#I also had drug induced psychosis i think. so- interesting how my therapist was able to parse that. i should text him.

[thetangibleghost]

I gotta confess it is so much more fun talking to Sal as if he is a separate person like he wants and not a member of the system. He's super creative like. Its just fun.

[trans-axolotl]

hey ive only recently learned that antipsychiatry is a thing and im trying to learn more about it. i came across your psych ward post and i totally see your point. and im trying to think about what could be done differently. for example a couple years ago my friend had drug induced psychosis and his friends brought him to a hospital where he then had to stay in the psych ward. especially in the beginning i could tell he hated it there. but at the same time he was having delusions. and unfortunately i just dont know what else couldve been done in that situation to help him. do you think theres a better way to deal with that kind of situation? or would it only be possible to deal with it differently in a totally different world? i hope its ok to ask u this question im just interested in ppls perspective who have personal experience w this

hey, anon! thanks for the ask.

I think it can be really difficult at first to imagine what alternatives to psych wards are when psych wards are all we've ever known. It can feel like the options are psych wards or no mental healthcare at all, which really sucks! But I firmly believe that there are other options, and in fact there are people creating those in the world right now. My answer might get a little long, but I'm going to try to organize my thoughts!

Replacing psych wards is definitely a big task, and is one that requires fundamentally reshaping the entire psychiatric system. Right now, so much of mental healthcare is really entwined with the restrictive, carceral, and oppressive systems of government. Whether it's the fact that most crisis hotlines call the police, that therapists have mandatory reporting laws around self-harm, or incredibly restrictive medication laws that make it difficult for people to actually get the meds they need, almost every area of professionalized mental health is connected to this fucked up structure. Lots of different parts of the mental health care system work together to perpetuate psychiatric incarceration, so it's not just psych wards that are the problem.

Another factor that feels important to me when talking about getting rid of psych wards is addressing some of the factors that push people into psych wards in the first place. There are always going to be mentally ill/mad/neurodivergent people and there are always going to be people in crisis, but I think that if our mental healthcare system wasn't so fucked, that maybe some people would be able to get help before things get to a crisis point for them. If medication was more accessible, if therapy wasn't super expensive, if there is more acceptance and education and resources and communities were better informed about how to support mentally ill people, then maybe not as many people would end up in some types of crisis. We can't talk about getting rid of psych wards without also talking about fighting against racism, colonialism, capitalism, transphobia--the things that are contributing to a lot of people's experiences of crisis.

In terms of actual physical replacements for psych wards, something that I think is really promising is peer respite houses. Basically, peer respite houses offer 24/7 crisis stabilization, staffed by people with lived experiences of mental health. They differ from psych wards in that they are not locked spaces, they are usually in a home-like environment, they are not focused on psychiatric diagnoses, and there's a large focus on trying to eliminate power imbalances between staff and residents. Here's a great link to read more about the mission and structure of peer respite. Here's a link to a mostly current directory of peer respite in the USA. I think peer respite is pretty awesome, and that's definitely something that's on my personal crisis plan for when I get to a crisis point where I cannot stay safe living on my own.

Realistically, psych wards don't really provide treatment, don't really work for many people, and are not really places that you go for healing. When you're at a psych ward, you aren't getting tailored therapy, you often only see a psychiatrist for fifteen minutes once or twice a week, and the stated goal really isn't on healing or treatment. It's on crisis stabilization to get you to a point where you are no longer at risk of harming yourself. And I think peer respite can do crisis stabilization so much more effectively, without locking up people, without giving them huge medical bills, without restraining people or drugging them without consent. There's a lot of peer respites that are connected to outpatient treatments and get people set up with therapy and medication if that's what they need.

I can't really speak to what would or wouldn't have worked for your friend, but I fundamentally believe that mentally ill/mad people deserve the right to our autonomy, and deserve our consent to be respected. It can and does get tricky in cases when people are harming themselves, delusional, or incoherent. However, as someone who has experienced all of those things, that is still not an excuse to just take away people's ability to consent and to lock people up. There are ways to support people who are refusing treatment, don't think there is a problem, or are unable to express their wishes. I could go on about that specific topic for a lot longer haha, but I'm just going to end with the fact that although it can seem like psych wards are the only option, there actually are a lot of people creating community resources as alternatives to psychiatry! We are working on building the different world that we want to see, and even though we are definitely not even close to there yet, there really are so many cool things that people are already doing to support each other.