It was more of an asylum than the asylum!
Practitioners worried about the discrimination, the economic exploitation by foster families, and the poor material circumstances that patients faced in the community. They were also concerned that clinical care in the community was inferior and tended to be more coercive. When former patients landed in the psychiatric wards of general hospitals, for example, they encountered a ward culture that was highly regimented and demanded strict compliance with rules of decorum. General hospital staff, mindful of the expectations of public visitors and other patients and unaccustomed to psychiatric cases, were prone to respond harshly to disruptive or non-conforming behaviors. Moreover, general hospital measures of success turned on producing the “good patient”: one who embraces the sick role and submits to treatment. By this standard, illness itself could be interpreted as non-compliance, with the consequence that patients were often subject to unwarranted seclusion and restraint simply because they were incapable of adapting to unforgiving hospital routines.
Going to work at the general hospital was like stepping back in time. It was more of an asylum that the asylum! It was very regimented… and residents who acted-out had a really tough time because the [nurses] couldn’t understand when it was the illness, not the person.
In psychiatric nursing, it’s about being non-threatening and treating people as equals… But at [the general hospital] I got in trouble for that kind of thing. Nurses were supposed to lord over their patients and to make them behave in certain ways. And I was there to help people get better, not to teach them manners.
[General hospital wards] were like military academies. When you have difficult people, that’s what you do, you just lower the boom on them, make it regimental. People got punished for being themselves.