they are not substantially better
They have to be better along the "how long were they detained?" axis because for decades there were about 40% less asylum beds than there had been previously. I think it's likely that the underlying thought processes and biases- i.e. normal people looking crazy enough to diagnose if you already think they're crazy- are not significantly different, and that's what most people care about anyway. (Being able to convince a doctor that I'm sane is more important to me than whether it takes 2 days or 19!)
Being able to convince a doctor that I'm sane is more important to me than whether it takes 2 days or 19!
Why is that? That's the case if you need psychiatric certification for a job or a medical procedure or something. But generally, being locked up somewhere people can make you take arbitrary medication is bad, and grows worse over time (medication kicking in and unsafe to quit too quickly, effects of detention, damage to your outside life), whereas a piece of paper telling you to take some medication can be ignored. Is there something I'm missing, like insurance premiums?
I haven't seen any links to this on Lesswrong yet, and I just discovered it myself. It's extremely interesting, and has a lot of implications for how the way that people perceive and think of others are largely determined by their environmental context. It's also a fairly good indict of presumably common psychiatric practices, although it's also presumably outdated by now. Maybe some of you are already familiar with it, but I thought I'd mention it and post a link for those of you who aren't.
There's probably newer research on this, but I don't have time to investigate it at the moment.
http://en.wikipedia.org/wiki/Rosenhan_experiment