State Mental Health Hospitals – Lost in the Past

The padded room. The straight jacket. The nurses tightening the leather confines on a writhing patient. That is the image that comes to my mind when I hear “state mental health hospital.” Unfortunate as it may be, this is not an entirely outdated image. While community- and university-based treatment facilities for mental illnesses have slowly begun progressing into recovery-based approaches, state hospitals on the eastern reaches of the country seem to be lost in the past; focusing on stabilization rather than treatment.

In the 1950s, those with mental illnesses were seen as societal misfits and were, consequently, jailed. The prison system became stressed and, as a result, the government issued funding for the creation of mental health asylums and hospitals. It is more then mere coincidence that such facilities were constructed directly next to state penitentiaries.

As mental health hospitals cropped up along the eastern coast, the mental health population was transferred from jails to asylums. Yet something was still wrong; the focus was still on simply removing the individuals from society. In the opinion of many practitioners, the purpose of hospitals was, to a large extent, to warehouse humans rather than to treat mental illnesses. Even for the most well-intentioned facilities treatment was largely an impossibility; the staff to patient ratio was incredibly imbalanced, meaning stabilization, rather than treatment and progression, became the priority.

But mental health workers did the best they could do with what they were given, and such workers should be commended and applauded for their bravery and devotion. As the years have progressed, treatment facilities have become far less stressed, making quality treatment within a state hospital a possibility in regards to patient-staff ratios. Unfortunately, as the mental health community has progressed into the concept of mental health recovery rather than mere treatment, the state institutions have not yet followed.

State practitioners still largely focus upon stabilization rather than systematic recovery. The difference is in the end result. Recovery focuses upon creating an improved living condition wherein those suffering from mental illnesses can continue to live rich, fulfilling lives while living on their own and being self-sufficient. Recovery is also largely driven by the consumer rather than the practitioner. Treatment and stabilization plans, on the contrary, do not focus upon self-empowerment and enrichment, but rather upon finding the right combination of medication to insure minimal down-spirals while the mental healthcare consumer remains in their current condition. Stabilization tactics are also largely driven by the mental healthcare practitioner, thus lack motivation goals innate to inwardly driven recovery methods.

The problem arises in the fact that stabilization might truncate symptoms with medication at a certain level, but such a treatment plan does not encourage a reduction of symptom interference levels or self sustainability. Stabilization of mental illnesses assumes the current condition of the mental healthcare consumer is as good as their life is going to get; the assumption that one can recover from a severe mental illness to live a fulfilling, successful life is not even made evident.

Mental illnesses and mental recovery demand a systemic, systematic treatment plan that addresses several factors of an individual’s life. The social network needs to be addressed. Housing needs to be addressed. Employment needs to be addressed. And yes, medication and symptom stabilization does need to be approached as well, but it is one factor of the overall treatment plan, not the entire purpose of mental healthcare systems.

To find out more about recovery-based facilities, check out the Mental Health Center of Denver’s homepage at MHCD’s homepage, or access their research and evaluation team’s homepage at Research and Evaluations.

The mental health recovery movement is continuously growing. State institutions are a great improvement over mental hospitals of the past, but the road to recovery lies in mental health recovery based approaches; those that treat multiple levels of a consumer’s life simultaneously. Recovery needs to be the focus, not stabilization. Fulfillment rather than existence. Happiness rather than mundaneness.

– Lex Douvasa

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