It was a hospital facility, yes. However, not all of the patients had mental illness diagnoses -- there were kids who'd been court mandated after convictions for everything from kidnapping/rape to simple possession to running away. The rest of us were pretty clearly psych admits -- several (like me) were post suicide attempt, one had an eating disorder, and at least one had psychosis.
I've made a list of the big things that seemed like The Program --
1. strip searches (I spent time on the adult psych unit before being moved and we were NEVER searched) -- arriving on the unit, after each pass out of the building, and whenever staff felt like it. Our stuff got searched constantly.
2. limited contact with parents -- only if you earned it and only about stuff you were supposed to talk about. Any complaints = manipulating. Crying = manipulating. Stuff about what happened to other patients = breaking confidentiality. It was often hard to know what to talk about. Also, if you'd confessed to something (using drugs/alcohol, being sexually active, being molested, breaking rules at home) on the unit, then you had to tell your parents on their next visit. Forget to do it = no more visits.
3. groups -- which I think was known in The Program as raps and Syanon as The Game. They were almost constant during the day. The longest I can remember were like 4 hours. But we had to confront each other and the confrontee had to listen without responding. We'd say terrible stuff to each other, no use at all. One thing that was different was that we got to speak in group as soon as we started, as long as it was negative. Saying something supportive was "rescuing" and, just for me, they'd make a siren noise like an ambulance. You couldn't leave group once it started. I have a very vivid memory of saying to one kid who told me I was being "gamey", "You know, I don't really need to take advice from someone who molested a little kid." and getting sat on Time Out.
4. Time Out -- this was like a version of OP or seclusion. It came in two fun forms -- chair and room. On chair time out, you got to sit in a hard wooden chair without arms facing a wall for 16 hours a day. The room variation was standing in a corner of an isolation room for 16 hours a day. Every day until staff decided you were working. If you fell asleep or sat on the floor or even acknowledged the presence of the kids and staff around you, you got an extra day tacked on the end of your time. I did 11 days before my doc decided even TO wasn't helping and I needed to move on to paradoxical therapy. Other kids did 30-90, depending on when they got stuck on it and when their insurance ran out.
5. the indefinable "work" -- whatever you weren't doing, apparently. Working was a terrible concept for me (I guess I was slow, like the girl who hasn't talked to her mom in two months). Since I was there for depression, I thought at first it was not trying to hurt myself. Nope. Following ALL of the rules, ALL of the time? Nope. Acting cheerful and feeding back (i.e. verbally abusing other kids) in group? Nope. Confessing everything I ever did wrong? Nope. Making stuff up to confess? Nope. It was like the friggin' GRAIL, this working business. Twenty years later, I'm sure I'm still not working. If the Pope ever canonizes me, Pearce will be there, pointing out that I can't be a saint because I never worked.
6. sick-before-proven-guilty rules -- you know, no showers or using the bathroom by yourself because you might try to kill yourself. No shoelaces, jewelry or belts, ditto. No envelopes or stamps because they might contain LSD. No homemade food, even on Christmas, because your parents might be slipping you alcohol or drugs in it. Plastic spoons if you were on any kind of precaution. If not, you still had to file by a staff member before you put your tray up so they could write down how much you ate and count silverware. Every personal hygiene product screened for illicit substances. And all that stuff had to be kept at the nurse's station, so you had to ask for a Kotex or a tampon, which was really fun because of the
7. constant confrontation by staff and medical professionals -- it was just harassment, day in and day out. Ask for a tampon and the tech would holler across the room "Such and so's on the rag, that's why she's not working today." Ask about a rule and you were manipulating. Bump into something (not unheard of among adolescents) and get ridiculed. Meds time was rough -- I had to take seizure medication twice a day for, well, seizures. If you asked for your meds a second early, you were attention-seeking. If you didn't ask soon enough, you weren't being responsible. Either way, you at least got hassled, if not punished. Best thing was to watch carefully (but not appear to be watching, because that was playing staring games) until someone asked first, then bust your butt to get up there.
Dr. Pearce was the worst one. Other than the day he told me I was going home, I cannot remember a single meeting with him where he was not verbally abusive. I was a baby, I felt sorry for myself all the time, I didn't deserve to have parents who loved me (and they didn't any more, or why was I here), I thought I was in a health spa, I had no valid feelings, I was incapable of being honest, on and on and on. Even the day I was going home, he told me that my insurance had run out and they couldn't keep me so they were sending me home for a week until my court hearing to place me in the state hospital.
8. We had a level system, too. You had to earn a certain number of points before you could move up a level. No one made it past level 3 that I saw, even though there were like 5 levels. Some of the points were for easy, understandable stuff (being on time for group), but most were those amorphic "working"-type things. When you had enough points, you could ask to be moved up a level, but it wasn't certain.
9. Restraints as punishment. Get mad (and who doesn't, after being tormented non-stop for weeks on end) and you get restrained. Oh yeah, they'd tell your parents it's because you were "violent" (and sometimes we were), but there was no chance to settle down. Once you'd slammed your book down on a table, stomped your foot, whatever, you were going to spend some time strapped to a bed. If you didn't shut up at visiting time, you got Haldol. The rest of the time, your screaming was a good lesson to the other patients.
Sorry this is so long, Ginger. I'm sure there's more.
