Is forced treatment for the mentally ill ever humane?

IN AMERICA’S big cities, a walk down the street or a wait for the subway can be an exercise in avoidance. Scores of commuters in Los Angeles, New York and elsewhere don metaphorical blinders every day in order to ignore those sleeping fitfully on the train or battling psychosis on the street. Such indifference is morally fraught, but it is also a reflection of how common homelessness and public displays of mental illness have become.

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 lack of affordable housing is the biggest driver of homelessness.) The Department of Housing and Urban Development’s 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. They are more likely to be suffering from drug addiction and mental illness, both of which can be made worse by living on the streets. The number of people sleeping outside has increased by roughly 3% since 2020, cancelling out the modest decline of people in shelters. As the ranks of unsheltered people have grown, an old question re-emerges: how should government help people who may not be able to help themselves?