this post was submitted on 11 Jun 2024
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[–] [email protected] 22 points 5 months ago (3 children)

TBH the information I gleamed from this is that Pakistan somehow has mental hospitals when much of the USA lacks that sort of amenity.

[–] [email protected] 10 points 5 months ago (1 children)

I would not put too much faith in the quality of their care.

[–] [email protected] 1 points 5 months ago* (last edited 5 months ago)

Still better than the Gulag, but yeah my heart goes out to gay club man.

[–] [email protected] 2 points 5 months ago (3 children)

If you live in the US and experience a psychotic episode, a suicidal crisis, or another mental health emergency - where do you go?

[–] [email protected] 17 points 5 months ago (1 children)

Don't need to go anywhere. The police will come and shoot you.

[–] [email protected] 11 points 5 months ago (1 children)

Americans are so lazy, everything has to be a delivery service.

[–] [email protected] 4 points 5 months ago

Fucking hell, this was cold and I am a terrible person for laughing at it.

[–] [email protected] 2 points 5 months ago (1 children)

Real answer? Social Services is probably the number to call unless there is a emergency medical issue in which case just regular 9-1-1.

Likely you will either ride in an ambulance or with two social workers in a car to the hospital. 24-48 hours out-patient while you are stabilized. If it is a temporary situation, say you had an insanely high fever and were delirious you would just go home. If it wasn't temporary highly likely assigned a case manager for placement.

Despite what you see in the movies/TV you will not be thrown into an mental institution you will not be forced to take a cocktail of drugs that make you a zombie.

[–] [email protected] 2 points 5 months ago (1 children)

My experience does not come from movies. I am an outpatient psychotherapist (in a country with a reasonably functioning psychiatric system). I have repeatedly seen patients slip into psychomental crises where outpatient care is no longer sufficient. The local psychiatric clinics were sometimes real lifesavers. That's why I find the idea of healthcare without emergency institutions confusing. I would find it terrible not to be able to offer my patients anything in such emergencies.

[–] [email protected] 0 points 5 months ago (1 children)

Ok well I am not sure what to say except my entire family is crazy so I have seen the procedure, also my wife is a hospital nurse. Pretty much every hospital has a floor for emergency mental health admissions.

[–] [email protected] 1 points 5 months ago (1 children)

Ah okay. So deinstitutionalization in that context was meant to include psychiatric institutions into general hospitals? Because that I can totally get behind.

Based on the other comments I got the impression that there simply is no inpatient treatment plan for mental health in the US.

[–] [email protected] 0 points 5 months ago (1 children)

There used to be huge asylums. Now there are almost none and the few that remain are nearly empty. The big thing is stabilize the patient and setup a plan so they don't have to come back again. Which usually involves housing, assigned case manager, medication, food stamps etc.

[–] [email protected] 1 points 5 months ago

That sounds really good. Glad to hear it.

[–] [email protected] 0 points 5 months ago* (last edited 5 months ago) (2 children)

You hope that being talked at over the phone is enough to save your life, lol. Other than the suicide hotline or a regular doctor's appointment, you've got no options. Dial 988 for mental health crisis.

[–] [email protected] 2 points 5 months ago (1 children)

Bleak.

I don't quite understand how deinstitutionalizing was supposed to work here. That's like dissolving the fire department because we want to avoid cars. Was there no way to reform or replace the institutions? Just getting rid of an emergency service seems kinda like the situation you're describing was part of the plan.

[–] [email protected] 1 points 5 months ago

The institutions were reformed. By conservatives. The Reagan Administrations "reformed" them into something that the federal government doesn't pay for, while also cutting taxes.

[–] [email protected] 0 points 5 months ago

Crisis services

[–] [email protected] 1 points 5 months ago (3 children)

Deinstitutionalization is a good thing. The US lacks community treatment. We don’t need to go back to locking people up

[–] [email protected] 15 points 5 months ago* (last edited 5 months ago) (1 children)

What?? We desperately need mental health institutions back. No, we don't need the romanticized victorian dungeons, but what we do need is an alternative to jails. Secure treatment facilities. We have... four, on the west coast. Two of which have at most ~160 beds. The priority waiting list for admission is decades long (no, that isnt an exaggeration) and there isn't a non-priority waiting list. If you're not a priority, you just go to jail!

Community treatment is critical and we totally lack anything like it, but good god deinstitutionalization was one of the biggest public health and social equity diasters this country has ever had.

[–] [email protected] 3 points 5 months ago (1 children)

It was a failure because it was co-opted by the right (Reagan) and manipulated into a way to cut public health expenditures.

The original idea, from the left and advocated for by people like JFK, was much different

[–] [email protected] 0 points 5 months ago

Deinstitutionalization was dreampt up by deluded idealists that slept with a copy of Naissance de la Clinique firmly lodged in their asses. Abolishing asylums was good, because at the time asylums were the aforesaid victorian dungeons. But from the outset, the movement was based on the belief that a magic pill would cure everything and all long term treatment was oppressive.

Antipsychotics enabled community treatment at all. But the wholesale rejection of both long term and secure treatment facilities was an indefensible failure of reasoning and an abject tragedy, and one that was set in motion by Hoffman and his peers when they penned the foundational texts of the movement.

We desperately need secure treatment facilities. There is no solution if we do not have them, just the continuing abject failure of basic human decency that we currently have. This system is broken, and it is directly the fault of everyone who began the deinstitutionalization movement and their total inability to foresee the obvious consequences of their actions. Regan was evil and JFK was understandably bitter, and even though they both worked to bring the end of asylums, they are both still guilty for their roles in bringing this current hell down on us.

[–] [email protected] 12 points 5 months ago (1 children)

Okay but a pipeline of funding care seems a lot better than criminalizing homeless people who exist as a result of deinstitutionalization.

[–] [email protected] 1 points 5 months ago* (last edited 5 months ago) (1 children)

Right. Thank you for repeating what I just said in simpler terms ig

[–] [email protected] -1 points 5 months ago

Anything to avoid talking about the elephant in the room, and what the hadiths and Koran say to do to homosexuals.

No, instead we dance around it by talking about safe subjects like what Reagan did in the US.

Yes please let's talk about what a shitty US president did 44 years ago that impacted the US population instead of talking about what an Islamic military dictatorship did to a gay guy this week.

[–] [email protected] 8 points 5 months ago (2 children)

The US went from over-treatment to no treatment. Neither has a net positive outcome.

[–] [email protected] 0 points 5 months ago (1 children)

Deinstitutionalization has nothing to do with the lack of funding for mental health programs today. Two separate issues.

[–] [email protected] 1 points 5 months ago (2 children)

Actually, funding has a very large part to do with moving away from institutions. You'll find money is behind most big decisions in this country. Not that I'm defending the hell that is institutions

[–] [email protected] 1 points 5 months ago (1 children)

That’s true. My point is that closing institutions and funding the alternatives are separate mechanisms. It should have been done all at once but Reagan didn’t see it that way

[–] [email protected] 1 points 5 months ago
[–] [email protected] -1 points 5 months ago

Actually this article is about Pakistan

[–] [email protected] 0 points 5 months ago

I am pretty sure there are social workers in the US.