Restricted Freedom: Understanding Control in Both Psych Wards and Prisons

Restricted freedom refers to the limitations or constraints placed on an individual's autonomy, often within institutionalized settings such as psychiatric wards and prisons. In these environments, individuals experience varying degrees of control over their movements, behaviors, and personal choices. These restrictions are typically justified by concerns for safety, treatment, or punishment. While these measures are intended to protect both the individuals within the institution and the broader community, they often come at a significant psychological cost. Let's explore how restricted freedom is implemented in psychiatric hospitals and prisons, the rationale behind these restrictions, and the psychological impact they can have on individuals:

Psychiatric wards, or mental health facilities, are designed to provide treatment and care for individuals with severe mental health disorders. The restriction of freedom in these settings is often seen as necessary for both the safety of the patients and the safety of others. For example, individuals experiencing acute psychosis, severe depression, or suicidal ideation may be placed under constant observation or even confined to a locked unit to prevent harm to themselves or others. These restrictions might include limited movement, supervised activities, and strict visitation rules.

Someone was assigned to watch me around the clock. 24 hours a day. Being watched made me insanely paranoid.

In some cases, patients may be involuntarily committed to a psychiatric facility due to the perceived danger they pose to themselves or society (like me). The movement of patients within the ward may be carefully monitored, and certain privileges, such as unsupervised outdoor time, may be contingent on behavior or progress in treatment. While these measures are meant to ensure safety and prevent harm, they can also contribute to a sense of powerlessness and a loss of personal autonomy, which can exacerbate symptoms of anxiety or depression. Losing autonomy and feeling powerless were already pieces we were dealing with, yet placing us in these facilities only emphasized our loneliness.

In prisons, the restriction of freedom is explicitly tied to the concept of punishment.

Incarceration removes an individual's ability to move freely, make personal decisions, or engage in many activities they would otherwise have access to in society.

The primary purpose of these restrictions in prisons is to serve as a deterrent to criminal behavior, to maintain order within the facility, and to ensure the safety of both the prisoners and the guards.

Prisoners often experience limitations in many aspects of daily life: they may be confined to cells for long periods, have restricted access to visitors, and have limited control over when and what they eat, when they sleep, or what activities they can participate in. Additionally, prisoners may face additional restrictions depending on their behavior or security classification (which are all the case with psychiatric wards as well). High-security prisoners may have even more stringent limitations, such as solitary confinement, which involves isolation for 23 hours a day.

These restrictions are intended to maintain order and safety but can lead to significant negative effects on the mental health of prisoners. The harsh environment of imprisonment, especially in overcrowded or poorly maintained facilities, can contribute to stress, anxiety, depression, and, in some cases, a loss of identity or purpose. Long-term incarceration, particularly with prolonged solitary confinement, can lead to severe psychological damage, including symptoms similar to post-traumatic stress disorder (PTSD).

The restriction of freedom, whether in psychiatric hospitals or prisons, has profound psychological effects. In both settings, individuals experience a loss of control over their lives, which can lead to feelings of helplessness, frustration, and anxiety. The constant surveillance and lack of privacy are also major sources of stress, contributing to a heightened sense of vulnerability.

In psychiatric wards, patients may feel infantilized or stigmatized due to their lack of control over basic aspects of their daily routines. This can lead to a sense of demoralization, as patients may internalize the belief that they are incapable of managing their own lives or that their condition defines their entire identity. Furthermore, the lack of autonomy can hinder recovery, as patients may not feel empowered to engage actively in their treatment or make decisions about their care.

Similarly, prisoners often experience feelings of anger, despair, and a diminished sense of self-worth due to the harsh and often dehumanizing conditions they face. The lack of privacy, forced routines, and limited access to meaningful activities or relationships can lead to social withdrawal, aggression, or mental health issues like depression and anxiety. The experience of isolation, especially in solitary confinement, can exacerbate these effects, leading to severe psychological trauma.

Over time, the prolonged restriction of freedom can also affect an individual's behavior. For instance, individuals in psychiatric wards may become more passive or withdrawn if they feel that their input into their treatment is irrelevant. In prisons, prisoners may develop maladaptive coping strategies, including aggression or disengagement, as a response to the constant stress and lack of personal agency.

The key challenge in both psychiatric hospitals and prisons lies in balancing the need for safety and security with respect for individual autonomy. While the restriction of freedom may be necessary to prevent harm, whether due to mental health issues or criminal behavior, it is essential that these restrictions do not unduly harm the individual’s sense of agency or mental well-being.

In psychiatric wards, creating an environment that fosters a sense of autonomy within the limits of safety is important for patient recovery. Providing patients with choices and involving them in decisions about their treatment can help preserve their dignity and support their mental health. Similarly, in prisons, reforming the penal system to emphasize rehabilitation and the restoration of autonomy, such as through education, vocational programs, and improved conditions, can reduce the negative psychological effects of incarceration.

Ultimately, both psychiatric hospitals and prisons must find ways to respect the humanity of those within their walls, ensuring that safety does not come at the expense of mental health or personal dignity. Effective treatment, rehabilitation, and restorative justice models that consider the psychological needs of individuals can provide a more humane and effective approach to these institutional settings.