Psychiatric hospitals, also known as mental hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients. Others may specialise in the temporary or permanent care of residents who, as a result of a psychological disorder, require routine assistance, treatment, or a specialised and controlled environment. Patients are often admitted on a voluntary basis, but involuntary commitment is practiced when an individual may pose a significant danger to themselves or others. Modern psychiatric hospitals evolved from, and eventually replaced the older lunatic asylums. The development of the modern psychiatric hospital is also the story of the rise of organised, institutional psychiatry. While there were earlier institutions that housed the "insane" the arrival of institutionalisation as a solution to the problem of madness was very much an event of the nineteenth century. To illustrate this with one regional example, in England at the beginning of the nineteenth century there were, perhaps, a few thousand "lunatics" housed in a variety of disparate institutions but by 1900 that figure had grown to about 100,000. That this growth coincided with the growth of alienism, later known as psychiatry, as a medical specialism is not coincidental.[2] The treatment of inmates in early lunatic asylums was sometimes brutal and focused on containment and restraint.[3][4] With successive waves of reform, and the introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment, and attempt where possible to help patients control their own lives in the outside world, with the use of a combination of psychiatric drugs and psychotherapy.[5] These treatments can be involuntary. Involuntary treatments are among the many psychiatric practices which are questioned by the Anti-Psychiatric movement. Involuntary treatment is emphatically opposed by the mental patient liberation movement, but this movement does not have any issue with any psychiatric treatment that is consensual, provided that both parties are free to withdraw consent at any time. Most psychiatric hospitals now restrict internet access and any device that can take photos.[6] American psychiatrist Thomas Szasz insisted that psychiatric hospitals are like prisons, not hospitals, and that psychiatrists who subject others to coercion function as judges and jailers not physicians.[15] The French historian Michel Foucault is widely known for his comprehensive critique of the use and abuse of the mental hospital system in Madness and Civilization. He argued that Tuke and Pinel's asylum was a symbolic recreation of the condition of a child under a bourgeois family. It was a microcosm symbolizing the massive structures of bourgeois society and its values: relations of Family-Children (paternal authority), Fault-Punishment (immediate justice), Madness-Disorder (social and moral order).[16][17] Erving Goffman coined the term "Total Institution" for mental hospitals and similar places which took over and confined a person's whole life.[18]:150[19]:9 Goffman placed psychiatric hospitals in the same category as concentration camps, prisons, military organizations, orphanages, and monasteries.[20] In his book Asylums Goffman describes how the institutionalisation process socialises people into the role of a good patient, someone "dull, harmless and inconspicuous"; in turn, it reinforces notions of chronicity in severe mental illness.[21] Franco Basaglia, a leading Italian psychiatrist who inspired and was the architect of the psychiatric reform in Italy, also defined mental hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents, and patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism.[22] American psychiatrist Loren Mosher noticed that the psychiatric institution itself gave him master classes in the art of the "total institution": labeling, unnecessary dependency, the induction and perpetuation of powerlessness, the degradation ceremony, authoritarianism, and the primacy of institutional needs over those of the persons it was ostensibly there to serve-the patients. http://en.wikipedia.org/wiki/Mental_hospital

• published: 25 Aug 2012
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