Why Are Psychiatric Hospitals Often Perceived as Prisons?

Psychiatric hospitals are frequently viewed as akin to prisons, with perceptions stemming from a variety of factors within the treatment environment. Drawing on my extensive experience in mental health care facilities and prisons, I will elaborate on the reasons behind this perception and how these perceptions can impact the treatment of mental health patients.

The Reality of Treatment in Psychiatric Hospitals

As a nurse with over 14 years of experience in both mental health facilities and prisons, I have witnessed firsthand the stark differences in the treatment of mental health patients and prisoners. My work in mental health facilities has included time in high-security psychiatric settings, and my background in the corrections system has further deepened my understanding of the distinct realities of each environment.

Throughout my career, I have consistently observed that mental health patients are not treated like prisoners or inmates, irrespective of their mental health issues. The closest parallels often arise in situations where a patient poses an imminent risk to themselves or others. However, the treatment is aimed at stabilizing the patient, rather than punishing them. Once stabilized, patients are usually released, highlighting the primary focus on healing and recovery rather than long-term confinement.

Personal Trauma and Experiences with Mental Health Care

One of the most challenging experiences came during my time on active duty, where the lack of support and the recommended treatments were traumatic. The sole psychiatrist I consulted suggested Electroconvulsive Therapy (ECT), a treatment I would never wish upon anyone. The hardship intensified, leading to a referral to the Veterans Administration where I was finally admitted to a locked ward. The combination of medications and trauma led to blindness, necessitating physical restraints.

The aftermath of my admission was a quest for understanding what triggered such a severe reaction. Despite the fear of stigma and embarrassment, the healthcare team eventually concluded that I was not a danger but required extensive support. This experience underscores the importance of understanding and addressing the underlying causes of extreme reactions in patients, and the need for compassionate, evidence-based treatment.

Security Measures in Psychiatric Hospitals

While some psychiatric hospitals have residents who are under lockdown, this practice is more common in prisons than in typical hospitals. The security measures in psychiatric hospitals are primarily focused on ensuring the safety of staff, patients, and visitors. In contrast, prisons have a much greater emphasis on security due to the criminal justice context.

In psychiatric facilities, patients are rarely locked in as a routine measure, unless they are a clear danger to themselves or others. This control is distinctly different from the continuous confinement in prisons, where security is a constant presence and more restrictive.

The Intersection of Medical and Justice Systems

The differences in treatment philosophy between psychiatric hospitals and prisons reflect the broader disparity between the medical and justice systems. Psychiatric hospitals operate under a medical model, prioritizing patient care and recovery. In contrast, prisons are governed by the justice system, focusing on punishment and control.

Some argue that it is more cost-effective to treat people using the medical model, but funding priorities often favor the justice system. Approximately 40% of prison inmates have mental health issues or addiction problems. This statistic underscores the systemic neglect of mental health care and the overreliance on the criminal justice system to address these issues.

The prioritization of prison spending over mental health and medical treatment programs highlights a lack of political will to effectively address these issues. Thislegates a cycle of incarceration for individuals who could benefit from psychiatric care instead.

Conclusion

While there are parallels between certain aspects of psychiatric hospitals and prisons, especially in terms of security and treatment of dangerous patients, the core philosophies and primary goals of these institutions remain distinct. The medical system aims to heal, while the justice system focuses on punishment and control. Understanding these differences is crucial for improving the treatment of mental health patients and addressing the broader issues of healthcare and prison reform.