They never would have released people based on budget cuts, the hospital gets money based on how many beds they had filled, they would cut staff down to 7 staff to 40 patients or some shit like that. People who were there for suicides would be there for a very short time typically (7-28 days maybe, rarely more than that).
One of the most dangerous patients in the hospital I worked was a 450lb woman who also did shit with her menstral blood / shit. She also knew if she fucking fell on someone their back, knees, or ankles might be fucked for life and HAD fucked multiple staff up for life. The hospital had to have a restraint chair straight up built for this bitch (if you've seen the reality show "Jail" they have a similar one) because the fat on her arms went over her fuckin hands and so she had to be strapped in all along the arms, and she was just so huge.
Probably about 40% or so of the criminally commited patients were pedophiles (and would never be released). The rules/privilege system on the forensic side made their consequences high enough that most would not talk about the sick shit they liked / had done. I think you mostly hold onto the fact that they will never rejoin the public and will die there, and you're a part of keeping that evil from the world.
As far as rehabilitation I think that depends alot on what type of patient we're talking about, however where I worked was more of a stabilization facility or prison. When patients got discharged they would be going to a group home or halfway house type of place before being on their own again. that being said.
- For personality dissorders (antisocial personality disorder = sociopaths / psychopaths, Borderline personality disorder, Narcissistic personality disorder, Histrionic personality disorder, and others, some of which I don't personally believe exist) that shit is a part of the person. The disorder is never going away, for borderline patients the best you could hope for is they live somewhat isolated with a team of caregivers that know how to mitigate the damage they're going to cause. For the majority of the rest it basically comes down to how well they can learn consequence / how well our system of law can impose itself upon them (I'd say they should never be let out personally, the lower IQ ones are never going to stop thinking they can get away with X Y and Z, the smarter ones might actually give up whatever exploitive behaviours they've used but the world has enough problems without them)
-For Mood dissorders I'd say theres the highest degree of rehabilitation / therapy potential, useually with medications on board too. Bipolar dissorder is probably more medication + brain chemistry than anything else, and anxiety dissorder is probably more behavioral therapy than meds (granted people normally need some kind of benzo to get to a level where they can actually make productive attempts at changing their behaviour). This shit is a real mixed bag.
-Schizophrenia I would say is 100% medication, now theres alot of shitty ways our (USA) mental health system deals with this however. (ALSO "A Beautiful Mind" is a fucking garbage piece of shit movie, John Nash Jr. Didn't fucking Mentally alpha his way through hallucinations, second generation anti-psychotics where developed and he chose to take and stay on them, whereas he wouldn't stay on the first generation ones because of how much worse the side effects where) So there are a few things to explain here. One is that first generation anti-psychotics (AKA typical antipsychotics) have a crazy ammount of side effects and those side effects are profound. Patients WILL gain weight, like alot of weight, especially in their gunt. They'll lose like 20-25% of their IQ while they're on them, fine motor control, useually their entire sex drive, they'll probably sleep 12hrs a day, and a bunch of other shit. Second generations (Atypical antipsychotics) Have some of the same side effects but generally a MUCH lower severity. Some of the second-generations have some other benefits (Invega Sustenna is a once a month shot, so a patients social worker / psychiatrist will know long before a patient is going off their meds when they fail to get their monthly shot (said shot being meds for the future, giving time to revoke their LRA (Less restrictive alternative, aka their release agreement) and get their ass back before they do crazy shit.
Another aspect of this is that ALL antipsychotics can cause EPS (extra-paramydial symptoms = ticks / involentary movement) the big dick EPS being a thing called Tardive Dyskinesia. Tardive Dyskinesia is basically an involentary movement that is serpentine in nature (wavy movements I guess), most common being in the lips. TD is essentially PERMANANT, on or off the meds that caused it, apparently theres the potential for that shit to go away like 15 years down the road but idk. Now Doctors used to think that if you took someone off their antipsychotic meds for a period of time and then put them back on them it would eliminate the risk of TD, however it is now known that the opposite is true and it greatly accelerates the development of TD / causes it. This shit is relevant because when you have a person with schizophrenia every time you take them off their meds (OR they stop taking them) or rapidly change them they become more resistant to antipsychotics in general forever. One of the psychiatrists I worked under for about 2 years would use a spring analogy, the mind can bounce back a certain number of times before it breaks and won't ever be sane again. Everything I saw working there lead me to think that was a rather accurate way to describe it. The patients that had been in and out of the hospital, or just in it for decades could never be brought to sanity, and sometimes we would get someone in who had been living a normal life with schizophrenia for 20 or 30 years and they changed to a new doctor and that doctor wanted to change shit up with their meds, caused them to break from reality, and they did some shit to end up at the hospital. Useually those patients would have a very short stay for a schizophrenic and be back out for us to never see them again.
--------- These are just my personal thoughts from working there, I'm not even an RN or anything but thats my take ---------
TLDR:
Execute or imprison the personality dissorders
Mood dissorders need a personal combo of drugs / therapy, maybe no drugs eventually depending on person
Schizophrenics that take their meds consistantly are basically normal people, you literally might know 1 or 2 and not know it. (1 / 100 people has it)
