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OK. So now the question is "What can we do to help, given that there's already lots of money sloshing around"? Rather than lecture on what not to do, what do y

by Kalium 12y ago

OK. So now the question is "What can we do to help, given that there's already lots of money sloshing around"? Rather than lecture on what not to do, what do you propose as steps towards resolving these problems?

DanBC 12y ago
"don't stigmatise people with a mental illness" is the call to action. Stigma prevents people getting help, even for mild MH problems that respond well to talking therapy. Stigma increases social isolation and reduces opportunities for work. We know that both of these make mental illness worse.
- BadassFractal 12y ago
  Respectfully, I don't see how this is actionable for me as an individual. Ok, I'm not stigmatizing people with mental illness, now what? I still have hundreds, if not more people, with mental illness roaming downtown, living on the streets, regularly leaving feces on sidewalks, screaming at passerbys and expressing what appears violent behavior and nothing is being done about it.
  - DanBC 12y ago
    I can't fix your police or healthcare systems, and I do appreciate that it sucks if you have people behaving unpredictably around you. We do need to remember that if they have a mental illness then they're probably not living on the streets out of choice, and that if they had affordable meds and healthcare you would be seeing a lot less people on the street. What I can do is to ask you to not assume that violent behaviour is a result of a mental health problem; or to not assume that a person with a mental illness is going to be violent. (Apparently I can do that more politely than I have so far.)
- Kalium 12y ago
  I disagree. It's a negative step - don't do X, for some value of X. OK. Fine. What's next? I asked in search of positive steps.
  - DanBC 12y ago
    Tackling stigma is a positive step. I don't know why you don't get that. It is more than just "don't do x". You're just arguing about words. "Don't discriminate against people with a mental illness when recruiting for a job" becomes "give people with a mental illness the same treatment at job interviews". But if you want a bigger list: Reform the broken healthcare model in the US Push for evidence based treatment. This will usually be a short course of CBT; sometimes it'll be a talking therapy and meds. Sometimes it'll be meds and talking therapies and weekly / monthly visits from a nurse or an occupational therapist. Rarely it'll be a stay in hospital. Even more rarely it'll be a forced stay in hospital against the patient's wishes. Even more rarely it'll be a forensic hospitalisation - a forced stay in hospital ordered by the courts instead of a prison stay. Push for employment programmes to get people with a mental illness back into employment. See for example the Sainsbury Centre for Mental Health documents http://www.centreformentalhealth.org.uk/pdfs/dwp_commissioning_strategy_our_response.pdf http://www.centreformentalhealth.org.uk/pdfs/dwp_commissioni... Push for social inclusion programmes; volunteer for those programmes; San Francisco has a death by suicide rate of 9.8 per 100,000. There is probably some work to do around funding suicide prevention work (which happens earlier than a suicide attempt) and funding suicide intervention (which happens around the time of an attempt). http://www.sfhip.org/modules.php?op=modload&name=NS-Indicator&file=indicator&iid=2393 http://www.sfhip.org/modules.php?op=modload&name=NS-Indicato...
    - Kalium 12y ago
      Find me a qualified candidate who can function in my workplace, and there won't be any discrimination issues. That doesn't mean I'm going to tolerate the sort of acting out described above. I can and do regularly work with the mentally ill, but I'm not about to go recruiting amongst the homeless in hopes of finding a skilled software engineer. "Reform the broken model" is a positive, actionable step in the same way that "Change the culture!" is a positive, actionable step. Which is to say it's a statement of a goal rather than anything immediately useful. But more "arguing about words", right? You shouldn't cite the suicide rate without context. Following your link, SF is doing better than average in California.

by Kalium 12y ago

DanBC 12y ago

"don't stigmatise people with a mental illness" is the call to action. Stigma prevents people getting help, even for mild MH problems that respond well to talking therapy. Stigma increases social isolation and reduces opportunities for work. We know that both of these make mental illness worse.

BadassFractal 12y ago
Respectfully, I don't see how this is actionable for me as an individual. Ok, I'm not stigmatizing people with mental illness, now what? I still have hundreds, if not more people, with mental illness roaming downtown, living on the streets, regularly leaving feces on sidewalks, screaming at passerbys and expressing what appears violent behavior and nothing is being done about it.
- DanBC 12y ago
  I can't fix your police or healthcare systems, and I do appreciate that it sucks if you have people behaving unpredictably around you. We do need to remember that if they have a mental illness then they're probably not living on the streets out of choice, and that if they had affordable meds and healthcare you would be seeing a lot less people on the street. What I can do is to ask you to not assume that violent behaviour is a result of a mental health problem; or to not assume that a person with a mental illness is going to be violent. (Apparently I can do that more politely than I have so far.)
Kalium 12y ago
I disagree. It's a negative step - don't do X, for some value of X. OK. Fine. What's next? I asked in search of positive steps.
- DanBC 12y ago
  Tackling stigma is a positive step. I don't know why you don't get that. It is more than just "don't do x". You're just arguing about words. "Don't discriminate against people with a mental illness when recruiting for a job" becomes "give people with a mental illness the same treatment at job interviews". But if you want a bigger list: Reform the broken healthcare model in the US Push for evidence based treatment. This will usually be a short course of CBT; sometimes it'll be a talking therapy and meds. Sometimes it'll be meds and talking therapies and weekly / monthly visits from a nurse or an occupational therapist. Rarely it'll be a stay in hospital. Even more rarely it'll be a forced stay in hospital against the patient's wishes. Even more rarely it'll be a forensic hospitalisation - a forced stay in hospital ordered by the courts instead of a prison stay. Push for employment programmes to get people with a mental illness back into employment. See for example the Sainsbury Centre for Mental Health documents http://www.centreformentalhealth.org.uk/pdfs/dwp_commissioning_strategy_our_response.pdf http://www.centreformentalhealth.org.uk/pdfs/dwp_commissioni... Push for social inclusion programmes; volunteer for those programmes; San Francisco has a death by suicide rate of 9.8 per 100,000. There is probably some work to do around funding suicide prevention work (which happens earlier than a suicide attempt) and funding suicide intervention (which happens around the time of an attempt). http://www.sfhip.org/modules.php?op=modload&name=NS-Indicator&file=indicator&iid=2393 http://www.sfhip.org/modules.php?op=modload&name=NS-Indicato...
  - Kalium 12y ago
    Find me a qualified candidate who can function in my workplace, and there won't be any discrimination issues. That doesn't mean I'm going to tolerate the sort of acting out described above. I can and do regularly work with the mentally ill, but I'm not about to go recruiting amongst the homeless in hopes of finding a skilled software engineer. "Reform the broken model" is a positive, actionable step in the same way that "Change the culture!" is a positive, actionable step. Which is to say it's a statement of a goal rather than anything immediately useful. But more "arguing about words", right? You shouldn't cite the suicide rate without context. Following your link, SF is doing better than average in California.