5 ms·

> Who will write the definitive book on how everything went downhill over the past 10 or so years? I feel like most of that would just be 200 pages of saying "

> Who will write the definitive book on how everything went downhill over the past 10 or so years? I feel like most of that would just be 200 pages of saying "And then, San Francisco didn't allow enough housing to be built." over and over.

fnordpiglet 4y ago
I figured it would be 200 pages of “and that’s a result of Reagan’s drive to shut down public mental health” I very much doubt the visible homeless problem is a result of housing - the iceberg is a result of housing. The visible homeliness wouldn’t be solved if rent were half - that doesn’t treat schizophrenia
- simonw 4y ago
  Becoming homeless through no longer being able to afford rent (a common cause of homelessness) is extremely bad for your mental health.
  - Jcowell 4y ago
    In this case Housing would be a preventive measure but it doesn’t deal with the problem that everyone truly wants dealt with: the mentally I’ll. How do we solve the mentally I’ll problem? Is it that involuntary commitment with excessive oversight is incomparable with American values of freedom ?
    - trilbyglens 4y ago
      Involuntary commitment was done away with as in the past the conditions in many facilties were super bad. Rather than reform the system they just shut it down. Now there's just nothing at all.
      - fnordpiglet 4y ago
        Leaving humans to rot in the streets seems morally more convenient but not better.
- creato 4y ago
  I think Reagan was an absolute disaster responsible for a lot of our problems today, but this isn’t one of them. Mental institutions of Reagan’s era were a humanitarian nightmare. But, I am not sure there is a humane solution to serious mental illness. It requires the attention and care that probably only immediate family members are capable of providing, while simultaneously requiring medical treatment and security that only mental institutions are capable of providing. The problem we are having today is we’ve excused criminal behavior due to mental illness. I agree prison probably is inappropriate in most cases, but so is just letting them back on the street.
  - fnordpiglet 4y ago
    They were in some, but not all cases. Turning them out into the streets to rot in the gutter while they spiral out in their insanity is certainly morally more convenient, but not, IMO, superior to attempting to build an infrastructure that provides treatment and long term care for people suffering so deeply as this. Freedom that’s a living hell isn’t freedom, it’s just freedom from responsibility for caring. A lot of seriously mentally ill folks burn their family care due to the extreme burden it places on them, and the fact a lot of mania and schizophrenia accompanies a willful belief in their own sanity and autonomy, and a lack of personal knowledge of their state. This makes keeping them under care and medications extraordinarily difficult. Prison isn’t the answer. Mental health facilities is. That’s the real alternative to letting them back into the streets. Prisons aren’t equipped to treat anyone.
    - seanp2k2 4y ago
      >”Freedom that’s a living hell isn’t freedom, it’s just freedom from responsibility for caring.” The problem is that the latter is far too attractive and convenient for a large percentage of this country. Then simply move out of a city center, get some guns, put up some fences, and it’s no longer a problem that you’re directly personally affected by.
  - seanp2k2 4y ago
    And most importantly in “free market”-loving America, lots and lots of funding that no one is willing to provide. When they inevitably break some laws, it’s easier for everyone to swallow their obscene housing costs under the guise of “we’re keeping these criminals away from society”.
- chimeracoder 4y ago
  > The visible homeliness wouldn’t be solved if rent were half - that doesn’t treat schizophrenia By itself? No. But literally every viable path to addressing serious mental illness requires stable housing as a prerequisite. Without it, there's literally no way to manage the problem - just different ways of shifting it around over and over again.
  - fnordpiglet 4y ago
    I know. But there’s housing that’s affordable outside of San Francisco and seattle city cores.
    - seanp2k2 4y ago
      Anywhere within an hour drive of SF is extremely expensive, and without a car, extremely difficult to eke out a living outside of a major metro area even if they wanted to.
      - fnordpiglet 4y ago
        It’s not difficult to eke out a living in most of the country. Unemployment is 3.5% across the nation, not just in San Francisco.
- xref 4y ago
  It feels like so many convos, especially here on HN, start from the false equivalence that homeless == mentally ill. It’s an issue sure, but not even a primary cause. https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/export-bIrK4-3-735x1200.png https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/0...
  - fnordpiglet 4y ago
    I’m sorry I think you misunderstood me. When I talked about visible / invisible and the iceberg of homelessness I referred to this exactly. However the issue in the discussion here is visible homelessness - the stuff that frightens people away from the downtowns of the west coast. Indeed the vast majority of homelessness happens away from your view and is no less tragic.
- Turing_Machine 4y ago
  > I figured it would be 200 pages of “and that’s a result of Reagan’s drive to shut down public mental health” Reagan hasn't been Governor of California for nearly 50 years.
  - red-iron-pine 4y ago
    But he sure was president of the US, and that's where he pushed to repeal the Mental Health Systems Act of 1980. He certainly did try to crush it on state level, too, as a governor.
    - Turing_Machine 4y ago
      And? 1980 was 43 years ago. I'm still not seeing why the present-day problems can reasonably be blamed on "Reagan". Why don't Bush I, Clinton, Bush II, Obama, Trump, and Biden bear any responsibility? Or, in California, Brown, Deukmejian, Wilson, Davis, Schwarzenegger, Brown (again), or Newsom? Why haven't any of those people undone what "Reagan" supposedly did?
      - fnordpiglet 4y ago
        Because of the act mentioned above. They presumably could have undone it, but the real damage was the dismantling of the public mental health infrastructure and the market economic approach to mental health via managed care that has turned out to be so disastrous. With the passage of the 1980 act the hospital networks were shut down and dismantled, and reimbursements via insurance for mental health were hobbled due to industry maneuvering despite many repeated attempts by congress to “fix” the loop holes exploited. The ACA actually did address the issues but by the point of the ACA decades of rot had set in - the hospital networks were long gone, mental health as a profession obliterated due to rapidly declining reimbursement rates (my father is a phd in clinical psychology with professorships and fellowships from Yale with an established private practice and hospital practice and saw his income go from upper middle class to upper lower class in 30 years, so he switched to doing evals for super secret government stuff). Even with the “fixes,” there’s no meaningful professional class in mental health - just a bunch of undergrads with a certificate, and even then not enough by a light year. But worse of all, there aren’t beds in facilities for the acute care people need today. Have bipolar and need inpatient care during a manic episode? It’s a multi month wait for a short term bed in Washington state, and the facilities are frightening and you’ll be co-habitating with criminally insane people. I know someone who was bunked with a serial rapist on trial - across the hall was two women who were gang affiliated schizophrenics on trial for murder and felony assault respectively). My friend was very well off with a well connected family. Doesn’t matter. Even then they could only house him for two weeks before sending him home deeply manic. They needed the bed for a criminally insane schizophrenic who had killed someone. That’s why it’s Reagan’s fault. He set up the stage so effectively it’s taken this long to turn around the basic issue of payment, and now we have no providers or services or infrastructure left to pay for.
- red-iron-pine 4y ago
  Reagan’s shutdown of mental hospitals is a big problem, but a distinct lack of housing and space is SF's problem. California and other warm states, on a long timeframe, absorb a lot of homeless people -- only places you can sleep outside all year and, like, not die. Not an option for NYC or Minneapolis. So inevitably they have all of these people, and no place to put them. Nor the political will to crack down, since California Capitalists want things to be nice while still flogging the NIMBY-isms.
  - seanp2k2 4y ago
    At this point, feces on the sidewalk /is/ part of the SF aesthetic, so in a way, by refusing to allow anything more than two or three stories to be built in many neighborhoods, they’re correct in that they’re preserving it. Then again, it’s not like the high rises ever end up including a significant amount of affordable housing anyway, so that doesn’t even make a dent in the issue.
    - fnordpiglet 4y ago
      I lived in SF in the 1995-2002 time range and feces and used condoms and needles were literally everywhere even then. I’ve only ever seen this in SF in all my travels and places I’ve lived the country and world over, even places with severe homeless problems. It’s definitely a part of the charm - human excrement and Victorians.

fnordpiglet 4y ago

I figured it would be 200 pages of “and that’s a result of Reagan’s drive to shut down public mental health” I very much doubt the visible homeless problem is a result of housing - the iceberg is a result of housing. The visible homeliness wouldn’t be solved if rent were half - that doesn’t treat schizophrenia

simonw 4y ago
Becoming homeless through no longer being able to afford rent (a common cause of homelessness) is extremely bad for your mental health.
- Jcowell 4y ago
  In this case Housing would be a preventive measure but it doesn’t deal with the problem that everyone truly wants dealt with: the mentally I’ll. How do we solve the mentally I’ll problem? Is it that involuntary commitment with excessive oversight is incomparable with American values of freedom ?
  - trilbyglens 4y ago
    Involuntary commitment was done away with as in the past the conditions in many facilties were super bad. Rather than reform the system they just shut it down. Now there's just nothing at all.
    - fnordpiglet 4y ago
      Leaving humans to rot in the streets seems morally more convenient but not better.
creato 4y ago
I think Reagan was an absolute disaster responsible for a lot of our problems today, but this isn’t one of them. Mental institutions of Reagan’s era were a humanitarian nightmare. But, I am not sure there is a humane solution to serious mental illness. It requires the attention and care that probably only immediate family members are capable of providing, while simultaneously requiring medical treatment and security that only mental institutions are capable of providing. The problem we are having today is we’ve excused criminal behavior due to mental illness. I agree prison probably is inappropriate in most cases, but so is just letting them back on the street.
- fnordpiglet 4y ago
  They were in some, but not all cases. Turning them out into the streets to rot in the gutter while they spiral out in their insanity is certainly morally more convenient, but not, IMO, superior to attempting to build an infrastructure that provides treatment and long term care for people suffering so deeply as this. Freedom that’s a living hell isn’t freedom, it’s just freedom from responsibility for caring. A lot of seriously mentally ill folks burn their family care due to the extreme burden it places on them, and the fact a lot of mania and schizophrenia accompanies a willful belief in their own sanity and autonomy, and a lack of personal knowledge of their state. This makes keeping them under care and medications extraordinarily difficult. Prison isn’t the answer. Mental health facilities is. That’s the real alternative to letting them back into the streets. Prisons aren’t equipped to treat anyone.
  - seanp2k2 4y ago
    >”Freedom that’s a living hell isn’t freedom, it’s just freedom from responsibility for caring.” The problem is that the latter is far too attractive and convenient for a large percentage of this country. Then simply move out of a city center, get some guns, put up some fences, and it’s no longer a problem that you’re directly personally affected by.
- seanp2k2 4y ago
  And most importantly in “free market”-loving America, lots and lots of funding that no one is willing to provide. When they inevitably break some laws, it’s easier for everyone to swallow their obscene housing costs under the guise of “we’re keeping these criminals away from society”.
chimeracoder 4y ago
> The visible homeliness wouldn’t be solved if rent were half - that doesn’t treat schizophrenia By itself? No. But literally every viable path to addressing serious mental illness requires stable housing as a prerequisite. Without it, there's literally no way to manage the problem - just different ways of shifting it around over and over again.
- fnordpiglet 4y ago
  I know. But there’s housing that’s affordable outside of San Francisco and seattle city cores.
  - seanp2k2 4y ago
    Anywhere within an hour drive of SF is extremely expensive, and without a car, extremely difficult to eke out a living outside of a major metro area even if they wanted to.
    - fnordpiglet 4y ago
      It’s not difficult to eke out a living in most of the country. Unemployment is 3.5% across the nation, not just in San Francisco.
xref 4y ago
It feels like so many convos, especially here on HN, start from the false equivalence that homeless == mentally ill. It’s an issue sure, but not even a primary cause. https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/07/export-bIrK4-3-735x1200.png https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/0...
- fnordpiglet 4y ago
  I’m sorry I think you misunderstood me. When I talked about visible / invisible and the iceberg of homelessness I referred to this exactly. However the issue in the discussion here is visible homelessness - the stuff that frightens people away from the downtowns of the west coast. Indeed the vast majority of homelessness happens away from your view and is no less tragic.
Turing_Machine 4y ago
> I figured it would be 200 pages of “and that’s a result of Reagan’s drive to shut down public mental health” Reagan hasn't been Governor of California for nearly 50 years.
- red-iron-pine 4y ago
  But he sure was president of the US, and that's where he pushed to repeal the Mental Health Systems Act of 1980. He certainly did try to crush it on state level, too, as a governor.
  - Turing_Machine 4y ago
    And? 1980 was 43 years ago. I'm still not seeing why the present-day problems can reasonably be blamed on "Reagan". Why don't Bush I, Clinton, Bush II, Obama, Trump, and Biden bear any responsibility? Or, in California, Brown, Deukmejian, Wilson, Davis, Schwarzenegger, Brown (again), or Newsom? Why haven't any of those people undone what "Reagan" supposedly did?
    - fnordpiglet 4y ago
      Because of the act mentioned above. They presumably could have undone it, but the real damage was the dismantling of the public mental health infrastructure and the market economic approach to mental health via managed care that has turned out to be so disastrous. With the passage of the 1980 act the hospital networks were shut down and dismantled, and reimbursements via insurance for mental health were hobbled due to industry maneuvering despite many repeated attempts by congress to “fix” the loop holes exploited. The ACA actually did address the issues but by the point of the ACA decades of rot had set in - the hospital networks were long gone, mental health as a profession obliterated due to rapidly declining reimbursement rates (my father is a phd in clinical psychology with professorships and fellowships from Yale with an established private practice and hospital practice and saw his income go from upper middle class to upper lower class in 30 years, so he switched to doing evals for super secret government stuff). Even with the “fixes,” there’s no meaningful professional class in mental health - just a bunch of undergrads with a certificate, and even then not enough by a light year. But worse of all, there aren’t beds in facilities for the acute care people need today. Have bipolar and need inpatient care during a manic episode? It’s a multi month wait for a short term bed in Washington state, and the facilities are frightening and you’ll be co-habitating with criminally insane people. I know someone who was bunked with a serial rapist on trial - across the hall was two women who were gang affiliated schizophrenics on trial for murder and felony assault respectively). My friend was very well off with a well connected family. Doesn’t matter. Even then they could only house him for two weeks before sending him home deeply manic. They needed the bed for a criminally insane schizophrenic who had killed someone. That’s why it’s Reagan’s fault. He set up the stage so effectively it’s taken this long to turn around the basic issue of payment, and now we have no providers or services or infrastructure left to pay for.
red-iron-pine 4y ago
Reagan’s shutdown of mental hospitals is a big problem, but a distinct lack of housing and space is SF's problem. California and other warm states, on a long timeframe, absorb a lot of homeless people -- only places you can sleep outside all year and, like, not die. Not an option for NYC or Minneapolis. So inevitably they have all of these people, and no place to put them. Nor the political will to crack down, since California Capitalists want things to be nice while still flogging the NIMBY-isms.
- seanp2k2 4y ago
  At this point, feces on the sidewalk /is/ part of the SF aesthetic, so in a way, by refusing to allow anything more than two or three stories to be built in many neighborhoods, they’re correct in that they’re preserving it. Then again, it’s not like the high rises ever end up including a significant amount of affordable housing anyway, so that doesn’t even make a dent in the issue.
  - fnordpiglet 4y ago
    I lived in SF in the 1995-2002 time range and feces and used condoms and needles were literally everywhere even then. I’ve only ever seen this in SF in all my travels and places I’ve lived the country and world over, even places with severe homeless problems. It’s definitely a part of the charm - human excrement and Victorians.