No, I’m not talking about the old school, abusive asylums where anybody and anyone who didn’t do what they were told got banged up for life and locked up in cages.
I’m talking about long term residential, secure facilities for those experiencing chronic psychosis. Schizophrenia and Bipolar (who experience psychosis) lend themselves to this particularly.
I’m not sure where the disconnect is, but we have to stop expecting people experiencing severe, chronic, psychotic mental illness to function as a regular and functioning member of society. It doesn’t help anyone. We don’t expect people with Alzheimer’s/ dementia to remember medications, appointments, how to dress, what to say, work. We understand they’re implicitly not capable.
A person suffering from a mental illness that causes life long, chronic psychosis is the same. It’s no good telling them to just ‘try harder’, go to appointments, take medication. They haven’t got capacity - without guidance or care, they’re not going to be able to do this consistently, if at all. ‘Care in the community’ is not fit for these patients. The impact of unchecked psychotic illness is severe. It doesn’t just pose major risk to the person, but inadvertently others around them. The care required in terms of monitoring/ psychological support/ safeguarding is too extensive for many family and friends.
I’m saying this as a person with long standing psychotic bipolar, before anyone gets up my ass. The demands/ expectations placed on us to work, function, maintain, perform, manage are unreasonable and not feasible. Were taken into hospital for short term stays, kicked back out and expected to go back to work next Monday. Drive. Pay bills. Take medication. Make multiple appointments whilst working. Shamed for not working.
Long term facilities need to be brought back.