Monday, April 19, 2021

Asylum 1

What to do about persons with mental illness or psychiatric disorder - it's a challenging problem that's probably always existed. 

Back in the 1800's there was a wave of "Institutionalization," the movement to create institutions to bring the mentally ill out of homes and off the streets, in order to protect both patients and the public. The trend was based partially on the belief that they were not hopeless, that some could be treated and helped back to mental health.

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Well-publicized failures of some institutions with inhumane practices led to a wave of "Deinstitutionalization" in the mid-20th century. Community clinics, half-way houses, toughening the standards for admission or readmission, and simply releasing patients were all substituted for institutions. It helped that psychiatric drugs became available. They could limit psychotic episodes and reduce the need to restrain and confine patients.

Today we have a new situation: "Gone are the days of long-term psychiatric hospitalization and housing for the most severely mentally ill. Instead, for better or for worse, patients in need of psychiatric admission are treated for five or seven days and discharged back to the community—sometimes without a place to live.

(cont'd tomorrow)

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