The smart people “play” healthy, not admitting ongoing doubts and concerns. Why? Because you go to the hospital to make rapid medication changes. The therapy offered is often insufficient, both in terms of one-one-one therapy and simply what you can cover during your stay. Overstaying is enough to make anyone clinically depressed. It can also cost a lot; while it is illegal to fire for mental health leaves, it is not uncommon to get let go for “unrelated reasons”, to prevent paying for future stays, or simply because they’re uncomfortable supporting their employees to this extent.
Mental health hospitals are aimed at maximizing the number of beds in use, ensuring everyone is at least as medicated as the doctor thinks they can handle, and pumping insurance companies for money. If you are considering one, use it to prevent crises, not to expect any kind of therapy suited for long-term help. The simply do not have the available attention, funding, or even reliable pharmaceutical research to make a dent in the latter.
To be honest, I have high hopes for psychedelics to make fruitful, therapeutic use in a short stay. As it is I’ve lost faith in the pharmaceutical industry to demonstrate the pills they make are effective, let alone not harmful to the general population. 3/5ths of the mental health prescriptions I’ve been given have been pulled from the market, linked to high suicide rates, or linked to other serious medical issues (no shit, Risperdal made me lactate as a male.)
...and of course, the absolute worst part is seeing people you know will never function in society, many rimes without family. I suppose better the asylum than the street, but we will likely always need long-term mental health care in publicly funded facilities.
Thoses drugs are dangerous and do not cure a patient usually leaving them in a worse state mentally. When you are the one forced to make these decisions its tough because there are no easy answers.
I find the traveling through time reference interesting. I remember the line from slaughter house 5. What cosmic truth was he approaching?
> People see distorted faces, visions, hear things and the worst part are not these hallucinations, but delusions, strong beliefs
> but to them it was like they really uncovered some deeper meaning.
> ome internal conflicts ... and then started decompensating
If anyone is interested in a taste of what that might be like, the recent game "Hellblade: Senua's Sacrifice" is very impressive. It's basically a psychosis simulator, developed under heavy consultation from a group of patients that suffer from psychosis/delusions.
Similar to how you mentioned it's not just the hallucinations, the game does things like using "find the perspective that makes those logs look like a rune/glyph" to prime/encourage the plater to see potential "deeper meanings". Headphones are required, because binaural recording techniques are used very heavily to e.g. place voices in specific locations "in" and around your head.
Warning: this recommendation includes a very strong trigger warning re: grief, mental and physical abuse, and (obviously) the very graphic realities of severe psychosis and other mental health issues.
Commentary by the devs and some of the consulted patients about making the psychosis simulator: (some mostly-minor spoilers) https://www.youtube.com/watch?v=0jF3rr6t2Hg
Development diaries: https://www.youtube.com/playlist?list=PLbpkF8TRYizaT6GfMcKBG...
If you prefer watching as LP, I recommend (Yogscast) Hannah's: https://www.youtube.com/playlist?list=PLK9CD9s2JfIeoub7dINHI...
Additionally, some classes of people are mandated reporters. If they fail to report the threat, or attempt, they will lose their license and, I think, can face both civil and criminal charges. Again, some variation depending on jurisdiction.
Teachers, health care professionals, day care workers, police, etc. are all mandated reporters. They must, by law, report an attempt or threat. An attempt, by law, means a minimum of 72 hours of involuntary commitment. After which, a judge can be called in to extend the stay.
I had a sister who was mentally ill. For my last two years in the Marines, I was a transportation officer at a detention facility (brig), where I was a mandated reporter and sometimes had to work with people who had developed their mental illness during their enlistment or had somehow managed to pass the psych eval and managed to enlist. There were a suprisingly large number of them.
So, I've had some exposure to the system and the missus used to work in the field. For a while, I volunteered to help some of them out. I used to take some fishing, hiking, and to do things like archery practice. I was a mandated reporter during that, and had to take a number of classes on mental health.
If you're curious, I stopped because I don't have the heart for it. It isn't that I don't have a heart for the mentally ill, it's that I don't have the heart for the system in which they are stuck. I don't like being powerless and I was unable to effect change.
Unfortunately, the system is designed to deal with a broad spectrum of people with myriad complexities. They do tend to take a very hard line approach and to assume the worst. They also have reason to not always trust the patient.
It's tricky with mental health. In many ways, it's a damned if you do and damned if you don't situation. This is more true during the initial observation period and one of the reasons many facilities do isolation for the first 24 hours, even for voluntary commitments.
It should be noted that voluntary commitments can rapidly and more easily become involuntary commitments. After all, the patient has already admitted that they are unwell.
Nope, I have no idea how to fix this mess.
I think for the majority of cases committing themselves usually makes the situation worse.
whose mental health care provider? Yours, or the one who is legally bound to be an agent of the state? you wouldn't talk to a lawyer who was obligated to report your confidences to the police, so why a doctor?
Yes. Once admitted you have something no matter how convincing you are. Never talked to someone who walked out having not be diagnosed with something.
Warning: This may be a bit long and hastily written.
For reasons, I once doubted my sanity. To make a long story short, I used to use an obscene amount of drugs. I'm an addict in recovery, sort of - I take prescribed Suboxone.
I didn't use because I didn't feel well, I used because I wanted to feel even better. I was never a stereotypical addict, I was a functioning addict. I had no major trauma, no abuse history, or any history of mental illness.
I used because I liked being high. I wasn't escaping anything. My life was fine. I just liked getting high. My drug of choice was opiates, they helped me sleep and not think all the time. In fact, I have a Ph.D. in Applied Mathematics - from MIT. I have plenty of money, healthy relationships, and no real criminal record, or at least convictions.
So, after rehab, I doubted my sanity. I doubted whether or not I was sane. I mean, what sort of sane person wants to shut their brain down and get high? What sane person knows the risks of addiction but still chooses to inject themselves with untested drugs purchased from shady people?
So, I went to the shrink and we had a few sessions. I did my best to be absolutely honest with them. Even during the peak of my drug use, I was completely honest with my physicians. They are tasked with saving my life, I shouldn't lie to them. I did the same thing with the head doctor.
Finally, he sets me up for advanced and expensive training. It was three eight hour days, one of which was spent taking this giant test called something like the MMPI. It is one of those tests where you fill in the ovals and it's thousands of questions long.
Two of the days were spent talking to people and doing some writing. They didn't feel obligated to hook me up to any of the machines.
It took a bit for the results to come back and it turns out, I'm not even remotely insane. I kind of hoped I was, because then I'd have a reason for some of my choices. Nope... I'm probably more close to clinically sane than the people who administered the tests.
Except, and this is the important part, they won't tell you that you're sane. This isn't verbatime, but it went something like this, "You show no signs of your life being negatively impacted by any diagnosable mental illness. You exhibit no significant traits of any clinically diagnosable disability as defined in the DSM-V." It was something like that.
So, even after all those tests, and apparently being pretty damned sane, they still wouldn't call me sane - only that I wasn't able to be diagnosed with anything on the list and that my life wasn't being harmed by any uncontrolable brain functions.
That's as close to sane as they appear to admit. The initial head doc hadn't done the tests, but had sent me out for them. We both got a good chuckle at the responses.
He then recommended I visit a therapist once a week and offered me some sleeping pills.
At the very least, they do seem inclined to keep you in their care. They won't say you're sane, either. Even when they couldn't pinpoint an issue, they still wouldn't say I was sane. The closest they came was saying that I'd no signs of my life being harmed because of a mental process I couldn't control.
Go figure?
Also, you have an interesting life story :)
It helped my Mom and me immensely when our family member had a psychotic break. I highly recommend them if you can make the time.
Here, "psychiatric hospital" literally means "prison with carpets". There are locked doors instead of bars, and caretakers instead of guards, but it's a prison all the same.
My brother had a mental breakdown (not violent or criminal, but threatening enough to himself for police to be involved), and ended up in the state "hospital" for quite a while. I almost wish it was a prison instead, because at least prison is honest about what it is.
These "hospitals" may be necessary for some, but as soon as you walk inside, you take a deep dive into the uncanny valley, and you yourself begin to question your own sanity. I won't even try to imagine what it would be like to be thrown inside with no trial, and told that you can't leave unless you prove to your accusers that you are adequately "normal"
The worst thing about the situation is that my brother didn't believe or understand he was ill, and the state gave him every reason to be angry, and reject the situation, rather than come to terms with it.
Thankfully now, he is in an assisted living facility, is allowed to leave, and can feel more like a human being, but while he is very normal, functional, etc. he can't just go find work and go live his life. There doesn't seem to be an end game, and that alone is its own prison.