I was recently involuntarily held in a mental hospital where I went through prison like conditions (strip search, had to wear scrubs, was locked in a room outside certain times a day, stuff like that) and thankfully came out in one piece after 8 days of this crap. I was just wondering why we subject people to these conditions when they haven’t even committed a crime?
I have some experience with mental health in Australia and it is pretty dire honestly. There is a constant sense that the staff are concerned first with making sure you don’t hurt yourself because that would be a breach of their duty of care. This unfortunaty made much of the interaction between staff and patients adversarial.
I am currently entering the individual suppory industry and we have a concept called dignity of risk. You have to remember that people are entitled to take risks that they consider worthwhile regardless of what you think. This means if someone wants to smoke weed that is their choice, I can’t stop them. If they want to drink that is their choice and I have to respect that. This is because they are their own people and have their own autonomy.
One is to ensure people do not come to harm or allow harm to others. As harsh as it seems, the whole point is to stop people from killing themselves or enabling someone else to kill themselves.
The other is to prevent illegal drugs coming in to mental health units. Unfortunately mental health services are also overwhelmed by social issues and drug use is rife. The units don’t want to deal with high patients who can be aggressive or even OD.
It can seem harsh but it’s not like a prison. A prison is punishment, while a mental health unit is often a place to hold someone in a crisis so they can’t harm themselves. The loss of freedom and dignity can feel like punishment, particularly on over stretched understaffed units but they’re trying to save lives. It’s a blunt tool as a last resort.
If someone has been involuntarily committed it means they’ve already shown an intention to harm themselves or others. So the goal is not to stop them from feeling bad but to physically prevent them from doing harm.
The trouble is that there’s often not a difference in treatment between being involuntarily committed because you’ve demonstrated that danger and you checking yourself in because you can’t take care of yourself right now.
I cannot speak for the US but here in Germany we have different types of mental hospitals. Broadly there are open and closed asylums.
Closed ones are for people who are an immediate danger to themselves and/or others and open ones for people who just need therapy and a bit of supervision.
In open psychiatries you’re also allowed to keep your phone and get visitors (and sometimes even go home on weekends) while in closed ones, depending if your acute or not, you might have the privilege of free movement within the station or you might be confined to your room unless under direct supervision.
I mean, the US medical system is terrible in basically every way, but it’s nice to know it’s worse than everyone else in this particular way, too.
I expect there’s probably the “rich folks” version of your open asylums that are marketed like “mental health retreats” or something and cost as much as a house, but generally if you don’t have the luxury of shopping around reviews for the hospitals you’re staying at, you’d just wind up in a “closed” one here. And the person who needs to check in because otherwise they know they won’t eat for a week probably isn’t checking reviews.
That’s so you won’t kill yourself. They let my best friend out after an hour because he was a hassle to deal with, he was dead a few hours later.
The literal reason they brought him in in the first place was because he was trying to fight off the cops trying to stop him from throwing himself off a bridge downtown.
I’d rather that they had restrained him for a couple of days.
I hope you recover soon. I’ve been depressed in the past and convinced that suicide is the right path. It is not - when you’re mentally ill you lose perspective and people telling you “it’ll get better” or “life is worth living” but thay will seem hollow.
If you find it difficult to understand why people want you to live then maybe think of it this way: what have you got to lose? If you’ve decided it’s over and there is no point, then you might as well try the support and the medication because you’ve got nothing left to lose.
I’m glad I took the support and the meds. It did get better, and that was the route for me to heal and change the direction of my life.
I hope you try, and maybe realise that it wouldn’t be a true decision if you’re too mentally unwell to make a rational decision.
Because it is a prison. It’s meant as a threat to hold over you to keep you afraid and not talk and prevent you from getting competent care from medical professionals. It’s also an easy throwaway place where society can chuck the “undesirables” and forget about them. It’s not a hospital. It’s not meant to help you get better. It’s punishment and isolation. That’s the point.
At least in my country, you're in there because you're a danger to yourself or others, with weight on the latter because if you're suicidal and lucid then they can't section you.
So it is kinda the same thing, like people in prison are kept in that way because they're dangerous to the population.
Obviously there's voluntary admissions and stuff, but they're fewer and the staff there aren't really briefed so it's easier to care for everyone the same
Welcome to Murica, where you have the FREEDOM to receive subpar care when you need help the most.
I’m a fellow citizen of the bald eagle who also has dealt with psychological issues and the United States’s terrible health and mental care system. I read through your posts and saw you’re thinking of ending it. I don’t know your situation, but I’ve been somewhere similar. I have an incurable, chronic, progressive health condition that causes some disability and just hurts like a motherfucker. Not looking for sympathy, just explaining.
I was dead set on ending it because I couldn’t imagine going through life always in pain, being a burden to my spouse, family, and friends, and just being a big overall sad sack like I was. Obviously I didn’t. I got help and worked through my giant pile of issues and I’m glad I did. I think about how I was then and my life now with my wife and friends and my stupid, silly cats and I always start crying because I love all of them and everything so much and I was so close to giving all of this away.
I agree with you 100% - everyone should have bodily autonomy, including the right to end your life as you see fit. Just give it a lot of thought. It’s fucking morbid, but what kept me going for the first few weeks is that I could always kill myself later. I didn’t need to make a decision then, I could always make a decision later if trying to make things better was as impossible as it seemed. It was a ton of work and it really sucked sometimes but it got better. Even when things regressed hard, I kept looking for ways to keep improving because at the heart of it, I really didn’t want to die, I just couldn’t imagine living, so I worked on making a life that I could believe in.
No matter what, don’t look at this as a failing. People like us can have a certain strength and appreciation for life that others who haven’t had to deal with this don’t understand. If you need to talk with someone who at least might get it, I’m here.
My honest answer is that we have dark impulses and instead of fully handling them, as a society we have just managed to channel them through institutions.
The idea of vulnerable people being tormented by jailers is attractive to the darkest parts of our souls, and we have disavowed those parts of ourselves and hence cannot acknowledge them in order to control them.
As a result our society manifests this sadism in many of its institutions for dealing with vulnerable people.
Because it’s cheaper. If this is in a country where you or your family can sue because of a liability of the private institution or public one, then they treat everyone as a threat. Doesn’t matter why you’re there, you have to be treated just like the psycho Hannibal. Because if you turn out to be like that, and they didn’t screen you “for your safety and the safety of the staff”, it would be lawsuits galore.
Unfortunately, this seems to be the answer. Most people who are in short-term institutions like this get there through some type of psychotic break. Their incentive is not to really provide any care, but to maintain an orderly environment while the break passes (whether a manic episode, suicide attempt, etc.). This is also why they will tend to hold people for the maximum length legally allowed - they can bill more and most of them have guaranteed funding.
Because if you don't keep a close eye on mental patients, some of them might hurt or kill themselves or other people - sometimes in extraordinarily resourceful and unexpected ways. It's rare and overhyped, but the fact that it does happen means the system needs to account for it. Then add the usual amount of greed, incompetence, stigma etc., and suddenly the only way of accounting for that is, well, prison style.
Your explanation is surface level correct, in that it is in essence society’s justification, but ultimately they’re run like prisons because it’s initially cheaper to treat all mental health patients the same and because there might be one individual that is a danger to themselves (and even less likely, others) then we get the ‘prison-style’.
The trouble of course comes in that in the long term this model likely costs far far more, because it’s incredibly damaging as human brains don’t fit in boxes.
Ita probably also a revenue gathering tactic for private psych hospitals: just like private prisons have no incentive to reduce reoffence, private psych hospitals have no incentive to help patients reenter society.
You and many others probably know this already but for those that don’t: in countries like the United States, private prisons actually lobby to make it more likely that previous offenders will return to jail. They seek stricter sentencing so offenders are incarcerated longer and to remove funding for nonprofits and programs that provide rehabilitation.
Just let that sink in. There are human beings that are doing their best to make sure people fail and are punished without rehabilitation, hoping they become trapped in the prison system, all so shareholders can make a buck. How fucked up is that?
Ableism specifically, with a sprinkling of capitalism and all of its other ills - sexism, racism, queerphobia, and so on, on top, just to wrap it up nicely.
So not only are disabled and mentally ill people framed by our society as harmful burdenous wastes of oxygen (like defiant women and PoC were, and often still are), but those there to "care" for us are also not trained, nor paid enough, to actually give a shit about how they treat us. By design.
They can achieve all the therapeutic benefits they seek, and significantly more (like actually accommodating our needs instead of forcing us to comply with theirs), if they treated their patience like the human beings that we are rather than the threat and burden they've been indoctrinated to see as us. Thing is, that way they won't get to abuse their power over vulnerable people, so the system is never going to change, because that's exactly what it's there for (any small exceptions to the rule just prove the rule, and this includes both more holistic and respectful settings and the actual individuals involved in "care" who aren't in it to feel superior to others, even subconsciously - both are exceedingly hard to come by).
In a society obsessed with hierarchy, it really isn't surprising that institutions that exist firmly if not exclusively to enforce a superior/inferior paradigm, by whatever means necessary, are the default.
I'll admit I've only skimmed these, but they're probably a good place to start if you want to take a deeper dive in to the topic:
I guess you’ve only got to be attacked by a couple of people who should have been in a secure wing of a real prison before you start to treat everyone as a dangerous lunatic.
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