Promoting dependency: how psychiatric hospitals profit from the failure of psychiatric care
Posted Sep 16 2011 4:58pm
Psychiatric hospitals dont work. By any measure I know of they dont work. I have seen statistics that say as many as 25% of people are rehospitalized within a month and 40% within a year. Rather you believe it is because of the lack of quality in psychiatric hospital care, the lack of community resources or whatever they simply dont work. Hospitals, at least in Tennessee, have come up with a unique solution.
Most hospital stays for voluntary admissions have been decreased to 5-7 days. Hospitals have coped by devising their own farm system to keep a ready supply of patients to harvest. Most of them have some version of a partial hospitalization program or intensive outpatient program or both. From day one in the hospital these programs are marketed to new patients hard and heavy. If your insurance indicates you can pay for it you will find that you are told how essential those services are to your recovery. If you have problems during these programs the odds are, depending on your insurance, you will be told that you might need “a couple of days of inpatient for stabilization.” This cycle can be repeated as often as needed. If you finish outpatient then the odds are strong you will be referred to a doctor or therapist for outpatient care that has ties or affialations to the hospital. If you have problems again you will find yourself back in the hospital and the same cycle going again.
I am not saying there is anything conspiratorial on part of the hospital. I think by and large people try their best. There doesnt have to be any conspiracy. The process doesnt work and if you have enough numbers you will have enough people to recycle back through the system.
The effect is not that people just become dependent on care but on your brand of care. Certain people come to belong to certain hospitals. If you ask people about it they will point to the “chronicity of mental illness” and remark how bad it would be if they werent there. No one is likely to point out that this in part a system problem.
It is in some sense the ultimate business. Not only do you profit from the success of those you serve, but you also profit from their failures. The net effect of all this is to leave the medical model firmly entrenched. Things that talk about recovery and independence sound nice, but those who “really understand” how low the expectations “realistically” should be for those in psychiatric hospitals just shake their head at how pollyannish it all sounds and find further justication for the “medical truth” that they are sure governs what they do.
Psychiatric hospitals dont work. By any measure I know of they dont work. I have seen statistics that say as many as 25% of people are rehospitalized within a month and 40% within a year. Rather you believe it is because of the lack of quality in psychiatric hospital care, the lack of community resources or whatever they simply dont work. Hospitals, at least in Tennessee, have come up with a unique solution.
Most hospital stays for voluntary admissions have been decreased to 5-7 days. Hospitals have coped by devising their own farm system to keep a ready supply of patients to harvest. Most of them have some version of a partial hospitalization program or intensive outpatient program or both. From day one in the hospital these programs are marketed to new patients hard and heavy. If your insurance indicates you can pay for it you will find that you are told how essential those services are to your recovery. If you have problems during these programs the odds are, depending on your insurance, you will be told that you might need “a couple of days of inpatient for stabilization.” This cycle can be repeated as often as needed. If you finish outpatient then the odds are strong you will be referred to a doctor or therapist for outpatient care that has ties or affialations to the hospital. If you have problems again you will find yourself back in the hospital and the same cycle going again.
I am not saying there is anything conspiratorial on part of the hospital. I think by and large people try their best. There doesnt have to be any conspiracy. The process doesnt work and if you have enough numbers you will have enough people to recycle back through the system.
The effect is not that people just become dependent on care but on your brand of care. Certain people come to belong to certain hospitals. If you ask people about it they will point to the “chronicity of mental illness” and remark how bad it would be if they werent there. No one is likely to point out that this in part a system problem.
It is in some sense the ultimate business. Not only do you profit from the success of those you serve, but you also profit from their failures. The net effect of all this is to leave the medical model firmly entrenched. Things that talk about recovery and independence sound nice, but those who “really understand” how low the expectations “realistically” should be for those in psychiatric hospitals just shake their head at how pollyannish it all sounds and find further justication for the “medical truth” that they are sure governs what they do.