A brief history of Psychiatric hospitalization

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Wednesday, May 29. 2013

A brief history of Psychiatric hospitalization

The humane treatment of the mentally ill was a major civilizational advance. At a time when there were really no effective treatments for the major disabling mental illnesses (ie Schizophrenias and Bipolar Disorder), providing these patients asylum from the rigors of real life was better than Bedlam or locking Aunt Jane in the attic.

Today, our treatments for Bipolar Disorder (aka Manic-Depression) are pretty good. Our treatments for the group of Schizophrenias are not very good. We can often remove acute symptoms but can not help people function at a normal level. They are mis-wired.

Efforts to help the seriously-ill, in hospitals, hospices, was termed "Moral Treatment." The asylum approach was largely undone with the deinstitutionalization movement under JFK. Thus bag ladies.

Here's a summary: A New Moral Treatment - Humane institutionalization can help the mentally ill and protect society. He might be right. I am not sure.

Posted by Dr. Joy Bliss in Our Essays, Psychology, and Dr. Bliss at 16:55 | Comments (6) | Trackbacks (0)

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Bipolar has a wide range of the degree of symptoms. Many people who are bipolar function without medicine or psychiatric treatment. Some cannot safely live in society without being a danger to themselves and others. Many famous musicians and artists were bipolar and their "illness" enabled them to create music and art we all appreciate. I have known people who are bipolar who oncethey were medicated functioned barely above a zombie level. I have known some who would have probably killed themselves or caused harm to others and the medication saved them. Probably the worst results of bipolar is the effect it has on their children and family. I would suggest being very careful with a bipolar person who becomes angry with you or feels you have wronged them. While some cannot control their anger/temper at all and can explode at the slightest provocation others are perfectly capable of hiding their feelings while planning to do you harm and they can be extremely singleminded in their efforts.

#1 GoneWithTheWind on 2013-05-29 17:41 (Reply)

While it might be cost effective than our present system (and puts those smelly noisy people out of sight out of mind) we would see the good old days of the snake pit return along with forced hospitalizations of the inconvenient, dissidents, etc.

A good example would be a case that came across my desk 30+ years, ago, share cropper's daughter committed for "talking to white men" and being ungovernable as a teen some 20 years prior. When I saw her she had just been released with the dx of simple schizophrenia.

#2 walt moffett on 2013-05-29 23:25 (Reply)

Erving Goffman's Asylums was misread and resulted in deinstitutionalization.

Goffman was studying institutions in general, by way of studying the social dynamics of mental institutions; and clueless readers took their instutional dysfunctions as recommending getting rid of them.

Which I suppose just illustrates another institutional dysfunction.

A great book, by the way.

#3 rhhardin (Link) on 2013-05-30 08:39 (Reply)

Hark: If you want some real chills running up and down your spine, read the wiki on 'sluggish schizophrenia'. Here's the bing:

http://www.bing.com/search?q=sluggish+schizophrenia&form=IE8SRC&src=IE-SearchBox

...to demonstrate that the condition --identified in the USSR and epidemic as soon as noticed, at least among political doubters who someone denounced for any reason.

The angry, sullen behavior probably occasioned by the forced detainment and psychiatric testing itself, became the symptoms of the officially-sanctioned diagnosis of 'sluggish schizophrenia' --an official mental illness, and the case for incarceration (in the part of the Gulag that has the syringes).

And it's still in the Russian med lit!

Don't believe me, look at the third (+/-) from the top of the search results, the wiki entry, and read the para on the malady. See how the game is worked by the credentialed state doctors --in their own words.
===

Now go to sleep and dream of Eric Holder and Janet Napolitano appointing the Surgeon General. See in your dream their faces, ecstatic as they hear of the unlimited possibilities of an American epidemic of 'sluggish schizophrenia'!

#4 buddy larsen on 2013-05-31 01:07 (Reply)

nut graf:

A carefully crafted description of sluggish schizophrenia established that psychotic symptoms were non-essential for the diagnosis, but symptoms of psychopathy, hypochondria, depersonalization or anxiety were central to it.[44] Symptoms referred to as part of the "negative axis" included pessimism, poor social adaptation, and conflict with authorities, and were themselves sufficient for a formal diagnosis of "sluggish schizophrenia with scanty symptoms."[44] According to Snezhnevsky, patients with sluggish schizophrenia could present as quasi sane yet manifest minimal but clinically relevant personality changes which could remain unnoticed to the untrained eye.[44] Thereby patients with non-psychotic mental disorders, or even persons who were not mentally sick, could be easily labelled with the diagnosis of sluggish schizophrenia.[44] Along with paranoia, sluggish schizophrenia was the diagnosis most frequently used for the psychiatric incarceration of dissenters.[44]

#4.1 buddy larsen on 2013-05-31 01:15 (Reply)

I get the sense that the sane worry too much about locking up the insane. I would put most of the drug addicted in the category of clinically insane and lock them up on medical grounds. We treat drug addiction like it is a top tier illness when it is not, but among those drug addicts that maintain no relationships with sane people, are unable to work, are repeat criminals, engage in dangerous sexual practices; especially male homosexuals, we don't diagnosed them at all, do we? I am quite sure that drug treatment does not include screening for anti social disorder, but it should, and the truly sick should be put away.

Whether people start crazy or end up that way doesn't matter, they need help that the rest of us can't provide. In the mean time we shouldn't feel guilty about protecting ourselves from them. Pretty sure we have many of them in prison right now. I think it would be more courageous to treat them than pretend they are criminals being rehabilitated. Yes, I know the prisons don't really rehab.

#5 Bob C. on 2013-06-02 11:41 (Reply)

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Wednesday, May 29. 2013

A brief history of Psychiatric hospitalization