Different Perspectives on the Mental Asylum: Accusing Each Other?

I finally read the New York Times op-ed by Dr. Christine Montross “The Modern Asylum.” And I also read the comments on it in the letters to the editor section, which tell both sides of the story on mental asylums from people who know a lot about it.

One of the letters was from Dr. Jeffrey Geller, who supports the concept of the modern mental asylum. While you could say he has a conflict of interest because he’s the medical director (among many other positions) of the Worcester Recovery Center and Hospital in Massachusetts, you could say that about any of those whose opinions are influenced by the groups to which they belong.

As a psychiatric hospitalist, I see many of the problems arising from deinstitutionalization that Dr. Montross describes and I see them every day. That’s what led to my posts (here’s one) about Iowa Governor Terry Branstad’s plan to close two of the 4 Mental Health Institutes (MHIs) which looks like it’s moving forward despite the objections of many, despite the petitions, despite the call for a consideration of alternatives (like the Worcester Recovery Center and Hospital) in light of the lack of readiness of privately funded community mental health resources to pick up the slack when the MHI beds close.

My petition is stalled, but then I’ve been through that before.

The different perspectives on the hot button issue of mental asylums sounds like people are accusing each other of being responsible for the mess we’re in.

How do we get around that?




  1. The commentary in the Times combined with the original article by ethics professors, speaks to the “disposition” or “discharge problems”. Those with two or more conditions of mental illness, substance abuse, intellectual disability, medical, or aging issues. These individuals get stuck in the hospital because there is limited or no community resources to address these. As far as community based services, they become a square peg in a round whole. We need to develop better community based programs to reduce length of stay for comorbid conditions. Inpatient and outpatient communities need to work together to let policy makers know the realities faced for these individuals.

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  2. I think the only way out of blaming is to think “Yes/and” not “Either/or.” We need well run, caring psychiatric hospitals and we need a wide range of other services. I pinned this one; https://www.pinterest.com/pin/147141112801939861/

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