We know that the longer psychosis goes untreated/the more times someone goes off the meds, the harder it is to treat, and that what happens in the first few years of someone developing a psychotic disorder makes a huge difference in long term outcomes.
An American might develop psychosis in their mid 20s, end up committed for a few weeks and placed on antipsychotic pills until they're no longer floridly psychotic, and then go home, not follow up with doctors/refill meds, and end up on a cycle of this with more and more brittle symptoms until they're homeless and have no real chance of recovery.
The same person in Northern Europe would likely be hospitalized for longer initially, started on an injectable that only needs to be given once a month, and they leave the hospital with fewer residual symptoms. They're then followed by an ACT team with a nurse visiting to check on them and make sure they're eating and keeping housing, and ensuring that shot goes in their arm every month. They don't necessarily fully recover, but a lot of them end up being able to do some kind of schooling/employment/volunteering and they are either stable enough to keep housing without being evicted for disruption, or are shuffled into staffed group homes.
In the US the system broke down in the 50s and 60s and collapsed completely in the 70s and 80s due to bad treatment options and often very inhumane conditions and cases of misdiagnoses. The widespread misdiagnosis problem only stretched the system further and compounded the existing problems. I would be curious to see where Finland's trajectory in this regard lies.
In old books you read about
https://en.wikipedia.org/wiki/Catatonia
being intractable, now it usually clears up in 15-30 minutes with benzodiazepine medication. In the 1950s we got the Phenothiazines which were the first hope for many patients, there has been a huge amount of progress since then and managing most of these people outside the hospital is possible. People also came to see involuntary commitment as immoral as described by Thomas Szasz, depicted by the movie "One Flew out of the Cuckoo's Nest" and shown by this experiment
https://en.wikipedia.org/wiki/Rosenhan_experiment
The trouble isn't that we tore down the old system but that we didn't completely build a new system to replace it. There are deep issues involving people's agency. Right now we are in a society that thinks it is wrong to make people to take drugs they don't want to take, a different society (maybe even ours in N years) will think is it wrong to not make people take drugs for serious mental illness.
It can be exasperating to care for an elderly person with dementia, they can range from very agreeable to rather disagreeable but most of them have had enough experience with caring for people and being cared for that they can have some empathy with their caregiver -- even if they have a hard time remembering it.
People with serious mental illness have disturbances in those relationships (remember how Freud asked "tell me about your mother?") and are much harder. And if they want to kill you because they think you are something other than what you are they're more able to do it.
Communities that adopted "housing first" early on had great success with it. In the fentanyl age there's a lot of fear that a volunteer or someone who isn't paid nearly enough will open a door from time to time to discover a dead body.
IMO, I'd rather have to mitigate that hazard if it meant we got actual, effective treatment for folks with super fucked-up brains than have what we have today in the US... but I'm in no position to change the country's policies.
On the other hand I'm still a touch angry that it was missed in a psych eval I had in school that, I'm told, was a really superior psych eval for a kid in the 1970s. (Kohut's Analysis of the Self was a major discovery for me when I did a round of research trying to understand an crisis at work circa 2006 but I missed the literature connecting his work to schizotypy in the 1980s; a really good monograph came out in 2013 which fell into my hands a year ago... and I think "now it all makes sense" but "I lost so much time") It's hard to come out because (i) so much about it is offputting, and (ii) I find schizotypes on YouTube to be so annoying I can't stand to listen to them for more than 30 seconds. Those of you who think there's something weird about what I write here are right... It's what you get when you mix verbal intelligence too high to measure with a good measure of line noise. At least I find it easy to emphasize with people with schizophrenia and schizoaffective because "thought disorder" doesn't seem so strange to me.
I was at risk but dodged the bullet to get schizopherenia but I worry about psychotic dementia.
At least in the US, it's basically seen now as a violation of due process to be imprisoned like that without committing any crime. Psychiatric services are on offer, but can be refused.
To clarify, I don't know much about Finnish mental health in particular as opposed to the general trends in Northern Europe.
If using the technical term, I think you might mean “Continental climate”.
From the very Wikipedia article you shared:
> The north temperate zone extends from the Tropic of Cancer (approximately 23.5° north latitude) to the Arctic Circle (approximately 66.5° north latitude). The south temperate zone extends from the Tropic of Capricorn (approximately 23.5° south latitude) to the Antarctic Circle (at approximately 66.5° south latitude).[4][5]
I thought that it broke down due to a Supreme Court decision (O’Connor v. Donaldson, 422 U.S. 563 (1975)) but perhaps they were interrelated.
In Europe such a policy might make sense, but in America where being dumped on the street is rather common the situation is different. Also, in America the general social situation is quite different from life in Finland.
Is this a studied phenomenon I can read about? I'd appreciate any literature suggestions if you have them.
I asked her where she slept. She said "you don't sleep". You don't even have to run an experiment to know that sleep deprivation, even in your own home, causes psychosis. Now add the shock of being exposed to filth for the first time, poor climate control (homeless don't walk around with multiple layers of Patagonia and a nice backpack to stash them in as it warms up), the very real threat of sexual or physical assault, the shocking awareness that you are now "one of them" and know that a sizable percentage of your acquaintances would immediately distance themselves from you if they knew your plight. We're not even talking about food and vitamin quality here.
It's popped up in the news (and in the comments here too) a bunch about how parts of the US's prescribed 'solutions' to this is to put people on antipsychotic medications. One big effect is that these medications sedate. If someone has passed out and has an inability to be roused and can hardly function if roused is an insane risk for homeless people. People aren't getting no sleep for funsies. Antipsychotics being used to chemically restrain the inconvenient is just abhorrent. Making them considerably less safe as a result is just inexcusable.
Not to mention the extrapyramidal side effects of antipsychotics that compound chronic health problems like metabolic syndrome. I'm sure that the nurse who's hardest science class was in high school who's now allowed a prescription pad after an only only diploma mill 'masters' is prescribing complex medications appropriately and managing overall health impacts of such meds when even experienced psychiatrists fuck it up (but NPs are a rant for another time.).
Having been homeless and on antipsychotic medications (thankfully not at the same time) it's just nuts to me that it's even considered a possible solution to homeless people having mental health issues (arising from circumstance or not) or being 'nuisances' is to just sedate them and leave them for dead.
Disclaimer: Antipsychotics are a tool and they can greatly impact a person's life in positive ways. Also in negative ways. They're also not just used for psychosis. I just wanted to clarify I think there's nuances in my anti antipsychotic rant here lol
> The transition to using the word "homeless" has resulted in transforming something we can't easily measure -- "drug addicted or mentally ill people being a public menace" -- into something that we can measure -- "people without a good living arrangement".
> the former is the actual problem that we care about
The word homeless is pretty old, not something people have 'tranistioned' to any time recently.
I haven't seen anyone trying use 'homeless' as a euphemism; they are actually concerned about people without housing. That is the big problem.
You apparently believe "drug addicted or mentally ill people being a public menace" is a comparable problem, but your comment is the first time I've heard that. Nobody is conspiring to hide it; they just don't think about it like you do.
I spend a lot of time in cities and know others who do too. None feel menaced by people who are unhoused - why would that be menacing? - or high. High people generally don't know you are there, and are easily avoided. I've had zero problems; I don't know of anyone else who has.
Also, the subtext is about eroding human rights. You have no more rights than a homeless or high person. Feeling 'menaced' is not sufficient to compromise someone's freedom. That's what freedom means - of course people can always do things that others don't mind; freedom means doing things other people don't like. I find your comment menacing; who decides who gets locked up?
This is completely detached from reality. I find it hard to believe you are being truthful unless you're doing some sort of gotcha where you carry a gun or are some sort of jiu-jitsu master. Here's an example of people being afraid of the homeless and another of drug addicts, just from last year in NYC but there's thousands of examples.
- Why throngs of NYC’s homeless are choosing Penn Station over shelters — and leaving commuters in a constant state of fear https://nypost.com/2024/08/28/us-news/nycs-homeless-cheer-pe...
- Business owners and residents along Midtown Manhattan’s “Strip of Despair” are so frequently robbed and harassed by drug-addled “psychopaths” that they’ve stopped trying to resist — or even bother calling the cops for help. https://nypost.com/2024/06/17/us-news/horror-stories-from-ny...
I don't mean to say with this that ALL of them are dangerous, but you trying to portray that you never even heard of someone being afraid of homeless or drug addicts and the trouble they sometimes create is like saying you don't know which color the sky is. Like you honestly never seen an aggressive person who is high?
Anyway if not, I can tell you I've had a drunk homeless guy throw a bottle at me for no reason other than walking home. The next day I talked to him and now I know Cyril, my local homeless drunk and high Russian guy, and sometimes give him socks, but even he admits that when he drinks and huffs nitrous he gets a bit crazy.
what's completely detached from reality is that the problem is so bad in (US) cities like NYC that it seems inconceivable that it isn't a universal truth that cities just have an indigent population that regularly threatens and sometimes follows through on threats of violence to passersby.
How did we let the problem get this bad‽
You don't know how ridiculous that is. Stop watching propaganda and just visit NYC. I'm tempted to buy you a ticket. Or just ask someone who lives there.
Makes you wonder how badly social media is distorting the rest of our lives.
As someone who has lived in San Francisco, CA for the past long-ass while, I agree with the paragraph that you're objecting to. I own no firearms, and can hardly throw a pillow, let alone a person.
Maybe try, like, talking to more homeless folks? Or at least observing them from a distance? They're folks like anyone else, and most of them (like most folks) simply don't want police attention, so doing anything more to regular folks than asking for spare change isn't in their repertoire. Honestly, I'm a LOT safer in the parts of the city where there are folks out on the street than I am places where there's noone. [0]
[0] The only times I've gotten mugged or robbed were when I was in the fancy parts of town where there's noone on the street to provide assistance... and my assailants were groups of folks who looked to be doing well for themselves, rather than rough-looking folks looking for cash for a score.
Bitcoin bros!
Well if you say so, but it's reality. Have you lived in a city? I think you would know.
> https://nypost.com/...
The post pushes right-wing propaganda; it's a Rupert Murdoch publication, the same as Fox News. Ignore it.
Manhatten is so safe it's dull. It's lost its edge, its variety, its lifeblood which is the dynamic people. Really, I'm not kidding you. Look up the crime stats. Or just go visit - if more people would stop believing the right-wing nonsense and just see things for themselves, they'd be much happier (and how about holding the the NY Post, etc. accountable?).
> Like you honestly never seen an aggressive person who is high?
No, or if they are aggressive, they are aggressive to the empty air around them - I don't engage in conversation. But people high on opiods, which is most common by far, are quiescent. Some are basically asleep standing up, drooling in place. Very scary!
Wow.
I agree that it's an often implied issue, but I think the sub-subtext, the point of it all, is far more serious: whether you can do things to other people - via the state or personally - for arbitrary reasons. That is, whether people have universal human rights. That is the elephant they are hunting.
They have found their best test cases, their best steps toward destroying universal human rights, with homeless people, people without legal immigration status, and those engaging in progressive protests.
They won't stop there, of course. It's either human rights for all or for none.
Only when we meet people in the fearful place they're at, and they feel heard, can we start to try to make them see that the fear is not justified or rational compared with the actual risk posed by the homeless or mentally ill or what have you.
I do agree, it's human rights for everyone or no-one.
I recently visited NYC and understand your specific angle, but "homeless" actually can just mean "person without a home" without connotations of mental issues or substance abuse.
There are extreme cases where people willfully live under bridges or something but that's super rare.
"Nothing ever happens" says person nothing happened to. Meanwhile, these are just some examples that made the news:
* https://www.bbc.co.uk/news/world-us-canada-67386865 "A suspect has been arrested two days after former US Senator Martha McSally reported being sexually assaulted while on a run in Iowa [...] The suspect, who is thought to be homeless,"
* https://www.bbc.co.uk/news/uk-england-derbyshire-65569357 "Derby homeless man raped women who offered to help him"
* https://www.bbc.co.uk/news/uk-41484206 "A "manipulative" homeless man who turned on a family who befriended him has admitted the "frenzied" murder of the mother and her 13-year-old son."
* https://www.reuters.com/article/lifestyle/life-sentence-for-... "A severely mentally ill man was sentenced to life in prison on Friday for beheading a Hollywood screenwriter [...] a homeless former Marine described by his lawyer as "very, very mentally ill", pleaded guilty [...] in a crime without motive."
* https://www.cbsnews.com/losangeles/news/long-beach-woman-sex... "Long Beach woman sexually assaulted by homeless man in broad daylight"
Fortunately I haven't witnessed any murders or rapes, but the most shocking for me was that I've visited Vancouver twice in my life, and on both visits, lone women walking down the street in broad daylight were chased after and opportunisticly molested by drunk vagrants hanging around on Robson Street. Broad daylight. They had absolutely no shame. And other than the molested women fighting them off and running away, nobody did or said anything.
Everyone has a right to walk about in public unmolested, and I would want the police to arrest those men and prosecute them for sexual assault.
You're delusional or misinformed if you think this doesn't happen. Of course it happens.
On the other hand, you can be molested or assaulted by drunk and beligerent homed people. And, more importantly, homeless people are much more at risk of assault or rape by the homed, than the homed are of being assaulted and raped by the homeless. For all the articles I linked above, they are dwarfed by news reports of homeless people being shot, beaten, stabbed, set on fire or raped.
So, overall, homeless people as a whole are neither saints nor devils. They are who they are, and each individual has a different situation. We should feel a lot of empathy for them, and want to help them into a less precarious position... but we also want to do it because we're mindful of the danger to the public that untreated mental illness poses.
Maybe """ "Nothing ever happens" says person nothing happened to.""" is honestly telling the truth that they don't concieve of anything happening to them because they live outside of this insane bubble we're in that it's just accepted for cities to just have a violent homeless population that "we can't do anything about". Maybe we're the idiots in this situation.
> you can be molested or assaulted by drunk and beligerent homed people. And, more importantly, homeless people are much more at risk
I don't know enough to say "much" more, but I think those are good points. There's nothing special about being homeless, in terms of crime, except you are much more exposed to it.
> on both visits, lone women walking down the street in broad daylight were chased after and opportunisticly molested by drunk vagrants hanging around on Robson Street. Broad daylight.
How do I spend so much time in cities and never see anything like that? I'm sure some of these stories people tell are true, but wow.
What will you do with this person after you've committed them? It turns out that forcing people to detox isn't effective. Addiction is a disease with no reliable cure; you can't just give someone a round of antibiotics.
But if you think it's possible, demonstrate it to the world: Get yourself addicted, then detox, and you should be fine!
If your assertion is that getting someone off of drugs in the short term plays absolutely no role in getting someone off drugs in the long term, then I'm not really sure what to say to you. It's my understanding that people primarily get and stay sober out of fear of losing absolutely everything and dying. The trouble with rehabilitating the homeless is that they've effectively lost everything but their lives, and yet remain addicted. In this sort of situation, involuntary commitment would necessarily have to involve serious attempts at community building to show them they can have things in their life again - if they stay clean.
Respectfully, your glibness and the borderline denial of reality makes it difficult to have this conversation because I don't feel as if I'm typing with someone who legitimately wants to improve the situation. Most seriously, your suggestion that I get myself addicted to drugs (which demonstrates that you've completely neglected to consider that you could be typing with a person who has had substance abuse issues - it hasn't even occured to you) indicates that you're not taking this seriously, but rather attempting to appear virtuous by banging on about freedom and being totally unafraid while preventing any possible consideration of solutions to a major humanitarian crisis.
That is the wages of fear. It results in attacks on the things that alarm us, including other commenters, unhoused people, and addicted people. Unhoused and addicted people are nothing to fear.
And on top of that, fear doesn't justify hurting other people. It's a very different thing being afraid and vulnerable, and being afraid and in a position of power. You have a position of power relative to unhoused and addicted people. Power corrupts; powerful people don't have a check on them; they think their hunger or fear or lust or whatever are important, are the natural priority. Your fear isn't a priority over the freedom, rights, and welfare of addicted people.
The only thing to fear is fear itself, according to someone who was smart, courageous, and who had led people through danger we can't imagine, and held positions of great power.
Your theory of how addiction and homelessness work conflicts with what I've heard from many experts I've spoken to and that I've read. That doesn't make you wrong, but look up the research.
It is telling that your opinion isn't based on talking with addicted and/or homeless people.
> How disappointing that you are resorting to the ad hominem attacks; we could have learned from each other; we could have connected.
I think you should still consider learning from what Boogie_Man said.
If you don’t think it’s a problem then give me your address so I can yell at you through the window and poop on the sidewalk. Part and parcel of living in a big city, right?
If I want to get a homeless person off of drugs, it sure as crisps is not going to happen until they have a roof over their head. The core issue is the lack of affordable housing. That should be priority number 1.
I have multiple family members who fit this pattern and it's absolutely godawful. The addiction literally rules them. They will perpetually ask for money for "needs" then spend it on drugs. If another family member houses them, they will sneakily maintain their addiction and steal from family to support it when necessary. If you offer them housing on condition of getting sober, they will choose addiction and homelessness. If you offer them housing without condition, they will use it to stay an addict in perpetuity, who everyone else is paying for. I don't think this last is a remotely viable solution with the number of addicts out there, which is only growing.
I'm not saying this to condemn addicts/mentally ill people. I just want to give an idea of just how hard this problem is to fix.
The problem is that people can end up homeless for all sorts of reasons, and even if that reason is some sort of mental illness, being homeless is an often-traumatic experience that easily exacerbates and worsens a person's mental condition.
There was a period of my life where I slept rough (long story) and I can personally confirm that a lack of sleep security (not to mention "stuff security", the fear of having my meager possessions stolen) will start someone on the path to mental illness; some amount of paranoia and mental fog seems almost inevitable in those conditions.
providing active junkies:
1) completely free units to destroy 2) 24/7 emergency care teams 3) completely free healthcare and mental healthcare 4) no sobriety expectations of any sort 5) no possibility to be kicked out of the program for any reason
is going to be cheaper than putting them in jail or an institution? wow sounds almost too good to be true
it would be interesting (or funny) to get a summary on exactly how they are deriving the cost metric for this. i would just about guarantee they've taken creative liberties to make the numbers fit.
according to HUD[0] infestations, flooding, and fires are "typical behavior problems" in housing first programs. only in "extreme circumstances" does this warrant switching them to another unit. there is no way these are cheap damages to fix.
housing first programs are often mixed into ordinary developments too. i bet families living near or adjacent to these units really enjoy living next to completely unstable addicts. housing first programs explicitly prioritize the least stable, most mentally ill addicts too. but it's the humane thing to do at everyone else's expense.
a lot of cities in the US have a housing first program, among many other programs in a similar vein (ie safe injection sites). take san francisco for example. they spend billions of dollars every year on programs for the homeless. from what i hear the situation is still terrible. there are even businesses moving out of SF directly citing quality of life.
the cost of living in my city is so expensive that there are adults that work full time who have to have roommates to live at subsistence level. there are also housing first programs here that give junkies units for free to continue getting high in indefinitely. this is a ridiculous situation. either way i would rather it cost more to have people institutionalized or put in jail for breaking the law. this would also do good for actually having resources to help the ones who are actually down on their luck.
In terms of cost, we need to look at the total social cost. If (big if) we were to assume that property destruction in housing units costs money, it is no strech to think that any marginal decrease in for example medical expenses (much more expensive in total social resource terms) more than make up for it. And a marginal improvement in a long-term expensive social problem would easily justify a high initial upfront cost.
I'm not saying you're wrong for asking the question, just that I have no problem accepting the findings that housing first is a cheaper solution in the long run if it gets more people clean and off the streets--as the evidence indicates.
why would there be a decrease rather than an increase? they're linked up with a full time care team as well as paths for more healthcare services. they also are allowed to continue to destroy their body with drugs. a local newspaper just ran an article here about how many health problems they have when they get into the local program.
yes i am very bias about the topic, and it wouldnt matter to me if it were much cheaper. but it truly doesnt sound plausible. i do not think setting up society so that people can comfortably get high all day, for free, at everyone else's expense, is a good or fair setup. there are many people struggling to stay afloat. maybe we could focus on solving that first. or focusing on the sober homeless.
So is what the US is doing right now working? Just the in healthcare, the US pays more per person when addressing this problem than anywhere else in the world, and gets nearly the worst result. Isn't that alone worth trying something else?
The fact that you're paying for a drug user to be warm and safe may stick in your craw, but it helps more people get clean, and so is good for them, their families, society and even your neighborhood as they return to be productive members of society. The money spent on their childhood and education isn't "wasted". They are less likely to be a nuisance.
Your feelings of disgust towards these people is a natural reaction. But if you can manage to see past it and realize these are human beings no different than you, by far and away mostly people who want to get clean but find it impossible in their circumstances and need help doing so, then you could be part of the chorus of voices pushing for positive change.
Let's all pull in the same direction: strong social safety nets, community building and mental health care to prevent people falling to drugs. And if they do, the care and assistance they need to pull themselves out of it. Not everyone's going to manage to do it, but eveyrone deserves a solid second chance.
> 1) completely free units to destroy 2) 24/7 emergency care teams 3) completely free healthcare and mental healthcare 4) no sobriety expectations of any sort 5) no possibility to be kicked out of the program for any reason
> is going to be cheaper than putting them in jail or an institution? wow sounds almost too good to be true
Both of those are very expensive (about $100 a day for incarceration [1] and up to around $1000 a day for psychiatric treatment [2]) – and obviously a housing first program is not a drop-in replacement for them either as being homeless in itself is neither a crime nor a mental illness. I would also wager a destructive addict in their own home causes less property damage (on average) than one in temporary housing / on the streets. A 24/7 emergency care team is not a thing in assisted living facilities in Finland, and the housing provided by housing first programs is not at all limited to assisted living facilities – it is often just a completely regular rental apartment. And healthcare and mental healthcare are (nearly) free for anyone, not just "junkies". And the other two points are not even related to costs.
> housing first programs are often mixed into ordinary developments too. i bet families living near or adjacent to these units really enjoy living next to completely unstable addicts.
Actually I think it's beneficial if addicts are not lumped together in a stigmatized "housing first development". To maximize chances of rehabilitation and integration in society addicts need to be surrounded by well-functioning people, not other addicts. Otherwise you're just creating a slum where being an addict is normalized, and the problems continue to spread and get worse.
> housing first programs explicitly prioritize the least stable, most mentally ill addicts too.
Of course sufficient resources must exist to help everyone so the prioritization does not mean some people get no access to help they need. In Finland we use a broad definition of homelessness which includes people staying with relatives or friends. Providing housing to those groups helps prevent long-term homelessness. [3, p. 13-14]
> the cost of living in my city is so expensive that there are adults that work full time who have to have roommates to live at subsistence level. there are also housing first programs here that give junkies units for free to continue getting high in indefinitely. this is a ridiculous situation.
I agree the situation is ridiculous. An essential part of the housing first approach (that seems to be entirely neglected in the US) is to build enough affordable homes.
[1] https://www.federalregister.gov/documents/2019/11/19/2019-24...
[2] https://pubmed.ncbi.nlm.nih.gov/22588167/
[3] https://ysaatio.fi/wp-content/uploads/2018/01/A_Home_of_Your...
i have seen estimates saying 50% are addicted to substances. in any case housing first prioritizes the most unstable and mentally ill to give immediate housing. this is a very typical feature of the program. if you are finnish, you should check out some videos of what our homeless are like. it's obviously not the same for multiple reasons.
>Actually I think it's beneficial if addicts are not lumped together in a stigmatized "housing first development".
again, to everyone else's detriment.
>An essential part of the housing first approach (that seems to be entirely neglected in the US) is to build enough affordable homes.
this is a funny statement considering wages in finland vs real estate prices. ive been told by a top 5% income finn that buying a house is not really possible for most people there currently. you can only inherit. the wages are lower, the taxes much higher, and real estate more expensive. of course you probably mean the technical "affordable housing" definition which just means housing for anyone making under median area income. the money to fund these things comes from somewhere, and it seems to typically always be the middle class.
Income is lower but actually taxes are fairly similar in the lower income brackets thanks to progressive taxation (and I'm not too concerned about the top earners starving). Buying a home in Helsinki – which is the only place in Finland where real estate prices are actually a problem – takes about 9 year median income, quite similar to cities in the US. Outside the Helsinki metropolitan area real estate prices are not bad at all. Either way if you're top 5% income you can easily afford to buy a house.
> of course you probably mean the technical "affordable housing" definition which just means housing for anyone making under median area income. the money to fund these things comes from somewhere, and it seems to typically always be the middle class.
Abundance of apartments affects prices for everyone including the middle class. The only ones not benefiting from affordable housing are (literal) rent-seekers, the people and companies owning real estate purely as an investment.
outside the area where 30% of the entire country lives? ok. the actual number of years for helinski metropolitan area appears to be 10, and is higher than boston and nyc which are both INCREDIBLY expensive places to live. note that is generously comparing the actual cities to the metrpolitan area of helsinki.
the next largest metropolitan area is tampere, which is 6.9 years at median salary. this is very slightly cheaper than where i live which is also a very expensive city to live in. the city i live in is straight up not affordable to buy a house in at median salary.
>Either way if you're top 5% income you can easily afford to buy a house.
they are able to, but this wasnt the point of what they said. you have to be top 5% to comfortably own. doing some number crunching with chatgpt (lets pretend its accurate) to own at median salary in tampere requires more than 50% of your post tax income. that's with a 20% downpayment on a 300k house.
if i got any of those numbers wrong, feel free to correct. in the interest of time, they were done with chatgpt. i believe the prompts and data asked for should be simple enough to be accurate.
>and I'm not too concerned about the top earners starving
should also be noted that this top earning income is the equivalent of 80k USD. if they lived in the US they would be making double that. in the us, this is near median in a lot of places, and quite attainable in most.
"Finland’s success is not a matter of luck or the outcome of “quick fixes.” Rather, it is the result of a sustained, well-resourced national strategy, driven by a “Housing First” approach, which provides people experiencing homelessness with immediate, independent, permanent housing, rather than temporary accommodation (OECD, 2020)"
I’m Finnish and I have a close family member with a severe mental illness, so I should be reasonably well positioned to answer your question. But it doesn’t make any sense to me.
How does any of this relate to homelessness?
To get people off the streets, you give them a place to live. Then you can start solving their other problems. It’s common sense.
This misguided moral compass outweighs even sensible practices like harm reduction. People would rather see junkies die on the street of hepatitis than give them free housing and needles. It satisfies some primal need that, eventually I hope, our species will be better off with less of.
Why would these parasites deserve anything else than a basic (read: not unconditional gibs) chance to get out of this mess while some decent people struggle to live while still playing by the rules? You'd give "free permanent housing" to junkies while ignoring normal people living from hand to mouth? Because yes, resources are limited and should go to those deserving and actually capable of giving back to the system. Successful socialism isn't the same as charity.
Even worse, these basic chances make sense in the US, but in western Europe where socialism is in its "train without brakes" phase, no. If you managed to fail in this context, you're the failure, not the system.
you should use some of the superhuman empathy you have to explore other perspectives on the issue. even for just a minute.
Because, if so... let's just sit with that for a second and think it through.
it's important to note that it's probably not a very large set of them that dump their needles publicly. this is outright sociopathic and evil, which i don't think most of them are. this distinction is important because the sociopathic homeless do make it a much more taboo issue to deal with.
Housing support with social services on the side can be done well enough to help some fraction of the drug-using homeless recover. Some fraction may remain drug addicted, but now have a safe space, which is also an improvement. Some fraction may have lasting mental illnesses they struggle with, but even then a safe space for that struggle improves both the prognosis and the surrounding community.
the original context was a ridiculous characterization of anyone being against a needle program. i am giving you one context of why someone might be against one, from the perspective of how it has been going in my city. whether standard protocol or poorly implemented, that is how it has been going.
>You spend a lot of time accusing others of dishonesty and condescending, but your own comments read much more in that spirit.
the condescension is hard to avoid when replies are posing snarky rhetorical questions which make understanding or addressing anything difficult. if you felt i've been dishonest, feel free to point it out. but preferably not in the way you did a second ago which took the form of "SO WE SHOULDN'T DO ANYTHING TO IMPROVE EVER?" which was clearly a good faith interpretation.
I don’t know how you get from that to “ridiculous characterization of anyone against a needle program.” Needle programs aren’t even the most important thing under discussion here, housing is. As you’re pointing out, knowingly or not, needle programs in isolation reduce some harms but increase others. Housing is often the root issue in harm reduction, but also one of the most expensive and politically charged.
But there's no evidence that drug services increase drug use.
This may not be exactly the quote, but it was something like "Disorder is domination of public space for private purposes."
As an SF resident, that really resonated; day-to-day quality of life here (for me, at least) feels much more impacted by that type of "disorder" than "homelessness" generally (obviously we need housing solutions too)
[1] https://www.nytimes.com/2024/10/18/opinion/ezra-klein-podcas...
The first thought I had on reading this was ‘the world has a car disorder’.
Finland also is rather aggressive with involuntary detention of those deemed to be a potential danger to themselves or others.
A major upside: if you lose your job, you won't be at risk of becoming homeless! it would allow you to take a much stronger negotiating position with your boss. It would allow you to take a much stronger position with your landlord regarding rent increases too.
The housing first initiative in Salt Lake City provides ample evidence that if people have a stable living situation it is way easier to get them to take their medication, get into rehab, keep them out of dangerous situations. It’s actually more cost effective in the long term to house the chronically homeless instead of kicking the can down the road.
If you actually care about what you claim to care about you should be supporting housing first.
That means 1) get people housed with minimal red tape and basically no conditions 2) treat mental health and drug addiction
The evidence is clear that it works and that it is more cost effective than dealing with the fallout when homeless people unravel.
Unfortunately politicians who had preconceived notions about this topic ignored the evidence and revoked funding for the program. Your statement that it is impossible to treat or cure mental illness and drug addiction (which the evidence does not support) places you in that camp. You, my friend are the worst part of the problem. Because the evidence exists to disprove your stance, but you hold a strong opinion without having bothered to check the science.
Their education system is pretty interesting, and their policing system has some approaches to interacting with the community as well. If I can find the links I'll share.
Skepticism is fine, but it shouldn't be a reason to discount or dismiss something, nor does it mean to accept it. Take it in as a data point.
I think, frankly, and I base this on experience with family undergoing involuntary commitment in Europe... we really are still a bit collectively traumatized or basing our takes on what happened prior here in the US from past abuse of involuntary commitment systems.
It can be compassionate. It can help people get psychiatric and psychological help they didn't know how to access. It can help get people back on their feet and transition them into a return to normalcy. It can work.
If your country is small and rich, government can be highly functional. But please stop comparing it to a larger place, it's apples to oranges.
The state implemented the vaccination program and transferred responsibility to the insurance pool system with its own financial interests. The pool system determines assessment criteria and makes evaluations without external oversight. Initially, there was talk of "million-euro compensations." The government guaranteed to finance the remainder if pool funds were depleted.
Legal cases have been fought against LVP regarding time limits of confirmed cases. Compensations have remained a fraction of original expectations. Narcolepsy patients are too small a minority to influence Parliamentary politics or re-enter public discourse. This special group has been left alone to defend their rights within the pool system.
The compensations were based on Käypä Hoito Guidelines for accident injuries, which are unsuitable for narcolepsy: narcolepsy doesn't necessarily cause clear cognitive deficits despite its severity, and comparison to brain trauma is not medically possible. The drafters would probably agree if asked that it wasn't intended for this use. A person with narcolepsy can be formally capable of work, but this might consume all of their alert hours & energy, leaving nothing for actually having a life. The system may equate narcolepsy, in permanent damage, with injuries similar to a broken finger in workplace accidents, hence the permanent disability compensations are insufficient for dignified life.
The wage compensation issue is more significant. The determination basis for loss of earnings compensation is problematic as it's based on achieved education and work history, although the illness has impaired these opportunities. The same neurological illness produces different compensations depending on onset timing, as those with established careers may fare better than those who couldn't compete for university placement. This particularly affects those who became ill in childhood/youth, as it doesn't account for lost opportunities. In practice, even those from educated backgrounds with academic potential (e.g. top grades or plans for university before narcolepsy) may receive compensation based on average or low income.
Opportunity cost compensation appears unlikely. The state has not promoted reassessment of applicability of Käypä Hoito criteria.
There is insufficient monitoring of equality in compensation decisions and appeals, inadequate communication about compensations (the question whether all victims are even aware of their rights seems open), and questionable document management and decision-making transparency. LVP defines compensation terms, makes compensation decisions, and handles appeals, creating a conflict of interest as LVP has financial incentive for strict interpretation.
Permanent damage compensations are treated as earned income by Kela, requiring their use for basic living expenses, though they're meant as lifetime compensations for an incurable neurological illness.
(this is partly machine-translated from personal notes)
Not understanding how homelessness (or poverty generally) leads to mental illness is remarkably disconnected.
The "visible" homeless, ironically, are extremely difficult to measure. They often don't carry or won't present identification, they often have no family or support structure, they often make little to no attempt to use services.
The "invisible" homeless are the opposite, and can be easily measured, because they have all of those things.
When you see numbers trying to measure homeless people, it will almost always be the "invisible" homeless. Sending people out with clickers to count the homeless people on the street is nearly impossible, so the best we can do is various sampling approaches with huge margins of error.
It's foremost NOT about mental&substance issues treatment but general financial aid to anyone in need.
I think this phraze from the article summarizes it well.
"The Finnish experience demonstrates the effectiveness of tackling homelessness through a combination of financial assistance, integrated and targeted support services and more supply: "
It's a holistic system that actually kicks-in way before one is in danger of being homeless, and if someone would suddenly find themselves homeless, the state security blanket is available to all. So 1. direct assistance 2. support services and 3. supply.
On the first order, this is not related to substance abuse or mental illness, and should not be viewed as such. They are just a way to make sure nobody freezes to death.
The way these policies link with mental&substance issues is that before 90's you were denied housing if you had ongoing substance abuse issues. This policy was dialed back to allow all housing regardless of any other issues, specifically because it was considered being homeless does not help in any way to resolve the above matters.
So viewing this as "something only for ill people" is the wrong lens. It's a system for everyone. Of course mentally ill and those suffering substance issue are often without financial means so they are represented in the population receiving support.
But the actual treatment to the above issues is a separate policy matter (after nobody was excluded anymore).
The downside is that unless a polity has similar wide cover social security system in place, I have no idea what learnings you could get from this.
US is rich. Vastly richer than Finland. PPP GDP for US in 2023 was 73k $ and for Finland 64k $.
The systems are quite different. But it’s not about total wealth as such. If we use GDP as rough back-of-the-envelope estimate (problematic I know!) us could implement similar system economically but politically probably not.
The gini coefficient gives some hints about these differences (US 0.48, FI 0.28). In Finland people are taxed until there are very little income differences and then that money is used for social policies and healthcare. So everybody gets high quality healthcare for all of the serious stuff (until you reach best-before-date and government pulls the plug), you never need to freeze to death, go hungry (in theory at least) and your kids will have free education. Based on my limited understanding of US politics and social structure I find similar arrangement improbable.
But it’s not about country’s total wealth!
> us could implement similar system economically but politically probably not.
But they won't. Spending significant amounts of money on your poor is a decision made by politicians and society as a whole. Some countries choose to do it, some don't.
> But it’s not about country’s total wealth!
Again, the existence of more billionaires does not make a place rich. In fact it could prove destabilizing in the long term because billionaires use their money to lobby against policies for the poor.
The answer I suppose is that both Finland and US are rich by global standards, but the US has a middle class only because of policy decisions it made post WW2 (GI Act, housing, education, etc.) that are quickly eroding.
So yes, Finland is "richer" in the sense that a greater % of its population live better lives.
The transition to using the word "homeless" has resulted in transforming something we can't easily measure -- "drug addicted or mentally ill people being a public menace" -- into something that we can measure -- "people without a good living arrangement".
Sure, the latter is important in a lot of ways too. And there housing is a tolerable solution.
But the former is the actual problem that we care about. It's nearly impossible to measure. It's nearly impossible to fix. The horrors of involuntary commitment vs. the horrors of not having involuntary commitment vs. the horrors of using the criminal justice system vs. the horrors of not using the criminal justice system.
The fact is that we have no real model for treatment of severely mentally ill people. We have a number of effective drugs, but they rapidly become ineffective if not taken. Our ability to treat or "cure" people in these conditions is essentially non-existent.
The question I would ask of Finland before considering this data or analysis to be interesting is what is their state of involuntary indefinite commitment.