This is exactly what I was thinking. I spent time in inpatient psychiatric units involuntary committed a handful of times when I was younger because I had a rather debilitating phase of bipolar disorder that lasted, on and off, about 10 years. I later saw faces of people living on the streets who I was in treatment with - they'd be homeless, outside the liquor store, in emergency rooms, down by the river in a tent...

The treatment is there, the community services boards are on the other side of inpatient treatment to support people once they get treatment and return to the community - the resources are all available, and shelters are available for those who are not drinking or using drugs. In fact the local community service board is what got me on the path to recovery - while many people I was in the hospital with went back to their substance use, rough living, etc.

This isn't the early 20th century and we can't involuntarily commit these people to psychiatric or substance-abuse-recovery facilities. It's a tough balance. And some of these people (and think of Portland, San Francisco) actually want to live free, do whatever the hell they want to do when they want to. I've lived through it. The resources are there, putting their hands out to the most vulnerable to lift them up - but quite frankly some of the folks are so far gone and are hell bent on living their lifestyle (that seems rough and sucky to us) you can't turn them around.

It's a conundrum for sure.