My grandmother was in an institution for a while after a miscarriage and a grandfather after the Korean war. The abuse of patients / inmates in those days was very bad.
There was never really a moment where we stopped as a society and demanded a full account of all the things (sexual abuse, drugging people into compliance, electroshock as punishment, etc) that happened back then, the abusers by and large got away scott free as we quietly shut down the "hospitals".
Isn't this generally the norm historically for everything? It seems extremely rare that there's ever a full accounting of atrocities committed by a state and justice administered. The Nuremberg Trials are one case where such an attempt was made, but even here it fell far short of real justice as only the people at the very top were prosecuted, which apparently led Winston Churchill to set up a "death squad" of assassins to find the lower-ranking Germans who were involved and murder them extra-judicially. And this is for an action (the Holocaust) where it was so infamous and horrible there's a special word for it, and the trials were conducted by the victors after a brutal world war in which the Germans suffered a humiliating and utter defeat. With things done by the US government to its own citizens, they're lucky if they get an apology before they die, many decades later, probably from some President who wasn't even alive when it happened.
And a nontrivial number of those people are there as a result (to some degree or another) of their mental illness. We're already paying the cost, we're just doing it in a particularly ineffective, inefficient, and cruel way.
That never prevented him to create a word soup to rationalize his claim of having a grasp on any other macro reality he has no skin in, or to build elaborate social engineering schemes and solutions for everything based on EA.
Note in Scott's argument, how it's taken for granted that the US can't possibly build such facilities to hold and help "tens of thousands of people", but never acknowleding that it can trivially have prisons that hold 1,230,100 people (2022, Bureau of Justice Statistics).