Is forced treatment for the mentally ill ever humane?

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Is forced treatment for the mentally ill ever humane?
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Worsening homelessness prompts new mental-health policies in California and New York

Most Americans who experience homelessness do so briefly. They stay with family or crash on a friend’s couch until they can afford rent. The latest count of homeless people, tallied on a single night in January , found that 22% of them are “chronically homeless”, and that there were 16% more perennially homeless adults in 2022 than in 2020. Many live in tents beneath highways or in public parks.

The mayor’s plan follows a policy change on the opposite coast. At the urging of Gavin Newsom, California’s Democratic governor, in September the state legislature passed the Community Assistance, Recovery, and Empowerment Act, creating a new civil court system aimed at directing the mentally ill and homeless to treatment and housing.

The schemes may be different, but the outrage they inspire is similar. Any discussion of compulsory treatment for the mentally ill is tangled up in a decades-long fight over the balance between protecting people’s civil liberties and bodily autonomy, and ensuring their safety and that of others.

Logistical questions abound, too. Luke Bergmann, the director of behavioural health services in San Diego county, worries about how severely ill, often isolated, patients are supposed to travel to their court appointments, and whether there will be enough beds in long-term care facilities to house them. Watchdogs on both coasts wonder what kind of clinical training police will receive, and whether racial bias will lead to worse outcomes for black and Hispanic homeless people.

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