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View original on lemmy.world

113 replies

lemmy.world

The issue with institutionalization (besides SCOTUS ruling it violates the ADA in 1999’s Olmstead v LC, rendering it illegal for anyone with a disability), is that it’s expensive. That’s why Reagan defunded them all.

To be clear, deinstutionalization was a good idea, but unlike JFK’s push, Reagan pushed for it without replacing institutions with well-funded community services. Which would be cheaper than institutions, most of which sit unoccupied and decaying, so there’s also the question of where Trump wants to put these people.

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lemmy.world

This doesn't get said enough. Getting rid of them was a legitimately good idea, the some of the abuses in those places was hair-raising. We just didn't replace them with anything, so the mentally ill all just turned into homeless mentally ill, which just made more people miserable, which in turn probably contributes to more individual incidents of mental illness occuring.

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jeffwreply
lemmy.world

Many also ended up in jails and prisons

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gulliblereply
kbin.social

And many more simply died. As it turns out, releasing the disabled onto the street, surprisingly, wasn’t a perfect option.

21

Canada did the same damn thing at the same damn time with the same damn repercussions because our PM followed Reagan around like a damn lapdog. 🤬

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Dkarmareply
lemmy.world

Getting rid of them was a SHIT idea what are u talking about?!?!

0

Exactly what I said. Needed to be done, just needed an improved plan instead. Choices were No Plan, A Bad Plan, and A Good Plan. Mental institutions were a bad plan. We got rid of them and went with no plan. We need a third possibility nobody tried--a good plan.

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It comes down to the same issue with the police. When you look at the effort it would take to reform what was wrong, it would be nearly impossible. A better idea would be to toss out everything and start from scratch.

Just take a look at how mental institutions were in the last moments before they were closed: https://timeline.com/willowbrook-the-institution-that-shocked-a-nation-into-changing-its-laws-c847acb44e0d?gi=187e20cd91e2

https://www.thirteen.org/metrofocus/2016/01/the-story-that-revealed-willowbrooks-horrors/

https://www.geraldo.com/willowbrook-ii/

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lemmy.dbzer0.com

Im in the disability field and honestly I feel like we need something and need it bad. Not institutions, at least not like they were, but I honestly wouldn't be surprised to see some people in the disability community respond positively to this with the hopes that its different this time, lord know the people who like him don't believe his words at face value. I can also tell you thers definitely is a not insignificant amount of people in the community who have a neutral to faborable feeling on Trump.

The key here I think is that during the pandemic, even before mask mandates, we started seeing services get cut, orgs defunded, and staff reduced. So much of the disability community right now is relying on support staff and self directed program funding, which is essentially the disbursement of medicare and medicaid funding to one individual, not necessary with a medical background, to help the person with the disability with their day to day stuff and goals stated in their Individual Service Plan. The flexibility is great but its just one person at a time, they don't even get a budget to do things typically.

A lot of people with disabilities are missing the structure of actual organizations that has the resources to do more than what a one on one support worker can, and someone on Trumps team is either smart enough to know that, or quite lucky.

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jeffwreply
lemmy.world

Nice, I also used to work in the disability field (ID/A). And you’re right, although at least in my state we haven’t had cuts, more so just a lack of sufficient new funding.

I will say that I don’t think many in the disability will support this, but some do seem ignorant of the past and the old realities of institutionalization.

And yeah, self-directing is a double edged sword. I’ve seen it done well and I’ve seen it abused by families just to get some extra money, while not really sufficiently meeting the needs of their family member with disabilities. I also think it’s nearly inescapable in the future, given the staffing shortages we already see in direct care and the aging boomer population that will require even more staffing.

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Self directed seems to be the answer to budget problems, but there should be pooled resources that all support staff can tap into if we want to even keep the same level of service we had pre pandemic, and honestly the disability community still deserves more than that bar. Hopefully we get there.

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lemmy.world

question of where Trump wants to put these people.

Decriminalize/legalize all drugs, transfer all for-profit prisons back to the government and/or not for profit charities, shuffle prisoners around to free up prisons to be converted to mental healthcare and drug rehabilitation facilities, and fund it with a taxed and regulated drug market.

Not that he thinks far enough to come up with that.

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lemmy.world

Most reputable sources have reported decriminalization in Oregon did not lead to an increase in overdoses, which correlates with the rest of the fucking planet and isn't surprising.

However, your source is behind a paywall, so I can't check it out.

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jordanlundreply
lemmy.world
lemmy.world

Yeah, after reading each link provided, you're reaching. I'm not sure if you're paid to be a shill or just brain washed, but the decriminalization is overwhelmingly recognized as a benefit to humanity.

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jordanlundreply
lemmy.world

Not in Oregon it's not. Source: I live here. I watch it DAILY.

The #1 problem we have is that there's NO incentive to get treatment. If you get caught with drugs it's a $100 fine and that fine gets waived if you call a toll free number and ask about treatment. You don't actually have to GET treatment, all you have to do is ASK about getting treatment.

16,000 people ticketed, 137 called the treatment line. Tons of people using the free needle exchange and naloxone though.

https://www.opb.org/article/2022/02/14/oregon-drug-decriminalization-measure-110-grants-treatment-recovery-services/

It's just not working. Likely it will be repealed in the next election.

https://philomathnews.com/drug-decriminalization-stumbled-in-oregon-and-other-states-are-taking-note/

https://www.kgw.com/article/news/local/the-story/oregons-drug-decriminalization-flaws/283-6b5c022f-f437-4476-ba44-c6d163ca6d7b

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If the entire world does something successfully and you don't. Where do you think the problem lies?

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lemmy.world

I suddenly can't see the comment chain where we were having a conversation. Did you delete your comments as after I posted the law that you said didn't exist?

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lemmy.world

Weird. I can't access that comment chain anymore, but I can see the comments in our history. Maybe it's a Sync issue (the platform I'm using)

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lemmy.world

It's because Lemmy is broken-ass piece of shit garbage. Comments I wrote and deleted still show up for other people, too.

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lemmy.world

😆

A typical and predictable response from someone selfish and immature enough to knowingly do nothing about serious and exploitable bugs on a platform they choose to be wholly dependent on for online discourse. And they expect people to blindly go along with it simply because they did.

If we were on a spaceship, and I was telling you about serious air leaks in the hull, would you look at me and tell me to my face "Feel free to leave" as you suffocate? Or would you go patch the holes?

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What a massive edit you've made to your comment.

Your metaphor is really shitty though. Feel free to leave :)

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kbin.social

Republicans made a deal with JFK to phase out mental health hospitals and replace them with community based facilities that had a more home like atmosphere.

They did the gutting part.

Then JFK was assassinated.

Republicans decided that they didn't have to do any more after that, and LBJ used most of his political capital to get the voting rights act passed.

That's why our mental health system is so broken.

If republicans wanted to fix the system, they could start with funding the VA. Many of our troops wind up with mental health conditions due to their time in the service.

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Zepporeply
sh.itjust.works

back when they rolled that out (Bush era) was when they really started assaulting people with vacuous catchphrases. Opposition to the Iraq was was answered with 'support the troops!' which made no sense... okay, I support them, I don't want them to go get PTSD from urban warfare and killing civilians and leave their lives here to sit around in a tent in the desert at 130 degrees. Another one was if you opposed anything Bush/Cheney was doing, "Why do you hate America??", which is obviously a ridiculously loaded question and very shitty debate tactic.

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The VA needs some serious reform in how they operate. A major problem with staffing there is just plain burn out and then 6 months to hire a replacement. The entire organization is understaffed and over worked.

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Driving the news: "When I am back in the White House, we will use every tool, lever, and authority to get the homeless off our streets," Trump said in a video posted on his campaign site in August, saying that he'll work with states to ban urban camping.

  • Trump said his administration would offer treatment and other resources for people who are "just temporarily down on their luck" or have less severe mental health issues.

  • "And for those who are severely mentally ill and deeply disturbed, we will bring them back to mental institutions, where they belong," he said, "with the goal of reintegrating them back into society once they are well enough to manage."

So "every tool, lever, and authority" except building shelters and affordable housing. Because, of course, the homeless themselves are the problem that needs to be fixed, not a symptom of a society that needs to be fixed.

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lemm.ee

A Democrat proposes a way to help the mentally ill: HOW ARE WE GOING TO PAY FOR IT?

A Republican proposes a more expensive way to punish the mentally ill: NOW THIS IS GOOD POLICY

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They flat out don't understand how federal laws are enforced. Most of the shitty anti-welfare or anti-handout "ideas" they have would not save money. I always ask these chucklefucks if they would still support those ideas if they cost more than they saved. They can never answer that question.

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lemm.ee

Yesterday, browsing wikipedia, stumbled on articles that talked about this very thing, on how Russia took advantage of mental health systems. They started to classify nonconforming, rebels as mentally ill. A frequently used diagnosis was sluggish schizophrenia. Anyone who was socially awkward, thought differently got this diagnosis. Cuz if someone is questioning our government, they must be sick in the head

They used this heavily for decades to discredit political rivals, forcible confinement, lock them away, work camps. Think gulag archipelago.

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lemmy.world

I agree that we should take care of our mentally disabled instead of letting them roam the streets.

I do not think that's what cheetoman would do with those institutions.

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lemmy.world

I'm British and we have our fair share of crazy homeless people. However, I was absolutely shocked when I visited San Francisco at the levels of crazy I saw wandering the streets. It was unbelievable and would just straight up not happen in the UK, these people would be in a hospital or care home.

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Mr_Blottreply
lemmy.world

Too young to remember "Care in the community", perhaps?

Btw that was Reagan's fault

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Yes too young to remember. Interesting.

Still though, the difference was stark. It does seem like less people slip through the net in the UK from my admittedly limited experience.

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lemmy.world

This is how it begins. Trump and his idiot sidekick fascist moron Mike Johnson will try to do a 1939 round 2 against all the gays, transgenders, stoners and while they're at it the jews again because fuck people.

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TechyDadreply
lemmy.world

As an American Jew, I think one of the big reasons why the right is so pro-Israel is because it gives them a place to ship people like me to. They will ignore that I was born in the US, have never been to Israel, have no plans to go there, and that my ancestors didn't even come from there. (Eventually, if you go far enough back, they might, but my attempts to trace my ancestry hit a dead end in Poland.)

The right love that they could just round up all the Jews in America, stick them on a plane, and dump us in Israel to "dispose" of us.

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Dkarmareply
lemmy.world

Duh! Why u think Israel isn't in Europe?!?! No one wanted the Jews anywhere near them so they shoved them into Palestine.

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loutrreply
sh.itjust.works

They weren't "shoved", zionism was thought up and promoted by Jewish people. Widespread antisemitism in Europe was indeed a major reason for it, but still.

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Fair. Imo they should have been given Germany instead.

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_dev_nullreply
lemmy.zxcvn.xyz

Holy fuck this is fantastic! Finally an AI use that I can get on board with, typos and all!

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That's a bit ironic, given that he should be committed to one himself.

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lemmy.world

we will bring them back to mental institutions, where they belong

As someone that struggles with mental issues, and has spent some time in a facility when I was at my worst, this line pisses me off to no end. Feels no different than what he would say about so-called criminals or immigrants. Wish he would go where he belongs.

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kbin.social

A comprehensive mental health system would have both out-patient and in-patient treatment, just like with physical health. The problem is we've had both extremes - all institutionalization, and all out-patient.

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canthidiumreply
lemmy.world

Very true. The place I stayed in for a few days was good though and they had out and in-patient treatment. And they recommended doing in-patient treatment where you would go in for most of the day but could go home after, after I did my locked in in-patient. I was happy with their treatment, but yeah, very much exception to the rule.

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jeffwreply
lemmy.world

Partial Hospitalization isn’t super rare. I wouldn’t call it an exception to the rule. Many chose not to pursue it, but programs are out there.

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Ah good to know. I hadn't seen it before, but that might just be saying more about locations I used to live. Thanks!

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lemmy.world

I get it, mental institutions are responsible for some of the most egregious human rights violations of the 20th century.

But that's an argument to REFORM those institutions, not ELIMINATE them.

We should learn from the lessons of the past and, at the same time, make sure people get the mental health care they need.

If they can be successfully treated and released? Fantastic. If they need to be held for the rest of their lives? It's better than allowing them to roam the streets posing a danger to themselves and others.

We see it in Portland ALL THE TIME.

https://www.kgw.com/article/news/crime/portland-psychiatric-facility-unity-center-behavioral-health-lawsuit-attack/283-81de7a64-3a80-4b3d-8968-53b10f9a1d95

https://www.koin.com/local/washington-county/tigard-police-patient-assaults-ambulance-crew-on-mental-health-call/

https://katu.com/news/local/hatchet-attack-in-portland-a-sign-of-a-bigger-problem-mental-health-advocate-says

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I like where your head is at but I doubt Donald thinks that way. He's not really a reform person.

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Kedlyreply
lemm.ee

I've worked in both Community Living Housing and one of the Last Institutions in Canada (Which I recently learned has closed as well). And I got FAR more training and resources to do my job at the Institution, and the residents had far more supports and programming. Even a broken clock is right twice a day, we need to reopen institutions, and just have better systems in place to prevent abuse

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Peppycitoreply
sh.itjust.works

Community Living is the institution. It certainly has its problems though.

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Kedlyreply
lemm.ee

I guess my point is that governments dont have infinite amounts of money. With traditional institutions all of the money that gets budgeted all goes towards one complex where it can be used to its fullest, which allows for better funding for staff training and better community programming for the residents, as well as specialty staff (MDC had dedicated dr's for the residents, providing them faster access to a doctor than the rest of us would get). Funding issues aside, community living is great for medium to high functioning individuals, but can be AWFUL for lower functioning ones. In an institution, a high needs low functioning individual can get more socializing in because they can have 1 staff dedicated to them while the others can just generally overlook the other residents. With community living, as the staff is spread out, this can lead to high needs individuals to be locked up in a household on their own, as there isnt the staffing to be able to let them share a place with others or to visit the community (where they would be a danger to themselves and the community). And lastly, since the staff is spread out, there are FAR more instances where theres only a single staff in the household, which personally I think actuallY INCREASES the chance of abuse

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Peppycitoreply
sh.itjust.works

I'm sure you know more than me, which should be easy since I don't know much. My mom was a community liver all my life. Bureaucracy is a fucker for sure, but I wonder if this is also a grass is greener thing? Maybe your institution was good because it was the only one? Community Living is fucked because it follows the path of all Canadian agencies? My mom certainly had nothing good to say about the nuns who ran the show in her youth.

She didn't have many good things to say about upper management in CL either though.

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Kedlyreply

I think community living is amazing for medium and high functioning individuals, if you can be guided into being safe for yourself and around others reasonably easily by a staff member? Community Living gives you a more "Normal" life. Low functioning individuals however that pose a danger to themselves and others end up far more isolated with community living than they'd be in an institution. MDC, the institution I worked at had just as horrific a history as most of the other institutions did, I think though, after working there, that was more due to the times than it was due to it being an institution, as, like I said, as of 10 years ago, there was two weeks of training before staff was even allowed to start working on any of the wings, meanwhile with community living I was kind of just thrown into the fire and had to figure things out as I went. Positives with community living mentioned though, I DO have to once again point out we live in a capitalist society, and Community Living requires more funding spread out, which is harder to pry from the government, than an institution gets, which means it inevitably ends up getting less funding for its residents.

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Maggotyreply
lemmy.world

Okay. I agree.

Now tell me with a straight face you think Orange Face is looking to help these people instead of just removing them from view.

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jordanlundreply
lemmy.world

Oh, definitely not, but that's not a reason to not try. :) It's a reason to invest and make it actually work.

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Oh for sure. I'm just not going to be surprised when these and the safe camp sites for the homeless turn into concentration camps.

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lemmy.world

Counterpoint: Mentally ill people have the same rights as everyone else and therefore can't be locked up without a criminal conviction, no matter how annoying their symptoms may be.

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jordanlundreply
lemmy.world

Then we need a national version of the Baker act to commit them for their own welfare. Just because they haven't harmed anyone else (yet) doesn't mean allowing them to roam loose isn't actively harming them themselves.

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mriormroreply
lemmy.world

How about before we look into finding ways of permanently locking away mentally ill or neurodivergent people, who are already relegated as second class citizens, we find ways of shifting our civic budgetary concerns away from bloated PD coffers and into mental health and advocacy programs instead?

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mriormroreply
lemmy.world

Yeah, no thanks. The moment you lock away groups of people "for their own good" is the moment the majority of the voting public dehumanizes them and only ever perpetuates an 'out of sight, out of mind' mentality in regards to policy.

There is a real storm coming across all of the world in regards to our collective mental health crisis and we're doing a very good job of ignoring it or thinking that reactionary policy that historically has shown to be terrible on most accounts is the best way to confront it.

This is going to play out much the same way as our climate crisis unless we start truly examining, at a policy level, why our contemporary institutions are failing us collectively.

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sh.itjust.works

I’m sure he’d love to revive the tradition of putting “troublesome” women into them.

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Yep, that was the first thing I thought of after reading the headline. I read 'The woman who.would not be silenced' and it left a big impression on me.

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One of Ronald Reagan's gifts to California was a homelessness problem. He closed down the state's asylums and never built the community based netowrk that was supposed to care for the mentally ill. The homeless caused an increse in petty crimes, which meant you needed more police and jails.

It worked so well he took it national when he was elected President.

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It's very American to struggle greatly and fail to solve issues other countries don't have.

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lemmy.world

Can't afford the rent on Mara Lago anymore eh?

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Having it classified as a mental institution should give him some huge tax breaks and government funding as well. He has certainly proved he has mental illness.

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jeffwreply
lemmy.world

Spoken like someone who has never been in one. They’re completely different places. It’s incredibly difficult to hold someone more than a day or two in an institutionalized setting. Even SCOTUS has ruled it violates your rights (Olmstead 1999). You pretty much get to a judge within a few days of an involuntary commitment (assuming it’s the weekend, less if it isn’t) and then again within a week or two. Long term holds are insanely rare.

I’ve been in them only to visit, but I’ve heard descriptions from staff (friends) and patients (former clients of mine) and it’s nothing like the 70s. The industry went through massive reforms, partially in response to One Flew Over the Cuckoo’s Nest, but insiders had been pushing since even before that in some cases.

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lemmy.world

Spoken like someone who assumes every institution is held to these standards. The quality and treatment varies WILDLY in the US across different states, or even different counties. Some are arguably borderline torture, with patients having no autonomy nor rights.

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jeffwreply
lemmy.world

Regardless of the quality of an individual facility, it’s a myth that people are held long term. Also, the quality of the worst facilities today are still a far cry from the 70s. There’s a large amount of legal protections around people being involuntary held. Nothing is comparable to legitimate torture.

To be clear, you can ONLY be held if you continue to be a threat to yourself or others. The only rights you can lose are those that involve stopping damage, violence, suicide, homicide, etc. and the more extreme the case, the more extreme the intervention. I’m not going to lie and say that people who are physically violent and attempt to harm staff don’t get chemically sedated.

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lemmy.world

It is absolutely not a myth, long term involuntary holds do continue to this day. In my state, you get a 72 hour hold to determine if you're a danger to yourself or others, followed by up to 3 month holds which can be repeated indefinitely. I can quote exact laws if that will help you grasp what I'm saying. I just got done with clinicals in a psychiatric hospital, I can assure you what you're saying is categorically incorrect.

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jeffwreply
lemmy.world

Sure, I’d love to see a quote from a state law where the 90 day hold is authorized after 72 hours. Never heard of such a model in any state I’ve lived in

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Here's a summary with the referenced law.

However, the psychologist providing treatment can recommend further care. If they think you are gravely disabled or are a threat to yourself or others, they can certify you for more treatment. If you do not agree to this treatment, it will trigger a court process under CRS 27-65-107. If you get certified for more care, it can last up to 3 months.

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jeffwreply
lemmy.world

I’ve actually met psychiatrists who work in these facilities and medications are notoriously difficult to balance. I’m sorry that you felt condescended to, but considering the insanely high legal threshold for commitment and the fact that you were approved for an entire week reflects how extreme your situation probably was.

0
lemmy.world

This is condescending. Instead of listening to the lived experience that the OP gave you, you're telling them that they must have been really sick to have to stay for a week.

Going from a 72-hour hold to a 7-day hold is relatively easy, especially in the south where I worked as a crisis responder. All you need is for a doc to recommend the additional days. Judges typically will grant the extension to 7 days with minimal input from hospital staff. Now, 14- and 21-day holds, a judge is usually going to want more. But 7? That was almost always a given if the first 72-hour went through.

Anyway, none of that really matters beyond the technical. What matters is not saying "I'm sorry you felt that way, but you probably deserved it."

1

Or, hear me out, I’ve seen way more than a sample size of 1 and have heard a bunch of people use that commenter’s complaint. Every one of them was held with good reason. I also don’t support fearmongering about vital treatment that saves lives, so it needed to be said.

That damage to society by people bashing mental health treatment is far greater than the damage to one person’s ego by me explaining that treatment doesn’t happen unless it’s necessary.

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jeffwreply
lemmy.world

Please stop spreading misinformation. You clearly don’t understand the system. As I explained in my other reply to you on this post, that’s just not how involuntary commitments work. Commitments beyond a few days are difficult, beyond a week requires such crazy evidence that some who could benefit from it don’t get it, and beyond a few weeks/a month is incredibly rare.

Obviously we need wraparound community services, but you’re pushing an outdated fiction about institutionalization.

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As I said, SCOTUS has already held its illegal. I’ve seen no case challenging that, let alone one that’s made it to a high level of appeal. Holds are up to 72 hours, meaning you see a judge by the 72nd hour. Like I said, it’s often before that. Getting a judge to extend the hold is insanely hard. The fact that they were able to extend yours speaks to how rough your situation was. I’m sorry if that sounds harsh, but I’m not trying to mince words

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Fuck the hell off trump. We dont need this kind of ableist barbarism.

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Zorquereply
kbin.social

I think he wants One Flew Over the Cuckoo's nest, not actual mental healthcare.

9

At first I thought this might be a good thing, but then I realized “wait a minute. If Trump wants it, it must be horrible and fucked up in some way.” So I read the comments.

Yeah. It’s horrible.

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