Talk:Psychiatric hospital

Institutionalisation

More detail should be provided regarding the rationale for institutionalisation and how and why institutionalisation was seen as apt solution for the problem of madness.

The Tuke's York retreat, moral treatment should feature here. Also, Foucault, Scull, and later critics of their positions.Freekra (talk) 01:55, 26 November 2009 (UTC)

Footnotes

Please ensure that all new additions to this article have proper citations to authoritative sources.Freekra (talk) 20:57, 26 November 2009 (UTC)

I think before any adds new content to the article, we should look at the unsupported claims in the text that need citations to back them up. I have added citation needed tags to a lot of the unsupported statements in the article. Not all of these statements are wrong - although not a small number are irrelevant - but they should have some verifiable source. Freekra (talk) 21:34, 26 November 2009 (UTC)

I'm going to ruthlessly delete any unsourced statements. Especially the litany of biased, incoherent and irrelevant statements that confound this article. If that makes for a much shorter article, so be it. It needs to be substantially rewritten. At the moment it's a bit embarrassing. Freekra (talk) 02:59, 29 November 2009 (UTC)

Revision and Reorganisation

I think that this article needs serious revision and total re-organisation and that this should be discussed before new contributions are made.

These is a specific history to the provision of institutions as a solution to the problem of insanity. Despite multiple theses on the subject it is possible to construct an integrated narrative on the subject.

Most histories would begin in the 18th century with an account of the then existent insitutional provision for the insane in jails, workhouses, a few charitable institutions etc. Then deal with the Trade in Lunacy - i.e. the private madhouses.

Following this would be the semi-mythical Pinel moment (striking off the chains) and, more importantly, the York Retreat - the birth of moral treatment - the success of which suggested to reformers that institutionalisation was the solution to the apparent increase in insanity. Asylums (not psychiatric hospitals - they did not exist at this point) were intended to be small-scale curative institutions rather than custodial centres for the chronically insane.

Next begins the era of building public asylums on a national scale - the timing of this differs from region to region but say from the first third to the mid-nineteenth century. These institutions are mostly small in scale holding around 100 patients max. They have moral managers (mostly) rather than medical men running them.

These public institutions increase in size from the latter half of the nineteenth. Slowly they are medicalised (doctors - or alienists - take over their management). The outlook is still optimistic.

From the end of the 19th century these asylum becomes a problematic institution. The notion that madness might be cured falls into abeyance. Therapeutic nihilism sets in. Asylum populations increase. Custodial Era.

Early to mid-twentieth century - voluntary admission is allowed. From the 1930s extreme therapies are introduced.

From anywhere from the 1950s to 1980s (depending on region) decarceration kicks off. Anti-psychiatry and critique of total institutions from about the 1960s. The asylum (mental or psychiatric hospital from about the 1920s) becomes a discredited institution.

Would anyone like to add to, critique, or suggests improvements on such a chronological structure? Freekra (talk) 21:16, 26 November 2009 (UTC)

I am thinking: If a reader come to this article they are ‘most’ likely to be expecting an article about modern buildings and their internal organisations etc.

Therefore, would it make for a clearer structure if all the history goes over to History of mental disorders and we can have just the briefest comment here about history or even a disambiguation comment at the top of the page with a wiki-link to the historical stuff. This article on psychiatric hospitals can then concentrate on the current situation on a regional bases without the hassle of weaving a time line through it as well.

Even so, the development of psychiatric hospitals, including the competing philosophies, political pressures, medical discoveries and so on and so forth, is worthy of a separate article in itself. This more detailed history and analysis, could go in (say) a new article entitled Development of psychiatric institutions. A link to this new article can then be placed both here and in the History of mental disorders. This would also avoid a duplication in this article, about the current criticisms levelled at the modern psych. hospitals.

Perhaps the article History of mental disorders should be renamed History of how mental disorders were regarded – a bit wordy but more descriptive of the content. I don’t feel inclined to dig through books, searching out good references, until we can all see where were going on this.

I think we are trying at present, to get one article to cover too broad a topic.--Aspro (talk) 13:34, 29 November 2009 (UTC)

Agreed. History of mental disorders is fine though. It will have to be a history of concepts and practices about mental illness rather than a natural history of psychiatric "disease entities" in any case so I don't think the "regarded" bit is necessary. Create a new page called, in my opinion, History of psychiatric institutions rather than "development of ..." where we can paste anything relevant about psych insitutions historically that we have here. Most of that should go into the talk page for the new article in any case - as a lot of it is quite a mess and would need to be sorted through before posting into the new article. Agreed anyway. How long do we have to wait before we can do it? Freekra (talk) 14:54, 29 November 2009 (UTC)

I'm going to move the physical and drug therapies too. They're mostly historical at this point and have a big impact on asylum populations in the twentieth century. Freekra (talk) 16:29, 29 November 2009 (UTC)

Deletion of Middle East Section

Middle East

Main article: Islamic psychology

Unlike medieval Christian physicians who relied largely on demonological explanations for mental illness and treatment, medieval Muslim physicians and psychologists relied mostly on clinical observations. Such scholars made significant advances to psychiatry and were the first to provide psychotherapy and moral treatment for mentally ill patients, in addition to other forms of treatment such as baths, drug medication, music therapy and occupational therapy. ^{[citation needed]}

In the 10th century, the Persian physician Muhammad ibn Zakarīya Rāzi (Rhazes) combined psychological methods and physiological explanations to provide treatment to mentally ill patients. His contemporary, the Arab physician Najab ud-din Muhammad, first described a number of mental illnesses such as agitated depression, neurosis, and sexual impotence (Nafkhae Malikholia), psychosis (Kutrib), and mania (Dual-Kulb).

In the 11th century, another Persian physician Avicenna recognized 'physiological psychology' in the treatment of illnesses involving emotions, and developed a system for associating changes in the pulse rate with inner feelings, which is seen as a precursor to the word association test developed by Carl Jung in the 19th century. Avicenna was also an early pioneer of neuropsychiatry, and first described a number of neuropsychiatric conditions such as hallucination, insomnia, mania, nightmare, melancholia, dementia, epilepsy, paralysis, stroke, vertigo and tremor. Freekra (talk) 03:18, 29 November 2009 (UTC)

I've deleted the above section, unfortunately, as it has nothing to do with psychiatric institutions. It's a pity because it was actually sourced and well written. I know there were lots of such institutions in areas outside of Europe and America so it would be good if we could actually write about them. Certainly, I know that Egypt has some very old hospitals for the mentally ill, dating back to the 15th century. Freekra (talk) 03:18, 29 November 2009 (UTC)

"History" section

I've reinstated the "history" section, this time with an extremely brief precis of the entire history of psychiatric institutions article. This is standard Wikipedia house style when a section is refactored out of an overlong article into its own main article. -- The Anome (talk) 02:22, 30 November 2009 (UTC)

Splitting types into US and UK sections

At the risk of some duplication, I am thinking of splitting the section “Types” into US and UK sub-sections. It is at present, difficult to expand, because although these types on different sides of the Atlantic are roughly similar in purpose, there are differences in both terminology, detail and scope. If these were included in one section it could lead to misunderstandings.--Aspro (talk) 19:06, 9 June 2010 (UTC)

The military psychiatric Hospital

Are there known facts or sources about military psychiatric Hospitals? 84.73.27.207 (talk) 14:42, 8 July 2010 (UTC)

English variation?

We need to determine whether this article is to use American or British English variation. I am especially seeing inconsistency in "ise/ize" suffixes. I have no opinion but would like to see one style selected and the article use it consistently. Jojalozzo 17:00, 23 January 2012 (UTC)

Why do we 'need' too? This is an article of international interested. How would it improved the global readability. Take it from me, these trifles are only of interest to spelling fascists and proof-readers in banana republics . Even Shakespeare himself, spelt his name six different ways. Quote: “Attempts to regularize or reform the language, including spelling reform, have usually met with failure.” Ref: English_orthography#Spelling_irregularities.--Aspro (talk) 19:25, 23 January 2012 (UTC)