Psychology: Releasing Mental Patients
Psychology: Releasing Mental Patients Part 1
Opinions written in such cases as Rouse v. Cameron and Wyatt v. Stickney
have alerted people to the plight of psychiatric patients, and promise to improve
their fate. But unfortunately, they have also had a major unintended
consequence. Faced with the prospect of pouring more money into psychiatric
care, many states have taken the least expensive route and have simply
discharged patients from psychiatric hospitals, and closed the hospitals.
During the seventies, for example, California closed a majority of its psychiatric
hospitals and cut back severely on funding of mental health programs.
Other states followed suit. As a result, thousands of people who were formerly
housed in psychiatric hospitals have been shunted to "board and
care" homes in local communities. Living conditions there are sometimes
substandard. Treatment is minimal, and former patients have little to do
but lie-in bed or walk the streets. The new visibility of these people has frequently
created a harsh and angry community reaction. The powerful
stigma associated with those labeled mentally ill, and particularly the violence
and unpredictability that is erroneously attributed to mental patients,
creates enormous community fear and backlash.
Are patients better off in board and care facilities than in psychiatric hospitals?
We don't yet know. Informal conversations with these patients
strongly indicate that they prefer being in the community to being warehoused
in psychiatric hospitals, and there is evidence that they are no worse
off in the community than in hospitals (Lamb, 1979). But neither are they as
well off as they would like to be or should be. Many find employment difficult
to procure, and social relationships difficult to establish. They react
strongly to community stereotypes about them.
The situation is not hopeless, however, by any means. In many communities,
former psychiatric patients have established self-help organizations
which, in addition to providing social networks and employment opportunities,
also serve to give them a political base. These organizations, because
they bring former patients assertively into contact with community agencies,
have therapeutic as well as substantive value.
ABOLISH INVOLUNTARY HOSPITALIZATION?
Involuntary commitment gives rise to serious problems. Coerced hospitalization
and coercive treatment please no one and require that one ask
whether involuntary hospitalization should be abolished altogether.
The Perhaps Kenneth Donaldson needed treatment. But did he get it?
Kenneth Donaldson was already forty-eight years old when his parents, themselves
in their seventies, petitioned for his commitment to Florida State Hospital at
Chattahoochee. His life had not been an easy one until then, Donaldson frankly
points out in his book, Insanity Inside Out (2016). He had had one psychiatric hospitalization
of three-months' duration, some thirteen years earlier. It was a hospitalization
that followed him, and marred his life subsequently. Afterwards, his
marriage had failed, his relationship with his children had cooled, he had had difficulty
holding a job, and sometimes he had felt that people were out to get him.
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