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The Shrink Rap blog surveyed former psychiatric inpatients and found that 62% said their experience was not helpful and they were “the same or worse at discharge”.I’d like to dismiss this as people just carrying a grudge for having to be there at all, but the same survey finds that a very similar 56% of voluntarily admitted patients said the same thing (although not all “voluntary” admissions are as voluntary as the name expects).

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Some clever person might ask: “Hey, don’t most psychiatric medicines require more than a week to take effect? The most common type of case I see is “person who was really angry, said ‘I’ll kill myself’ in a fit of rage, and then their partner called the cops and they were brought to hospital.” These people stop being angry after a day or two and then no longer make these comments, even assuming they meant it in the first place which most of them don’t.

The second most common type of case I see is “person who was really angry, did try to kill themselves, and it didn’t work.” Again, these people have stopped being angry.

Heck, my power was out the past couple of days, and I couldn’t use the Internet, and I was calling the power company and being like “COME ON YOU NEED TO FIX THIS ALREADY I AM LOSING DAYS OF MY LIFE THAT I COULD OTHERWISE BE SPENDING IN IMPORTANT STUFF.” So now I try to avoid throwing stones.

(there’s another aspect of this, which is that people constantly protest that horrible things will happen to them based on that week.

The only people you really have to worry about most of the time are the manic ones and occasionally severe autistics, and even they’re usually okay.

For a place where two dozen not-very-stable people are locked up in a small area against their will, violence is impressively rare.Yet in the two years I’ve worked at Our Lady Of An Undisclosed Location, years when each doctor has talked to each of their patients at least once a day, usually alone in an office, usually telling them things they really don’t want to hear like “No, you can’t go home today” – during all that time, not one doctor has been attacked. I am constantly impressed with how deeply the civilizing instinct has penetrated.When I go out of the workroom and tell Bob, “I’m sorry, but you’re disturbing people, you’re going to have to stop banging on the window and shouting threats, let’s go back to your room,” then as long as I use a calm, quiet, and authoritative voice, that is what he does.There’s a similar idiom around “Bedlam”, which comes from London’s old Bethlehem psychiatric hospital.In fact, psych hospitals are much more orderly than you would think.I remember that my first week on call, somebody had a seizure and I totally freaked out – AAAAH SEIZURE WHAT DO I DO WHAT DO I DO?

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