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> If you're all-knowing and all-good, great. Otherwise seems like a pretty gross violation of basic human rights - what about the false positives... We could te

> If you're all-knowing and all-good, great. Otherwise seems like a pretty gross violation of basic human rights - what about the false positives... We could temporarily solve many of the world's problems if we had more authoritarianism, but it never ends well in fiction or in real life. I think this is a broad argument that applies equally to prison, too; would you bite that bullet and argue for abolishing prison as well? If not, I think your conclusion is a bit hyperbolic. In practice the discussion is (should be) quite nuanced. If someone is a clear and present danger to themselves or others due to mental instability, then it seems reasonable to me to confine them until that danger is resolved. But of course, that's a slippery slope and so the danger should be clear and substantial, and involuntary commitment should not be an indefinite thing, a tool used to take homeless off the streets, for example. A robust and independent ethics board reviewing decisions is an important component. One thing to note is that lots of other countries do this, and the US is something of an outlier; one could just look at other countries for examples to evaluate whether this idea would present a terrible slide into authoritarianism. For example, in the UK: https://www.nhs.uk/mental-health/social-care-and-your-rights/mental-health-and-the-law/mental-health-act/ https://www.nhs.uk/mental-health/social-care-and-your-rights.... One could also do an A/B test by analyzing California circa 1972 when the Lanterman–Petris–Short Act ended involuntary commitment: https://en.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%80%93Short_Act https://en.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%80.... Was the US more authoritarian in the 60s, when involuntary commitment was common? It's reasonable to suggest it was overused (see, One Flew Over The Cuckoo's Nest), but so were many medical practices (see, forced sterilization of women). I think it's reasonable to suppose that we use a lighter touch if we tried again. Fortunately, this is an issue that lots of smart people write on already: https://slatestarcodex.com/2016/03/07/reverse-voxsplaining-prison-and-mental-illness/ https://slatestarcodex.com/2016/03/07/reverse-voxsplaining-p....

DanBC 4y ago
> one could just look at other countries for examples to evaluate whether this idea would present a terrible slide into authoritarianism. For example, in the UK: https://www.nhs.uk/mental-health/social-care-and-your-rights https://www.nhs.uk/mental-health/social-care-and-your-rights.... The English system unambiguously leads to abuse. We see autistic people held for years in secure services because it's thought they pose a risk of harm to others, but often that risk is evidenced by behaviours they exhibit while under severe restriction in hospital. I'd argue that if you put anyone in a locked room with nothing but anti-ligature clothing and keep them there for a month they'd act aggressively. See also the many documentaries about abuse, eg Winterborne View, St Andrews, Edenfield Centre, TEWV, etc etc.
- denton-scratch 4y ago
  > I'd argue that if you put anyone in a locked room with nothing but anti-ligature clothing and keep them there for a month they'd act aggressively. Anyone? I can't speak generally, but the people I know that have been forcibly treated didn't become more aggressive, they became less aggressive. They got on well with the care staff, continued taking the pills on release, and were glad they'd been treated. I've known a couple of schizophrenics, but I know nothing about their response to treatment or incarceration. My experience is restricted to a handful of people with bipolar.
  - DanBC 4y ago
    There's a difference between forcible treatment, and being kept in a room wearing nothing but anti-ligature clothing, with none of your belongings, no blankets, no furniture, food being provided through a hatch in a door, etc. It's great that you've met a couple of people with severe mental illness that had good experience of care - most people do. But it's not relevant to what I said. Solitary confinement is torture, which is why it's banned unless there's no other option. In the English system seclusion is used far too often, and often as a first not last resort. This is also true for restraint and rapid tranquillisation. There are national and local programmes of work trying to reduce use of force, and we've even had a recent law change to prevent the use of force in mental health units. The new law recognises that people's human rights were being abused. https://www.legislation.gov.uk/ukpga/2018/27/enacted https://www.legislation.gov.uk/ukpga/2018/27/enacted https://www.gov.uk/government/publications/mental-health-units-use-of-force-act-2018 https://www.gov.uk/government/publications/mental-health-uni... https://restraintreductionnetwork.org/ https://restraintreductionnetwork.org/ We're reforming the mental health act because we recognise that people's human rights are not respected, and to improve the use of advance directives and reduce the use of compulsory treatment, especially the use of force: https://commonslibrary.parliament.uk/research-briefings/cbp-9132/ https://commonslibrary.parliament.uk/research-briefings/cbp-...

DanBC 4y ago

> one could just look at other countries for examples to evaluate whether this idea would present a terrible slide into authoritarianism. For example, in the UK: https://www.nhs.uk/mental-health/social-care-and-your-rights https://www.nhs.uk/mental-health/social-care-and-your-rights.... The English system unambiguously leads to abuse. We see autistic people held for years in secure services because it's thought they pose a risk of harm to others, but often that risk is evidenced by behaviours they exhibit while under severe restriction in hospital. I'd argue that if you put anyone in a locked room with nothing but anti-ligature clothing and keep them there for a month they'd act aggressively. See also the many documentaries about abuse, eg Winterborne View, St Andrews, Edenfield Centre, TEWV, etc etc.

denton-scratch 4y ago
> I'd argue that if you put anyone in a locked room with nothing but anti-ligature clothing and keep them there for a month they'd act aggressively. Anyone? I can't speak generally, but the people I know that have been forcibly treated didn't become more aggressive, they became less aggressive. They got on well with the care staff, continued taking the pills on release, and were glad they'd been treated. I've known a couple of schizophrenics, but I know nothing about their response to treatment or incarceration. My experience is restricted to a handful of people with bipolar.
- DanBC 4y ago
  There's a difference between forcible treatment, and being kept in a room wearing nothing but anti-ligature clothing, with none of your belongings, no blankets, no furniture, food being provided through a hatch in a door, etc. It's great that you've met a couple of people with severe mental illness that had good experience of care - most people do. But it's not relevant to what I said. Solitary confinement is torture, which is why it's banned unless there's no other option. In the English system seclusion is used far too often, and often as a first not last resort. This is also true for restraint and rapid tranquillisation. There are national and local programmes of work trying to reduce use of force, and we've even had a recent law change to prevent the use of force in mental health units. The new law recognises that people's human rights were being abused. https://www.legislation.gov.uk/ukpga/2018/27/enacted https://www.legislation.gov.uk/ukpga/2018/27/enacted https://www.gov.uk/government/publications/mental-health-units-use-of-force-act-2018 https://www.gov.uk/government/publications/mental-health-uni... https://restraintreductionnetwork.org/ https://restraintreductionnetwork.org/ We're reforming the mental health act because we recognise that people's human rights are not respected, and to improve the use of advance directives and reduce the use of compulsory treatment, especially the use of force: https://commonslibrary.parliament.uk/research-briefings/cbp-9132/ https://commonslibrary.parliament.uk/research-briefings/cbp-...