Treatment of mental illness; the use and misuse of sedation and the seclusion room.

Nine hundred and thirty-nine patients admitted to the locked receiving ward in the psychiatric service of the U. S. Naval Hospital, Oakland, over a ten-month period, many of them psychotic and in an acute initial episode, were treated with an intensive group therapy program, which more appropriately should be called a therapeutic community. During this time, the ward medical officer did not put any patients in a seclusion room. Patients who did not require a locked ward were quickly transferred to the open receiving ward which was established five months after this program began. It was possible to greatly diminish the quantity of sleeping medicine prescribed and practically to eliminate the use of barbiturates given parenterally. Restraints were never used. To be dealt with in this atmosphere of candor and relative freedom seemed to evoke a responsive attitude in the patients and many of them benefited from it.