A brief note on lunatic asylums
Aug. 20th, 2008 09:17 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
narcasseHaving made a brief foray into Batman fiction recently this mostly constituted an excuse to read Arkham Asylum: A Serious House on Serious Earth and complain about the casting of Cillian Murphy in the role of Scarecrow, again. But beyond that it did trigger the beginnings of something that’s been nagging at me from time to time, namely the portrayal of mental asylums in fandom.
Firstly I’ll begin by clarifying that I have indeed seen the interior of three different mental health hospitals, or rather two mental health wings of two large hospitals and another separate hospital on top of that. All three of these were hospitals where the patients were not voluntarily admitted and had been sectioned under the Mental Health Act to give a general description of things. Which is to say that I have some small idea of the reality of the matter.
Which brings me to my problem with some, not all, fandom portrayals of such institutions. My largest issue right away isn’t even with the details of any such facilities but rather the strange portrayal of mental illness not having a huge impact on anybody’s functionally. Mental illness isn’t fun, and sufferers can’t simply turn it off and on at their on convenience. Someone who qualifies for sectioning simply doesn’t have enough control over their condition so as to appear functional. Anything that varies from the commonly accepted ‘norm’ but is controllable so that it remains undisclosed for the most part won’t get anybody sectioned and will most likely be gauged to be a personality quirk. Personality quirks do not get people sectioned. What does lead to an individual being sectioned is a variance that deviates even further than standard deviation allows. For example, the medical establishment calls it DID these days but anyone who fits the classic trauma-split DID model but is distinctly functional and displays a little bit of common sense isn’t likely to get locked up for it. The sociopath who thinks terrible thoughts but never acts on them nor reveals them in anything other than a carefully managed context where nobody takes the threat seriously will be likely judged to have a rather black sense of humour rather than homicidal tendencies. The schizophrenic who may hear voices whispering awful things but takes their medication and doesn’t act on those directions will likely remain on medication for the rest of their life but won’t be sectioned. And so on. It’s been a while since I’ve read over the medical criteria but if they’re not a danger to themselves or others and do not display the tendency to be then being carted off in an ambulance just isn’t happening.
Mental health issues then aren’t convenient or particularly controllable, though they can occur in degrees of seriously. And when it really comes down to it what really matters is how functional the individual is when it comes to interacting with society. Any number of conditions can occur all over the place but if they’re controllable and thus the individual is functional then for the most part nobody else is ever likely to notice. But once an individual is rendered non-functional as a member of society by their condition then along come the medical staff to talk them into an ambulance for a long ride to a hospital wing that’s a little bit out of the way.
The interior of said hospital wings doesn’t tend to be the stuff of Victorian nightmare or so I’ve found, though the exterior might fit the bill depending. I lived within walking distance of one such Victorian edifice some years ago and from the outside it certainly was intimidating. But at any rate, from what I recall of the interior of those two hospital wings they were both very bright with lots of white light flooding just about every nook and cranny and sporting a distinct lack of furniture in the corridors. If I remember correctly both kept patients capable of receiving visitors on upper floors but that might have simply been the result of ward allocation within those wings. Such floors tended towards an abundance of medical staff, mostly nurses and orderlies and separate rooms for the patients where the blinds for the safety glass were on the outside. One or two somewhat disturbing rooms sported nothing but a mattress on the floor while others contained beds and side tables. At least that was the case with two of the locations. The other, where I spent my time in the doctor’s quarters watching Disney’s Sleeping Beauty one evening, was somewhat more secure and featured covered safety glass around the door to the patients’ section so that visitors wouldn’t be treated to the patients staring out at them as they walked past. In this hospital the doctors wore panic alarms at all times which just about sets the tone of it.
I’m not entirely sure what counted as treatment in the last of the three hospitals but in the former two, while medication was preferred, electroshock therapy was also in use. Not because it was some sort of grand cure, which is wasn’t, but because sometimes it was the last resort because nothing else was working. And even then sometimes all it did was scramble the short term memory so that patient seemingly forgot about their condition for a little while before it surfaced all over again. Put simply, it wasn’t pleasant stuff even in the case of patients whose conditions didn’t require panic alarms to be worn by the medical staff. And in those less severe wards sometimes the worst part was the almost ‘normal’ but not quite and thus jarring nature of things. Because when it comes down to it, the extreme cases can be pointed out and analysed because they’re so extreme; the minor cases will never come to attention because they’re self-regulating but it’s the median ones, where everything looks like it should be fine but it simply isn’t that are the most disturbing.
All of which amounts to less of a rant and rather more of a light analysis and description which could probably have been summarised quite neatly by stating that when it comes down to it: genuine mental illness isn’t fun or convenient. And likewise, mental wards and hospitals don’t tend to be particularly pleasant either.
Firstly I’ll begin by clarifying that I have indeed seen the interior of three different mental health hospitals, or rather two mental health wings of two large hospitals and another separate hospital on top of that. All three of these were hospitals where the patients were not voluntarily admitted and had been sectioned under the Mental Health Act to give a general description of things. Which is to say that I have some small idea of the reality of the matter.
Which brings me to my problem with some, not all, fandom portrayals of such institutions. My largest issue right away isn’t even with the details of any such facilities but rather the strange portrayal of mental illness not having a huge impact on anybody’s functionally. Mental illness isn’t fun, and sufferers can’t simply turn it off and on at their on convenience. Someone who qualifies for sectioning simply doesn’t have enough control over their condition so as to appear functional. Anything that varies from the commonly accepted ‘norm’ but is controllable so that it remains undisclosed for the most part won’t get anybody sectioned and will most likely be gauged to be a personality quirk. Personality quirks do not get people sectioned. What does lead to an individual being sectioned is a variance that deviates even further than standard deviation allows. For example, the medical establishment calls it DID these days but anyone who fits the classic trauma-split DID model but is distinctly functional and displays a little bit of common sense isn’t likely to get locked up for it. The sociopath who thinks terrible thoughts but never acts on them nor reveals them in anything other than a carefully managed context where nobody takes the threat seriously will be likely judged to have a rather black sense of humour rather than homicidal tendencies. The schizophrenic who may hear voices whispering awful things but takes their medication and doesn’t act on those directions will likely remain on medication for the rest of their life but won’t be sectioned. And so on. It’s been a while since I’ve read over the medical criteria but if they’re not a danger to themselves or others and do not display the tendency to be then being carted off in an ambulance just isn’t happening.
Mental health issues then aren’t convenient or particularly controllable, though they can occur in degrees of seriously. And when it really comes down to it what really matters is how functional the individual is when it comes to interacting with society. Any number of conditions can occur all over the place but if they’re controllable and thus the individual is functional then for the most part nobody else is ever likely to notice. But once an individual is rendered non-functional as a member of society by their condition then along come the medical staff to talk them into an ambulance for a long ride to a hospital wing that’s a little bit out of the way.
The interior of said hospital wings doesn’t tend to be the stuff of Victorian nightmare or so I’ve found, though the exterior might fit the bill depending. I lived within walking distance of one such Victorian edifice some years ago and from the outside it certainly was intimidating. But at any rate, from what I recall of the interior of those two hospital wings they were both very bright with lots of white light flooding just about every nook and cranny and sporting a distinct lack of furniture in the corridors. If I remember correctly both kept patients capable of receiving visitors on upper floors but that might have simply been the result of ward allocation within those wings. Such floors tended towards an abundance of medical staff, mostly nurses and orderlies and separate rooms for the patients where the blinds for the safety glass were on the outside. One or two somewhat disturbing rooms sported nothing but a mattress on the floor while others contained beds and side tables. At least that was the case with two of the locations. The other, where I spent my time in the doctor’s quarters watching Disney’s Sleeping Beauty one evening, was somewhat more secure and featured covered safety glass around the door to the patients’ section so that visitors wouldn’t be treated to the patients staring out at them as they walked past. In this hospital the doctors wore panic alarms at all times which just about sets the tone of it.
I’m not entirely sure what counted as treatment in the last of the three hospitals but in the former two, while medication was preferred, electroshock therapy was also in use. Not because it was some sort of grand cure, which is wasn’t, but because sometimes it was the last resort because nothing else was working. And even then sometimes all it did was scramble the short term memory so that patient seemingly forgot about their condition for a little while before it surfaced all over again. Put simply, it wasn’t pleasant stuff even in the case of patients whose conditions didn’t require panic alarms to be worn by the medical staff. And in those less severe wards sometimes the worst part was the almost ‘normal’ but not quite and thus jarring nature of things. Because when it comes down to it, the extreme cases can be pointed out and analysed because they’re so extreme; the minor cases will never come to attention because they’re self-regulating but it’s the median ones, where everything looks like it should be fine but it simply isn’t that are the most disturbing.
All of which amounts to less of a rant and rather more of a light analysis and description which could probably have been summarised quite neatly by stating that when it comes down to it: genuine mental illness isn’t fun or convenient. And likewise, mental wards and hospitals don’t tend to be particularly pleasant either.
