Category: Medical

What to Know Before Admitting Yourself to an Inpatient Psychiatric Hospital

Coping Strategies, Mental Health, Psychiatric Hospitals

A few ideas and options:

  1. Bring your best advocate with you. It may be your spouse, parent, close friend, or relative—someone who knows you and is familiar with your situation.
  2. Breathe. Recognize that the staff wants to help you, not hurt you.
  3. Be patient. It’s a process—there are steps to go through and paperwork to be completed
  4. Once inside, advocate for yourself. The doctor will see you. Be honest with him.
  5. Your picture will be taken, and no, they are not stealing your soul.
  6. You will be in a secured unit, locked in. At times they let you out of the unit for visits or short excursions.
  7. Do your best to cooperate with staff and your fellow patients. It may be a while before you are discharged, so bear in mind you are there to get better. Plus, you’ll earn extra “points” for being polite and pleasant.
  8. Read your patient rights and understand them.
  9. Your personal belongings will be inventoried, so they will take out shoestrings, belts, hoodies, nail clippers, razors, and anything else deemed potentially dangerous.
  10. Don’t mind the eccentric behaviors of the other patients, they’re fighting a similar battle.
  11. Accept that the insides of the building may not be the most aesthetically pleasing. (That said, don’t concentrate on abstract paintings if they have them. Abstract art is a bad idea for psychotic symptoms).
  12. If you are in a state of psychosis, the TV may sound as if it’s calling your name. It’s not, but if the AV stimulation is too much, try to leave the room or focus on a different activity.
  13. Be mindful of the opposite sex (or the same sex if you’re so inclined). Establish personal boundaries and adhere to them; the psych ward is not a place to start a romance.
  14. Listen to the staff and don’t give them a hard time.
  15. Be friendly and polite. Remember, there are human beings here with feelings.
  16. Seek out a friend and get to know some people.
  17. Read.
  18. Give yourself time and space. You are on a journey to getting better and that takes time and space.
  19. Take a photograph in your mind’s eye. Journal about it. Capture the chaotic and colorful journey. Write about it. Express yourself. Get to know who you are at this time.
  20. Be kind, regardless. Don’t expect people to respect you because a.) everyone’s imperfect and b.) they can’t respect others if they don’t respect themselves.
  21. Challenge your mind and do a puzzle, but don’t read into it—it’s just a brain exercise.
  22. Take advantage of physical activity when there’s recreation time. Your body needs a physical outlet to help process the stress your mind is going through.

Cure for Hysteria of Antiquity

History of Psychology, Hysteria, Medical, Therapies

In antiquity, women who had anxiety, mood swings and depression were sent by their husbands to the doctor, who diagnosed them with a disease called ′′hysteria.” Their treatment was based on a ′′pelvic massage” with the purpose of achieving hysterical paroxysm, now known as orgasm.

There were so many women who began to attend consultations to have their ′′treatment for hysteria′′ that doctors at the end of the workday were exhausted and their hands were shaky; that’s why they decided to invent a useful device that produced rhythmic vibrations and that hysterical paroxysm was achieved easier and faster in the patient without the need for the common manual massage: this is the origin of the vibrator. At that time it was seen as a healing artifact, even the wealthiest women had them in their homes for when they felt ′′bouts of hysteria.”

Francis Galton and the Nature vs. Nurture Debate

History of Psychology, Medical, Mental Health, Philosophy

Francis Galton counted many gifted individuals among his relatives, including the evolutionary biologist Charles Darwin. So it’s not surprising that Galton was interested in the extent to which abilities are either inborn or learned. He was the first person to identify “nature” and “nurture” as two separate influences whose effects could be measured and compared, maintaining that these two elements alone were responsible for determining personality. In 1869 he used his own family tree, as well as those of “judges, statesmen, commanders, scientists, literary men… diviners, oarsmen, and wrestlers,” to research inherited traits for his book Hereditary Genius. As predicted, he found more highly talented individuals in certain families than among the general population. However, he could not safely attribute this to nature alone, as there were also conferred benefits from growing up in a privileged home environment. Galton himself grew up in a wealthy household with access to unusually good educational resources.

Galton proposed a number of other studies, including the first large survey by questionnaire, which was sent out to members of the Royal Society to inquire about their interests and affiliations. Publishing his results in English Men of Science, he claimed that where nature and nurture are forced to compete, nature triumphs. External influences can make an impression, he says, but nothing can “efface the deeper marks of individual character.” However, he insists that both nature and nurture are essential in forming personality, since even the highest natural endowments may be “starved by defective nurture.” Intelligence, he says, is inherited, but must be fostered through education.

In 1875, Galton undertook a study of 159 pairs of twins. He found that they did not follow the “normal” distribution of similarity between siblings, in which they are moderately alike, but were always extremely similar or extremely dissimilar. What really surprised him was that the degree of similarity never changed over time. He had anticipated that a shared upbringing would lessen dissimilarity between twins as they grew up, but found that this was not the case. Nurture seemed to play no role at all.

The “nature—nurture debate” continues to this day. Some people have favored Galton’s theories, including his notion—now known as eugenics—that people could be “bred” like horses to promote certain characteristics. Others have preferred to believe that every baby is a tabula rasa, or “blank slate,” and we are all born equal. Most psychologists today recognize that nature and nurture are both crucially important in human development, and interact in complex ways.

Sources: The Psychology Book (DK)

Austen Riggs Center Psychiatric Hospital

Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Family Therapy, Mental Health, Psychiatric Hospitals

The Austen Riggs Center is an open psychiatric hospital and treatment program that promotes resilience and self-direction in adults (18+) with complex psychiatric problems. They specialize in the long-term treatment of psychiatric disorders with intensive psychodynamic psychotherapy and a full range of psychiatric services, offered in a completely voluntary continuum of care that includes inpatient, residential, and day treatment programs.

They treat the individual, not the diagnosis. Diagnostic labels cannot capture the essence of an individual’s struggles or strengths, and they often obscure what people have in common. Many of their patients have multiple diagnoses, and many have been identified as “treatment resistant” in the past. Often they seek psychiatric treatment at Riggs because they need a different approach, and many opt to stay in our long-term residential treatment program following an initial evaluation and treatment period.

All patients have intensive psychodynamic psychotherapy four times a week with a psychiatrist or clinical psychologist. The goal is to help the person expand their capacity for work, play, and love by fostering improved self-esteem and resilience, and by helping them acknowledge and come to terms with whatever has previously blocked their development.

Recognizing the importance of the social context, they offer in-depth family evaluation, support for family members, and family therapy, as well as a robust Therapeutic Community Program in which patients can develop supportive peer relationships and learn about themselves with others. They offer opportunities for participation in patient government, in social and recreational activities, in reflective process groups, and in health and wellness activities such as meditation and yoga.

The Erikson Institute for Education and Research of the Austen Riggs Center studies individuals in their social contexts through research, training, education, and outreach programs in the local community and beyond. Part of that offering includes an Adult Psychoanalytic Training Program and Fellowship in Hospital-Based Psychotherapy for psychiatrists and psychologists. The program takes a systems perspective, emphasizing cultural and familial contexts, as well as individual development across the lifespan.

The basic ingredients essential to fulfilling the Center’s mission are:

  • Treatment organized around an intensive individual therapeutic relationship, focusing on the patient’s recognition and tolerance of experiences of conflict and pain, leading to the development of a sense of perspective on the illness
  • An open therapeutic community involving all staff and patients
  • A careful assessment phase, including psychological testing
  • A range of programs, geared to individual levels of capability and need
  • Continuous treatment by the same multidisciplinary team as patients move between programs
  • Psychopharmacologic treatment
  • Group work, substance use treatment, family treatment and help with reintegration into the external community
  • A broad activities program offering creative expression, with patients in the role of student, and in a “treatment free zone”
  • Ongoing staff training, research and education to further the primary clinical task
  • Recruitment and retention of quality staff

Vision:

In an increasingly complex and fragmented world, the dignity of the individual, the importance of human relationships and the centrality of a sense of community are more difficult to find. The focus and traditions of the Austen Riggs Center orient the staff to help troubled patients meet these and other rapidly changing psychological challenges of contemporary society. We will continually build on our distinguished past, helping our patients develop personal competence in a completely open setting that emphasizes the individual’s capacity to face and take responsibility for his or her life—past, present, and future. We nurture our patients’ strengths, foster their social functioning and encourage family collaboration. Through our research and training programs, we educate professionals in our psychodynamic perspective, applying this learning to a broad range of psychosocial problems. Finally, in this time of diminishing mental health benefits, we will continue to develop cost-effective treatment settings that focus on individual psychotherapy, community living and that attend to resource limitations as both reality to deal with and metaphor for other limits and losses.

Values:

  • Affirmation of the dignity and responsibility of the individual
  • Recognition, appreciation and enhancement of individual strengths
  • Importance of human relationships
  • Respect for individual differences
  • Centrality of the psychotherapeutic relationship
  • Learning opportunities in a community of differentiated voices
  • Importance of examined living
  • Attention to the conflict between individual choice and the requirements of a community
  • Openness to innovation and creativity
  • Open setting to promote personal responsibility and freedom of choice in treatment
  • Importance of recognizing and preserving multiple roles, including those of student and community member
  • Provision of treatment based on quality and outcome, not profit

Located in the small New England town of Stockbridge, MA, three hours from New York City, two hours from Boston, and one hour from Albany, NY, the Austen Riggs Center is fully licensed by the Massachusetts Department of Health and accredited by the Joint Commission.

Serious Mental Illness By The Numbers

Bipolar Disorder, Justice System, Mental Health, My Schiz Life, Psychiatric Hospitals, Schizophrenia, Self-Care, Suicide

Serious Mental Illness By The Numbers:

Prevalence and Treatment Rates*:

~ 8.3 million adults with schizophrenia or bipolar disorder mental illness (3.3% of the population)+

~ 5.5 million – approximate number with severe bipolar disorder (2.2% of the population), 51% untreated+

~ 2.8 million – approximate number with schizophrenia (1.1% of the population), 40% untreated+

~3.9 million – approximate number untreated in any given year (1.6% of the population)+

Consequences of Non-treatment*:

~ 169,000 homeless people with serious mental illness**

~ 383,000 inmates with mental illness in jails and prisons

~ 50% – estimated percentage of individuals with schizophrenia or bipolar who attempt suicide during their lifetimes

~ 44,193 suicide deaths in 2015

~ 10% – estimated percentage of homicides involving an offender with serious mental illness (approximately 1,425 per year at 2014 homicide rates)

~ 29% – estimated percentage of family homicides associated with serious mental illness

~ 50% – estimated percentage of mass killings associated with serious mental illness

  • Numbers and percentages of US adults
    +National Institute of Mental Health, 2016
    **2015 Annual Homeless Assessment Report

Mad Poet’s Society: McLean Hospital, Robert Lowell, Sylvia Plath, and Anne Sexton

Literature, Mental Health, Most Admired Authors, Poetry, Psychiatric Hospitals

In suburban Massachusetts, on 240 acres of peaceful grounds, is a literary legend—of sorts. McLean Hospital, with its long history of treating the blue bloods of Boston, has become an unlikely poetry landmark after providing both recuperation and inspiration to Robert Lowell, Sylvia Plath, and Anne Sexton.

Plath was the first of the three to stay at McLean. In 1953, during a summer at home before her senior year in college, Plath swallowed a bottle of pills and crawled beneath her house. Her failed suicide attempt led to months of treatment at McLean and began her long relationship with the psychiatrist Ruth Tiffany Barnhouse. While there, Plath received insulin-shock therapy, anti-psychotic drugs, and ultimately electroshock therapy. The experience surfaced years later in her poem, “The Hanging Man,” which begins, “By the roots of my hair some god got hold of me / I sizzled in his blue volts like a desert prophet.”

Lowell was admitted to McLean in 1958, though his infamous manic outbursts had already resulted in numerous stays at other mental institutions. Over eight years, he stayed there four times, correspondeding frequently from his hospital address, and sending letters to Theodore Roethke, Ezra Pound, and even Jackie Kennedy. Written about his first stay at McLean, his poem “Waking in the Blue” mentions Bowditch Hall and was pasted on the wall of the nurse’s station there for years.

Highly competitive with Plath, Sexton tried for years to be admitted to McLean, but her therapist, aware of the high cost, refused to admit her. Sexton first entered McLean as a teacher. In 1968, she was invited to lead a weekly poetry seminar in the hospital, providing Sexton with her first teaching experience, after which she became a professor at Boston University. In 1973, a year before her death by suicide, Sexton achieved her wish and was admitted to McLean for a five-day examination.

Plath and Sexton both attended a poetry seminar taught by Lowell at Boston University in 1959. They were each inspired by his confessional poetry and the appreciation for madness that he cultivated. In “Elegy in the Classroom,” Sexton wrote about Lowell: “I must admire your skill. / You are so gracefully insane.” Through his encouragement, they began to turn their personal experiences into verse—a quality that would mark their later work.

Plath discovered she could mine her McLean experiences for literary inspiration. She wrote in her journal, “There is an increasing market for mental-hospital stuff. I am a fool if I don’t relive, recreate it.” Thus she began her famous novel, The Bell Jar. Years later, in his introduction to Plath’s posthumous poetry collection Ariel, Lowell said, “Everything in these poems is personal, confessional, felt, but the manner of feeling is controlled hallucination, the autobiography of fever.”

Source: poets.org

Knocking Round the Zoo – by James Taylor

Counter Culture, Mental Health, Music, Psychiatric Hospitals

This is an autobiographical song describing Taylor’s stay at McLean, a psychiatric hospital near Boston where he stayed while finishing high school. Taylor was attending a strict boarding school called Milton Academy when he suffered a bout of depression that led his family to pull him from the school and send him to McLean, where he took classes at their affiliated school.

In this song, he explains how it felt like a zoo, with bars on the windows and people coming to look at you – his sister Kate broke down in tears during one visit.

While Taylor was at McLean, he spotted Ray Charles, who was sent there for his heroin addiction. Taylor’s siblings Livingston and Kate also ended up spending time there. Over the next 15 years or so, James ended up in various other rehab centers and hospitals to treat his addictions.

Just knocking around the zoo
On a Thursday afternoon,
There’s bars on all the windows
And they’re counting up the spoons, yeah.
And if I’m feeling edgy,
There’s a chick who’s paid
To be my slave, yeah, watch out James.
But she’ll hit me with a needle
If she thinks I’m trying to misbehave.

Now the keeper’s trying to cool me
Says I’m bound to be all right,
But I know that he can’t fool me
‘Cause I’m putting him uptight, yeah.
And I can feel him getting edgy
Every time I make a sudden move,
Whoa, yes it’s true.
And I can hear them celebrating
Every time I up and leave the room.

Now my friends all come to see me,
They just point at me and stare.
Said, he’s just like the rest of us
So what’s he doing there?
They hide in their movie theaters
Drinking juice, keeping tight,
Watch that bright light.
‘Cause they’re certain about one thing, babe,
That zoo’s no place to spend the night, no.

Just knocking around the zoo
On a Thursday afternoon,
There’s bars on all the windows
And they’re counting up the spoons, yeah.
And if I’m feeling edgy,
There’s a chick who’s paid to be my slave,
Watch out Kootch.
But she’ll hit me with a needle
If she thinks I’m trying to misbehave.

E. Fuller Torrey On Deinstitutionalization

Mental Health, Psychiatric Hospitals

Deinstitutionalization:

“It is important to understand the magnitude of deinstitutionalization. In 1955, when the United States had a population of 164 million people, there were over 558,000 mentally ill individuals in public mental hospitals. In 2006, the United States had a population of almost 300 million; if in 2006 we had had the same number of individuals in public mental hospitals as we had in 1955 in proportion to the population, the number of hospitalized patients would have been just over one million. In 2006, there were in fact only approximately 40,000 individuals in public mental hospitals.

Deinstitutionalization was not a onetime experiment that might be easily reversed. Once a patient was discharged from the hospital, that bed was no longer available for that person to return to or for a new patient to use. Eventually, at least forty state mental hospitals were closed altogether. Many of the seriously mentally ill individuals…who today are homeless, incarcerated, victimized, violent, or otherwise not receiving treatment have never been hospitalized at all.”

~ E. Fuller Torrey, from The Insanity Offense: How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens

#MentalHealth #Deinstitutionalization #TheInsanityOffense #MySchizLife

Justice system and mental health

Justice System, Mental Health, Mental Illness Treatments, Psychiatric Hospitals

Justice system and mental health:

~ 2 million people with mental illness are newly incarcerated each year.

~ Recent findings show that there are 10 times more individuals with serious mental illness in prisons and jails than in state mental hospitals.

~ 83% of inmates with mental illness did not have access to treatment after release.

~ In a recent outcome study, 64% of inmates with mental illness released from prison were rearrested within 18 months, and 48% were hospitalized within the same time period.