New York City to Remove Mentally Ill People From Streets Against Their Will

[Model35mech]

22. It's hard to treat things whose mechanisms are poorly known or unknown

It's quite remarkable that over 125 years of modern psychology the mechanisms of many, possibly most, psychological disorders remain mostly obscure. That's not a knock against all those who should be thanked for none-the-less working to better define the mechanisms.

And in the absence of real understanding narratives are developed and applied and enter the traffic of average human discourse... like mental disorders are a 'chemical imbalance'... and the 'cause is complex', and thus hard to understand 'mix of genetic, developmental and environmental factors'. But these running beliefs actually don't provide a mechanism to target.

So, it seems much of treatment is aimed at mitigation of a confusing array of overlapping symptoms that make diagnosis itself a system of elimination of speculations on identity of disorders, usually focused on things that cause harm and disruption of life to the afflicted and their (usually) close others. And so treatment looks to relieving apparent manifestations of dysfunction and distress of the afflicted and not underlying mechanisms of causation.

In this its important to appreciate that real, and yes, often misperceived, social dysfunction seriously impacts political consideration of how cities, counties, and states choose to address the epidemic of mental illness.

And policy decisions are based on the knowledge and stigmatized beliefs of politicians and members of the electorate. How limited the difference between harm to others actually is between mentally-well people and mentally-disordered persons is largely overlooked. A gap that generated punishing stigmatization. And I do have concern that stigmatized beliefs may be as significant to New York's policy-making as is psychology and neuroscience.

The mayor of New York seems concerned about the number of homeless, their lack of social capacity, and consequent incapacity for self-care, which are burdensome for New York, and every other place in the country. I would assume he is creating this policy in a social milieu that is at least as complex and limited in understanding as mental disorders are.

Clearly some of the social sequelae of mental disorders can be addressed by collecting the homeless off the street and placing them in settings with care. I will hope for the Mayor's policy that treatment will actually follow, rather than caging the afflicted, and later gifting them with a bus-ticket to another unsuspecting and unprepared city (google 'Greyhounding the mentally ill).