zlacker

[parent] [thread] 42 comments
1. xivzgr+(OP)[view] [source] 2025-02-17 06:39:12
I’m not sure what the right answer is, but asking people who are used to rough and tumble life outside to then behave civilly indoors with zero tolerance seems…set for failure?

There are those that do succeed but those are certainly the most motivated to do so. Others are in transition: know they should get indoors but know their difficulties.

Rather than kicking them out, maybe they are required to attend some mandatory psych sessions. Maybe they go maybe they don’t but at least there support to help them work thru their issues of why they blew up at the staff (as in this instance).

replies(4): >>Aunche+w2 >>bnralt+93 >>zdragn+lw >>tiahur+461
2. Aunche+w2[view] [source] 2025-02-17 07:10:46
>>xivzgr+(OP)
> asking people who are used to rough and tumble life outside to then behave civilly indoors with zero tolerance seems…set for failure?

This is what I'm saying the ranger is doing. Someone who gets extremely distressed by indoor living is not a good candidate taxpayer funded indoor living. On the other hand, that housing given to someone who is capable of navigating welfare bureaucracy on their own may actually enable someone who is at risk spiraling down a path of no return to turn their life around.

replies(3): >>b112+ml >>lazide+uy >>hnbad+ve1
3. bnralt+93[view] [source] 2025-02-17 07:16:21
>>xivzgr+(OP)
> I’m not sure what the right answer is, but asking people who are used to rough and tumble life outside to then behave civilly indoors with zero tolerance seems…set for failure?

This is true, and that's why housing first is a terrible policy (I've seen it fail spectacularly first hand). Many of these people simply can't take care of themselves, and putting them in free apartments doesn't fix their situation, but it does make life miserable for long-term residents. All while being extremely expensive.

> Maybe they go maybe they don’t

Here they have frequent wellness checks. It doesn't solve anything. This shouldn't be a surprise - someone who's incapable of living civilly when given a free apartment likely isn't going to be a person who's going to put the time and effort into mental health classes.

replies(1): >>vidarh+y7
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4. vidarh+y7[view] [source] [discussion] 2025-02-17 08:01:59
>>bnralt+93
You seem to be assuming a specific version of housing first that is by no means the only option, and then dismissing the concept as a whole on that basis.
replies(1): >>bnralt+oa
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5. bnralt+oa[view] [source] [discussion] 2025-02-17 08:25:45
>>vidarh+y7
My "specific version" is the version used by government agencies, which specifically states that the government is giving people free permanent housing without requiring prerequisites.

HUD[1]:

"Housing First is an approach to quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions and barriers to entry, such as sobriety, treatment or service participation requirements."

California Department of Housing and Community Development[2]:

"Housing First is an approach to serving people experiencing homelessness that recognizes a homeless person must first be able to access a decent, safe place to live, that does not limit length of stay (permanent housing)...Under the Housing First approach, anyone experiencing homelessness should be connected to a permanent home as quickly as possible, and programs should remove barriers to accessing the housing, like requirements for sobriety or absence of criminal history."

[1] https://files.hudexchange.info/resources/documents/Housing-F... [2] https://www.hcd.ca.gov/grants-funding/active-funding/docs/ho...

replies(2): >>vidarh+0b >>throaw+Yj1
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6. vidarh+0b[view] [source] [discussion] 2025-02-17 08:31:23
>>bnralt+oa
The versions used by US government agencies.

Presumably you're aware that's not the only option, as your last comment before the one above was on a thread about the Finnish approach, which has found it to be cheaper and to act as a gateway to get people other help.

replies(1): >>kjkjad+zc1
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7. b112+ml[view] [source] [discussion] 2025-02-17 10:19:24
>>Aunche+w2
I've always wondered why such people don't live in a rural area. You could literally set aside parks for people wanting to live in this fashion, used to living in this fashion, but also provide facilities (bedding, small cabins, water supplies, washing machines, etc, etc).

You'd need, I think, to have security guards on hand. Not to stop drug use, but instead to stop violence against other homeless, to intervene if medical attention is required, and so on.

While the costs would be higher than some other solutions, it would be lower (I think) than paying for private housing.

Of course, you'd have to force move people, and that's not going to happen. That is, unless you make squatting in a park a crime, and the result is "you're going to be incarcerated in this very nice outdoor place" the "jail".

Maybe a medical order.

My point is, I don't see an issue with some of your logic. Some people won't transition to inside living, or being close to others.

But if you take people used to living in parks, move them to a park with cabins(tiny homes), and state run water/facilities, the cost might be the same, but they'd have a warm bed, etc.

replies(4): >>lupusr+Rr >>ninala+CC >>bombca+xL >>pkaedi+C12
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8. lupusr+Rr[view] [source] [discussion] 2025-02-17 11:15:53
>>b112+ml
A few people might be cut out to be rural hermits, but most need other people to fuel their lifestyle with food, booze and drugs, etc. Hard to buy fent by stealing bicycles if you're in a remote park.
9. zdragn+lw[view] [source] 2025-02-17 11:52:45
>>xivzgr+(OP)
> maybe they are required to attend some mandatory psych session

According to the social workers I know who work with this population, there is a persistent fear that any form of offered mental health help is a trap for institutionalizing people.

By and large, people who are chronically homeless due to mental health issues will prefer to remain homeless over being required to see a psychiatrist and having to take medicine, or so I'm told.

replies(2): >>lazide+ky >>hnbad+K12
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10. lazide+ky[view] [source] [discussion] 2025-02-17 12:07:46
>>zdragn+lw
The issue is also that it’s selection bias - folks who permanently benefit from the treatment leave the system, so you end up with a more and more concentrated population of people who don’t (or refuse to) permanently benefit from it.

Barring other factors, of course.

replies(1): >>AStone+d13
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11. lazide+uy[view] [source] [discussion] 2025-02-17 12:09:14
>>Aunche+w2
The ranger is a hero. And hero’s are often toxic in long running scenarios for exactly the reason outlined - they are trying to make up for a systemic failure through self sacrifice, therefore enabling the underlying system failure.
replies(1): >>hnbad+9h1
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12. ninala+CC[view] [source] [discussion] 2025-02-17 12:39:44
>>b112+ml
What everyone wants, and these people want more than most perhaps, is autonomy. Your idea might work so long as there are few rules that would cause people to be kicked out and so long as money is also provided. It probably won't work if people are forced into it because being forced into things is one of the reason they are in their situation already.

More carrot and less stick, more compassion and less puritanism might have a chance of working.

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13. bombca+xL[view] [source] [discussion] 2025-02-17 13:38:57
>>b112+ml
The people who are capable of this do this on their own.

The California high desert is full of variations of this in shacks and trailers across the nearly uninhabited expanse.

The biggest problem is support, but if they can navigate enough to get government assistance they can survive for quite a long time.

14. tiahur+461[view] [source] 2025-02-17 15:49:19
>>xivzgr+(OP)
We used to have work farms, SF had a few. They were shut down by the same counterculture types that said turning a blind eye to drugs and vagrancy wouldn't be a problem.
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15. kjkjad+zc1[view] [source] [discussion] 2025-02-17 16:24:03
>>vidarh+0b
The finnish approach isn’t on the same scale as the number of homeless people in the US and is hard to apply.
replies(2): >>johnny+GR1 >>vidarh+4a3
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16. hnbad+ve1[view] [source] [discussion] 2025-02-17 16:34:31
>>Aunche+w2
> taxpayer funded

I don't understand the reflexive nature many people present in jumping this kind of framing. Of course it's taxpayer funded. Everything is taxpayer funded. Even when it's not literally paid from taxes collected by the government, it's probably funded by people who pay taxes.

The price you pay for your groceries funds not just the wholesale purchase of the goods you pay for but also the labor, facilities, equipment and resources used to purchase, deliver, store and sell those goods. Considering the total amount of taxes collected versus the revenue of the place you get your groceries, you probably contribute more of your income to operating that place than to any single service funded directly from taxes. The amount of those grocery expenses that goes directly into profits alone is probably still greater than that. Housing first specifically also literally is cheaper than the previous approach by reducing expenses for medical services, policing and incarceration.

So "taxpayer funded" is neither a meaningful qualifier if taken literally nor do its implications stand up to scrutiny.

The most common reason for using this phrase is an emotional appeal to selfishness. Your money is being spent without your say on services you don't benefit from. I find that framing morally appalling but even so, what is the alternative? What the US did before was more expensive. Not housing people means more health issues and ER visits. Throwing them in prison means housing and feeding them at a massive multiple of the cost of a housing first initiative. If you want to save costs without spending money on housing, I guess you could cut their access to medical services but then you might as well allow law enforcement to shoot them on sight as the outcome will be the same.

> On the other hand, that housing given to someone who is capable of navigating welfare bureaucracy on their own

What you're describing is triage, not housing the homeless. If your housing program is small enough that you have to engage in triage and turn people away, it's not addressing homelessness, it's addressing a fraction of the homeless population. It's better than nothing, sure, but it's not enough.

Also triage means weighing the necessary resources for treatment against the likelihood of recovery and the likely extent of the recovery. You don't treat someone who can walk it off but you also don't treat someone who's in very poor health or too far gone to be saved without using a disproportionate amount of resources.

Triage is not how you organize a hospital. Triage is how you respond to an overwhelming emergency situation without access to necessary resources. Triage is a last resort measure to reduce the number of people who will die, not a strategy for helping people survive and thrive.

Homelessness is not a natural disaster, not a spontaneous pandemic. Homelessness is a longstanding social issue most often directly arising from poverty and lack of mental health support. If your concern is with the support being wasted on people with worse chances and not support being insufficiently funded for that kind of decision not having to be made, I think you might be overestimating your humanitarianism.

replies(4): >>pc86+do1 >>Aunche+6K1 >>PaulDa+XL1 >>Yeul+Ol3
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17. hnbad+9h1[view] [source] [discussion] 2025-02-17 16:49:08
>>lazide+uy
This is needlessly cynical. The hero isn't toxic. The narrative of an individual effort in lieu of calling out the systemic issue is what's toxic. I don't see any way she could have better spent her energy contributing to systemic change whereas by doing what she does she literally improves the lives of others.

Favoring narratives of individual heroes over narratives of systemic changes is a cultural problem. Whether it's Atlas Shrugged, the Odyssey or Harry Potter. It instills a learned helplessness and an artificial desire for a "strong man fix things" that can be very difficult to overcome. But it also atomizes and fractures society and benefits those with the most individual wealth and power.

The ranger is a hero. What she is doing is good. But she shouldn't have to do it. And nobody should have to do so much. The article intentionally buries its lede: if this is what it takes to save one person, how can we save thousands? The implied answer is again helplessness: of course this isn't scalable so we can't. What she is doing is too much for one person, so we can't expect it of others. But the real answer is that literally none of this would be necessary if the system were actually built to help these people.

Her work does not require a herculean effort because it is difficult. It requires so much effort because it is being made difficult. The right question isn't how can we scale this, the right question is how can we make it easy enough that we don't need her to be a hero. The question of scalability answers itself once you've removed the obstacles.

replies(2): >>AStone+1j1 >>lazide+ek1
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18. AStone+1j1[view] [source] [discussion] 2025-02-17 16:58:07
>>hnbad+9h1
perhaps the pervasive narratives of systemic toxicity and chronic social issues that get us down? are those good for society? should we listen to those news stories all day? and believe that things are so awful that There Oughtta Be A Law And Reform?

those who cried out to quote Tax The Rich unquote, were likewise upset by the tariffs being imposed which are taxes on the rich... a really uniform and effective one! taxing corporations by tariffs is much father reaching than taxing individuals. individual heroes.

those who cannot interpret epic fantasy sagas as allegory or larger than Life metaphors are already helpless and they just need entertainment and some opiates.

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19. throaw+Yj1[view] [source] [discussion] 2025-02-17 17:02:18
>>bnralt+oa
Its been a success in Canada when tried https://www.cba.org/Publications-Resources/Practice-Tools/Ta...
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20. lazide+ek1[view] [source] [discussion] 2025-02-17 17:03:27
>>hnbad+9h1
that’s what i said?
replies(1): >>hnbad+L12
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21. pc86+do1[view] [source] [discussion] 2025-02-17 17:25:10
>>hnbad+ve1
"Taxpayer funded" pretty obviously means "paid for or subsidized by the government directly" and it seems bad faith to pretend you don't know that.

Of course you can probably find some government subsidy somewhere and trace it to grocery stores but nobody realistically claims grocery stores are taxpayer funded.

The government directly putting homeless in hotels over and over again is very clearly taxpayer funded and everybody knows what is meant when someone says that.

replies(2): >>Dangit+Vw1 >>johnny+0S1
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22. Dangit+Vw1[view] [source] [discussion] 2025-02-17 18:22:14
>>pc86+do1
If you think this is a reply to their comment, you must not have read it.
replies(1): >>hnbad+S52
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23. Aunche+6K1[view] [source] [discussion] 2025-02-17 19:44:08
>>hnbad+ve1
> Your money is being spent without your say on services you don't benefit from.

I don't mind strangers benefitting from my tax dollars. No where do I even imply this, so this idea is completely coming from your own preconceived ideas about those who disagree with you. The problem with this case is that I'm not sure anyone is benefiting from these tax dollars. These men aren't asking for help. They're being pressured into accepting help. Someone resourceful enough to trap racoons isn't fundamentally so helpless that they require 7 months of handholding to apply for temporary housing. He required 7 months because that wasn't something he was interested in the first place but is willing to occasionally humor a pretty ranger. She would have much more success meeting them where they're at. For example, she can set up an arrangement where the rangers will stop harassing the campers and tearing down their encampments if they keep the surroundings clean.

> What you're describing is triage, not housing the homeless

Yes, I'm talking about triage because that's exactly what the ranger is doing.

replies(1): >>hnbad+K32
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24. PaulDa+XL1[view] [source] [discussion] 2025-02-17 19:56:59
>>hnbad+ve1
Also, to repeat a point I often make about this ...

Until sometime around the 1980s, even in the USA poverty and homelessness were scene as systemic failures - "our system should not lead to those results". Post-Reagan, the attitude has shifted dramatically and now poverty and homelessness are broadly seen as personal failures, a mixture of poor morals, bad character and weak decision making. We even used to be a little inclined towards a potential role for the state in helping individuals deal with bad luck, but now bad luck is seen as "gravitating" towards individuals whose fault is all theirs.

This has necessarily drastically altered government policies at the local, state and federal level. We are much, much worse for it, no matter which interpretation of poverty and homelessness is more factually correct.

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25. johnny+GR1[view] [source] [discussion] 2025-02-17 20:40:12
>>kjkjad+zc1
Well we spent more time ignoring the issue. Of course we need to climb more to get out. I don't think "but it's hard" is a good mentality when it comes to solving hard problems.
replies(1): >>vidarh+Wb3
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26. johnny+0S1[view] [source] [discussion] 2025-02-17 20:43:27
>>pc86+do1
Grocery stores are subsidized by the government. I would call pretty much any grocery chain store that gets government handouts to be taxpayer funded, yes.

>The government directly putting homeless in hotels over and over again is very clearly taxpayer funded and everybody knows what is meant when someone says that.

And why are we framing is as bad? You're either funding their low income housing, or you are funding their jail cell (and they are not generating any real sense of income to stimulate the economy).

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27. pkaedi+C12[view] [source] [discussion] 2025-02-17 22:01:39
>>b112+ml
Your last idea reminds me of https://mlf.org/community-first/

From what I hear, it is quite successful, giving their residents the dignity and autonomy they need to stand on their own.

replies(1): >>b112+Cv2
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28. hnbad+K12[view] [source] [discussion] 2025-02-17 22:02:34
>>zdragn+lw
The obvious problem is that that fear is entirely justified and rational.

Even if you disregard history, the current POTUS literally talked about concentrating homeless populations into centralized camps away from the general population.

How realistic this fear is and how probable it is, is of course debatable. But given that these people probably didn't have any positive experiences with mental healthcare and institutions and that the public discourse often describes them as analogous to vermin or disease and focuses on "removing them" rather than helping them, trusting a psychiatrist - especially if it means having to go to them, especially into a clinical environment - let alone taking psychopharmaceuticals seems like it would require quite the leap of faith.

replies(1): >>zdragn+mE3
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29. hnbad+L12[view] [source] [discussion] 2025-02-17 22:02:38
>>lazide+ek1
You said heroes are enabling the system.

Hero narratives are enabling the system.

Those are two different things. She likely doesn't consinder herself heroic. The story about her however is written in such a way to portray her as heroic. It doesn't leave room for any other option than helplessness and hoping for more heroes to emerge.

Framing it as heroes being toxic and enabling the system suggests accelerationism: if things only get bad enough (i.e. if we stop "enabling" the system by trying to work around it), the people will see how bad things are and demand change. But accelerationism doesn't work. When things are bad enough, the people will want a simple answer and a promise of a fast change. Stable systemic changes don't work fast and they are rarely simple.

To put it another way, heroes aren't toxic, heroes are harm reduction. Harm reduction is good because it helps people in the here and now. But harm reduction is not a solution to problems. Solving problems requires putting in the ground work of building bottom-up social structures. There's no reason to believe she would be just as good and enduring in doing that as she is in what she does now. And most importantly, she wouldn't be helping those she helps now because she might not even see it resulting in change within her lifetime.

So given that heroism doesn't work and letting things get worse doesn't work, what now? It sounds like we need a hero to take on the herculean task of dismantling the individualist atomizing culture norms - oh.

replies(1): >>lazide+tS2
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30. hnbad+K32[view] [source] [discussion] 2025-02-17 22:18:58
>>Aunche+6K1
> She would have much more success meeting them where they're at. For example, she can set up an arrangement where the rangers will stop harassing the campers and tearing down their encampments if they keep the surroundings clean.

We must have read different articles because the one I read stated that her job description is literally to remove people from these parks, just in a more humane way than just harassing the campers and tearing down the campsites. You can make an argument that they should be allowed to let them live there but her job isn't simply to keep the park clean but to stop people from living there.

> Yes, I'm talking about triage because that's exactly what the ranger is doing.

Again, we seem to have read different articles because to me it didn't read like she was prioritizing specific individuals for movement into housing using any of the considerations I described.

replies(1): >>Aunche+M82
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31. hnbad+S52[view] [source] [discussion] 2025-02-17 22:39:20
>>Dangit+Vw1
Thanks. To clarify for those who can't muster the attention span to make it to the second paragraph: my point is that the phrase is a red herring designed to trigger an emotional response because we're bad at comprehending how miniscule our relative contribution to each "taxpayer funded" expense actually is.

The parent of your post is a good example of how effective it is at doing that, especially when combined with the claim of an apparent wasteful use of that money. If you pay tens of thousands of dollars in taxes and hear about a million dollars of "taxpayer money" being supposedly wasted, your emotional response reflects an imagined scenario where all of your taxes went into that alleged waste even if individual income taxes alone represent over $2 trillion (i.e. million million, or thousand billion) of the US federal budget and your actual relative lifetime contribution to that individual project can't even be measured in cents.

Not to mention that the news sources referring to that spending as waste may be reporting on inaccurate or incomplete information (even when deferring to an official source) and may be misrepresenting or omitting the actual economic efficiency of that spending (e.g. the entire "condoms to Hamas" incident where the official announcement turned out to not only apparently have mistaken about US medical aid in Gaza specifically but also misrepresent the total spending on contraceptives for AIDS relief by the US across the globe as going to a single place - the benefit to Americans of providing contraceptives to HIV hotspots should be obvious enough).

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32. Aunche+M82[view] [source] [discussion] 2025-02-17 23:12:25
>>hnbad+K32
> We must have read different articles

Doubling down on the preconceived judgments I see. Yes I read the article, and from it, I can tell she is given a lot of autonomy. I don't thinking allowing a "client" to camp for seven months while you file for paperwork is part of her job description either.

> it didn't read like she was prioritizing specific individuals for movement into housing

She is convincing people who otherwise would have refused offers for housing to take housing. If that's not triage, then you shouldn't have brought that up to begin with.

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33. b112+Cv2[view] [source] [discussion] 2025-02-18 02:46:30
>>pkaedi+C12
Neat. I was thinking more rural, but if this works, it works!
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34. lazide+tS2[view] [source] [discussion] 2025-02-18 07:35:18
>>hnbad+L12
You might want to actually read my comment? The details in the article re-enforce the point.

The noted person she was ‘saving’ attacked someone when she was on vacation, and she is lamenting how if she had been there she could have stopped him from being kicked out again. And she’s angry (and reading between the lines, probably burning out) and lashing out at people. And not assigning any agency to the person she was ‘helping’. That is toxic. Regardless of her hero status. I’m sure she didn’t start this way, but this is a result of being put in this position over and over again and trying to do the right thing.

Like a combat vet with PTSD who attacks a random clerk at a grocery store due to a sudden trigger, or goes around yelling at everyone all the time because they’re always pissed off. That isn’t usually because of a one time event.

That she is also doing what she is doing, is also enabling the brokenness of the system by not allowing it to fail in a terrible way so the public or those in charge actually do something different.

Expecting heros to solve systemic issues by going so above and beyond that they ruin themselves is also toxic. That’s that I’m calling out.

Someone who jumps on a grenade in a foxhole is a hero - and those around them owe them their lives. That should be celebrated.

That someone got close enough to throw a grenade into that foxhole was likely due to many screwups, and if we ignore that, and even reinforce the environment that resulted in it, we’re just murdering heros, aren’t we?

Not that anyone wants to think long and hard about that of course.

It doesn’t mean all of these problems are solvable - some parts of life are, and likely always will be, meat grinders for a number of reasons. Maybe this is one of them.

Thoughts? I think we’re actually in agreement frankly.

I know the common human fallback is going to the ‘strongman’ (the ultimate hero fantasy).

IMO, that will almost certainly ultimately fail, and is toxic for anyone to try to even ask, because really we need to take a legitimately honest accounting of what we need/want, what price we’re willing to pay for it, and then actually follow through.

As a society. So there don’t need to have heros constantly ruining themselves to try to save us.

Notably, however, some people will still try to martyr themselves, even in those situations, to be the hero no one was asking for. But that is a different kind of problem.

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35. AStone+d13[view] [source] [discussion] 2025-02-18 08:57:48
>>lazide+ky
The point of drugs is not to benefit the patient!! The drugs and treatments protect the community and serve the collective good.

The drugs are administered first to foster obedience, credulity, and fidelity. The patient learns to keep their appointments, lest the drugs be withdrawn. The patient becomes a regular customer at the pharmacy, which must also be done on precise schedules. The drugs must be taken as directed, and the patient learns how to read and understand and follow intricate rubrics for rituals at home, and what foods to avoid, how to coordinate meals with the drugs, etc.

The patient, having demonstrated obedience and fidelity is well-supervised now by the clinic and provider. The drugs are "virtual shackles" that stand in for actual restraints and confinement methods. Just as "chemical castration" substitutes for surgical mutilation, any patient who's on drugs and making regular appointments can be let loose, a feral in the human population, often undetected and blending in.

https://en.wikipedia.org/wiki/History_of_psychiatry#/media/F...

https://en.wikipedia.org/wiki/Philippe_Pinel

It's important to consider that Mental/BH has never been a medical discipline, and while today's scrubs and white coats are the priestly raiment of BHT, NP-LPN-RPh-BH, and M.D.s alike, they take blood pressure and do labs, and they prescribe drugs and work in clinical systems, even Western-style BH is, fundamentally, a religious temple cult of profound spirituality. In order to fit the mold of modernist secularism, the BH temple must array itself in trappings of science and respectable, professional jargon. The BH orthodox profession is that mental illness begins and ends in the body, somewhere, hopefully the brain, or at least where the neurotransmitters flow, to be manipulated by sacramental means. Because if mental illness is not bound or subject to the body, or the secret HIPAA-protected rites and liturgies are not concrete and high-tech, then treatments become subjective, outcomes are unpredictable, and evidence cedes ground to superstition or faith in deities and the intangible world of spirit, which must be ignored in order to promote and foster D.E.I.

Ramp up drug regimes trying to blunt aggression, anxiety, restlessness, independent thought and reason, resistance to authority, and other compulsions to harm others, or sometimes the drugs magnify those compulsions and homicidal ideations, and the patient just goes totally apeshit, until the hospital can get to billing their insurance in earnest. But since President Reagan "closed the asylums" the paradigm shifted to keeping people out and free and at-liberty. Because institutionalization is an excessive burden on taxpayers, families, and insurance carriers, and it's labor-intensive: this is recapitulated in the past 5 years because the "Flatten the Curve" mantra was promulgated because there are widespread staff shortages and a lack of skilled, certified HCPs, especially for Defence Against the Dark Arts. I recommend viewing the critically acclaimed, award-winning film "Ladybird" starring Saorsie Ronan; her mother is a psychiatric nurse played by Laurie Metcalf, and see how Ladybird herself turned out

Even for the HCPs on staff, BH facilities are closer to meat-grinders than revolving-doors, as they burn out, train up, move up, drink their own Flavor-Aid, circulate within the system. So those homeless psychos meet a new team of strangers every month or so. Over 25 years, I personally witnessed one clinic that changed its name/brand/ownership 5-6 times, expanded/moved at least 3 times, and there are literally dozens of BH systems that didn't exist 10 years ago, including 8-story hospitals with no 6th floor.

https://www.azahcccs.gov/Fraud/Downloads/ProviderSuspensions...

Would you believe dozens of New Religious Movements operating under auspices of BH services? You may find yourself in a shotgun shack, worshipping Shiva or Kali, or I don't know, in a UFO cult, or practicing tantric yoga with authentic Punjabi Guru, because Medicaid funding. BH Funding for Treatment is Public Safety and a National Security concern: every time a mass shooting is reported on the news, Congress acts to bolster BH funding and services, and so "every time a shell casing pings, someone's clinic builds a wing!"

Ask anyone working in hospice/palliative care and they may confide that drugs are administered when family or staff are irritated or vexed by the patient, rather than basing it on the needs of patient herself. An incoherent or insane patient may be unable to articulate their needs, but when they act out, or become criminally dangerous, they must needs smacked down. "The Squeaky Wheel Gets the Grease" indeed.

https://en.wikipedia.org/wiki/Rosemary_Kennedy#Lobotomy

The patient works with the provider to identify and treat more and more conditions. The drugs layer-up, and sometimes extra drugs are shoveled on top, to complement really debilitating effects. But in general, the drugs are exacerbating and magnifying the patient's sins and proclivities. The drugs are interacting and the patient is increasingly entangled in the intricate ritual of provider->pharmacy->daily pill rituals->pharmacy->provider->pills.

It's impossible to know whether recovery is attributable to a true underlying change or whether the drugs have papered over the worst symptoms. Therefore, it's never advisable to stop those drugs or titrate off them, because they don't get labeled with maximums or limits like the OTC stuff can be (this guy once OD'd on fiber supplements).

In the case of "lunatics" and other folks who just had a temporary nervous breakdown or trauma-based freakout, they certainly can recover and exit the system--anyone can exit the system until they're court-ordered or incarcerated, anyway.

There's plenty of other non-drug treatment for outpatients on the streets; counseling/therapy can be done 1:1 or in groups and other supports in the clinic for building life skills, etc. The homeless nutjob population can typically get benefits from us taxpayers to keep them in the clinic 3-5 days a week, just doin' stuff, because the clinic is pretty much a church, and the mentally ill need a religion with structure, rituals, priests, and sacraments like Prozac.

replies(1): >>lazide+553
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36. lazide+553[view] [source] [discussion] 2025-02-18 09:35:10
>>AStone+d13
It does benefit the patient to not have to be smacked down by society, kill themselves, die of exposure, etc. right?

There is a reason why the old saw of ‘if you’re poor, you’re crazy. If you’re rich, you’re just eccentric.’ is largely true.

If you’re a threat to society, society will become a problem to you. If you don’t have the resources to deal with that, then you have a real problem.

replies(1): >>AStone+b83
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37. AStone+b83[view] [source] [discussion] 2025-02-18 10:06:35
>>lazide+553
It's typically illegal and possibly immoral to die by suicide, but again, as a matter of national security, it contributes to the collective good when insane persons fall by the wayside and lessen the harms and burdens for the proletariat, taxpayers and institutions. There are dozens of medications to help foment ideations and actual attempts of self-harm, so the patient benefits by staying out of courts and prisons and teenagers

The more cooperation that can be elicited from the mentally ill, in terms of becoming sicker, and medicated, and incapacitated or dead, the easier it becomes for citizens who support spouses and sane children, for citizens who work and pay taxes, for sane citizens who own property and generate revenue by leveraging assets, for free humans pumping iron, or those exercising the rights to liberty and the pursuit of happyness.

All of the above are increasingly threatened unless mentally ill humans stop procreating, and be removed from law-abiding democratic communities, and until then, controlled and supervised. An incapacitated patient won't leave home, won't start any fights, and won't disrupt a workplace or elementary schools, if the patient struggles for existence, barely able to prepare meals or get sufficient sleep.

The USA is deeply in debt, overpopulated, gripped and choked by a dark, imperceptible 6-year pandemic that marches through every corridor and vehicle, and still the immigrants flow inwards through the Golden Door, ready to work and assimilate, but is our national Zeitgeist on life support? The feeble-minded and mentally ill, malcontents: especially those without caregivers or supportive families, human weeds! They hinder progress, hinder democracy, and they threaten national security.

replies(1): >>lazide+5i3
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38. vidarh+4a3[view] [source] [discussion] 2025-02-18 10:29:32
>>kjkjad+zc1
The classic US exceptionalism "but we're bigger" argument is almost always nonsense because you can subdivide. You're already split in 50 states. You have cities, counties. A system doesn't need to be perfectly applied everywhere at once to start to help.

Furthermore, the Finnish example shows savings per homeless, despite a far cheaper healthcare system. US savings vs. having these people cost a fortune of ER capacity would likely be far higher per homeless.

US potential savings are vastly higher.

Why US taxpayers are so consistently willing to burn taxpayer money to keep things worse when there are more efficient alternatives always confuses me.

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39. vidarh+Wb3[view] [source] [discussion] 2025-02-18 10:50:42
>>johnny+GR1
It's not even "but it is hard", but the perennial excuse of "scale", as if the US isn't split in states, and cities, and counties. This comes up so often when someone don't want to acknowledge a solution that works elsewhere (everything from trains to, well, this), and ignoring that you don't need to solve the entire problem everywhere at once to make things better.

If this was some super-costly policy that needed a big apparatus around it, then they'd have a point, but e.g. in Finland, one estimate is that it costs them up to 9,600 euro a year less to house a person first vs. leaving them homeless. As such, just starting to provide some housing units and gradually grow it would be a win for every local government with a homeless person.

It only starts to become a challenge if a few local governments reaches such a level of provision that it attracts homeless people from surrounding areas that don't do anything themselves, but that's not a reason not to start.

Sometimes it feels like US taxpayers wants the government to burn money if the alternative is to do something that might help other people with it.

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40. lazide+5i3[view] [source] [discussion] 2025-02-18 12:01:20
>>AStone+b83
Uh, did you intend to literally write an argument for authoritarian eugenics? Aka, that darkest part of Nazi’ism?
replies(1): >>AStone+Pya
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41. Yeul+Ol3[view] [source] [discussion] 2025-02-18 12:38:43
>>hnbad+ve1
Social housing programs in Europe were first invented in the 19th century. Part of it was altruism to be sure. But the richer part of society also understood that the slums were hotbeds for disease, crime and revolution.
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42. zdragn+mE3[view] [source] [discussion] 2025-02-18 14:37:27
>>hnbad+K12
It is and it isn't. The conversations I'm referencing happened back when Obama was in office.

Every state does have some form of civil / involuntary commitment, though nothing like before the 80's.

Many drugs also come with unpleasant side effects, especially if someone steals them from you and you're stuck with withdrawals. I'm reminded of one person my friend was helping who hated taking his medicine, but if he didn't, he would inevitably become increasingly paranoid that vampires were out to get him. Helping the poor guy live anything close to a "normal" life was a constant challenge.

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43. AStone+Pya[view] [source] [discussion] 2025-02-20 16:16:16
>>lazide+5i3
Yes. I borrowed plenty of tired rhetoric and I'm deeply troubled by the knock-on effects of eugenic policies, but from a grassroots view here among the human weeds, I confess that I'm also describing the status quo in the developed West, and the duty of citizens of that Western culture to engage and participate in the darker side and a culture of death, according to the Divine Plan for each of us.

From across the pond, it seemed that Nazism resulted in the expelling/extermination of foreign, undesirable influences and a stirring up of nativist fervor in order to validate those actions.

Also here across the pond, we've had major immigration by Eastern Bloc or Soviet refugees in the past century. They're a huge influence on our culture and ideology and the direction we've taken since the Civil War. And we see nativist fears and xenophobia in things like the McCarthy "Red Scare", but were they entirely unjustified when today we're screaming about Facebook and soviet interference in elections? ... And our voices are raised in chorus of "get these homeless off the streets, expand [mental] [women's] [right-to-die] health care, defund Churches [and mosques, synagogues and Wiccans?] will no-one rid us of these troublesome [cops, judges]?"

Surprise plot twist: the vicious military expansion that was nipped in the bud left more of a historical mark than the mass emigrations and migrant movements going on underneath the wars. The USA got Albert Einstein, rocket science, a regime change in Hollywood, new captains of industry and finance, and lifeboats full of philanthropists. We children of the Cold War wouldn't know one another at all if it weren't for the IETF, NSF, ARPA-DoD, and TLAs that you can't stand.

Eugenics may be a pseudoscience or a discredited ideology, but is it also entirely without merit, or unjustified? What does a nation do when she's deeply in debt, and more people are struggling for smaller pieces of the pie, and her reputation and huge tracts of land are an attractive destination for refugees and migrants? I guess some of her citizens log into free websites and give unpaid "Billion Keyboard Monkeys" labor to the guys who host the servers.

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