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Old 01-13-2020, 03:16 PM   #11
Misterpain
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Default Re: Article: How hospitals are beginning to look more like prisons

Last number i heard was 11.7 psychiatric beds per 100,000 regular hospital beds ,these days you have to look like a serious threat in order to get a bed ,and in most cases staying a week is the outside limit of reimbursement ,the goal is maximum medication as soon as the clock starts running on the 72 hours in hopes to somewhat stabilize you for discharge when the clock strikes 72.

Community care model was an improvement in care outxomes and cheaper in cost than the asylum system. And it truly was ,until government and insurance decided mental health was not a "neccesary priority" and every year they divert and devote money to pet projects or shareholders instead of where it should be going . About 19 years ago one of my local hospitals had an entire building that was mental gealth,different security levels ,and different disorders unto themselves , they were losing huge amounts of money in insurance reimbursement because insurance didn't like to pay older established programs and programs that didn't make "patient soup " everyone treated as one ,regardless of chief complaint or what they had been hospitalized for .

Prison like conditions will continue and substandard revolving door care will continue unless and until mental health gets fully funded again .

I truly believe the bean counters believe if you make getting well pleasant ,people will use it as vacation spot , but the key to that is treating employees better most people don't have living wages and benefits ,so there is lots of "social problems" that need correcting and they all involve equality. Treat everyone better across the board and ultimately there would be less mental health issues ,because people would have more safety valves instead of the system of last resort.
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Old 01-17-2020, 12:43 PM   #12
StreetcarBlanche
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Default Re: Article: How hospitals are beginning to look more like prisons

Haven't state hospitals always resembled prisons? It's a shame because if they did incorporate more mindful activities like yoga, art and music therapies, even have a greenhouse for patients to visit then I think the mental hospital's purpose would be less clinical and prison-like and more respite and healing oriented. Pretty scary stuff -- state mental hospitals. Even the short-term stay floors are scary as ****. I went to visit my roommate during her first hospitalization (first for me, as her roommate, not a first hospitalization for her) and they'd taken away her clothes, her cellphone, her purse. She had scrubs on and looked like ****. Her room was barren -- just a bed, a table and an empty closet. The tv in the "lounge" was blaring loud and there were some patients that were (I think) schizophrenic because they were yelling and rocking. Everyone was pooled together with just one nurse sitting there, watching tv, ignoring the patients around her. This must be what my cousin does (she is a psych nurse on a children's floor at a state mental hospital).

https://www.nursing.upenn.edu/nhhc/n...ric-hospitals/

Quote:
Today, only a small number of the historic public and private psychiatric hospitals exist. Psychiatric care and treatment are now delivered through a web of services including crisis services, short-term and general-hospital-based acute psychiatric care units, and outpatient services ranging from twenty-four-hour assisted living environments to clinics and clinicians’ offices offering a range of psychopharmacological and psychotherapeutic treatments. The quality and availability of these outpatient services vary widely, leading some historians and policy experts to wonder if “asylums,” in the true sense of the word, might be still needed for the most vulnerable individuals who need supportive living environments.
Deinstitutionalization - Special Reports | The New Asylums | FRONTLINE | PBS

Quote:
Eight American studies of arrest rates of discharged psychiatric patients, done between 1965 and 1978, were analyzed by Judith Rabkin. "Each study found that arrest or conviction rates of former mental patients equaled or exceeded those of the general population in at least some crime categories when patients were considered as a homogeneous group." Rabkin concluded, "There has been a pronounced relative as well as absolute increase in arrests of mental patients."57 Especially impressive was Larry Sosowsky's study of arrest rates of patients discharged from California's Napa State Hospital between 1972 and 1975, after the Lanterman-Petris-Short Act had taken effect. Compared with the general population, discharged patients with no previous arrest prior to hospitalization were arrested 2.9 times more frequently. For the category of "crimes against property" (e.g., shoplifting), the discharged patients were arrested 4.3 times more frequently. Discharged patients who had been arrested prior to their psychiatric hospitalization were arrested approximately 8 times more frequently than the general population.58

More recent studies have reported similar trends. John Belcher's study of 132 patients discharged from Columbus State Hospital in Ohio during 4 months in 1985 is particularly interesting. The patients were followed up at 1, 3, and 6 months to ascertain what had happened to them. By the end of 6 months, 17 percent of the 132 patients had been arrested. However, only 65 of the 132 discharged patients had diagnoses of schizophrenia, manic-depressive illness, or severe depression, and 21 of these (32 percent) were among those arrested and jailed. According to Belcher, "These 21 respondents were often threatening in their behaviors" and exhibited bizarre behavior "such as walking in the community without clothes and talking to themselves."59 They also did not take medications needed to control their psychiatric symptoms and frequently abused alcohol or drugs. Significantly, all 21 of these former patients also became homeless during the 6-month follow-up period, again affirming the close connections between severe mental illnesses, homelessness, and incarceration.

It appears, then, that jails and prisons have increasingly become surrogate mental hospitals for many people with severe mental illnesses. In New York, the estimated population of 10,000 mentally ill inmates in the state's prisons "now surpasses [that of] the state's psychiatric hospitals.60 In Austin, Texas, "the Travis County Jail has admitted so many prisoners with mental disabilities that its psychiatric population rivals that of Austin State Hospital."61 In the Dallas County Jail, "On any given day you will find about 900 mentally ill and mentally retarded inmates [which] is more than twice the number housed in the nearest state mental hospital."62 In Seattle "quite unintentionally, the jail has become King County's largest institution for the mentally ill."63 In the San Diego County Jail, where "14 percent of the men and 25 percent of the women are on psychiatric medications," an assistant sheriff observes that "we've become the bottom-line mental health provider in the county."64 And the Los Angeles County Jail, where approximately 3,300 of the 21,000 inmates "require mental health services on a daily basis," is now de facto "the largest mental institution in the country."65 …
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