“We Need a New Paradigm” — Rethinking Psychiatry’s Hospitalization Survey


This spring, Rethinking Psychiatry put out a survey on people’s experiences of psychiatric hospitalization, with Cindi Fisher as the primary researcher. This survey was based on a survey done by Mad in America and used with their permission.

Our survey mainly focused on people’s experiences with hospitalization in the Pacific Northwest (Oregon and Washington). However, some respondents had been hospitalized in other places. The survey results were consistent with recent stories of unsafe and inhumane conditions in Oregon and Washington.

The results overwhelmingly showed tremendous dissatisfaction with past experiences of psychiatric hospitalization. Many responses indicated that hospitalization had done far more harm than good. The overwhelming majority of respondents reported that they did not feel safe, secure or respected in the hospital.

“We need an entirely new paradigm in addressing community problems and individual suffering!!! Until then I am certain peer support and unbiased science will be helpful.” — comment from survey respondent

Many people believe that horrific conditions in psychiatric hospitals are a thing of the past, but that we have come a long way since the days of “One Flew over the Cuckoo’s Nest” and “The Titticut Follies.”

While conditions in modern psychiatric hospitals may not be as horrific as what was portrayed in those films, they are still often light years from being safe, secure, humane, or therapeutic.

Not everyone has a negative experience in psychiatric hospitals — some people, including some of our survey respondents, state that they had some positive experiences, and in some cases say that psychiatric hospitalization saved their life. Even so, it is essential that our society provide alternatives to psychiatric hospitalization, and provide comprehensive care that reduces the likelihood of psychiatric hospitalization.

Rethinking Psychiatry is advocating for better options: peer support, respite homes, innovative treatments like Open Dialogue and Emotional Freedom Technique, and access to holistic, comprehensive, person-centered care. This survey confirms that our system is not working and we need far better treatment options.

To hear the stories of psychiatric survivors who become activists for change, you can listen to this Portland radio show. The three panelists, Kevin Fitts, Laura Van Tosh and Becky Edens, spoke on a panel at Rethinking Psychiatry’s September 2019 meeting about how their own experiences with psychiatric hospitalization lead them to  advocate for better treatment options.

To learn more about Rethinking Psychiatry, visit www.rethinkingpsychiatry.org.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. A survey is a good start.

    In one of our South shore Quebec hospitals, an attendant in a psych ward from 2011 until 2017, took photos of the patients hospitalized there, amongst other behaviours. The hospital attendant is presently in jail. Did the hospital send letters to the patients informing them of these violations to their privacy? NO. The hospital can send letters to patients asking for donations, every six months and yet when they are asked to communicate with these patients informing them of these violations….they respond they are doing enough. How do patients find out about this? If, per chance, they see an article in the newspaper, concerning the criminal attendant. When I asked the police why patients were not being notified, they replied “they had enough victims for a conviction”. The hospital isn’t sure they should start doing background checks on employees.

    Yes, a survey. A wonderful start.

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  2. A survey?
    They did a survey of “patients” from the previous year and it was found that 45% of the females claimed they had been subjected to sexual assaults. Okay there were some issues with this survey but it was what our, at the time, Minister for Mental Health said about the survey that interested me. “You can’t listen to them, they’re patients”.
    Yes please do the surveys but understand that there are some people who have made thier minds up before any data is collated. In fact, I think if they did a survey on what was to be for lunch at the annual Royal College meeting I feel that the (ex) Minister might say “You have to listen to them, they’re doctors”.

    Imagine how dangerous that attitude is for “patients”. Imagine being one of the respondents who may be being abused only to have the person charged with your care say such a thing? I know it takes time, but it just might be worth checking if it is happening before dismissing the claims because they’re patients. Not an uncommon attitude though from what i’ve observed over the years.

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    • It’s horrific but it’s true.
      The main problem in this arena seems to be undue pressure & influence.
      The blind faith in reputation.
      That reputation granted, unearned, to medical industry & that includes the power to set the reputation of others.
      Similar things happened for decades with CSA in the church.
      The victims were all seen as “lying”
      The priests were all seen as telling the truth.

      It’s the essence of institutional abuse.
      An unimpeachable reputation on one side & the ability to control the movement &/or reputation of others – who inevitably become victims one way or another.

      But the whole thing is kept in place by prejudice. It has to be. The moment one group of people has absolute power over another group of people & can say whatever they like or do whatever they like, abuse has already occurred. Whether it escalated to SA or violence or not. The act of controlling another’s rights or identity & preventing them being full legal persons is already abuse.

      That’s the abuse UNCRPD (UN convention on rights of persons with Disabilities) was written to solve. Unsurprisingly, the authoritative UN guidelines are being viciously attacked, or simply buried & ignored by vested interests.

      Because they make it clear non-consensual detention, “intervention”, substitute decision making (taking control of others’ decisions) & “incompetence” or “best interests” models are a human rights abuse.

      It means nobody is allowed to subject anyone else to involuntary anything purely because they are different. Everyone who wants support needs to be allowed to access support they choose. They can’t be forced into Psychiatry or its constructs for any reason.

      But if people want Psychiatry, they can choose it. They can even choose to be consensually detained if they wish.

      There’s no end to mechanisms that could allow such things to work in practice. But in countries that have ratified UNCRPD, despite UN pressure to end forced Psychiatry, true rights don’t get into domestic discussion. There’s also plenty of mud in the water with misinterpreting of rights from medicalised or other prejudiced perspectives in international legal literature. UN official guiding documents make them pretty clear. But many are so entrenched in prejuducial views, they seem not to be able to take things in even when they are spelled out explicitly. If they do take them in, they hit the roof, outraged that anyone would dare breach their prejuducial views or entitlement.

      Many people who stand to benefit from UNCRPD don’t know about it or understand it. Status quo is so entrenched, even those who know of & support rights sometimes have a hard time understanding not everyone is the same & can’t just group people together based on how they are perceived by others and subject them to a “paradigm”. Any “paradigm”. Diversity is hard for a lot of people to get their heads around.

      Of course, it would be a lot easier if there were resources & manpower to spread unadulterated education on what the rights are & what they mean. Explain diversity, as opposed to same thing for all. Everyone gets the rights, but how each chooses to exercise them will be very different. Accepting diversity means everyone gets to be themselves. Once people understand it, most want it because it makes room for all of them.

      Only exceptions, of course, those who benefit from oppression. They resist it with everything they have. Nor because they don’t understand it, but because rights are “disruptive technology” to those who gain power & influence by taking them away from others.

      Those are few compared to the number who ultimately benefit from rights. Think there is a lot to gain by a greater understanding of what they are. At the moment rights being distorted & co-opted.

      Better understanding of rights amongst those who genuinely want things to improve/change in the world would go a long way to making it a lot harder to hide, distort or co-opt rights.

      Co-option, distorting or ignoring rights is easy to do when there’s nobody to point out “no that’s not what the rights mean”. Can’t stand up for rights when few know we have them or what they truly are…

      It makes me sad when people talk about “new paradigms”. They are missing the point. There are already many diverse ways to understand life in all its diversity. The problem is there is no respect or access to them because so many are entrenched in the status quo: of doing things to people, “managing them”, so deeply entrenched in the prejudice that the idea everyone should have equal rights seems preposterous to them at first.

      But so it has been with every situation where one group of people thought themselves “superior” to another. Eventually once enough people catch on & stop letting prejudice hold sway. It’s the bigotry that’s shunned. Those who want inequality try to pull out every trick in the book. But there’s not much they can do once it is they who become the minority. That’s why they do everything they can to try & ward people off from “getting ideas above their station”. They know all too well how such ideas spell the end to inequality when they spread far enough & won’t back down.

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      • I like your comment fnert777.

        One of the issues that has amazed me regarding my situation is how a Community Nurse lies to police and certain things happen as a result, and yet they continue to maintain that lie despite their being no evidence to support the straw man, and only a preference for the lie.
        Okay, so because i’m not a “patient” this guy has effectively used police to torture and kidnap me, I get that. Now one might imagine that when they figured that out they might have done some stuff to conceal these facts. I get that too. But police telling me that “it might be best I don’t know about that” when I explain they tried to murder me? Okay, the attempt to murder I get too, I mean its what criminals put in a corner tend to do, but where else do they obtain assistance from police to do this?

        And yeah, I get it i’ve been slandered as a nutjob and what i’m saying might not be true, but ya might want to check first?

        Simple, all I need is proof that I was someones “patient” on the day I was spiked and snatched from my bed. I know it doesn’t exist and in which case I am the victim of some serious organised criminals. Not that the reputation of Mental Health Services can suffer as a result of the negligence, fraud and slandering. The Operations Manager tells me that they fuking destroy anyone who has a valid complaint, And they have the authority of our Minister to do so. He, despite zero proof prefers the false narrative and has reinforced it with his stamp of approval, and a need to totally ignore the protections of our Mental Health Act. And he wants support for his Euthanasia Bill with all those protections? Ones that he has demonstrated will not be observed despite knowledge of their existence?
        These are the same people who were ‘overlooking’ CSA in the Church for years using the same methods. Isn’t it about time we moved a little quicker on these negligent abusers?

        Mind you the standing of our Politicians is only just above that of car salesmen. A shame because in some countries they are seen as being trustworthy and may not have a need to torture, maim and kill and disguise it as ‘medicine’.

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  3. I am not educated enough to understand this ‘hospital survey’. I think what it means is that they realized the little folks are onto them and thus did a research on how to reframe the current model to make it more palatable to the little folks and also to themselves. I’m sure it is difficult to keep trying to impress the same messages onto folks who are suspicious. “the new and improved psychiatry”…..wait, I think we are only in the research stages. More to come. In the meantime, I tell my kids to never ever set foot into those doors, not even after the well thought out/rehearsed shift to a new ‘paradigm’.

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