PTSD Prevalent but Under-recognized by Inpatient Psychiatry


A team from the University of Texas Health Science Center in Houston presented their finding at the 2016 Annual Meeting of the American Psychiatric Association (APA), in Atlanta, Georgia, that the prevalence of PTSD in the psychiatric inpatient setting is much higher than the national average.  With as many as 91% of patients in a psychiatric hospital being exposed to at least 1 trauma, while the national 12-month prevalence of posttraumatic stress disorder (PTSD) in the United States is 3.5%, the researchers recommended that “clinicians should explore a diagnosis of PTSD more frequently in the inpatient population.”

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]


  1. “With as many as 91% of patients in a psychiatric hospital being exposed to at least 1 trauma”

    The whole place is a Trauma, strip search, phone confiscation along with your numbers in it, cigarette confiscation- nothing like quitting smoking in the middle of a crisis to feel better. Needle threats if the pills make you feel sick.

    Mental illness is just like cancer and diabetes… Then why don’t you lock up and treat people with cancer and diabetes with like dog shit too ??

    If I fell off a roof and broke my leg I get a nice bed and a nurse call bell but if I fall for the lies of the psychiatric pharmaceutical industry and go from insomnia to panic attacks after stupidly trusting and taking their poison I get locked up and treated worse than a criminal.

    Clinicians should explore a diagnosis of PTSD more frequently in the inpatient population cause those rat hole lockups themselves cause the condition.

      • The most traumatic experience of my life. If you’re not depressed going in, you will be coming out. Do not send anyone you care about to this hell hole. The dr I had stopped 4 major depression medications cold turkey that I had been on for a long time. The withdrawal was unbearable. I also had my first and only ect treatment a couple days after arriving to river point. I had non stop nausea the whole time I was there. I told the staff, and they gave me zofran over and over again. I told them this didn’t help. Finally after a few days of no eating or drinking, not that anyone noticed or cared, a nurse got me a dose of phenergan shot. It helped for a few hours. I told staff I have not been able to eat or drink and asked for a Sprite and some saltines or something mild like that. They replied, “let me check” and I never heard anything from them. A few days after being discharged from this place, I had to go to my local ER and get iv fluids from being dehydrated. I remember lying in fetal position in bed crying with the worst headache, body aches and nausea I’ve ever felt in my life. I literally thought I was dying. A patient tried to help me. The patient went to get a nurse. Last thing I remember is nurse standing over me asking what’s wrong even though I’m saying my head hurts over and over. Then I blacked out and woke up early the next morning. Nobody checked on me or asked if I was ok. Headache and nausea continued. I told more than one person I have extremely bad reflux and they would never continue my reflux med.

        I was walked in on in the bathroom several times. There are no windows that you can look out of. They all have something on them so you can’t see out. Forget going outside any unless you smoke or if you count the walk to the mini cafeteria with the worse food ever. I’ve never been in jail but I imagine it would have to be very similar to this place. I saw 2 patients come and go in my room and no one cleaned the rubber mattresses or sanitized them with anything, they just put new sheets on the bed and used the same plastic pillows without cleaning them either. At one point I was walking to my room as a man was coming out of my bathroom where he had urinated all over the toilet.
        This place is nasty and disgusting. There is ONE room that you can go to if you’re not in your room. I remember being forced to stay in that room for several hours one day even though I felt so sick like I was gonna fall out any second. While we were required to stay in that room, they locked our patient rooms. The room was hot, and smelled bad. Body odor from about 25 people cramped up in this small room. There was a couple of guys that wreaked of urine. The furniture is completely worn out with holes. Very uncomfortable to sit in especially for hours at a time. I looked down in the chair I was sitting in and it was filled with crud.
        There’s only one phone that you can actually hear and understand the person on the other end. Total of 3 phones but 2 are useless.
        There was a guy that was put on our side that clearly should have remained on the “dark side.” He would get in your face, very loud obnoxious and interrupt every and anybody. He would fart whenever wherever. Finally they had someone following him to be one on one. Then after a day or 2 they sent him back to the dark thankfully.
        In summary, please do not get yourself stuck in this place. I don’t even want to go to any doctor for anything anymore. I get someone to go with me when I see my doctors now because I fear some dr might suggest I go back to a similar kind of hospital to get my mood swings and emotions back in check because they are still screwed up from stopping all those meds I was on.

      • agree with everyone speaking negatively about this place. It is awful. It does feel like a prison. The staff and nurses mistreat people. They ease drop on phone calls. They don’t let you use pens. They complain if you come to them about anything, like a toothbrush or soap. They come in at 5am to take your vitals and then if you sleep in an miss therapy, something must be wrong with you. Not to mention the psychiatrists should all lose their licenses for prescribing and forcing people to take medication after a five minute “consultation” with you, and they magically know what mental disorders you have, which is usually multiple.They also try to purposely get a rise out of you by telling you you’re going to be leaving and then last minute change their minds to see how you react to negative stimulation. I was lucky and had people look after me while I was there as I was the youngest person there, however these patients were better to me then the staff. They purposely keep you until your insurance runs out so ready or not they’ll kick you out when it does, but god forbid you’re ready to go before it does, they will keep you until it runs out. It felt like I was in prison and the only thing this place did positively was keep me from breaking down ever again so I never have to go back. Take my, and everyone else’s advice, and do your best to keep your family away from this place. The goal is for people who need help to get better, not to cheat them and make them feel crazy. I am truthfully sympathetic to anyone else who has been here as well.

      • I too checked myself into this place for help with depression. I am a nineteen year old white female. I was told this place is voluntary and that I could leave at any time. I was told they would be doing evaluations on me to see if this was a chemical imbalance and help me out in the best possible way. Wow, was I wrong. I should have known when I first got there. I had to walk around the back and tell the “security”/”front desk” staff why I wanted to be admitted. Right away there is no privacy. He made me state around other people why I wanted to be checked in. He then made me remove my jewelry and hair clip. I was then asked to sit in a waiting room for several hours until I could be seen. I should have left then!!!! I then was taken into a room with a female member of their staff and told to take off my clothes so that she could check my body. I felt completely completely completely violated but was told I had NO choice. I had to remove my bra because there was wire in it. So after several hours of waiting, I was finally taken in the area where I was then held against my will. I was told to fill out several papers and then given no type of guidance on what to do. I was told the doctor would not be in until THE NEXT DAY AND THAT I COULD NOT BE RELEASED UNTIL THEN. When you sign the papers, you are not told that you are being held their against your will. Even if you go in voluntarily, once you sign those papers you cannot leave until a doctor release. I was told the longest they could hold me is 48 hours. However, while I was there I learned that several patients had been there for at least several weeks. So all day and night I had to sit around and do absolutely nothing. I was placed in a room with three other female room mates to sleep. One of my room mates was brought in on a stretcher, one was a drug addict and had AIDS among other things and the other woman had been there several times and would constantly remove her clothes. I felt so uncomfortable. One of my room mates continually threatened the other patients. The beds are not comfortable and I doubt they are clean in any way. There were bugs in the room and in my bed. The food was disgusting but you had to eat in order for them to release you. If you do not eat and cooperate they will say that you need to stay. They ask you several personal questions such as when your last bowel movement was. Don’t get me started on the bathrooms. The pictures of this place look nothing like the actual place. This place is basically a psych ward. None of the staff care about the patients or believe anything you say. YOU ARE TREATED AS LESS THAN HUMAN. The next morning I was woken up by another woman that came into my room. Throughout my stay she continued to follow me around and ask me questions that did not make sense. I did not feel safe in away. Men are staying right across the hall and the bedroom doors do not lock. A man could have easily come into my room and raped me. Actually any of the other patients could have caused harm to me! The doctors do NOT car about you either. I had to lie and tell them I over reacted and that I am not really depressed because I was in fear that otherwise I would not be released. I truly felt like I was in jail. I left smelling terrible and feeling so traumatized. I am still deeply bothered and disturbed by my stay at this place. Please safe yourself and do not go. There is no way this place could help anyone with depression. If you aren’t depressed going in, trust me you will LEAVE depressed.

      • NEVER send your child or check yourself into this facility. Please. I went to UBC about 3 weeks ago for depression. I’m 17, so I was put in the kids side of the hospital. I have to say, this is the worst experience I think I’ve ever had. The women who watched us could not care less about how we felt or what we needed. They shook a few disabled girls around on the first day I was there. The nurses were just as bad. A pregnant teen complained of severe stomach pains to the watchers, and the nurses, and neither helped. The nurses just said to go sit down. Sleeping conditions were horrid. It was like sleeping on a wrestling mat, and the pillows were just filled with air. I had stains of something right next to my bed, my best guess was feces or blood. I’ve been out of there for a couple weeks, and every night I still have nightmares about being sent back to this place.

    • Arbour Fuller Hospital

      I was there once awhile back and was voluntarily there, I couldn’t sleep, as that is one of my worst symptoms of P.T.S.D>, Bi-Polar 2, And anxiety, ADD. Yes a lot, so anyway, I requested staff to get help medication wise to sleep, as I took a pill at home nightly, and they said I must see the Doctor on duty, so I said “sure”. I went to see her, she was immediately mean, cold, impersonal, God-I wish I could remember her name! She refused me and when I showed only verbal anger, and disagreed – SHE ACTUALLY HAD FOUR MALE STAFF MEMBERS TIE ME DOWN FACE FIRST TO THE BED!!! AND LEFT ME IN THE DARK WHICH IS MY FEAR! AND I AM A RAPE VICTIM AND SAID THAT THE MEN CANNOT TOUCH ME, I HARMED NO ONE, THEY DIDN’T RESPECT ME, OR ANYTHING I HAD TO SAY!!! THAT IS A LAW SUIT ALL DAY, Lucky for them it was long ago, to long to press charges of neglect and cruelty, personal disregard for a patient in their care by choice, or forced, but I was by choice. Today I called, to go in for out patient psychiatry services and THEY DON’T HAVE THAT ANY MORE!!!, NOT IN SOUTH ATTLEBORO, WHERE I LIVE.WHAT KIND OF MENTAL HOSPITAL IS THIS? They fail all around, and I’ve heard horror stories by 2 of my friends that were R.A,’s there. They hire off the street & with no experience, or college in psychology, to work with people with addictions and the mentally ill. They are lucky they even get one star from me, and many others all I see is bad reviews chee, wonder why???

    • They traumatized me. Made my situation ten times worse than what it originally was. The staff are super rude and take their power to an advantage, they treat kids like animals. I could understand how this could “help” some people, but people with depression or anxiety will have a horrible time here. It’s literally a hell hole. I hope it shuts down.

  2. PTSD is another fake diagnosis.

    Yes, trauma is real, but having gone through trauma does not result in a diagnosable disorder. Responses to trauma are individual and occur on a continuum of severity. Let’s stop pretending that some people have PTSD and there’s a clear cutoff point where other people don’t. Reality don’t work like that…

  3. Recognizing the trauma they are inflicting on their own prisoners?

    On e of my worst tortures from psychiatry was being “inpatient” and having to listen to jackhammers all day long, at random intervals ( from construction work in the hospital). At a sound level that made it impossible to have a conversation during the session of jack-hammering.

    In a normal world this sound-noise exposure would be called torture as I could not leave the (prison) hospital, while all the employees could come and go as they wish.

    The people working in the psych ward are monsters, to have allowed the patients to be subject to the torture. My Post Traumatic Stress Disorder came from the “healers” prison, that they call a hospital.
    Because the torture was from sound, the proof is very difficult to provide to a legal body as evidence of damages.
    If you have a recording of a sound-noise you can use a program named Audacity to make a visual representation of the sound-noise recorded. With this visual display, you can show the duration of time of the noise and the intensity.

    Examples of

  4. “Under-recognized?” Geez, talk about the understatement of the year! So we have 91% of the psychiatric hospital residents reporting traumatization vs. less than 5% of the general population, but their “mental illness” is caused by brain chemical imbalances and is unrelated to what happened to them. The relevance and primacy of trauma is ACTIVELY SUPPRESSED in the psychiatric community, in my observation. It is at best considered an “additional stress factor that contributes to their illness” and is often not even considered. I once evaluated a 17 year old developmentally delayed girl (maybe 6-years-old developmentally) hospitalized for aggression. She had been fine behaviorally but suddenly became withdrawn, and a year later disclosed to her mother that she’d been sexually abused, after which time she became aggressive. Her diagnosis: “Bipolar Disorder!” Apparently, the rape, which marked both the time of her initial withdrawal, and the time of her aggressive behavior emerging when disclosed, had nothing to do with her “mood swings” and aggression. Idiots! Is it possible they were really THAT stupid???

    —- Steve

    • Yes they really are that stupid. And they get paid for it. No accountability for their actions.
      “Brain chemical imbalances” is what they are selling, and the slave has to buy it or else.
      Reasons for behavior would make the patients human beings, and not “chemical imbalances” to be fixed.
      Take this magic pill. “I (need to) believe I am helping you with this magic pill” the stupid one thinks. I call psychiatry a religion for the faith they have in the pills to magically do good things ( instead of bad things).

      • I agree – it is clearly a religion, the DSM is the Holy Text, and the Psychiatrists are the Priests of the Order. The biggest difference is that this Church allows members to be forced to “join” against their will. Which kinda makes it worse than even the worst cults around. At least most of them allow people to choose not to come in the door.

        —- Steve

    • The relevance and primacy of trauma is ACTIVELY DENIED by the psychiatric community and mainstream medical community. And my forced psychiatric hospitalization was, hands down, the MOST traumatic experience of my life. One of the doctors was even later arrested, and convicted, for having lots of patients medically unnecessarily shipped long distances to himself, “snowing” patients, and performing unneeded tracheotomies on well insured patients for profit.

      It actually took quoting my oral surgeon, “concerns of child abuse are not cured with antipsychotics,” for my last psychiatrist to become so embarrassed by his behavior that he finally weaned me off drugs and said I did not need to see him any longer.

      Today’s psychiatric industry is a child abuse covering up industry, not a “mental health” industry.

      • Maybe we should promote your oral surgeon to be in charge of the psychiatric hospital. It seems likely we’d get better results.

        I have heard similar statements from others, that psych hospitalization was worse than whatever trauma they’d experienced in the past. It is hard for me to comprehend how anyone could consider that kind of intervention “therapeutic.” The pro-force movement bemoans the fact that the poor “mentally ill” are languishing in our jails instead of getting “needed treatment.” I’m kinda getting the impression they’re better off in jail, if for no other reason than they have to let you go when your sentence is over.

        —- Steve