When you go to the hospital for a physical health condition, you don’t expect to spend years or decades of your life in that hospital. If that were the case, we’d say that hospital is failing its patients. We wouldn’t praise their treatment models as the standard for recovery. So why is that happening in our mental health system?
The average length of stay in Connecticut’s psychiatric hospitals is three and a half years. Let that sink in. The story of people held in our institutions is one of the most overlooked in discussions about our state and nation’s mental health systems.
Knowing the kind of abuse and trauma this system imparts on people, I was truly taken aback to read the author of a recent op-ed titled “We can do better for the mentally ill” describe Connecticut’s psychiatric hospital campuses as “beautiful.” We cannot allow psychiatry’s nostalgia for psychiatric institutions to obscure the history of what those places were, and what they are today.
Psychiatric institutions aren’t now, and never were, places of recovery.
The three and a half year average length of stay in Connecticut’s psychiatric hospitals is an average, not a maximum. For some people, years turn into decades. For many, that time is spent there against their will — this is in no small part due to coercive practices in psychiatry and our state’s Psychiatric Security Review Board (PSRB). Today, most people are only reminded about Connecticut’s psychiatric institutions when news breaks about abuse and neglect in these facilities. These are not places of recovery.
The author is correct to say that the current mental health system is set up to fail people. People with mental health conditions are disparately impacted by homelessness, incarceration and violence. But this isn’t a state of nature for people with mental health conditions. We’ve constructed homelessness through our public policy. We’ve criminalized behaviors brought on by trauma and inequality. It doesn’t have to be this way.
Psychiatry has a word for the effects of bad public policy. It calls them symptoms. Whatever trauma has been imparted on a person by our psychiatric hospitals or crises of homelessness, poverty, racism, etc. is viewed by psychiatry as a personal failure, and not a policy failure. This is something that people with mental health conditions both in and out of our psychiatric hospitals know all too well.
At one point, the author asks: “If we know all of this, why is full and successful recovery from serious mental illness not the norm?” — But recovery is not what the author describes in his op-ed. The solution to the mental health impact of our public policy failures is not to warehouse people for their disability. The solution is to fix the policy.
To be clear, this response is less intended as a critique of the author, as it is a criticism of psychiatric hospitals, our public policy, and psychiatry as an institution. I’m writing this because I know that good intentions are not a safeguard against unintentional harm — especially in psychiatry.
To support recovery, our policy-makers need to give people a path to recover outside of years-long stays at state hospitals. They need to fund supportive housing and voluntary community-based programs to ensure placements and integration in the community. They need to expand and provide insurance coverage for peer support services and peer respites, which help people recover consensually and in a supportive environment. And they need to do away with coercive institutions and policies such as the Psychiatric Security Review Board and court-ordered treatment, which deprive people of their freedom and years of their lives when they’re better suited for placements in the community.
In future discussions about mental health in Connecticut, I hope people will consider the crisis in mental health services that’s less often seen. This is the crisis that’s happening in our state hospitals and depriving people of years of their lives within hospital walls.
We live in one of the wealthiest states in the wealthiest country on Earth. We have every means to help people recover outside of institutions and within their own communities — that is, if we choose to fund it.
Jordan Fairchild is the Coordinator and Community Organizer for Connecticut’s Keep The Promise Coalition.