Psychiatric Hospital

A psychiatric hospital (also called a mental hospital) is a hospital specializing in the treatment of persons with mental illness. Psychiatric wards differ only in that they are a unit of a larger hospital.

Mental hospitals have a number of differences from other hospitals. First, they generally have elaborate procedures to prevent suicide by patients (for example, appliances with power cords are not allowed, and access to stairways and high, open windows is restricted). Second, they attempt to reduce the amount of sensory stimulation that the patients have. Contrary to popular belief, mental hospitals are generally quiet, even boring places. Third, mental hospitals often try to provide as normal an environment as possible. For example, unlike most other hospitals, patients in mental hospitals wear street clothes rather than examination patient garments.

Since the 1960s, efforts have been made to improve mental health care. Nevertheless, many problems remain, especially for those with little money to pay for more expensive facilities. The use of restraints and medication for punishment rather than treatment, the lack of adequate staff and resources, the lack of documentation of forced treatment, as well as other serious deficencies remain all too common.

There are a number of different types of mental hospital. One is the crisis stabilization unit, which is in effect an emergency room for mental situations. Because involuntary commitment laws in many jurisdictions require a judge to issue a commitment order within a short time (often 72 hours) of the patient's entry to the unit and because moving a severely ill mental patient can be extremely dangerous, especially as the patient may try to harm himself/herself or others, many of these stabilization units have conference rooms which are used as courtrooms for emergency commitment procedures.

Another type of mental hospital is used for medium term care lasting several weeks. Most drugs used for psychiatric purposes take several weeks to take effect and the main purpose of these hospitals is to watch over the patient while the drugs take have their expected effect and the patient can be discharged.

One other type of mental hospital is designed for long-term care: a combination hospital and prison for the criminally insane. In the United States, these are generally operated by the state government and exist in a few centralized locations. In many cases, persons within these hospitals have been charged with serious crimes and have been found not guilty by reason of insanity. As a result, in addition to the precautions to prevent suicide there are also precautions against escape (such as are found in a prison). The treatment of persons within such institutions has been a subject of long-standing debate. A minority of people have advocated for their abolition, on the grounds that the insanity defence should not be permitted and those confined to such institutions should be incarcerated in a regular prison instead, on the grounds that the inmates' confinement to these "hospitals" punishes them for crimes of which they have been judged not guilty, and on various other grounds.

One final type of mental institution which is not a hospital is a community-based half-way house which provides assisted living for mental patients for an extended period of time. These institutions are considered to be one of the most important parts of a mental health system by many psychiatrists, although many localities fail to provide sufficient funding for them.

Some observers, including Thomas Szasz, have objected to calling mental hospitals "hospitals" (see anti-psychiatry). Lawrence Stevens has described mental hospitals as "jails." ¹

History of mental hospitals

to be written, should mention

• Asylums
• Bedlam
• development of modern humane attitudes
  • Dorothea Dix
• In the U.S., JFK's call for reforms and the results
• Care in the community