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Re:What American Mental Health Care Is Missing by lazide on Monday February 14, 2022 @04:00PM (#30338269)
And for people that won't take paths back? And are actively harming the people around them?

Those people exist. Not a huge number of them, but they have an outsized effect.

We used to have sanitariums, or locked folks up in jail if they got that bad. They suck, it's expensive, they are ripe for abuse.

But having random insane people wandering the streets accosting people, or in rare cases even murdering them, isn't working either.

Re:What American Mental Health Care Is Missing by DoreenMichele on Monday February 14, 2022 @04:05PM (#30338350)
Crisis management is always a necessity during a crisis but you don't crisis manage your way to a solution.

I'm not interested in investing more of my time in crisis management for this problem space. I'm looking to find ways to actually shrink the problem.

I'm not saying we should stop doing any crisis management and I'm baffled that multiple people are reacting as if I had.

I'm saying one key piece is we need to resolve our housing supply issues. It's one piece. It's not a comprehensive solution but I think it's really important and far too many people seem to think lack of housing is somehow wholly unrelated to homelessness, which also baffles me.

I don't see how anyone can assert that but I run into pretty frequently.

Re:What American Mental Health Care Is Missing by lazide on Monday February 14, 2022 @04:26PM (#30338575)
The crisis management (in California referred to as 5150) is a revolving door that only 'helps' anyone by temporarily patching them up and letting them go back to whatever bad habits and environment got them there in the first place.

Better housing will help some. Better accessible care will help some. Better other things will help some.

But there is no fall through default option here being exercised if those options don't help those who aren't helped enough by those options they stop being a repeated danger to themselves or others. In theory it's possible to still get committed. It's almost impossible to actually get committed (as in persistently kept away from society in a controlled institution), and those places are so underfunded and terrible, the street might actually produce better outcomes for everyone.

'Crisis management' is about taking a crisis and not making it a crisis anymore.

But it's generally about a short term emergency intervention, not about long term control of a situation that is fundamentally unstable, unsound, and not 'resolvable' due to a persons own actions. There are people who cannot and will not do what is necessary to stay sane. There are not a lot of them. But they do exist.

We can reduce the overall size of the problem through housing reform. But it doesn't remove the need for some kind of not-a-humanitarian-disaster institutionalization in a non trivial number of cases