8 Comments

Those dealing with mental health issues are the best to consult as to what they need, and no one else. The rest is all speculation and conjecture that does no good.

Expand full comment

yup! respecting patient autonomy is something that the medical field is still catching up to.

Expand full comment

Wonderfully written. I’m from Toronto and we see many of the same issues. The social determinants of health (food, shelter, etc.) must be addressed first and foremost, as well as implementing care within communities where individuals can find help that is most suitable for them.

Expand full comment

Thank you for speaking out. The "Quality" of care at some of these facilities is also questionable.

https://www.motherjones.com/crime-justice/2023/10/universal-health-services-foster-kids-uhs-investigation-takeaways/

Warehousing people (including foster kids) for profit with little if any "therapeutic" intervention other than hefty doses of antipsychotics.

Expand full comment

Where would you implore an elected official to begin? My guesses would be housing that is affordable in reality and not just name, access to clean drinking water and reliable internet, and more robust transportation networks to start.

Expand full comment
author

Good question! Housing is foundational for so many people - that without it - it's hard to even begin to think about other facets of your health. I think that one of the richest things we can do for policy makers is to help them see the interconnectedness of these issues - that goes a long way towards getting us to stop tinkering so much with workarounds and get the the heart of the issue.

Expand full comment

Hi, I live in California and without delving deep into the pros and cons question this approach. A thought that comes to mind is that we created our own problem. In 1978 - Prop 13 passed. Among other things, mental health hospitals were closed - many of those folks ended up on the streets. I wonder if we had kept those hospitals open - but in a more humane fashion - we would be having a different conversation.

Expand full comment
author

Yes, it is very much a catch 22 we find ourselves in. It seems that because of our underinvestment and lack of strategy around delivering actual community mental health, we get to the place we are now - stuck - or even worse, pursuing the wrong solution to the wrong problem. On our watch, it feels that this moment requires us to remind people of how we got here and what we could do to best get out of a pretty horrific situation (the evidence gives us some direction).

Expand full comment