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55-699: The Maine Insane Hospital , later the Augusta Mental Health Institute ( AMHI ), was a psychiatric hospital in Augusta, Maine . It was the principal facility for the care and treatment of Maine's mentally ill from 1840 to 2004, and its surviving buildings represent the oldest surviving complex of mental care facilities in the United States. The complex is located on the east bank of the Kennebec River , immediately south of

110-574: A physician , nurse , optometrist , dentist , veterinarian , or other health care provider . The word patient originally meant 'one who suffers'. This English noun comes from the Latin word patiens , the present participle of the deponent verb , patior , meaning 'I am suffering,' and akin to the Greek verb πάσχειν ( paskhein , to suffer) and its cognate noun πάθος ( pathos ). This language has been construed as meaning that

165-404: A business relationship. In veterinary medicine , the client is the owner or guardian of the patient. These may be used by governmental agencies, insurance companies , patient groups, or health care facilities . Individuals who use or have used psychiatric services may alternatively refer to themselves as consumers, users, or survivors . In nursing homes and assisted living facilities,

220-568: A controlled environment due to their psychiatric condition. Patients may choose voluntary commitment , but those deemed to pose a significant danger to themselves or others may be subject to involuntary commitment and treatment . In general hospitals, psychiatric wards or units serve a similar purpose. Modern psychiatric hospitals have evolved from the older concept of lunatic asylums , shifting focus from mere containment and restraint to evidence-based treatments that aim to help patients function in society. With successive waves of reform, and

275-459: A decade, medical errors are even more likely to happen in a doctor's office or outpatient clinic or center. A day patient (or day-patient ) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used by psychiatric hospital services using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However,

330-513: A number of institutions specializing only in the treatment of juveniles, particularly when dealing with drug abuse, self-harm, eating disorders, anxiety, depression or other mental illnesses. In the United Kingdom, long-term care facilities are now being replaced with smaller secure units, some within hospitals. Modern buildings, modern security, and being locally situated to help with reintegration into society once medication has stabilized

385-445: A resident physician . At the beginning of the 19th century there were a few thousand people housed in a variety of disparate institutions throughout England, but by 1900 that figure had grown to about 100,000. This growth coincided with the growth of alienism , later known as psychiatry, as a medical specialism. The treatment of inmates in early lunatic asylums was sometimes very brutal and focused on containment and restraint. In

440-527: A time, though this practice still is periodically employed in the United States , India , Japan , and other countries. Modern psychiatric hospitals evolved from, and eventually replaced, the older lunatic asylum. Their development also entails the rise of organized institutional psychiatry . Hospitals known as bimaristans were built in the Middle East in the early ninth century; the first

495-578: Is called ambulatory care . Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is called outpatient surgery or day surgery, which has many benefits including lowered healthcare cost , reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limited urinary-tract , eye , or ear, nose, and throat procedures and procedures involving superficial skin and

550-494: Is called inpatient care . The admission to the hospital involves the production of an admission note . The leaving of the hospital is officially termed discharge , and involves a corresponding discharge note , and sometimes an assessment process to consider ongoing needs. In the English National Health Service this may take the form of "Discharge to Assess" - where the assessment takes place after

605-612: Is far less risk of patients harming themselves or others. In Dublin , the Central Mental Hospital performs a similar function. Community hospitals across the United States regularly discharge mental health patients, who are then typically referred to out-patient treatment and therapy. A study of community hospital discharge data from 2003 to 2011, however, found that mental health hospitalizations had increased for both children and adults. Compared to other hospital utilization, mental health discharges for children were

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660-540: Is still registered, and the provider will usually give a note explaining the reason for the visit , tests , or procedure / surgery , which should include the names and titles of the participating personnel, the patient's name and date of birth , signature of informed consent , estimated pre-and post-service time for history and exam (before and after), any anesthesia , medications or future treatment plans needed, and estimated time of discharge absent any (further) complications . Treatment provided in this fashion

715-557: Is widely known for his comprehensive critique of the use and abuse of the mental hospital system in Madness and Civilization . He argued that Tuke and Pinel's asylum was a symbolic recreation of the condition of a child under a bourgeois family. It was a microcosm symbolizing the massive structures of bourgeois society and its values: relations of Family–Children (paternal authority), Fault–Punishment (immediate justice), Madness–Disorder (social and moral order). Erving Goffman coined

770-663: The Home Secretary can, under various sections of the Mental Health Act, order the detention of offenders in a psychiatric hospital, but the term "criminally insane" is no longer legally or medically recognized. Secure psychiatric units exist in all regions of the UK for this purpose; in addition, there are a few specialist hospitals which offer treatment with high levels of security. These facilities are divided into three main categories: High, Medium and Low Secure. Although

825-1173: The Isle of Man , and the Channel Islands , medium and low secure units exist but high secure units on the UK mainland are used for patients who qualify for the treatment under the Out of Area (Off-Island Placements) Referrals provision of the Mental Health Act 1983 . Among the three unit types, medium secure facilities are the most prevalent in the UK. As of 2009, there were 27 women-only units in England. Irish units include those at prisons in Portlaise, Castelrea, and Cork. Psychiatrist Thomas Szasz in Hungary has argued that psychiatric hospitals are like prisons unlike other kinds of hospitals, and that psychiatrists who coerce people (into treatment or involuntary commitment) function as judges and jailers, not physicians. Historian Michel Foucault

880-521: The mental patient liberation movement . There are several different types of modern psychiatric hospitals, but all of them house people with mental illnesses of varying severity. In the United Kingdom , both crisis admissions and medium-term care are usually provided on acute admissions wards. Juvenile or youth wards in psychiatric hospitals or psychiatric wards are set aside for children or youth with mental illness. Long-term care facilities have

935-399: The 1973 academic investigation by Rosenhan and other similar experiments , several journalists have been willingly admitted to hospitals in order to conduct undercover journalism . These include: Patient A patient is any recipient of health care services that are performed by healthcare professionals . The patient is most often ill or injured and in need of treatment by

990-747: The Insane Hospital; Maine State Archives File – Box 86, Folder 25). From 1841 to 1845, psychiatrist Dr. Isaac Ray served as the hospital's superintendent. In that role Ray was one of the original thirteen founding members of the Association of Medical Superintendents of American Institutions for the Insane . Names: Maine Insane Hospital (1840); Augusta Insane Asylum (date of this change, unknown); Augusta State Hospital (1913); Augusta Mental Health Institute (AMHI) 1973; Riverview Psychiatric Center (2004) Numerous buildings and new wings were added over

1045-507: The aggression of some of the patients. In Western Europe , the first idea and set up for a proper mental hospital entered through Spain . A member of the Mercedarian Order named Juan Gilaberto Jofré traveled frequently to Islamic countries and observed several institutions that confined the insane. He proposed the founding of an institution exclusive for "sick people who had to be treated by doctors", something very modern for

1100-421: The center of a series of connected buildings, they were built in 1836–40 to a design by Hallowell architect John Lord. To these were added stepped wings (in keeping with the then fashionable Kirkbride Plan ) in the 1850s and 1860s; these were designed by Francis H. Fassett , with later alterations designed by George M. Coombs . In the 1880s, when "pavilion housing" prevailed as the preferred method for housing

1155-589: The center, and especially that patients themselves are heard loud and clear within health services. There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct. Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect', that are difficult to capture with institutional monitoring. One important way in which patients can be placed at

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1210-627: The centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible. Incidents, such as the Stafford Hospital scandal , Winterbourne View hospital abuse scandal and the Veterans Health Administration controversy of 2014 have shown the dangers of prioritizing cost control over the patient experience. Investigations into these and other scandals have recommended that healthcare systems put patient experience at

1265-959: The condition are often features of such units. Examples of this include the Three Bridges Unit at St Bernard's Hospital in West London and the John Munroe Hospital in Staffordshire . These units have the goal of treatment and rehabilitation to allow for transition back into society within a short time-frame, usually lasting two or three years. Not all patients' treatment meets this criterion, however, leading larger hospitals to retain this role. These hospitals provide stabilization and rehabilitation for those who are actively experiencing uncontrolled symptoms of mental disorders such as depression, bipolar disorders, eating disorders, and so on. One type of institution for

1320-477: The difficulty of distinguishing sane patients from insane patients. Franco Basaglia , a leading psychiatrist who inspired and planned the psychiatric reform in Italy , also defined the mental hospital as an oppressive, locked, and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents. Patients, doctors and nurses are all subjected (at different levels) to

1375-516: The east by Hospital Street and the west by the Kennebec River , which separates the hospital from the state capitol complex. The National Historic Landmark Kennebec Arsenal , a former federal military facility, lies just to the north, and the modern complex of the Riverview Psychiatric Center is located just to the south. The hospital complex is a sprawling collection of buildings, most built of brick or stone, dating from

1430-510: The extremities). More procedures are being performed in a surgeon 's office, termed office-based surgery , rather than in a hospital-based operating room . An inpatient (or in-patient ), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as with coma or persistent vegetative state , patients can stay in hospitals for years, sometimes until death . Treatment provided in this fashion

1485-399: The focus in these units is to make life as normal as possible for patients while continuing treatment to the point where they can be discharged. However, patients are usually still not allowed to hold their own medications in their rooms because of the risk of an impulsive overdose. While some open units are physically unlocked, other open units still use locked entrances and exits, depending on

1540-545: The fore in the 1960s has opposed many of the practices, conditions, or existence of mental hospitals; due to the extreme conditions in them. The psychiatric consumer/survivor movement has often objected to or campaigned against conditions in mental hospitals or their use, voluntarily or involuntarily. The mental patient liberation movement emphatically opposes involuntary treatment but it generally does not object to any psychiatric treatments that are consensual, provided that both parties can withdraw consent at any time. Alongside

1595-554: The former Kennebec Arsenal , and now primarily houses state offices. In 2004, the hospital was replaced by the Riverview Psychiatric Center , located just to the south. The hospital's core complex was listed on the National Register of Historic Places in 1982, with the listing enlarged to encompass the entire campus in 2001. The Maine Insane Hospital is located on Augusta's east side bounded on

1650-667: The goal of treatment and rehabilitation within a short time-frame (two or three years). Another institution for the mentally ill is a community-based halfway house . In the United States, there are high acuity and low acuity crisis facilities (or Crisis Stabilization Units). High acuity crisis stabilization units serve individuals who are actively suicidal, violent, or intoxicated. Low acuity crisis facilities include peer respites, social detoxes, and other programs to serve individuals who are not actively suicidal/violent. Open psychiatric units are not as secure as crisis stabilization units. They are not used for acutely suicidal people; instead,

1705-527: The hospital's founding in 1840 to the mid-20th century. On March 8, 1834, the legislature passed resolve to establish the Maine Insane Hospital by the appropriation of $ 20,000 upon condition that a like sum be raised by individual subscription within one year. Before the expiration of the time limit, Hon. Reuel Williams of Augusta and Hon. Benjamin Brown of Vassalboro contributed $ 10,000 each for

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1760-413: The introduction of effective evidence-based treatments, most modern psychiatric hospitals emphasize treatment, usually including a combination of psychiatric medications and psychotherapy , that assist patients in functioning in the outside world. Many countries have prohibited the use of physical restraints on patients, which includes tying psychiatric patients to their beds for days or even months at

1815-429: The introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment; and further, they attempt—where possible—to help patients control their own lives in the outside world with the use of a combination of psychiatric drugs and psychotherapy . These treatments can be involuntary. Involuntary treatments are among the many psychiatric practices which are questioned by

1870-410: The late 19th and early 20th centuries, psychiatric institutions ceased using terms such as "madness", "lunacy" or "insanity", which assumed a unitary psychosis, and began instead splitting into numerous mental diseases, including catatonia, melancholia, and dementia praecox, which is now known as schizophrenia . In 1961, sociologist Erving Goffman described a theory of the " total institution " and

1925-751: The lowest while the most rapidly increasing hospitalizations were for adults under 64. Some units have been opened to provide therapeutically enhanced Treatment, a subcategory to the three main hospital unit types. In the UK, high secure hospitals exist, including Ashworth Hospital in Merseyside , Broadmoor Hospital in Crowthorne , Rampton Secure Hospital in Retford , and the State Hospital in Carstairs , Scotland . In Northern Ireland ,

1980-542: The many 'pauper lunatics'. Nine counties first applied, the first public asylum opening in 1812 in Nottinghamshire . In 1828, the newly appointed Commissioners in Lunacy were empowered to license and supervise private asylums. The Lunacy Act 1845 made the construction of asylums in every county compulsory with regular inspections on behalf of the Home Secretary , and required asylums to have written regulations and

2035-477: The mental institution may be used for the incarceration of political prisoners as a form of punishment. One notable historical example was the use of punitive psychiatry in the Soviet Union and China . Like the former Soviet Union and China, Belarus also has used punitive psychiatry toward political opponents and critics of current government in modern times. In the United Kingdom, criminal courts or

2090-415: The mentally ill is a community-based halfway house . These facilities provide assisted living for an extended period of time for patients with mental illnesses, and they often aid in the transition to self-sufficiency. These institutions are considered to be one of the most important parts of a mental health system by many psychiatrists , although some localities lack sufficient funding. In some countries,

2145-406: The mentally ill, a number of smaller outlying buildings were added, based on a master plan developed by Francis Fassett in the 1870s. The pavilion housing plan proved uneconomical for the large numbers of patients, and dormitory-style buildings were built, combining patient wings, housing for workers, and an administrative hub. The campus also includes a number of utilititarian service buildings, and

2200-425: The patient has gone home. Misdiagnosis is the leading cause of medical error in outpatient facilities. When the U.S. Institute of Medicine 's groundbreaking 1999 report, To Err Is Human , found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year, early efforts focused on inpatient safety. While patient safety efforts have focused on inpatient hospital settings for more than

2255-538: The phrase "Maximum Secure" is often used in the media, there is no such classification. "Local Secure" is a common misnomer for Low Secure units, as patients are often detained there by local criminal courts for psychiatric assessment before sentencing. Run by the National Health Service , these facilities which provide psychiatric assessments can also provide treatment and accommodation in a safe hospital environment which prevents absconding. Thus there

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2310-443: The process by which it takes efforts to maintain predictable and regular behavior on the part of both "guard" and "captor", suggesting that many of the features of such institutions serve the ritual function of ensuring that both classes of people know their function and social role , in other words of " institutionalizing " them. Asylums as a key text in the development of deinstitutionalization . With successive waves of reform and

2365-616: The project, believing fresh air and removal from the stresses of society were important for patient care. Dorothea Dix Psychiatric Center (DDPC), Riverview’s sister hospital, is named after this early advocate for Maine’s mental health services in Maine. Dr. Cyrus Knapp was the first Superintendent of the Hospital (12/28/1840 Report on the Warrant in Favor of Dr. Cyrus Knapp, Superintendent of

2420-515: The purpose. Subsequently Mr. Brown offered as a site 200 acres of land on the Kennebec in the town of Vassalboro which the legislature accepted, but which was not considered a suitable location, and the land with Mr. Brown's consent was sold by the state for $ 4,000, and the more suitable site in Augusta was purchased with $ 3,000 of this money. Mental health advocate Dorothea Dix was a consultant on

2475-430: The role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in shared decision-making about their care. An outpatient (or out-patient ) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance

2530-456: The same process of institutionalism. American psychiatrist Loren Mosher noticed that the psychiatric institution itself gave him master classes in the art of the "total institution": labeling, unnecessary dependency, the induction and perpetuation of powerlessness, the degradation ceremony , authoritarianism, and the primacy of institutional needs over the patients, whom it was ostensibly there to serve. The anti-psychiatry movement coming to

2585-472: The term resident is generally used in lieu of patient . Similarly, those receiving home health care are called clients . The doctor–patient relationship has sometimes been characterized as silencing the voice of patients. It is now widely agreed that putting patients at the centre of healthcare by trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction. When patients are not at

2640-570: The term " total institution " for mental hospitals and similar places which took over and confined a person's whole life. Goffman placed psychiatric hospitals in the same category as concentration camps , prisons , military organizations, orphanages , and monasteries. In his book Asylums Goffman describes how the institutionalisation process socialises people into the role of a good patient, someone "dull, harmless and inconspicuous"; in turn, it reinforces notions of chronicity in severe mental illness. The Rosenhan experiment of 1973 demonstrated

2695-457: The term is now also heavily used for people attending hospitals for day surgery. Because of concerns such as dignity , human rights and political correctness , the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used include health consumer , healthcare consumer , customer or client . However, such terminology may be offensive to those receiving public health care , as it implies

2750-459: The time. The foundation was carried out in 1409 thanks to several wealthy men from Valencia who contributed funds for its completion. It was considered the first institution in the world at that time specialized in the treatment of mental illnesses. Later on, physicians, including Philippe Pinel at Bicêtre Hospital in France and William Tuke at York Retreat in England, began to advocate for

2805-482: The type of patients admitted. Another type of psychiatric hospital is medium term, which provides care lasting several weeks. Most drugs used for psychiatric purposes take several weeks to take effect, and the main purpose of these hospitals is to monitor the patient for the first few weeks of therapy to ensure the treatment is effective. Juvenile wards are sections of psychiatric hospitals or psychiatric wards set aside for children with mental illness. However, there are

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2860-649: The viewing of mental illness as a disorder that required compassionate treatment that would aid in the rehabilitation of the victim. In the Western world, the arrival of institutionalisation as a solution to the problem of madness was very much an advent of the nineteenth century. The first public mental asylums were established in Britain; the passing of the County Asylums Act 1808 empowered magistrates to build rate-supported asylums in every county to house

2915-507: The years to the Hospital campus. By 1920, the total area of the hospital property, including the farm and grounds, was approximately 600 acres, of which 450 acres were under cultivation. Patients worked on the farm and in the laundry. The buildings are reflective of changing trends in the treatment of the mentally ill over that period of time. The oldest portions of the complex are known as the Administration and Stone Buildings. Now at

2970-622: Was built in Baghdad under the leadership of Harun al-Rashid . While not devoted solely to patients with psychiatric disorders, early psychiatric hospitals often contained wards for patients exhibiting mania or other psychological distress. Because of cultural taboos against refusing to care for one's family members, mentally ill patients would be surrendered to a bimaristan only if the patient demonstrated violence, incurable chronic illness, or some other extremely debilitating ailment. Psychological wards were typically enclosed by iron bars owing to

3025-636: Was landscaped to provide an attractive environment to the patients. The complex remained in continuous use until 2004, when the Riverview Psychiatric Center went into operation. As the patient population declined in the 20th century, spurred in part by changing trends in treatment methods, elements of the complex were repurposed to other uses, primarily state offices. Psychiatric hospital Psychiatric hospitals vary considerably in size and classification. Some specialize in short-term or outpatient therapy for low-risk patients , while others provide long-term care for individuals requiring routine assistance or

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