> part of why mental health is so terrible in the US is that we do a terrible job empathizing with people who suffer from it

This isn't just a US problem, though it may be worse there in some ways. There's also the problem that "mental health" is not well understood scientifically, yet the medical community acts as though it were. You can thumb through the DSM V and find countless seemingly well-defined "diseases" described using the language of science, yet for few is any underlying cause known and very often the "symptoms" are vague and useless for differential diagnosis. Ultimately all of this is defined by a group of people who have a particular agenda that does not necessarily serve the rights and best interests of the individual being diagnosed as potentially "ill".

That does not mean there is no such thing as a disease of the brain or body that affects behavior, only that anyone who tells you they know what behavior is a sign of disease and what is not, or of which disease it is a sign, or the cause of that disease, much less a proper course of treatment, is usually at best guessing and at worst lying. The psychology and psychiatry communities are roughly where the rest of medicine was in the early 19th century: deeply paternalistic researchers with impressive titles and great big books full of fancy language that amounts to little more than guesswork and superstition, who are nonetheless at least trying to pursue difficult knowledge in what they best understand to be a scientific manner, and a much larger body of clinical practitioners who are for the most part little better than self-serving quacks.

Until that changes in deep and fundamental ways, I'm not ready to condemn anyone to forced treatment, nor to criticize any self-treatment short of criminal injury to others. Medicine couldn't save you from TB in the 19th century (too often, it still cannot), and it may well be that neither can it save you from addiction or myriad other brain diseases today. The solution to that was and is the scientific pursuit of knowledge for the future, not the mockery or damnation of those who decline the usually ineffective (or "heroic", or otherwise horrifying) treatments on offer at the time.

> To engage and promote mental health, it is better to try and see where people are coming from. Admitting that it is a rational option is not necessarily an endorsement. If you think it is, you need to reevaluate why you believe that all things rational are identical with all things good.

Very true. Moreover, people are far too quick to criticize others' decisions as irrational when the other person's value system differs from the critic's. Very often the choices being made are rational in the context of the subject's value system, but the critic cannot or will not understand or accept that the subject does not share his or her values (or indeed that multiple value systems are possible), and so criticizes their choices under their own and concludes that they are irrational. A declaration that someone is irrational says a great deal about the critic but rarely anything much about the subject. Getting past this block is perhaps the most important aspect of useful empathy.