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Comment by dangerlibrary | Hacker News Reader

You are describing an extreme form of mental illness that is not as common as more treatable / manageable forms. If all "mentally ill" people were as incapable of cognition as you suggest, psychology and psychiatry would be very sad, hopeless professions.

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True, but in the article, both Partovi and Ruffin cite examples of clients who "claim they own a house, or that a relative will show up any day now", despite being injured/homeless/exposed.

To me at least, it seems logical that a reasonable person would choose shelter over being outdoors and injured for 15 years. Making that choice is their right, but let's address their mental health problems first to give them the autonomy to make that choice.

Mentally healthy people lie to themselves all the time too.

Homeless mentally ill people be lying to save face, or that me be at least a component of what they are saying.

If you spend enough time with them, you may get a lucid moment where they can be honest with themselves and you; but it is very time consuming to get there.

Yes, but you and the grandparent commenter seem to treat it as black and white -- either they are sane, or ALL logic has gone out the window. Many (most?) actual mentally ill are not like that (spoken from first and secondhand experience) -- SOME logic has gone out the window, and there is room to "negotiate" or "convince" in alternate ways. But that requires getting to know them, caring, spending enough time to earn some trust and understand more what kind of entreaty would most appeal to them.

A good comparison is a young child (or an elderly person slowly getting senile)! They often believe silly things, but it's not all or nothing. It's possible to "reason" with them, but it takes more effort, time, and care, that's all.

You're 100% correct. I've edited my comment to add the caveat that I should have originally added- I'm talking about the extreme cases here.

99% of people with milder forms of mental illness do need to be treated with respect of autonomy. It's the last 1% that worry me.

I'd argue that our approach should be similar to how we (should) approach people in general: innocent until proven guilty. In my opinion it's preferable to have the occasional mentally ill person do something terrible if it keeps us from having a mentally ill person deprived of their freedom and autonomy without it being necessary.

Well, psychology and psychiatry are sad mostly hopeless professions :).

To my surprise, not according to the frontline psychiatrists I've been able to ask personally, who took the worst cases over decades (they were government employed and never saw a paying customer.) It's not just that we do have some effective medications, it's also that people with mental illnesses (other than age-related dementia of course) tend to improve markedly as they age, especially over age 50. Admittedly, that discussion was a couple decades ago, however.

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