Discussion When did the current trends of forced hospitalization for suicidality begin in the US/UK?

[GoodPersonEffed]

I could google this, but I don't even know where to begin to start. Maybe someone else knows.

Please bear with me here. I put the questions in italics, but there are reasons for the other things I wrote. If it's too TL:DR-y for anyone, um...I don't know what to say!



When did it become a widespread thing to hospitalize people for considering or planning suicide?

For reference, I'm 49 years old. Things were not like this when I was younger, and I don't know when they became that way.

When I was a teenager, I had a boyfriend commit suicide (1985), which was an extreme anomaly. Kids rarely committed suicide, and it was so shocking, news of it spread throughout the school district. I lived in a very large city, and it was not in one of the more conservative parts of the US. Teen pregnancies were also much more rare, but not unheard of. (By the way, I should take into account that I was white middle class, and went to a predominately white school mixed with Latinos and Blacks, who probably made up one-third to half of the school population of over 1,800 students). At that time, school shootings were not a thing. We had some plain clothed security guards because it was a large city public school with a little crime and frequent fights, but having security was not the norm throughout the country.

In the years following, even into my early thirties, whenever I saw a therapist or psychiatrist, if they asked if I had suicidal thoughts or intentions, it was always about gauging where I was, or in the case of a psychiatrist, considering it as a symptom. At that time, it was extremely difficult to get put in any kind of mental hospital or mental instituion.

Spoiler: Maybe Related?

Perhaps this is related, perhaps not, but when I was younger, reporting physical abuse by a parent did not end up with a visit by child protective services. I told a school counselor in junior high (1983-1985) who I voluntarily went to as a therapist, and there was no intervention nor threat of it. In high school, I saw the district psychologist (1987) and told him I was considering running away from home due to the physical and verbal violence, and he agreed that was the best thing to do in my situation. However, CPS involvement really started to become a thing in the Nineties, at least for wipipo, so maybe not related, or not on the surface.

So when did all this mental health intervention and taking away of rights begin? When did privately run behavioral health centers/mental health jails begin? When, in the US, Britain, and other countries, did it stop being safe to consider ending one's own life, and to talk to one's own mental health practitioner about it in order to receive support? When did mental health treatment become so controlling, authoritative and intrusive for people who didn't have the worst of the worst conditions and couldn't take care of tasks of daily living, or get and maintain independent housing?

Again, for more history, which comes from independent research I did for my uncompleted graduate thesis...Mental hospitals used to be notoriously atrocious. People were held against their wills and forced to take medicines. In the Sixties in the US, President Kennedy's sister was lobotomized for mental health problems and was completely changed. So Kennedy is credited with instigating the deinstitutionalization of mental health treatment, and community mental health centers opened so that people with mental illnesses could be part of the community rather than locked up. Around the same time, or in the very early Seventies, the consumer movement began, which was made up of people who had been abused by psychiatry in instutions and injured by forced medications. So there was a strong trend to deinstitutionalize mental health care and to make taking medications a personal choice.

At what point did the trend begin toward temporary forced instutitionalization, medication and management of care, whether by the NHS mental health services in England, or by community mental health centers or private practitioners in the US? When did suicidality become "criminalized" in the mainstream? (Not criminalized, but loss of autonomy, freedom, and rights, with a separate judicial system.)

 

[Sinkinshyp]

I've watched some pretty sick crap on youtube about the history of psychiatry. I don't know when the forced hospitalizations came about. The history of psychiatry is interesting, sad and disgusting. I know years ago if someone suffered some form of mental illness like schizophrenic their families would lock them away in asylums. Geraldo Rivera did a pretty sad documentary about Willowbrook asylum. You can youtube Geraldo Rivera willowbrook, and youtube search the history of psychiatry. I know what I saw the mental health practitioners should have had lifetime prison sentences.

 

[GoodPersonEffed]

I've watched some pretty sick crap on youtube about the history of psychiatry. I don't know when the forced hospitalizations came about. The history of psychiatry is interesting, sad and disgusting. I know years ago if someone suffered some form of mental illness like schizophrenic their families would lock them away in asylums. Geraldo Rivera did a pretty sad documentary about Willowbrook asylum. You can youtube Geraldo Rivera willowbrook, and youtube search the history of psychiatry. I know what I saw the mental health practitioners should have had lifetime prison sentences.

I've done a lot of studying on the history of psychiatry. It's always been abusive, from its roots. Foucault and Szasz both give interesting accounts. Szasz disagrees with some of what Foucault claimed about the origins, but both point out horrors from the very beginning. Szasz seems to think that imprisonment and control are inherent, while Foucault saw it more from the perspective of discourse and power, such as the power to define a person and use them as an example for wider social control.

 

[HadEnough1974]

Probably at about the same time it became profitable to lock people away in prisons? I vaguely remember watching a movie about a woman who was put in a psych ward and a fellow "inmate" explained how it's all about the money.
Here's what I'm talking about:

Feds probing psychiatric hospitals for locking in patients to boost profits

At least three federal agencies are looking into Universal Health Services.

arstechnica.com

 

[GoodPersonEffed]

Probably at about the same time it became profitable to lock people away in prisons? I vaguely remember watching a movie about a woman who was put in a psych ward and a fellow "inmate" explained how it's all about the money.

I wouldn't be surprised.

That relates to my question about privatized inpatient facilities. I could see how there may be a correlation. Privatized prisons -- when did that shit start?

I was in two of those privatized inpatient facilities, both times voluntarily trying to get help for trauma-based suicidality (every time, actually). They were both utter shit, but the second one was blatantly, intentionally abusive.

Hospital psych wards weren't much better as far as effectiveness, but there were at least half-ass attempts to do something to help. They were still all about pushing to stabilize with meds.

I went to one specialized, nationally recognized PTSD inpatient program that had more effective groups and didn't push meds as hard, but there was still a lack of compassion and some creepiness, from the famous director down to the staff.

I have never felt really safe, cared about, or effectively treated in any inpatient program, and more often left feeling worse than when I went in.

 

[HadEnough1974]

I wouldn't be surprised.

That relates to my question about privatized inpatient facilities. I could see how there may be a correlation. Privatized prisons -- when did that shit start?

I was in two of those privatized inpatient facilities, both times voluntarily trying to get help for trauma-based suicidality (every time, actually). They were both utter shit, but the second one was blatantly, intentionally abusive.

Hospital psych wards weren't much better as far as effectiveness, but there were at least half-ass attempts to do something to help. They were still all about pushing to stabilize with meds.

I went to one specialized, nationally recognized PTSD inpatient program that had more effective groups and didn't push meds as hard, but there was still a lack of compassion and some creepiness, from the famous director down to the staff.

I have never felt really safe, cared about, or effectively treated in any inpatient program, and more often left feeling worse than when I went in.

I'm so sorry that you've had such experiences. I was attending what was called the day hospital, totally voluntary, from 10 am to 2 pm daily for 4 months. Art therapy, group setting, music therapy, compassionate and caring people. I'm in Montreal, Canada, (you know the socialist country with socialized medicine).

You could talk to a nurse at any point. I was not medicated and meds were not pushed on me. Meds had been pushed on me by other psychiatrists though but not at the day hospital. To be specific, the Allen Memorial Institute. Very kind and compassionate during my time there.

 

[esse_est_percipi]

Szasz seems to think that imprisonment and control are inherent, while Foucault saw it more from the perspective of discourse and power, such as the power to define a person and use them as an example for wider social control.

Yes, if you survey the history of the concept of 'madness', you find 'epistemic ruptures', which is what Foucault talks about, and the discourse radically changes from one epistemic paradigm to the next, which is also connected to a specific regime of power.

So, pre-16th century (i.e pre-scientific revolution), the discourse around the concept of madness was completely different and played a different role and had a different social function.

By the time Descartes was writing the meditations, he was able to use 'madness' as a device which was equivalent to ascribing delusion, error, irrationality to a person (i.e. not fit to participate in 'normal' social and economic life).

This use of madness in his work was only made possible because of a wider social and institutional shift of discourse on madness which was itself part of a wider epistemic rupture with the previous pre-scientific method era.

Because in the pre-scientific era, 'madness' actually had more of a positive social role to play, in relation to religion and the theology (i.e. Erasmus' 'in praise of folly', which belongs to the pre-scientific revolution epoch and is part of a completely different epistemic discourse on madness).

So I'm not sure imprisonment and control are inherent to the very concept. I don't know much szasz though

 

[GoodPersonEffed]

Big questions, but I'm assuming you want quick, relevant information and not vague essay-length guesswork.

Definitely seeking relevant information. I get if people want to comment about the history, it's interesting stuff, but I'm interested in a specific trend.

So perhaps this trend of hospitalizing people just for planning suicide or mentioning suicidal thoughts is actually relatively recent, i.e. post-1960, and has economic/profit-related explanations.

It could be that the deinstitutionalization of mental illness post-1960 is actually a misleading indicator when considering the specific institutional treatment of suicidiality.

In my experience, it's definitely recent. I'm thinking it started this milennium.

I don't know that suicidality on its own was cause for institutionalization prior to 1960. From what I understand, it was for extreme, chronic conditions such as schizophrenia, catatonic depression, what we would now call bipolar that wasn't "discovered" until after deinstutionalization but would have been diagnosed as hysteria or schizophrenia. I think what I was pointing out was that there was a trend to get people out of institutions and to allow them to choose for themselves whether or not to take medication long-term no matter how severe or debilitating the condition, and now there is a trend for temporary institutionalization to "stabilize" someone who is considering suicide or has attempted. I also don't know if suicide attempts automatically resulted in mental hospitalizations.

All I know is that, prior to this milennium and even partway into it, it was for me, as a white middle-class American woman with health insurance, safe for me to tell a mental health practitioner that I was considering suicide. It was safe for me to tell my friends and family, and no one would come knocking at my door to do a wellness check or to force me to go to a hospital. No one would have even thought to report me to anyone.

 

[esse_est_percipi]

I've done a lot of studying on the history of psychiatry. It's always been abusive, from its roots

I know. It's actually terrifying when you start reading about the history.

Do you know about the neurosurgeon antonio egas moniz? Invented lobotomizing. Creepy and disturbing guy, as well as walter jackson freeman II, who spent his career travelling america cutting people's heads open and severing parts of their brains, killing a not insignificant percentage of them.

"After almost ten years of performing lobotomies, Freeman heard of a doctor in Italy named Amarro Fiamberti who operated on the brain through his patients' eye sockets, allowing him to access the brain without drilling through the skull. After experimenting with novel ways of performing these brain surgeries, Freeman formulated a new procedure called the transorbital lobotomy. This new procedure became known as the "icepick" lobotomy and was performed by inserting a metal pick into the corner of each eye-socket, hammering it through the thin bone there with a mallet, and moving it back and forth, severing the connections to the prefrontal cortex in the frontal lobes of the brain.He performed the transorbital lobotomy surgery for the first time in Washington, D.C., on a housewife named Sallie Ellen Ionesco.This transorbital lobotomy method did not require a neurosurgeon and could be performed outside of an operating room without the use of anesthesia by using electroconvulsive therapy to induce seizure. The modifications to his lobotomy allowed Freeman to broaden the use of the surgery, which could be performed in psychiatric hospitals throughout the United States that were overpopulated and understaffed. In 1950, Walter Freeman's longtime partner James Watts left their practice and split from Freeman due to his opposition to the cruelty and overuse of the transorbital lobotomy" - wikipedia, walter jackson freeman II

Horrific stuff. The guy was a psychopath

I don't know that suicidality on its own was cause for institutionalization prior to 1960

Yes I think that could be correct. It would have to have been part of a broader range of symptoms related to psychosis, depression, etc.

I also don't know if suicide attempts automatically resulted in mental hospitalizations

I don't know about the USA, but in the UK that isn't automatically the case. I think it's judged on a case by case basis (at least since suicide illegality was abolished in 1961)

 

[TAW122]

I recall seeing an anti-psychiatry video on YouTube over 10 years ago (not sure if it is still up or just hard to find) and I recall the video talking about back in the 18th/19th century sometime, the insane were horribly treated (locked up, tortured, and even suspected to be superstitious and cursed). Keep in mind that back then, modern medicine and understanding of the brain is still lacking and/or uncharted territory. Furthermore, religion still has a profound influence in those days compared to the late 20th century or even 21st century. I'd like to say that psychiatry may have some roots in social order, control, and undertones of religious aspects to it (then again, the church and religion held a lot of power in those days and earlier, monarchies (royal families)).

 

[Checkmate3]

So when did all this mental health intervention and taking away of rights begin? When did privately run behavioral health centers/mental health jails begin?

I don't know exactly when it started, but I can say for sure that it was already in effect in 2001 in the US.
I also believe that the better health insurance you have, the longer they will keep you there.

 

[Wayfaerer]

probably when the light bulb first appeared above their heads that there is money to be made.

 

[Sinkinshyp]

I don't know exactly when it started, but I can say for sure that it was already in effect in 2001 in the US.
I also believe that the better health insurance you have, the longer they will keep you there.

I swallowed 50 pills in an attempt to CTB a yr and a half ago. I was kept for 30 hours until I saw the psychiatrist. They DID NOT accept my insurance. The social worker asked questions, I replied and when she asked and we don't take your insurance right? I said nope and I have no ability to pay either. The doctor decided I can be released. I wanted help to ease the pain. I was honest and admitted to trying to CTB when I took those 50 pills. Now there aren't any psych available to me with my insurance. I can't see a counselor, psychiatrist therapist nothing.. none take my insurance in my area. As a teenager I was in and out of psych for maybe under a yr and a half. That was around 31-33 yrs ago now I guess. It was so much different. Medical wasn't for profit so much as it is now. I was able to get help. In hospitalization and a great psychotherapist.

As I mentioned above, the youtube videos I have watched in regards to the history of psychiatry they all should have been imprisoned for life. They treated people as human guinea pigs and tortured them.

 

[Checkmate3]

I swallowed 50 pills in an attempt to CTB a yr and a half ago. I was kept for 30 hours until I saw the psychiatrist. They DID NOT accept my insurance. The social worker asked questions, I replied and when she asked and we don't take your insurance right? I said nope and I have no ability to pay either. The doctor decided I can be released. I wanted help to ease the pain. I was honest and admitted to trying to CTB when I took those 50 pills. Now there aren't any psych available to me with my insurance. I can't see a counselor, psychiatrist therapist nothing.. none take my insurance in my area. As a teenager I was in and out of psych for maybe under a yr and a half. That was around 31-33 yrs ago now I guess. It was so much different. Medical wasn't for profit so much as it is now. I was able to get help. In hospitalization and a great psychotherapist.

As I mentioned above, the youtube videos I have watched in regards to the history of psychiatry they all should have been imprisoned for life. They treated people as human guinea pigs and tortured them.

I know.
In 2001, I was under my parents' insurance, which was excellent. They kept me in that hellhole for 2 months. While some other people "without a fixed place of residence" stayed there for no more than 1-2 days.

 

[HadEnough1974]

I'm so sorry that you've had such experiences. I was attending what was called the day hospital, totally voluntary, from 10 am to 2 pm daily for 4 months. Art therapy, group setting, music therapy, compassionate and caring people. I'm in Montreal, Canada, (you know the socialist country with socialized medicine).

You could talk to a nurse at any point. I was not medicated and meds were not pushed on me. Meds had been pushed on me by other psychiatrists though but not at the day hospital. To be specific, the Allen Memorial Institute. Very kind and compassionate during my time there.

@GoodPersonEffed I hope you don't mind my question, you mentioned that you sought help twice at psychiatric wards and both times you didn't get the help that you needed.

Do you think that if you got what you needed back then, might you still considering ctb? You can answer in private if you wish.

I know that you tend to be private about your reasons to want to ctb and if you chose not to answer I respect that as well.

Peace

 

[GoodPersonEffed]

@GoodPersonEffed I hope you don't mind my question, you mentioned that you sought help twice at psychiatric wards and both times you didn't get the help that you needed.

Do you think that if you got what you needed back then, might you still considering ctb? You can answer in private if you wish.

I know that you tend to be private about your reasons to want to ctb and if you chose not to answer I respect that as well.

Peace

I actually got over my PTSD-related suicidal stuff. My reasons now are due to external things outside of my control. It's a rational response. I desire things to get better, I don't desire to die, but things aren't going to get better, they get worse and will continue to. Since I don't have a more peaceful method than SN, when things are more unbearable than SN, SN it will be. If I had N right now, it would be very soon. I'm ready for the suffering to stop.