When Mental Hospitals Resemble Jails

prison

A friend recently forwarded me this article from The Atlantic, arguing how the Cook County Jail in Chicago could be considered the “largest mental-health facility” in America due to the high percentage of inmates who have received or are eligible to receive mental illness diagnoses, as well as the massive size of the jail itself. The article examines the appropriateness or lack thereof of such an arrangement, mentioning an added layer of mental health screening, jail diversion options, and the admirable amount of “advanced mental health training” that the prison staff receives.

What immediately came to mind for me was not how jails can sometimes resemble mental health treatment centers, but how mental health treatment centers can come to resemble jails. I will share a true anecdote from a psychiatric hospital in a certain city in a certain Southern state in the United States. Without revealing too much, I will say that this particular state received a D grade for mental health treatment from NAMI in 2009.

The sad tale: An older woman of Asian descent, having immigrated with her family to America decades ago, receives regular government disability checks. Her physically and emotionally abusive father and sister demand that she turn this income over to them. If she refuses, they retaliate by having her committed to a hospital for being “crazy.” She is placed on a geriatric unit with older, far less functional individuals with dementia – many of them sleep through the day on heavy medication cocktails or are even placed in restraint chairs. Because English is not this patient’s first language, she has difficulty communicating her needs and story to the nurses and psych techs, and they often dismiss her as an annoyance. A rotation of fly-by-night psychiatrists have pressured this woman into receiving electric-shock therapy, a procedure that she hardly understands and instantly regrets. She complains of shooting pain throughout her entire body that makes it hard for her to sleep in the days afterward. Her involuntarily commitment order has long expired, and so has a follow-up legal request to hold her against her will. The doctors, nurses, psych techs, and social workers are ignorant of the actual legal steps to extend a legal hold, and no effort has been made to provide legal representation, or to inform the patient of her rights. She waits in an illegal, unethical state of limbo for over a month as she continues to receive pressure to conform to invasive and harmful procedures from medical staff that know almost nothing about her. Nobody cares. Nobody takes action. The facility never faces a single consequence. When insurance stops paying, the patient is discharged back to the home of family members who steal her money and beat her.

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