Saturday, November 20, 2010

Be Careful Whom You Bring Home


Broadmoor Hospital

A recent interview aired on BBC radio Nov. 20, 2010  concerned Broadmoor, a high security psychiatric hospital in England for men. This notorious British hospital has housed numerous dangerous inmates and captured the imagination of the British public since Victorian times.

Dr. Gwen Adshead
The Independent

The interviewer questioned Dr. Gwen Adshead, the unexpectedly mellifluous New-Zealand-raised Psychiatrist and Forensic Psychotherapist (and here is a wonderful example of what is generally meant by the word, I think).

We heard that patients are not admitted voluntarily to Broadmoor. They are admitted when they are considered a risk to society and other people and then are frequently subjected to revisions and reviews.

These risk of violence of these patients is raised by:
1) a paranoid state of mind caused by drinking or drugs
2) anti-social attitudes, they don't like others and see others as a predator on prey
3) the homicidal

She asserted the surprising point: you are most likely to be murdered by a person you sleep with, so be careful whom you bring home.

Broadmoor patients are "survivors of a disaster of which they are the disaster."

Dr. Adshead emphasized there is no direct link between crime and mental illness. At the same time, a causal relationship needs to be looked at in brain scans, how they think, their behavior, how their childhood histories have affected them, their world views and how they regulate negative feelings.

The most common illnesses at Broadmoor are:

1) paranoid schizophrenia
2) major affective (mood) disorders
3) psychotic disorders (loss of contact with reality),
4) borderline (mood) disorders
5) anti-social, callous, cruel attitude to others.

Broadmoor has a further function; it protects the public from homicidal individuals. It's a rehabilitative, restorative, and therapeutic community, according to Dr. Adshead. We are "homo narrans." Humans love to tell stories, and make meaning out of our stories.

 In Broadmoor:
  • 1/3 of patients came from prisons
  • 1/3 were impossible to manage in general psychiatric settings.
  • 1/3 had an incomprehensible natural "element to offend".

The patients and doctors look at diagnosis and treatment options and the fear that brought them there. Treatment options are available; patients come angry, frightened, resistant to treatment. At Broadmoor, they join "a community of the excluded." Everyone needs to be attached to where they feel more secure and can grow, she said,  and most become interested in treatments. Unfortunately, some patients enter Broadmoor nasty, cruel and predatory. Nurses have to work hard and learn not to retaliate.

When asked why she works there, she said that she is interested in why people want to hurt other people, and wanted to work with the best people on the most complicated cases. Dr. Adshead says they way a society treats the least loved members is a measure of the health of a society. She says Broadmoor is giving compassionate, highly skilled treatment, and she said "it's good to be part of it."

Wikipedia says patients stay from six months to thirty years at Broadmoor. Built in 1863, Broadmoor is located in Crowthorne, Berkshire, United Kingdom. Women  patients are housed at Southall. Other famous British psychiatric hospitals are Ashworth in Merseyside, Rampton, in Nottinghamshire and Carstairs in Scotland.

Click here for the interesting podcast interview at BBC.com.

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