Welcome To My World

h/t IOTW

IOTW links to a story called "Why it’s so hard to get mentally ill Californians into treatment"
(besides the obvious answer, which is because my fellow Californians keep electing them to office):

(EXCREMENTO, CA) For years, Diane Shinstock watched her adult son deteriorate on the streets.  Suffering from severe schizophrenia, he slept under stairwells and bushes, screamed at passersby and was arrested for throwing rocks at cars.Sometimes he refused the housing options he was offered. Sometimes he got kicked out of places for bad behavior.  Shinstock, who lives in Roseville and works on disability issues for the state of California, begged mental health officials to place him under conservatorship—essentially, depriving him of his personal liberty because he was so sick that he couldn’t provide for his most basic personal needs of food, clothing and shelter.
But county officials told her, she said, that under state law, her son could not be conserved; because he chose to live on the streets, he did not fit the criteria for “gravely disabled.”

RTWT.

This is my life, every day for 20 years in the ER, and every other ER, nationwide, especially so if the community is larger than 50K people, and if it doesn't snow there in the winter, multiply that by a factor of 10.

We didn't have 500,000 visits a year at the Busiest ER On The Planet™; we had 1000 regulars who came in 500 times apiece.

I've now been to...fourteen ERs in three counties in nearly twenty years doing this, and it's no different anywhere you go.

Schizophrenia is like heroin addiction: it's a social death sentence, and it's almost never getting any better. The worst part, for family, is that Suzy or John (mostly John, victims are about 1 1/2 times more likely to be male than female) is perfectly normal until late high school or early college, even honors students, and then that last bit of wiring in their heads doesn't go in right. It short-circuits, and they stop being normal, brighter-than-average kids and become, frankly, batshit crazy. I can only imagine the never-ending horror for parents of raising a child, getting them safely past all the normal hurdles of growing up, sending them to college, thinking things are okay, and then watching them completely melt down before your eyes.

Meds help, but only if someone with schizophrenia takes them.
The meds make them feel "weird" (which is what we who aren't schizo call "everyday life" 24/7/365/forever), but they seem fine. So they decide they're not sick, and don't need the meds. And become actually weird, hearing voices who aren't there, seeing people and things that aren't real, and end up in my patch, barking, frothing mad. So we re-medicate them, they get put on a psych hold, they get better, go home, and the cycle repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats. And repeats.

Frequently, after burning all bridges with family, friends, and everyone else, and being thrown out of every care facility in an entire time zone, for cause, they end up on the streets. Where they "self-medicate". I.e., with pot, meth, heroin, benzodiazepines, alcohol, bath salts, paint, glue, or pretty much any substance they can get into their hands, and their bodies.

In a lucid moment, a juvenile patient once confided to me, straight-up, that he got wasted because when he got The Voices In His Head drunk or stoned enough, he couldn't understand them or hear them any more. Pure medical genius, right there.

Oh, and The Voices? They never tell you "You look great!" "Everybody loves you!" "You're a wonderful human being!"

That would be too easy, right?

The Voices always say "You suck. Kill yourself. Everyone hates you. Why don't you die?"

Go watch A Beautiful Mind. Or every scene with Gollum in the LOTR movies. (No points for guessing which sections of those latter movies I will completely skip over, wholesale, in that entire trilogy, because it's too much like pulling a shift at work, except without getting paid.) There was even a great TV MOTW with James Garner as the sane brother, and James Woods as the nut, that they showed in nursing school, because the writers and actors got it so right.

The article tries to pin this mess on Reagan (color me shocked), for signing Lanterman-Petris-Short in CA in 1967. But every other state was doing the exact same thing, and in fact LPS was in the legislative pipeline and conceived under Democrat CA governor Pat Brown, Moonbeam's father, before Reagan was even thinking about politics.

The state - in fact every damned one of them - wanted to get rid of psych hospitals long before One Flew Over The Cuckoo's Nest (which was outdated tripe from 30 years earlier when the film was made, but why let facts interfere with a good screed, right?), simply because crazy people don't pay their bills, you do. So warehousing them in Bedlam was nothing but a money hole the size of the Grand Canyon, nationwide.

And the do-gooders got together with the penny-pinchers, and decided collectively that since psych hospitals were so terrible, understaffed, under-funded, and yet still too expensive, because staff needs salary and crazy people need food and medicine, why not just turn everyone so "unjustly imprisoned for life" out onto the street?
What could possibly go wrong?
"The state budget will save millions!"

Whereas instead, as we all experience daily, they're free to run into traffic, attack people, burglarize and rob and steal to get money for drugs/alcohol/whatever, crap on the streets, and generally validate every reason that we have for why we used to throw a net over them and lock them up for life.

Which we can't do, because you have to be a "danger to self, danger to others, or gravely disabled", the definition for which last means that if you are mentally with it enough to scrounge garbage to eat out of a dumpster, drape yourself in trash bags when it rains, and construct a cardboard pallet and hovel to sleep on and in, you're not "gravely disabled."
Just...eccentric, and living an "alternative lifestyle choice".
Don't believe me, ask the district attorney, the state bar association, and the Do-Gooders League Of America. This ain't a California thing, it's a U.S. of A. thing, coast-to-coast.

So they're free, and now everyone else has to lock their doors, put up bars, keep their kids inside, and pack heat, so that these literal lunatics can run wild and free.

Brilliant.

And the article shows that TPTB haven't figured it out, even after 50 years' time.

The do-gooders just want them to be free (and to hell with their best interests, or anyone else's).
The rent-seekers want more money, and no rules for them.
The families want somebody else to solve (and most importantly, pay for, their batshit crazy uncles, cousins, brothers, and sons).
And the police, the hospitals, and the courts are simply tired of dealing with their bullshit, and that of the interest groups who want it to continue more than they want what we have now to stop.

My bent is a libertarian approach.
After three trips to hospital on a 5150 for being off your meds, we throw a net over you.
We put you in a helicopter, and we drop you off on one of the Channel Islands currently inhabited mainly by goats.
Once a week, the helicopter flies over, and they kick out food bundles.
There are no trees, and the islands are 30-40 miles away, in waters best described as sub-arctic even in July; those people aren't swimming or floating back, ever.
If the family is all broken up over this, they can pay for private care. They can visit them on Shutter Island whenever they like. They can bring them food, clothes, or anything else to make their stay more pleasant. They can even bring doctors and medicine there to address any other needs. The whackjobs are now free to chase butterflies, run around naked, or even try to fly off the cliffs; I don't care.
I don't want them euthanized, or harmed in any way. I want them free. Over there.

What they aren't free to do, is continue to run around in traffic, assault people and each other, crap on your porch, or walk around in society off their meds.
Three strikes, and you're out.
Now they're free, and so are we.

The do-gooders have tried it their way. So have the penny-pinchers.
Now it's time to solve the problem.