Monday, March 17, 2014

In Their Shoes


There was an op-ed in the New York Times recently by the Executive Director of the Colorado Department of Corrections about the 23 hours he chose to spent in solitary confinement (ad seg, I think is what our forensic friends call it) --- see "My Night in Solitary Confinement."  

In a similar experiment, psychiatrist-blogger Simple Citizen spent a day going through the motions of being a patient on a Residential Treatment Unit where he is the psychiatrist.  He details his experiences in "My Day as a Patient."

I don't believe these experiences are anything like the real thing, nor do I believe they are meant to be.  For one thing, the person having them has not gone through the lifetime of events, traumas, distresses that led the inmate or patient to be in those places.  Or in the case of the patient, the doctor also is not experiencing both the internal discomfort that comes with the mental illness, or the side effects which come with the medications, or the emotional upheaval that comes from having been left there by their family, and the insecurities that come with being a teenager or any brand.  And they both get to go home.  Why, Dr. Simple Citizen, do the kids have to stand on line facing straight ahead without talking while they wait for breakfast?  What's wrong with talking?

Still, I like that these people did this, it's good that they want to try to understand what their charges are going through.  Even if it's not a complete understanding, it still acknowledges that the condition is different with a willingness to see and understand what the other is going through, for better or for worse.  

On a completely different note, Simple Citizen pointed me to his post by mentioning in our comment section that he used to work at an involuntary state hospital.  What's an involuntary hospital?  I ask because Clink has pointed out to me that the rates of patients in public facilities varies greatly, state by state, for involuntary hospitalization.  Wait, so there are facilities that only take involuntary patients?  In our state hospitals in Maryland, at this point, the vast majority of beds are for forensic patients-- you get there by way of a judge.  If you have a chronic, severe psychiatric disorder requiring long term treatment which you'd like to get voluntarily, you're out of luck, we don't do that.  Or if you have a chronic, severe, intractable condition which makes it so you can't live in the community, you may have no where to go.  But when we did have state hospitals, many of the patients were there voluntarily, and some got better and discharged in a matter of weeks.  So I'm perplexed about a hospital that only has involuntary patients, what if they want to sign in?  Help me out here, Simple Citizen and others.