We should differentiate between truly low functioning schizophrenics that are in active psychosis and people who developed psychotic features through years of drug abuse. One is born that way or organically develops the condition, the other makes hundreds of small decisions that lead to destructive consequences that society is left to confront. Both are worthy of compassion. But, the latter has responsibility for their own choices. They should be held to a higher standard of expectations, including managing their own medical path and showing up to appointments.

One thing this article avoids, and most other advocacy articles do also, is acknowledgement of the vast numbers of mentally ill people who do prioritise their own care and participate in a structured treatment. It's disrespectful and ableist to group the worst behaviours of people that abandon their own care for street drugs, with the condition itself. Those people need to be held responsible for those decisions.

Consequences for destructive behaviour are crucial for a functioning society. Even many low functioning people understand consequences. What we have done is slowly remove the consequences for multiple tiers of progressively worse behaviour.

I have seen many freakouts and assaults in large cities and have also seen them act right up to the threshold of a consequence. Then when police show up, suddenly they know exactly what to say to get out of it. That is not someone who doesn't understand what is happening.

Involuntary hospitalisation needs to remain a tool, even as a last resort, to prevent escalation of conditions and for the safety of the general public.