News for hackers. Stuff that matters.
Re:Parents Break Teen Out of Mayo Clinic by outside1234 on Monday August 13, 2018 @06:35PM (#17754097)
On the flip side, we have thousands of obviously mentally ill people on the street homeless because we can't commit them because of that human autonomy that you mention.

It all points to public healthcare where there is governance at a political level and not profit level.

Re:Parents Break Teen Out of Mayo Clinic by lylecubed on Monday August 13, 2018 @06:48PM (#17754157)
It's unconscionable to suggest that hospitals be allowed to legally kidnap people because of something as hand wavy as 'some homeless are mentally ill'.
Re:Parents Break Teen Out of Mayo Clinic by PiggySpeed on Monday August 13, 2018 @07:06PM (#17754254)
This is a complicated issue. I've seen this happen in practice. As long as the process remains conservative and respectful of the patient, it results in better outcomes for the patient and a more peaceful society.

The cases where I have seen this happen: schizophrenia, drug-induced psychosis, acute mania, dementia.

Patients come out far better in an institutionalized setting, as opposed to being on the streets and walking aimlessly in dangerous traffic.

Re:Parents Break Teen Out of Mayo Clinic by theoh on Monday August 13, 2018 @10:58PM (#17755281)
Having experienced this: I think the word "conservative" doesn't quite capture the severity of detaining someone for mental health reasons. It has been argued that when someone is detained on mental health grounds, this is equivalent to a breach or suspension of the social contract in respect of that person. It is extremely unsatisfactory, though it might be a least bad option.

Outcomes might be better than if there was no intervention, but that doesn't necessarily imply that mental health services are effectively doing anything more than providing "protective custody".

Re:Parents Break Teen Out of Mayo Clinic by lylecubed on Monday August 13, 2018 @07:27PM (#17754371)
There's a huge, gigantic, gaping chasm between a hospital patient with no history of mental illness with two parents, neither of which have a history of mental illness, and a schizophrenic homeless person. Saying one has anything to do with the other to justify a hospital kidnapping its own patients is seriously messed up.
Re:Parents Break Teen Out of Mayo Clinic by PiggySpeed on Monday August 13, 2018 @07:36PM (#17754427)
I was referring to your reply to outside1234's comment. His answer was in the scope of the "obviously mentally ill" population. And I addressed your reply to that.

It is incorrect to take my response outside of its intended context and attempt to attack it there.

[dead]
Re:Parents Break Teen Out of Mayo Clinic by PiggySpeed on Monday August 13, 2018 @07:52PM (#17754527)
Context change was implied as soon as the respondent began with the words "on the flip side...". The topic in this sub-tree is now about that "flip side". Discussion has expanded into new areas.
[dead]
Re:Parents Break Teen Out of Mayo Clinic by PiggySpeed on Monday August 13, 2018 @08:20PM (#17754675)
Waste of time. I won't entertain this any further.
Re:Parents Break Teen Out of Mayo Clinic by modells on Monday August 13, 2018 @07:35PM (#17754420)
Reagan’s LPS Act didn’t apply any nuance, common-sense or transition when defunding JFK’s community treatment program, and just dumped people whom aren’t in contact with reality or self-care onto the street. Complete lawlessness is infinite tyranny.
Re:Parents Break Teen Out of Mayo Clinic by briandear on Monday August 13, 2018 @08:12PM (#17754641)
https://www.nytimes.com/1984/10/30/science/how-release-of-me...

Also, O’Conner vs. Donaldson was the key case that caused a significant shift in mental health treatment.

Blaming Reagan is intellectually lazy.

Re:Parents Break Teen Out of Mayo Clinic by mnw21cam on Tuesday August 14, 2018 @06:59AM (#17756817)
Committing someone to enforced treatment is an absolutely massive action. In the UK, it requires a police officer, doctor, and social worker to all agree that it is necessary.
Re:Parents Break Teen Out of Mayo Clinic by DanBC on Tuesday August 14, 2018 @07:14AM (#17756862)
It doesn't require police.

There are different forms of detention, and different forms of forced treatment.

These are described (for England) in the Mental Health Act.

This is what it means to be sectioned - you are detained under section of the mental health act.

The most common sections are:

Section 136: a police officer can detain you in a public place and take you to a place of safety to be assessed. This requires one police officer. It lasts a maximum of 24 hours (but it can be extended by 12 hours).

Section 2: this is a short 28 day hold for assessment and treatment. It requires 2 doctors and an AMHP. Traditionally AMHPs were social workers, but they don't have to be and there are increasing numbers of nurses becoming AMHPs.

Section 3: this is a six month hold for treatment. It requires 2 doctors and an AMHP.

Section 4 is another short term hold (72 hours) that can be used in emergencies if there's only 1 doctor available.

https://www.rethink.org/living-with-mental-illness/mental-he...

Re:Parents Break Teen Out of Mayo Clinic by DoreenMichele on Monday August 13, 2018 @09:31PM (#17754956)
Some people are on the street because it is the least worst option available to them.

They changed the law in part because of the horrifying conditions under which people were living who had been committed.

Having slept in a tent for nearly 6 years, I would take that over de facto imprisonment in an asylum any day. I did spend 10 days in an asylum in my teens. This is not an uninformed opinion by any stretch.

Re:Parents Break Teen Out of Mayo Clinic by DaiPlusPlus on Thursday August 16, 2018 @07:11AM (#17773619)
What if “asylums” were much better funded and better equipped - closer to (if not exceeding) celebrity rehab facilities than today’s popular-culture impression of an archaic asylum?
Re:Parents Break Teen Out of Mayo Clinic by DoreenMichele on Thursday August 16, 2018 @07:44AM (#17773777)
My sister actually works for the CDC and she's had cancer multiple times. She was patient zero in a study in another state from the one she lived in. One of the times she had cancer, she flew regularly to a state of the art facility for about 18 months to not die from her very aggressive form of cancer.

At that time, we were still close. When we talked on the phone, we would quote some Star Trek line about "Good God Jim, you can't leave him in the hands of 20th Century medicine!"

(Not the quote, but the rescue scene where the good doctor describes chemo as "sounds like the Spanish Inquisition": https://www.youtube.com/watch?v=MMaGnpVaSGQ)

I was in a really nice facility. I was not crazy. I was just a teenager who had been molested and raped by a relative who was not old enough to legally advocate for myself. (it's a long story)

You would need to do better than merely throwing money at the problem and upgrading our current cages to cushy gilded cages for me to feel that it had some hope of being better than sleeping in a tent in the woods on my own recognizance.

"Bars do not a prison make". And gilded bars do not a civilized climate make by any stretch of the imagination.

Re:Parents Break Teen Out of Mayo Clinic by mikestew on Monday August 13, 2018 @07:11PM (#17754284)
obviously mentally ill people on the street homeless because we can't commit them because of that human autonomy that you mention.

Obviously mentally ill, or politically out of favor? I see what you're getting at, and I'm sympathetic. OTOH, history has shown that slope to be unbelievably steep and not very grippy, IMO. I wish I had even the remotest hint where to start to find the happy medium.

Re:Parents Break Teen Out of Mayo Clinic by ams6110 on Monday August 13, 2018 @07:10PM (#17754276)
> It all points to public healthcare where there is governance at a political level and not profit level.

Might want to consider that political abuse of psychiatric diagnoses to get opponents or agitators involuntarily committed to asylums or hospitals is not exactly unheard of.

Re:Parents Break Teen Out of Mayo Clinic by lapinot on Monday August 13, 2018 @08:18PM (#17754667)
This is plain stupid. A for-profit hospital will benefit from abusing any patient while a political abuse only targets a small portion of opponents. And political abuse is an issue of the counter-powers in your political system, not of the way hospitals work: a functional political system will have functional public hospitals, but a functional economy will have private hospitals whose interests diverge substantially from the patients ones.
Re:Parents Break Teen Out of Mayo Clinic by Gibbon1 on Tuesday August 14, 2018 @06:28AM (#17756676)
> This is plain stupid.

Not stupid you are just young and ill informed.

> While on a phone call with Helen Thomas about the Watergate break-in, King pulled the phone cord from the wall. She was held against her will in a California hotel room and forcefully sedated by a psychiatrist after a physical struggle with five men that left her needing stitches.

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

Re:Parents Break Teen Out of Mayo Clinic by lapinot on Tuesday August 14, 2018 @07:32AM (#17756940)
I'm not saying this does not exist, i'm pretty aware that this is a real problem. I'm just saying that this remark--even if true and on point--doesn't constitute a valid argument against public hospitals since (1) this problem of public hospitals has already a much more widespread cousin in the private sector and (2) it is not intrinsically a problem of the hospital but a governance issue (which is called power abuse and has a lot of other symptoms).
Re:Parents Break Teen Out of Mayo Clinic by Gibbon1 on Tuesday August 14, 2018 @08:14PM (#17762970)
The US got really leery of committing people to mental hospitals on little hard evidence because the power was being widely abused.

The usual argument is there options in between living on the streets and being imprisoned in a mental hospital. My brother is mildly retarded and lives in a apartment complex where there very minimal supervision. He has a car and a job and can come and go as he pleases. 'Supervision' is there mostly to protect him from 'us' not the other way around.

Re:Parents Break Teen Out of Mayo Clinic by grandmczeb on Monday August 13, 2018 @06:52PM (#17754185)
> It all points to public healthcare where there is governance at a political level and not profit level.

Because no-one has ever been kidnapped for political reasons?

Re:Parents Break Teen Out of Mayo Clinic by danharaj on Monday August 13, 2018 @06:43PM (#17754132)
> we have thousands of obviously mentally ill people on the street homeless because we can't commit them because of that human autonomy that you mention.

I think there's more to it than that, if we look at some graphs over time.

Re:Parents Break Teen Out of Mayo Clinic by ChuckMcM on Monday August 13, 2018 @06:54PM (#17754194)
It is always nuanced of course. The inability to lock people up in California as a result of the patients rights act[1] had its effects, but a general backing off of mental institutions from both the Federal and State governments was a big problem. The 55% number in [1] matches up with my experience with homeless in the Bay Area. The tricky bit is that survivor bias is an issue as well as mentally ill people are less likely to 'blend in' and keep a low profile so in street encounters it can seem like a higher percentage than it is. Similarly in food kitchen lines the mentally ill are at a disadvantage if they lack planning skills to get into the line.

[1] 2015 In the San Francisco Homeless Count, 55 percent of people experiencing chronic homelessness report they have emotional or psychiatric conditions. -- https://www.kqed.org/news/11209729/did-the-emptying-of-menta...

Re:Parents Break Teen Out of Mayo Clinic by TheCoelacanth on Wednesday August 15, 2018 @12:07PM (#17767127)
Have these homeless people been offered housing and treatment in a setting that preserves their autonomy and turned that down? I highly doubt it. Commitment shouldn't even be under consideration except for people who have refused treatment without confinement.
Re:Parents Break Teen Out of Mayo Clinic by fsloth on Tuesday August 14, 2018 @06:46AM (#17756760)
"obviously mentally ill people on the street homeless"

The problem with forced treatment is that while there is a category of people who can be said to be in need of help, there are others who are quite within their right to do with their lives whatever they please, as long as they are not explicitly breaking the law, but prefer non-conventional life choices.

The main problem with enforced norms is that it pigeonholes everyone into "standard acceptable human" categorization, and if you don't fit into it, you become an outlaw.

The western societies had great fun categorizing people into various abnormality groups, leading into practical eugenics (forced sterilizatin) and forced incarceration. See for example [0].

Germany's 1940's escapades brought this arbitrary categorization fad to an end with the holocaust, where it became explicitly clear what the logical end result is when you start mass categorizing people into first-grade and second-grade citizens.

I have close relatives who would have benefitted from forced treatment, but I still prefer a society that does not do this.

True, there is a difference between eugenics and declaring someone 'too sick', but not that great actually since we don't really have a reliable gauge for a persons mental health - hence, it becomes arbitrary categorization based on just not falling within subjective norms of the dominating culture within society.

[0] https://www.nature.com/scitable/forums/genetics-generation/a...

Re:Parents Break Teen Out of Mayo Clinic by maze-le on Tuesday August 14, 2018 @07:00AM (#17756818)
As you pointed out: " there is a category of people who can be said to be in need of help, there are others who are quite within their right to do with their lives whatever they please". But, if you only provide help to those who need it and are willing to accept it, there would be no forced-treatment-problem like described. I am convinced that quite a few of the "homeless, mentally ill" would be willing to accept help, that they are usually denied (because of the lack of a house, job and insurance).
Re:Parents Break Teen Out of Mayo Clinic by TomMarius on Tuesday August 14, 2018 @08:17AM (#17757181)
Reposting a comment I made in another thread here:

But public healthcare service is much worse in my experience. I'm forced to be a part of a public system but I'd very much prefer to be able to pay private insurance and use private hospitals. We have private hospitals, but the government insurance isn't accepted there (because the law and the system doesn't allow it) and that makes it prohibitively expensive to me even though I'm a software developer for a USA company making nearly 6 figures - I'd have more than enough money for private services, but the government demands so much that I simply don't have enough left, and so I'm forced to take the "free" services (very huge quotes as I'm paying US$1500 per month for my government health insurance specifically - it's a separate line on my tax report).

Anecdotal story: One time I've driven my girlfriend to a major hospital (in the capital city of the country) because she had acute abdomen pains and the ambulance wouldn't even get there within 20 minutes (again, I live in the capital city). We spent more than 4 hours waiting before somebody even looked at her even though I tried really hard to get someone to look at her immediately, it simply wasn't possible; during our journey from the main gate to the emergency room, we were met with extreme disinterest in anything regarding our well being or providing good services at all. They sent me to a wrong building THREE TIMES while I was carrying her in hands even though I asked VERY CLEARLY where the emergency service is. When we got there, I had to pay around 100 CZK (5 USD) to even get into a queue, but no one told us, with no signs or anything around - the problem is that I specifically asked THE GUY THAT I LATER PAID TO if we need to do something. He didn't even look at me and he didn't even know where is the emergency room in his building. And then I had to pay around 50 USD for parking there for so long.

I have many first-hand experiences like that, e.g. you wouldn't believe the conditions and treatment that awaits you if you need to be hospitalized (5 and more people in one room, of course no AC, one shower and 2 toilets for ~10 rooms, one electrical socket for the whole room, of course no internet, TV always on at full volume, food that couldn't even be considered leftovers from neighboring low-tier restaurants, total disinterest of nurses and straight-up anger towards patients that need anything, people often need to have their beds in the hallway because there are not enough rooms, etc).

If you're pregnant, tough luck, there are literally 5 year-long queues to get into a "good" hospital (very low quality by US standards) and if you want something that is at least of average quality by US standards, you have only two options: Corruption or private - I have a whole savings account for that, but I'm a high income individual (it costs around US$50k in a private "high quality" hospital that'd be considered below average in the US, and there is no way to insure yourself against expenses in private hospitals, and even if there was, it'd be on top of the US$1500 I'm already paying).

My grandfather died because of these low quality services, but of course tough luck suing anyone or getting any compensation, that's simply not possible because "that's just how it is" is considered to be acceptable defense of the hospital and the system. Even if you're successful, the biggest compensation ever granted (and that happened just once) was around US$10k.

The only thing that is "good" (average compared to the US) is what we call "high-intensive hospital care", but you don't get into that very often - that's a completely separate department for people with very severe illness or very severe other problems, and of course even if you really need it, qualifying for it is very hard because there are not enough places.

Fuck public healthcare services. I'm completely okay with donating (even through taxes) some sum of money so everyone can have access to healthcare, but I want to buy my own healthcare services on a free market.

I live in Central Europe, btw. I expect downvotes to flow, but it'd be nice to have a discussion, so please, reply instead of downvoting if possible.

Re:Parents Break Teen Out of Mayo Clinic by GFischer on Thursday August 16, 2018 @02:44PM (#17777442)
That sounds like incredibly awful implementation. I live in Uruguay where we have a hybrid system, it's single-payer in that everything is funded through the state, but you have a choice of medical systems, mostly are Mutual Organizations ("Mutualistas").

And, while there are some bad wait times for non-life threatening surgery, I consider the overall system really good. My sister-in-law had major surgery and hospitalization and care was very good.

It's not so strict as a pure "public" service, and there are state-managed hospitals where you can get bad experiences like crowding and bad care, but never to the level you're describing.

And I can (and did) choose to have some better services on top of the basic ones so I have amazing emergency services and same-day specialists, for an extra 200 dollars (on top of my mandatory health tax bill which is also like 500 dollars).

http://www.expatfinder.com/uruguay/expat-guides/article/heal...

Re:Parents Break Teen Out of Mayo Clinic by anon08142018 on Tuesday August 14, 2018 @04:22PM (#17761546)
As someone who lives in the US, its frustrating to me that many people will read your anecdote and simply think that any public funding of healthcare equals communism, "death panels", delayed care, and abysmal levels of service.

My anecdote is that here in the US, if you lose your job and find yourself without insurance, you can literally go bankrupt from a relatively minor injury or sickness due to the extreme cost of medical care. There are plenty of long lines, bad doctors, and low quality hospitals here too so its not like you get rid of those things by going private. People decline to call the ambulance because they are afraid of getting charged thousands of dollars for it if their injury is not covered by insurance which sometimes ends in their death.

I watched my mom die in the hospital and if it weren't for a recent law passed by Obama, we would have had to dip into what little savings we had just to keep her comfortable for her last few days. There is a lot of space for a middle ground that does not need to be limited by your experience or mine.

Re:Parents Break Teen Out of Mayo Clinic by TomMarius on Tuesday August 14, 2018 @04:41PM (#17761702)
I agree completely, neither extreme is ideal. As I said, I think that given current system it's desirable to fund basic healthcare from taxes, but I think there should be an option to avoid state services if I decide to do so. The major problem in my story isn't insurance itself even though it's expensive as hell, it's that the hospital isn't a business and I'm unable to use my mandatory insurance to cover private healthcare costs. I personally think the Swiss system is good.

I never wanted to imply that private services are always high quality, but there definitely is more motivation and it shows - while there might be a considerable portion of bad hospitals in the US, here are literally just a handful below average ones (compared to the US) in my country and it's impossible to get there legally.

Of course low quality hospital beats no hospital, but you should be able to fix that with some kind of mandatory insurance that is state-sponsored if the person is poor, for example, no? Don't forget that I'm reacting to a comment praising public hospitals from control reasons, not about absence of social safety.

I don't understand why people in the US can't or don't pay their insurance themselves instead of through their employer, though. Seems like a huge risk - well you described it.

Re:Parents Break Teen Out of Mayo Clinic by anon08142018 on Wednesday August 15, 2018 @09:30AM (#17765857)
Because insurance is a private industry and there are few goverment assisted options if you are very poor its very expensive to purchase it by yourself in the US. Private insurance has every incentive to keep raising prices and to keep lobbying the government to stay away from the market.

Your employer can group all of their employees into a single risk pool, so each employee gets a discounted rate. When you purchase insurance on your own you are no longer in a group and so the cost is far more. Doctors are also incentivized to prescribe you drugs you don't need and drugs that insurance covers instead of the correct medication.

My wife had to wait to get surgery on her leg because she just signed up with a new employer and didn't have insurance yet. If she had gotten the surgery without insurance it would have cost somewhere around $100k US.

Re:Parents Break Teen Out of Mayo Clinic by TomMarius on Wednesday August 15, 2018 @09:34AM (#17765885)
> Because insurance is a private industry and there are few goverment assisted options if you are very poor its very expensive to purchase it by yourself in the US. Private insurance has every incentive to keep raising prices and to keep lobbying the government to stay away from the market.

This is proven to be false by Switzerland, where people purchase their private health insurance themselves.

Re:Parents Break Teen Out of Mayo Clinic by anon08142018 on Wednesday August 15, 2018 @09:53AM (#17766015)
Yes, lots of things are possible. I imagine there are both cultural and regulatory differences between the health insurance market in Switzerland vs the US.
Re:Parents Break Teen Out of Mayo Clinic by TomMarius on Wednesday August 15, 2018 @09:57AM (#17766036)
Yes, I agree. I suspect it's a regulatory problem, that's why I asked - I'd like to know the specifics.
Re:Parents Break Teen Out of Mayo Clinic by anon08142018 on Wednesday August 15, 2018 @10:15AM (#17766148)
This link seems to cover a lot of the differences. It sounds like a decent system, but not one that would ever work in the US. The private healthcare companies have too much to money to lose and would use the media to frame such as system as communist and dangerous.

https://www.quora.com/What-is-the-difference-between-the-US-...

Re:Parents Break Teen Out of Mayo Clinic by TomMarius on Wednesday August 15, 2018 @11:15AM (#17766643)
If that's true, then literally any plans for public hospitals or healthcare insurance are doomed from the beginning, isn't that right?
Re:Parents Break Teen Out of Mayo Clinic by anon08142018 on Wednesday August 15, 2018 @11:38AM (#17766889)
Basically. That is a good summary of the political debate over healthcare for the last few decades in the US.
Re:Parents Break Teen Out of Mayo Clinic by hollandheese on Tuesday August 14, 2018 @05:11PM (#17761936)
Obviously you haven't been to many US hospitals if you think the care is much better than that here.
Re:Parents Break Teen Out of Mayo Clinic by TomMarius on Tuesday August 14, 2018 @05:37PM (#17762143)
I was always given an opportunity of choice in the US and I never paid that much. I can't really choose a hospital here, the public ones are all the same and the mandatory insurance makes private care unavailable. I was also never met with such bad behavior towards patients, yeah it wasn't perfect, but it was helpful and I was treated as a person, not a piece of shit that is disturbing and isn't worth a look.

I'm in no way praising the US system though. Just saying that public hospitals have been tried and it's really bad. I think the Swiss system is good.

Re:Parents Break Teen Out of Mayo Clinic by throwaway080383 on Monday August 13, 2018 @09:28PM (#17754945)
We can't commit them because mental hospitals keep getting closed.
Re:Parents Break Teen Out of Mayo Clinic by crankylinuxuser on Tuesday August 14, 2018 @08:13AM (#17757158)
Justifiably so. When a "hospital" has more power over penal settings and indefinite imprisonment combined with no oversight, its time for them to go.

I'm sure there is a good balance here, somewhere. But what we had and now have isn't it. A better balance feels like it should include a judge, 2 doctors with at least 2 hr patient time for each, and someone else that the patient knows.

Re:Parents Break Teen Out of Mayo Clinic by throwaway080383 on Wednesday August 15, 2018 @11:21PM (#17771643)
The hospitals aren't being closed due to some guilt over them bearing too many similarities to the prison-industrial complex. They're being closed to save money, and the patients are thrown out on the street. Quite the opposite direction of paying more doctors to help these people.