LSD in a Coercive Milieu Therapy Program

1977 ◽  
Vol 22 (6) ◽  
pp. 311-314 ◽  
Author(s):  
E.T. Barker ◽  
M.F. Buck
Keyword(s):  
Mental Hospital ◽  
Medical Model ◽  
Great Benefit ◽  
Street Drugs ◽  
Milieu Therapy ◽  
Maximum Security ◽  
Therapy Program ◽  
Patient’S Perception

Over a five-year period, thirty patients in a maximum security mental hospital were treated with LSD (500 mcmg. I.M.). Three different styles of interviewing procedure evolved with experience: a medical model, a “responsible street model”, and a non-directive model. The interviewer's orientation appeared to significantly affect the patient's perception of the LSD experience. Since it was felt by the authors that no one set of biased inputs has any demonstrable merit over any other, (except in satisfying the interviewer), the non-directive model was deemed most reasonable. Although all patients reported that the experience was of great benefit, no one else could see changes for better — or worse. Chromosomal studies showed the usual increased frequency of breaks. It is noted that cytogenetic experts do not now see this finding as a contraindication to the use of the drug. It was not thought that the LSD administration in hospital was a significant factor leading to use of street drugs after release. The only difference on administration to psychopaths and schizophrenics was that one-third of the psychopaths (6 of 18) acted out by punching or kicking at someone nearby. When used with the safeguards described, the drug seemed safe and valuable to use in our communities of long-stay patients, because of the high morale engendered.

scholarly journals The Total Encounter Capsule

1977 ◽  
Vol 22 (7) ◽  
pp. 355-360 ◽  
Author(s):  
Elliott T. Barker ◽  
Alan J. McLaughlin
Keyword(s):  
Health Centre ◽  
Role Playing ◽  
Bench Mark ◽  
Liquid Food ◽  
Milieu Therapy ◽  
Maximum Security ◽  
The Social ◽  
Mental Health Centre ◽  
The Many ◽  
And Function

For the last nine years, groups of patient volunteers in the Social Therapy Unit of the maximum security section of the Mental Health Centre at Penetanguishene have been making regular use of the Total Encounter Capsule. The Capsule is a specially constructed, soundproof, window-less, but continuously lighted and ventilated room, eight feet by ten feet, which provides the basic essentials — liquid food dispensers, washing and toilet facilities — and in which it is possible for a group of up to seven patients to live for many days at a time, totally removed from contact with the outside. It functions as a place of undisturbed security where a small group of voluntary patients can focus upon issues they feel important enough to warrant the exclusion of the usual physical and psychological distractions (including staff), in a setting where the risks of suicide or homicide that might attend extremely intense personal encounters are at a minimum. The many ways in which groups of patients have used this facility are reviewed and the problems of researching the effectiveness of the program are discussed. Included in the paper is an overview of the historical development of all the intensive coercive milieu therapy programs at Penetanguishene so that the purpose and function of the Capsule can be seen in context. Designed initially as an attempt to overcome the problem of the escapist role-playing of the articulate psychopath, the greatest value of the Capsule is now seen more importantly as the way in which it provides a brief, very intense, but safe experience for a patient to look forward to or back upon as a bench mark during a lengthy stay in hospital.

Drugs and Motor Activity in Chronic Schizophrenia

1969 ◽  
Vol 115 (524) ◽  
pp. 851-856 ◽  
Author(s):  
Ivor H. Jones
Keyword(s):  
Mental Hospital ◽  
Drug Effect ◽  
Chronic Schizophrenia ◽  
Substantial Contribution ◽  
Therapeutic Action ◽  
Chronic Patients ◽  
Milieu Therapy ◽  
Hospital Patients ◽  
Moral Therapy ◽  
Better Than

The therapeutic optimism which accompanied widespread introduction of milieu therapy has now been tempered, but there is still little doubt that it makes a substantial contribution to the treatment of the chronic schizophrenic. Much the same has been said about drug treatment. However, Hordern and Hamilton (1963) suggested that the results obtained with phenothiazines were no better than the findings of those pioneers who introduced moral therapy over a century ago. They further claimed that reports of a beneficial drug effect came from those places where resources were most meagre. If their view is correct it may mean that drugs and certain environmental factors have a therapeutic action in common on chronic mental hospital patients. These chronic patients, who are in large part schizophrenics, usually show the symptom of volitional defect more prominently than any other single symptom. It is possible therefore that both moral therapy and drugs may be acting primarily on this symptom. The present experiments aimed at examining this proposition.

Repetitive and Non-Repetitive Violent Offending Behaviour in Male Patients in a Maximum Security Mental Hospital – Clinical and Neuroimaging Findings

1997 ◽  
Vol 37 (2) ◽  
pp. 150-160 ◽  
Author(s):  
Michael Wong ◽  
Peter Fenwick ◽  
George Fenton ◽  
John Lumsden ◽  
Michael Maisey ◽  
...  
Keyword(s):  
Mental Hospital ◽  
Suicide Attempts ◽  
Positive Family History ◽  
Violent Offenders ◽  
Conduct Problem ◽  
Violent Behaviour ◽  
Maximum Security ◽  
Violent Offending ◽  
Positron Emission ◽  
Eeg Abnormalities

Objective: To examine if different violent offending behaviours are associated with different clinical and neuroimaging profiles. Method: Thirty-nine schizophrenic and schizoaffective offenders from a maximum security mental hospital – 20 repetitive violent offenders (RVOs) and 19 non-repetitive violent offenders (NRVOs) – were selected for clinical and neuroimaging assessments. Results: Both groups had positive family history of mental illness and violence. Age, diagnosis, duration of illness, victim profiles and use of weapons at the time of the index offence were similar. RVOs had a higher prevalence of early parental separation, juvenile conduct problem, previous convictions of crimes not involving violence, impulsive suicide attempts, delusion of their lives being threatened at the time of the index offence and electroencephalographic (EEG) abnormalities localized to temporal lobes. NRVOs had a higher prevalence of sexual inexperience and command hallucinations to kill at the time of the index offence. Asymmetric gyral patterns at the temporo-parietal region were particularly common in RVOs and absent in NRVOs. Non-specific white matter changes in magnetic resonance imaging (MRI) and generalized cortical hypometabolism in positron emission tomography (PET) were present in both groups. Conclusions: Different structural and metabolic changes in the brain were associated with different violent offending behaviours. The complex interaction between violent behaviour, clinical features and neuroimaging findings in schizophrenia requires further studies.

Schizophrenics Remanded to the Forensic Psychiatric Institute of British Columbia, 1975–1990

1994 ◽  
Vol 34 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Jeanette Smith ◽  
Faye Grant ◽  
Phil Brinded
Keyword(s):  
British Columbia ◽  
Mental Hospital ◽  
Psychiatric Treatment ◽  
Psychiatric Evaluation ◽  
Psychiatric Institute ◽  
Maximum Security ◽  
Fitness To Stand Trial ◽  
Schizophrenic Patients ◽  
Schizophrenic Group ◽  
Forensic Psychiatric

Clinical and legal data were collected on 1265 schizophrenic patients remanded to a maximum security hospital, for psychiatric evaluation of fitness to stand trial. Schizophrenics accounted for over half of the remand population. When compared to the non-schizophrenic group, they had more previous admissions to the Forensic Psychiatric Institute and the Provincial Mental Hospital. They were also more likely to be found unfit to stand trial or to have their charges stayed by the Crown. However, approximately half of the schizophrenics in this study returned to Court, fit to stand trial and with no further psychiatric treatment provided. This study raises major questions about the purpose and value of remanding schizophrenics to a maximum security hospital for in-patient fitness evaluations.

Acute wards: problems and solutions

2002 ◽  
Vol 26 (10) ◽  
pp. 383-385 ◽  
Author(s):  
Jeremy Holmes
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Hospital ◽  
Community Psychiatry ◽  
Therapeutic Community ◽  
Milieu Therapy ◽  
Shared Space ◽  
Creative Therapies ◽  
Problems And Solutions ◽  
Acute Wards

There has been a curious linguistic shift in the use of the word community in mental health (Holmes, 2001a). In the 1950s and early 1960s community psychiatry was synonymous with milieu therapy and the therapeutic community – that is, the attempt to create a vibrant community of patients and staff, in a shared space, working actively together to overcome disability, illness and stigma. The contrast was with insitutional psychiatry, caricatured as the silent, soulless and, at times, abusive wards of the Victorian mental hospital. The therapeutic community had two main psychotherapeutic tools: group therapy and creative therapies such as art therapy and psychodrama. These approaches were pioneered in specialist units such as the Henderson hospital (Norton & Haigh, 2002) but, more generally, progressive acute units emphasised the use of ward groups and the importance of patients playing an active part in decision-making.

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