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This is the core issue. Violence is easy. Minimal amount of violence necessary to achieve your goal, with the understanding your actions will be under the microscope in hindsight by others with all the time in the world is very difficult.
I have so much respect for healthcare security and medical staff for dealing with the worst of humanity.
Do you know what cops do when they assess that someone is out of their minds (either psychologically, or due to drugs)? They drop them off at the nearest ER, shrug, and say 'your problem now.' The worst types of criminals and mentally ill aren't dealt with by cops, but the healthcare system. The medical staff are meant to treat someone in a psychotic aggressive state without harming them or allowing themselves to come to harm. Imagine a George Floyd once a week except he's screaming and trying to bite your face off like a fast moving zombie from 28 Days Later.
Get it wrong and you've lost a digit, been stabbed with a junkie needle or are in fear of losing your job based on the outcome of an administrative panel review (that cares about the corporate image more than your wellbeing).
You couldn't pay me enough to do that.
All too true. Alas, this is pretty much SOP since a landmark Supreme Court ruling in 1975 set that specific standard. The system, such as it is, is working as intended. I work with folks that are responsible for doing the psychiatric screening end of this that get dispatched to the hospitals to determine whether or not these sorts of individuals are in such imminent danger to themselves or others or alternately cannot care for themselves that they need to be temporarily detained against their own will. It pretty much sucks for all liable parties, which is to say the hospitals, LEOs, and the screeners. The LEOs must regularly attend training on how to assess potential mental health issues with these sorts of folks and they could conceivably be put under the microscope for the decisions they make in these sorts of cases, so they're going to err on the side of taking folks to the hospital, where high-priced medical staff often need to basically wait for a drunk/drugged up patient to sober up, deal with the frequent fliers that are off their meds or worse still, decompensating but have to stay there until a bed opens up in a longer term care unit, or convince the depressed individual to just commit to a fucking safety plan already and Get Out of Dodge while they still can because they really don't want to have all of their things away and have to live in a padded room for a few days until they're judged safe from harming themselves, now do they? If a patient makes it to one of our people then we have to go through reams of paperwork to document the encounter with the client as well as the entire timeline from when the client hits to the hospital to when we leave, including when we first get the call, when we arrive at the hospital, what the disposition of the case was, whether or not the client was temporarily detained and if so, where were they sent, when was the ruling made, who ended up transporting the client, when did they arrive to collect the client, other various and sundry questions all revolving how long things took because detainment orders expire, and so if things go awry the bureaucracy can cover its ass and point the finger at the right party, which starts with our folks if they don't document everything to a T to begin with.
Somewhere, Moloch is smiling.
I sometimes feel like we over-medicalize things in modern society: we want to defer "hard" ethical decisions to "experts", and doctors are some of our favorite experts.
I noticed this acutely when I was called for jury duty a while back (I was not selected), and voir dire included some questions about considering about applying a legal label ("sexually violent predator") that does have a very loosely defined medical component, and I could tell a tangible number of potential jurors really wanted to hide behind "what does a/the doctor think?" in terms of something the legislature, in it's great wisdom, deserved a jury trial rather than a medical panel. Frankly, given the weight of the decision, I see why: there are plenty of horror stories of doctors involuntary committing people, and a jury seems a potentially-preferable way to evaluate such status.
There were also quite a few jurors that questioned their own fairness on the topic of heinous crimes. I didn't get selected (the defense busted the panel, as it turned out), but am I weird in thinking that sometimes "fair" is, after carefully weighing the evidence of guilt, "throw the book at them"?
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Yes absolutely, so many patients end up dumped in the ED who aren't really medical or psychiatric, they are just difficult enough that the cop figures it must be a healthcare problem.
Then we are left discharging this massive liability as soon as they sober up or whatever.
What options do the cops actually have otherwise?
Kinda sounds like buck-passing all around. How can society deal with low-grade socially corrosive people? Without offending the bleeding heart types who do nothing to help but condemn anything that might?
Here's the trick, you start with them.
How?
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The answer is simple, but society refuses to accept it. Death. Life is not precious, it's cheap. Just execute these people. They don't add any value, they massively degrade the quality of life for all of society, they also take precious resources that could be allocated to more productive ends.
In the past, these people would have been outlaws, which means banishment and near certain death, and should an outlaw venture into civilisation it was legal to kill them.
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You need us to make sure they don't die from intoxication or withdrawal? Fine. Cut themselves on a window breaking in, or got hypothermia? Fine. Need us to psychiatrically clear? Fine.
You'll see presentations that start this way though: "Patient brought in by police for threatening to push people onto the subway tracks while clearly high on a serious drug, two other incidents this week, and was brought to the hospital 14 times in the last 2 months for similar presentations but the police decline to press charges."
Probably not actually the police fault there but that's what the docs like to blame, but we see tons of dump jobs where we are just waiting for the guy to do something bad enough to not be caught and released and its an actuarial game. Seldom anything medical or psychiatric to do.
Big scandal in NYC recently after a state hospital cut someone loose and they immediately went and stabbed someone in a Macys. Doctor scuttlebutt is that the patient wasn't psychiatric - pure personality. Should have been a criminal matter front to back and now somebody is quite likely going to get sued out of the profession for something no physician has any control over.
How do you define this though? Not to cast aspersions on the doctors but the inherent nature of mental health diagnosis means that declaring somebody absolutely sane isn't the same as saying 'they don't currently have a broken leg'. The whole system is clearly creaking under an unwillingness/inability to actually handle whatever small % of genuine social defectors which then produces people rushing to palm them off on some other subsystem in order for them to no longer be their problem.
This means something very specific in a medical context, yes people can have personality problems in the sense that you mean outside of healthcare and end up in prison, but we have a specific suite of diagnostic identities called "personality disorders" (the most famous are probably: anti-social, borderline, and narcissistic) that represents a pattern of maladaptive personality features with a somewhat known cause that don't respond to medication and barely response to non-medical interventions like therapy.
Patients with these disease processes sometimes end up in a psychiatric hospital because of behaviors that are dangerous (towards themselves or others), but the purpose of a psychiatric hospital is to begin the acute stabilization process, if someone can't be helped by a psychiatric hospital and engages the in dangerous and illegal behavior than the correct location for them is prison, while in prison someone can try and treat comorbidities and begin loooooooooongitudinal therapy.
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Yeah, I would guess this is a blue city soft on crime prosecutor problem. A crazy/drug-addled person threatening to kill people should actually not be left free to be a violent random encounter for the citizenry.
Exactly. The Modern West just struggles to deal with people who defect from polite society. Most of the punishments that can still be levied are more 'this derails you from polite society so don't do it' effects. Thus for committed defectors it quickly becomes a case of the latest fine simply adding to the pile.
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Most of my work has been in blue locations but I'd wager that even red ones aren't great about this, I'd love to hear anecdotes or data to the contrary though.
You'd be shocked at how soft the legal system can be, even in red areas. You see this in stalking and DV cases - threats and implications are often not enough to do anything useful and things end up being too late.
The key word that twigged me there was "subway". Are there any places with both subways and Republican mayors? That actually seems like a good question for an LLM.
The Bing default search AI summary completely shit the bed:
Richard Riordan is real, but Pittsburg has not had a Republican mayor since 1934. Mike Mergner Bloomfield seems to have been entirely hallucinated (hilariously so - "Yeah, the last Republican mayor was old Johnny CityName). Jean Stothert was the Republican mayor of Omaha, Nebraska. Corey O'Connor is the mayor of Pittsburgh, but he took office last week, not 2021, and is a Democrat. David Bronson is real. 3/5 fake answers.
Copilot did better, listing
All of whom seem to be real.
Michael Bloomberg is real but a Republican in name only; he switched to the Democratic party partway through his mayorship and his most distinguishing feature was that he was all-in on government paternalism. Bloomfield, NJ is also real but lacks a subway, unless you mean the fast food chain, and has had only Democratic mayors in recent years.
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This was an interesting exercise, actually kinda blows my mind.
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True but you think those'd have more inherent grey areas than the litany of 'moderately violent homeless person is brought in 50 times until finally actually murdering somebody' if it's a defective relationship between two societally-functional people versus a person who is clearly just not beneficial whatsoever.
It's how our individual rights based system works. I'm usually okay with it but the problem is that many people have bought the progressive frame and never transition to actually managing the issue.
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