Psychiatry and Mental Health Essay: Cases of Abuse in Psychiatric Units

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According to a 1998 study conducted in Sydney, Australia, a total of 62 percent of violence was recorded in psychiatric units. One of the objectives of this study was to prove that abuse in facilities were common, and the only reason that statistics may lower is because they go unreported. The issue of abuse in a facility is questionable in Charlotte P. Gilman's short story “The Yellow Wallpaper”. The supposed treatment of the narrator is a clear sign of physical abuse; shown from the environmental surroundings, as well as how John attended the narrator with her illness. The background information about where the narrator stands does not relate to the issue of physical abuse. Using reported incidents, studies and a personal interview with an employee in health care, will further prove the concern of ill-treatment of patients.

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Physical abuse is defined as deliberately or accidentally assaulting another being, not including verbal abuse. Examples of assault within a facility can consist of malnutrition, enforcement of drug dosages, striking the patient, sexual abuse, and physical threats against the patient. In “The Yellow Wallpaper”, John is the physician that possibly misdiagnosed and deliberately abused the narrator in hopes of treating her illness. He trapped the narrator in a room with poor living conditions. The nursery the narrator was living in was described by her as “the furniture in this room is no worse than inharmonious…, the wallpaper…is torn off…, the floor is scratched and gouged and splinter.”

Being in these living conditions is considered abuse. The narrator also describes how John and other small characters repeatedly treats her like a child, belittling her as a woman in the given era, as well as giving her high dosage of what she describes as “pains to control [her]self…that makes [her] very tired” (Gilman). Descriptions given by the narrator is exemplified and can be linked to the emotional abuse an audience may see. In a personal interview, the anonymous interviewee revealed that patients will not always realize they are being physically assaulted; “their mental illness can be in the way of them reporting incidents or used as an excuse and be dismissed, because of this, it can cause emotional issues in the long-run.”

Cases revolving around similar issues were common around the 1800s, which was when medical experimentation with patients were common. Journalist Geoffrey Reaume investigated the Toronto Hospital during 1883 through 1937 for reported abuse in the mentally-ill patients. In the abstract, it is mentioned that “in an effort to uncover the experiences and perspectives of patients about abuse in institutions, this article will present…material from the Toronto Hospital for the Insane” (pg. 65). In the journal, it is stated that some of the evidence gathered were from “over 30 other existing documents written by this former patient.” Reaume did not rely on only reported accounts of abuse from patients or staff members because “compilation of statistics on the number of…abuse between inmates and staff…during this period was not usually maintained by administrators” (pg. 66). It is revealed that assault conducted by staff members was common in the examined institutions. Background of patients were also considered and was said to be an influence due to the era of Reaume’s journal.

During the late 1800s, social classes changed due to industrialization. Women and children started working in factories, African-Americans were gaining citizen rights, and working conditions were unregulated. In this era, higher social statuses were expected, but “there still remained a wide gap between the rich and the poor” (Social Class in America). It is expected that because the narrator in “The Yellow Wallpaper” is a woman, she was condescended. It is implied by John and Jennie when trying to convince the narrator into believing that there is nothing mentally wrong with her. In this era, it is common that women were belittled and expected to not know how to do anything, unless it involves being a stereotypical housewife. Women were not treated equally compared to men, and it still happens today. In regard to relating this to today, as a woman, it can be dismissed and go untreated.

In addition, the background factors always play a role, even in present times. Health Care workers can discriminate their patients due to their background. The background information can include race, gender, age, or their social or cultural environment. Reasoning behind discriminating assaults is usually argued that it is the lack of training on the worker’s part. This, however, is no excuse. The anonymous interviewee stated that “it would seem moral to not want to hit a patient with a mental illness, but you’d be surprised as to how frequent it happens. When I began working in [a facility center], I immediately saw a woman smack an elderly patient in a wheelchair for not moving fast enough. The receptionist acted like nothing happened.” After asking about her own actions, she responded with, “I reported it immediately. Even if she was fired, there is what I would describe as a culture behind every facility center like this one.” The interviewee also added details about similar incidents and asked to not state any names for anyone’s safety.

The supposed culture she describes is from lack of moral respect from both patients and workers. She describes it a common practice that mainly falls on the worker’s part. “[Workers] believe that because a patient can’t act upon assaults, it’s fine to hit them or insult them. Any new workers will see these actions and believe its fine too.” She added how misconceptions are also common regarding the facility; people want to believe that facilities or nursing homes are a safe place for people of any age with physical or mental disabilities. “There’s faults in the system as well,” she says. To paraphrase, the way “the people in charge” underestimate how much a worker can handle. “I’ve seen a worker of mine have to take care of at least ten patients at once; a few that have serious mental illnesses like schizophrenia, severe bipolar disorder, and much worse that needs to be handled by at least three workers per patient.” She explained how some colleagues are put in irrational ratios with patients that need more specialized care, especially with experience.

It is evident throughout “The Yellow Wallpaper” on other ways the narrator is mistreated. John frequently disregards the narrator’s complaints and does not let her socially interact often. Because the short story is in the narrator’s point of view, it is difficult to know the extent of her surroundings and true relationship with John. This mistreatment of the narrator’s illness evidently caused her to have an episode, which can also be a result from the isolation. Nina Grant et al., conducted a study to “investigate associations between social isolations and cardiovascular…responses to acute stress” (29). They studied social isolation among healthy middle-aged adults to understand it’s relation to stress from the heart and lipids. The results from the study proved that stress responses can be seen in “the tasks…increases in cardiovascular activity and subjective stress” (33). It was also discussed that “high levels of social isolation were associated with negative” results to the tested patient. To restate, the isolation of the narrator resulted negatively to her condition; stress levels increased and played a major role in the narrator’s episode.

In the personal interview that was conducted, it was asked how common abuse had go unnoticed. The interviewee stated that it “unfortunately happens all the time.” She added that the any scene with physical abuse is laid out with “the victim, the abuser, and the silent witness.” The “silent witnesses” can either cover up any evidence or act ignorant to the situation. It was also asked if she witnessed negative results as part of neglect on either the health care or family’s part. She stated: I have never [personally] witnessed it, but I know it happens. I’ve been involved in cases surrounding this issue. In a recent case, I went to a house in an assessment to provide services, and when I entered the house, the mobile home was surrounded with what seemed to be 30 dogs, feces all over the walls, no food in the refrigerator, and the patient was not taken into medical care or follow-ups…she had financial support for her disability…, and there were three adults living with her who obviously paid no attention to her, even in regard to her medication…

The case was [reported and] confirmed, she was temporally placed into a foster home. She included that their neighbors did not take actions to their living conditions in thoughts of “maybe that’s just how they live” and for their “lack of sympathy.” It was restated that she did not condone the mistreatment of any patient and tries to put an end to it. There are plenty of nurses arrested for abusing their patients. There are also unfortunate cases where sexual abuse is part of the assault.

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