It’s hard to say. I assume so, though I also assume that wasn’t often. In his autobiography My Lobotomy, Howard Dully relates his father’s report that his step-mother doctor-shopped until she found Walter Freeman, who suggested lobotomizing Howard.
ETA not the same thing, but indicated some doctors were evaluating Howard as a normative kid.
I can tell you that because I was in the system as the “mad” one I was unable to get help for my manic partner who proceeded to blow up our lives after convincing authorities she was fine and I was not to be trusted. She was later diagnosed and found a decent life with medication.
That entirely bites.
I wasn’t around back in those days, but I can tell you what would happen today if someone presented like that. They would be told to go home and follow up as an outpatient with a psychiatrist before ever even seeing the inside of the facility.
Yes, I have seen such cases. I’m not a psychiatrist but I do perform the medical admission screening on patients that are admitted to the psych hospital. I have in fact seen cases where the psychiatrist sent someone home who had been brought in by someone else.
Yes, I see this refusal now, quite a lot. Not so much in the pre-Rosenhan era, though.
(And I must apologise because I started my story with the full intention of telling you of my later struggles to get help for a very unwell partner but stuff intervened and the important paragraph was left out, there are good reasons for my low post count). I believe the perceived power of the people involved was all important. I was perceived as untrustworthy, my parents were important. Husbands mattered more than wives etc.
This.
If I call the police or a practicing psychiatrist and tell them that District Supervisor Joe Smith is acting all odd and quirky and may be a danger to himself, and should perhaps be held for observation for awhile, nothing is likely to happen to him. Something might happen to me instead, although most likely it would just be ignored.
I had a friend (now deceased) who was incarcerated in a psych ward for a year by her parents, pretty much because she was rebellious and argumentative (which she was as an adult too). As a minor she had no recourse whatsoever – this would have been in the early 1960’s. By the time she was 18 she had figured out what to say and how to act to get out of there.
Psychologist Martin Seligman went, undercover, to the same hospital (Norristown State) shortly after the Rosenhan study — with Rosenhan — and did not replicate it. I can’t find any clear statement of this on the internet except for Seligman saying he was treated “wonderfully” while Rosenhan was treated badly.
My added information is based on a university presentation Seligman gave at or near the time (1973 or shortly after) and that I attended. I realize that, given memory tricks, saying that means I hardly have proved my claim. But I believe Seligman said something to the effect that staff, without saying he was faking symptoms, did politely say that his symptoms did not match with the illnesses they were experienced in treating.
Here’s an outstanding book on a very old-time mental asylum:
The Art of Asylum-Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry by Nancy Tomes
The basic picture is of an outstandingly compassionate place that deteriorated after the founder died.
The answer, again, is certainly that most psychiatrists did not admit everyone they were asked to evaluate to eleemosynary institutions. Although there have been abuses, they still do not believe every case is psychiatric (as medical problems can be the cause; e.g. patients with low blood sugar may act oddly), authentic (patients or relatives or others may misrepresent their truth with varying levels of skill and duplicity), serious (concerns may be trivial) or best served by inpatient care (which also has capacity limits).
Old-time mental asylums? In the late 1980’s and early 1990’s there were still psychiatric facilities that were hospitalizing people who didn’t need to be there. National Medical Enterprises got themselves in a bit of trouble for that at a number of their hospitals in Texas. They had “psychiatrists” with questionable credentials who received bonuses for keeping the psychiatric units full of insured patients. You could go to the hospital and they would help you fill out an affidavit on a person you wanted hospitalized, they had notaries on-staff who would make sure it was “legal”, they had couriers on-staff who would get the papers over to a judge, they had judges receiving kickbacks when they committed someone, and they had bounty hunters on the payroll, because in Texas it was legal for bounty hunters to serve commitment papers and haul people off to the hospital.
I was an intake coordinator at a psychiatric unit (not in Texas) that was contract-managed by a National Medical Enterprises subdivision called Psychiatric Institutes of America. I would interview possible patients at the emergency room and then call the psychiatrist who would make the decision whether or not to admit them. Some were voluntary admissions, some were court-ordered 96-hour holds. However, even when it was court-ordered, the doctor could say “no”. On one occasion, deputies brought in a man for a 96-hour involuntary hold, and I thought the whole thing was fishy. There were no dates in the affidavit saying when the suicidal behavior (attempted carbon-monoxide poisoning in his garage) occured. The prospective patient agreed everything in the affidavit was true, but stated it happened months ago when he was feeling depressed , and he was currently fine. There needs to be a risk of imminent harm for an involuntary hold. The suicidal behaviors need to be current or within the last few days. It turned out that his wife went to the courthouse while he was at work, and she filed for divorce, wanted full custody of their kids, and was trying to use her husband’s alleged mental illness as a justification. Getting him hospitalized would help make her case look better. After the judge signed off, the deputies showed up at his job and took him into custody in front of his boss and coworkers. The whole thing was awful. The psychiatrist agreed with me and refused to admit the guy. The deputies were pissed. The judge made someone give him my unlisted home phone number and literally called me in the middle of the night to threaten to have me arrested if I ever set foot in his county.
Psychiatric Institutes of America eventually fired me because I didn’t do enough to keep the unit filled to capacity. I was not at all surprised when I learned about their problems in Texas.
As long as there are for-profit hospitals and patients with good insurance, I assume there will be some cases where unethical providers take advantage of involuntary hospitalizations. But, I would hope that the majority of doctors/psychiatrists do not play that game.
I’ve definitely heard about the for-profit facilities, especially the ones aimed at teenagers (and their parents’ health insurance).