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?
Hi! Mental health social worker here- it’s for the patient’s safety, safety of other patients, and worker safety. Many people coming in are there because they’re at risk of harming themselves. Staff have to make sure (1) nothing that could possibly be used as as a weapon on themselves or others is identified and removed and (2) a thorough status of the patients needs documented when they come in. Oftentimes, people come in with injuries or conditions they either don’t mention or don’t realize are issues. If someone has that on their body and it’s not documented at intake then it could later be used as saying they received an injury while staying at the hospital. Many people coming in are depressed but are without a typical sense of reality and just need a safe place to be temporarily but some people coming in are having full psychotic episodes where they’re not in the same reality and information is misconstrued, they’re experiencing paranoia and making statements that people are hurting them, etc. I know that the process of everything must be really difficult especially when you’re there because you’re already going through something difficult but it’s kind of the only way to ensure everyone is safe. Unfortunately, staff can’t go strictly off what someone says or does to determine what intake process they have since there’s a large amount of people coming in who say one thing but you quickly find out a very different thing is going on with them. Hope all the best for you! I don’t work directly in our inpatient hospital but adjacent/work on processing their assessments for the state so still somewhat familiar and I worked in a residential setting with minors previously. If you hear someone in social work state that “anything can become a weapon,” they’re not kidding. I’ve had so many innocuous things become weapons in my time.
I guess I get what you mean but it was still humiliating to strip naked for strangers and open up if you get my meaning. I still feel humiliated by it.
Okay, sure. But the alternative would be “someone gets stabbed”
I’d rather be stabbed since I have a death wish
…you realize that means you in particular actually NEEDED to get searched, right? I was about to say “oh you got caught up in the rules that keep other people from killing themselves” but no, you personally actually are why those rules exist then.
There are lots of things I could say about the lack of intermediate options for people with lower acuity/less severe mental illness but if you were actually having thoughts of wanting to be dead then a unit that controls things that strictly may actually have been completely appropriate.
Still sucks. You don’t even wanna know what the ICU does to keep people alive; they have a tube for every hole and then some. It’s certainly traumatizing but if the other option is being dead it’s generally considered a worthwhile tradeoff, same with intubation or any other terrifyingly invasive shit we do to keep people alive. Sure the throat tubes keep you breathing and therefore alive, but it’s not actually like, good for your throat. A lot of the healing after a hospitalization is from the hospitalization itself, for any type of hospitalization for any type of disorder.
Could also have been a sketchy facility tho. Plenty of those exist too. It can be hard to tell from patient reports like this because of how much the intense emotional states can affect perception.
I don’t want to hurt anyone else, just myself. I can’t help it at this point so I don’t think mistreating me is going to solve it
If you want to hurt yourself, it’s their duty to make it as difficult as possible for you to do a very thorough job of it. Unfortunately, it’s a long line of patients before you, who came up with very creative ways to bring in weapons, that made the staff put you through that humiliating experience. They have seen too many deaths, and suffered injuries themselves.
And remember, if someone jumps a woman on the street and beats the shit out of her or cuts her open, she hopefully gets some kind of support. But if she’s a nurse on the job, her supervisor will react with “what was your failure that caused this to happen?” They can’t really control what goes on in their patients’ heads, so they control the things they can.
I thought I had bodily autonomy? I can get an abortion if I want, not sure why I can’t blow my brains out if I want to under the same principle. Seems a weird reason to incarcerate someone.
And again, I never hurt anyone there or anywhere, I’m not a violent person. Isn’t that what matters, only if you want to hurt others?
It’s not just you that they’re worried could get stabbed, it could be anyone.
I took some psych courses in University and one of my profs was full of anecdotes about patients he’d cared for, there were people who were perfectly nice and calm and then in a split second something would go unpredictably wrong and they’d be savagely attacking whoever they could get their hands on.
And then a moment later they’d be beside themselves with dismay over having “lost it”, apologizing sincerely and profusely. He said it was really hard keeping on your toes in there. He permanently lost his hearing in one ear when one of his patients slapped him out of the blue one time, to both of their surprise. If anything remotely like a weapon was easily accessible it could go very badly.
I’m sorry your experience was unpleasant, and of course I can’t remotely speak to it myself - it was your experience, not mine. But it could be that the stuff that was done was for everyone’s protection.
Thanks but they had no reason to think I’m going to hurt others
I think you may have missed a significant chunk of what I wrote. The prof told me that they couldn’t know who was going to try to hurt others. Often the patients themselves didn’t know whether they were going to hurt others.
I’m not a nutcase so there’s no threat of that.
Touché salesman
No, that would be the response.
That’s because, despite all of the excuses this person has made for themselves, the point is to humiliate you. They want to make sure you know your place, that they are in charge, and that standing up for yourself is futile.
I havent made any excuses
Sorry, but I don’t buy this. Many, many years ago I had a loved one in one of these prison-like institutions - I fought hard to get her out of there and into a better place.
Miraculously, her (supposed) “violent tendencies” disappeared the moment we got her out of the prison-like place and into one where she wasn’t treated like a subhuman.
No, no, you see, they must treat patients like subhuman, otherwise how will they know their place?? (/s but only just, since that’s exactly how many people running and working in these hell holes actually see the world).
I’m sry, but I’ve been to lots of psych wards in Germany, and none were anywhere near this restricting, and there weren’t many incidents.
Patients attack you cause your system treats them like convicts. Treat them like a human and they will react way better
Patients attack you cause your system treats them like convicts. Treat them like a human and they will react way better
Imagine having to explain such an obvious fact of life to someone who claims to work in mental health, and what that means for the people they’re in charge of “helping”… 🤯
That’s not a lot of paragraphs.
Adding that the scrubs part is specific to that location as not all hospitals follow that. Ours allows clothes from home if they meet certain requirements (and are thoroughly checked first). The only time scrubs would be used is if someone didn’t have enough clothes or if they came in like on a hold as you mentioned and nothing was available that was deemed safe. I know there are some places that just use the same outfits for everyone regardless. Our location also doesn’t do mandatory outside time or anything like that. Time spent in different groups, community areas, and outside are all just really encouraged. If someone is avoiding that thing then they process it with a psychiatrist as it’s usually due to something like depressive symptoms getting in the way and we want to address that.
I work with psych patients. It’s mostly to screen if they need to be in/out patient, new prescription, or whatever they need. Our hospital mostly gets people that have detention orders (judge orders them to get help at the facility) which means they can’t leave until they’ve been evaluated by a therapist and a plan to help them is setup. Sometimes it’s people that either chose to stop taking the meds for whatever reason or ran out of their prescription and can’t afford to get more and get brought in for their behavior. There’s patients that come in every 4 or 5 months because their prescriptions only last 90 days.
The scrubs allow patients to have clean clothes that we know don’t have anything they can use to hurt themselves or others. Some patients haven’t slept, eaten, showered in days. Giving them a shower, clean clothes, and food helps a lot.
I had a patient that while anxious and going through somethings, was talking to me, venting, occasional jokes, etc. Calm and polite the whole time. Out of nowhere, they ran towards another patients room, but only got half a meter in. They squared up like they were going to fight me, but immediately went back into their room after I asked them to. Once in the room they starting kicking the bed trying to break off a piece of rail.
By that time security, RN, and 2 other staff members were there to witness the patient wrap a blanket around their neck and try to choke themselves. All this within about 90 seconds. From calm to actively suicidal. I got yelled at for allowing the patient to enter another patients room.
There are patients that scream, threaten to kill you, and are overly aggressive and then break down crying after you tell them to stop yelling.
I’m sorry OP had a horrible experience and mental health doesn’t get appropriate funding. I’d say 95% of ppl are good patients, but the rules are for the 5% that aren’t and we can’t know which ones are gonna be the 5%.
You are wrong thinking that it’s right.
I would literally rather die than go to one of your prisons. I have clinical depression, all my friends know that trying to involuntarily hold me would not end well. Once was enough.
this sounds heavenly for mental recuperation!
Fuck your safety.
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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.
Relevant article: https://www.aclu.org/news/smart-justice/private-prison-giant-corecivics-wants-corner-mass
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?
If someone wants to kill themselves, let them. It’s nobody’s place to impose life on anyone else.
Exactly
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 we’ve been propagandized that mental health is a moral failing rather than a societal failing …
Exactly this, if you can’t contribute to society as effectively then you have no worth
Exactly
Not sure why you’re being downvoted - this is a great summary of the issue
I was in a psychiatric hospital for like 6 months, but like a pretty nice place (I wasn’t institutionalized or anything, this was something I chose) and heard horror stories from some of the other patients there about those places. I’m so grateful that I never had to go through that…
I literally thought one of my friends had been exaggerating until we got a new patient and he had similar stories. Horrific stuff.
In theory it’s for safety, both for the patient and the workers. A lot of the point of inpatient facilities is to monitor the people, and ensure they can’t harm themselves or others, while their circumstances or medications get sorted out.
That’s not to say every facility is perfect, and that’s not saying anything about you. But generally, it’s for their own good.
Yeah when I complained about my treatment, they said it’s for my and others safety and to calm down. Even if they’re right, it’s still a really horrible experience.
Yeah when I complained about my treatment, they said it’s for my and others safety and to calm down
So they gaslit you in to complying with their ill treatment…
There is zero logic to the idea that treating mentally ill people like shit is actually helping them, and anyone trying to convince you otherwise either has a vested interest in maintaining the status quo and/or is just a run of the mill ableist who thinks we somehow deserve it for being such a pain in their asses.Edit to add: I’m truly sorry you’ve had this experience, and that you weren’t only gaslit about it by the staff at the place, but also by people here using the textbook abuser line “it’s for your own good”. The first and most important thing anyone who actually cares about your wellbeing can do is to hear you, and treat you with the same respect they would treat someone not in crisis (or even better, but worse??? and then twist it in to being your fault? fuck that, and fuck them).
Thanks for the support
Wait until you see American schools
I play a game with my spouse when we drive past large institutional complexes surrounded by tall fences called Prison, or school?
They aren’t anymore, usually, yours must be bad.
Btw, you didn’t say where.
USA
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.
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 respect your friends decision
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.
Two reasons.
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.
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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.
I agree, it would be great if we had more varied and tailored options.
Because it is essentially a prison, a place to control you while seperating you from the general population.
Also I am sorry that happened to you.
Because most countries use them as prisons.
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.
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
Someone got hurt/killed by something smuggled in. So the hospital got sued. The hospital thought, I guess we need to strip search everyone to make sure that it doesn’t happen again because that was a lot of freaking money. Later, there was a physical altercation. Or several. And there weren’t enough workers to keep everyone safe. And patients got hurt. So the hospital got sued. So the hospital thinks, we’ll just keep these people locked up so they can’t attack anyone else, and our workers aren’t so overwhelmed.
This could all be fixed if they hired more people, had more training, basically spent more money. Why don’t they do that? you may ask. Well, you see, they keep having to pay these lawsuits…
Yeah the one I went to likely was underfunded as it was a total hole in the wall dump. Worst experience ever. And Im told jail is worse so just hoping I don’t get arrested
I had a friend get 5150’d back in the late '80s. It wasn’t…uh, fun, he said. But not as bad as what you experienced. I think it’s shittier now. I’ve had a couple friends in jail, and a few in prison, over the years. Jail sounds like it’s kinda shitty, but nothing like prison.
I actually heard that county jails are worse than prison
Could be. My sample size is very small.
County time counts two for one, sometimes 3
