201 Comments Posted by dme

surly girl, what's a "pikey?" Is it a reference to scavengers in general or to those who steal materials for resale/reuse--or something else altogether?

I heard about a case here in the US where some guys went in a clearly marked ("danger," "private property," "no trespassing," blocked-up entrance) abandoned mine to hunt for copper or other materials that they could sell to a scrap metal recycler. Once inside, they got lost and were rescued after a two or three day search by the mining company and local fire departments, who searched at substantial risk to themselves. Now the wannabe thieves have sued the mining company, saying there was not adequate warning of the danger and the company should have taken more measures to prevent unauthorized entry. Do lawsuits like this happen in other parts of the world, or is this an American phenomenon?

I recently watched an episode of "Law and Order" that looked like parts of it were filmed in abandoned sections of a mental hospital. The worst conditions were in a ward that had been closed, called "Ward 5" in the show, with a small "Ward 5" sign above the door, like the one in this picture. I think the episode was called "Land of the Free" from season 17. It was about the conditions in veterans' hospitals where wounded veterans from Iraq and Afghanistan are treated. I couldn't find any details about the filming of the location shots on the show's website. Does anyone know where it was filmed?

Usually the possibility of someone attempting to fake mental illness to avoid responsibility for a crime comes up right away--one of the questions on petitions for mental hygiene evaluations (the precursor of commitment to a psychiatric hospital) is what criminal charges, if any, the patient faces. When doing an intake, social history, or psychiatric evaluation the professional always asks about any involvement the patient has with the police, other government agencies, the military, etc.

Careful evaluation will usually detect the "fakers" relatively quickly (often because they forget that a person who really has a mental illness has it *all* the time, not just when the doctor is thought to be watching). I have found it more difficult to determine how great a role a patient's *known* and long-diagnosed mental illness or developmental disability plays in determining his/her culpability for an act.

I worked with one man whose psychiatrist suggested to him that he (the patient) would benefit from a girlfriend. The patient began asking every woman he knew or saw on the street to be his girlfriend, and persisted in asking even if told "no." At least one woman felt threatened, and there was the possibility of him being labelled a "sex offender." We were able to demonstrate to the court that what he needed was social skills training, not punishment. That was a relatively straightforward case where the patient genuinely intended no harm (he thought he was "following doctor's orders," something he had always been encouraged to do) and did not know that he was violating any social norms. It is much more difficult when violence is involved.

Bub, please share some of your experiences with us. What were some of the biggest changes you saw in your 24 years of living there? I'm sure I'm not the only one who is interested, especially because those were the years that saw both the worst overcrowding and the advent of deinstitutionalization.

I doubt if any hospital ever used coffins as beds. But such a story could easily stem from the use of "Utica cribs" in the nineteenth century. Their size and shape had a coffin-like appearance, although the sides were slatted rather than solid.

It's hard in comments like this to discern a writer's motivation when all we have is the words. The benign "gallows humor" of a person working in mental health can come across just the same as someone else's uneducated or mean-spirited derision.

I sincerely hope that all ATV riders wear proper protective equipment, especially helmets. Brain injuries can really make a person "crazy." One of the scariest things about traumatic brain injuries is that in civilian life, they are nearly all preventable.

I thought *I* wrote run-on sentences! I must have missed the memo that abolished punctuation. Either that, or grammar is one of the casualties of the technology revolution. (just friendly teasing, please don't take offense) :-)

When I was in college, I kept track of my weight by stepping on the freight scale (just like this one, except with a digital readout) in the back of my dorm's basement. It was used there to weigh bulk quantities of food brought in from the loading dock, before the deliveries were taken upstairs to the kitchen.

A common expression in mental health care for those patients who cycle in and out of psychiatric hospitals, never seeming to stabilize enough to be successful in community living, is "revolving door" patients. This gives a new, literal, meaning!

Regarding placing a woman in a psychiatric hospital because she was unmarried and pregnant, i think the old belief went something like this: the social stigma, guilt, shame, censure, ostracism, embarrassment of getting pregnant before marriage was *so* great for the woman, her child, and her family, that any woman "in her right mind" who "fell" and had premarital sex, would immediately marry the man, even before finding out if a child had been conceived. With unwed pregnancy being such an extreme social disgrace, one that "ruined her life," any woman who found herself "in trouble" and didn't get married so that her child would be "legitimate" (and not a "bastard"), was obviously "out of her mind" or "insane." I recall being told by older female members of my family that they didn't know which was worse, a girl who had premarital sex and got pregnant, or a girl who used birth control so that she wouldn't get pregnant when she had premarital sex. It can be very interesting to go through old marriage records and compare them to records of the first child born to the couple. In many, many cases full-term babies were born well before the couple had been married for at least nine months.

The daily census reports I'm familiar with never had any confidential information. They were strictly counts--how many open beds, how many patients with special instructions (seizures, dietary restrictions, elopement precautions, suicidal, etc.), how many "adverse incidents," maintenance problems, staff on leave, things like that. At the most they might have initials (if a patient was injured or so ill s/he had to be transferred to the infirmary, for example). It's important to track this information so that when there is a new admission, the patient can be assigned to the most appropriate ward--if one ward already has several patients with elopement precautions, but another ward has none, a new patient needing the same precautions would be assigned to the ward that currently has no such patients. They are also useful in assigning staff so that you have the most intensive staffing with the patients who have the most involved care.

If you're on a plane that still has the ashtrays and "no smoking" signs on the seatback, that's a strong clue as to the age of the plane. As late as 1992 one could still smoke on international flights, and I think also on domestic flights of more than two hours' duration.

Many older psychiatric patients smoke because back in the days before Thorazine, hospitals tended to *encourage* smoking for the small benefits patients seemed to derive from nicotine, and also as "bribes" to get a patient to do what the staff wanted.

I have never smoked myself, but I think people are taking the "non-smoking agenda" too far. I have lived in countries, worked in offices, and been part of social groups where I was the "odd" one because I didn't smoke. I prefer non-smoking environments, but I'm not so fanatical about it that I would presume to tell other adults what they can do and where they can do it. I would rather have an indoor smoking room than have to make my way through a thick cloud of smoke and piles of discarded cigarette butts to get in the front door of a building.

Now they are setting up regulations that ban smoking even in bars and introducing bills to prohibit smoking in one's own private vehicle if there is a child in the car. It kind of reminds me of the poem about the Nazis that talks about how first they came for the Jews, then they came for the homosexuals, then for the communists, etc. "but I said nothing because I was not Jewish, gay, communist, etc" and ends with the line "Then they came for me, and there was no one left to say anything." When we restrict the rights of others, it's only a matter of time until we lose our own rights.

If this is a seclusion room, the intent was not for it to be used as a punishment (I'm sure sometimes it was, most likely by overworked, totally stressed-out staff, but the fact that it was misused does not mean it did not have a legitimate purpose). Sometimes patients will actually request to use a time-out room, able to recognize that they are too close to losing control, and knowing that they need a place with minimal stimulation where they can be alone and safely discharge all the negative energy and emotion. Yelling, screaming, crying, pounding the walls, etc. until the person is once again calm. It is considered a sign of progress when a person can recognize how his/her emotions are escalating, and requests a brief period of isolation. The hope is that the person will continue to progress to the point where other coping strategies are developed and utilized, and seclusion is no longer needed.

When seclusion is used properly, it requires a lot of extra documentation and monitoring, periodic consultation with the psychiatrist if it continues beyond a specified duration of time (15 minutes is the time span that was used in the places I've worked). Each use of seclusion/time out is reviewed by the client rights committee. Any regulatory or supervising agency always looks very, VERY closely at records of seclusion and time out. The facility is required to have a formal policy addressing the use of time-out and seclusion (where the time-out or seclusion room is, what it contains, under what circumstances it can be used, what other options have to be unsuccessfully implemented before seclusion is used, the follow-up required, etc.) So staff are very unlikely (today) to use it inappropriately, if for no other reason than to avoid all the extra paperwork and investigation. The protocol for time out or seclusion requires that staff take steps to re-establish rapport with the patient afterwards.

I know that I, personally, would prefer to be locked in a small room by myself to calm down than be physically held/restrained by staff until I calmed down. Time-out/seclusion instead of physical restraint also reduce the risk of injury to the patient, the staff, and other patients.

I'm sure I'll be told I'm reading too much into this, but looking at the soap dispensers and cookies from a sociological perspective, they make up part of the culture of the group. Those "tired old jokes" have helped to create this cyber community and a part of its common history. A new person can feel like a "real" member when they happen upon the origin of the jokes and understand them. In your family, don't you have stories that you tell over and over?

I did q quick search on "ice baths in mental hospitals." The links I came up with mostly just repeated references to past treatment practices that "included submerging patients in ice baths until unconscious" or "horrible medical practices like ice baths." There were no references that actually described or recommended ice baths. In some sources the reference was "ice bath," while in others it was "ice-water bath." In a survey of treatment history, I found a reference to William Tuke, who established the York Retreat in England in the nineteenth century and "discouraged ice baths." One book included a poem with the lines
"I was raped by orderlies, gnawed on by rats, and poisoned by tainted food.
And I survived.
I was chained in padded cells, strapped into straitjackets, and half-drowned in ice baths.
And I survived." (Farmer, 1972)

So I think we have an urban legend, that started with some truth (water that felt cold to the person in the bath), and then was made much more sensational than it ever was in reality. There is a big difference between "ice" and "ice water." "Ice water" is a general description used for cold water. If I get into a swimming pool with a water temperature of 85 degrees, I'm going to complain that it's "icy." The poem above may have a degree of poetic license--"ice bath" creates a much more vivid image than does "cold bath."

(BTW--and DON'T TRY THIS AT HOME--ice water does have legitimate medical uses. Putting one's face in very cold water is one home remedy than can be used to "shock" one's heart back into sinus rhythm in cases of specific arrhythmias, but ONLY under the direction of a cardiologist.)

I've found the posters here to be some of the most interesting and intelligent people I've encountered anywhere on the Internet. Some of the least interesting people are the ones who complain about the comments of others not being "appropriate" or whatever. If a person's time is so severely limited that it is upsetting to read a few short words written in fun, I wonder how they have time to be on the Internet at all. And no one forces anyone to read it. Just skip over it. But don't try to make the rules for everybody else (set up your own site if you want to do that). Also, the really smart people are usually the very last ones to question anyone else's intelligence or lack thereof.