Shit rolls downhill; profits roll up. Source: fellow nurse.

My psych unit is having a pretty severe pants-in-the hall deficiency tonight and I’m definitely not getting paid enough for any of it.

Yes that’s ideal. I would argue most of the “lost causes” you’re describing are victims of the current system and we owe then something akin to long-term secure units until they’re sick enough of the restrictiveness of even a non-abusive containment system to put in the work to recover, but that’s semantics. At the end of the day everywhere should be doing it like that and housing and rehabbing these people, emphasis on the housing since it’s a prerequisite to the rehab.

Yeah. And they’re volunteering to risk something that’s at least horribly traumatic and at worst just a straight up human rights violation because they don’t have any better places to go and that’s by design.

No that’s 100% exactly what I’m talking about because no one should be going to psych hospitals for any of those things, and the fact that we’ve not allocated the resources to treat those things in the community (which would actually be cheaper) is the entire failing of that “deinstitutionalization” movement. It was supposedly going to be a whole movement where we shifted to community care models but they never actually allocated proper funding for that so it became just another way to fuel the prison industrial complex.

I’ve never even worked a psych hospital that did proper 1:1 talk therapy on the regular. I as a nurse working a 12h shift with 6-8 patients and also being responsible for equipment checks, groups, checking on all my patients at least hourly etc am often the closest thing some of these people get to a therapist. At the absolute MOST most of those things should be being treated at a CSU which is a type of voluntary stepdown unit that usually has 1 nurse on-site continuously and that does a cursory belongings search and NO body searches. Most of them function like rehabs but do other mental health services as well as detox. I shouldn’t be being asked to strip search depressed people, but I also can’t risk one of them being dumb enough to bring a proper sharp or ligature onto my secure unit for people who genuinely can’t be trusted not to shank or garotte a bitch. Ffs one time the ER just didn’t even check at all and an actively psychotic pt rolled onto the unit with a loaded fucking gun in their bag that my tech just happened to find during a routine belongings search and I’ve found all kinds of other weapons on people. My unit is tightly controlled for a reason and most people receiving psychiatric care don’t need it and therefore should never gave to experience it.

Almost none of the people you’re describing should be setting foot on even the classier units I’ve worked, and they wouldn’t have to if proper community resources like medication management, talk therapy, and even CSUs were more available. I remember reading at one point that there was like one psychiatrists office serving like half of Montana at one point. The lack of those services (and particularly the lack of adequate insurance reimbursement for those services - those professionals still need to feed and house themselves and their families) are a very intentional component of this fucked up orphan crushing machine.

Doesn’t shock me tbh. The “deinstitutionalization movement” was a fucking joke all they did was dump people out on the street so they could use their 0 community living skills to go get their mental Healthcare from prison instead, and now that people are getting sick of being screamed at on the street by homeless schizophrenics on drugs (not like there’s anything better for them to do) they want them locked up again so they can make health insurance companies money instead of doing literally anything to actually heal their communities. I have an entire nursing theory and set of practices just for this specific population because we’ve just completely fucked so many of them up, probably most of them permanently. And I’ll say it until I’m blue in the face but housing is the #1 driver of the American mental health crisis. They joke about “what radicalized you” and it’s 8 fucking years of working in psych hospitals even when I’m proud of the care I’m giving just watching the system as a whole is killing me. What I do should be considered ICU level psych care for that handful of people who are actually actively psychotically tweaking so why are all of the units I work mostly full of not even depressed but just understandably sad homeless people?

I feel like this is something I knew but didn’t know was something that had actually been studied. I’ll tell a lot of science concepts and stories from history and mythology that normally bore people but I’ve always had a habit of telling them “drunk history” style so I’ll be telling people shit like,“And they didn’t invite discord to the party because why the fuck would you but you also can’t just not invite her because that’s how you piss a bitch off.” and “and Paris, being a dumbfuck who doesn’t know how to think with his upstairs brain-” and honestly I was already somewhat like that but spending a bunch of my formative years on tumblr really honed it.

I’m never sure if my difficulty integrating with those communities is because they are by nature diffuse or because after having to go to FCA camps as a kid and sing hymns off projector screens that were just re-written country songs about Jesus instead of ford pickup trucks I not only can’t take any religion seriously but specifically and actively refuse to. My higher power commands that I shitpost. I actually got into an argument online with someone insisting that I was doing it wrong (also they were accusing me of being transphobic which is another community I don’t get on with because the surgery is and forever will be the only part of my gender I have ever taken seriously).

Honestly this discussion also highlights the issue that what’s considered inappropriate varies widely and often changes both in terms of prejudice and in terms of context. Most people would agree that an image of a penis entering or inside of a vagina is pornographic unless it’s a medical diagram laying out the anatomical and physiological aspects like the one in the anatomy book my otherwise puritanical parents let me read at the age of six. Most people would agree that nudity is sexual except for, again, anatomical diagrams, but also many classical artistic depictions such as paintings and statues. Hand holding isn’t generally considered sexual except to some people if the people happen to be of the same sex but not if you come from a culture where hand holding is a normal level of intimacy for non sexual friends. Breasts are for some reason considered sexual in most of the areas heavily colonized by people from the places where lactose tolerance past childhood evolved but not most other places which is super handy if you like being able to feed infants. Most people agree that kissing for an extended period while rubbing areas close to the genitals is sexual, but often not enough to restrict it from being viewed by teenagers.

TLDR; what’s even considered “sexual” or “porn” can vary wildly and has historically been used to suppress education, various minorities, and general freedom of expression.

Christian esotericism has been a really relaxing segue into a healthy spirituality for me. There’s no people demanding I pray the “correct” way or give them money they won’t tell me what they’re doing with or telling me that saying a dead guy’s name will keep me from going to an eternity no one can prove exists. Just me and the dead guy’s words that tell me to party hard and chase rich people with whips. And tarot cards; I’ve honestly gotten more out of them than therapy lately because I’m a lot more honest with myself but I still get something similar to a third party opinion on things by sort of bouncing the thoughts outward then back in.

That was the whole purpose of tumblr so yeah. I kid, as I did get started on there at like 14 as a part of various Fandoms, but by the time I was 18 I had been using it for porn for quite some time, largely because fandom is also mostly for porn.

Psych specializing in charges

In addition to my above comment I’ll add specifically on response to this question: I’ve noticed that in addition to Maslow’s hierarchy of needs, people specifically need to feel as though they are in control of getting those needs met in some way. And this can be different for each individual depending at the very least on what they’re physically capable of, but also what they can cognitively and emotionally manage. I suspect this is because if you didn’t cause it to happen, then that means it’s being controlled by some outside force, which means it can just as easily stop happening.

So in addition to having food, a house, etc, you have to feel as though you, at least in some small way, caused yourself to have food and a house. And this can even manifest in someone causing unsafe situations, especially if that need has consistently been unattainable, because they still won’t have whatever it is, but at least they then feel as though they have control over it. You see this all the time with personality disorders (I should know, I’ve got one that took 3 years of therapy to get under control), but the level of dysfunction described here is… extreme to say the least.

This particular type of problem in this article is usually caused by dysfunction the esteem/respect level of needs. When you can’t cause yourself to be respected, you cause yourself to be feared. And because being feared is a fundamentally unstable system (most victims will start standing up for themselves eventually and at least in some small way), it can escalate very quickly and often even before the people directly involved realize what’s happening. It also tends to be very difficult to undo and return to a place of positive esteem because the person has lost the trust of those around them.

And fundamentally, as with any problem of this nature, the person themselves has to take a leading role in their own recovery, and by the time you’re this deep in, that’s very unlikely to happen. I was just cutting myself to get people’s pity and yelling / bucking up at people who upset me as a young adult and it still took me three years of wholeheartedly engaging in literally the most intensive therapy that exists to get to the level of functioning I’m at now; this is… a little farther down the rabbit-hole.

They’re also likely doing it to the monkeys because the consequences are lighter than doing it to humans (not that that makes it more or less ok). Note that they want to see them in diapers and bottle-fed, which is not something monkeys typically do. Specifically, I suspect that while the acts are likely illegal, possessing the media itself probably isn’t, while it very much would be if it was a human child.

I used to work on a unit for men with charges, so we often got men who could not be placed on the coed unit next door. One time when we had a particularly high number of men on suicide watch, a member of administration came to investigate why we had so many. I informed him that many of them were due to sexual misconduct; they would engage in self-injurious behavior so that they would have 1:1 observation assigned, which is a task mostly done by nursing assistants. Because Healthcare is largely female dominated and nursing assistant is often a role for less experienced workers or those in school, most of the nursing assistants were female and in their early 20s (if not 18-19). They then had a young woman to masturbate to that would literally be fired if they lost line of sight.

These observations were also usually ordered by a male doctor who wanted to play it safe rather than risk his medical license on one of them being willing to actually off themselves when he could have ordered the observation. I typically managed this by making sure to assign a male staff member, (and in particular the gassy one when possible since he preferred sitting to rounding anyway), but I wasn’t always on shift to make those assignments and often even when I was there were only female staff members on duty and the best I could do was assigning the bitchiest middle aged woman possible, but I digress.

The admin guy wanted to know if they were somehow misguided enough that they thought this would be sexually appealing because some fucking how the (as it turned out) director of psychiatry for the hospital didn’t have the perspective to understand that that was just the closest they could get to regularly raping someone without consequences (I will give him the grace of understanding that he was not and likely never was a forensic psychiatrist).

TLDR; what they can “get away with” is definitely a factor here. This isn’t them getting off on the most extreme thing possible. They would do worse / more illicit if they could.

It’s not even the "needs help themselves aspect. That screws them, they say most psych nurses are crazy too, it’s whether they’ve done the work on it, and I think you’d find similar levels of low competence from somebody who just didn’t pay enough attention in school (AND they wouldn’t have the life experience to know what they’re talking about).

Yeah to me I see it as the commoditization / paywalling of normal human supportive interaction. Therapy should be there to supplement normal supportive relationships when they’re unavailable to you or you have a large enough stressor in your life that they’re inadequate to help you manage.

I don’t like the idea of moving towards a society where it’s just expected that most truly supportive interactions have a strict professional-client paid relationship instead of a naturally ebbing and flowing give and take between two friends who are close enough. To me that just feels like capitalism further encroaching into my life by tallying up the worth of every interaction I have so they can demand their cut.

I’m already seeing a therapist for my existing severe mental illness through one of those online gig style therapy services because that was the only place I could find any openings, and they’re already taking their cut that way. I can’t imagine choosing this if I wasn’t already someone who had been hospitalized several times. Difficulty sustaining stable interpersonal relationships is literally a key hallmark of my disorder, and if I was better at it I’d much prefer it! (I’m working on it, LOL).

Well I’m night shift so it’s while I’m sleeping. But they can’t just give you a day off either because that would also just solve the real issue. Not that therapy is never necessary, but having worked in mental health 8+ years now, 90% of the time 90% of people just need a damn day off (often more than one). Traumas and chronic dysfunctions will absolutely always exist, but we really need to stop focusing (as much) on the “everybody should go to therapy” side and much more on the “what the fuck are we doing to all of these people that all of them need so much therapy???” side (spoiler: It’s too much work for too little pay, and the rent, as always, is too. damn. high.).

I’m wouldn’t interpret that word choice in terms of intrinsic human value, I would interpret it as a facet of class warfare. Mate selection isn’t even the only way in which social status screws men over; we don’t send rich people’s sons to the front lines of the wars they start either. Actually now that I think about it I wonder if those things are related; the bourgeoisie playbook has always heavily featured using masculinity as a way to push men towards violence for their own benefit. It used to be killing people in other countries, and now it’s shifted more towards keeping people scared to step out of line in their homelands (although it’s always been at least a little bit of both, and moves in waves). They need us to want to kill each other in some way or other, this is just one facet of that strategy. I forget who it was recently that actually said (a little too publicly) that if they don’t get us all back under control soon they’ll never be able to send us to war again.

What a coincidence!

Well the patients and families use them too and insurance doesn’t reimburse for hospital acquired infections so a patient catching something from the hospital means their care gets put down as money the hospital won’t get back.

It’s more,“please don’t put the thing you put in people’s digestive systems into the food dispenser; that’s disgusting.” People have caught c-diff, vre, h-pylori, and the vowel hepatises from improperly cleaned GI-scopes.