What's Wrong With Mental Health

So today, at the psych hospital where I work with adolescents, something interesting happened. A female patient grabbed a staff member, took her keys and threw them across the room to another patient. At the old hospital where I worked, she would have been on the ground in a restraint in no time. She posed a threat to safety AND no one had any way of knowing what she would have done. An added plus is that restraining any 14 year old for a small moment is amazing behavior modification.

The outcome of the scenario was the girl was sent to the quiet room, where she got what she wanted...a nap...and never had to suffer any consequences for her behavior. Seems to be a theme lately...well, always...at this hospital. I don't know how many times I've heard that we can't treat this (affluent, white, spoiled) population that way, because "they expect more." So we have random kids getting up and walking out of group without asking first, no structure, and no set of expectations, rewards and punishments. What is up with that?

I feel like I need to sit the staff down and make them watch Super Nanny. She at least seems to understand that expectations, rewards, and punishments are necessary to teach kids how to become decent, respectful, productive human beings. The staff here seems too busy talking about their crazy weekend, their dog, their kids, or whatever to give a damn if some kid has some boundaries.

Some kids even refuse their family visits. I understand that a large part of a kid's problem sometimes is the parents...but it's the kids with the most supportive, unabusive families that seem to be the most unappreciative of what they have. One girl even wrote that her mother was a horrible mother for taking away her cell phone. What a damn shame.

Yes, I'm cynical. Yes, I'm pissed off. I guess that's what keeps me going in school. I want to get my degree and take these people out of mental health. It's naive and impossible, but I'm going to try nonetheless. Some of you are probably thinking that I'm a barbaric controlling automatron for even suggesting that a 14 year old needs to be restrained. Hmm, I started to qualify my thoughts, but I've decided not to. If you work in mental health, I think you might understand.

Anyway, this hospital is more like a social club than a treatment center. Being on an inpatient unit isn't supposed to be fun, inviting, or warm. It's supposed to be brief, contrived, uncomfortable, and make a healthy individual desire to leave as soon as possible. Not by torture, demeaning acts, or other unhealthy means...but because once someone is on the turnaround from a mental illness, the last place most teenagers would ever want to be is locked up, restricted, and with people who hate generally hate life at the moment that they are in the hospital.

I love teenagers. They are the revolutionaries that will change the world. Directing their fire and energy can give their lives meaning and purpose, a sense of efficacy, and develop a communities next leaders. That's why I find it especially grievious when an adolescent has lost their fire for life. However, the way to fan the flame lies somewhere between legalistic power struggles and loosey goosey boundaries that are never enforced. There need to be expectations that leave room for creative expression. Questioning boundaries, rules, norms, and expectations is healthy and the only way that the status quo will ever change, but teaching kids to do so in a manner that is not detrimental to everyone involved is necessary to prevent their own self destruction.