Does Abuse Still Go On in Mental Health Hospitals?

Reader’s Question

I cannot get over some of the things I saw during my stay in hospital two years ago. Some of the patients were treated by the staff in such a way that I was relieved to get out of the hospital and grateful that I was not treated in the way I saw other patients being treated. I was really upset at first but eventually thought I got over it. But now I have nightmares about the hospital and some of the things I saw. In the meantime, I’ve also learned that what I saw is not considered standard (e.g., agitated patients being kept in a fixed room for long times). So, now I am feeling like an accomplice of the mistreatment in a way. How do I get over the nightmares of fear and guilt over what I saw in the mental hospital?

Psychologist’s Reply

The treatment of the mentally ill has progressed dramatically over the last 40 years. The advent of powerful and effective medications has eliminated the need for many patients to endure long, harsh, confinements in institutions. But sometimes short-term and even longer term institutional care is necessary. Despite all the advances that have been made, it’s unfortunate that some abuses and instances of mistreatment still occur.

In the U.S., organizations like the National Alliance for the Mentally Ill (NAMI) are active in the fight to dispel misconceptions about mental illness and to find and put an end to instances of maltreatment.

Studies show that most instances of mistreatment in mental hospitals often involve improper restraint or seclusion of patients considered overly disruptive or potentially “violent.” Other common instances involve poor attendance to patient problems and improper use of behavioral contingencies.

Mental institutions of various sorts have a hard time recruiting and maintaining an adequate, well-trained staff. The lion’s share of the duties often fall to staff with little formal training and to persons who are overworked and underpaid. This of course is no excuse for patient mistreatment.

Sometimes, what appears as mistreatment is often just the harsh reality of intervening in very hard to handle situations. But when genuine abuse is suspected or witnessed, there are many things a person can do.

  • Most states have a mental health services division of their Dept of Health and established standards for mental health care. Anyone can report instances of abuse or suspected abuse or raise issues concerning the standard of care.
  • Organizations like NAMI have special task forces that seek not only to identify situations that put patients at risk but also to ensure that uniform standards are implemented in institutions serving the mentally ill. Some of the standards NAMI advocates include:
    • Establishing uniform standards for mental health worker training,
    • Establishing strict and uniform standards for justifying extreme measures like seclusion or restraint, and
    • Setting up a system-wide reporting system for all instances of abuse, neglect, or mistreatment.

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Some ex-patients have formed mental health advocacy groups, and effective mental health treatment is a primary goal of the formal organizations of psychiatrists and psychologists. Hospital accrediting associations also set standards for hospital operations and conduct routine inspections. So, there are many avenues to possibly pursue if you’re concerned about the kind of care or lack of it that you may have witnessed during your hospital stay.

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