IMO there were guys like this when I was a kid growing up in the mid-60s.
They were just not allowed to remain free long enough to sink to the utter depravity we see today. Somewhere between calling himself trans and punching his mother out he would have been quietly taken off by a doctor and 2 burly ex-GIs in white coats to a state funded mental hospital.
You are exactly correct. Community treatment is a joke and is directly responsible for the homeless catastrophe.
They came and took him away, hahahohohehe; would have been kinder for him and much better for society.