Do mental hospitals, where someone would have to go for an extended period of time, still exist?

Most of these institutions have been shut down over the years, but YES, there are some long-term psychiatric facilities. Regardless of modern medicine, you are always going to have some need for such institutions.

Some people are extremely mentally ill and require lots of psych meds. Many of these people are very low functioning even with medication and need oversight/supervision to make sure that they take their medications, do daily tasks, etc. But without supportive families/caregivers/whatnot, who is going to oversee these patients?

This is where these facilities come in to take care of them. Yes, they are sad places and I feel bad for those patients, but they need lifelong care.

As far as I know they do, but it is very rare now for people to be committed like that. When people are found not guilty by reason of insanity for horrible crimes they are usually sent to a mental institution.

Other people who are not criminals, but cannot function in society at all present a signifiicant chance of harming themselves or other can also wind up in institutions for long periods but it is rare because the state doesn’t want to pay of it, it is cost prohibitive for families, and insurance won’t cover it.

@seekingwolf Thanks for the answer. So these places are really only for extreme situations where the person would need help for life. Is a situation where someone would be comitted to the hospital, get better after a few years, and then be released because they “got better” a completely unrealistic scenario?

@DrewJ

From what I’ve seen, yes, it was mostly for a few people who were wards of the state and needed it for life.

I wouldn’t say it was completely out of the question. We do have a psych ward in the hospital where I work, but no one stays for years. They get them out beforehand, either on their own or to another facility. We had some long-timers who needed lifelong care go out to a long-term care facility that deals with psych issues. I have no idea if they are still there or were eventually released.

This is what I think would be more realistic: patient has serious psych issues. Spends some time in and out of psych wards. Always placed on some form of outpatient care after each stay, but can’t seem to stick to it, so they end up back in the ward eventually. Longest stay is a month or so. Eventually, the right doctors/right treatment is found for that person, they slowly get better, eventually released, and stick with their outpatient program to completion.

As @JLeslie said, it’s unlikely that someone would remain there that long (years, years) because no one wants to fund that unless ABSOLUTELY necessary (ie, person is completely dysfunctional, needs that care for good, etc)

I have a good friend in her eighties who has had periodic bouts of severe depression and both times, after trying medication and traditional therapy, volunteered for electroconvilsive therapy. ECT It was very sucessful…I do not know the interval between the first and second treatments, but it was many years.

There are certainly mainy inpatient psychiatric facilites but without doing the research, I can’t answer your other questions in detail

Here is a very detailed discussion of this put out by the National Alliance on Mental Illness (NAMI), the umbella organization for mentally ill patients.

In California, only child molesters and criminally insane are put into mental hospitals.

Thanks for all the answers. I basically need a good reason or situation where my character would be under constant supervision for a few years because he has been labelled as having some sort of mental illness and at the very beginning of my story he is just being released of this constant supervisions/care and is now has “freedom”

Any realistic scenario I can put him in?

@seekingwolf – Does the in and out of psych wards cover this? Would a patient have to have mandaory checkings? Or everythign is voluntary?

Ditto what @seekingwolf said. Most of these institutions are now private and only for patients with money or good insurance.

What @JLeslie is talking about are state hospitals for the criminally insane. These are usually run under the auspice’s of the state’s Department of Corrections and, as in the case of Florida’s Chattahootchee State Hospital (1876-Present), have a long history of human rights abuses. The Chattahoochee facility, under it’s former name, Florida State Hospital for the Insane, was

”...sued in O’Connor v. Donaldson, a case that went to the US Supreme Court, which ruled that the hospital had illegally confined one of its patients. The decision contributed to the deinstitutionalization movement, which resulted in changes to state laws and the closure of many public mental institutions in the country. The hospital today treats patients with severe mental disabilities who have been civilly or forensically committed to the institution.”
~Wikipedia

And that’s what happened to our public mental health institutions, the Deinstitutionalization Movement, which sadly did not take into account America’s future debilitating substance abuse problem.

@DrewJ

In my hospital, some psych ward admissions are voluntary, others are not at all, completely involuntary. I don’t know what you mean by mandatory checkings but in my psych ward, each patient is checked every 15 min for safety purposes by a mental health technician who walks around and checks in each room. I used to do this when I worked nights sometimes on the ward. Of course, everyone receives nursing and physician care daily

If you really want your character be more realistic and stay for years in such a place, consider having him commit a crime while insane. Perhaps as a young child? I have heard of cases where people stay for years having committed crimes while insane and they are places into special facilities instead of jail. Once he has served some time there and is deemed “sane” and “fit”, he would then be released. He wouldn’t have his TOTAL freedom in that he would have to check in with a mental health professional once in a while and, (very likely), he’d probably be released into a halfway house of some kind, where he could get support on how to transition back to a normal, functioning life. Eventually, he would get his freedom.

Just some ideas.

Here, there is one state mental hospital, and the only way to be admitted there is by the courts for committing a crime and being determined to be incompetent due to mental illness. Those consumers are treated, and when they reach a level of stability, they are released and have mandated out-patient care at a mental health clinic also run by the state.

Some of the consumers may remain in the state facility for years, but that scenario is extremely rare.

Since this is set in the present day, you might be interested to know that people who receive care for mental illness from hospitals or clinics are termed consumers. They are not called patients, unless they are actually in-patient.

Involuntary commitment to any kind of institution without a crime is rare.

There are a couple state run hospitals in WA.

John Hinckley Jr., who shot Ronald Reagan, has been in St. Elizabeths Hospital in D.C. for most of the last 30 years.

@jaytkay St. Elizabeth’s has quite a history. That is where they kept poet Ezra Pound for over 12 years for broadcasting anti-capitalist propaganda on Italian radio during WWII, until his friends finally got the US government to release him.

People who are considered at danger to themselves or other people con be voluntarily or involuntarily committed to a psychiatric hospital. However, most of them will be treated short term – possibly for a few weeks or months – “stabilized” on meds or with ECT and then released with either a follow-up outpatient treatment plan or none.

In the state of Florida the longest someone can be involuntarily admitted into a psychiatric facility is 72 hrs. It quite often begins with an arrest or a visit from a home health nurse on a bad day. It takes a doctor’s opinion and judge’s signature. This is done under the Florida Mental Health Act and we call doing this to someone Baker Acting them . Sometimes it’s providential, other times with other patients it is ineffective and they are unwilling to voluntarily sign themselves into a facility after a mere 72 hrs of treatment. Many times the patient wants help but has no insurance and is therefore cut loose. @janbb It sounds like New Jersey has a more generous policy.

@Espiritus_Corvus Going on anecdotal experiences from friends rather than legal knowledge.

Yes they do. I live in a city that is known for it’s psychiatric hospital. It used to be called AMHI(Augusta Mental Health Institute). It is a series of stone and brick buildings which are now considered historic and can’t be torn down. The buildings are used as offices for the city now. Here is a picture. The stone buildings are freaky as hell up close. Notice the new hospital in the bottom right.

They built the new facility 10 years ago and now it’s called Riverview Psychiatric Center. They hold forensic patients for many years.

Any realistic scenario I can put him in? Camarillo State Mental Hospital

Closed in 97, but you might use a similar locale.

Did you check into The Ridges, formerly called the Athens Lunatic Asylum?

@Dan_Lyons The Ridges webpage makes fascinating reading, thank you for the link.

It is an incredible story, @Adagio . I worked with mentally challenged people for a few years in Athens, and some of them had resided there and told me their stories.
Being near Appalachia, some of the children (circa 1950s) weren’t the brightest. Well, if your child was particularly slow or obstinate and you tired of him like DP (initials only) then you could have him/her committed to the Ridges for treatment. Unfortunately treatment included multiple daily rapings and hosed down with a firehose at high pressure until you are actually driven insane (where before you were merely slow or troublesome).

There are a few around here. I won’t name them because that would specify my location. In addition, most regular hospitals around here have psychiatric wards. There are also two around here that are closed down. One is just abandoned, on a beautiful piece of property and I heard it’s got asbestos but it’s being rehabbed, and another is abandoned but they use the buildings for book sales and stuff with the town.

@jca: I suppose it would be in bad taste to say they offer crazy discounts on their books.

There’s one near me as well that is still operating. Giant, antique brick building on a large piece of land.

They’re all great old brick buildings – it would be nice if they could be repurposed to do something else.