A tour of one of Indiana’s remaining Psychiatric Hospitals
The work of the asylum is far from over…
Now that popular culture considers the “asylum” a dirty word, you can Google or YouTube the term “asylum” and find any number of images and articles that promote the idea of the asylum as a spooky, gothic facility in which countless acts of atrocities, misery, and suffering took place within the confines of a decaying structure now the interest of some urban decay project. It is far too easy for the abandoned skeletons left behind to be considered this way.
But the bottom line is that largely underutilized State Hospital grounds sit in the heart of counties where a new psychiatric threat has taken a deadly hold, namely the opioid epidemic, a disease that has claimed the lives of multiple people in Wayne County, where Richmond State Hospital is the 4th largest employer. It is my contention that leadership of the State Hospitals have a moral obligation to help legislators, FSSA officials, and key stake-holders to find solutions to this problem. For even though it was never thought that the populations of State Hospitals could or should ever expand, a problem has presented itself that unfortunately America’s current healthcare system is unable to address. The nature of addiction is such that afflicted persons and families are in a constant cycle of pain. The addiction makes people behave in ways in which, under normal circumstances, they would have considered impossible. These behaviors that are all aimed to feed the addiction leaves the afflicted feeling ashamed of themselves, and increasing their baseline anxiety that can often be a trigger for their relapse. They live through a constant cycle of brief resolve, then relapse, and a roller coaster of acute emergency room overdose visits, short-term detox treatments, abandoned volunteer residential programs, and ongoing legal issues. I am not suggesting that there does not exist those individuals who can end the cycle of their addiction through outpatient resources. This has happened, and shall continue to happen. I am saying that there is a large number who have journeyed so far down the path of their addiction that there is only one opportunity to treat them effectively and to put a huge dent in the addiction epidemic of the country in a way that no one currently offers. Our modern way of treating addiction does not take into account a fundamental point—the environment must be changed in order to effectively treat the addiction.
In my many years of treating persons with substance use disorders, I have seen patients place fake “FOR SALE” signs in front of their property, or even literally move out of state, to avoid the dealers who would try to draw them back in to use. I have seen patients take alternative routes home from work to avoid the liquor store where they would normally purchase their nightly fifth of vodka or bourbon. I have seen patients bury themselves in work, or hobbies, or 12-Step programs, all in an attempt to avoid the cravings at the expense of other areas of their life, such as their marriage. This is all because the addiction literally changes the neurologic structure of the brain over time, and it takes months and even years to reprogram the brain to not rely on the drug for control of internal emotional states. Successful treatment of addiction requires one to “change the brain,” and to do so requires one to “change the environment.”
