I have 4 people in my immediate social orbit. Two of them have serious behavioral disorders - one has been in inpatient psychiatry (twice), the other has never sought any treatment and in fact denies she has any problems. Another has somewhat less severe behavioral disorders but much more serious physical problems. The last one is simply very old and has health problems.
What is to be gained by "talking about the real problems" with this group? Pretty much nothing, because none of them can or will do anything about it. And the few times myself or someone else has brought up some problem directly, lets just say it didn't go well.
As a meta comment I have yet to see a take from this author that didn't seem to have some pretty clear bubblethink behind it. Not great to be edging into an epistemology domain I associate with Bryan Caplan - like a person whose opinions you pretty much always want to invert to get at closer to the real truth.