Are psychiatric hospitals inhumane?

Question

I've been told that if I am confined to a psychiatric ward in Thailand, since I am a dual citizen, my rights will be signed away, my Green card worthless; and I will NEVER return to America.

I'm also told that if a patient is totally hopeless, they give them an "oral cosh," which means that they drug the patients to heavily sedation or unconsciousness. This would deprive the patients of movement and complex speech, rendering any sane person useless as well. I've been told my grandmother worked in a retirement home, and abused the elderly guests - even leaving them to die.

Apparently, all patients can only get worse, due the horrible restraints, foul odor, and unsocial behavior of the other patients.

Is this an accurate representation of modern psychiatry?

Answer 1

It depends where you go. Many psychiatric hospitals are very tightly regulated... as are the involuntary commitment laws. Where i live in Australia, most psychiatric wards are quite pleasant places (im a psychologist) and any over drugging is investigated straight away. However, some of the patients are restrained because of thier violent and unpredicatable behaviour and are only restrained for the safety of them and everyone around them. I have never smelt any foul odours. As for antisocial behaviour... some can get quite agressive at times and only then are they sedated. Hope this answers your question

Answer 2

I can't speak for the legalities involved, or how things are run in Thailand, but my work has had me spending some time in various mental institutions, and I know some other folks who have worked in some and I can give you a general picture of how things are run in these places.

First of all, there's a range of mental illness that's staggering, mild to crippling beyond all belief. There are long term facilities out there that more or less only handle the 'too crazy for living' for the rest of their life patients. They get folks who are schizophrenic and med resistant, while violent and paranoid. Autistics with OCD symptoms so severe they can't bathe on their own. Basically the worst cases where independent living is completely impossible. These are ugly, depressing places, and most of these people end up here after a long stay at a lesser facility that just can't manage them.

For the most part psych wards in the US are featured at most major hospitals. They're frequently divided into two sections, one for acute care, and one for longer term patients. Acute wards tend to get a lot of suicide attempts, 5150s(California term for a 72h psych hold), or basically people who need a week or two to get stabilized. They're strictly kept to the med regime prescribed by their doctor, and there's a good bit of free time and regular therapy. The purpose of the acute ward is to stabilize people who have had a psychiatric crises and get them back on with their lives. Longer term patients spending months or years in a facility are rather similar. They're kept to a strict medication regime, there's regularly scheduled activities and the environment is controlled. Heavy sedation and restraints are used for violent episodes - but this practice is under intense scrutiny, used for very short periods to abort a crises. This is handled in a very upstanding manner these days, as the law has little tolerance for abuse of such methods.

I can't speak for geriatric facilities/nursing homes - I have no experience in that end of things. I do know that they are poorly regulated, frequently staffed by untrained people and are notorious for abuse. On the other hand, an acquaintance of mine in my undergraduate years worked at an Alzheimer's and disabled elderly facility near our campus. It was an upstanding, well managed facility.

Basically, I don't think that's accurate at all. Again, I can't speak for the legal issues, but you seem to have captured some image out of the 1950s mixed with the absolute worst case scenario psych cases - the people who can't manage their own daily needs. By simply posting on here it's fairly clear you're not one of these, and in the US system, I can't even conceive of you ending up in of them. These are places where people with even a modicum of sanity don't end up.

I hope that's reassuring. I can't speak for the Thailand system, but that's how things tend to be in the US. Your local setup may vary.

Answer 3

Pretty much. They "say" that if they don't sedate them, they will become wild. But my question to them is, how are people supposed to get better if they cannot work things out. Whats going to happen when the drug's effect wears off and they get their old personoia back. Anyways, you are correct that they will take your citizenship away. And they do seem to neglect patients quite often.