Disclaimer: All persons, places and things in this document are imaginary; any resemblance to actual persons, places or things is purely coincidental.
I saw a show on BBCAmerica the other night...it was late, after evening shift; it appeared to be a pilot for a series...two hours long about a psych hospital in Great Britain. It was about two psychiatrists having an argument about the correct diagnosis/treatment of a patient.
The older psychiatrist, kind of a pompous ass, was asserting the patient was a borderline with a brief psychotic episode and should be returned to the community as fast as possible...extended hospitalization would only institutionalize the patient, the hospital needed the beds, he should be set free. The younger, idealistic psychiatrist thought the patient was schizophrenic, had no resources, needed the help and the structure of the hospital. He strongly advocated the patient be kept (given a long term cert, in American lingo). The patient, being crazy, was mostly unable to identify his own best interest or contribute to its achievement.
Although some of the language was odd or wrong, the theme of the show was surprisingly pertinent...one tended to like the young idealist who wanted to keep the patient in the hospital...one noticed that the arguments of the pompous ass psychiatrist were uncomfortably like ones own. The show did a pretty good job of portraying the patient with a confusing complex of symptoms. It was difficult to be sure who was "right".
At the end of the show, the ass had prevailed and the patient was set free...to wander aimlessly, friendlessly in the city at night, looking into store front windows in the cold.
One big difference (between the situation as described on TV and reality as I know it) was the hospital facility itself. In the show, the patient has his own room; the two docs spent hours in that room with the patient, talking with him, discussing his options, opining, arguing, etc. The patient periodically wandered out of his room into lovely landscaped lawns and gardens. You never saw another patient. The room was nice, modern, clean, comfortable.
On that level, the choice of keeping the patient or turning him loose looked obvious...quality of life would be so much better in that room than on those streets...
And it's made me start thinking about how that compares to the reality on the ground (so to speak) here. Like the pompous ass in the show, I tend to think we should set them free, if at all possible. I'm assuming that there's a greater possibility of some reasonable quality of life out there than I know there to be in here...but you know, I'm probably wrong about that...given the state of funding for mental health services for the indigent, this hospital may be one of the best "placements" available. If that's true, we should hang on to our patients as long as possible in many cases...setting them free is tantamount to throwing them into a swampy lake.
Thinking that we should be keeping them, not setting them free makes me feel...well, crazy.
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11 comments:
Very interesing look at the topic......Who is right ???? Is anyone ever right?????? For most we can only hope to do the best we can for a client.......
"The true measure of the greatness of a society may be found in how that society treats its most vulnerable members." Some fine sage once said this, and if Gadde Fly can tell me who, well, dinners on me.
If this is true, and I think that it is, then we as a society are a despicable lot. We have elected spineless 'leaders' in Colorado who feel it noble to build roads instead of hospitals. A barbarian occupies the White House, and his minions roam free in the halls of our government and courts. Those who are the 'least' among us ... the poor, the ill, the minorities ... are viewed as having brought their condition upon themselves, thus excusing society from resposibility for their wretch existence.
Some modicum of hope can be found in the efforts of the few who advocate on behalf of those without a voice. I am speaking, in part, of those people who are on the frontlines ... the mental health workers, the nurses, the care-givers who demosnstrate compassion where there is little hope.
We did this to ourselves, and it is we who must correct this obscenity. Keep hope alive!
Here's an intersting related link. Google MindFreedom International. A perspective that most people on the staff end of the continuum either aren't exposed to or don't consider
Dear Shining Elmer,
I am unable to alter the comments in any way before posting them to the blog..it's all or nothing. I hope you'll re-write the part of your comment you'd like published.
Thanks for writing.
g.f.
At the madhouse
One must truly wonder, given the mostly bleak outlook, how willing the 'line staff' are to confront their own demons and recognize the impact on the real therapeutic key, themselves ? One does not find many beyond that line that can fully recognize, or even worse, truly acknowledge the parallel process that exists within what the madhouse has become.
More importantly, how does this trickle to the ones who matter most, the true reason for the existence of the madhouse, those entrusted in it's care ?
They must decide for themselves whether they are part of the problem or part of the solution. That will be the true measure of their value to those invisible few locked in the darkness.
Can you feel it ? Can you see it ?
Shine the light !
In a serious attempt to earn dinner I offer the following:
Spinoza said: "To give aid to every poor man is far beyond the reach and power of every man...Care of the poor is incumbent on society as a whole."
John F. Kennedy said, "If a free society cannot help the many who are poor, it cannot save the few who are rich."
Or, maybe this: Samuel Johnson: "A decent provision for the poor is the true test of civilization."
Well...that's as close as I can come for tonight...good enough for dinner? Please advise.
g.f.
It is interesting that you would use the J.F.K. quote......After All he was the one to give the land to build the Mad House...
Dinner and more! Eat up! The journey is long and perilous into the madhouse.
Tibetan proverb - Go slowly so that you may return.
Dinner was great....here's another quote (maybe it'll work again)
Adam Smith: "No society can surely be flourishing and happy, of which the far greater part of the members are poor and miserable."
g.f.
"The first human who hurled an insult instead of a stone was the founder of civilization." Sigmund Freud
Can I go to dinner too?
Absolutely! Great one.
I'll be the one wearing a while carnation. See ya' there!
g.f.
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