Why Psych Treatment Should Be Community Based

The Hospital Setting

Psychiatric hospitals are notorious for lack of funding and quality treatment of the patients. I spent time at both a juvenile and adult ward, and they aren’t any fun, especially when you’re in the frame of mind you’re in.

Just in the nature of their structure, putting many people in a confined, secured unit with a ratio of maybe 15+ patients to 1 staff member, those numbers alone could cause any normal person to become irritable in the type of space they occupy. There are daily trips to the gym or the courtyard, but time-limited and in groups.

There is no going anywhere at your own discretion. You can’t leave. They lock you in. You’re left to twiddle your thumbs and watch whatever is on the TV, or go to your room and (try to) nap. Just that thought in a sane mindset makes me angry.

Vs. The Community Mental Health Outpatient Clinic

Community mental health programs are successful. I worked at one as a caseworker for a year and a half and the patients/clients seldom went to the hospital. If and when they did, they were accompanied to the ER.

There are ways to proactively and preventatively treat those with mental illness, and community programs are one. I’d argue that if I’d had been in a community support program in my sickness, I would have probably not had to be admitted to the psych units. I would have listened to my caseworker and been more apt to accept my mental illness and take my meds, to maintain my stability.

When a Hospital Visit is Necessary

There are cases that those with mental illness need psychiatric hospitals. They should be for psychotic breaks and suicidal emergencies. Suicidal thinking is one thing. Having a plan and means to carry out the plan is another.

When someone is capable of hurting themselves or others, I agree that it is best for their safety and others, to put them in a place where they cannot have access and means to harm anyone. Until they can prove they are safe, they need monitoring and care for their psyche through therapy and medications in an acute care setting.

Prevention is the Best Medicine

If they have a case manager in a local community healthcare clinic, they have an advocate, someone to keep them accountable to their goals. They have someone to walk them through the days and weeks to follow their wellness plan. These are safeguards set in place, and they are worth every amount of funding the state and/or federal government can give.