Rampenthal, Analysis One Who Flew

“He conducts these tours – serious women in blazer jackets, nodding to him as he points out how much things have improved over the years.” – Bromden on Public Relations

There are a few times in which someone in the story talks about the improvements of the hospital, about how much better it is compared to years past. That has me wondering what people will say about our current mental hospitals in a few years. They will most likely cut them down in the same way.

In my first post on this blog I commented on my personal experiences with mental hospitals. I have had family spend time in a high security facility. Patients aren’t allowed out until they are given approval by the doctors there. Most are out pretty quickly though, not because they are healthy enough to be released, but because their insurance doesn’t cover the stay. Doctors are often forced to release patients against better judgment. Not only because of insurance issues, but also because of a lack of space. There are always new patients coming in (often from the ER) and so they need to release the less-serious patients, even if they haven’t properly been helped. I read about these issues on a few sites, including this one with multiple accounts by people who stayed in a ward. I also saw it first hand – my family member was released after only three days, only to have a massive breakdown shortly after, which led to them being re-admitted.

I noticed that the doctors, and especially the nurses, were almost zombie-like. They weren’t mean or cruel, but they weren’t friendly and warm either. They are overworked and understaffed. They don’t have the time to do much for patients. They make sure they don’t hurt themselves, but they don’t do too much to help in the long run. My family member was given a bottle of pills and sent away after those three days. The medications were never taken. That visit to the psych ward was essentially useless.

I also once had a class with someone who worked at a mental hospital. She said she lost count of how many times she had been bitten, punched, and spit on by patients. Nurses and other staff may go into the job with good intentions, but are quickly shut down by the reality of it. Plus, there isn’t much they can do in only a few days.

The only one who was friendly and kind was the social worker. She really wanted to see the patient get the help they needed. But again, as nice as she was, she couldn’t do much other than give a pile of pamphlets on mental health. She wasn’t heard from again after that.

Thy cruelty and experiments of the old days may be gone, but it’s been replaced by apathy and insurance battles.


One thought on “Rampenthal, Analysis One Who Flew

  1. frickeh8

    I too was struck by the descriptions of the Combine in this week’s reading. The supposed “improvements” and tours to demonstrate these improvements were disheartening.The use of shock therapy and lobotomies were still going on behind the scenes. (Interestingly, shock therapy is still used today for treatment resistant forms of mental illness. Though in those instances it’s completely the choice of the patient.) Some of the other analyses also pointed out the similarities between the treatment of the patients in the book and in modern day mental institutions.

    I myself have had experience with such institutions, and I have mixed feelings about them. On the one hand, there were scenes that felt familiar. I’ve seen the malaise and apathy during medication times, and how often patients are given sedatives just to get them to stop being a pest. Patients who had a known drug problem were being given narcotics simply because they wouldn’t stop asking for them. It was during these times that I felt the disconnect between manifest purpose of the facility and the advertised purpose. The entrance and lobby of the institution I’m familiar with was warm and inviting, but the inside was cold and lit with harsh lights. Patients weren’t separated into Acute and Chronic, but there were different wings for differing severity. If the touring party that Chief describes walked through a modern day facility, would they be more impressed, or about the same?

    That isn’t to say that everybody who works in a mental institution is apathetic and negligent. I also saw psychiatrists who were working hard to find the right treatment options for patients, and group leaders determined to be a positive force in a place burdened with so much negativity. For every one apathetic and condescending worker there were three people who were trying to make a difference. There is certainly still so much room for improvement, but I hope and believe that stories like One Flew Over the Cuckoo’s Nest help open society’s eyes to the reality of mental health treatment.



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