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100
3 votes
Nov 21, 2015

This really isn't a fair question... in fact, we need to think about the reverse.

Most mentally ill people aren't a threat to others. In fact, mentally ill are far more likely to be victims than anything. I've known many mentally ill people, including two people with untreated schizophrenia, and I've yet to see any of them cause harm to others. I personally have been diagnosed with mental illness, and the primary cause of my own illnesses is abuse. The mentally ill are far more likely to come to harm than to cause it.

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0 votes,
Nov 23, 2015

This is a crucial point, but I do think the question deserves a direct answer.

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0 votes,
Nov 26, 2015

Well, then first we need to know, how often do mentally ill people actually pose a threat to others? Very rarely. How often do the mentally ill cause harm to others compared to everyone else? Less frequently.

The solution is actually simple. Most of the rare cases of mentally ill people harming others occur when they lose access to medication or treatment. The solution is making sure that people who need treatment have access to it. That they can get the medication and help they need. People who have problems taking medicine need an aide to make sure they get their medicine and go to their appointments. That's pretty much all it takes.

In short: make sure that people who need treatment and medication can get it.

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0 votes,
Nov 26, 2015

We actually don't need to know the first issue whatsoever. The scale of a problem is actually not terribly relevant to the merits of efforts to deal with that problem.

I agree that medication is, say, 95% of the solution. But is it practical to assume that, no matter how vigorous our mental health system or how complete our civic society buy-in, that there will never be untreated people? If so, what other approaches might we use to make sure that the mentally ill do not harm others?

I am sensing that you, like me, are very worried about efforts that would rob the mentally ill of autonomy, threaten their civil liberties, or harm them unduly. But then I think that priority should be said out loud.

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100
2 votes
Nov 23, 2015

Obviously, the best approach both in efficaciousness and from a perspective of liberty and diversity is to improve treatment access and eliminate barriers like stigma, miseducation, and psychological quackery like Scientology. We also need to pursue research to find better ways of treating or managing conditions like malignant narcissism, psychopathy, and so forth.

This goes beyond health care reform and PSAs. It means that schools have to teach about mental illness issues. It means that the average person has to be prepared to promote good information about mental illnesses and disabilities. We have to have a public support system that causes people who may have a mental illness to feel empowered to go get diagnosed, get treatment, and have the support and understanding of their families. Scholarships will have to be pushed through both by private and public actors to promote more therapists and social workers. And, while we're on the subject of social work, we need to fix our failing social work and foster care systems with actual money and reform.

Until we can do that, it seems grotesque to me to pursue approaches that are repressive or violate the civil liberties of the mentally ill.

A smaller aspect of this will have to be training for police, for reasons I will get into in-depth a little later. If police are better able to understand the mentally ill and defuse situations, that will massively reduce the number of times that the mentally ill actually do harm others. Most mentally ill people who do harm others (which, again, is a tiny minority) do so out of fear, paranoia, confusion, anger or frustration.

I am sure that there are other smart and creative policy approaches we can try at all sorts of levels, but to me the approaches centering on treatment access, reducing stigma, and empowering the mentally ill will be the best.

Avisia's point is utterly crucial, however. Everything from our natural fear of people who are different to procedural cop dramas have helped a lot of us to think that it is mostly the mentally ill who harm others. In fact, this is totally false. The vast majority of people who harm each other are not mentally ill, the mentally ill are tremendously likely to be victims, and the vast majority of the mentally ill will never commit any serious crime.

Still, there is a nugget of truth to the idea that the mentally ill can be dangerous. In a report debunking the "war on cops" myth, the FBI found that a lot of cases where officers got shot were due to the mentally ill. This is of course a very small phenomenon in general, since cops are actually safer on the job than ever.

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100
1 vote
Jun 15, 2015

Raise taxes, educate therapists, psychologists and psychiatrists, pass laws and guidelines concerning mandatory treatment, build institutions to house people determined to be a danger to themselves and others. Pay for it publically.

But that would potentially trample on people's rights (forcing treatment) and socialism (using taxes to pay for it) is always bad, right?

We used to have state run asylums. They weren't always nice places and sometimes they were hell on earth, so we got rid of them and didn't replace that system with anything. We just pushed the people who needed help out onto the street to fend for themselves. and back on families ill-equipped to handle their loved ones.

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-1
1 vote
Jun 15, 2015

people that don't want to take that risk should just stay away from mentally ill people.

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Nov 23, 2015

Psychopaths, narcissists, and other dangerous people with mental illnesses are very good at blending in and destroying lives.

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