In recent times a good deal of criticism has been directed towards the practice of involuntarily committing individuals to state and private mental hospitals. Most of this criticism focuses on the lack of effective due process; conflicts of interest in the case of private facilities; and failure to adequately explore alternatives.
In my view, all of these criticisms are valid, and warrant attention.
But there is another side to the story that is seldom aired outside the mental health centers. A great many clients like going to the mental hospital; they plan their trips in advance and “freak out” at the appointed time, knowing that the knee-jerk response of the mental health center will be a court-ordered admission.
Why would they do this? Most of the individuals who carry long-term serious “diagnoses” (dismissively referred to as “the chronics”) are poor. The closest they can get to a vacation is an annual trip to the state hospital. When they get there, they are welcomed solicitously by the staff. They have consultations with the psychiatrists, who adjust their so-called medications. Meals are provided. The buildings are heated and are usually nicely decorated. The grounds are pleasant and relaxing. If a person is so inclined, he can paint pictures or engage in other activities. And most of all, he can catch up with old friends and meet new ones.
He can have a reasonably comfortable and pleasant few weeks, provided he goes along with everything the psychiatrists and the nurses say. He needs to acknowledge contritely that he stopped taking his “meds;” that he realizes this was a terrible error; that he knows he does this every summer and that he shouldn’t; etc, etc. etc., It’s called playing the game. Of course those hapless individuals who either don’t know the game or who simply refuse to play – their situation is not so comfortable.
Nor is this dynamic confined to the state hospitals. I once became aware of a private mental hospital where similar dynamics prevailed. At that time Medicaid would pay for up to two weeks a year in a psych hospital. (This may still be the case; I don’t know.)
Anyway, the word in the “chronic” circles was that this hospital was nicer than the state hospital, and that the facility accepted Medicaid. Almost all “chronic” mental health clients have Medicaid, and it was common knowledge that these individuals planned and arranged their two-week stays along the same general lines as outlined above.
Now don’t get me wrong. I’m not trying to make light of the matter. As mentioned earlier, there are serious problems with the committal concept and with the procedures.
But there is another problem – that the condition of the most helpless mental health clients is so wretched and unfulfilling that they arrange for themselves to be committed to a mental hospital as a vacation!
These are individuals who approached the mental health system years, or even decades ago. They were assigned disempowering and destructive “diagnoses.” They were patronizingly encouraged to keep their expectations low. They were ordered to consume large quantities of damaging drugs. Seldom was any attempt made to help them acquire the kind of social/living skills they would need to lead an independent, fulfilling life. Many have advanced drug-induced brain damage.
They are victims of a spurious and brutalizing philosophy which robs people of their sense of worth and encourages them to give up on life.
We don’t need more mental health programs. We need to abolish the mental health system and replace it with non-medical programs that offer people real help with problems of living. They need help finding and keeping jobs and saving their money so that they can afford real vacations!