Live data from Hacker News

Intake – American's largest psychiatric chain

buzzfeed.com

31–40 of 105 posts

Re: Intake – American's largest psychiatric chain

#31

I should hope this comes as no surprise to anyone. Every single psychiatrist I've ever visited had the same policy, only their lock was medicine rather than a door (outpatient vs inpatient). I feel bad for the lady because she didn't know any better and joked about suicide, but shouldn't it be common sense you don't tell anyone about that--you don't even joke about it-- especially to a doctor with the power to commit…

It's entirely possible to discuss suicidal ideation with a competent therapist/psychiatrist without being committed.

Re: Intake – American's largest psychiatric chain

#32
post #14

"Current and former employees from at least 10 UHS hospitals in nine states said they were under pressure to fill beds by almost any method — which sometimes meant exaggerating people’s symptoms or twisting their words to make them seem suicidal — and to hold them until their insurance payments ran out." Don't worry, free-market ideologues will coolly tell you. Their logic will seem airtight: over time, if Intake's p…

"Free-market", like many -isms may mean many different things to different people.

However, it seems clear that pressure to profit, pressure to grow fast, to raise ever larger rounds, etc. leads to huge missteps, both in tiny startups and in huge corporations. If you replace "beds" in that quote with "bank accounts" you get the Welles Fargo scandal. Ditto for Theranos. And these are only the very recent examples (that we know of).

Re: Intake – American's largest psychiatric chain

#33
post #29

Earlier quoted context omitted.

I mean, this sounds a lot like criminal kidnapping.

And indeed she reached a settlement with the company which presumably means they were worried about losing a lawsuit or worse.

Why weren't criminal charges pressed? Why is nobody in jail? Holding people hostage is definitely illegal.

Re: Intake – American's largest psychiatric chain

#34
post #29

Earlier quoted context omitted.

And indeed she reached a settlement with the company which presumably means they were worried about losing a lawsuit or worse.

Why weren't criminal charges pressed? Why is nobody in jail? Holding people hostage is definitely illegal.

Because in the US (at least) if the victim won't press charges the police can't take action. And in a case like this the defence will attempt to attack the (alleged, at the time of the trial) victim's credibility, which can be devastating. It's the main reason why rapists so often get away with it. Also why gang members are hard to convict.

Some crimes don't have a legal victim, e.g. murder (victim is dead) or so-called "victimless" crimes (prostitution, drug possession, speeding, etc).

Re: Intake – American's largest psychiatric chain

#35

American asylums are a perfect example of the sin and corruption at the root of American society: dehumanizing and illegal detainment of human beings to preserve power and profits. ... In the 1970s, a researcher sent fake (healthy) patients to asylums. They were loaded with powerful antipsychotics and not allowed to leave until they faked the cures the psychologists expected to see. When the fake patients were all ou…

I can't speak about asylums in the 70s, but I think modern mental health centers have problems, some different, some similar. First is that these tend to be either state-run or contracted, and there is a great incentive to provide the bare minimum of care. There is also a serious issue with organization. My father used to work at some of these institutions. He's a psychologist with a PhD and 20+ years of experience treating the mentally ill. His bosses, who are in charge of running the place and determining policy, had high school educations. The nursing staff, who spent most of the time with the patients, also had high school education (maybe some nursing school education, but usually not). I think we should increase funding for mental health clinics, and put the professionals in charge.

Also, I understand the aversion many people have to even the concept of asylums, but the problem is in the implementation, not the concept. De-institutionalization is great, asylums should be an absolute last resort and many cases can be more easily dealt with in out-patient care or medication. But, absolute de-institutionalization means the mentally ill wind up homeless or in prison.

Re: Intake – American's largest psychiatric chain

#36
post #21

I should hope this comes as no surprise to anyone. Every single psychiatrist I've ever visited had the same policy, only their lock was medicine rather than a door (outpatient vs inpatient). I feel bad for the lady because she didn't know any better and joked about suicide, but shouldn't it be common sense you don't tell anyone about that--you don't even joke about it-- especially to a doctor with the power to commit…

> Every single psychiatrist I've ever visited had the same policy, only their lock was medicine rather than a door (outpatient vs inpatient). I'm confused, are you complaining about psychiatrists forcing medication on people? I thought the entire point of seeing a psychiatrist was to get on medication...

People also go to psychiatrists to be screened for whether they need medication, likely at the recommendation of a therapist.

Re: Intake – American's largest psychiatric chain

#37

American asylums are a perfect example of the sin and corruption at the root of American society: dehumanizing and illegal detainment of human beings to preserve power and profits. ... In the 1970s, a researcher sent fake (healthy) patients to asylums. They were loaded with powerful antipsychotics and not allowed to leave until they faked the cures the psychologists expected to see. When the fake patients were all ou…

I can't speak about asylums in the 70s, but I think modern mental health centers have problems, some different, some similar. First is that these tend to be either state-run or contracted, and there is a great incentive to provide the bare minimum of care. There is also a serious issue with organization. My father used to work at some of these institutions. He's a psychologist with a PhD and 20+ years of experience t…

There's also a problem that the money saved by closing the big institutions wasn't put back into better community (outpatient) care. So people have to be acutely unwell to get any treatment. People with chronic problems don't get the treatment.

Re: Intake – American's largest psychiatric chain

#38
post #34

Earlier quoted context omitted.

Why weren't criminal charges pressed? Why is nobody in jail? Holding people hostage is definitely illegal.

Because in the US (at least) if the victim won't press charges the police can't take action. And in a case like this the defence will attempt to attack the (alleged, at the time of the trial) victim's credibility, which can be devastating. It's the main reason why rapists so often get away with it. Also why gang members are hard to convict. Some crimes don't have a legal victim, e.g. murder (victim is dead) or so-cal…

Kidnapping in the the latter category it does not require anyone to press charges. Assault is the same way as well. If LE has evidence they can move on it. The fact of the matter is prosecutors don't want to risk their win loss ratio.

Re: Intake – American's largest psychiatric chain

#39

Earlier quoted context omitted.

There can be pernicious motives whether a facility is nominally for profit or not. (For instance, say there is a doctor who gets paid in proportion to the time they spend treating patients at a non profit facility)

That's true, but removing the profit motive of the facility removes one major incentive for coordinated, large scale corruption like this. Other incentives (like production-based compensation being gamed by unscrupulous individuals) will have to be dealt with in other ways.

So without profit, the operating metric will be what exactly?

Re: Intake – American's largest psychiatric chain

#40
post #29

Earlier quoted context omitted.

And indeed she reached a settlement with the company which presumably means they were worried about losing a lawsuit or worse.

Why weren't criminal charges pressed? Why is nobody in jail? Holding people hostage is definitely illegal.

And out of all medical patients; Psychiatriatric patients are the least vocal/proactive. Most are just trying to make it through the day. Or, that's what a Psychiatrist once told me.

Taking advantage of patients is not uncommon. I see Psychiatrists/Psychologists abuse their position in society for wealth. It's an art afterall too.

My opinion of the speciality couldn't be lower.

These are just my opinions from being around the system for decades, from Psychologists to Psychiatrists. I'm sure there are good/ethical/moral health professionals out there. So save any santimonious speech. These are just my antidotal observations.

Post reply on HN