Trigger Warning: (found in hyperlink indicated below) sexual abuse, violence, physical and verbal abuse
I step out of a hot shower and into warm, comfortable clothes. I quietly walk down the hallway, into a room where the news plays on TV. I walk to the bookshelf and choose A Million Little Pieces by James Frey from rows of novels. I take the book to my room and quietly read. I am about four pages in when I hear a knock on my door. My nurse has arrived to bring me my medication.
Years of controversial treatments, mystery induced fear and media misrepresentations have created a cultural perception in Western society that psychiatric institutions are full of padded cells, arm restraints and forced medication injections. There is also a widely held perception of psychiatric inpatients being dangerous and violent.
My experience being institutionalized was vastly different. In late April 2017, I was admitted to the Centre for Addiction and Mental Health (CAMH), in downtown Toronto to be treated for a bipolar manic episode. What was at first scary became positive.
In Western media and popular cultural perception, psychiatric institutions have been portrayed as frightening, confining buildings only for those who are severely ill or dangerous. The location where I stayed first opened as a provincially-run mental health facility in 1850. It was called the Provincial Lunatic Asylum. In 1998, CAMH first formed as part of province-wide efforts to redesign healthcare. One of their four key challenges to address was stigma.
Jennifer Bazar, a curator at Humber College’s Lakeshore Grounds Interpretive Centre, says the average Canadian today still “assumes the worst” when they think about psychiatric institutions. She says that psychiatric institutions evoke fear of the unknown and that, similar to people fascinated with exploring abandoned buildings, there is a sense of mystery behind the closed doors of institutions.
“A lack of understanding perpetuates assumptions,” Bazar says. “Often our minds go to the most radical assumptions.”
Ideas of institutionalization have also been widely popularized by classic films like Silence of the Lambs and One Flew over the Cuckoo’s Nest. Recent adaptations include those in American Horror Story and Pretty Little Liars.
Clark McRorie, a film student at Ryerson University, says these shows and movies traditionally portray psychiatric wards in a negative light. He argues they often include “some form of torture.”
“They use this setting for a horror story vibe, where you see people getting electric shock therapy or drowned in ice water, or being forced to take medication,” he says.
This narrative can lead people to fear psychiatric institutions. But the week I spent at CAMH was one of the most transformative, challenging and positive experiences I have ever had.
CAMH is one of the leading teaching and research institutes for mental health in the world. The morning after I was admitted, a physician gave me a physical examination – an important reminder that healing is both mental and physical. There were scheduled activities throughout weekdays, like art and yoga classes, smoothie-making workshops, access to the fitness center and trips to the gym across the street to play basketball.
I spent my stay writing poetry, relaxing, making friends, but most importantly, I spent time being sick.
Inpatient care felt like the first time I was allowed to be mentally ill, and for that, I was grateful. For years leading up to my stay, I had been denying or trying to justify the emotions I felt, attempting to appear stable for my friends and family. The way people responded to my feelings in inpatient care was different than anything I had experienced before.
One patient saw me upset and said only, “I’m sorry you’re crying, Jessica.” That was all. There was no questioning, no embarrassment and no shame – only understanding. That compassion was one of the most helpful aspects of my stay. I was surrounded by people going through similar things, and had a support team of nurses, medical doctors, dietitians, and psychiatrists who were all there to help us.
Not all institutionalization experiences are like mine. Around the world, some psychiatric institutions are as horrific as some films portray them. In recent years, institutions in (hyperlinks trigger warning) Shanghai and Guatemala had been found to be using the same forced injections and physical restraints seen in popular films. This type of abuse has been found even in California, where a federal review in 2015 found rampant abuse in five mental health institutions.
But the more that we discuss and normalize conversations about institutionalization, the more we normalize our perceptions of what institutionalization should be. This leads to widespread empowerment to challenge abuse as something inherently wrong within the mental health care system.
Curiosity and communication are important in understanding topics like institutionalization. It’s easy to be afraid of the unknown and form opinions based on movies and TV shows. Bazar points out the importance of hearing all sides of the story, recognizing the history and realizing that we must “accept that (the conversation) is uncomfortable.”
Conversations about mental health must be open. We must understand that while some are afraid, there are distinct reasons behind their fear – in this case, decades of misconception and misrepresentation.
McRorie says in recent years, some media representation has shifted. The dehumanization of people with mental illness is less prominent. Characters with mental illness are portrayed less as scary and dangerous and more as real people. This can be seen in movies like Silver Linings Playbook and A Beautiful Mind, where people with mental illnesses are portrayed in a more realistic way.
“We are talking more, and willing to talk more. I think we just have miles to go,” says Bazar.
