I'm a psychiatrist, and there are a few things to consider about this story:<p>1. The bulk of people in a psychiatric hospital are there voluntarily. They can walk out the door at any time.<p>2. When a patient is in a hospital involuntarily, their stay is subject to state laws about involuntary hospitalization. This, as far as I know, universally requires 2 independent professional opinions that a patient is actively suicidal, actively homicidal, or overtly incapable of taking care of themselves to the point it puts their health at risk.<p>3. Psychiatric stays are generally very short (less than 5 days), despite the fact that most medications don't start working that quickly. Stays have become unrealistically short.<p>4. Despite the general outcry about involuntary hospitalization, most family members of a person with a severe illness will tell you that they struggle to get their loved ones admitted even when the situation gets dire.<p>5. Again despite the outcry, a number of states have been expanding the liability of psychiatrists for the actions of their patients. For example, if my patient were to hurt themselves or someone else, I can expect years of depositions and lawsuits. This does not justify hospitalizing someone who does not need it, but does speak to a double standard about our role in protecting society.<p>THIS LIABILITY STILL APPLIES WHEN AN INSURANCE COMPANY TELLS ME THEY ARE GOING TO STOP PAYING FOR HOSPITAL TIME 2 DAYS AFTER SOMEONE TRIED TO HANG THEMSELVES. If I release them, it's on me. If I keep them, they face huge bills even if they have insurance. This sucks.<p>6. MOST IMPORTANTLY, <i></i>WITHOUT INVOLUNTARY COMMITMENT MANY PATIENTS GO TO JAIL OR PRISON<i></i>. I work in correctional settings. The decline in psychiatric beds is strongly correlated with the spike in mentally ill people behind bars. Without an avenue to get them treated, they end up getting arrested for their behavior, when they should have gotten treatment instead.
This is an appropriate article to comment with the Rosenhan Experiment. From Wikipedia: <i>The study involved the use of healthy associates or "pseudopatients" who briefly feigned auditory hallucinations in an attempt to gain admission to 12 different psychiatric hospitals in five different states in various locations in the United States. All were admitted and diagnosed with psychiatric disorders.<p>After admission, the pseudopatients acted normally and told staff that they felt fine and had no longer experienced any additional hallucinations. All were forced to admit to having a mental illness and agree to take antipsychotic drugs as a condition of their release. The average time that the patients spent in the hospital was 19 days. All but one were diagnosed with schizophrenia "in remission" before their release.</i> [1]<p>This article also makes me think Wells Fargo-esque pressure from above is to blame, but won't be heavily punished by the authorities. At least in the WF case two executives had to pay back $75m. [2]<p>[1] <a href="https://en.wikipedia.org/wiki/Rosenhan_experiment" rel="nofollow">https://en.wikipedia.org/wiki/Rosenhan_experiment</a><p>[2] <a href="https://www.washingtonpost.com/news/business/wp/2017/04/10/wells-fargo-knew-about-sham-accounts-problem-as-far-back-as-2002" rel="nofollow">https://www.washingtonpost.com/news/business/wp/2017/04/10/w...</a>
I once met a mural artist who told me a very memorable story of his peculiar time at the cuckoo's nest, how he got there and how he left. It was the 1960s-70s and all had been reasonably normal in his life, until his attendance at a certain party. Though he was untroubled in the company of recreational drug fiends, he didn't participate, at least not deliberately. However, someone had surreptitiously spiked the punchbowl with LSD. Being a gentle and kind sort of creature, he unwittingly embarked on a profound psychedelic odyssey. Still under the effects of the punch and yet unable to rationalize the situation, he called his sister for help, who persuaded him against his better judgment to check in to a psychiatric hospital. Shortly after, his state of mind returned to normal where he was able to assess the cause, but the talons of the ward took hold and would not let him go. They'd already begun to medicate him heavily with tranquilizers which clouded his mind and dulled his resolve. His pleas for understanding were ignored and he soon realized that he'd become a prisoner. In this situation his only assets were his art and good character. In a sanctioned stupor he devised a plan; he would begin "cheeking" his medicine in the presence of the nurses and spitting it out in their absence. He was permitted art supplies, the results of which quickly earned him respect among the staff. He'd use this to eventually obtain permission to paint outside in the courtyard, where he'd scan every possible vector for a way out. His fear had began to impel him after seeing inmates which were previously articulate and sociable become zombies after what he presumed were lobotomies. He suspected he was on the list for the same. Once he gained the trust of the staff, he finally sprang for freedom. He got it and never returned. He carried on with his art, remaining perfectly sane, innocuous and successful in his trade.
A great example of how for-profit healthcare (or anything else) can fail.<p>Corporate entities have an obligation to do whatever they can legally get away with in order to maximize profits. They do not have a prerogative to benefit society, or help human beings apart from what they choose to do.<p>Every country has to decide whether the benefits of privatisation of the various services outweighs the societal costs caused by private entities having different goals.
This is one of my greatest fears: that I'll be labelled as insane, then taken away and locked up against my will, and when I try to plead sanity, nobody will believe me. Because they "know" I'm insane.
My grandma was kept alive an extra 10 days to let her medicare run out in rural Oklahoma. I'm not sure of all the details because it was 15 years ago and I was a teenager, but my dad said medicare stopped paying for some level of care and then they let her die (she was a vegetable from a stroke).
Private prisons profit from recidivism (rather than rehabilitation) just as psychiatric "hospitals" do.<p>Though at least in a private prison, you <i>know</i> how long your sentence is, it is an objective measure.<p>When imprisoned in a mental asylum, <i>you don't know how long you will be in there for</i>, because your release is dependent on the subjective whim of those who stand to profit from the continued occupancy.<p>There are no objective tests to determine whether or not a person is mentally ill, and this further exacerbates the existing conflict of interest.
Looking forward to charges of fraud and, where applicable, imprisonment under false pretenses[1], resulting in stiff prison sentences for those responsible.<p>[1]: The notion that psychiatric hospitals should be able to keep people there against their will is <i>extremely</i> suspect. A possible exception is a patient being convicted in court of an actual crime, and sent there instead of to prison by the legal system. Even then, the very likely possibility that the hospital staff would extend the patients stay indefinitely would necessitate the judge setting some upper bound on how long the patient can be kept against their will.