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I think in cases like Berges, some form of institutionalization is probably a massive improvement over the current method. That is to say, if I knew my life were going to go down Berges' trajectory, I would rather be institutionalized, and failing that I would rather be dead. His fate is viscerally horrifying to me, and the fact that we, from my perspective, encourage and allow such states to play themselves out without meaningful intervention is unconscionable.
Berges didn't need the full weight of the war-on-drugs criminal justice system. He didn't need a SWAT takedown. But neither did he need to be treated to a revolving-door parody of civil consequences. Once it became apparent that he was completely incapable of making good choices under his own power, he should have been locked up in some sort of minimum-security prison, there to either have the opportunity to rebuild some semblance of personal character, or at least be protected and to protect others from his own worst impulses.
Nor is it obvious to me that our society proliferates Bergeses in the same way it proliferates schizophrenics and people with nine toes. I think there is a fairly direct causation from the absurdly permissive social policies, particularly around highly addictive drugs, crime, and vagrancy, and the way his life ended. He lost control, and the social structures around him refused to help him in any way that worked or mattered.
Piss and shit on the streets, everywhere, together with trash, filth, used needles, infectious waste. Rats, and with them outbreaks of vermin-borne plagues. These are some of the highlights of the social experience in west-coast Progressive strongholds. I think "rotting sewer" is a reasonable summation. I don't want to live in such conditions, and I don't want to share a polity with the people who create and sustain them.
As for crime...I'm wondering if you've checked the stats lately. Here's 1900 to 2000. Here's the recent years, including the eye-popping 30% increase in 2020 that correlated with a major Progressive push to reform policing. I don't see how one matches those figures to a claim of "crime generally going down." We are currently sitting somewhere around five times the murder rate we enjoyed prior to the first modern Progressive era of the 1920s-30s, and the downward slope we enjoyed following the massive increase of the second progressive era of the 1960s-70s seems to be well and truly over.
Worse, one must consider the staggeringly massive investments and restructurings our society has made over the last century, all in an explicit attempt to solve the problem of violent crime. From militarized policing, mass-incarceration, ubiquitous surveillance, forensic science, to trauma medicine, to the increasingly regimented and invasive educational and psychological interventions, we've expended vast sums of money and human lives, and done massive, highly questionable modifications to our core social institutions, many of them with their own harmful side effects. And all this, by our best evidence, could only partially slow the long-term increase, and that to only a limited degree. Now we're headed back up again, quite rapidly, with our previous policy options thoroughly expended. When the murder rate skyrocketed in 2020, that was with a century of crime-suppression and harm-mitigation techniques, many of them ruinously expensive, already in place or expended.
So now... what?
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