Medical Health Treatment vs. Mental Health Treatment

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2000

In 1986 I had my first experience spending time in a hospital. While riding a bicycle to a friend’s house my front tire hit a stone in the road and I went down. My next memory was waking up in the hospital and being told to try and remain still under the X-ray machine. No matter how hard I tried not to move I could not stop shaking. I remember people being around me, telling me that everything was going to be alright, one person even held my hand trying to comfort me through what was happening.

Being 11 at the time I could not fully grasp why everyone was paying so much attention to me or why my parents were so worried. I did not know a doctor had told my mother that my chances of recovery were 50/50, nor did I know how bad things like a fractured skull or brain swelling were at the time. All I could understand at that age was I got hurt, I was in the hospital and everyone wanted to help. Every experience I had going to the hospital from then on felt like a relief when I got there. Whether I needed stitches, or that time I ended up having systemic poison ivy, I knew walking through the doors of that building would lead to getting help and feeling better.

As we grow older and our lives change we experience new things, some good, some bad. Through a series of events that took place in my late 20s and early 30s, I began to live with depression. With time moving on and life continuing to unfold the stressors built up enough that trying to leave this world just seemed to be my best option.

Like my very first hospital experience, my next memory was waking up in the ER not knowing what was going on, how I arrived there, or what was going to happen next. It was not until years later that I began to understand how people living with mental health challenges looked at hospitalization so much differently than I did. It opened my eyes to be in the hospital for mental health challenges rather than a physical injury.

In March of 2024, I paid a visit to the hospital once again, this time as a person trained in peer support and someone who had become an advocate. After years of living with depression, PTSD, suicidal ideation and anxiety I had forgotten all of the good experiences I had as a much younger person.

In the first week of March while cleaning up a piece of land my foot became trapped between the branches of a fallen tree. I was finally able to free myself by pulling my foot out of my shoe. Taking a couple of steps, one shoe on and the other still off, I made my way over to a stump, sat down, and replaced my shoe. At that time it seemed to be nothing more than a slight annoyance. I then went back to work and completed the task at hand.

Two weeks later I began to experience what could be described as a burning sensation in my calf, feeling as if it were a fairly bad sunburn. Unfortunately, I ignored it and chalked it up to an insect bite even though there was no visible mark. After another two weeks went by, things took a very bad turn. My foot swelled, and it was clear at that point I was facing some kind of infection. Some friends helped me get to the emergency room and I was quickly admitted when the scope of the damage became apparent.

Being a diabetic and having lost most of the feeling in my feet, I never felt the splinter enter my foot nearly a month earlier. It is not every day a person is told that a part of their body needs to be removed. I got lucky only losing a toe, but at that moment all I felt was fear in a way I had never experienced. Today I am back on my feet and completed the wound care without any issue. Looking back on my latest visit to the hospital I discovered some things that might have gone unnoticed if this event never took place. As someone who advocates for mental health services and the people who need them, I can say that, for my work, this experience was a good thing and I believe it can help others.

During my week in the hospital something became very clear — the difference between how I was treated when dealing with the medical staff versus how I had been treated by the mental health staff in the same hospital a few years earlier.

Before I was brought up to my room I spent several hours in the emergency room and had a meal there. It was a typical tray, the food was not half bad, and even though I had a loss of appetite from receiving the news about the severity of the infection, I still managed to eat a little.

In my room, after the surgery was over my tray was delivered for lunch. I was a little annoyed to discover that they had forgotten the flatware, no knife, fork, or spoon to be found. I told the nurse and she was able to get a spork from the collection of plastic utensils on the cart in the hall. Still not having much of an appetite, for the next meal I had asked for soup, a diet ginger ale, and a sugar-free lemon ice. I sipped the soup from the bowl and didn’t notice there was no spoon until it was time for dessert. I didn’t have dinner that night because of a scheduled procedure the next day that required fasting.

After I was brought back to the room the next afternoon, I ordered lunch and was very eager to eat. When the food arrived it once again came with no flatware on the tray. I called the nurse and at this point, even the staff was annoyed with the kitchen. They called down there to see what was going on. About an hour later a “doctor” walked into my room and started asking how I was feeling. Based on her questions and my observation that she did not have a stethoscope around her neck, it finally clicked that this was someone from the psychiatric department fishing to see if I was experiencing suicidal ideation.

Even though it had been five years since I was hospitalized for depression, suicidal ideation, or any other mental health concern, hospital safety protocols came online because of my history. One would think if they truly believed mental health is fluid, or even capable of changing over several years, they might have asked how I was feeling before trying to save me from myself.

Here are the major takeaways and observations I made:

Medical Emergency: Going into the ER I was not asked to put on a gown, that happened once I got to a private room. I was allowed to keep my cell phone, wallet, and other belongings.

Mental Health Emergency: Going into the ER I was ordered to put on a gown, and had my possessions taken away despite my objections.

Medical Emergency: I was scared, shaking, and on the verge of tears. They waited for me to calm down before asking to do a blood draw and having an IV put into my arm. Everyone was friendly and tried to reassure me that everything was going to be okay.

Mental Health Emergency: After being taken to the hospital against my will I was told they would be doing a blood draw — when I refused, they threatened me with security. When I refused to provide a urine sample they threatened to use a catheter. Even though I was speaking in a calm voice and advocating for myself they seemed to want to rush through the motions just to get me to the psychiatric unit. Everyone was rude, one nurse even went as far as saying “I don’t have time for your shit” after I declined to have my vitals taken.

Admitted to the hospital for a Medical Emergency: After being taken to a room several nurses and doctors came to see me. They explained everything in detail, what they wanted to do and how they thought it would be best to move forward. For the first time in a long while it felt like I was part of my treatment team.

Admitted to the hospital for a Mental Health Emergency: Once I arrived on the floor a staff member went over the unit rules. I was also told that it was required to have vitals taken throughout the day as per hospital policy. I was never asked about personal preferences or what I was comfortable with; to me it felt like my treatment team was in charge and nothing I had to say carried any weight in the decisions being made.

Making choices in a Medical Situation: At one point post surgery, I was asked if I would consider taking a medication to help resolve an issue; without getting too graphic let us just say it was to help my body regulate itself properly. I opted out and suggested trying to correct the problem using a dietary solution and if it did not resolve itself over the next two days I would take the medication. The nurse respected my choice and kept tabs ensuring the issue did not become a larger problem.

Making choices in a Mental Health Situation: Within less than 12 hours of being admitted to the psychiatric department, I was called up to the nurse’s window during the time they distributed medications to the patients. I was handed a cup of water and a small clear plastic container with three pills inside, all different. They were ordered and given to me with no explanation whatsoever. When I asked what they were and what they were supposed to do, the answers I got back were extremely vague. I opted not to take the medication and for the rest of my stay, I was referred to as non-compliant.

These experiences happened within two visits to the SAME hospital. The differences in the quality of care and consideration of the emotional state of their patient were night and day. We talk about the importance of mental health parity but for the most part, it is only about access to care and insurance coverage. We need to focus on the quality of care, the amount of empathy a person receives. We need to ensure that the overall experience of hospitalization is positive. So many people talk about the bad experiences they have had at the hands of psychiatric units all over our country, and a lot of those people stop seeking the services those hospitals provide.

I understand that opinions may vary about the services provided by hospitals, both for mental and physical health. One thing I think we can all agree on is that every person seeking help should be treated with respect, informed of their options, and have a strong sense that their concerns are being addressed.

With over 50,000 people lost to suicide in the US in 2023 alone — more than 1.6 million suicide attempts, and over 12.3 million people having serious thoughts of suicide — shouldn’t hospitals be working harder against alienating those who truly need help?

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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.

25 COMMENTS

  1. Things aren’t likely to change much as long as people are led to believe that emotional problems are primarily biological.

    I think the main problem lies in the minds of people thinking that a medical/hospital setting is the proper place to turn to when experiencing emotional distress. The services of a medical doctor/hospital too much of the time are not what’s truly needed and too often can lead to worse medical and emotional problems that can be very difficult or even impossible resolve down the line.

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    • On the other hand, there’s growing evidence that people’s state of mind and/or feeling states can be significantly affected by the foods they eat and conversely significantly improved by eating different foods, which btw isn’t meant to suggest in any way that psychic difficulties are indicative of “mental illness”. And it’s more than likely that it will take a long time for information like this to finds its way into the minds of the majority of medical professionals. So, in the meantime check out Dr. Josef’s recent video on diet and psych meds.

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  2. This is an amazing article, thanks so much.

    I’ve been thinking of this lately. In physical medicine, there are clear ways of diagnosing and treating diseases. There may be times when you need a 2nd or 3rd opinion, but by the end of all that, you should have a clear idea of what to do. It’s not the same thing in mental healthcare. You can go to 5 different doctors, get 5 different options, and still not have a clear picture of what your problem is.

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    • There is, of course, no possible way to objectively establish “the truth” in “mental health” diagnoses, as there is no way to determine ANY diagnosis beyond simply describing it. If there is ever even ONE test to determine ANY “mental health” diagnosis, I will be shocked.

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  3. I’m not the only one. Thank you for this article, Jeffery. I don’t have to share all my experiences, but as a woman with bilateral temporal lobe epilepsy, I have experienced both the treatment “attitudes” in a single visit. The seizures I have don’t look like the type everyone is familiar with, and I have panic attacks in between cluster seizures. Treatment is crucial. Giving antipsychotics to a seizing epileptic can be fatal. I have several NDE and PTSD just because of this ignorance. How can we move forward and make a change?

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  4. Is there mental illness, or is this a smokescreen concept covering the actual psychological, emotional, instinctual, neurological and physiological injuries of a brutal and blind social process? If you don’t first answer this question nothing you say about the phenomena you call ‘mental illness’ has any value at all. And none of you ever answer this question. There is no evidence at all that the cause originates in the brain. Why would the brain naturally become unbalanced? Surely the corruption or disruption or destruction of natural functioning implies invariably either an unnatural or a traumatising factor. Our blind ignorance and stupidity as a collective and as individuals is doubtlessly this factor. So is our concept of ‘mental illness’ really any more rational or true then our concept of witchcraft? I promise you, the concept of mental illness has even less truth because at least the concept of witchcraft left room for mystery and a presumption of ignorance rather then expertise. And both psychiatry and witchcraft persecution are the same kind of violence. Perhaps witchcraft persecution is the urform of psychiatry. Criminal justice is in the same family too. It is blind violence and ignorant processing of the real without ever first seeking to understand the real as it is. Psychiatry and law say the real is right or wrong, which is true delusion. The real is actual. Only words can delude us into thinking the real is right or wrong, that people or brains are right or wrong. They are actualities we need to understand, not problems to process for the convenience of a society full of vampires, grifters, goons, tricksters, fiends and clowns.

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  5. Last time I went to mental hospital, I thought I was going into Charlie’s chocolate factory because everyone in there, patients and staff, looked like umpa lumpas, except the psychiatrists who looked like thinly veiled, white nailed devilists.

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  6. Why do people allow themselves to be infantilized by medical doctors when going through emotional/psychological problems? To me it looks as though there needs to be more of a collective effort to dethrone psychiatry so people can begin reclaiming their lives from a corporate entity driven more by its lust for power than doing good. The fact that most “mental health workers” are in their own way as infantilized as the people they “treat” is no excuse for their habit of doing harm in the name of good in large part due to an “education” substantially funded by the pharmaceutical industry. Nor should it any longer be denied that many if not most “mental health workers” are driven by an unconscious desire to hold an unreasonable amount of power over vulnerable people.

    In short, there’s no use in wasting time waiting for the powerful to relinquish their control.

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  7. “were night and day.”
    In all fairness so was your behavior. According to your narrative, during your mental health visit you refused to have your vital signs taken, refused to have a blood test, refused to give a urine sample and refused medications.
    But you didn’t refuse those things during your other visit.

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    • In all fairness I am in charge of my health care choices, whether that is for my mental health or physical health. If the hospital respected me at all or the choices I made this article would have never been written.

      Furthermore there is no reason to take blood or urine for testing for someone who is experiencing depression or suicidal ideation. The only two reasons to conduct those tests, first is to check for drug use and the second is to pad their bill. When you are brought to the hospital for suicidal ideations one of the very first questions they ask are, what medications are you on and do you use drugs or alcohol. To insist those tests after I answered “No” tells me believe that I was not trusted to give accurate answers.

      On my second visit of course I didn’t refuse those things. Why would I have refused a blood test to determine whether or not an infection was in my blood that could have killed me? Taking that a step further ask this question instead, why were suicide prevention protocols put into place when a person came into the hospital seeking life saving treatment? Does that seem logical to you?

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      • Hear, Hear!
        I support every word.

        I both worked in a psychiatric hospital and was admitted to medical/surgical wards, on the same timeframe and within the same health organisation.

        I can testify that the medical doctors and nurses respected both my physical needs, emotional needs and my refusal to undertake certain intervention, in sharp contrast to what I witnessed and many testimonies I collected in the psych space.
        In the “mental health” service, not just the staff suffered from reduced empathy, they could also neglect people’s physical and medical needs, dismissing their sound complaints as “poor insight”.

        And I don’t believe it is due to lack of funding, as some people suggest. It is first and upmost due to the rotten culture and corruptive training provided by the field.

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      • Studies have shown that suicide completers have very low levels (below 10) of Vitamin D. Low Vitamin D can cause the symptoms of the different psych conditions and the lower the level, the more severe the symptoms.

        Studies have also shown that a large % of people who are depressed have low Folate.

        Low folate is associated with more severe depression, longer episodes, higher risk of relapse and less effectiveness from antidepressants. Low folate can cause high homocysteine which is toxic to neurons.

        So if they had checked Vit D, Folate, homocysteine, maybe my son would still be alive. But instead they gave him an antidepressant that lowers Folate and Vitamin D without checking to see if his levels were low.

        Since diabetics usually have low Vitamin D, I think they should have offered to check yours.

        Of course they hide the fact that antidepressants lower Folate. Instead they say Folate increases the effect from antidepressants.

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        • As I suspected, your references are only talking about probabilities and associations. There is no inkling of a biological CAUSE that would apply to all situations. Valuable information, to be sure, but nothing to do with validating “depression” as a legitimate diagnosis with a unitary cause. So for sure, Vitamin D and folate should be considered viable interventions for people experiencing mood problems, but this certainly allows for a HUGE range of possible causes, and also doesn’t eliminate the possibility of low folate or low Vitamin D cases NOT being depressed or suicidal, which would also kill off any fantasies about a causal role for any one biological condition in depression or suicidality.

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        • This points to a huge problem. That every case and every cause should be investigated AND I point to the fact that no matter the cause daily longterm psychoactive drugs are never the answer. All that does is make things worse because of the side effects.

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      • What a clear and spot on message delivered here. There is different treatment! And Mr. Santo you pointed them out, ( as they are in most cases). I deal with anxiety and panic disorder. I ended up in the ‘mental health’ side of the hospital; it’s night and day between the two. Yes, some who have a mental illness are our of control, can’t make decisions, throw and attack, have mixed drugs, or haven’t taken their medication. Yet, most of us are dealing with a mental ILLNESS, and are doing everything that is asked including being honest, because what we are going through is brutal!!! We should be getting the same type of treatment one would get if they came in with broken arm. I am terrified of Psychiatrists and Therapists. I hope to share my story-the trauma one therapist caused me. When I first met him, “You’re in a safe place here…..” Never could I have imagined the ending with this creep.

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  8. I had the demonstration of this when, in 2019, I was admitted in a psychiatric hospital for depression/suicidal ideation and, halfway through my stay, I suddenly felt faint at the breakfast table. It was action stations, all the other patients were asked to leave, 2 nurses were supporting me, telling me to breathe deeply (apparently, my pupils were totally dilated and it scared them off). I didn’t faint but they took me to the treatment room where I had an ECG and was ‘pampered’ (‘Gosh, you scared us!) for 20 minutes, and asked to go and rest in my room.
    I noticed the different treatment but, unfortunately, I couldn’t feel faint on demand!

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  9. The difference between how you get treated and regarded and cared for with a physical medical problem compared with a psychiatric one is nothing less less than being on a different planet.

    I went through what I was told by the oncology consultant was “radical and aggressive” cancer treatment for several months last year. From the initial diagnosis in January 2023 – when I was told I had a year to live unless I underwent the treatments – to date – during very difficult, frightening and life-sucking ongoing side effects, I cannot remember being treated with such kindness, gentleness, respect and compassionate care anywhere, let alone in hospitals, since meeting the doctor in the NHS mental health system who was in fact a Jungian Analyst and whose kindness and humility was previously unknown to me within twenty years in the NHS mental health system. As I have previously written about on this site, this man undoubtedly saved my life. At that time, under his direction, the NHS mental staff in his hospital were also kind and compassionate, caring and respectful and the whole experience of my recovery from deeply repressed childhood trauma was changed, enhanced and uplifted ever since from then on.

    But prior to that I experienced the gamut of unspeakable, often cruel and terrifying treatments and behaviour including repeated misdiagnoses, ECT and endless medications, by doctors and staff in the NHS mental health system over six hospitalised breakdowns and prior to that the misdiagnoses by psychiatrists and erroneous judgements caused by the cultural stigma of mental and emotional distress as shown in my extensive medical records.
    It also should be mentioned that, as has been mentioned in the article and comments above, it is not possible – at least in the early stages of coming to face one’s trauma – to ascertain the “Truth” of the causes of individual mental and emotional distress – in complete contrast to the diagnosis and treatment of cancer – where the diagnosis is made after many tests and scans which reveal the evidence of for instance a tumour which not only can be seen on camera but which the oncologist and medical staff have extensive experience of which and what treatments will have the best chance of curing it. Unlike the subjectivity and guesswork of psychiatric diagnosis and medications. This creates the ability to surrender and trust the expertise of the oncology consultant and his staff.

    From the outset of my cancer diagnoses I have been completely amazed at how differently you are treated by everyone from medical staff to the general public when they hear you have cancer as opposed to anything concerning a mental or emotional health problem. My experience over the last two years has been to literally discover a new world- of kindness, friendliness, gentleness and compassion all around me. It is like being in a wonderland compared with what has often felt like callous disregard, judgement and discrimination – and suspicion throughout all the previous years of being in recovery and fighting to stay alive through intensive psychological trauma. Ignorant people might comment that my “behaviour and attitude” during depression and distress could have been the reason for being treated in such negative ways, but I have not behaved any differently during my years of surviving cancer than my decades of surviving the long-term results of childhood abuse.

    People have said it is down to the huge amount of funding cancer receives – certainly it is well-known that the mental health system is seriously under-funded – and as a GP I met a few weeks ago said “The mental health system is broken into a thousand pieces.” But I believe it is far deeper than that. What is so important when you meet with any health professional when you are ill or in pain, whatever the cause, is the eye-to eye contact with the person to whom you are confiding your distress. In the cancer world the eye-contact has been, without exception, soft, gentle, kind, sympathetic and empathetic – like having your forehead stroked when you are a tiny child with a fever. The effect is to feel immediately calmed and reassured in your heart. It engenders a feeling of trust and hope and love. In contrast I would say from my memory, without fail, any and all interactions with mental health staff (apart from those I was so fortunate to meet when under the care of the Jungian doctor) from the administrative staff at a mental health day-care reception to the ward staff – were often (though not of course always)a mixture of hardness and suspicion, irritation, even annoyance, sharpness and judgement – and perhaps, sadly – fear. The effect I can remember clearly was to be plunged into deeper fear and anxiety along with a sinking increase of shame the feeling of being worthless – and seen as worthless.

    My cancer was declared cleared last December – but has been found to have remained in the lymph nodes in the last couple of months, requiring ongoing treatment which may not be curative. And yet my experience of the last two years has been the most healing and spiritually uplifting time of my whole life. I have never felt happier or physically and mentally better. Because of the funding raised in so many ways for cancer patients out of which all sorts of healing treatments have been and are offered free of charge, I have met up with a whole community of healers including masseurs, reflexologists and reiki practitioners, plus voluntary community cancer support groups and been brought out of years of isolation and formed new friendships where shared experiences have created support, respect and empathy. I cannot remember ever before going to bed feeling happy and waking up with a feeling of peace, despite having to now adjust to the unpredictability of a terminal diagnosis.

    The experience of the cancer community is something we need to bring into the mental health community along with similar centres for coming together and developing mutual sharing and healing support and learning and for the whole attitude and fear and stigma over mental ill-health to be overturned.

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  10. Unless mental health laws, they make it legal to take away people’s civil liberty supposedly protected by the Bill of Rights, are abolished, what need do mental wards have to treat their patients the same as a voluntary customer?
    Mental wards are a business, but unlike medical wards that are also a business, there’s no need to make the customer happy in order for a repeat profit or a favorable review.
    The CMS (regulatory agency) does surveys & takes patient reviews seriously but they don’t even ask mental patients bc psychiatrists have created the narrative that mental patients are unreliable witnesses of their own experiences.
    So of course there will be huge differences between a mental ward and a medical ward.
    Not that I think that’s OK.
    I think it’s disgusting & disgraceful!

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  11. Dolls can easily be torn apart. Computer brains can malfunction. The world has turned us into stuffed toy versions of our selves. We’re as useless as stuffed toys. And we speak these audio stuffed toys, and we think these mental stuffed toys. Everything is stuffed toys. This is not reality – it’s doggerel form. Life knocked the stuffing out of me and there is me all over the floor. I have ribbons for guts and my throat is always dry. But I sell well on the Chinese market. I’m being purchased now. “那将是2000元。” she says. Have a nice day watermelon people

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  12. incredibly true here. I was admitted to the hospital as a minor after an overdose attempt and was forcibly restrained multiple times and involuntarily injected with an antipsychotic. At one point a nurse pulled my dad aside and admitted the hospital was completely in the wrong to have restrained me and actually did something illegal!

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  13. From my own experiences as well as those of people I’ve spoken to, or read about, this disparity between the quality of physical and mental health “care” is definitely the norm. I believe it’s because “mental illness” refers to 3 separate things: neurological illness, psychological disorders, and situational problems. People with neurological illness and situational problems would be treated kindly, but because they get lumped in together with psychological disorders they receive the stigma from these disorders. And psychological disorders are stigmatised because 1) many people with personality disorders are abusive, and 2) people have control over psychological disorders (although it usually takes a lot of effort and self-honest introspection, and people can control their behaviour but can’t just choose to eliminate the disorder overnight).

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