Where are the homeless supposed to go?

[u/Garey_Coleman]

Cities have been cracking down on homeless people so they can’t have encampments or stay on sidewalks. At the same time usually the shelters are full. So those who are unable to get into a shelter, where are they supposed to go?

[u/DebtBeautiful8188]

Away is the correct answer, but for a lot of people, away usually means institutionalization. Prison for the ones they think are criminal and/or lazy, and a mental institution for the rest. People can be sympathetic to mental illness, especially when it presents in an obvious, but non-threatening manner, but they usually don't understand how the system works and why just throwing everyone in an asylum is a bad idea.

People often also overestimate how many resources there are available for people who are experiencing some form of homelessness. I worked in a DV shelter for a while, and people would share very... interesting opinions with me. Largely out of ignorance, but that ignorance made them feel safe and secure, so they didn't really want to listen to me when I'd try to explain.

edit: I realize looking back at this, I wasn't clear in what I meant by away. I was looking at another comment and thinking of how society as a whole thinks. imo we need to put way more resources into housing and reintegrating homeless folks back into society, but also accepting that some people would rather just live in a different way. There are no quick and easy solutions to this, however, and we still have to respect people's dignity and freedom to make their own choices. Sometimes, that means that people will make what we consider to be a bad choices. But considering that the mentally ill are way more likely to be victims of violent crime than to commit those acts themselves, I'm not fond of the idea of institutionalization as a solution for everyone, and I think that we as a society need to come to terms with what is discomfort and what is a true threat to our health and safety.

[u/Nasskit1612 → u/DebtBeautiful8188]

I had to do a clinical rotation in the psych ward. One guy I was working with had schizophrenia and hurt his mom(he had stopped taking his meds bc he felt fine), so he couldn’t go home. He was being released on the street bc there was no where for him to go - shelters were full. So he’s medicated and “fine” now and being put into the street. How is he going to continue to take his meds? I live in the north, how the f is he going to survive winter? 🤷‍♀️

[u/StormMaleficent6337 → u/Nasskit1612]

What state is he in?

NY has “Code Blue” laws which means social services has to put you in a hotel for the night if it’s under 33 degrees, or at a shelter… but shelters are usually full so people go to motels/hotels and chill there

Growing up in NYC, I saw many people spend all winter in shelters and hotels because of Code Blue

You call 311 and they have to place you somewhere

Sometimes it’s even things called “warming stations”

I don’t know if any other state has this, but it’s a good reason why the homeless should go to NY during the winter, because it’s for non-NY residents as well

A huge reason why a lot of homeless take buses to NYC when it starts to get cold

[u/Caius01 → u/StormMaleficent6337]

California doesn't have that, which is why more homeless people freeze to death in LA than NYC

[u/StormMaleficent6337 → u/Caius01]

Yup

As far as being homeless goes, or receiving benefits like food stamps and Medicaid, NY really is the best state to be in

Of course it leads to many people abusing the system, but better that than honest homeless people starving and dying and sleeping on pavement

[u/[deleted] → u/StormMaleficent6337]

i've never seen an individual abusing the system, and i've seen many things. i have seen politicians, the wealthy, and corporations abuse it tho. many times, ongoing.

people being people, yeah, maybe here and there someone gets a few hundred they "shouldn't" get or something. but you have to have proof/documentation to get things, usually even just to go to a food bank.

[u/StormMaleficent6337 → u/[deleted]]

That’s true, but I’m talking about people claiming 2-3 other people on their food stamps because they “buy and prepare” food with them, even if that’s not the case, and those people make too much to qualify as well

I couldn’t care less, good on them for getting 750 instead of 350 a month, I’m just pointing it out on here for ya’ll

[u/thatsthefactsjack → u/[deleted]]

My ex applied for cash-aid without disclosing the long time live in partner's six figure income and hid tens of thousands of dollars, to become eligible at the end of 2023 and collected until May 2025. They got more than a few hundred dollars and didn't care whether our kids had enough food, clothes, shoes or anything else. They didn't worry about the kids because of equal parenting time. If I couldn't feed or get our kids the basics necessary for life, to them, that was my problem. All to get out of paying support and stick it to me and the kids.

The system is absolutely rife with vindictive parents who weaponize the system against the other parent. In my case, they intentionally deprived our children and me of mental, emotional and financial stability. I notified DCSS several times of their fraud and provided best evidence. DCSS buried their heads and maliciously prosecuted me anyways. I raised hell with investigative agencies and the court. They and DCSS are now under state investigation.

[u/[deleted] → u/thatsthefactsjack]

vengeful ex's are the bane of any system. good luck!

[u/Recent-Stretch4123 → u/[deleted]]

To republicans, "abusing the system" simply means using it at all

[u/[deleted] → u/Recent-Stretch4123]

good point

[u/yunggak → u/StormMaleficent6337]

In america system abuse u

[u/StormMaleficent6337 → u/yunggak]

In NY you can actually abuse the system, more than in any other state

I know people that claim 3-4 people on their food stamps and get around 1,000 bucks every month just for groceries, even though they don’t really need it

And they keep that going for years

It’s also the best state to have Medicaid in, in terms of what it gets you, especially for dental

[u/Signal-East-5942 → u/StormMaleficent6337]

I spend 1000 a month on groceries for my family of 4 and I live in Kentucky, significantly cheaper than New York. It’s not for you to say whether they “really need it”.

[u/rommi04 → u/StormMaleficent6337]

Doubt

[u/NikkiNot_TheOne → u/StormMaleficent6337]

Ok, ok, as someone from MA, I am stepping in neighbor!! We have a pretty good system here too 🤣. You'd think the country would model after our states! But that would mean the rich 1% wouldn't be in control. It makes me sick!

[u/StormMaleficent6337 → u/NikkiNot_TheOne]

I lived in MA for a little while, but I was working in Boston, this was after my homeless years in NYC

SO i never really checked up on your social services

You guys have housing for homeless if it’s 32 or below in the winter and an extensive shelter system in general?

[u/NikkiNot_TheOne → u/StormMaleficent6337]

Yeah we do but I am not sure if we have the Code Blue or something like that where they can call and def get shelter.

I am so happy you're doing much better!

[u/sugahack → u/StormMaleficent6337]

I can personally attest to the fact that no one is getting rich on the dole. If you were going to run a con, you do it for profit.

[u/StormMaleficent6337 → u/sugahack]

No doubt, but you know what I mean… claiming 3 people on your stamps instead of 1, so you get like 750 a month instead of 300

I have no problem with it, just stating it is what it is

[u/sugahack → u/StormMaleficent6337]

Not sure where you live, but you wouldn't be able to do that here. They check that shit and then check it again every 6 months. Cross reference it against the irs and social security. Look up your property tax records. They're thorough

[u/StormMaleficent6337 → u/sugahack]

I saw it happen a lot in NY (the city but also upstate)

I have no idea how thorough the checking was or if people ever got in trouble

They would just say the stamps were used for buying and prepping food for 1-2 people other than themselves, and get stamps for 2-3 people monthly instead of the single amount

[u/sugahack → u/StormMaleficent6337]

Back when they still used foodies it was a lot easier to get away with crazy stuff. Go to the hood and there were always at least a couple people selling foodies in the parking lot. Gas station I worked at was the one in town at the time that took foodies. So all day long little kids would come in and buy one piece of penny candy at a time using a one dollar foodie. They'd take 0.99 in change home to mom or dad. Rinse and repeat. Late afternoon here would come mom or dad with a bag full of change to buy their kools and a 40

[u/No_Foundation7308 → u/StormMaleficent6337]

I worked for the City of Nashville. One year we hit the single digits which was extremely rare. Parks and recreation set up ‘warming stations’ in community centers etc

[u/DairyKing28 → u/No_Foundation7308]

Hi. I'm homeless in Nashville.

I moved here last year because I was homeless in another city. I went to save my cat during a storm, caught her under a bridge, went to get her, had cops see me, and they arrested me on trespassing charges. I moved as part of a plea deal. Nashville seemed to have had better jobs than Huntsville did. I have been lying to most of my friends about my situation because I'm both ashamed and I don't want them to worry.

I'm not an addict. I barely drink. I'm fully sane. I'm employed. The problem is I live in the South without a car. Finding good stable work in Huntsville is virtually impossible without a vehicle. I was going through dead end jobs that didn't pay anything over 15 dollars an hour....all while trying to appear normal enough to be employed. I couldn't afford room to rent much less an apartment unless those jobs gave me a lot of overtime.

I got lucky and moved here knowing at least two people who were kind enough to let me use their addresses. I then found a bridge to hide and sleep(usually chasing other homeless away who are addicts or who are mental. Helps protect my stuff so I can be normally employed. I literally couldn't work otherwise). So this year I spent the winter outside, including the week long cold snap where temps were in the single digits. Shelters were full and I generally avoid them to begin with, so I slept when snow was LITERALLY on top of me. I woke up with my entire body frozen. Had I not gotten a lot of blankets, a thick coat, and a shit ton of hand warmers I'd be dead right now. I gutted that shit out just so I can continue working.

I've been going through some major depression because I work as a stagehand. As such, I've worked with and alongside some professional and aspiring producers, aspiring artists, AND celebrities. I've spent my life growing up dirt poor. Watching people have good lives while I slave away in hopes of getting a place to live or...just to be normal, is soul-crushing.

However, in spite of my current situation, I'm doing better here than I was in Huntsville. I'm not in jail. Thank God. I still have a job I'm working my ass off to make a career.

I still don't have a car or license. I know what it'll take to get it but I'll have to take classes for it. They ain't cheap. I'm talking between 3k-5k at least just to feel like I've mastered it. And then find friends who will let me borrow their vehicle for the test.

I'm not mentally ill. I'm just poor, living in an expensive city to try to learn skills that will maybe one day translate into a career that can help me afford a place to live. And I'm trying not to be bitter watching other people be successful. But it hurts.

Seeing what Donald Trump is trying to do is disheartening, but far from surprising. But it's not him that makes me sad. It's watching poor Nashvillians think that the homeless and the Spanish are the reasons they can't get ahead in life.

[u/StormMaleficent6337 → u/No_Foundation7308]

Crazy it had to reach single digits

Our warming stations are already set up in NY, throughout the whole state… they only open if it drops below 33 tho

Waiting for single digits is crazy, but I know nothing about the homelessness scene in Nashville (I hope it’s none too bad!)

[u/No_Foundation7308 → u/StormMaleficent6337]

We’re usually above 35 and we never, in at least the 7 years I worked for metro, had to have warming stations. This freak weather was the only time

[u/ChocolatChipLemonade → u/StormMaleficent6337]

Re: Code Blue - for the people sleeping on the Manhattan sidewalks on flattened cardboard boxes and no coin cup, while it’s freezing cold - why?

[u/StormMaleficent6337 → u/ChocolatChipLemonade]

Stubbornness for many, especially the older folk… they don’t want to deal with social services, even though Code Blue doesn’t need paperwork done like a regular shelter stay would… and they really don’t care if they die on the street at that age, it restores some dignity and people are always giving coffee and food to old homeless people in NYC… they have communities there as well with fellow homeless elderly folk, and they know the best restaurants that hand out free food after closing and where to “dumpster dive”

For many others, legit mental health issues that literally won’t allow them to seek help

And I can say for a fact, because I had many friends in this situation, they literally don’t know about calling 311 and Code Blue laws… even though I tried to explain it after I had to use it, they need it explained thoroughly and still can’t really believe it… many homeless legit have no idea and go years before they find out about it and what social services can actually offer homeless people

And then the 4th group… they just want to drink and do drugs and not get kicked out of a hotel or shelter for doing such things

Always something going on in NYC 24 hours a day, even on the coldest days of the year…

PS: I will say it does get annoying as hell calling 311 everyday after 5pm and requesting a placement… sometimes you‘ll get a motel/hotel for a week paid for, other times it’s just a day or two and you gotta call up all over again and see where they’ll place you

This leads many people to just roughing it for a few days before calling up again

[u/Traditional-Bar-8014 → u/StormMaleficent6337]

More than just stubbornness, a fair amount of what looks like belligerent behavior is actually defiance and a form of 'advertisement' if you will.

At least I remember choosing to stay in certain spots that were perhaps less comfortable but more annoying to the societal flow because I wanted to be more obvious.

I think there is benefit to us being in the way versus all shipped off to some facility...out of sight and out of mind is a dangerous position to be in...

[u/Affectionate-Data193 → u/StormMaleficent6337]

Small towns in upstate NY have do this too, but they use the shittiest hotels available, so some of the (usually) guys that I see would just rather stay out on the street.

I fix and run boilers for a church diocese now, and we try to keep some space open during the day for folks to warm up.

A lot of these guys have been let down by the system so many times that they would just rather stay out.

[u/StormMaleficent6337 → u/Affectionate-Data193]

Yup, Code Blue is for the entire state of NY, not just the city

Small towns from the Hudson Valley to the central Albany area to the Adirondacks and Finger Lakes regions…. they can all provide these services

In a lot of these small towns, there is no actual homeless shelter, so yeah, like you said, usually the shittiest motel available, but it’s still a room

[u/Glass_Pick9343 → u/StormMaleficent6337]

In NYC you can literally move around the entire city underground without coming up for sunlight, maybe im off by 25% but still

[u/Lysmerry → u/StormMaleficent6337]

This seems preposterously expensive compared to building more shelters. But I guess shelters would be viewed as a permanent solution that will keep the homeless in the city while Code Blue can be sold to voters as an emergency. No one wants a shelter in their neighborhood either.

[u/StormMaleficent6337 → u/Lysmerry]

Biggest reason is the infrastructure is already in place for 1000s of hotels and motels throughout NYC, and of course the rest of the state as well

It takes A LOT of red tape to get a homeless shelter approved, then up and running, and then staying open instead of closing down because it’s not “up to code”, whether that means in the kitchens, the bathrooms/bed areas, or because of staff treatment

Of course many people also protest against them as much as they can, like you said, because no one wants them in their neighborhood

I don’t even think more shelters is the solution, nor would benefit the homeless

As someone who has stayed in shelters for about 2 years, there’s almost always a whole bunch of empty beds available no matter where you go

People just prefer to stay on the street or they try to get a hotel/motel room or they aim for low income housing and hold out until that magically happens

You also have to go to an “intake center” first, and then they place you in whatever homeless shelter is available, and a lot of people don’t want to put up with this “hassle” and never even make it to the intake center

You can’t decide which shelter to go to, Intake will pick one for you and social services pays for your ride over there

DHS (Dept of Homeless Services) is in charge of all this in NYC

If you get into a DHS shelter, you can basically stay there for as long as you want as long as you don’t break the rules, I’ve known people to stay at these places for years sometimes (esp if they’re a vet on a waiting list for housing)

Non-DHS shelters are also available, but usually just for 1-2 months

Anyways, because you can’t pick where you go, and many shelters in NYC are quite dangerous, people don’t even bother with the Intake

This is a shelter that opened many years after I was homeless, but I’ve heard through the grapevine is a truly awful place, probably worse than prison… I’d rather just wing it on the streets:

https://bklyner.com/new-mens-shelter-opening-next-year-on-sackett-street-in-gowanus/

^ More of these shelters is pretty much pointless

I will say though that upstate in many places, all throughout the state of NY, shelters are much better and safer and provide a lot more support, and often times your own room by yourself or with a roommate… 3 meals a day and loads of support to find a job and work with social/case workers

I did live briefly in an upstate shelter and it was way better than NYC ones

If you got any questions, feel free to ask

[u/Icky-Tree-Branch → u/Lysmerry]

I’m in Canada, but my in my city, the province is taking the crappiest closed hotels (buying them), rehabbing them, and turning them into housing for the unhoused. 

I think it suddenly became really important to “handle” when the homeless encampment downtown that spanned a couple of blocks couldn’t just be bulldozed due to legal stuff. It was horrifying there, complete with run down campers or built shacks, things frequently catching on fire and lots of overdoses. And that camp was “the good one.” There was another one a few blocks away that consisted of people who had been chased out of “the good one” due to violence or just causing too much trouble. 

[u/Stunning_Scheme_6418 → u/StormMaleficent6337]

Here in Colorado Springs we have three or four homeless freeze every winter because they don't really do much except for when it gets really cold they open warming shelters for the evening.

[u/StormMaleficent6337 → u/Stunning_Scheme_6418]

Damn, that’s crazy to me… esp Colorado Springs in the winter… what cost does it take to just always have warming stations at the ready?

And you don’t even open em at 33 or below… surprised huge lawsuits from those deaths haven’t made warming stations mandatory

[u/Stunning_Scheme_6418 → u/StormMaleficent6337]

You would think. Yeah I think they open the warming shelters 20 21° something like that. This is the Red Dot in the blue state that we don't take care of our folks here either

[u/vorpal8 → u/StormMaleficent6337]

Most states don't have that, sadly.

[u/StormMaleficent6337 → u/vorpal8]

Yup, I know

In fact I’m pretty sure NY is the only one

It’s not just the city, either

It’s literally the entire state, so technically you can call 311 on those 33 and under nights and get a room whether you’re in Niagara Falls or the tip of Long Island

[u/NikkiNot_TheOne → u/StormMaleficent6337]

That is great!! I am sure so many of the homeless don't even know of it.

[u/StormMaleficent6337 → u/NikkiNot_TheOne]

Yeah, it’s never really advertised

I’ve never seen an ad on TV or heard one on the radio, and I lived in NYC / NY for a very long time

Not even posters in the subway down in NYC that mention it (which is where a lot of homeless spend most of their time)

Even when there ARE posters, it’s about hiring people for 311, not about what it actually can do for homeless people… no one would look at this poster and think “okay, if I’m ever out on the streets, I now know what to do!”

https://www.instagram.com/p/CpitEK2uQJd/

It’s a word of mouth thing that just gets around

It’s very strange because the government WANTS people to use it when it’s needed, since they have the budget to put homeless in hotels and they prefer them there instead of the street, but they very rarely promote 311 and all the benefits calling that number can bring someone

And they especially don’t promote the Code Blue laws, but it’s one of those things everyone who has been homeless knows about

Many NYC residents go homeless for the first time and never heard of Code Blue or 311, it’s pretty insane… but fellow homeless people are quick to educate you and fill you in

[u/MidorriMeltdown → u/StormMaleficent6337]

My state in Australia does Code Blue for when we have extreme weather in the colder months, and Code Red during heatwaves.
https://glamadelaide.com.au/sa-activates-code-blue-and-red-for-extreme-weather-heres-what-that-means/

[u/Ruthless4u → u/Nasskit1612]

A big problem is people stopping meds the moment they feel better, because why keep paying for something they don’t “ need “?

While not a psych ward I did work with long term dementia patients. A lot of the same issues but they would in up in LTC

[u/ChocolatChipLemonade → u/Ruthless4u]

Yeah it’s complicated. When my mother graduated pharmacy school long, long ago, her first position was at the state mental institution, working under a psychiatrist. These were patients that absolutely could not survive in the outside world. She said that when they privatized the system, it created an abundance of homelessness and loss of care for those that needed it. Kinda just pushed those institutionalized people out on the streets and said, “Good luck!” It was more about money than anything else.

[u/Professional-Tax-615 → u/ChocolatChipLemonade]

I'll never stop saying it. Ronald Reagan is the reason that the United States will always have a homelessness problem. He's the reason that mentally ill people have no place where they can go live and get treated properly. Republicans voted him in right? So Republicans are the reason the world is a s****y place - as usual.

[u/ChocolatChipLemonade → u/Professional-Tax-615]

I agree with you. He just wanted to reduce funding and put responsibility onto the states, and wipe his hands clean of it. He clearly did not have the compassion or experience needed to continue the social programs that had been created before him.

[u/thingstopraise → u/Ruthless4u]

EDIT: everyone is jumping in to provide reasons that people stop taking meds. I already provided a specific reason here: it is so stupid to stop taking meds because of feeling better. I didn't say it was stupid to stop taking meds because of finances, or social pressure, or blah blah. I am speaking SPECIFICALLY of the people with no interceding factors and who verbally acknowledge that they're doing better on meds than they do without them. Then they say that because they're doing better, they no longer need the meds... even though they just admitted that they're doing better while on meds than while off meds. Then they go off the meds and have a psychotic break, and it is somehow compleeeeetely unforeseeable.

My stepsister was one of these people. She knew, and stated, that she was better on meds. She decided that since she was better on meds, she no longer needed meds. She went off the meds that she said were helping her. She had psychotic breaks. She went back on medication and felt better. Rinse and repeat. How do I know that this was her thought process? Because she TOLD ME. She had no financial issues, no social pressures, no severe side effects, etc that were preventing her from taking her medication.

Mental illness is not someone's fault, but it is their responsibility.

---

It is so stupid to stop taking meds because of feeling better. What is even the thought process here? They're feeling better BECAUSE OF THE MEDS. "Oh, since I went on my blood-pressure meds, my blood pressure has been better. I can go off my meds now!"

If they're still crazy enough to go off their meds because of feeling better, then they need a higher dose of meds.

I have been taking 7 psychiatric medications, solely for PTSD and its sequelae, daily for the past several years. Not once in my life have I ever thought, "Huh. My flashbacks have been better recently. Time to go off the med that made my flashbacks better!"

(No, I'm not over-medicated. My psych is a retired Army psych who once directed an entire group of 600+ Army psychiatrists. He knows what he's doing.)

[u/naazu90 → u/thingstopraise]

Let me explain from the perspective of someone who has worked with patients who need long term/lifelong medications.

First, people don't like to keep taking medication. They want to get cured, not just treated. It makes a lot of difference at a psychological level to know you no longer have something, rather than you needing to take meds to control it.

Second, we used to counsel patients to not stop taking their blood pressure medications by telling them that unlike a fever or infection where you complete the required course of medication and get cured, here you have to keep taking the medication because your BP is normal because meds are controlling it. If they stop taking it, it would go up again. We would also counsel about what complications could arise out of uncontrolled BP - stroke, because that sounds the most devastating to patients and is quite effective at scaring them into compliance.

Third, side effects or fear of side effects. Psychiatric medication usually comes with more side effects than others.

Fourth, psychiatric conditions are still associated with significant stigma. People like to tell themselves that they no longer need to be on pills. You can call it whatever you want. All of us suffer from one delusion or another.

Finally, the cost of medication, if the patient is from low socioeconomic groups, particularly in my part of the world.

Not everybody shares the same views/outlook as you. People are complex, complicated creatures. Whether their choices make sense to you or not, is immaterial.

[u/thingstopraise → u/naazu90]

But I'm not speaking about those people with those specific issues. I'm talking about someone who 1) admits that they're doing well *now that they're on medications*, 2) admits that they were doing worse *without* medications, 3) says that now they're doing better, they can go off the medications, and 4) (surprised Pikachu face) have a tooootally unforeseeable psychotic break when they're off the medications.

I'm talking about people who ADMIT OUT LOUD all of these things and who have *no other intervening factors*. My stepsister, for instance.

"I'm overweight. I'm going to exercise and track my eating. Okay, great, now I'm at a healthy weight and am fit. I guess that means I don't need to exercise or track my eating any more. I can go back to eating like I used to, and being sedentary too. Oh fuck-- why am I gaining weight?"

Also, there is... no such thing as being "cured" of mental illness, just like there's no such thing as being "cured" of type-1 diabetes. It can be managed, but there is no *cure*. There's no cure for my broken elbow; it healed, but it will always have a fracture mark, and I'll always have a little click when I turn my forearm. There's no cure for asthma; there is only management. It's the same with mental health. And we'd call people stupid for going off their insulin because they want to be "cured", too.

Mental illnesses are not someone's fault, but they absolutely are someone's responsibility. We can't say, "That person was drunk-- they didn't know what they were doing when they drove the car," even if that person only crashed into a tree and just hurt themselves. Why is it *any* different with mental illness? If the person is sober, and knows that they are sober, and knows that they shouldn't drive while drunk... then why the fuck would they get drunk and drive while drunk? That's stupid. That is indicative of stupidity. We all agree about that. Now, replace it with, "I'm stable on meds. I am not doing anything to harm myself or others. I know that when I'm not on meds, I harm myself and others. But now that I'm stable, I no longer need meds." If that's their thought process, then they... are not actually stable on the meds.

[u/InformalVermicelli42 → u/thingstopraise]

It's a symptom of schizophrenia and bipolar disorder, called anosognosia and it's not a choice. Their functioning is so poor that they cannot understand that they are ill.

My sister is afraid of mirrors because she doesn't believe that she really looks like her reflection. To her, it looks like a whole different person.

[u/ConfusionsFirstSong → u/InformalVermicelli42]

Yes. This. Anosognosia, or lack of insight. People can even seem to have insight one moment, and the next day not have it at all. It’s how these illnesses work, they fluctuate constantly.

[u/Blazured → u/thingstopraise]

It's not really like that. It's:

No meds = Normal

Meds = Suppressed normal

If you feel normal off your meds, your brain will tell you to stop taking your meds because they're suppressing you. Even though you need do need meds because you're not actually normal off them.

[u/thingstopraise → u/Blazured]

If you feel normal off your meds

No, we're talking about people who feel better while they're on their meds, and then, because they're feeling better, choose to go off their meds. Their "better" brains are the ones that make the decision to go off of them, and then their behavior of course goes completely nuts.

I had a stepsister who was relatively normal on her bipolar meds. Every couple of years she'd get the great idea to go off of them because she was doing "so well". Insert a couple of months of crazy behavior such as trespassing, property damage, and assault... before she'd be forced by the psych ward to go on the meds again. She'd be decently normal for a period of time, then go off then again on purpose due to feeling better, then rinse and repeat.

Edit: she literally TOLD ME that she no longer needed them because she felt better... while she was still on them. Oh my god. I am not criticizing anyone here other than people who KNOW that they feel better since they've been on medication and then decide to go OFF the medication because they DO feel better. That is it. I'm not criticizing anyone who can't stay on the med due to side effects or cost or whatever else. I'm criticizing the active choice to not take them when you admit that you have felt better while on them, and therefore think that feeling better means that you don't need to take them.

[u/Blazured → u/thingstopraise]

Yeah I understand where she's coming from because I also have meds for my PTSD and antipsychotics. You feel better on your meds, you're functioning, but you're not "normal" in your head. You feel normal off your meds. Of course you're not normal, but for you that's your normal unmedicated self.

Meds help you function and get your shit together, but generally it doesn't banish the tiny little thought in your head telling you that you're normal without them or don't need them. It can even manifest as anxiety or fear to take your meds because they're stopping you from feeling normal. So that can translate as delaying taking them some days, and can compound because the delay in taking them allows the thoughts telling you to stop taking them become stronger. You need more than just meds to deal with that.

So if meds help fix you and get your shit together, you think you don't need them anymore because you're fine and you can continue on without them because you can handle being a normal person.

[u/bardicboob → u/Blazured]

Honestly that person is just a loser. They think their mental illness is the only way to be mentally ill.

[u/thingstopraise → u/Blazured]

Eh. I have never thought that I was normal without my meds? I have always identified my PTSD as a horrible protrusion into my life that prevents me from doing even basic tasks, and I'm very grateful to the medications that I have which allow me to function. Maybe I was "normal" in the sense that I had always had PTSD symptoms, but I was not "normal" in the sense of functioning.

I guess it comes down to how someone relates to themselves, their symptoms, and their medications. What does "normal" even mean? There is no normal.

I know what "crippling PTSD symptoms" are. I know what "cannot see a trigger without crying" is. I know what "sweating so much in my sleep that I lay on towels" feels like.

Even if that were normal for everyone in the world, I wouldn't want to be that way. Why would I? Whatever side effects I might have from medication, they are far preferable to the literally crippling PTSD, as in "leaving work on disability" PTSD, that I had before.

And yes, therapy is needed too. But it's not "accidentally skipped one day of medication" that makes someone quit cold-turkey. They were already not adaptive on the medication that they were on. I am talking very specifically about people who by their own admission are doing very well on their medications and then go, "Ah, I'm doing so well, I can go off of them!"

[u/NormGthePaintballGuy → u/thingstopraise]

I have on a couple of occasions made this mistake and stopped taking my antidepressant/anxiety meds because I thought I was 'fixed' and didn't need them anymore. Some people honestly just don't understand their own situation and want to believe the problem can be 'cured' and gotten rid of like an infection. It's also in part due to stigmas about being permanently medicated; fearing some potential long term side effect, or not wanting to be one of the 'crazies' who has to take meds to stay sane.

Also, the way a person's mind works can change drastically depending on whether they're in the grips of a mental health crisis, or medicated and in therapy; there have been versions of myself that, from my current vantage point, I don't understand or relate to... And having been better for some time now, sometimes I forget what my mind was like when depression and anxiety were calling all of the shots... You don't see hope when you're depressed, yet you refuse the idea of hopelessness when you're well.

Everything is easy when your brain is functioning correctly, and nothing is easy when it isn't. Through mental wellness we become much more capable, fooling ourselves into thinking that we've defeated mental illness once and for all, that it can never come back, regardless if we remain medicated or not.

[u/Blazured → u/thingstopraise]

PTSD is generally quite different. I know the symptoms, but I generally just take my meds to deal with that, I don't take them for whatever sort of psychosis I obviously have. The doctors obviously suspect it too, given the meds I'm on, but whatever it is (it's undiagnosed and I don't want to self-diagnose) it's just made worse by my PTSD.

Off my meds I'm happy, charming, make people smile and laugh easily, and can navigate social situations incredibly easily. But I'm also incredibly self-destructive and impulsive, prone to extreme fluctuations in mood, and can't really function in regular life without causing it to blow up around me. The meds dull me but cause me to be able to function in regular life, but my head knows being medicated isn't the normal me and doesn't like being dulled. Logically I know I need to take them, but my head doesn't want me to so that translates into me procrastinating or delaying on taking them, and eventually just not taking them if I don't force myself to keep on top of it. My body doesn't want to.

So meds make you stable and you feel cured. You're functioning like a normal person so the voice telling you to stop taking them can become louder because, well, you're fine now. You don't need them anymore. But if you stop taking them properly that voice becomes louder, which causes you to continue to stop taking them, and then you begin to feel more 'normal'. On my meds I'm a functioning adult. Off my meds I ended up homeless and sitting in a mental hospital, for the second time in two months, with a broken nose and a completely ruined life.

I distinctly remember being unfairly annoyed at my girlfriend once when she noticed that I was off my meds, despite the fact that I felt fine. She knows me well enough that she can notice the subtle shifts in my behaviour that I don't notice until things become more extreme. My annoyance towards her came from my body not wanting to take my meds because I felt fine and I didn't understand how she could notice something that I couldn't notice. Her noticing meant I'd have to take them even though my body didn't want to. I remember later sitting on my bed with her looking at my meds in my trembling hand, building up the courage to take them. "I feel fine, I'm functioning normally, I don't need to take my meds, I'm scared of taking my meds" is what my body was telling me. It took my girlfriend sitting beside me and gently giving me support just to build up the courage to swallow a few pills.

So you need more help than just meds to deal with the big part of you that wants you to stop taking them. It's not as simple as "just take your meds" when a big part of you is telling you not to. When that part of you is scared of taking them. That's why you see people, who need to take them, stop taking them when their life is normal and functioning. "I'm cured, I'm fine, I don't need them". So this is probably why your sister stops taking them too, even though she needs to.

[u/GoneWilde123 → u/thingstopraise]

Bipolar checking in: I feel better on my meds and I’ve stopped a few times. First time I stopped I was off for ten years, I started off pretty good for a few years and was mostly fine for a few years after. A little weird but nothing an understanding person couldn’t handle. By the end of the ten years, I was in fact very fucking sick. I’m not going to get into details but I was undeniably not okay and it just kept getting worse. I’d say it took a solid couple of months to pull it together.

I got better and then the urge started to kick in. I wanted off so badly. I missed my energy, I missed my messed up sense of time, I missed being skinny, and I’m sure there was other reasons but the point is - I’m on a lifelong medication every single day. I’m just a human, following up every couple of months with a psychiatrist, getting blood tests, doing therapy, taking meds twice a day, and it just builds up. That’s just what I have to do to BREAK EVEN. Sometimes, I just want to give up on being healthy and be my best delinquent self. It was fun… for a while anyways.

That being said I’ve very recently had to stop taking meds (for medical reasons for a brief period of time) and it took a total of four weeks before I started running my life into the ground. Then, once getting back on them it took FOUR MORE weeks to get back to thinking normally.

So yes, it’s better to be on meds and logically I understand that. But what I want is to be free. I didn’t ask to have this disease, I didn’t ask for this life, and now I’m just stuck in it.

[u/A_Glass_DarklyXX → u/thingstopraise]

The mistake you’re making here is using your own logic. Many people don’t define “better” in the same way. Some people feel they are sluggish, “not normal”, can’t react and respond in a way they’re used to. If they live on the street they say their meds take away their ability to react and they become vulnerable to crime. I’ve had patients say they’ve been sexually assaulted when medicated and on the street because meds for schizophrenia and bipolar disorder often are sedative.

It’s just hard for them to remain consistent every day for the rest of their lives. Most patients who take any medication experience attrition. Throw in the additional reasonings: they can’t remember to take their meds, they don’t remember to refill them, don’t have a place to refill them, or their meds get stolen on the streets, especially if they have street value.

[u/MovinOn_01 → u/A_Glass_DarklyXX]

And the horrible side effects....

[u/thingstopraise → u/A_Glass_DarklyXX]

I literally was told by my own stepsister that she went off her meds because she thought that she was feeling better and no longer needed them.

Edit for formatting. In the context of this conversation in this thread above, we were talking about people who literally explicitly say that they're quitting their meds because they feel better. We were not talking about people whom we think should feel better on meds but who decide that the side-effects aren't worth it and therefore go off the meds.

We were talking about people who specifically can and do take their medications and who choose not to because of the fact that they themselves think that they are feeling better and therefore no longer need them. Nowhere in my comment did I mention any other type of rationale. I did not say that it made no sense for someone who gets them stolen or for someone who can't afford them. I very specifically stated that it made no sense for someone to knowingly and willingly go off a medication when they knowingly state that they feel better since they've been on the medication.

[u/theLumonati → u/thingstopraise]

You’re criticizing mentally ill people for making poor choices because of their mental illness and their subsequent lack of self awareness, and then you’re getting bent out of shape by the fact that those choices are not logical. I totally get your frustration over dealing with a family member who has done this, you have every right to be frustrated by it, but you’re not going to find a satisfying answer here as long as you keep trying to force a logical framework onto their actions.

[u/[deleted] → u/thingstopraise]

the meds, like all drugs, have side effects. also, sometimes meds stop working for people. we don't know why, it just happens. also, sometimes they aren't on the right ones, or the dosage is wrong. it's not cut and dried.

[u/Maxcrss → u/[deleted]]

No, but most times some meds are better than no meds for people who desperately need them.

[u/[deleted] → u/Maxcrss]

sure, when they work, they work. just tryna clue people into why someone might stop using them.

[u/Maxcrss → u/[deleted]]

Yes I’m agreeing with you.

[u/[deleted] → u/Maxcrss]

gotcha

[u/bardicboob → u/thingstopraise]

Hey goober, they’re not stupid, they’re sick. You should consider yourself lucky you’ve never been in that situation.

[u/thingstopraise → u/bardicboob]

We're not talking about people who don't know that they're doing better. We're talking about people who say, "I sure am doing well on my medications. I wasn't doing well when I wasn't on my medications. But now that I'm doing well, I'm going to go off my medications. I don't need them any more! Okay, I'm off them, and-- fuck!"

I am talking about people who literally say that shit out loud. They know that they're doing better because of meds and they decide to go off them anyway because, since they're doing better, they... no longer need the meds. According to them. Someone having mental illness doesn't absolve them of responsibility. It is not their fault, but it is their responsibility.

[u/bardicboob → u/thingstopraise]

You are calling people stupid for being sick. Being deluded into thinking they no longer need their meds is a symptom of their illness. You’ve had several people tell you this isn’t something you can apply logic to and yet you still try.

I’ll keep my sanity, peace.

[u/kimmytoday7894 → u/thingstopraise]

Maybe stop being so judgemental to the struggle of others? You have no clue what someone else's story is. And you're on 7 psych meds and you're judging people? Learn humility.

[u/thingstopraise → u/kimmytoday7894]

"Learn humility" because of being on 7 psych meds is... in itself a judgement, isn't it? From you? Because apparently, the state of being on psych meds means that you need to be humble about others? Is that how your thought process works? Because you are also, in this same message, defending people who... choose to go off their meds. Which one is more in need of humility, do you wonder? Or... is it wrong altogether to say that others need to learn humility because of their medical state? Shouldn't it actually be, according to your logic, that I need *less* humility, since I've managed to stick to taking 7 medications for years and years?

That being said:

Are we talking about the same thing? I was talking about people who:

1. Fully acknowledge that they are doing better now that they are on medication.
   
2. Acknowledge that they are doing better than they were when they were not on medication.
   
3. State, out loud, that they are going off their medication.
   
4. They explain out loud that they are going off their medication because they now feel better.
   
5. They have stated that they feel better because they are on medication.
   
6. They decide to go off the medication.
   
7. ??? They have psychotic episodes after they choose to go off this medication.

We aren't talking about people who don't know what they're doing. I specifically talked about people who choose to go off their medications while knowing that the medications have made their life better.

"I was drowning until I put on the life vest. I have stopped drowning since I put on this life vest. I am no longer drowning. This is a good thing. This must mean that I no longer need the life vest. Therefore, I should take off the life vest. Okay, I'm taking off the life vest and-- holy fuck, I'm drowning!"

Does that not... seem fucking stupid to you? People with mental illness aren't helpless. It's condescending to say that they don't know what they're doing when they do it, especially when they *explicitly say* that they're doing X for Y reason.

"I kept getting sunburned until I used sunblock. Now that I use sunblock, I don't get sunburned. Since I haven't been sunburned in a while, it must mean that I no longer need sunblock. I'm going to quit using it. Great! Oh fuck-- I'm so sunburned!"

[u/kimmytoday7894 → u/thingstopraise]

So no, I am not judging. I'm saying that given you're on 7 psych meds, you should have more compassion for those suffering from mental illness. But also, not all psych meds need to be taken forever. There are some psych meds that can be stopped safely. But people with severe mental illness also don't always have the reasoning ability to realize their case is different and its a med they need lifelong. Nonecompliance with meds is actually a symptom of some psychiatric disorders. No reason to be insulting to these individuals just because they don't follow the posters vision of whats appropriate.

[u/[deleted] → u/Ruthless4u]

another problem: cops doing sweeps and throwing people's meds away.

[u/rainbowsunset48 → u/Nasskit1612]

That is why I quit social work

[u/Just-Performance-666 → u/Nasskit1612]

Nowhere to put people in those situations really. Even if they had stable housing provided, the chances of them doing exactly the same thing and stop taking their meds because they feel better is pretty high. I worked in a psych ward for 2 years. I saw the same people every few weeks, months over and over again.

[u/KawaiiBibliophile → u/Nasskit1612]

I work in public policy. Specifically on issues of criminalization, mental illness, and homelessness. He won’t be able to stay on his meds. He won’t be able to”fine” anymore and he will commit some petty offense that was created to criminalize homelessness and mental illness and end in a jail that more than likely doesn’t have the resources to assess nor treat him and will cycle in and out unless someone is able to get him stabilized and into permanent supportive housing (assuming that stays around). 😩

[u/lizerlfunk → u/Nasskit1612]

I made almost this exact same comment elsewhere in the thread based on my late husband’s experiences working in mental health.

[u/obscuredreference → u/Nasskit1612]

It’s very sad, for sure. 

However it’s weird that society always feels bad for the guy who ends up in the street and will likely not keep taking his meds. 

Where’s the people feeling bad for the old woman he hurt (his mom), or for the people he’s going to hurt once he’s off those meds?

It sure sucks, and there’s no easy solutions because they all require resources that often aren’t available, and if they were, they’d likely be missing from some other cause in need too, like fixing the foster children system or something. 

[u/Best-Description-231 → u/Nasskit1612]

I work at a homeless shelter clinic, and everyone that is dced to streets usually ends up becoming a freq flyer. which means they get treated even worse in the ed and dced in much worse conditions. the winters are extremely tough with wound care consistency but we do our best to outreach those who need daily care that probably wont seek on their own.

[u/BladeOfWoah → u/Nasskit1612]

"Well hopefully he d- It is unfortunate to hear but we only have a limited amount of resources to distribute out." - corrupt administration.

[u/Elegant-Ad-9221 → u/Nasskit1612]

There is a documentary called Life With Murder about a man who beat his mother to death during a psychotic break and was being housed in a mental institution instead of a prison. He knew what he had done too

[u/Hot_Storm3252 → u/Nasskit1612]

That’s my argument for socialized medicine.

What are the indirect cost to not having socialized medicine?

Crazy guy goes to hospital for a few days gets better, but now he’s fiending for drugs and robs someone and steals a car injuring someone in the process.

When all this could have been avoided with bipolar medication. 

[u/soleceismical → u/Hot_Storm3252]

Absolutely. And there's also the fact that so many people like that that come through hospitals have gotten so many brain injuries over time that make them more and more disabled in terms of cognition, impulsivity, executive function, etc.

The drugs injure the brain (opioids starve it of oxygen, meth is directly neurotoxic and can also cause bleeds), and they also tend to get traumatic brain injuries from fights and from falling off stuff taking risks while high or manic or psychotic. Or maybe they get traumatic brain injury crashing the car they stole.

So now a person who might have led a normal, independent life with the right medical care and medication instead spins out and gets brain injuries and is now a 6 or 7 on the cognitive functioning scale. And is discharged to the streets even though the medical staff know they likely need lifelong assistance, because (a) we don't have socialized medicine outside of the emergency department and (b) we can't force them in to treatment if they don't want it, even though part of their condition is being unaware of their condition (anosognosia) and safety risks.

[u/jeefra → u/Hot_Storm3252]

It's a crazy guy, how do you get him to consistently take his meds? How do you make sure he doesn't sell them instead? How do you know that it was the bipolar disorder that got him to rob someone and not just typical junkie stuff?

And, it's not like he's ever gonna pay for the medical treatment he got, he essentially has free healthcare already. Socialized healthcare is a benefit for poor/middle class people, people who actually pay for healthcare and insurance. People who are destitute don't pay either way.

[u/Hot_Storm3252 → u/jeefra]

There’s no assistance for the uninsured outside of acute care from the hospital.

The current system bandaids the issue until another “episode”, and the process repeats.

You can’t get any mid/long term care like psycho therapy, drug rehabilitation, or mental health assistance without insurance(maybe in some liberal states).

I used that example because I see it everyday. 

People who are homeless statistically have higher mental health issues. They don’t have access to their medicine. They don’t have access to a refrigerator to keep their medicine from melting(I’m in Florida), or they sell it because they need money for something. 

Now we have someone on the street with mental illness who will probably commit a crime costing tax payer money, the victim money, the health system money. When we could possibly reduce this type of situation from forming to begin with.

We can’t end mental illness, or homelessness but we sure can reduce it resulting in less crime. 

The issue is people try to apply logic to the issue at hand when someone with say schizophrenia doesn’t use logic when having an episode.

[u/Silver_Recognition_6 → u/Nasskit1612]

Dude should be institutionalized... a ward of the state in a state bin.

[u/Nasskit1612 → u/[deleted]]

Are you worth money to house? Like, if you had a mental break and were not in touch with reality anymore, are you worth housing? Is your child? So I think yes they are worth it.

[u/bannedbooks123 → u/Nasskit1612]

When I lived in the city, it was unnerving to see people who clearly weren't mentally well walking around. I'm scared they would try to hurt me or my child in a psychosis. It's not safe for them or anyone else to be on the street like that.

[u/Commercial_Wind8212 → u/Nasskit1612]

no.

[u/y2ksosrs → u/Nasskit1612]

I think hes pointing out someone with a history of violent mental illness poses a danger to society.

[u/Scuba9Steve → u/y2ksosrs]

Which is why we should spend that 50k a year to prevent them from killing someone. And once that happens theyd be in prison getting tax dollars spent to support them anyways.

[u/y2ksosrs → u/Scuba9Steve]

That's usually what happens. But its drug related a large majority of time, cant get high in a shelter.

[u/Nasskit1612 → u/y2ksosrs]

I hear that. Do they not deserve help? Some people can’t manage their diabetes with plenty of help from drs, people who reality changes need help too. I think the current system is deeply flawed. “Away” is just the streets. Where they are still a danger to society. Not all people with unmanaged mental illness are violent

[u/y2ksosrs → u/Nasskit1612]

I agree I used to work directly with the homeless, all day every single day. The biggest issue is you cant get high in the shelters. They deserve help. But let's not pretend like they arent dangerous on average, as most people dont want them in their property as soon as they own it.

[u/Nasskit1612 → u/y2ksosrs]

That is absolute facts. I think part of the issue is not addressing things at a young enough age. But this could fall into a whole discussion. There are so many things that need to addressed that will take years of work before we see results. People don’t want that, they want something now.

[u/BeefmasterDeluxe → u/y2ksosrs]

Yes, tax dollars are often used to fund violent lunatics destroying society (politicians, police)

[u/Sheraby → u/Nasskit1612]

Thank you

[u/inab1gcountry → u/[deleted]]

Not “your money”. “Our money” and yes. Using tax dollars to support people is the right thing to do, and is cheaper than locking them in prisons or psych wards. The ICE budget alone is enough to BUY A HOUSE for every homeless person in the USA with millions left over

[u/Nasskit1612 → u/[deleted]]

I get the back and forth. When I met him, he was a “regular” guy. I felt really bad for him. I don’t know what the answer is. We need a better system than what we have.

[u/abitmessy → u/[deleted]]

Do you actually pay $50k to house someone from your taxes or are you asking if a particular human is worthy of being cared about?

[u/Daelda → u/[deleted]]

Yes. Everyone is worth housing, giving basic food/clean water, and giving basic healthcare.

[u/NotAnAnticline → u/[deleted]]

If you're making enough money to pay $50k a year in taxes, you can afford to put some of that tax money towards helping your fellow humans who aren't as fortunate as yourself.

[u/PatchyWhiskers → u/[deleted]]

Yes, because otherwise he’s going to hurt someone as one of those “scary homeless guys” you Republicans love to demonize.

[u/Commercial_Wind8212 → u/PatchyWhiskers]

i'm not a republican. are you going to force these folks into some kind of facility?

[u/PatchyWhiskers → u/Commercial_Wind8212]

Wasn't that YOUR implication?

Funny that there are no Republicans on the internet but the Republican party still gets a lot of votes. Ghosts?

[u/Customisable_Salt → u/[deleted]]

Do you actually think that if you don't house them they cost the public purse less? Even  approaching the situation with zero humanity it simply makes sound economic sense to help them now. You're too short termist in your perspective. 

[u/_TallOldOne_ → u/[deleted]]

So your proposal is to what? Come on….say it.

[u/Scuba9Steve → u/[deleted]]

When they end up in prison after hurting/killing people, they'll still be supported by tax dollars. You're just trading spending tax dollars for crime + still spending tax dollars.

[u/saladdressed → u/DebtBeautiful8188]

Does your area have a lot of beds in mental hospitals available? I live in a large city and we have none. Non-homeless people who need inpatient care can’t get it and are on waiting lists.

[u/extralyfe → u/saladdressed]

... do you think homeless people are taking the beds?

[u/saladdressed → u/extralyfe]

I don’t know. But since there are currently no beds “institutionalizing” the homeless is not an option in my city with a sizable homeless population.

[u/Comprehensive-Put575 → u/DebtBeautiful8188]

Absolutely. “Overestimate how many resources there are” is huge in this. It’s been steadily eroding for decades and alot of people are under the impression it’s still 1980. These institutions at best are hanging by a thread if they even exist at all anymore

[u/sugahack → u/Comprehensive-Put575]

I've tried to explain this idk how many times. I'll share a worry about whether or not I will be able to access a resource and everyone jumps in with all the wonderful resources there are out there. Like, if that helps you sleep at night, but that's all most of those do

[u/Comprehensive-Put575 → u/sugahack]

Exactly. There’s so many people think that there’s just a homeless shelter where you can go in every town. But depending on where you live you could be hours away from one. It could be full any given night. Some of them only open in the winter. Then they’re not necessarily habitable and sometimes people are safer not going there. They’re selective sometimes too and often families cant stay together either.

Even the bridge programs to try and prevent people from becoming homeless are financially dried up. Even section 8. They love to rail against it, but it takes people years to get on that sometimes.

Same with mental health services. Got a relative who needs longterm care? Good luck. They pretty much only intervene when someone is actively in psychosis and even then they hold them just long enough to stabilize them on meds and dump them out again. Or jail. They’ll wait until the mental health deteriorates to the point it devolves into an arrestable offense. Nevermind that the family has been desperately trying to get help for them for months or years before that.

And they also think all these problems are entirely self-inflicted because they have no understanding lf the economic hardships people face today. They don’t understand that 40-60% of homeless people in this country have jobs. These people are working! But conditions are so bad they cant afford any available accomodations at all where they live with that job. But people absolutely refuse to acknowledge there’s a housing afforability and wage crisis.

[u/sugahack → u/Comprehensive-Put575]

I am disabled and have been most of my adult life. I am a pro at navigating the system. I get so mad at those people who say just call 211. What a joke. Who is paying this person to do an internet search without enough and outdated results

[u/Particular-Poem-7085 → u/DebtBeautiful8188]

mental institutions give them the greyhound treatment and the beautiful cycle continues. A practice of releasing troublesome patients with a one way ticket out of town.

[u/Sad_Ad3148 → u/Particular-Poem-7085]

What is the "greyhound treatment"? I just finished my clinical rotation (nursing) on a psych ward last spring. What they do is treat any medical issues they have (usually addressed on a med-surg floor), get them back on their meds if they've been non-compliant (lack of resources is often the reason, money, transportation, etc.), and use a multidisciplinary approach (social workers, nurse case manager, psychiatrist) to help them discharge safely, with a plan (follow-up appts, meds, housing support, crisis support). These "troublesome" patients often have histories of trauma, poverty, or systemic injustice. Psychiatric illness is a difficult thing to live with.

[u/PyroDesu → u/Sad_Ad3148]

What is the "greyhound treatment"?

Putting them on a Greyhound bus to another city, possibly another state.

A lot of states like sending their homeless to California.

[u/InteractionGreedy249 → u/Sad_Ad3148]

Your psych ward must be better than any I've ever went to. At mine they ignore my medical issues that I think are a major contributor to my psych issues (I get a rash and join pain with my psychosis which is also generally triggered by my period, fairly sure it's autoimmune,) you generally don't get to see the psychiatrist until discharge and he's an asshole and they don't particularly care if you can afford your meds, and the support afterwards you listed is non-existent. They put resources on the board that they don't actually have. Then they charge you $7,000, sue you if you can't pay it, and garnish your wages 25% at 12% interest and then garnish your bank account on top of it, keeping you trapped in a cycle of poverty. I've been having my wages garnished for a psych visit for a decade and exactly $10 has gone towards the principal and I've paid almost $4,000. I can't get anyone to help me. It's monstrous, and was never intended to be help.

[u/thingstopraise → u/InteractionGreedy249]

You've got to declare bankruptcy. Each state bar association has a list of low-cost or no-cost bankruptcy lawyers who will help you at a reduced fee based on your income. You can discharge all debt but student loan debt in bankruptcy. If your financial situation is that dire, you should be eligible for a Chapter 7.

[u/InteractionGreedy249 → u/thingstopraise]

Unfortunately I'm still accumulating a ton of medical bills I can't pay, so bankruptcy wouldn't help me yet. I'm almost done with my five year plan to hopefully get a diagnosis for my physical health stuff and then hopefully get treated and be healthy enough to work full time. I should be on track to declare bankruptcy in 2027 if all goes well. 

[u/thingstopraise → u/InteractionGreedy249]

Laws surrounding medical bills have changed, depending on your state. You would have to look up your specific laws. But my state, for instance, prevents garnishment from patients who are eligible for free or low-cost care, and as of October 1st, no medical bills will be permitted to go on a patient's credit report. And only 25% of the person's disposable income (after all bills etc) can be garnished.

[u/InteractionGreedy249 → u/thingstopraise]

My state has only gotten worse I'm afraid. In 2022 they made it legal to garnish bank accounts on top of wages, so taking the 25% of your wages and then garnishing the rest from your bank account when direct deposit hits. 

[u/bamamaam → u/InteractionGreedy249]

My heart goes out to you...

[u/Minute_River6774 → u/Particular-Poem-7085]

Be glad you live in an area you can still talk about mental institutions

[u/futurecrackpot → u/Particular-Poem-7085]

It’s true. I received the greyhound ticket out of town and a ride to the bus station. Needed it bc they transported me from an hour away, in chains from an ER, and I had no way to return home. Watched someone else sell their ticket and leave the station.

[u/RELLBEFLEXXIN → u/DebtBeautiful8188]

You support housing, reintegration, and safe sleeping sites, which I agree with. But when you bring up institutionalization, you jump to the extreme as if “lock them all up” is the default thinking. I don’t believe that’s the common attitude outside of the loud, ignorant minority.

For the past three years I’ve worked Homeless Outreach in Philadelphia, including the Kensington & Allegheny area. My team has helped many people into resources tailored to their journeys. But where we consistently run into a wall is with those living with severe mental illness and addiction.

I’ve worked with participants whose limbs are literally rotting off, yet they refuse medical care. In those cases, we’re forced into a medical hold process that feels like pleading our case in court. We approach people with empathy, up-to-date info, and staff with lived experience. Still, without access to stable, professional institutions that can step in when someone is truly incapable of making safe decisions, many will just suffer in the street.

So yes -housing first, dignity, personal choice, all of that is essential. But a humane system also needs responsible, compassionate institutions to intervene when someone’s illness puts them beyond the point of rational self-care. Ignoring that reality only ensures more unnecessary deaths.

[u/MrandMrsMuddy → u/RELLBEFLEXXIN]

Yeah I feel like it shouldn’t be a controversial view that people who are incapable of living independently should probably be in some kind of facility.

[u/Direct_Village_5134 → u/RELLBEFLEXXIN]

It's wild that society understands we can't let old people with dementia make their own medical decisions and leave them to their own devices, but if the person has schizophrenia it's totally unacceptable to compel treatment or put them in a home.

I think what it boils down to is widespread ignorance of mental illness and some amount of denial that mental illness is a real illness. Thus they choose to believe a schizophrenic can cure themselves through will power alone.

[u/RELLBEFLEXXIN → u/Direct_Village_5134]

Agreed. Now tack on an addiction fentanyl to that person with schizophrenia, and people will still argue that mental institutions aren’t necessary? Like c’mon we’re struggling out here.

[u/Sheraby → u/RELLBEFLEXXIN]

I said this elsewhere: I don't believe we're capable of providing secure, safe, compassionate institutions as a general solution. I'm sure they're possible in some specific instances, but for it to become a broader policy there are a lot of things that need to change.

Thanks for your work and your care.

[u/Direct_Village_5134 → u/Sheraby]

Do you believe our current system of letting them rot in the street is a better one?

[u/Sheraby → u/Direct_Village_5134]

Absolutely not. Safe, supportive, compassionate care should be the baseline. I was commenting on our failure to meet the need.

[u/adminssoftascharmin → u/DebtBeautiful8188]

Away in institutions. Compassionate institutions. Give them their DOC too, ideally getting them towards MAT. Once they are arrested and assessed to be at the feral levels we see today they are sent there until deemed fit. And if they can't fit the meld after too many strikes its a prison stay, and back to the facility. After enough law breaking in the facility they just end up in prison for their respective sentence and then back to the facility.

But the facilities are compassionate. They are given decent food, clean water, comfy beds. Books, entertainment, counselors, therapists, social workers etc. The goal is to get them on MAT, get their mental health better, and transition them back into the world. Even if they are homeless, they understand the rules they need to follow and will end up right in the facility again if they don't.

And if they never wanna leave and be a lifer than fine. We already pay so fucking much in taxes for prison lifers under horrendous conditions, this shit is a drop in the bucket. Society is massively improved, they are in a better place albeit not free to leave.. and..

There will ALWAYS be homeless people, but the kind that isn't going to be a downfall to society and represent the decay of western capitalism. Hollywood even type-ifies them and there part of Americana. These buskers or city employees cleaning up the streets aren't the problem with homeless people and they aren't the ones bothering people or representing a threat. Now with the feral homeless removed, we are left with these ones and all the resources that open up for them who deserve it. Then we focus on re-integrating these people back into the world if we can, and if not then they need to understand the new process.

Just so people know I consider myself progressive and a hippy. I've also spent time on the streets of the Tenderloin, sleeping overnight with encampments getting to know them. I consider this the only path ahead and we have the tax dollars to do it but no government willing.

[u/Sheraby → u/adminssoftascharmin]

I really hear you. I'm pretty progressive too, and I've been both unhoused and a volunteer support worker. Sad to say, I don't believe we as a society are capable of compassionate institutions, certainly not right now (beyond isolated examples, mostly for the financially well-off). There are reasons deinstitutionalization happened.

There's a whole lot of economic reform and social growth needed so that compassionate institutions can become a reality for anyone who needs one, regardless of financial status. Sometimes I think it's achievable, sometimes I don't. Don't think it will be in my lifetime. Thanks for the thought-provoking comment.

[u/Direct_Village_5134 → u/Sheraby]

We put a man on the moon in the 1960s before computers even existed. Of course we have the capacity and ability to do this.

[u/Sheraby → u/Direct_Village_5134]

I believe human beings have the capacity to create a society where homelessness doesn't exist. I don't believe that, in the political and social realities of the US in 2025, we could create a broad solution to homelessness that includes humane, safe, supportive institutions.

I imagine there are examples of such places that exist. But I am doubtful that there is enough political power right now (and likely any time soon) to achieve long-term funding, or even short-term, and we would also need a pipeline of skilled professionals to staff them.

I would be very happy to be proven wrong. And although I have this doubt, that doesn't mean I don't think we should advocate for better solutions. Are you engaged in that kind of work? Are you familiar with the history of institutionalization, deinstitutionalization, and community-based care?

BTW, computers absolutely existed then. NASA used computers extensively in the Apollo program, including onboard computers. That required advanced technical skills in addition to strong political and societal support. My doubts reside in current societal and political will, in our governing and other systems, and, to a certain extent, human nature.

[u/adminssoftascharmin → u/Direct_Village_5134]

Capacity and ability? Yes.

Willingness? No.

No candidate is going to temporarily destroy their party for the long term benefit of society because we as a populace general are not capable of long-term thinking. It's always short term benefit above all for temporary wins as we push off disaster another week.

[u/pm_me_your_puppeh → u/DebtBeautiful8188]

We absolutely should try to reintegrate the people who can be reintegrated.

The biggest barrier to that is forcing them into the same spaces as junkies and other lost causes.

[u/BeerandSandals → u/DebtBeautiful8188]

I used to live near a VA that had specializations specifically for homeless veterans.

The primary reason for the beds being empty was due to the admin disliking alcohol and drugs.

Quite frankly from my experience with those outside the building…. They probably should stop drinking and doing drugs.

There were programs some would take, but at the end of the day most of the homeless just wanted to get fucked up.

On Reddit they’ll say therapist, but they had plenty of those too.

At some point folks are homeless because they want to be, and that’s an insane thought to have.

I was once homeless, I’ve had a few friends who were… and if it’s circumstance you figure your way out real quick.

If you want to sit all day and get fucked up… well that’s most of the noble homeless frankly.

[u/CarolinaAgent → u/DebtBeautiful8188]

“There are no quick and easy solutions to this, however, and we still have to respect people's dignity and freedom to make their own choices.”

There is no dignity in living in squalor on the street.

[u/Alternative_Chart121 → u/DebtBeautiful8188]

I think most of the backlash against homeless people is just people wanting to be able to use public spaces. People chilling on the riverbank minding their business? No problem. People sprawled out IN THE MIDDLE of the bike path with all their stuff under a dark bridge, causing me to almost run the over? Problem.

Nuance gets drowned out quickly nowadays. Pro homeless activists will excuse almost anything because "they're people too, they're out neighbors". Which is noble. But we are their neighbors too. And being homeless doesn't make it ok to trash public spaces, harass people, or poop in people's vegetable gardens (that was an interesting neighborhood Facebook group discussion...yikes). Using hard drugs isn't a right either (in fact it's illegal), and neither is being drunk in public. 

But the reality is that a lot of people aren't capable of taking care of themselves independently. "Adulting" is hard even for people with education and resources and good health. Not everyone is physically and mentally able to manage their lives. And having those people just live outside and hang out in public spaces all day is a horrible way to deal with that. 

[u/--sheogorath-- → u/Alternative_Chart121]

You say nobody cares about the people minding their own business but my experience begs to differ.

I spent two years homeless. Worked full time but my heinous crime was making less than median rent per month, so I was stuck sleeping in my car.

The model homeless by the definition of most of the people here. Completely sober, didnt even drink alcohol. More sober than the cops harassing me or the people calling the cops on me. Still run out of wherever I parked rhe car to try to sleep multiple times a week. Still threatened with arrest for existing.

People dont make a distinction between "good" and "bad" homeless. If people see you, they want you gone. Honestly when you're treated like shit even when you're the best homeless person you can be, what's the point of putting in the effort to be considerate?

[u/Sunomel → u/DebtBeautiful8188]

we still have to respect people's dignity and freedom to make their own choices.

Honestly, at what point do we not have to anymore?

If someone genuinely wants to choose to live on the street, and spends their time doing drugs and/or harassing the people around them, and refuses to accept any help, to use an extreme (but not unrealistic) example, I don’t see why we as a society need to respect someone who refuses to respect the basic standards of society

[u/FourScores1 → u/DebtBeautiful8188]

There are no “institutions” in the US. Kennedy and Regan got rid of them decades ago..

It’s jail, the ER, or the streets. Nothing else.

Institutions need to be brought back, which is what you’re trying to say.

[u/vorpal8 → u/DebtBeautiful8188]

Sometimes there aren't any beds at the psych hospital, either.

[u/N7Poprdog → u/DebtBeautiful8188]

Can't help people who refuse to be helped

[u/ClF3ismyspiritanimal → u/DebtBeautiful8188]

People often also overestimate how many resources there are available for people who are experiencing some form of homelessness.

Having actually known some actual people who were actually homeless, I can confidently say you are full of shit.

[u/--sheogorath-- → u/ClF3ismyspiritanimal]

How so? When I was homeless the only resource was a shelter that would've made em give up what little possessions I had left and quit my job to become a day laborer for the company the shelter had a contract with.

Housing assistance was only open to families, food stamps got denied because my expenses were too low, medicaid is only for families

Call me crazy but "give up everything you own and work for who we tell you to work for" isnt exactly great resources

[u/CoraCricket → u/DebtBeautiful8188]

I work in housing for chronically homeless folks who have serious mental health stuff like schizophrenia and it's actually SO hard to get the folks that need it into any sort of worthwhile institutionalization. We'll literally be praying for our favorite folks to get charged with a felony for whatever latest thing they did during a mental health crisis because that's one of the only ways to get actual longer term mental health care. The whole thing is fucked up.

[u/Soundwash → u/DebtBeautiful8188]

“That ignorance made them feel safe and secure” thank you for saying it that way. You put so eloquently what I’ve been trying to say about a lot of things. You are a wise individual

[u/Accurate-Fig-3595 → u/DebtBeautiful8188]

We can thank Reagan for closing the mental hospitals, forcing people out into the streets with zero support. But all lives matter. Pro life.

[u/NoTeslaForMe → u/DebtBeautiful8188]

they usually don't understand how the system works and why just throwing everyone in an asylum is a bad idea.

Understanding and recognizing that would undermine the popular (and not even historically accurate) meme of "Reagan caused homelessness by closing down all the asylums!"

[u/Dangerous-Safe-4336 → u/NoTeslaForMe]

Reagan also cut off federal funding for low income housing.

[u/BlixxOrchid → u/DebtBeautiful8188]

Freedom and dignity get lost in the shuffle of shelters and laws.

[u/melkatron → u/DebtBeautiful8188]

You're right. Institutionalization is the correct answer here, if we're talking about America. The administration has been vocal about criminalizing homelessness itself (not just cracking down on homeless criminals), as well as reopening the mental institutions, and at the same time pushing for further privatization of the prison system. Privatizing prisons means profit becomes the motivation behind the criminal justice system, because empty prisons don't turn a profit. Prisons provide cheap labor, which is the only way American manufacturing can compete with China and other countries, so a ton of money and influence goes into feeding the system more able-bodied prisoners.

[u/Chance-Day323 → u/DebtBeautiful8188]

That's how the Nazis started too...

[u/ApprehensiveCrazy714 → u/DebtBeautiful8188]

Yes. “Away” is a terrible and insensitive response. 

[u/HalfOrdinary → u/DebtBeautiful8188]

I'm in law school and they're teaching this (in electives) like it's a brand new discovery and not US history. 

Meanwhile Constitutional Law is taught as though the Supreme Court really considers the Constitution and the intent of the Founders.

[u/Capital-Cheesecake67 → u/DebtBeautiful8188]

The awful truth is a higher percentage of homeless people have mental illness compared to the housed population. Despite multiple ad campaigns there’s a cultural stigma associated with mental illness. It’s too hard to access mental health services unless you’re institutionalized or have a top tier healthcare provider.

[u/Radiant_Garden_9644 → u/DebtBeautiful8188]

agree

[u/Individual-Aioli-810 → u/DebtBeautiful8188]

I agree with your point about living in a different way. I detest living in a house, its very stifling for the soul and I find it insane to spend over 60% of income to be cooped up in a box

[u/MrandMrsMuddy → u/Individual-Aioli-810]

lol yeah what suckers we are, we should all be sleeping outside on the ground instead. Can’t wait for winter!

[u/Sausage_McGriddle → u/DebtBeautiful8188]

Where I live, over 50% of the locals are homeless thanks to foreign developers & tourists. They work (I work with several). Their kids go to school (my kids went to school with dozens). They aren’t sick, lazy, or criminals, they just can’t afford to do it in a house with a roof & 4 walls on the salary they make from those 3 jobs each parent has. And quite frankly, the attitude that all homeless need to be institutionalized or imprisoned like you just postulated is the biggest part of the problem.

[u/DowntownRow3 → u/DebtBeautiful8188]

Yup. I didn’t grow up in a safe home and online I was told so many times to just “run away to a shelter/foster care” in a middle upper class, car dependent sprawling suburb….and still blamed after explaining I will have no resources once I leave

[u/Lonely_Cupcake1727 → u/DebtBeautiful8188]

Yep! And I think a lot of people also don’t realize that psych wards are not some magical place where your mental illness gets thoroughly treated, but rather it’s just a place where the goal is to get you stable enough to not be at risk of hurting yourself or others. It’s short-term stabilization and maybe some referrals for medication prescriptions, intensive outpatient therapy programs, etc. upon discharge. But not everyone is privileged enough to be able to afford those, let alone homeless people.

[u/ConsciousFractals → u/DebtBeautiful8188]

Yeah I can tell you from personal experience that the resources are dang near nonexistent even in areas that are well off. Especially if your needs require more than a hot and a cot. Even if you can find a shelter that isnt full, there’s close to no way for them to accommodate complex sensory/medical/access needs — it can actually be safer to stay on the street/in a vehicle than in a shelter — both from a medical standpoint and a physical safety standpoint.

[u/Traditional-Bar-8014 → u/DebtBeautiful8188]

As a formerly homeless person, Away is a fever dream that rarely materializes.

In prison for failing to comply is the correct answer as the privatized detention system must be satiated.

[u/--sheogorath-- → u/Traditional-Bar-8014]

Most would also be quite satisfied if all the homeless were just dead too

[u/Traditional-Bar-8014 → u/--sheogorath--]

As if that was a finite number...