Something has been bothering me for the better part of two decades.  How do we help people who are mentally ill and addicted when they refuse to avail themselves of resources set up to help them?  We've all seen them.  They're the perpetual panhandlers.  They're the ones who refuse to go to cold weather shelters when it's six degrees outside and end of dying on the streets.  They're the ones prescribed and given medications, but do not take them (sometimes selling them for quick cash).  They're the ones walking around at 8am carrying a small bottle of fortified wine in a paper bag, or hanging out in an alley waiting for people to stop walking by in order to shoot up.  They're the disheveled ones shouting profanities at no one in particular as they walk down the street.  They're the ones who seem to have a knack for making the worst possible life decisions at pretty much every turn.

 

I'm not talking here about people who are just down on their luck in this "great" country that drives people with illnesses into poverty.  Those "down on their luck" people will often at least try to find/use services set up by private charities and the government to help themselves.  I'm talking about those that cannot seem to be helped as they have no urge, will or ability to even get help for themselves.  The only solution now seems to be to pursue these individuals via the criminal code in order to compel them to get the help they need.

 

I know when we used to have mental institutions that the issues weren't as bad, but there were issues with abuse of the system locking up individuals who shouldn't be there.  It's been suggested we can do things here and there like paying people to walk the streets in advance of severe weather to compel people into shelters.  Regardless of what we could try, any solution would require resources/money.  With the current state of politics in this country it's harder than ever to care for the vulnerable in our society.  Are there any ideas out there for things we can do to get the best bang for our buck to help these individuals?  What about if money were no object?  What could we do to help what I'm calling the "incapable" in our cities?

I think a big reason why you see people refusing to use shelters during cold weather and other recovery services is that they have histories with other people in that world and want to avoid them.  That's why it's important, I think, for every city to have multiple services and locations instead of a single large location. 

 

I volunteered for a few days at Our Daily Bread in Over-the-Rhine back in 2006, back when the neighborhood was still very rough.  It was amazing to see how the homeless people loved coming there for lunch and a movie since it was the only time in the day when anyone treated them with any respect. 

 

I know when we used to have mental institutions that the issues weren't as bad, but there were issues with abuse of the system locking up individuals who shouldn't be there.

Questionable treatment of those locked up was also a major issue, whether they were locked up legitimately or otherwise.

Some of the shelters also don't let them drink. I'm sure they have a lot of really good reasons for that, but if goinf in there means that you're going to be stuck sober overnight in a huge room of congregated males I can see why it would be unappealing.

Some of the shelters also don't let them drink. I'm sure they have a lot of really good reasons for that, but if goinf in there means that you're going to be stuck sober overnight in a huge room of congregated males I can see why it would be unappealing.

 

Yeah I did one of those 3-day weekends at the Talbert House back in 2005.  They separate the men from the women and there is obviously no drinking.  They had about 30 guys sleeping in each room, so plenty of snoring aside from all of the agitation in the air. 

 

 

So what would be the solution to the cold shelter problem to make it more accommodating?  Would it be to allow alcohol, mixed gender rooms, smaller rooms, etc...?  I'm not really liking any of these options except maybe somewhat smaller rooms.  It would be better to have them off the streets in the first place, but given behavior issues and addictions I don't know how to house these individuals except in a secured facility.  The only way to do that now would be through compulsory confinement which takes us back to criminal court.  As I said I'm at a loss.

Universal basic income

Wouldn't giving giving cash to these "incapable" individuals just be pouring gasoline on fire though?  I've noticed that the panhandlers near our home will immediately turn over any money collected into buying drugs and alcohol.  After a short break to get their fix they return right back to where they got the money to try and get their next fix.  I'd be curious to hear how to use this Universal Basic Income idea to help those that cannot handle the regular payments.

Nothing can keep a determined individual from destroying themselves.  But we can eliminate the rationale that there's no hope.  There are plenty of self-destructive addicts whose inherited wealth is the only reason they're not freezing on that same corner.  Nobody suggests those people deserve the torture of homelessness, but only because someone else took care of it and we don't have to see it.  Either the mentally ill deserve torture or they don't.  Shouldn't matter whose kids they are.

There are plenty of self-destructive addicts whose inherited wealth is the only reason they're not freezing on that same corner. 

 

Guns 'N Roses, though they earned the money

"There was no shortage of beds in shelters in the frigid pre-dawn hours when Ken Martin died this week, said the head of local agencies working on behalf of the city's homeless.

 

The problem is getting people to use them."

 

This article describes exactly what has vexed me for years.  I just can't get my brain around any real solutions for this problem other than nibbling at the edges of it.

 

https://www.wcpo.com/news/local-news/hamilton-county/cincinnati/plenty-of-beds-available-in-homeless-shelters-agency-head-says

 

Realistically, there are no solutions because you can't save those who won't save themselves, liberals would never permit banishing or criminalizing homelessness, and conservatives would never permit funding enough halfway homes, rehab centers, and adult care institutions.

 

Best we can all do is volunteer at shelters and soup kitchens, give food, blankets, or bottled water, and encourage or incentivize medical professionals to travel remotely to give cursory examinations to those willing to accept.

OK, here is the only "solution" I have been able to come up with.  I appreciate that is seems nearly impossible to implement this, but it's all I got.  Obviously, I'd love your thoughts in particular how we could rectify the solution that would pass some Constitutional muster.

 

What we could do is set up Mental Institutions like we used to have, but with very strict parameters as outlined below.  Obviously we've learned a lot about mental health over the last five decades, so I don't think that individuals would suffer as much in these types of institutions as they did in the past.  I'm hopeful having an improved upon permutation on what we had in the past would be a way to catch those that currently fall through the quite wide holes in our safety net.

 

OK, firstly I think these institutions would be for temporary triage situations only.  There'd be a soft limit to how long individuals could be there.  After some time of getting to understand the individual's needs they would be moved on to secondary solutions based on their situation.

 

Secondly, there'd be a couple of ways to be admitted.  One would be from voluntary self admission by individuals that have a moment of clarity and realize they can't currently take care of themselves.  The other would be from involuntary admission (I can see red flags being thrown through the Internet as I type this).  Even if an individual isn't actively breaking any laws, if they're engaged in life threatening situations I think that they should be able to be picked up and at least temporarily detained to assess ways to ensure they are not able to do themselves any permanent harm.  The devil would be in the details here.

 

Certainly there'd be financial burden as well as benefits to a system like this, but what do you think about the general plan?  Would we be able to implement a plan like this in this country?

^ Doesn't this already exist? There are psychiatric hospitals still in existence, you know. And the term '5150' is used to refer to an involuntary hold of people exhibiting damaging or dangerous behavior, usually for 72 hours. After the 72 hours, some are released, and some are transferred to other facilities or referred to other doctors or mental health professionals for further evaluation.

If it does maybe it just needs to be extended/enhanced to include additional situations for pickup as well as longer stays to get people into the services they need.

Services exist but not to the extent they're needed.

^ I largely agree with that sentiment, but in the cases being described in this thread, all the services in the world can't save those people. If you don't want help, you won't get it, no matter how many services are out there. The case of the homeless man in Cincinnati who froze to death on the street despite there being amble beds open in the shelter is absolutely tragic, but if you'd rather stay out in 6 degree weather than go to a warm shelter because you can't drink, or because the dudes in there are snoring or whatever, then sorry, you've made your choice and should have to deal with the consequences. The state shouldn't be responsible for forcing people to live and make smart decisions. We absolutely should provide services for the people who need them and choose to utilize them, but beyond that, what can we do?

 

LA's homeless situation is absolutely horrendous, and it breaks my heart to see the condition that many of them are in. I always wonder, 'what happened to their families?' Surely some/most of these people who are out on the streets have siblings, parents, aunts and uncles, etc. How can they sleep at night knowing their family is suffering in the street? At least we don't have dangerous cold to deal with, but these people live miserable existences, and many of them have severe health issues that are ignored. As tragic as it sounds, I often wonder why the suicide rate isn't higher among this community.