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Comment by wkat4242 | Hacker News Reader

Finland is a very different society than the US. It's mostly rural (megacities like in the US don't exist) and very very cold in winter (and even summer isn't the best). Welfare is high. People don't live on the street because they want to.

The mental illness is a bigger issue but here in Europe most countries have pretty decent healthcare for everyone (even the ones without money) so they don't have to be dumped on the street. Those people usually live their lives in institutions or assisted group living homes depending on their level of capability.

Drug abuse is probably the biggest cause of homelessness here but it's not that common compared to the US. Alcohol abuse is but it's treated similar to mental illness with decent care.

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>(1) People are comfortable on the streets, they enjoy the freedom, or they are at least accustomed to it, and paying rent/bills seems anathema to them.

I don't think anyone is comfortable in a tent in finnish winter.

I think mental issue is one of the big thing, article mention conselling is offered, which is good.

Additionnally some people often end up in the streets because they simply don't know their rights and that they can apply for social services. Many euro countries social services will take over payment of a home, basic insurance and needs, "supposedly" enough to have sonething to est everyday. But usually to get that you need a bank account and to habe a bank account you need a physical address. Many end up in the streets because they are at some point in a mental state where they are overwhelmed by the paper work stuff or ashamed to ask for help. Or because it takes too long to get the aforementionned help because of administrative delays.

From what I've seen online, Finnish winters don't seem to be any worse than Minneapolis, which will have tent encampments all through winter. They often aren't broken up and forced into shelters unless we get an especially bad cold snap; activists argue that forcing people out of tents means they lose possessions and are worse off.

https://www.cbsnews.com/minnesota/news/we-just-want-to-be-wa...

https://www.kare11.com/article/news/local/homeless-camp-resi...

There's a very tough residence among the "permanent" homeless to any program that offers housing, because it will come with some strings attached. Those with mental health issues fear (wrongly) that they will be involuntarily committed to an asylum or something similar. Others don't want to be forced to try to get a job, or give up drugs.

The "temporary" homeless can, and do, make use of the help the government and non-profit organizations provide. Job training, free bus passes, assistance with rent, food, hygiene etc.

Some in-between will always float back and forth. If they stick to their medicine, they can live pretty independently, but since they don't like the side effects, sooner or later they stop, have a psychotic break, and end up back on the street until a family member finds them and convinced them to get help again.

At least, this is my understanding from someone who works for a program whose funding and sole mission is to the homeless in Minneapolis.

> They often aren't broken up and forced into shelters

I don't think the article mention this.

> It's mostly rural

Not really any more than the US, the vast majority of people live in cities, or in this triangle zone between Turku, Tampere, and Helsinki.

Those cities can't really be compared to the cities in the US though.

But yeah calling it rural was not the best description. I agree. I was referring to the huge open areas of course.

The US has huge open areas too.

Actually, the biggest difference might be public transport: as long as they live in a decent city, you can give people transit passes and they can start to visit doctors, apply for jobs etc. like anyone else.

Sure they can. US cities are not uniform. For example Helsinki has roughly the population and metro density of Providence, Rhode Island. Finland may not have a New York or San Francisco, but that doesn't mean there's not good comparisons anywhere in the US.

In the US, this all comes down to the Reagan era decision to stop funding asylums. The mentally handicapped used to receive treatment, now they are forced onto the street.

I thought asylums were by-and-large just hellholes we locked people up in. I have no source, but my impression was that for every one person adequately treated, there were 20-30 that were neglected or horribly abused, like having all their teeth removed.

Some of them were One Flew/titicut follies yes. I don't think that means they should all be closed though, they should've been fixed.

> The mentally handicapped used to receive treatment

I think you meant to say “used to be locked up”

Provided with shelter? Check.

There's only so much you can do, no brain debugger+hot patcher invented yet.

It’s not a binary choice between living on the street and mandatory internment in something that resembles a prison, which is what I suspect was happening earlier.

Other countries solve it by having protected communities, with more or less supervision and independence depending on the condition.

What do those communities look like for people whose "condition" is the worst? The ones who won't accept treatment but desperately need it, and are a danger to themselves and others.

It's hard for some to accept that yes, some people do need in-patient mental care and possibly for an extended period of time

"prayer" or "social support" or whatever isn't a substitute for IV anti-psychotics

Yes there was abuse, and yes that should have been curbed.

>It's hard for some to accept that yes, some people do need in-patient mental care and possibly for an extended period of time

Some people, yes, but an incredibly small minority. The vast majority of people with severe and enduring mental illness can be managed perfectly well in the community if you have adequate community-based mental healthcare provision. The choice between asylums and people fending for themselves on the streets is a false dichotomy.

>"prayer" or "social support" or whatever isn't a substitute for IV anti-psychotics

We have a wide range of long-acting injectable antipsychotics that can be administered on a fortnightly or monthly basis. You do not need to lock someone up indefinitely in order to administer an injection once every few weeks. Some people will inevitably need to be compelled into treatment, but that number is much smaller if a) you have a mental healthcare workforce who have the time and training to establish rapport and build trust with patients and b) you use early intervention to reach people before they are in crisis.

Definitely not disagreeing with you, it does work like that in an ideal case/with a strong community/MH worker support

And you know how the story of "I don't need/don't like the meds/they're out to get me" story goes within the community of people who definitely needs that kind of treatment

But it wasn't curbed.

Unless I’m way out of the loop, there are still facilities for extreme cases, no? I think the difference is that patients cannot be detained there against their will, vs asylums were full of people who wanted to leave, after being forced there by someone else, and being treated like shit every step of the way

It's so much better now that these people receive treatment on the street, you can tell they are being treated because of all the hypodermic needles they leave laying around that formerly contained medcine.

I thought we were talking about mentally ill people, not drug users. The two are not mutually exclusive. You’re not necessarily mentally ill if you shoot dope, and shooting dope isn’t only done by mentally ill people.

This is part of the problem. People think that homeless people are all drug users, and that’s not accidental. I bet if you ended up on the street, couldn’t get a leg up to get off the street, you might eventually turn to drugs to help forget that you’ve been abandoned by society and a government that will bail out car companies and banks but won’t establish better systems to get people up and running again.

Comments like this definitely give the impression you're serious about making sure institutionalization is reintroduced for the benefit of the few patients needing intense interventions and not just out of concern for your fucking property values.

To say it "comes down" to Reagan seems highly revisionist in nature. After all, a quick trip across the border to Canada reveals they are having the same exactly issues - possibly worst given that the Trudeau government seems determined on growing the population at absurd rates, no matter what.

I think the key things we've seen that have hyper-accelerated the trent have been:

* The introduction of fentanyl to the West

* The lockdowns

* "Progressive" policies to be hyper-empathetic on criminals

At this stage no amount of asylums will put Humpty Dumpty together again. We would actually need a criminal system and society that is willing to have people face consequences - and that is currently a "far right" idea as far as the Woke West is concerned.

The US was never hyper-empathetic on criminals. Like, it is country with largest incarceration rates, super high convictions rates and a quite long sentences. Also, a country with incredibly expensive justice system.

Moreover, it is a country that keeps punishing criminals long after they left the jail with post conviction restrictions designed to make them fail.

Canada's and US' politicians take their ideas from the same think tanks, using them as opposites is not a good comparison.

Some provinces do not use all the funds available for healthcare from the federal government.

The immigration rate drastic increase is not helping, but the healthcare issues have started before.

This is rich coming from the person who thought putting sunblock on during airplane trips blocks cosmic rays

Well, mega cities don't exist if the whole country is only 5 million. Still, urbanization has been strong since the 1960s and has not stopped. The rural areas are getting truly depopulated. The vast majority of Finns lives in and around cities where you don't know your neighbors.

Finland has a (slightly) higher urbanization % than the USA according to https://ourworldindata.org/urbanization . Winter temps in the most populated south seem to be a bit warmer than Chicago and similar to Beijing - so not arctic or anything.

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