Helping the poor

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I agree that we should force addicts to get clean (but would argue that not all addicts need to be locked up in order to get clean and that we should only institutionalize addicts that need it to succeed), and I also agree that an addict should still be held accountable for crimes he commits.

On the flip side, I think we need to be taking a more treatment oriented approach where addicts are concerned. Sure, we should force all addicts to get clean, but we shouldn't be imprisoning a drug user who commits no other crime. Imprisoning an addict who has committed no other crime is really just wasting of government money, since most prisons don't have the facilities needed to provide the kind of care an addict needs to overcome his addiction. Pre-preemptively forcing a drug user into a detox program will have a much higher chance of success than imprisoning him ever would -- the recidivism rate is a lot better.

 

Drew, the problem is, how do you tell the difference between those that need to be institutionalized to get clean and those that don't? Additionally, what do you do about those that need to be institutionalized (and put through serious therapy) to stay clean? As Deise's lecturer priest pointed out (and he was right, btw) a lot of addicts of the hard drucs turn to those drugs in the first place to escape some serious mental issues. Some are diagnosable clinical problems, like extreme depression, bi-polar disorder, or schizophrenia. Others are just issues that need to be dealt with, like abuse as a child, or abandonment issues. If you clean these people up and then kick them back on the streets, or even put them in a welfare support system with housing and jobs and everything, they'll just turn right back to drugs because, as far as escaping the problems goes, they worked.

Add to that the fact that there are probably as many homeless due to mental issues without drugs as there are homeless due to drugs, whether caused by mental issues or not, maybe more. If we really wanted to help the bulk of the homeless today, you're talking about a major, costly program that will focus primarily on drug rehab and psychotherapy/psychopharmacology (i.e. putting them on different drugs).

 

The judge examines his background and criminal history and adjudicates as well as he can.

Probation and continued treatment.

Well, yeah, but I'm not just suggesting that we clean them up and kick them out. I'm suggesting we treat them and continue to treat them as long as it is deemed necessary.

...and I doubt I need to tell you that our current health care system has a gaping hole where mental health care is concerned and that fixing that would be a good first step. While this isn't the main thrust of Obama's healthcare reform, I'm hoping it will still begin to address that.

 

In the UK, if a drug addict is convicted of a crime there is a program in place (though a crap program if you ask me) where by an addict will be jailed, pending a consultatation, often (because the UK's prison system sucks) they well be let out on licence, the licence is put in place to help them give up e.g. if they are caught with drugs, instant jail. Weekly they have to see a consultation officer, who determins if they are at risk, if they fail to turn up to one of these sessions a warrant is issued for return to prison.

 

Yes, mental health care reform is VASTLY needed here in the US, but even universal coverage would only put a dent in the problem. There are quite a few homeless who could have afforded mental help anyway, but, due to the nature of their issues, they ended up homeless before anyone knew anything was wrong upstairs. Unless you're advocating a regular mental check-up, like we have physicals.

Hey, that's actually not that bad of an idea.

 

It really isn't a bad idea.

That said, this is also one of the reasons that I think we need to provide free* medical to all Americans (regardless of what method we choose to follow in getting there). A guy who has to beg in order to eat probably isn't going to beg for a $3 co-pay -- instead, he just won't see his doctor or psychiatrist. If it's free*, he's more likely to go.

* Yes, yes, it's never free...but, from a public health perspective, it should at least be free to those who can't otherwise afford it. No one's going to willingly get behind on his rent to see a doctor.

 

Actually, I think a "free" system would be disasterous. First of all, even free, psychology still has enough of a stigma that you wouldn't get many poor in under anything less than police escort. Secondly, such a system is a bad idea for medicine, where the results of poor practice can usually be seen quickly, but would be terrible in psychology, where poor practice may cause VAST damage, yet go entirely undetected for decades.

No, mental health reform would have to be preventative, and then a $3 copay for a 1-2 hour mental checkup is probably generous. The only problem is that it'd only detect the most obvious problems (psychosis, severe schizophrenia, etc.) and would be increadibly boring and invasive for the patient. Psychology depends heavily on building a trusting relationship between the patient and the doctor. You can't do that in 1-2 hours.

 

Free systems dont work, the amount of money required to administer and run such a system are astronomical, the NHS doesnt work because it cant afford to work.

 

Well said. That should be screamed from the rooftops every day in the health care thread.

 

The NHS is an idyllic dream, which is pretty rich coming from a country that hates communists. They expect doctors to stick with the public health system, with little or no financial incentive to do so. Britain drastically needs to get funding to back it up; it stands to reason that people must pay. The quality of doctors that are hired from abroad to replace them... is poor to say the least.

 

On top of that, they handle cases on a projected lifespan basis. My wife's grandmother has been waiting for a foot surgery for 20+ years. She was 60 when they decided she needed it, but because they didn't expect her to get more than a few years out of it, they put her in the middle of the list. Now, she's 80, can't walk thanks to the lack of the surgery, and is at the bottom of the list. I have heard rumors, though I don't know how true they are, that some in congress want to impliment a similar system for our national healthcare system. If that doesn't get the AARP crowd moving, nothing will!

 

You know, I never thought about it that way, but you are entirely correct. It is not only plausible, but quite probable that most people who have mental health issues did not know they actually had mental health issues at the time they developed mental health issues...

 

Actually, it's quite probable that many (perhaps even most) still don't know they have any mental health issues. They just think everyone turned against them, or they hit a string of terrible luck, or they've been cursed by the gods, or they're actually a small, furry animal who eats cheeseburgers that taste suspiciously like gravel.

 

I once looked after a woman who was allowed day release as her section was getting reduced. Took her to the local town and she stripped off and ran away when she was in a public toilet. She didn't see anything wrong with what she was doing at all

 

I've given money to beggars. I've also denied some requests for spare change and had one (minor) physical and one verbal confrontation because I would not part with some change. On a return trip from Montreal I gave a man what remaining Canadian money I had on me rather than converting it to U.S. currency.....he requested some change and I had never seen more desperate eyes on a man in my life. I also give about $500 a year to United Way through weekly deductions from my pay.

However, my most interesting experience with donating to the poor came about 15 years ago. I got a decent paying job and found it convenient to cash my checks at the grocery store I had worked at as a teenager. A man outside the grocery store one day said to me that he needed some money to buy food for his children. I had cash in my pocket and replied: I won't give you cash but I will take you grocery shopping for your children. In my 'infinite' early twenty something wisdom I fully expected him to balk and leave me standing there...instead he was completely open to the idea. He and I went grocery shopping for staples and such and then I took him and the groceries to a residence not far from the store. We carried the groceries in and his wife looked relieved and his children looked *hungry*. They beat the crap out of my cynical heart. Those kids have to be in their twenties now. I hope they had a better go than their father.

 

That was actually a really sensible idea. I mean, it could have backfired but instead you helped a guy out and KNEW that your hard earned cash was going to a good cause.

The people who ask me for cash are ones that have asked me every week for years and the ones that I KNOW are addicts because I used to hit with them

 

IMHO you should stop giving to the United Way. All the United Way does is bundle money it collects, take out an administrative fee, and then send it to other charities. You get more bang for your buck just giving the $500 directly to the charity you care about.

 

TGS: While true the United Way does send the funds to other charities, the administrative fee is minimal compared to fees from "charity collection services" used for phone drives. The charities the United Way donates to are rarely controversial and the majority are local (and the United Way is a major source of income for homeless kitchens). Many companies prefer to use the United Way rather than have employees choose a specific charity because the donation will not be controversial at all -- this is especially true for company match programs.

The United Way is a great charity to donate to. I applaud nunsbane for donating and would not recommend he stop. If, in the future, he can give more then he may want to look at specific causes. My wife donates to The United Way through work because that is the only charitable organization the company will match funds for. We also donate to St Judes -- which my company recently allowed for matching funds (although we donated for years without matching funds).