Experiences of patients hospitalized during the Texas mental health scandal.

TOPIC. The impact of psychiatric hospitalization on children and adolescents hospitalized during the Texas mental health scandal. METHODS. Content analysis of archival data and in-depth interviews. FINDINGS. subjects (N = 19) voiced complaints about the stigma resulting from the hospitalization as well as lack of individual care, violations of personal boundaries, ineffectual outcomes, permanent disruption to family relations, separation from family, trauma of seeing others restrained, and being restrained themselves. CONCLUSIONS. Unnecessary psychiatric hospitalization has long-term ramifications for children and adolescents in terms of self-view, family, and social relationships. Key words: Child psychiatry, mental health, psychiatric hospitalization, qualitative studies Little comprehensive or systematic research has been conducted on the experiences of the psychiatric hospitalization of young people (Schwartz, 1989) or the long-term memories and sequelae associated with such hospitalizations under the best of circumstances (Crespi & Ivey, 1987). Specifically, there has been no attempt to address the experiences of youngsters and families affected by the scandal involving widespread hospitalizations of patients during the mid-1980s and early 1990s at a time when the psychiatric hospital industry ran amuck and afoul of the law. This study was conducted to examine the experiences of these former patients as they look back on their hospitalizations during this time. This article (1) discusses the sociopolitical context of the scandal, (2) presents the major complaints by former patients and their families, and (3) reports the outcomes of in-depth interviews conducted with patients and families. Background No study results can be understood without an awareness of the greater context and some of the history within which the events under study are embedded. The events surrounding the for-profit psychiatric hospital scandal occurred during a time described by Phillips (1990) as "a glorification of capitalism, free markets, and finance" (p. xvii). Wall Street firms expanded in a newly deregulated environment, and the focus of collective corporate management narrowed to an intense profit orientation. Company and executive incentives and bonuses were based on the profit margins they generated, and the frenetic pace of financial activity was reflected in the short-term perspective adopted by top executive offices. Quarterly earnings replaced long-term strategic planning as a focus of scrutiny. Together with a nonstop pressure to produce, "too often ... little attention [was paid] to methods employed" (Johnson, 1992, p. 237). As mass media sources reported insider trading and other scandals, Wall Street executives denied that financial markets were infected with serious and fundamental ethical problems, attributing each emerging scandal to "just a few greedy kids" (Bruck, 1988). America's spiritual leadership became tarnished by corruption as well, justifying a "Gospel of Prosperity" with Biblical justification for their enterprises (Reichley, 1985). Television evangelists founded vast empires and lived in luxury, flexing their political clout and influence with the Republican administration. By the end of the 1980s, however, many of them began to self-destruct amid scandalous and sensational allegations of sexual indiscretions, hush money, and misuse of church funds (Hadden & Shupe, 1988). Corruption and abuse of office characterized President Ronald Reagan's administration as scandals emerged at the Postal Service, Environmental Protection Agency, Federal Aviation Administration, Agriculture Department, Health and Human Services Department, Pentagon, and at least 13 other federal agencies (Johnson, 1992). In addition, ethical misconduct tainted the president's most valued associates at the highest levels of government (Johnson). Against this background, American medicine underwent a transformation. …