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Source: (consider it)
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Thread: Dignity of risk, my ass
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Porridge
Shipmate
# 15405
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Posted
A shot at independence and a real life?
Or yet one more in a series of calculated efforts to reduce mental health caseloads? They did this experiment already. They tried it in the late 60s when I was a kid before I was in the field. They tried it again under Ronald Reagan, when they emptied the psychiatric wards and ballooned the homeless population. They tried it again in the 90s or early 20-oughts.
Here's what happens, every damn time: our homeless population goes up; there are more complaints about weird or even unacceptable behavior Out The in the communities; people getting victimized 6 ways from Sunday.
People with MMI need long-term support, help, and oversight to get on track. "Long-term" means "measured in years, not months." They cannot be uprooted, given a few hours per week monitoring for a couple or six months, and hope for some sort of life.
And "Corey" can go screw himself. "You got to remember, man" is not what will help Kelvin build a productive life. Do you have any idea what it's like to live your life on these meds? Has anybody checked on his dosages, or his status changes recently? Is it possible that's why Kelvin can't remember shit? Does Kelvin read and write? Have you asked him? Can you teach him how to remember things? Does he in fact have any of the skills he needs to be able to start on this project?
Assholes. At least give the guy a fighting chance.
Come up where I live, Corey, "man," and go to work for me. I will fire your ass so fast it will be spinning when it hits the sidewalk.
Jesus, Mary, Joseph and all the saints, will somebody please take these people seriously and deal with the issues the mentally ill face instead of the fucking budget crisis we're creating by dumping folks "in the community?"
They're not fucking "in the community." They're just being abandoned.
Again.
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Spiggott: Everything I've ever told you is a lie, including that.
Moon: Including what?
Spiggott: That everything I've ever told you is a lie.
Moon: That's not true!
Posts: 3925 | From: Upper right corner | Registered: Jan 2010
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Nicolemr
Shipmate
# 28
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Posted
![[Disappointed]](graemlins/disappointed.gif) Some people simply aren't capable of taking care of themselves. Even if they want to.
[ 28. December 2014, 21:42: Message edited by: Nicolemr ]
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On pilgrimage in the endless realms of Cyberia, currently traveling by ship. Now with live journal!
Posts: 11803 | From: New York City "The City Carries On" | Registered: May 2001
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
Especially if fuck all is spent on community support, and there is no recognition that they might need life long support.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Marvin the Martian
Interplanetary
# 4360
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Posted
Would it be better if he stayed in a home for the rest of his life?
Better for him, I mean, not for the mental health workers who are dependent on people like him being institutionalised for their own livings.
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Hail Gallaxhar
Posts: 30100 | From: Adrift on a sea of surreality | Registered: Apr 2003
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
That largely depends on how severe his chronic disabilities are. Reading that article it struck me that his initial set up should have at least included his meds being dispensed weekly into a doset by the pharmacy, and put up for collection on the same day every week. People often do better with their utilities & rent set up on direct debit on the day their income comes in as well.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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JoannaP
Shipmate
# 4493
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Posted
quote:
Originally posted by Marvin the Martian:
Would it be better if he stayed in a home for the rest of his life?
Better for him, I mean, not for the mental health workers who are dependent on people like him being institutionalised for their own livings.
Possibly. In a home he would be kept warm, fed regularly with a balanced diet, be given the correct medication at the correct time and have closer monitoring than he does now. Being stuck in a bare, barely furnished flat, apparently unable to go to the shops on his own, dependent on random carers coming in at random times does not seem to be living independently to me.
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"Freedom for the pike is death for the minnow." R. H. Tawney (quoted by Isaiah Berlin)
"Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety." Benjamin Franklin
Posts: 1877 | From: England | Registered: May 2003
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Nicolemr
Shipmate
# 28
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Posted
Not to mention the lack of human contact aside from those random carers. It sounds a cold and lonely way to live even if he could handle the other problems.
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On pilgrimage in the endless realms of Cyberia, currently traveling by ship. Now with live journal!
Posts: 11803 | From: New York City "The City Carries On" | Registered: May 2001
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mousethief
Ship's Thieving Rodent
# 953
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Posted
quote:
Originally posted by Marvin the Martian:
Would it be better if he stayed in a home for the rest of his life?
Is this so impossible in your brain that you can't even imagine it?
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This is the last sig I'll ever write for you...
Posts: 63536 | From: Washington | Registered: Jul 2001
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Porridge
Shipmate
# 15405
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Posted
1. Why is a guy who uses a wheelchair being housed in an apartment with doors too narrow for his wheelchair?
2. Why is he in a 2-bedroom apartment? How can he afford the extra space on $1200 a month? Is that a good use of his money? Did he get a choice about that?
3. Why doesn't Corey have the first fucking blue-light-special ghost of a gnat's-ass notion when Kelvin takes which meds? Why not just grease the guy's skids straight into jail or hospital? Screwing up the meds is the speed-dial way to do this.
Kee-rist, one of my fellow-managers has a client with an IQ of 40. I have sometimes had to pinch-hit for meds duty. Because we are trained always, always, to name the client, name the med, name the dose, and show the med each and every time we dose, that client saved me from a major med error by clamping his jaw shut and shaking his head when I tried to give him something he wasn't supposed to get. That repetition, twice a day, every day, over a period of years, saved both of us. If a guy with an IQ of 40 can learn this, so (probably) can Kelvin -- provided somebody makes some effort to teach him.
4. The guy can't cook his own collards. How can you put a guy in an apartment with a 12-piece pan set and no cooking skills?
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Spiggott: Everything I've ever told you is a lie, including that.
Moon: Including what?
Spiggott: That everything I've ever told you is a lie.
Moon: That's not true!
Posts: 3925 | From: Upper right corner | Registered: Jan 2010
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Palimpsest
Shipmate
# 16772
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Posted
Good intentions, piss poor execution. Another in a long set of failures. Living in a group home can be decent or horrible depending on if there's funding and motivated staff. Living on your own can be the same way. Unfortunately, moving them out of homes on their own is billed as a cost saving.
There's a long history of making grand plans and then failing to fund adequately. Things like inaccessible apartments, incompetent helpers and lack of follow through come from the latter as you know better than I do.
I did read an interesting article about Los Angeles, which has a pilot program that gets homeless, frequently disabled, mentally ill or alcoholic their own apartments without waiting for them to be ready to manage on their own. The argument is that it's actually cheaper than dealing with bringing them in by ambulance to emergency rooms over and over again. I can see where this can benefit people who might otherwise be living in a dumpster, but it seems like it can also end up like this guy.
Posts: 2990 | From: Seattle WA. US | Registered: Nov 2011
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Leorning Cniht
Shipmate
# 17564
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Posted
quote:
Originally posted by Palimpsest:
Unfortunately, moving them out of homes on their own is billed as a cost saving.
Which is only possible if the person in question requires very limited support - unless, of course, you just plan to dump the person and not provide the necessary support. Otherwise the math just doesn't work.
Posts: 5026 | From: USA | Registered: Feb 2013
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Palimpsest
Shipmate
# 16772
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Posted
It turns out that it's very expensive to keep treating homeless people in hospital emergency rooms.
housing the homeless is cheaper However, it doesn't work if you don't fund the support they need. I suspect it would still be cheaper to house and support these people, but the urge to underfund it keeps ruining the brave plans.
Posts: 2990 | From: Seattle WA. US | Registered: Nov 2011
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Golden Key
Shipmate
# 1468
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Posted
Here in California, a couple decades back, they got the wonderful idea to move as many people as possible out of mental institutions and into the community.
Problem was, they had to go some place to pick up their meds. If they didn't manage that, then they were off their meds, and often wound up homeless.
I have severe depression, managed well with meds. But when it's bad, getting up to go somewhere to stand in line to get one dose of meds wouldn't be exactly easy.
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Blessed Gator, pray for us!
--"Oh bat bladders, do you have to bring common sense into this?" (Dragon, "Jane & the Dragon")
--"Oh, Peace Train, save this country!" (Yusuf/Cat Stevens, "Peace Train")
Posts: 18601 | From: Chilling out in an undisclosed, sincere pumpkin patch. | Registered: Oct 2001
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Marvin the Martian:
Would it be better if he stayed in a home for the rest of his life?
What would be better for him would not being thrown into a system of below-the-poverty-line social security and expensive healthcare.
This stuff CAN work, but it sure as hell isn't going to work in a country which is pretty darn awful for low income people who don't have mental health problems to add to the mix.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Leorning Cniht
Shipmate
# 17564
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Posted
quote:
Originally posted by Golden Key:
Here in California, a couple decades back, they got the wonderful idea to move as many people as possible out of mental institutions and into the community.
It seems that some kind of assisted living might be appropriate for some people. It exists for old folks - does something similar exist for those who are younger but would find it hard to cope on their own?
Posts: 5026 | From: USA | Registered: Feb 2013
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Twilight
Puddleglum's sister
# 2832
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Posted
quote:
Originally posted by Marvin the Martian:
Would it be better if he stayed in a home for the rest of his life?
Hell yes it would. "Able to live independently," has been the holy grail for disabled people for so long we've begun to think it truly is the end all and be all of life. It isn't. The large majority of healthy people should not live alone.
You think you're more aware of the noises your house makes when you happen to be alone at night? Magnify that by a thousand for someone with paranoia. You think you wake up in the night and imagine your cough is the beginning of lung cancer? Magnify that by a thousand if you have depression. You spend the day over thinking a project? Imagine if you were in the manic stages of bi-polar?
We all need someone else to bounce ideas off before the bad ones spin out of control. We all need to be able to turn to someone else in the house and comment on the snow or the plane crash in the news. The most organized person sometimes needs someone to remind them to blow out the candles or to take our medicine.
Mentally ill people should never live alone.
Posts: 6817 | Registered: May 2002
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
I wouldn't go that far, it depends on the individual.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Byron
Shipmate
# 15532
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Posted
quote:
Originally posted by Palimpsest:
Good intentions, piss poor execution. [...]
Totally this.
Mental illnesses still has such stigma that it's necessary to say, right off, that the overwhelming majority of people who suffer aren't a danger to themselves or others, and are far more likely to be victimized than victimizer. There are, however, a small number who do need to be secured and treated against their will.
Every effort should be made to help people to live independently, but there must be substantial resources for the many who can't. Right now, jails and prisons are crammed with people who would, in times past, have been in asylums. That's not improvement, it's regression, a testament to the brutality of unintended consequences.
Posts: 1112 | Registered: Mar 2010
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The Rogue
Shipmate
# 2275
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Posted
quote:
Originally posted by Doublethink.:
I wouldn't go that far, it depends on the individual.
That seems to be a big part of the problem - everyone has their individual needs and there can't be a one size fits all solution.
However, more resources are required to properly manage each individual and they probably wouldn't vote anyway.
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If everyone starts thinking outside the box does outside the box come back inside?
Posts: 2507 | From: Toton | Registered: Feb 2002
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no prophet's flag is set so...
Proceed to see sea
# 15560
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Posted
Yup. We used to have Integrated Services, which involved gov't departments which all worked together: mental health, public health, education, both school boards (Public and RC), Legal Aid, Social Services. This meant everyone knew each other and people didn't slip through cracks so much. Well, they dismantled all of it between 1988 and 1993. All budgets hit, many programs cancelled. Corrections is growing. Yay!
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Out of this nettle, danger, we pluck this flower, safety.
\_(ツ)_/
Posts: 11498 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010
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Porridge
Shipmate
# 15405
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Posted
quote:
Originally posted by Doublethink.:
I wouldn't go that far, it depends on the individual.
Absolutely. Unfortunately, this particular process seemed to begin with "Would you like to try this?" rather than "What would you need to make a go of this?"
I'm all for ensuring people's civil rights. But just as some advocates go too far in one direction (do people really have some meaningful "right" to live behind a dumpster, in a subway station, or on an abandoned railway car? If so, how do we ensure that's by individual choice rather than by desperate need for lack of any viable alternative -- or worse, for lack of an alternative the poor sod has never experienced and cannot even imagine?), some others go too far in the other direction (my client's family's fear of her possible violent reaction to failure if we couldn't teach her to read, so let's not even try).
Over and over, we set up systems in efforts to serve individuals. Over and over, we discover this doesn't work, usually by killing a few of these folks in the process. Why do we keep trying to build systems for fitting irregularly-fashioned individuals into system-regulated holes?
We really are the People of the Lie. My clients are supposed to get Individualized Service Plans. They're really about as "individualized" as the compartments in your standard ice-cube tray. An agency has a speech therapist; clients get speech therapy. Is somebody asking if they WANT speech therapy or NEED speech therapy? Of course not; if the service goes insufficiently utilized, the agency loses the funding and the therapist, and by God we'd better keep that therapist employed, because somebody somewhere WILL need a speech therapist, and then what do we do?
Posts: 3925 | From: Upper right corner | Registered: Jan 2010
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Twilight:
Mentally ill people should never live alone.
Well, that's my life stuffed up for the past decade. ![[Roll Eyes]](rolleyes.gif)
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Twilight
Puddleglum's sister
# 2832
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Posted
If your experience has been a different then that's great but I've never known anyone who lived alone over long periods of time who was happy with the situation.
Posts: 6817 | Registered: May 2002
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Autenrieth Road
Shipmate
# 10509
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Posted
I'm happy living alone. Since 1988. Is that long enough for you?
[ 30. December 2014, 01:07: Message edited by: Autenrieth Road ]
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Truth
Posts: 9559 | From: starlight | Registered: Oct 2005
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Twilight
Puddleglum's sister
# 2832
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Posted
That's great. Do you have schizophrenia?
Posts: 6817 | Registered: May 2002
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Autenrieth Road
Shipmate
# 10509
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Posted
No. Was your comment limited to people with schizophrenia?
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Truth
Posts: 9559 | From: starlight | Registered: Oct 2005
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Huia
Shipmate
# 3473
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Posted
quote:
Originally posted by Twilight:
The large majority of healthy people should not live alone.
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We all need someone else to bounce ideas off before the bad ones spin out of control. We all need to be able to turn to someone else in the house and comment on the snow or the plane crash in the news. The most organized person sometimes needs someone to remind them to blow out the candles or to take our medicine.
Twilight for goodness sake, this is one of the most sweeping generalisations I have ever seen on the Ship! I live alone and have done so quite happily for over 40 years, the last 25 or so in my freehold home. I have lived with both depression (with other causes) and PTSD. There is no way on earth I want to live with another person (Georgie-Porgy fat'n'fluffy, being of the feline persuasion is another matter).
I have friends with whom I sometimes discuss big budget items - rewiring the house, relining the bathroom - but what I choose to have done is ultimately my decision
The biggest drawback is being totally responsible for all the bills and utilities, but that's a price I pay for my decision.
I realise this would not suit everyone.
Huia
[ 30. December 2014, 03:39: Message edited by: Huia ]
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Charity gives food from the table, Justice gives a place at the table.
Posts: 10382 | From: Te Wai Pounamu | Registered: Oct 2002
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Evangeline
Shipmate
# 7002
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Posted
quote:
The most organized person sometimes needs someone to remind them to blow out the candles or to take our medicine.
Oh piffle, many healthy people live alone and are happy about it. I know some married people and people in share accommodation or living with elderly relatives who wish they were alone.
I have lived alone for large parts of my adult life. Without my multiple daily doses of medication, I would die within a matter of a day or two. I could also die from an untreated reaction to my medication. I'm still alive and kickin' to tell the tales of solo life and I never burnt the house down, not even once.
Posts: 2871 | From: "A capsule of modernity afloat in a wild sea" | Registered: May 2004
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Twilight:
If your experience has been a different then that's great but I've never known anyone who lived alone over long periods of time who was happy with the situation.
Oh, I see, you want me to be HAPPY with my situation as well.
If you're offering to find me Mr Right, I'm delighted.I'd prefer early to mid-40s, around 6 foot or a little taller, white (Anglo-Celtic or Germanic heritage is often a winner), intelligence is an absolute must and he either needs to have eclectic musical tastes or no tastes whatsoever so he doesn't interfere with mine. Preferably a little bit romantic, also a bit outgoing and able to bring me out of my shell.
Or you could just think carefully about how you've collapsed together the issue about people moving from institutional care to living on their own with the vast numbers of people who live alone simply because that's a common thing these days. And how you've treated those forms of mental illness that make it difficult for people to function in society with those forms that don't.
I've got a history of mental illness, but the extent to which it affects my life is that I don't always do so well with getting up in the morning and I don't socialise as much as I'd like. I hold down a job with a 6-figure salary, I cook my meals and keep myself clothed. Yes, it's true that in bad periods I might resort to a few more takeaways and the pile of ironing grows, but fundamentally I can look after myself. And the issue here is about ability versus desirability. You've just gone ahead and mashed it all up into one wildly general statement that equates my lack of a loving boyfriend with a guy who has difficulty keeping track of daily events.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Twilight
Puddleglum's sister
# 2832
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Posted
Okay, okay sorry.
I was thinking of a time when my father was alone after my mother died and slid into lots of mixed up thinking and hanging out at Kroger everyday, making up questions for the ladies so he could have an excuse to talk to them, while at the same time my son with schizophrenia was off his meds and holed up in a rooming house with his windows sealed even though it was 90 degree weather, and my healthy brother, who lived alone, was calling me three times a day to talk about what he had just watched on TV. I guess that seemed like a broad enough spectrum to say "anyone."
Now I'm just envious of Orfeo's life.
Posts: 6817 | Registered: May 2002
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Anglican't
Shipmate
# 15292
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Posted
quote:
Originally posted by orfeo:
If you're offering to find me Mr Right, I'm delighted.I'd prefer early to mid-40s, around 6 foot or a little taller, white (Anglo-Celtic or Germanic heritage is often a winner), intelligence is an absolute must and he either needs to have eclectic musical tastes or no tastes whatsoever so he doesn't interfere with mine. Preferably a little bit romantic, also a bit outgoing and able to bring me out of my shell.
Damn, I'm a decade too young.
Posts: 3613 | From: London, England | Registered: Nov 2009
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
There are aspects that are negotiable.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Porridge
Shipmate
# 15405
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Posted
Wow. Outrage to matchmaking in 33 posts. Is this a record?
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Spiggott: Everything I've ever told you is a lie, including that.
Moon: Including what?
Spiggott: That everything I've ever told you is a lie.
Moon: That's not true!
Posts: 3925 | From: Upper right corner | Registered: Jan 2010
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
33? I'm losing my touch.
I should have just put the info in my sig.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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