McLean Hospital, founded in
1811, is the oldest
psychiatric teaching hospital in the
United States. It is located in
Belmont,
Massachusetts,
and is
affiliated with
Harvard University's School of Psychiatry. It is
widely respected in its field, and several local
universities, including
MIT,
Tufts, and
Harvard, have arranged for students with
mental health problems to receive
treatment there. The book and movie
Girl, Interrupted were set at the hospital.
As far as mental institutions go, it is apparently among the better ones from
a patient's perspective. Many people who are admitted against their will
leave with a deep-set hatred of the hospital, but the patients who have
been in and out of institutions around the country
report that appreciation is a matter of perspective. Unlike most institutions,
McLean has very distinct wards for violent and non-violent patients,
and someone suffering from depression is unlikely to wind up receiving
treatment next to someone with schizophrenia or severe psychosis.
Patients are generally treated with some amount of respect, at least in
the non-violent wards, and there are some good programs for
those suffering from post-traumatic stress disorder or severe alcoholism
and related depression. McLean also offers several different residential programs
similar to halfway houses, where patients can live fairly normal lives
while remaining in a protected environment in the evenings and receiving
regular psychiatric care.
The hospital does have its downsides, however. As is to be expected
for a nationally-renowned facility, there are crowding problems. Beds
can have long waiting periods, and sometimes patients with depression or
anxiety disorders can end up in one of the wards oriented towards
psychotic patients until a space is available in the other programs. Some
of the doctors are extremely competent and helpful, but others seem to
take the research hospital idea a little too much to heart. The true residential programs and assisted living environments that McLean offered twenty
years ago have largely disappeared due to modern insurance, and many of
the old campus buildings such as the chapel and recreational facility have
been converted into offices and classrooms.
Patients in McLean are assigned a psychiatrist responsible for determining
their medication and a therapist responsible for talking them through any
non-chemical causes of their disorder. The system has the advantage of not letting therapy slip in favor of drugs, but the now-common practice of
assigning more drugs than strictly necessary is certainly continued there. Few patients leave the hospital without being on at least two and frequently as many as five psychoactive drugs, although it is possible for a very determined patient to decline medication.
For "milder" disorders such as depression or post-traumatic stress disorder, a normal stay is between one and three weeks, though serious cases may take longer. Patients are expected to either move into one of the residential programs or have frequent visits with their psychiatrist and therapist once they leave the hospital, depending on the condition of the patient and what their insurance will cover. Many insurance programs insist that if a patient is healthy enough to not be locked into a safe and constantly monitored environment at all times, then the patient does not require further hospitalization, and a bed in the hospital costs something above a thousand dollars per night, so most patients remain
confined to their wards for the duration of their stay. The high price tag also
can result in delaying tactics on the part of doctors trying to ensure that a patient is properly treated before being removed from the hospital-- it is not unheard of, for example, to have a delay of two weeks before a simple inkblot test can be administered.
For those interested in the research aspect, McLean also administers a wide variety of studies on varying psychiatric disorders and their treatments. These studies are usually not limited to patients within the hospital, and frequently offer free treatment or health care for the duration.