Note: Comments of people who have been placed in psychiatric facilities and later recovered—in spite of psychiatric treatment, not as a result of it,—are included in side boxes to give a sense of the real-life experiences.
I was psychically abused/assaulted in a State Mental Hospital in Milledgeville Georgia in the late 70s. The staff at the Tennessee State Mental Hospitals where I was placed in the late 80s and as recently as 2005 are rude, talk down to patients, have a lot of emotional problems themselves, little if any compassion or empathy, and in my opinion, trigger a lot of the violence in the State hospitals here.
– Dennis Dodson, Mental Health Advocate
A study of the causes of violence in psychiatric hospitals was quite revealing. The majority of violent and aggressive incidents are triggered by staff members, not by patients. Considering the fact that nearly all the reports were written by staff members, one must wonder if the truth is even worse.
Published in Acta Psychiatrica Scandinavica, “The antecedents of violence and aggression within psychiatric in-patient settings” summed their results:
- The majority of violent and aggressive incidents across in-patient psychiatric settings are triggered when staff interact with patients.
- Staff more readily record patient behavioural cues as antecedents compared with mood ⁄ emotional cues.
- When staff is unsure of what precipitated an incident, they should pursue other potential sources of antecedent information.
I have seen and had therapists call me and other patients horrible names, and make fun out of us when they thought no one was listening. It’s not physical violence—but being called names and told you *are* no good, and what not—that not only hurts, but how do you get better?
– Susan Schechter, If You’re Going Through Hell Keep Going
To be included, a study had to be peer-reviewed, produced in English between 1960 and 2009, and focused on aggressive behavior of non-geriatric adults in psychiatric facilities. After reviewing hundreds of studies, the authors selected and examined 71 that had been produced in 13 countries:
I saw plenty, and it was always, without exception, brought on by a staff person who was poorly skilled in how to speak with someone who was in deep distress, and frequently by staff people who were just jerks—pushing people around, asserting their “power”, imposing arbitrary rules, various injustices, is how I would sum it up.
– Amy Smith
Because several different approaches were used in the studies, including different ways of reporting, it’s difficult to develop a cross-study indication of how much aggression and violence is preceded by staff, rather than patients. Only 7% of the studies captured information from the patients’ point of view. Nearly all the information was provided by staff members without consultation with patients.
… he was bullied on a 3 day hold a few years ago, where not only did they insult him, he has nightmares about what the doctors and therapists said. He calls it mind rape.
46 of the 71 studies showed that “staff-patient interactions” preceded aggressive and violent incidents the most. Of the 25 that didn’t, 6 studies blamed “patient symptoms” and 11 blamed “no clear cause”. “Patient-patient interaction” was given as the primary reason in 3 studies, “patient behavioral clues” in 3 studies, and “structural issues” in 1 study. One other study divided the results between what staff thought (“patient symptoms”) and what patients thought (“no clear cause”). Overall, the studies reported anywhere between 13% and 82% of aggressive or violent incidents were preceded by “staff-patient interaction”.
One day I was in my room and a nurse opened the door and walked in. Her intent was to check my glucose level before supper. She got her machine all set up and ordered me to do this and that to cooperate with her agenda. I got pretty snappish and uncooperative. She had some bad words to say about my attitude and I likewise about hers.
What she utterly ignored was that she had entered my room without knocking and left the door open—and I was standing there exposed, wearing only a T-shirt and underpants while all the passersby were fully clothed.
– Anne C. Woodlen, Notes in Passing
The study showed that 47% of all aggression-violence cases in acute facilities were preceded by staff-patient interactions, and was the most prevalent cited. In acute facilities, patient-patient interaction was given 25% of the time, patient conflict behaviors was 3%, patient symptoms was 33%, and no clear cause was given in 27% of the cases. One must ask how the patients view this.
The simple fact is that these facilities are not generally ones that people choose to enter of their own accord. They are locked, loaded with rules, highly crowded, horrifically boring, and inherently demeaning. That any study in which staff members provide most of the information could show staff responsibility for more patient violence than any other cause is astrounding when the reporting is done by staff members. How much worse is it?
The authors suggest:
Such findings underscore the influence that staff have in making wards safe and efficacious environments. It also suggests that most violent incidents are preceded by the staff exercising their power over the patient. Such findings underscore the influence that staff have in making wards safe and efficacious environments. It also suggests that most violent incidents are preceded by the staff exercising their power over the patient.
The patients are basically housed and herded from one place to another for “activities”. There’s basically NO services provided. Just dope um up and keep um where they’re supposed to be. Patients spend a lot of time sitting and watching TV.
The medications prompt confusion and violence in a lot of patients also. Couple that fact with rude and smart mouthed workers and you have a recipe for violence and people becoming regulars at the State Hospital.
– Dennis Dodson, Mental Health Advocate
Clearly, even if there is a goal of providing safe haven for psychiatric patients, there’s little effort to reach it. The study also documents a previously known fact, that violence is more common in locked facilities. While that may not be surprising, it clarifies that any claim of such facilities existing for the benefit of patients is inherently false.
Psychiatry has clearly become a corrupt field:
On a different inpatient unit, I had requested—appropriately, respectfully and repeatedly—a meeting with a unit administrator. He kept promising to meet with me but failing to do so. It got to be late Friday afternoon. The issue really needed to be addressed before the weekend and I strongly suspected that he was going to slip out the back door without seeing me, so I went and sat on the floor (there being no chairs) in front of his office door. I neither said nor did anything; I simply sat.
Staff members came and dragged me away. I went limp and made no effort to resist. They manhandled me so severely that I was left with bruising on my arms.
All it takes to avoid conflict is for the staff members to treat the patients with respect.
– Anne C. Woodlen, Notes in Passing
On top of all that, they routinely confine people in psychiatric facilities, which are clearly mistreating people and have no track record of curing them—and doing so by force.
As this study and the comments included in side boxes document, there cannot be much genuine intent to help the people caught up in their web. Psychiatry is a system that is based on an inherent lie, that creates its own diagnostic manual on the basis of a popular vote of people corrupted by Big Pharma, and that utilizes treatments of little or no benefit and enormous harm. Isn’t it well past time that these abuses be ended?
Tagged antecedents of violence and aggression within psychiatric in-patient settings, psychiatric hospitals, psychiatric violence, psychiatric violence antecedents, psychiatric violence causes, violence psychiatric hospitals