California Gov. Gavin Newsom has signed a bill that makes it easier for authorities to compel treatment for people with mental illness or addiction issues. The proposal is partly aimed at addressing the state’s growing homelessness crisis.
The trouble with incentives is that addiction is stronger.
Consider an emergency room, where a homeless person has arrived following a cardiac arrest in public. Thr person is revived and recuperating, but they require further help either for mental illness or subtance addiction.
Currently, the best the hospital can do is refer them to treatment, but they cannot compel a patient to seek treatment. If the person leaves the hospital and heads to their dealer, then they will continue to be a burden on society.
Treatment and getting better is the incentive. You’re not going to convince someone to give up drugs or alcohol by offering them tax breaks. Free meals work, but then people will show up just to get the meal, and won’t actually participate in treatment, because nobody can “force” them to be treated.
I honestly don’t know if this law will help with that. I understand the logic of it, but mental health and addiction is an extremely complicated problem. But to say “incentives work better than force” is to ignore the fact that we have incentives, and it’s not working.
I agree with you, except free housing should be available without conditions. Isn’t the threat of homelessness just another form of coercion? Americans have more than enough existing housing and food production to provide for everyone. We force artificial scarcity into both markets to preserve profits, because it’s harder to raise rents when a free option exists.
Mental health and addiction are both medical problems. Trust is always an important part of medical treatment, but trust runs both ways. Can we trust people with those issues to seek treatment on their own? Doesn’t society have a compelling interest in treating their conditions?
I’m not advocating for the police to start rounding up homeless people and dumping them in overburdened psych hospitals. I’m not even advocating for this law. We need far better treatment options, healthcare in general, and economic reform before we should ever expect to address homelessness and mental health. I just don’t think we should take anything off the table when it comes to ensuring people get treatment. Force might work for some people. It might make things worse for others. The goal, however, is worthy of discussion and the methods cannot be dismissed out of hand.
You are underestimating the type of people this law is targeting. Nobody who is just stressed out is going to be forced into an institution (although I agree the law should be carefully written to guarantee that). This is meant to get people who are full-on batshit insane off the streets and in an environment where they at least have a CHANCE of getting sorted out.
For example, I have a friend who is psychotic. No, I’m not misusing the word or exaggerating, this is a person who is sincerely and obviously psychotic, diagnosed as such by a psychiatrist, sees and hears things that are not there, believes that the government is all rape-demons from hell that are out to harvest our sanity.
When unmedicated, that is.
Once medicated, she is like “holy shit clarity thank god, keep giving me the medicine.” But if there’s ever a lapse, we go right back to the rape-demons from hell trying to force pills down her throat and the only way to save her is to, essentially, violate her by being the rape-demon from hell that forces pills down her throat. Which is of course very illegal but people care enough about her to do it anyway.
It would be very nice for it to NOT be illegal to save people from the rape-demons from hell, to have a support system in place aside from what is basically a secret cabal of friends and family as a safety net should this person end up somewhere alone and unable to access their meds.
It looks like they are also trying to implement funding for medical treatment as well, which is why the plan can be delayed up to two years.
But there are grey areas to being an immediate danger to themselves or others. If someone is walking into traffic because they are too high to be aware of their surroundings or a schizophrenic homeless man is randomly yelling at people in a park he lives in, there is a danger.
I would agree such people are a danger to themselves or others, but this law goes beyond that. Here’s the text of it if you’re interested. One need only be using drugs or alcohol or have a mental illness while being homeless.
Being “gravely disabled” means that someone is no longer able to provide for their own food, clothing, or shelter because of a mental health disorder. WIC § 5008(h). A person may be considered gravely disabled if, for instance, they are no longer eating enough to survive, or they have become unable to maintain housing.
So being homeless is being gravely disabled and can be used as a reason to forcibly commit the homeless if they use drugs or have a mental condition, regardless of whether they are a danger to themselves and others.
But it isn’t just being gravely disabled that puts you into custody.
And people keep asking for a kinder method, but what do you do when a person refuses the kinder method? From the looks of it, it sounds like California is trying to build the real housing staffed with social workers to go along with compulsory treatment.
This law might do more good than harm, I’m just concerned about its potential to be abused. Certainly there are a lot of homeless people who aren’t capable, need help, and aren’t getting it.
The law is definitely going to be used for surprise sobriety checks in cities as an excuse to begin to remove homeless encampments. However, it creates a standard of care to deal with some homeless as being sick instead of committing a crime.
The trouble with incentives is that addiction is stronger.
Consider an emergency room, where a homeless person has arrived following a cardiac arrest in public. Thr person is revived and recuperating, but they require further help either for mental illness or subtance addiction.
Currently, the best the hospital can do is refer them to treatment, but they cannot compel a patient to seek treatment. If the person leaves the hospital and heads to their dealer, then they will continue to be a burden on society.
Treatment and getting better is the incentive. You’re not going to convince someone to give up drugs or alcohol by offering them tax breaks. Free meals work, but then people will show up just to get the meal, and won’t actually participate in treatment, because nobody can “force” them to be treated.
I honestly don’t know if this law will help with that. I understand the logic of it, but mental health and addiction is an extremely complicated problem. But to say “incentives work better than force” is to ignore the fact that we have incentives, and it’s not working.
deleted by creator
I agree with you, except free housing should be available without conditions. Isn’t the threat of homelessness just another form of coercion? Americans have more than enough existing housing and food production to provide for everyone. We force artificial scarcity into both markets to preserve profits, because it’s harder to raise rents when a free option exists.
Mental health and addiction are both medical problems. Trust is always an important part of medical treatment, but trust runs both ways. Can we trust people with those issues to seek treatment on their own? Doesn’t society have a compelling interest in treating their conditions?
I’m not advocating for the police to start rounding up homeless people and dumping them in overburdened psych hospitals. I’m not even advocating for this law. We need far better treatment options, healthcare in general, and economic reform before we should ever expect to address homelessness and mental health. I just don’t think we should take anything off the table when it comes to ensuring people get treatment. Force might work for some people. It might make things worse for others. The goal, however, is worthy of discussion and the methods cannot be dismissed out of hand.
deleted by creator
You are underestimating the type of people this law is targeting. Nobody who is just stressed out is going to be forced into an institution (although I agree the law should be carefully written to guarantee that). This is meant to get people who are full-on batshit insane off the streets and in an environment where they at least have a CHANCE of getting sorted out.
For example, I have a friend who is psychotic. No, I’m not misusing the word or exaggerating, this is a person who is sincerely and obviously psychotic, diagnosed as such by a psychiatrist, sees and hears things that are not there, believes that the government is all rape-demons from hell that are out to harvest our sanity.
When unmedicated, that is.
Once medicated, she is like “holy shit clarity thank god, keep giving me the medicine.” But if there’s ever a lapse, we go right back to the rape-demons from hell trying to force pills down her throat and the only way to save her is to, essentially, violate her by being the rape-demon from hell that forces pills down her throat. Which is of course very illegal but people care enough about her to do it anyway.
It would be very nice for it to NOT be illegal to save people from the rape-demons from hell, to have a support system in place aside from what is basically a secret cabal of friends and family as a safety net should this person end up somewhere alone and unable to access their meds.
deleted by creator
The schizoid homeless this law is targeting ARE imminent dangers to themselves and others.
deleted by creator
I’d have to read the text of the bill
It looks like they are also trying to implement funding for medical treatment as well, which is why the plan can be delayed up to two years.
But there are grey areas to being an immediate danger to themselves or others. If someone is walking into traffic because they are too high to be aware of their surroundings or a schizophrenic homeless man is randomly yelling at people in a park he lives in, there is a danger.
I would agree such people are a danger to themselves or others, but this law goes beyond that. Here’s the text of it if you’re interested. One need only be using drugs or alcohol or have a mental illness while being homeless.
What is a grave disability?
So being homeless is being gravely disabled and can be used as a reason to forcibly commit the homeless if they use drugs or have a mental condition, regardless of whether they are a danger to themselves and others.
But it is along with mental health issues or substance abuse problems. It isn’t like only being homeless gets you into custody.
And custody includes putting a roof over a person’s head.
I don’t see how leaving these people in their current condition is the humane option.
deleted by creator
But it isn’t just being gravely disabled that puts you into custody.
And people keep asking for a kinder method, but what do you do when a person refuses the kinder method? From the looks of it, it sounds like California is trying to build the real housing staffed with social workers to go along with compulsory treatment.
This law might do more good than harm, I’m just concerned about its potential to be abused. Certainly there are a lot of homeless people who aren’t capable, need help, and aren’t getting it.
The law is definitely going to be used for surprise sobriety checks in cities as an excuse to begin to remove homeless encampments. However, it creates a standard of care to deal with some homeless as being sick instead of committing a crime.