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Who Profits from the Psychiatric Hospital?

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   Being committed to psychiatric hospitals has been practiced for several centuries. During the 1500s one of the original and best known psychiatric hospitals was created. It was located in London and called St. Mary of Bethlehem. The locals referred to it as "bedlam" and this is where the original definition of that term came from. This was considered a time of enlightenment because the school of thought concerning deviant behavior was shifting away from the belief that the patient was possessed by demons or that he or she was a heretic.

No more witches, in that day and age the insane were considered mentally ill and instead of being burned at the stake they were taken to a dark, dingy and cold cell where they lived out the remainder of their lives under abominable conditions.

Fortunately for the mentally ill, the conditions have improved even more since the 1500s. Nowadays instead of using a straight jacket to restrain the patient, we use mind altering (psychotropic) drugs.

Restraints, similar to straight jackets are still used in modern times with regularity, but they are usually second choice to a heavy dose of strong, intoxicating antipsychotic medicines. During these modern times, about 99.9% of the patients that are admitted to psychiatric hospitals are immediately placed on psychotropic medicines. And if these patients were already on these medicines when they came in, they will be placed on more of them upon admission. It is not unusual to see some of the patients taking 6 to 10 different types of medicines daily.

The primary medication is usually an antipsychotic medication. Some common antipsychotic medicines are Thorazine, Haldol and Clozaril. Antipsychotic meds are used to treat symptoms like hallucinations, delusions and illogical thoughts and ideas. They are also used for reducing aggressive tendencies in potentially violent patients. Although this use is not what antipsychotics were intended for, they do get used as tranquilizers for violent patients because of the convenience and speed that they sedate the patient.

A second popular class of psychotropics are called Antidepressants. The most common Antidepressant is Prozac. Antidepressants are used to treat depressions.

The third commonly prescribed psychotropic medicine are called Antianxiety medications. Some common Antianxiety drugs are, Xanax, Valium and Klonopin. These are used to treat symptoms of anxiety. In addition to these different medicines there are also drugs to treat Manic Depression (AKA Bipolar Disorder). The most common drug in this category is Lithium.

Now you might be asking, is it common for one patient to take all of these drugs at once? The answer is yes, and it happens frequently. Here is a hypothetical example of how it works:

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Leon, who has a very intense and profound case of Bipolar Disorder, stops taking his Lithium, and within days becomes so out of control that he is committed to a baker act facility for observation. When he arrives they put him back on Lithium immediately and they also put him on an antipsychotic like Clozaril to control him. Within a day or so Leon calms down but he becomes very depressed in the process. Now in addition to the other drugs, he is prescribed an antidepressant to relieve his depression. After this drug is administered Leon has a new problem, antidepressants cause anxiety to dramatically increase so now he is becoming very anxious. Next, the Dr. will prescribe Leon an Antianxiety medication. So now Leon is becoming quite stable (if not a total vegetable), but he is beginning to have side effects from the medicines he is taking! So what happens now? They give him another drug to reduce the side effects!

The drugs that are used to treat side effects are usually of the class known as Anti-parkinsonism agents. The most common Anti-parkinsonism is called Cogentin. This class of drugs was originally intended to treat the symptoms of Parkinson's Disease. The side effects of psychotropic medications are similar to the symptoms of Parkinson's Disease.

After all of these drugs have stabilized in Leon's system, he is observed to be in control. According to the staff of the hospital, he is under control, because now he is too sedated to be a problem to anyone. For a short time Leon might enjoy this feeling because he has no responsibilities and the only thing he is required to do in the hospital is attend mental health groups and activities. This is fine and well as long as he stays in the hospital. But unfortunately, after Leon has adjusted there is no longer any justification to contain him in the ward.

So Leon gets released and goes home to find that he is so heavily sedated that he can barely function in society, because it is much more humiliating to be a vegetable in society than it is in the psych ward. Can you guess what happens next? Leon quits taking his medicines (again) because it is not as much fun having your senses dulled in society as it is in the psychiatric hospital. Within a day or two of quitting all of the medications that he was taking, Leon begins to get his concentration back. Then shortly after that he gets his energy back and he begins to feel like a functioning human being again. But this feeling is short-lived because within another week or two Leon becomes manic again and the whole cycle repeats itself, sometimes over and over.

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Now it is time to ask the original question; who truly profits from the Psychiatric Interventions? I can provide a list, in order of who profits the most. #1. Pharmaceutical Companies make billions on psychotropic medicines. #2. The Hospital probably makes between $500 and $1000 a day on the patient. #3. The Psychiatrist makes from $100 to $300 per visit. #4. The hospital staff consists of the following- Nurse Practitioners, Primary Care Nurses, Social Workers, and Mental Health Techs. who all have semi decent wages. #5. on the list would usually be the patient. Occaisionally the patient does profit from the insight provided by the experience, the resources that he or she is directed to, and even the psychotropic medicines sometimes actually improve the quality of the patients life. In my starry night.jpg (18816 bytes)observations, for the most part, the patient does not profit from the experience. Outside of the fact that psychotropic medications usually reduce that patients ability to concentrate, and "block the patients feelings and emotions", there is a worse side to the process of hospitalization, this is the stigma associated with being committed to a psychiatric hospital and having a psychiatric label. The patient has to wear this label. The patients family, freinds and employment associates are usually aware of the hospitalization and psychiatric label. In addition too having the  mental illness itself, being labeled mentally ill adds injury to insult. It is a further humiliation that actually complicates the patients problems and further fuels the mental pathology. The patient isn't just a person anymore, he or she is a Borderline Personality or a Schizophrenic......a defective person. Having this label commonly creates feelings of inferiority and discomfort around people the patient believes are mentally healthy. This further exacerbates the deficiancy in social skills by the patients perception of being a total outcast.

Psychiatric Hospitals are run for the purpose of turning a profit just like any other business. What is in the true best interests of the patient is not an issue. What looks the best on paper and in the patients file is the issue.

When a patient is admitted the hospital he sees the Psychiatrist if he is lucky about twice a week for about 15 minutes each time. The patient is usually at his best when he sees the psychiatrist because he is looking forward to it. The Psychiatrist usually feels that the patient is not over-sedated because as far as the Dr. could see the patient was alert and oriented. Because of the Dr.'s ego he probably doesn't take into consideration that the patient is only alert because of the situation of being excited to see the Dr.(as the Dr. is the only hope of the patient being released from the hospital). So the Psychiatrist continues with the current regiment of medications because his observation (as superficial as it is) did not warrant him to reduce the medications that he previously prescribed.


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