Psychiatric Decisions

In the article, “Ambivalence Toward Constraint: The Disposition of Front-Line Clinicians”, Paul Brodwin discusses the conflict between providers of psychiatry and how they must make difficult decisions. Dealing with mental illness can be especially challenging due to the fact that there is not one correct solution. Young residents struggle with doing what they think is best for their patients while knowing that their choices will affect their lives profoundly. Brodwin outlines the issue many residents face of making choices based on their patient’s personality or on their mental illness, which can blur together very easily. When working with a patient, the person in charge of their treatment must leave all personal feelings aside in order to make the most objective decisions. The question that has been unanswered for years is what is the level of psychiatric power over patients and when does it become not okay? Another major issue at hand is the use of restraint and isolation. In the US, we have decided that locking a person in a small room and restraining them can have beneficial effects but there is still a question on the effects is has a person who is already in a bad mental state.

In a sociology course I took, I read of an experiment where people with no mental problems were admitted to psychiatric hospitals to test if the staff would realize they did not truly need help. In the Rosenhan experiment, twelve people were admitted and only one patient was discovered to be completely fine. This study correlates with the article I read because the experiment proves that working in psychiatry is extremely difficult as it takes a lot of training and quick judgment to try to make the best decisions in a given situation. People in this field try to make the best and most ethical decisions but there has been much controversy on the way psychiatric hospitals are run in the United States.