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Whatever other issues they may have, they are overwhelmingly mentally ill, largely schizophrenic, and the surrender in the US happened just outside your fifty-y

Whatever other issues they may have, they are overwhelmingly mentally ill, largely schizophrenic, and the surrender in the US happened just outside your fifty-year window when the Supreme Court decided that it should be much harder to institutionalize someone against their will. The timing was similar in the UK, from what I have read. Don’t know about the EU. The problem with severe schizophrenics is that they don’t like and won’t take their meds if left to their own devices [EDIT: regardless of how much social support you provide, even though we certainly didn’t provide enough]. Institutions are in no way perfect, but One Flew Over the Cuckoo’s Nest is not a documentary.

WorldMaker 22d ago
The causation arrow isn't unidirectional, though. Mental illness causes some homelessness, particularly often because in the US healthcare system medications are expensive and can lead to bankruptcy. (And it is certainly not the only path to bankruptcy in the US either.) But more and more studies are showing that the biggest problem with homelessness in the US is that it causes mental illness. (Same thing is being found with drug addictions: some cause bankruptcy and then homelessness, but to cope with homelessness many find new addictions after becoming homeless.) Most homeless shelters are run by religious charities. The majority of them treat homelessness as a sin, either by intentional policy or accidents of attitude. These "charities" often require a lot of work to keep being allowed to use their housing at their shelter from regular job hunting to regularly attending worship sessions to "zero tolerance" policies on everything from curse words to keeping private possessions to having pets to sometimes taking/keeping necessary medication. It's hard to keep your mental health in good shape when the groups that are housing you in the worst weather are berating you for being terrible sinners and treating you like prisoners. Outside of shelters the most common interactions between homeless people and the cities around them are interactions with cops, who very rarely have mental health training or social work experience, and treat homeless people like criminals because their job is sometimes to treat everybody as would be criminals. You ever really talk to a homeless person? The ones that really survive become very organized. They have a list of shelters memorized, which months they prefer to be at each one, what things they need to fake about themselves they need to do to survive in that shelter for a few weeks, how much "rent" they need to raise before they get there (some shelters often cost pennies per day just to show that the homeless person is "working" somehow; some homeless panhandle just to afford shelters), and exactly how long they can stay before they inevitably get kicked out (most shelters are "short term", intentionally). Just listening to all the rules and regulations and requirements makes me think I would go schizophrenic dealing with that world. It sounds like being stuck in a middle school that never ends, if that middle school's "classrooms" were all in entirely different parts of a city and all had deeply different rules. I can easily see why homelessness often causes mental illness in the US. Institutions are close to the right answer, but for an entirely different reason than you assert. We do need better secular institutions (in the endowed place of learning sense, not the mental hospital sense) with mental health as one goal among several such as long-term support in charge of dealing with the homeless. The numbers keep showing that the greatest fix we've found for homelessness is making sure that everyone has a home where they feel safe and private and don't have to do anything to "earn" much less keep that home.
- devilbunny 22d ago
  Right, so, what do you do about the guy who smears feces on the walls and won't take his meds? Because that guy is the one who makes public spaces unlivable. Including places like SRO hotels that actually could provide people with affordable living spaces.
  - gambiting 22d ago
    That's the guy who should be institutionalised, obviously?
    - devilbunny 22d ago
      Yeah, except that because the Warren Court was so incredibly arrogant, it's almost impossible to institutionalize anyone against their will in the US unless you go through all the process of setting up guardianship.
  - WorldMaker 22d ago
    This (straw) man scenario feels like a proximate cause versus root cause situation to me. You've managed to establish a relatively strong proximate cause (or so it seems) as "won't take his meds". Where did he get the meds he was supposed to take? How is he paying for them? Was he given the meds in a place of safety and security enough to have reason to trust the meds might help? If you were given strange meds that you don't understand anything about by someone who wasn't your personal doctor in a situation that feels like a prison out of your control, would you take them? That's equally a straw man question, but a useful one to maybe establish empathy for the situation that homeless "guy" might have found himself in. That's also assuming that is the correct proximate cause. As far as I know science has not yet found exactly a "don't use excrement as spray paint" drug. There are people that will do that which don't need meds and there are people that will do that even on most anti-psychotic meds. But let's talk about some of the root cause of it all: If you find yourself in a world that you cannot control, that won't let you use any bathroom without buying a coffee/being a customer, that doesn't want you to exist, that says you are only as valuable as the property that you own but then won't allow you any longer to own any property due to some bad luck or misfortune, at that point "the only spray paint I have to send a message about how much this world sucks" might seem pretty clear. I find it easy to have sympathy with that sort of (straw) man, because there is a logic to it. It's not necessarily a psychotic break. At least, not necessarily at first a psychotic break. What would I personally do to prevent that? I'd try to prevent people from being homeless in the first place. I'd try to get people mental health resources sooner ahead of crises rather than trying it do it in the middle of a different one (bankruptcy/homelessness). Which is the same as I suggested statistically seems to be the only thing that works: give people private houses with locks and keys and help them feel safe and secure in them, with a sense of ownership and privacy, and with no need to "earn" it or "rent" to keep it. Maybe it doesn't stop the person from covering "their own" walls in feces until they feel safe and secure enough (and that's still a public health problem in the meantime) to try an antipsychotic med that they need to take. But as far as I'm aware no one wants to take or trust an antipsychotic medication if they don't at first feel like they live in a safe enough or secure enough place. Which again also circles back to "institutions are almost the correct approach, but for the wrong reasons" I mentioned before. A place with mental health resources seems to be an important part of that, still, but I don't think you can address mental health problems in a prison, especially in a society that values private property and private spaces, without first addressing the problems around homeless not having access to private property and private spaces. But yeah, that's mostly just my opinion on the subject based on statistics and studies that I've read. You don't have to take my word on it. One archived secondary source (with additional links): https://academicweb.nd.edu/~rwilliam/ndonly/readings/SocProblems/05-WealthPoverty/Giving%20homes%20to%20the%20homeless%20is%20cheaper%20than%20leaving%20them%20on%20the%20streets%20-%20Feb%202019.pdf https://academicweb.nd.edu/~rwilliam/ndonly/readings/SocProb...

WorldMaker 22d ago

The causation arrow isn't unidirectional, though. Mental illness causes some homelessness, particularly often because in the US healthcare system medications are expensive and can lead to bankruptcy. (And it is certainly not the only path to bankruptcy in the US either.) But more and more studies are showing that the biggest problem with homelessness in the US is that it causes mental illness. (Same thing is being found with drug addictions: some cause bankruptcy and then homelessness, but to cope with homelessness many find new addictions after becoming homeless.) Most homeless shelters are run by religious charities. The majority of them treat homelessness as a sin, either by intentional policy or accidents of attitude. These "charities" often require a lot of work to keep being allowed to use their housing at their shelter from regular job hunting to regularly attending worship sessions to "zero tolerance" policies on everything from curse words to keeping private possessions to having pets to sometimes taking/keeping necessary medication. It's hard to keep your mental health in good shape when the groups that are housing you in the worst weather are berating you for being terrible sinners and treating you like prisoners. Outside of shelters the most common interactions between homeless people and the cities around them are interactions with cops, who very rarely have mental health training or social work experience, and treat homeless people like criminals because their job is sometimes to treat everybody as would be criminals. You ever really talk to a homeless person? The ones that really survive become very organized. They have a list of shelters memorized, which months they prefer to be at each one, what things they need to fake about themselves they need to do to survive in that shelter for a few weeks, how much "rent" they need to raise before they get there (some shelters often cost pennies per day just to show that the homeless person is "working" somehow; some homeless panhandle just to afford shelters), and exactly how long they can stay before they inevitably get kicked out (most shelters are "short term", intentionally). Just listening to all the rules and regulations and requirements makes me think I would go schizophrenic dealing with that world. It sounds like being stuck in a middle school that never ends, if that middle school's "classrooms" were all in entirely different parts of a city and all had deeply different rules. I can easily see why homelessness often causes mental illness in the US. Institutions are close to the right answer, but for an entirely different reason than you assert. We do need better secular institutions (in the endowed place of learning sense, not the mental hospital sense) with mental health as one goal among several such as long-term support in charge of dealing with the homeless. The numbers keep showing that the greatest fix we've found for homelessness is making sure that everyone has a home where they feel safe and private and don't have to do anything to "earn" much less keep that home.

devilbunny 22d ago
Right, so, what do you do about the guy who smears feces on the walls and won't take his meds? Because that guy is the one who makes public spaces unlivable. Including places like SRO hotels that actually could provide people with affordable living spaces.
- gambiting 22d ago
  That's the guy who should be institutionalised, obviously?
  - devilbunny 22d ago
    Yeah, except that because the Warren Court was so incredibly arrogant, it's almost impossible to institutionalize anyone against their will in the US unless you go through all the process of setting up guardianship.
- WorldMaker 22d ago
  This (straw) man scenario feels like a proximate cause versus root cause situation to me. You've managed to establish a relatively strong proximate cause (or so it seems) as "won't take his meds". Where did he get the meds he was supposed to take? How is he paying for them? Was he given the meds in a place of safety and security enough to have reason to trust the meds might help? If you were given strange meds that you don't understand anything about by someone who wasn't your personal doctor in a situation that feels like a prison out of your control, would you take them? That's equally a straw man question, but a useful one to maybe establish empathy for the situation that homeless "guy" might have found himself in. That's also assuming that is the correct proximate cause. As far as I know science has not yet found exactly a "don't use excrement as spray paint" drug. There are people that will do that which don't need meds and there are people that will do that even on most anti-psychotic meds. But let's talk about some of the root cause of it all: If you find yourself in a world that you cannot control, that won't let you use any bathroom without buying a coffee/being a customer, that doesn't want you to exist, that says you are only as valuable as the property that you own but then won't allow you any longer to own any property due to some bad luck or misfortune, at that point "the only spray paint I have to send a message about how much this world sucks" might seem pretty clear. I find it easy to have sympathy with that sort of (straw) man, because there is a logic to it. It's not necessarily a psychotic break. At least, not necessarily at first a psychotic break. What would I personally do to prevent that? I'd try to prevent people from being homeless in the first place. I'd try to get people mental health resources sooner ahead of crises rather than trying it do it in the middle of a different one (bankruptcy/homelessness). Which is the same as I suggested statistically seems to be the only thing that works: give people private houses with locks and keys and help them feel safe and secure in them, with a sense of ownership and privacy, and with no need to "earn" it or "rent" to keep it. Maybe it doesn't stop the person from covering "their own" walls in feces until they feel safe and secure enough (and that's still a public health problem in the meantime) to try an antipsychotic med that they need to take. But as far as I'm aware no one wants to take or trust an antipsychotic medication if they don't at first feel like they live in a safe enough or secure enough place. Which again also circles back to "institutions are almost the correct approach, but for the wrong reasons" I mentioned before. A place with mental health resources seems to be an important part of that, still, but I don't think you can address mental health problems in a prison, especially in a society that values private property and private spaces, without first addressing the problems around homeless not having access to private property and private spaces. But yeah, that's mostly just my opinion on the subject based on statistics and studies that I've read. You don't have to take my word on it. One archived secondary source (with additional links): https://academicweb.nd.edu/~rwilliam/ndonly/readings/SocProblems/05-WealthPoverty/Giving%20homes%20to%20the%20homeless%20is%20cheaper%20than%20leaving%20them%20on%20the%20streets%20-%20Feb%202019.pdf https://academicweb.nd.edu/~rwilliam/ndonly/readings/SocProb...