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Comment by readthenotes1 | Hacker News Reader

I have a relative who had to be taken to the hospital after scraping invisible mites out of their eyes with a razor blade. They asked them if she would like some antipsychotic medication and of course they said no.

As a result, my question is, is it ever humane to not force treatment on the mentally ill

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Obviously it can be. See lobotomization and ECT just for starters (yes, I know ECT is supposed to be better now, don't really buy it)

With respect, your statement about ECT is not aligned with reality. ECT is evidence-based and effective, with side effects that are less pronounced in many cases than drug-based therapies. It is approved for use in pregnant patients in the USA. One Flew over the Cuckoos Nest is not peer-reviewed.

> There’s a risk of memory loss. Most people who undergo ECT have temporary memory loss and confusion. Most people's confusion clears up quickly, and memory loss usually goes away entirely within a few months. However, some people do have permanent memory problems. Using the right-unilateral electrode placement and shortening the electrical current duration can reduce the risk of this happening.

https://my.clevelandclinic.org/health/treatments/9302-ect-el...

You agree to receive treatment, or you will not be released, and they get a court order rubber-stamped to say they can give you treatment without your consent.

I don't remember what happened after. ECT has that effect.

Not aligned with current consensus, perhaps. But before you equate that to "reality", recall that the profession once had consensus about lobotomy.

Evidence in psychological science is much more superficial than in, say, physics. I don't doubt that what you say is reflected in the literature, but I do doubt that it reflects the lived reality of those so treated.

You are asking the right questions

A lot of homelessness is due to different mental illnesses (not discounting the societal issues, and of course the drugs then make it worse)

I really feel society sucks at dealing with the action/inaction assymetries

Most homeless is due to mental illness. Almost always men with addiction issues. Many veterans suffering from PTSD. It's rarely the "single mother of two that lost her job at the plant" trope.

I think a better way to frame it is "most _chronically_ homeless is due to mental illness". However, most homeless people are not chronically homeless, and are homeless for <6 months. Those are the single mother of two who lost their job at the plant examples - or left an abusive relationship and is living in their car, or underemployed as a security guard and sleeping in a sheleter, etc.

Unfortunately, and equally sad, many of these folks work, send their kids to school, and struggle to get themselves into a stable long-term situation.

HUD data, for the US at least:[1]

- 582,484 total homeless

- 138,361 chronically homeless

- 122,888 total homeless reporting severe mental illness

- 48,373 total homeless victims of domestic violence

- 33,129 total homeless veterans

VA count of veteran homelessness was down 10% or more YoY in 2021 and 2022, and down 55% since 2010.[2] Veterans comprise about 10% of the total US population and 5.6% of the homeless population. Among veterans, PTSD was less of a risk factor than psychotic disorders, an equal factor to other mental health disorders, and mental illness in general was less of a risk factor than money mismanagement and could be mitigated by VA services, especially disability compensation.[3]