Discussion should carceral psychiatry be abolished or reformed?

[bijou]

do you have any thoughts, opinions or experiences with carceral psych institutes? if you're comfortable sharing your experiences i'd love to hear your perspective.

i'm relatively undecided as to whether or not these spaces should be reformed or completely abolished. while in my experience i have not had entirely traumatic stays. i feel this is mainly due to being in public, youth-oriented programs, also the fact i was a very passive client probably helped so i was never given the fateful butt-shot to "calm me down." i have friends and some family who were exposed to downright abusive practices. one of the reasons i am so paranoid to fail an attempt is ending up in an adult program.

i can see how inpatient can do some good in providing routine and peer support, but i also know the insidious nature of savior-complex psych nurses (from personal experience), involuntary drugging, and client abuse (from other clients and staff). some professionals i have interacted with have really encouraged the stigmatization of suicide. personally, i once heard a nurse making fun of me for spending so long on my "reasons to die" list, i overheard her in the nursing station say "she's still fucking working on that death list huh?" and that made me feel quite shit as a teenager.

what should be done to reform these institutions? should professionals be trauma-informed? should involuntary psych stays be completely abolished?

 

[TransilvanianHunger]

Involuntary stays are tricky as hell. They have their purpose and, to an extent, I think they can be leveraged to do good, but I would make them something of a last resort measure for someone who is incapable of making a decision on their own and requires urgent care. That's how it's supposed to work already, but the "incapable" label is applied too liberally for my liking.

The whole thing with psych nurses and other personnel requires a complete rethinking of how people who work in a psych ward are trained and selected for their positions, as well as how they're supposed to treat the patients. The human element is sometimes entirely missing there and patients are considered a nuisance, a thing that the staff must deal with, and sometimes little more than an inmate, instead of a human being who is there because they need medical assistance. I think that an improvement on training and hiring practices would go a long way towards making psych care better.

In short, I guess my pie-in-the-sky scenario would involve turning psychiatric institutions into places worthy of trust—facilities that people would be more likely to voluntarily visit when they're in need, without fear of being treated like a criminal and locked up for 6 months with no recourse. Make these places trustworthy, and suddenly you don't need to involuntarily commit a large percentage of the patient population, because people who need help and support won't be afraid of reaching out.

 

[Forever Sleep]

I've been lucky enough never to have been in one, so, I can't really say. Still- I think some people can GENUINELY become a danger to other people- as in- kill them, or seriously injure them. I think in that case- prison isn't a good environment for them but the public does need to be protected somehow. I think a secure institution of some description has to be the answer in these extreme cases.

Honestly- that goes for the wider community as well. I've known teachers who have had young pupils that lash out- biting, spitting and kicking staff AND other children. They were short staffed as it was but when they had to try and deal with violent behaviour- everyone suffered. Just HOW much should 'difficult' children/adults be integrated into regular society? When are the benefits to them outweighed by the possible danger they represent to people around them?

I remember there was a massive failing near where I lived once and someone on day release bought an axe and killed a random cyclist in a park. It's probably a good thing that there are programmes to rehabilitate people- both psychiatric patients and former criminals to an extent but when it fails- it fails catastrophically.

Like I say- I don't know enough about it really. I have no doubt that some places are better than others. Also- sadly that I expect abuse of power does go on.

Talking to other people- the main thing I noticed was that there didn't seem to be that many different grades of mental health institution- yet there are SO many grades of mental illness surely. Again- talking to people who have stayed in facilities- they have said beng around other patients FAR worse than them- also potentially disruptive and violent- really didn't help them. I suppose- if it doesn't exist already- I think it would be better to have different levels of facilities with different levels of security and different treatment programmes.

 

[LaVieEnRose]

Involuntary stays are tricky as hell. They have their purpose and, to an extent, I think they can be leveraged to do good, but I would make them something of a last resort measure for someone who is incapable of making a decision on their own and requires urgent care. That's how it's supposed to work already, but the "incapable" label is applied too liberally for my liking.

The whole thing with psych nurses and other personnel requires a complete rethinking of how people who work in a psych ward are trained and selected for their positions, as well as how they're supposed to treat the patients. The human element is sometimes entirely missing there and patients are considered a nuisance, a thing that the staff must deal with, and sometimes little more than an inmate, instead of a human being who is there because they need medical assistance. I think that an improvement on training and hiring practices would go a long way towards making psych care better.

In short, I guess my pie-in-the-sky scenario would involve turning psychiatric institutions into places worthy of trust—facilities that people would be more likely to voluntarily visit when they're in need, without fear of being treated like a criminal and locked up for 6 months with no recourse. Make these places trustworthy, and suddenly you don't need to involuntarily commit a large percentage of the patient population, because people who need help and support won't be afraid of reaching out.

I agree, if coercive intervention were actually done in a spirit of palpable caring it would be much more palatable.