) following their arrest. This just avoids the extraordinary cost to both society and the individual that comes along with an arrest being part of the process. The medical authoritarian system you're worried about already exists and frankly I saw no evidence of its abuse. Most psych facilities are over-enrolled and have no interest in keeping people around once they're stable enough to be released - which is a far cry from having healed or become functioning members of society.
- Breza 6y ago
  Very well said!
- imperio59 6y ago
  Psychiatry does not know how to cure mental illness. At best it knows how to medicate it and alleviate symptoms while causing very serious or deadly side effects. Investing more money into this doesn't solve the societal issues which come from drug addiction, lack of economic opportunity, a failing education system, etc I would rather see us focus on fixing schools and the economy than spend billions on these programs that have dubious outcomes
  - Talanes 6y ago
    >I would rather see us focus on fixing schools and the economy than spend billions on these programs that have dubious outcomes I couldn't find an exact number in the five minutes of searching I was willing to put in, but the budget seems to be in the single digit millions, a far cry from billions.
    - vidarh 6y ago
      And it also ignores that the alternative here is not "do nothing" but "send police instead", which also costs. And if it leads to arrests it costs even more. And if people end up getting a criminal record, it tends to reduce their long term employment prospect, and as a result reduce tax revenue/increase welfare costs. There seems to be plenty of potential for this to save money over time.
hellcow 6y ago
Do you live in an area with high homeless rates? As in, "there's a homeless camp of tents consuming multiple city blocks"-level of homelessness? It's horrible for everyone in the city--most of all for the homeless. These people suffer from mental health or drug issues and need help. The status quo of "leave them to fend for themselves" is simply an unacceptable outcome. The system launched by the DPD may not be perfect, but it's a whole lot better than what existed before. It's a huge step in the right direction.
- imperio59 6y ago
  In my observation a lot of the homeless in the camps with mental health issues are on medication or have been through mental health facilities several times and it just made things worse for them Source: working on the streets of Seattle a couple years ago every weekend.
  - mjevans 6y ago
    My own belief is that there isn't a single simple issue, but rather a web of many simple things that have complex interactions. Nearly all of those are political issues though. Technology can help with better communications and tools for debunking falsehoods in those communications. It might also eventually help with strong AI that's smarter and better than humans at offering a set of solutions and then letting people debate the ones that we agree are also emotionally the correct answers.
- zapzupnz 6y ago
  People need to remember that perfection is the enemy. Better to step forward in the right direction now than be paralysed by the fear it will never come to pass — obviously, the latter is a self fulfilling prophecy.
  - throwaway9980 6y ago
    I’m starting to feel like this perfect or nothing attitude is a massive amplifier of the problems we’re facing. “God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.” We’re way out of balance. Lot’s of courage, less wisdom, no serenity.
tantalor 6y ago
Explain what "insurance" has to do with it?
- GavinMcG 6y ago
  Private insurance often pays providers better rates than Medicaid, so patients with private insurance are on paper more "desirable" than patients without. The commenter is suggesting that translates into kidnapping, essentially.
  - tantalor 6y ago
    I would be pissed if I were involuntarily committed and they billed me.
minikites 6y ago
>No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial So it's better to be suffocated on the sidewalk for the crime of selling single cigarettes?
trianglem 6y ago
It’s still a step up in my opinion. This problem is also heavily mitigated by body cams.
- minikites 6y ago
  Assuming the cops don't just turn them off or "lose" the footage, which "mysteriously" seems to happen every time there's an incident (unless the cop is too stupid to cover their tracks).
  - recursive 6y ago
    Corruption or stupidity? Is there really no room for doing the right thing?
    - minikites 6y ago
      Cops who do the right thing are punished by their fellow cops, look up what happened to the real Serpico.
lettergram 6y ago
Well, there are places discussing this... just not anywhere which is for “defunding the police” That being said, totally agree. This will be and probably already is being abused.
eyelidlessness 6y ago
If you think cops can’t commit you against your will I surely hope you never come up against their guns and nearly total lack of accountability.
- mmcwilliams 6y ago
  This is the exact problem with that argument. Healthcare workers can commit you against your will just as police officers can as well.
  - eyelidlessness 6y ago
    Right. So the improvement is that health care workers who are actually qualified to make that determination show up and don’t escalate the situation with violence or legal trouble. That’s a whole lot of improvement. And sounds like very little downside since the risk associated is identical otherwise.
- astura 6y ago
  Exactly, the people who will be committed against their will would still be committed against their will if police respond. I know this for a fact because the one guy I know who encountered police during a mental health episode ended up commitment. The difference here is taking away the addition of police to the incidents. No handcuffs or jail holdings, no being roughed up or killed. Hopefully the mental health person knows how to de-escalate the situation - I think this is huge. I think the friend I mentioned above could have avoided impatient treatment if he had a qualified mental health person respond instead of the police, due to the situation around his incident/arrest. This just isn't a good faith argument.
trianglem 6y ago
I feel like this point is not made in good faith especially considering your other comments specifically praising cops and denigrating BLM activists. To address your point however, it’s still a huge step up from having an arrest record in addition to being committed.
- imperio59 6y ago
  If the arrest record is warranted, I fail to see your point. The outcome of not having a record when you probably should have one is probably net worse for society, given it won't show up later on a background check, for example.
  - trianglem 6y ago
    It’s the same point as - if a person needs to be committed they should be. We are in this position because cops have not been shown to be fully trustworthy in a lot of these situations. It is infinitely better to not have the cops involved at all unless they are absolutely needed at which point the medical care workers can send for them. This new way is a win-win for everyone involved.
yters 6y ago
What is the difference between a psych ward and a jail? No difference in tv shows, except they also drug you, do weird experiments, and you could get killed by fellow inmates without a problem. If getting committed to a psych ward replaces prison it sounds much worse.
- recursive 6y ago
  Presumably we're discussing real ones, not TV ones.
  - yters 6y ago
    My friend worked at a real one and it did not sound much different.
hedora 6y ago
It varies by state. In California, it’s essentially impossible to commit someone (source: I tried and failed, despite written permission from the person pre-episode, the blessing of their doctor, and the blessing of their family, multiple police reports from third parties, a divorce, eviction, repos, etc, etc.) In CA if you do somehow manage to maliciously commit someone, they’re held for up to 24 hours, and an independent doctor assesses them. Also, there can be civil penalties (as in the article you cite, where the victim successfully sued the hospital). If I had to choose between the two ridiculous extremes, I’d choose the Texas model.
- maxerickson 6y ago
  In Michigan you can petition that someone be involuntarily committed for treatment and then they get a hearing in front of a judge. It has to happen within a few days. (just enumerating, not particularly comparing)
  - hedora 6y ago
    Interesting. I wonder if that requires a lawyer or not. (Legal fees for this sort of thing are exorbitant in California, and the cases tend to be a stretch.) It’s an odd (broken?) process if the judge would ascertain the person’s mental health. Hopefully, most judges would call in professionals.
    - maxerickson 6y ago
      The prosecutor brings it before the judge. There is testimony, the judge isn't directly doing the mental health assessment. Typically a social worker is helping the petitioner figure it out. https://courts.michigan.gov/administration/scao/forms/courtforms/pcm201.pdf https://courts.michigan.gov/administration/scao/forms/courtf...
- random5634 6y ago
  I was going to come to say something similar. At least in CA or the part I am in (very liberal) getting someone committed for a longer period (3 months + etc) - I think may be pretty much impossible? This can be despite a whole host of criminal and self harming behavior. Pre pandemic I think it was probably easier to get folks in at least for a few days at a time to jail pending disposition of whatever the latest case was - which was time enough to fix locks / windows / doors etc or move.
danShumway 6y ago
> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial Increasing cop presence won't fix that problem. In multiple jurisdictions, cops can also refer you to be involuntarily committed. So we're not creating an extra judicial system that has no checks and balances, that system already exists and cops are a part of it. We're talking about the potential benefits of removing one harmful part of the equation. If you want to also talk about the negatives of involuntary commitment and make progress in that area, that's totally worth examining as well, but it's not an argument for flooding the streets with more cops. Getting arrested doesn't mean you can't be involuntarily committed afterwards. Also note that in some cases, getting arrested and thrown in a holding cell can on its own be just as traumatic of an event as being held for an involuntary mental evaluation -- particularly if someone is genuinely suffering from a mental attack. And arrests don't require trials either. A sizable portion of the people in our jails have never been convicted of crimes, they're just stuck there because they can't pay cash bail.
- imperio59 6y ago
  Difference is, if your only tool is a hammer, everything is a nail. If you send a mental health professional to all sorts of situations, their solutions will be mental health related (medication, treatment, commitment, etc...). If you send a cop, their solutions will involve the criminal justice system (citation, fines, arrest, jail time, etc...). One of these has a long history of strong checks and balances and improving itself over time (latest major improvement: body cams). The other one of these is primarily fueled by giant corporate lobbies who spend a lot on every single political campaign (read: Big Pharma). Can you guess which one is now being touted as the "new solution for all our societal ills" despite having no track record of actually being able to fix any of these ills?
  - deleted 6y ago
    [deleted]
    - narrator 6y ago
      The suicide rate has been steadily increasing since 2000. The effectiveness of the mental health profession is falling at an alarming rate: https://www.macrotrends.net/countries/USA/united-states/suicide-rate https://www.macrotrends.net/countries/USA/united-states/suic...
btmiller 6y ago
This is a dangerously bad take. Real progress is being made by this change and the assumptions you’re making risk taking wind out of its sails over essentially a non-issue.
sdenton4 6y ago
Uh, citation needed? Getting committed 'because their insurance was good' is likely not an issue here, as ~70% of the interventions were with homeless people. Here's the actual report: https://wp-denverite.s3.amazonaws.com/wp-content/uploads/sites/4/2021/02/STAR_Pilot_6_Month_Evaluation_FINAL-REPORT.pdf https://wp-denverite.s3.amazonaws.com/wp-content/uploads/sit... "[T]he STAR van provided transportation to 41% of its calls for service where an individual's information was recorded. Of those incidents (107), the most common locations were a shelter or homeless services (30), the walk-in crisis center (24), or a hospital (18)." It's unclear how many of these would involve an involuntary commit, and similarly unclear how the outcome would compare to a police encounter, which often comes with its own special brand of involuntary commit. One of the report recommendations is to create a longitudinal study to assess outcomes.
dfsegoat 6y ago
I imagine this also increases the surface area of interactions resulting in removal firearms from people, for reasons of mental health status. Those people may, or may not deserve it. E.g. California has a statute for 'mandatory relinquishment' of firearm, based on a mental health professionals findings [1] . [1] - https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=8102.&lawCode=WIC https://leginfo.legislature.ca.gov/faces/codes_displaySectio...
schoolornot 6y ago
The best part is the bill you get after being involuntarily committed!
suifbwish 6y ago
It is situations like this that justify the second amendment.
jdeibele 6y ago
What you're worried about is reasonable but it doesn't seem to have much to do with the article. There's no mention of the mental health clinician and EMT in the van grabbing people, throwing them in the van, and hauling them off to be committed. Instead they seem to be sympathetic listeners who can help with problems. Not solve, probably, and probably not permanently but anything that helps keep people from getting shot or locked up in jail is good.
- imperio59 6y ago
  I had a friend who was essentially committed against her will. She was never grabbed violently or thrown into a van. She was calmly told they would be committing her, then asked to strip and change into a gown, told to take the medication or it would be administered forcefully, etc... You have a very "Hollywood" idea of how this stuff happens. Reality is a lot more insidious.
  - ogre_codes 6y ago
    No idea what your friend went through, but that's not what this program does. The people in these programs can't commit anyone, or take them anywhere they don't want to go. The service works much much better that way because when the van rolls up, there is no fight or flee reaction.
newacct583 6y ago
First, that seems needlessly absolutist. We're literally talking about upending decades of emergency response practice here, surely it should be reasonable to talk about tweaks to the process (mandatory judicial hearings within N days of mental health detentions seem very reasonable to me) without demanding that a change be thrown out because of a theoretical problem. Second, is there data here? I mean, the article lists 748 tracked incidents. Did any even lead to an involuntary hospital admission? Shouldn't we figure this out first? Inventing terms like "medical authoritarianism" seems like more noise than signal, basically. Surely the fourth amendment as it stands can speak to the needs of mental health cases just as it can accused criminals.
ogre_codes 6y ago
> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, We've had a program like this for years here in Eugene Oregon. It's called CAHOOTS. One of the cornerstones of the program is it's all voluntary. There is no use of force, no dragging people off anywhere. People show up with a van and some basic medical supplies and help people. If the people don't want help and the only alternative is some form of restraint, they call the police. They almost never end up calling the police because most people just want a little help and a patient person talking to them gets it done. The fact that these people never themselves do anything against people's will is what makes this work so well.
- TedDoesntTalk 6y ago
  That sounds awesome. Thanks for sharing.
  - ogre_codes 6y ago
    I've posted this link elsewhere in this thread, but there are some details here: https://www.msn.com/en-us/news/us/this-town-of-170000-replaced-some-cops-with-medics-and-mental-health-workers-its-worked-for-over-30-years/ar-BB16lO1G https://www.msn.com/en-us/news/us/this-town-of-170000-replac...
ghshephard 6y ago
The police have the authority to place a person on a 48 hour medical hold, and will threaten to use that authority if you don't do what they tell you. They'll use it for something like a person who passes out not wanting to go to the hospital, even if they are with a friend who can take care of them if there is really an issue. I'd probably trust this crew in Denver more than I would a random police officer in making that assessment.
- imperio59 6y ago
  Maybe the 3-4 people in Denver are fine. The issues come with scaling this up nation wide to where you have tens of thousands of variously trained "health professionals" where outcomes will not necessarily match what you're seeing in a pilot where they obviously handpicked competent people to run it...
  - ddingus 6y ago
    Simply require a healthy percentage of staff be program successes. People who have been there and have come back. Those people will know how this all needs to work in order to do the healthy, hard, very human work required. They know stuff, hard earned, rough miles type stuff, that is both necessary and not taught effectively in any school other than when the bell rings at the fine school of hard knocks.
    - ddingus 6y ago
      Naysayers should work at, or observe one of these programs in action before coming to conclusions. I have this experience and know those people and what they can do. Think of them as the immune system to defend against the potential disease discussed above.
  - b_t_s 6y ago
    We already have this in the form of child protective services. Social workers are plentiful and paid quite poorly for a degreed professional. Cops with GEDs and social workers with bachelors degrees make very comparable salaries. For an extra 5 grand or so you can get one with a masters degree. So there's no sane reason to hire variously trained "health professionals" with scare quotes. The really tough part is getting tens of thousands of independent, ossified bureaucracies onboard with the idea of and giving up/redirecting some of their responsibilities/power/budget.
ddingus 6y ago
Portland had a similar program. It worked GREAT. (I am out of the city and have not kept up. Some form of it may still be a thing.) Now, in that program they could hold you for 72 hours tops. No criminal record, no arrest, just a record private to that program for maintaining patient history. No attorneys, no bail, nothing. Outreach staff were deputies well trained in deescalation and conflict resolution as well as EMT and other related first responder skills. They do not perform law enforcement and need their status to execute the program tasks only. We used to do that with law enforcement. We don't today. Some say we should. Some say we can't. No judgement from me. That is just the current lay of the land we all live with today. These programs offer a strong, effective, humane option and they save a lot of money. It saw a lot of use dealing with the following: Drugs and alcohol inebriation, violence and general inability to do self care. Homeless Mentally Ill Temporary mental distress. Say one ends up there flat out hammered. Ok, you stay, until you aren't. Same for most drug scenarios. The primary criteria for release? Not being hammered and or not being an asshole. This was the right thing to do almost every time too. Worked great as a more serious crime prevention, and self harm reduction. They could escalate to the court system, or a hospital, and or begin treatment at the integrated detox facility. All anyone need do was ask. For homelessness, it typically required something be going on, like people going to die, or who were otherwise at some grave risk. Those people could also just reach out. A ride in the van later, they can clean up, sober up, and then tap social services, or get into a shelter, temp housing, depending, or detox. Police could DEescalate to this program as well and did so frequently. People served by this program did not get criminal records, nor did they get a mental health record. What they did get was help, and where it made sense, some tough love, and hard, lucid talk. A significant percentage of the staff were former street people who had entered the program, got themselves good and then stuck around to help others. These people really matter. They have been there and are highly effective. At the time, it was nationally recognized as a strong alternative to the typical judicial system grinder chewing lives up rather than lifting them out. Here is something one of those people told me, and before I write it, I have in depth knowledge of the program via my spouse who worked front line outreach for many years: Help buys time. Real help is sans judgement too. Time is what people in trouble need. When they get it, they have an opportunity to make different choices, and when they do, they are no longer people in trouble. They become people getting out of trouble, improving. This is what they, and everyone else really need. Nobody knows what reaches people. We only know when we continue to try some of them are reached and when we try harder, with genuine concern and zeal, more are reached. Just reaching someone often is not enough. They fall back, need more time. This is as good as it all gets. Being human can really suck. Us lucky ones, who do not currently experience that suckage can count ourselves lucky and also for the help we may one day, ourselves need. That, at the core, is what these programs and others like them are, or need to be about. When they are, they work. Simple as that.
TedDoesntTalk 6y ago
> See https://www.buzzfeednews.com/article/rosalindadams/intake https://www.buzzfeednews.com/article/rosalindadams/intake for an example of what I mean. I stopped reading right after the patient admits to suicidal thoughts to a therapist. That can easily get you committed against your will, and for good reason.
- account42 6y ago
  > and for good reason What good reasons are those?
freyir 6y ago
Nobody talks about how difficult it actually is to commit mentally ill people in many places. Case in point, San Francisco, where severely mentally ill homeless people abound, many of whom who cannot look after themselves, and are left to suffer and die in the street out of respect for their civil liberties. Or those who terrorize neighborhoods for years on end, and everyone looks the other way out of respect for their civil liberties. Civil liberties are important, but prioritizing civil liberties to an extreme, above all else, is often harmful for the individuals they’re supposedly serving.
deleted 6y ago
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lazyasciiart 6y ago
A cop in Seattle was found to have involuntarily committed multiple people because he had a crush on the EMT who had to come transport them. I don't think keeping police involved is going to improve any of the things you care about.
bsder 6y ago
> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, which is an erosion of civil liberties (incarceration without trial). Having known several friends who got committed and held against their will in psych wards when there was no good reason to, because their insurance was good, this is an issue. In California, this doesn't seem to be true. I got to see this in action from the sidelines. Within 24 hours of being committed, the patient will have an advocate appointed for them and within 72 hours the patient will be released unless the health team can put up justifications that pass the advocate AND then judicial scrutiny. The doctors can kick up a fuss, but 7 days is the limit before it MUST pass a judge. I got to watch this in action, and the advocate was MUCH more aggressive on behalf of the patient than if the same person had been arrested and was relying on a public defender.
ashtonkem 6y ago
I see your point, but it’s worth considering that the tradeoff is potentially seeing said people shot by an armed officer, or thrown into jail where they’re likely to be hurt, abused, and otherwise suffer.
electro_blah 6y ago
beats getting killed.
Noos 6y ago
If anything, I wouldn't worry about this given the article. The majority of the incidents shown are homeless people berating retail staff over welfare card issues; technically they would be charged with trespassing because the police have to be called to make them leave the store. The example given was a mentally ill woman who had issues buying food with her debit card. If anything, it looks more like a crew of people handling nuisances committed by "regulars" as they pop up. The danger is probably they DON'T commit as much as they could, and put out fires rather than secure help. That is, they just keep enabling the nuisance calls. I'd be worried too about overreliance on this. If the guy suddenly pulls a gun or a knife on what was just being a public nuisance, you are having more or less medical workers in danger of their lives.
aligray 6y ago
That is terrifying.
franga2000 6y ago
I don't see how that risk has increased. It's pretty normal for police officers to call paramedics and mental health professionals in when subjects show signs of mental issues and substance abuse (there are even laws requiring them in some places). If the subject is in lockup or on the street by the time they arrive makes no difference since they have the exact same power to involuntarily commit them. Now, whether that power is something that should be more regulated is a different question entirely. I believe there is an appeal process for being committed and it can go to trial, so it's not like it's entirely authoritarian. If signs of abusing this power are found, then of course, something should be done about it, but again, who was the first respondent really doesn't matter in that discussion. EDIT: I read the linked article and holy shit, the US health system really is fucked. Honestly, when the incentives are that misaligned, I can see why you were worried (I was looking at this from a 1st world perspective; mild offense at the US intended). Maybe it would be smart to add an additional sanity check to the STAR system, but of course, until your healthcare mess is sorted, that's like putting a bandaid over a stab wound.
dragonwriter 6y ago
> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial Police can arrest you and hold you against your will with no trial, for a limited period of time (e.g., 48 hours excluding Sundays and holidays is a common tule, IIRC), on the premise that it is pending charges for criminal behavior (which may or may not be filed.) Mental health professionals (and, in many jurisdictions, law enforcement officers and others, too, can initiate this) can hold you against your will and with no trial, on the premise that it is for emergency psychiatric evaluation, for a limited time (72 hours is common.) Further involuntary detention, in either case, requires judicial process. I'm not seeing a particular additional danger here.
funkisjazz 6y ago
Presumably no arrests made though means people didn't fight the medical professionals trying to incarcerate them? So I assume most of them went voluntarily.
Uberphallus 6y ago
Indeed. It went the way Thomas Szasz described when he wrote The Therapeutic State [0]. It's a common trend in covertly authoritarian governments, but not only, to be able to remove people from the public without a fair trial: just question their sanity and have a doctor sign them in. Sometimes it isn't even the government, but someone well connected who needs someone else removed. [0] https://www.goodreads.com/book/show/6680331-the-therapeutic-state https://www.goodreads.com/book/show/6680331-the-therapeutic-...
- pietrovismara 6y ago
  Yet neither you or op seem concerned of being killed by the police for no reason, like it happened to many. Perhaps you are in the demographic that wouldn't be shot by a cop but could still be judged unstable by a medical professional.
  - Uberphallus 6y ago
    That's funny[0]. I'm not American, so don't pull the white guilt card on me. I've spent a total of 12 days in the US in my life, and I was pointed a gun by the police once. That's infinity percent more than in any other country I've lived visited or lived in, and I've traveled my fair share off the beaten path. When they saw their mistake, they spouted the generic excuse that I matched a description, something that wouldn't fly in any other first world country, but is somehow accepted in the US. Anyway, I'm white and I did nothing wrong, so I guess that officer just pointed that gun as joke with no intention to kill,[1] right? US police kills citizens at a rate seen only in developing countries. According to the wiki[2], US police kills 10 times as often per capita as the worst European offender of significant population (France), and ranks higher than places like Angola, Colombia or Rwanda, that have insanely higher crime rates. Let that sink in, and think whether the problem is race based or not. But don't worry, Biden won, the rates will remain the same but it will no longer be an issue worth being reported in the media ;) [0] https://www.statista.com/statistics/585152/people-shot-to-death-by-us-police-by-race/ https://www.statista.com/statistics/585152/people-shot-to-de... [1] https://www.youtube.com/watch?v=VBUUx0jUKxc https://www.youtube.com/watch?v=VBUUx0jUKxc [2] https://en.wikipedia.org/wiki/List_of_killings_by_law_enforcement_officers_by_country https://en.wikipedia.org/wiki/List_of_killings_by_law_enforc...
devoutsalsa 6y ago
If you’re high on drugs, yelling scary stuff, acting violently without technically doing anything illegal. and threatening to kill yourself, I’d restrain you myself if I could. What’s the alternative to locking you up or waiting until you hurt someone & shooting you dead? You’re out of your mind, ruining everyone’s day, and you need a timeout to get your shit together, so if you wanna act like a child with no regard for the well-being of those around you, I’d have zero problems with sending you to your room until you cool down. It just so happens your room is a padded cell at the local mental health facility.
- zeofig 6y ago
  OK, but were the other poster's friends doing any of the things you listed?
  - Broken_Hippo 6y ago
    Not everyone has many friends, and if your one or two friends (literally 1 or 2) aren't there, there is no one. Your family might live out of town, too. When my ex attempted suicide, he'd have succeeded if he lived alone. Few people would notice my own absence for some time if I lived alone, honestly.
pietrovismara 6y ago
> We should not create an extra judicial system that has no checks and balances You should be way more concerned about police brutality then.
pessimizer 6y ago
This is a miserable top comment. I also have a low opinion of the field of psychology, but cops can have you committed (and do) by bringing you to be evaluated by mental health professionals. Medical professionals can't shoot you. There's nothing in the article about creating a shadow mental health justice system. What they have is a van containing blankets and food, driven by two social workers.
- patcon 6y ago
  omg thank you, voice of reason. No disrespect intended to parent posters (i appreciate them sharing their anecdotal experience), but def sobering to see that at the top, and realize "oh, this is the common view of hivemind i'm participating in"
  - dsnr 6y ago
    No disrespect, but maybe you should not participate in the community, if you’re not prepared to handle different views. And thanks for posting without bringing anything to the table.
  - faitswulff 6y ago
    HackerNews is a pretty miserable place when it comes to social issues.
  - throwaway1239Mx 6y ago
    I have this vague hope that maybe the 'top comment' position is also based on number of replies, not necessarily upvotes, but then... the discussion itself is pretty sobering. The current program cost relative pennies, proved to be effective at both helping people and freeing up police workers to focus on crime/traffic-related issues. More effective use of city tax $$$$ through targeted spending of $. Seems like a win win win. Anyway, I agree with this particular branch of the discussion-tree.
    - Balgair 6y ago
      The FAQ doesn't have a specific entry about comment rankings, but I'd guess it's based off a similar system as the Stories rankings: "How are stories ranked? The basic algorithm divides points by a power of the time since a story was submitted. Comments in threads are ranked the same way. Other factors affecting rank include user flags, anti-abuse software, software which demotes overheated discussions, account or site weighting, and moderator action."
JeremyNT 6y ago
> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, which is an erosion of civil liberties (incarceration without trial). Having known several friends who got committed and held against their will in psych wards when there was no good reason to, because their insurance was good, this is an issue. Do you have a citation for this being a real side effect of the type of program listed here? The program as described in this piece seems novel and this article certainly makes it sound like a success. I know engineers and programmers like to poke holes and look for edge cases that might break any potential solution, but hopefully we can allow ourselves to celebrate the victories when we see them without letting the perfect become the enemy of the good.
kardianos 6y ago
This is actually a big issue with child/family services as well. A lot of what they do is extra-judicial, though in theory there is often judicial review... eventually. This is coming from a foster parent. Don't get me wrong, a lot of these services are needed, but you would hear stories of abuse by the system. Extra-judicial threats are something everyone should be on guard against.
JshWright 6y ago
The problem you describe is real, but this program is a net positive (even in terms of the problem you're concerned about). Cops escalate mental health related scenes, which leads to people getting arrested and then put in a hold (which often gets extended). If a social worker is able to resolve the situation without getting the cops involved, a cop isn't going to get personally offended that someone in crisis isn't "complying" and feel the need to punish them.
dqpb 6y ago
> Having known several friends who got committed and held against their will in psych wards I don’t believe you
smrtinsert 6y ago
If you don't mind, what country do you live in and/or what thought process led you to "medical authoritarianism"? I would like more background on this, because it seems relatively absurd for the United States, where we struggle to even get a doctor involved when they clearly should be.
giarc 6y ago
There are a few issues with your statements. The first being that the staff of this program have no incentive to "commit you against your will". Why would they do that? I work in healthcare and have met people that work in these types of programs. By and large they do it because they care, the stress and risk you get from working with these populations isn't worth the money. I work in Canada, so perhaps it's different in your country, but to be commited to a mental health facility here, a trained physician needs to "form" you, basically sign forms stating that you are a danger to society if not treated. There are strict laws surrounding this, it's not just some random decision. Lastly, you say this will lead to some "medical authoritarianism". Programs like these, as well as the ability to commit people to mental health facilities has been around forever, yet I see no evidence of this medical authoritarianism you speak of.
watertom 6y ago
In these situations the Police basically have 2 options. - Take into custody (Which could mean being committed) - Shoot I'll take my chances with trained health/mental health professionals who can understand "I took too much", or I'm having a mental health crisis and while I might seem "out of control" I'm really harmless. Frankly if those health professionals think I need to be committed I probably should be committed. The police can take you into custody and commit you as well, but if you are having a mental health crisis, and can't really follow the rigid police directions more than likely it's going to end poorly, because the police will do what's necessary to take you into custody, including killing you.
TimTheTinker 6y ago
Agreed. It’s worth noting that your concerns absolutely have precedent. In the USSR and other 20th century states, committing people against their will to mental health asylums was a very common way of dealing with political and religious dissidents.
- TimTheTinker 6y ago
  Article covering political use of psychiatry in the Soviet Union: https://en.m.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union https://en.m.wikipedia.org/wiki/Political_abuse_of_psychiatr...
okl 6y ago
They also like to do that with whistleblowers: "Mollath's forensic incarceration for seven years and the surrounding legal judgments became the basis of a public controversy in Bavaria and the whole of Germany when at least some underlying elements of his supposedly fabricated paranoid story about money-laundering activities at a major bank turned out to be true after all. Mollath himself had consistently claimed there was a conspiracy to have him locked up in a psychiatric care ward because of his incriminating knowledge; evidence that turned up in 2012 made his claims appear plausible." -- https://en.wikipedia.org/wiki/Gustl_Mollath https://en.wikipedia.org/wiki/Gustl_Mollath
b_t_s 6y ago
I would be shocked if the social workers riding around in vans are allowed to commit people. Social workers are kind of like nurses in that very few of them hold a PHD and they generally aren't allowed to diagnose or prescribe(varies by state and education level). They can provide all sorts of support, advice, counseling, etc to people in crisis, but when it comes to people who need to be committed, social workers mostly call 911 and hand it off to the cops, same as the rest of us. They can refer you for a voluntary psyc eval with a psychologist, or advise the judge that it might be a good idea to send you for an involuntary one rather than just sending you to prison, but they have very little power to decide anything for you. And if they're even remotely competent and you're not a blatant menace to society, then they're generally trying to keep you safe, stable, and out of institutions as much as reasonably possible. The whole ethos of social work is very different than psychology or law enforcement. It's very much focused on what concrete, practical things can be done to improve your health, happiness, safety, and quality of life. A lot of times it's simply hooking people up with services that they aren't savvy enough to find or access without help, or helping them get through stressful situation without falling apart and going to jail, using drugs, etc.

monadic3 6y ago

> No one is talking about the very big risk associated with this The left is. "Abolish the police"/"Abolish prisons" refer to an abolition of policing and the entire law enforcement/prison complex. Social workers (and, I suspect, other rapid response officials) are certainly part of this.

Benjammer 6y ago

Is the risk alone a "very big" risk? Or are you saying the difference in risk of this happening with a cop vs. a medical person is a "very big" difference? Are cops not also able to commit someone involuntarily? Why are you talking about objective "very big risk" without comparing it to the current situation and what is different about this? I did a google search for "can a police officer commit someone to a mental ward" and this is the first result, from harvard: https://blog.petrieflom.law.harvard.edu/2014/11/25/short-term-emergency-commitment-laws-require-police-to-assess-symptoms-of-mental-illness/#:~:text=In%20most%20jurisdictions%2C%20a%20police,short%2Dterm%20emergency%20commitment%20process https://blog.petrieflom.law.harvard.edu/2014/11/25/short-ter.... This says that a police officer is also able to commit someone in most jurisdictions. Why didn't you also mention this fact? FUD

aaronbrethorst 6y ago
I'd rather take my chances with a medical person than an amped-up dude carrying a firearm with basically no chance of getting fired (let alone imprisoned) if he shoots me.
Flozzin 6y ago
This is what I was looking for or I was going to post myself. Why is the risk of being involuntarily committed so much greater than having a cop do the same. Or a cop just throwing you in jail? The anecdotes of peoples loved ones being 'committed and only getting released when the money runs dry', seems far more preferable than their loved ones being thrown in jail and released when they can pay the bond. Or sit in jail and wait for a judge.
- Benjammer 6y ago
  >being thrown in jail and released when they can pay the bond. Or sit in jail and wait for a judge. Or shot to death on site because the cop doesn't have (enough?) training to deal with a mental health episode without resorting to violence.

Ericson2314 6y ago

You do realize that jails (not prisons) already house people quite long due to various dubiously legal reasons? Also that we got rid of most asylums so the risk of being committed is quite low by the pigeonhole principle?

imperio59 6y ago
You can get thrown in jail for a long time but there is a long list of legal ways to appeal a conviction. Yes, people get convicted wrongly but that is pretty rare. 97% of people at the federal level who get indicted just take a plea deal, so the proportion of people sitting in jail unfairly (assuming they pled not guilty) must be fairly low, at least at the federal level.
- tadfisher 6y ago
  This claim disregards those who take a plea deal because they believe they cannot win a federal criminal case, which is a superset of those who are actually innocent of their accused crimes.
  - ryanwhitney 6y ago
    Yeah. Oddly enough, the aforementioned “97%” stat brought me to an Innocence Project page[1] which leads with: > In nearly 11% of the nation’s 349 DNA exoneration cases, innocent people entered guilty pleas. Obviously a small and biased sample group, but guilty plea ≠ guilty. [1] https://innocenceproject.org/guilty-plea-campaign-announcement/ https://innocenceproject.org/guilty-plea-campaign-announceme... (2017)
- giantg2 6y ago
  There are a large number of people who take a plea just because they can't afford the bail and it would take a year or two to get to trial. Or because lawyers are expensive and it's cheaper to plead guilty than to defend your innocence. I've recently had an issue with an incompetent trooper (1 successful complaint and one pending) and incompetent magistrate (complaint pending). It will cost between $100 (win) and $650 (lose) to go through the legal process and defend our innocence. It's been more than 6 months too. All this is over "leash law" violation. But it's great to see both the trooper and magistrate commit civil rights violations, and have the civil rights lawyer tell you that they are violations but that the system doesn't care unless you suffer serious financial damages. So much for a justice system.

faitswulff 6y ago

Police officers can end your life against your will with no trial, so I see anything being an improvement over that.

imperio59 6y ago
I understand the media loves to hype these things when they happen, and they are all tragic incidents, but when you take a look at how often that actually happens compared to other things that can end your life, you realize it's really not actually that big a problem, compared to say... Murders or violent crime.
- faitswulff 6y ago
  Except murderers and violent criminals don't have essentially legal immunity.
  - dimitrios1 6y ago
    And this is the hyperbolic, overdramatic society we live in today, with no nuance or potential to see another side. Qualified immunity -- qualified meaning limited. Yes it is easy to abuse and has been abused, but rest assured cops have gone to jail for murder and involuntary manslaughter.
    - faitswulff 6y ago
      I'd love for you to show me how many of these officers went to jail for murder: https://www.statista.com/statistics/585152/people-shot-to-death-by-us-police-by-race/ https://www.statista.com/statistics/585152/people-shot-to-de...
      - dimitrios1 6y ago
        I'd love for you to first show me how many of those shootings were justified.
      - 6y ago

iujjkfjdkkdkf 6y ago

Yes, from the title I had expected it to be about health officials ignoring the law in instituting covid related restrictions. We definitely don't need more power in the hands of unaccountable technocrats.

GavinMcG 6y ago

This isn't changed by an arrest being the first step. As an EMT I frequently transported people to hospitals (or from hospitals to psychiatric facilities) following their arrest. This just avoids the extraordinary cost to both society and the individual that comes along with an arrest being part of the process. The medical authoritarian system you're worried about already exists and frankly I saw no evidence of its abuse. Most psych facilities are over-enrolled and have no interest in keeping people around once they're stable enough to be released - which is a far cry from having healed or become functioning members of society.

Breza 6y ago
Very well said!
imperio59 6y ago
Psychiatry does not know how to cure mental illness. At best it knows how to medicate it and alleviate symptoms while causing very serious or deadly side effects. Investing more money into this doesn't solve the societal issues which come from drug addiction, lack of economic opportunity, a failing education system, etc I would rather see us focus on fixing schools and the economy than spend billions on these programs that have dubious outcomes
- Talanes 6y ago
  >I would rather see us focus on fixing schools and the economy than spend billions on these programs that have dubious outcomes I couldn't find an exact number in the five minutes of searching I was willing to put in, but the budget seems to be in the single digit millions, a far cry from billions.
  - vidarh 6y ago
    And it also ignores that the alternative here is not "do nothing" but "send police instead", which also costs. And if it leads to arrests it costs even more. And if people end up getting a criminal record, it tends to reduce their long term employment prospect, and as a result reduce tax revenue/increase welfare costs. There seems to be plenty of potential for this to save money over time.

hellcow 6y ago

Do you live in an area with high homeless rates? As in, "there's a homeless camp of tents consuming multiple city blocks"-level of homelessness? It's horrible for everyone in the city--most of all for the homeless. These people suffer from mental health or drug issues and need help. The status quo of "leave them to fend for themselves" is simply an unacceptable outcome. The system launched by the DPD may not be perfect, but it's a whole lot better than what existed before. It's a huge step in the right direction.

imperio59 6y ago
In my observation a lot of the homeless in the camps with mental health issues are on medication or have been through mental health facilities several times and it just made things worse for them Source: working on the streets of Seattle a couple years ago every weekend.
- mjevans 6y ago
  My own belief is that there isn't a single simple issue, but rather a web of many simple things that have complex interactions. Nearly all of those are political issues though. Technology can help with better communications and tools for debunking falsehoods in those communications. It might also eventually help with strong AI that's smarter and better than humans at offering a set of solutions and then letting people debate the ones that we agree are also emotionally the correct answers.
zapzupnz 6y ago
People need to remember that perfection is the enemy. Better to step forward in the right direction now than be paralysed by the fear it will never come to pass — obviously, the latter is a self fulfilling prophecy.
- throwaway9980 6y ago
  I’m starting to feel like this perfect or nothing attitude is a massive amplifier of the problems we’re facing. “God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.” We’re way out of balance. Lot’s of courage, less wisdom, no serenity.

tantalor 6y ago

Explain what "insurance" has to do with it?

GavinMcG 6y ago
Private insurance often pays providers better rates than Medicaid, so patients with private insurance are on paper more "desirable" than patients without. The commenter is suggesting that translates into kidnapping, essentially.
- tantalor 6y ago
  I would be pissed if I were involuntarily committed and they billed me.

minikites 6y ago

>No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial So it's better to be suffocated on the sidewalk for the crime of selling single cigarettes?

trianglem 6y ago

It’s still a step up in my opinion. This problem is also heavily mitigated by body cams.

minikites 6y ago
Assuming the cops don't just turn them off or "lose" the footage, which "mysteriously" seems to happen every time there's an incident (unless the cop is too stupid to cover their tracks).
- recursive 6y ago
  Corruption or stupidity? Is there really no room for doing the right thing?
  - minikites 6y ago
    Cops who do the right thing are punished by their fellow cops, look up what happened to the real Serpico.

lettergram 6y ago

Well, there are places discussing this... just not anywhere which is for “defunding the police” That being said, totally agree. This will be and probably already is being abused.

eyelidlessness 6y ago

If you think cops can’t commit you against your will I surely hope you never come up against their guns and nearly total lack of accountability.

mmcwilliams 6y ago
This is the exact problem with that argument. Healthcare workers can commit you against your will just as police officers can as well.
- eyelidlessness 6y ago
  Right. So the improvement is that health care workers who are actually qualified to make that determination show up and don’t escalate the situation with violence or legal trouble. That’s a whole lot of improvement. And sounds like very little downside since the risk associated is identical otherwise.
astura 6y ago
Exactly, the people who will be committed against their will would still be committed against their will if police respond. I know this for a fact because the one guy I know who encountered police during a mental health episode ended up commitment. The difference here is taking away the addition of police to the incidents. No handcuffs or jail holdings, no being roughed up or killed. Hopefully the mental health person knows how to de-escalate the situation - I think this is huge. I think the friend I mentioned above could have avoided impatient treatment if he had a qualified mental health person respond instead of the police, due to the situation around his incident/arrest. This just isn't a good faith argument.

trianglem 6y ago

I feel like this point is not made in good faith especially considering your other comments specifically praising cops and denigrating BLM activists. To address your point however, it’s still a huge step up from having an arrest record in addition to being committed.

imperio59 6y ago
If the arrest record is warranted, I fail to see your point. The outcome of not having a record when you probably should have one is probably net worse for society, given it won't show up later on a background check, for example.
- trianglem 6y ago
  It’s the same point as - if a person needs to be committed they should be. We are in this position because cops have not been shown to be fully trustworthy in a lot of these situations. It is infinitely better to not have the cops involved at all unless they are absolutely needed at which point the medical care workers can send for them. This new way is a win-win for everyone involved.

yters 6y ago

What is the difference between a psych ward and a jail? No difference in tv shows, except they also drug you, do weird experiments, and you could get killed by fellow inmates without a problem. If getting committed to a psych ward replaces prison it sounds much worse.

recursive 6y ago
Presumably we're discussing real ones, not TV ones.
- yters 6y ago
  My friend worked at a real one and it did not sound much different.

hedora 6y ago

It varies by state. In California, it’s essentially impossible to commit someone (source: I tried and failed, despite written permission from the person pre-episode, the blessing of their doctor, and the blessing of their family, multiple police reports from third parties, a divorce, eviction, repos, etc, etc.) In CA if you do somehow manage to maliciously commit someone, they’re held for up to 24 hours, and an independent doctor assesses them. Also, there can be civil penalties (as in the article you cite, where the victim successfully sued the hospital). If I had to choose between the two ridiculous extremes, I’d choose the Texas model.

maxerickson 6y ago
In Michigan you can petition that someone be involuntarily committed for treatment and then they get a hearing in front of a judge. It has to happen within a few days. (just enumerating, not particularly comparing)
- hedora 6y ago
  Interesting. I wonder if that requires a lawyer or not. (Legal fees for this sort of thing are exorbitant in California, and the cases tend to be a stretch.) It’s an odd (broken?) process if the judge would ascertain the person’s mental health. Hopefully, most judges would call in professionals.
  - maxerickson 6y ago
    The prosecutor brings it before the judge. There is testimony, the judge isn't directly doing the mental health assessment. Typically a social worker is helping the petitioner figure it out. https://courts.michigan.gov/administration/scao/forms/courtforms/pcm201.pdf https://courts.michigan.gov/administration/scao/forms/courtf...
random5634 6y ago
I was going to come to say something similar. At least in CA or the part I am in (very liberal) getting someone committed for a longer period (3 months + etc) - I think may be pretty much impossible? This can be despite a whole host of criminal and self harming behavior. Pre pandemic I think it was probably easier to get folks in at least for a few days at a time to jail pending disposition of whatever the latest case was - which was time enough to fix locks / windows / doors etc or move.

danShumway 6y ago

> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial Increasing cop presence won't fix that problem. In multiple jurisdictions, cops can also refer you to be involuntarily committed. So we're not creating an extra judicial system that has no checks and balances, that system already exists and cops are a part of it. We're talking about the potential benefits of removing one harmful part of the equation. If you want to also talk about the negatives of involuntary commitment and make progress in that area, that's totally worth examining as well, but it's not an argument for flooding the streets with more cops. Getting arrested doesn't mean you can't be involuntarily committed afterwards. Also note that in some cases, getting arrested and thrown in a holding cell can on its own be just as traumatic of an event as being held for an involuntary mental evaluation -- particularly if someone is genuinely suffering from a mental attack. And arrests don't require trials either. A sizable portion of the people in our jails have never been convicted of crimes, they're just stuck there because they can't pay cash bail.

imperio59 6y ago
Difference is, if your only tool is a hammer, everything is a nail. If you send a mental health professional to all sorts of situations, their solutions will be mental health related (medication, treatment, commitment, etc...). If you send a cop, their solutions will involve the criminal justice system (citation, fines, arrest, jail time, etc...). One of these has a long history of strong checks and balances and improving itself over time (latest major improvement: body cams). The other one of these is primarily fueled by giant corporate lobbies who spend a lot on every single political campaign (read: Big Pharma). Can you guess which one is now being touted as the "new solution for all our societal ills" despite having no track record of actually being able to fix any of these ills?
- deleted 6y ago
  [deleted]
  - narrator 6y ago
    The suicide rate has been steadily increasing since 2000. The effectiveness of the mental health profession is falling at an alarming rate: https://www.macrotrends.net/countries/USA/united-states/suicide-rate https://www.macrotrends.net/countries/USA/united-states/suic...

btmiller 6y ago

This is a dangerously bad take. Real progress is being made by this change and the assumptions you’re making risk taking wind out of its sails over essentially a non-issue.

sdenton4 6y ago

Uh, citation needed? Getting committed 'because their insurance was good' is likely not an issue here, as ~70% of the interventions were with homeless people. Here's the actual report: https://wp-denverite.s3.amazonaws.com/wp-content/uploads/sites/4/2021/02/STAR_Pilot_6_Month_Evaluation_FINAL-REPORT.pdf https://wp-denverite.s3.amazonaws.com/wp-content/uploads/sit... "[T]he STAR van provided transportation to 41% of its calls for service where an individual's information was recorded. Of those incidents (107), the most common locations were a shelter or homeless services (30), the walk-in crisis center (24), or a hospital (18)." It's unclear how many of these would involve an involuntary commit, and similarly unclear how the outcome would compare to a police encounter, which often comes with its own special brand of involuntary commit. One of the report recommendations is to create a longitudinal study to assess outcomes.

dfsegoat 6y ago

I imagine this also increases the surface area of interactions resulting in removal firearms from people, for reasons of mental health status. Those people may, or may not deserve it. E.g. California has a statute for 'mandatory relinquishment' of firearm, based on a mental health professionals findings [1] . [1] - https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=8102.&lawCode=WIC https://leginfo.legislature.ca.gov/faces/codes_displaySectio...

schoolornot 6y ago

The best part is the bill you get after being involuntarily committed!

suifbwish 6y ago

It is situations like this that justify the second amendment.

jdeibele 6y ago

What you're worried about is reasonable but it doesn't seem to have much to do with the article. There's no mention of the mental health clinician and EMT in the van grabbing people, throwing them in the van, and hauling them off to be committed. Instead they seem to be sympathetic listeners who can help with problems. Not solve, probably, and probably not permanently but anything that helps keep people from getting shot or locked up in jail is good.

imperio59 6y ago
I had a friend who was essentially committed against her will. She was never grabbed violently or thrown into a van. She was calmly told they would be committing her, then asked to strip and change into a gown, told to take the medication or it would be administered forcefully, etc... You have a very "Hollywood" idea of how this stuff happens. Reality is a lot more insidious.
- ogre_codes 6y ago
  No idea what your friend went through, but that's not what this program does. The people in these programs can't commit anyone, or take them anywhere they don't want to go. The service works much much better that way because when the van rolls up, there is no fight or flee reaction.

newacct583 6y ago

First, that seems needlessly absolutist. We're literally talking about upending decades of emergency response practice here, surely it should be reasonable to talk about tweaks to the process (mandatory judicial hearings within N days of mental health detentions seem very reasonable to me) without demanding that a change be thrown out because of a theoretical problem. Second, is there data here? I mean, the article lists 748 tracked incidents. Did any even lead to an involuntary hospital admission? Shouldn't we figure this out first? Inventing terms like "medical authoritarianism" seems like more noise than signal, basically. Surely the fourth amendment as it stands can speak to the needs of mental health cases just as it can accused criminals.

ogre_codes 6y ago

> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, We've had a program like this for years here in Eugene Oregon. It's called CAHOOTS. One of the cornerstones of the program is it's all voluntary. There is no use of force, no dragging people off anywhere. People show up with a van and some basic medical supplies and help people. If the people don't want help and the only alternative is some form of restraint, they call the police. They almost never end up calling the police because most people just want a little help and a patient person talking to them gets it done. The fact that these people never themselves do anything against people's will is what makes this work so well.

TedDoesntTalk 6y ago
That sounds awesome. Thanks for sharing.
- ogre_codes 6y ago
  I've posted this link elsewhere in this thread, but there are some details here: https://www.msn.com/en-us/news/us/this-town-of-170000-replaced-some-cops-with-medics-and-mental-health-workers-its-worked-for-over-30-years/ar-BB16lO1G https://www.msn.com/en-us/news/us/this-town-of-170000-replac...

ghshephard 6y ago

The police have the authority to place a person on a 48 hour medical hold, and will threaten to use that authority if you don't do what they tell you. They'll use it for something like a person who passes out not wanting to go to the hospital, even if they are with a friend who can take care of them if there is really an issue. I'd probably trust this crew in Denver more than I would a random police officer in making that assessment.

imperio59 6y ago
Maybe the 3-4 people in Denver are fine. The issues come with scaling this up nation wide to where you have tens of thousands of variously trained "health professionals" where outcomes will not necessarily match what you're seeing in a pilot where they obviously handpicked competent people to run it...
- ddingus 6y ago
  Simply require a healthy percentage of staff be program successes. People who have been there and have come back. Those people will know how this all needs to work in order to do the healthy, hard, very human work required. They know stuff, hard earned, rough miles type stuff, that is both necessary and not taught effectively in any school other than when the bell rings at the fine school of hard knocks.
  - ddingus 6y ago
    Naysayers should work at, or observe one of these programs in action before coming to conclusions. I have this experience and know those people and what they can do. Think of them as the immune system to defend against the potential disease discussed above.
- b_t_s 6y ago
  We already have this in the form of child protective services. Social workers are plentiful and paid quite poorly for a degreed professional. Cops with GEDs and social workers with bachelors degrees make very comparable salaries. For an extra 5 grand or so you can get one with a masters degree. So there's no sane reason to hire variously trained "health professionals" with scare quotes. The really tough part is getting tens of thousands of independent, ossified bureaucracies onboard with the idea of and giving up/redirecting some of their responsibilities/power/budget.

ddingus 6y ago

Portland had a similar program. It worked GREAT. (I am out of the city and have not kept up. Some form of it may still be a thing.) Now, in that program they could hold you for 72 hours tops. No criminal record, no arrest, just a record private to that program for maintaining patient history. No attorneys, no bail, nothing. Outreach staff were deputies well trained in deescalation and conflict resolution as well as EMT and other related first responder skills. They do not perform law enforcement and need their status to execute the program tasks only. We used to do that with law enforcement. We don't today. Some say we should. Some say we can't. No judgement from me. That is just the current lay of the land we all live with today. These programs offer a strong, effective, humane option and they save a lot of money. It saw a lot of use dealing with the following: Drugs and alcohol inebriation, violence and general inability to do self care. Homeless Mentally Ill Temporary mental distress. Say one ends up there flat out hammered. Ok, you stay, until you aren't. Same for most drug scenarios. The primary criteria for release? Not being hammered and or not being an asshole. This was the right thing to do almost every time too. Worked great as a more serious crime prevention, and self harm reduction. They could escalate to the court system, or a hospital, and or begin treatment at the integrated detox facility. All anyone need do was ask. For homelessness, it typically required something be going on, like people going to die, or who were otherwise at some grave risk. Those people could also just reach out. A ride in the van later, they can clean up, sober up, and then tap social services, or get into a shelter, temp housing, depending, or detox. Police could DEescalate to this program as well and did so frequently. People served by this program did not get criminal records, nor did they get a mental health record. What they did get was help, and where it made sense, some tough love, and hard, lucid talk. A significant percentage of the staff were former street people who had entered the program, got themselves good and then stuck around to help others. These people really matter. They have been there and are highly effective. At the time, it was nationally recognized as a strong alternative to the typical judicial system grinder chewing lives up rather than lifting them out. Here is something one of those people told me, and before I write it, I have in depth knowledge of the program via my spouse who worked front line outreach for many years: Help buys time. Real help is sans judgement too. Time is what people in trouble need. When they get it, they have an opportunity to make different choices, and when they do, they are no longer people in trouble. They become people getting out of trouble, improving. This is what they, and everyone else really need. Nobody knows what reaches people. We only know when we continue to try some of them are reached and when we try harder, with genuine concern and zeal, more are reached. Just reaching someone often is not enough. They fall back, need more time. This is as good as it all gets. Being human can really suck. Us lucky ones, who do not currently experience that suckage can count ourselves lucky and also for the help we may one day, ourselves need. That, at the core, is what these programs and others like them are, or need to be about. When they are, they work. Simple as that.

TedDoesntTalk 6y ago

> See https://www.buzzfeednews.com/article/rosalindadams/intake https://www.buzzfeednews.com/article/rosalindadams/intake for an example of what I mean. I stopped reading right after the patient admits to suicidal thoughts to a therapist. That can easily get you committed against your will, and for good reason.

account42 6y ago
> and for good reason What good reasons are those?

freyir 6y ago

Nobody talks about how difficult it actually is to commit mentally ill people in many places. Case in point, San Francisco, where severely mentally ill homeless people abound, many of whom who cannot look after themselves, and are left to suffer and die in the street out of respect for their civil liberties. Or those who terrorize neighborhoods for years on end, and everyone looks the other way out of respect for their civil liberties. Civil liberties are important, but prioritizing civil liberties to an extreme, above all else, is often harmful for the individuals they’re supposedly serving.

deleted 6y ago

[deleted]

lazyasciiart 6y ago

A cop in Seattle was found to have involuntarily committed multiple people because he had a crush on the EMT who had to come transport them. I don't think keeping police involved is going to improve any of the things you care about.

bsder 6y ago

> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, which is an erosion of civil liberties (incarceration without trial). Having known several friends who got committed and held against their will in psych wards when there was no good reason to, because their insurance was good, this is an issue. In California, this doesn't seem to be true. I got to see this in action from the sidelines. Within 24 hours of being committed, the patient will have an advocate appointed for them and within 72 hours the patient will be released unless the health team can put up justifications that pass the advocate AND then judicial scrutiny. The doctors can kick up a fuss, but 7 days is the limit before it MUST pass a judge. I got to watch this in action, and the advocate was MUCH more aggressive on behalf of the patient than if the same person had been arrested and was relying on a public defender.

ashtonkem 6y ago

I see your point, but it’s worth considering that the tradeoff is potentially seeing said people shot by an armed officer, or thrown into jail where they’re likely to be hurt, abused, and otherwise suffer.

electro_blah 6y ago

beats getting killed.

Noos 6y ago

If anything, I wouldn't worry about this given the article. The majority of the incidents shown are homeless people berating retail staff over welfare card issues; technically they would be charged with trespassing because the police have to be called to make them leave the store. The example given was a mentally ill woman who had issues buying food with her debit card. If anything, it looks more like a crew of people handling nuisances committed by "regulars" as they pop up. The danger is probably they DON'T commit as much as they could, and put out fires rather than secure help. That is, they just keep enabling the nuisance calls. I'd be worried too about overreliance on this. If the guy suddenly pulls a gun or a knife on what was just being a public nuisance, you are having more or less medical workers in danger of their lives.

aligray 6y ago

That is terrifying.

franga2000 6y ago

I don't see how that risk has increased. It's pretty normal for police officers to call paramedics and mental health professionals in when subjects show signs of mental issues and substance abuse (there are even laws requiring them in some places). If the subject is in lockup or on the street by the time they arrive makes no difference since they have the exact same power to involuntarily commit them. Now, whether that power is something that should be more regulated is a different question entirely. I believe there is an appeal process for being committed and it can go to trial, so it's not like it's entirely authoritarian. If signs of abusing this power are found, then of course, something should be done about it, but again, who was the first respondent really doesn't matter in that discussion. EDIT: I read the linked article and holy shit, the US health system really is fucked. Honestly, when the incentives are that misaligned, I can see why you were worried (I was looking at this from a 1st world perspective; mild offense at the US intended). Maybe it would be smart to add an additional sanity check to the STAR system, but of course, until your healthcare mess is sorted, that's like putting a bandaid over a stab wound.

dragonwriter 6y ago

> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial Police can arrest you and hold you against your will with no trial, for a limited period of time (e.g., 48 hours excluding Sundays and holidays is a common tule, IIRC), on the premise that it is pending charges for criminal behavior (which may or may not be filed.) Mental health professionals (and, in many jurisdictions, law enforcement officers and others, too, can initiate this) can hold you against your will and with no trial, on the premise that it is for emergency psychiatric evaluation, for a limited time (72 hours is common.) Further involuntary detention, in either case, requires judicial process. I'm not seeing a particular additional danger here.

funkisjazz 6y ago

Presumably no arrests made though means people didn't fight the medical professionals trying to incarcerate them? So I assume most of them went voluntarily.

Uberphallus 6y ago

Indeed. It went the way Thomas Szasz described when he wrote The Therapeutic State [0]. It's a common trend in covertly authoritarian governments, but not only, to be able to remove people from the public without a fair trial: just question their sanity and have a doctor sign them in. Sometimes it isn't even the government, but someone well connected who needs someone else removed. [0] https://www.goodreads.com/book/show/6680331-the-therapeutic-state https://www.goodreads.com/book/show/6680331-the-therapeutic-...

pietrovismara 6y ago
Yet neither you or op seem concerned of being killed by the police for no reason, like it happened to many. Perhaps you are in the demographic that wouldn't be shot by a cop but could still be judged unstable by a medical professional.
- Uberphallus 6y ago
  That's funny[0]. I'm not American, so don't pull the white guilt card on me. I've spent a total of 12 days in the US in my life, and I was pointed a gun by the police once. That's infinity percent more than in any other country I've lived visited or lived in, and I've traveled my fair share off the beaten path. When they saw their mistake, they spouted the generic excuse that I matched a description, something that wouldn't fly in any other first world country, but is somehow accepted in the US. Anyway, I'm white and I did nothing wrong, so I guess that officer just pointed that gun as joke with no intention to kill,[1] right? US police kills citizens at a rate seen only in developing countries. According to the wiki[2], US police kills 10 times as often per capita as the worst European offender of significant population (France), and ranks higher than places like Angola, Colombia or Rwanda, that have insanely higher crime rates. Let that sink in, and think whether the problem is race based or not. But don't worry, Biden won, the rates will remain the same but it will no longer be an issue worth being reported in the media ;) [0] https://www.statista.com/statistics/585152/people-shot-to-death-by-us-police-by-race/ https://www.statista.com/statistics/585152/people-shot-to-de... [1] https://www.youtube.com/watch?v=VBUUx0jUKxc https://www.youtube.com/watch?v=VBUUx0jUKxc [2] https://en.wikipedia.org/wiki/List_of_killings_by_law_enforcement_officers_by_country https://en.wikipedia.org/wiki/List_of_killings_by_law_enforc...

devoutsalsa 6y ago

If you’re high on drugs, yelling scary stuff, acting violently without technically doing anything illegal. and threatening to kill yourself, I’d restrain you myself if I could. What’s the alternative to locking you up or waiting until you hurt someone & shooting you dead? You’re out of your mind, ruining everyone’s day, and you need a timeout to get your shit together, so if you wanna act like a child with no regard for the well-being of those around you, I’d have zero problems with sending you to your room until you cool down. It just so happens your room is a padded cell at the local mental health facility.

zeofig 6y ago
OK, but were the other poster's friends doing any of the things you listed?
- Broken_Hippo 6y ago
  Not everyone has many friends, and if your one or two friends (literally 1 or 2) aren't there, there is no one. Your family might live out of town, too. When my ex attempted suicide, he'd have succeeded if he lived alone. Few people would notice my own absence for some time if I lived alone, honestly.

pietrovismara 6y ago

> We should not create an extra judicial system that has no checks and balances You should be way more concerned about police brutality then.

pessimizer 6y ago

This is a miserable top comment. I also have a low opinion of the field of psychology, but cops can have you committed (and do) by bringing you to be evaluated by mental health professionals. Medical professionals can't shoot you. There's nothing in the article about creating a shadow mental health justice system. What they have is a van containing blankets and food, driven by two social workers.

patcon 6y ago
omg thank you, voice of reason. No disrespect intended to parent posters (i appreciate them sharing their anecdotal experience), but def sobering to see that at the top, and realize "oh, this is the common view of hivemind i'm participating in"
- dsnr 6y ago
  No disrespect, but maybe you should not participate in the community, if you’re not prepared to handle different views. And thanks for posting without bringing anything to the table.
- faitswulff 6y ago
  HackerNews is a pretty miserable place when it comes to social issues.
- throwaway1239Mx 6y ago
  I have this vague hope that maybe the 'top comment' position is also based on number of replies, not necessarily upvotes, but then... the discussion itself is pretty sobering. The current program cost relative pennies, proved to be effective at both helping people and freeing up police workers to focus on crime/traffic-related issues. More effective use of city tax $$$$ through targeted spending of $. Seems like a win win win. Anyway, I agree with this particular branch of the discussion-tree.
  - Balgair 6y ago
    The FAQ doesn't have a specific entry about comment rankings, but I'd guess it's based off a similar system as the Stories rankings: "How are stories ranked? The basic algorithm divides points by a power of the time since a story was submitted. Comments in threads are ranked the same way. Other factors affecting rank include user flags, anti-abuse software, software which demotes overheated discussions, account or site weighting, and moderator action."

JeremyNT 6y ago

> No one is talking about the very big risk associated with this, that mental health professionals can commit you against your will with no trial, which is an erosion of civil liberties (incarceration without trial). Having known several friends who got committed and held against their will in psych wards when there was no good reason to, because their insurance was good, this is an issue. Do you have a citation for this being a real side effect of the type of program listed here? The program as described in this piece seems novel and this article certainly makes it sound like a success. I know engineers and programmers like to poke holes and look for edge cases that might break any potential solution, but hopefully we can allow ourselves to celebrate the victories when we see them without letting the perfect become the enemy of the good.

kardianos 6y ago

This is actually a big issue with child/family services as well. A lot of what they do is extra-judicial, though in theory there is often judicial review... eventually. This is coming from a foster parent. Don't get me wrong, a lot of these services are needed, but you would hear stories of abuse by the system. Extra-judicial threats are something everyone should be on guard against.

JshWright 6y ago

The problem you describe is real, but this program is a net positive (even in terms of the problem you're concerned about). Cops escalate mental health related scenes, which leads to people getting arrested and then put in a hold (which often gets extended). If a social worker is able to resolve the situation without getting the cops involved, a cop isn't going to get personally offended that someone in crisis isn't "complying" and feel the need to punish them.

dqpb 6y ago

> Having known several friends who got committed and held against their will in psych wards I don’t believe you

smrtinsert 6y ago

If you don't mind, what country do you live in and/or what thought process led you to "medical authoritarianism"? I would like more background on this, because it seems relatively absurd for the United States, where we struggle to even get a doctor involved when they clearly should be.

giarc 6y ago

There are a few issues with your statements. The first being that the staff of this program have no incentive to "commit you against your will". Why would they do that? I work in healthcare and have met people that work in these types of programs. By and large they do it because they care, the stress and risk you get from working with these populations isn't worth the money. I work in Canada, so perhaps it's different in your country, but to be commited to a mental health facility here, a trained physician needs to "form" you, basically sign forms stating that you are a danger to society if not treated. There are strict laws surrounding this, it's not just some random decision. Lastly, you say this will lead to some "medical authoritarianism". Programs like these, as well as the ability to commit people to mental health facilities has been around forever, yet I see no evidence of this medical authoritarianism you speak of.

watertom 6y ago

In these situations the Police basically have 2 options. - Take into custody (Which could mean being committed) - Shoot I'll take my chances with trained health/mental health professionals who can understand "I took too much", or I'm having a mental health crisis and while I might seem "out of control" I'm really harmless. Frankly if those health professionals think I need to be committed I probably should be committed. The police can take you into custody and commit you as well, but if you are having a mental health crisis, and can't really follow the rigid police directions more than likely it's going to end poorly, because the police will do what's necessary to take you into custody, including killing you.

TimTheTinker 6y ago

Agreed. It’s worth noting that your concerns absolutely have precedent. In the USSR and other 20th century states, committing people against their will to mental health asylums was a very common way of dealing with political and religious dissidents.

TimTheTinker 6y ago
Article covering political use of psychiatry in the Soviet Union: https://en.m.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union https://en.m.wikipedia.org/wiki/Political_abuse_of_psychiatr...

okl 6y ago

They also like to do that with whistleblowers: "Mollath's forensic incarceration for seven years and the surrounding legal judgments became the basis of a public controversy in Bavaria and the whole of Germany when at least some underlying elements of his supposedly fabricated paranoid story about money-laundering activities at a major bank turned out to be true after all. Mollath himself had consistently claimed there was a conspiracy to have him locked up in a psychiatric care ward because of his incriminating knowledge; evidence that turned up in 2012 made his claims appear plausible." -- https://en.wikipedia.org/wiki/Gustl_Mollath https://en.wikipedia.org/wiki/Gustl_Mollath

b_t_s 6y ago

I would be shocked if the social workers riding around in vans are allowed to commit people. Social workers are kind of like nurses in that very few of them hold a PHD and they generally aren't allowed to diagnose or prescribe(varies by state and education level). They can provide all sorts of support, advice, counseling, etc to people in crisis, but when it comes to people who need to be committed, social workers mostly call 911 and hand it off to the cops, same as the rest of us. They can refer you for a voluntary psyc eval with a psychologist, or advise the judge that it might be a good idea to send you for an involuntary one rather than just sending you to prison, but they have very little power to decide anything for you. And if they're even remotely competent and you're not a blatant menace to society, then they're generally trying to keep you safe, stable, and out of institutions as much as reasonably possible. The whole ethos of social work is very different than psychology or law enforcement. It's very much focused on what concrete, practical things can be done to improve your health, happiness, safety, and quality of life. A lot of times it's simply hooking people up with services that they aren't savvy enough to find or access without help, or helping them get through stressful situation without falling apart and going to jail, using drugs, etc.