How I know it is the worse the average inmate, the less activities were offered. While a ward for voluntary anxiety patients will be shiny polished, you'll be greeted, choose your food, get maybe a single room etc. and you'll have a bunch of activities either fixed or selectable, besides of course the ability to leave the ward and to cancel if you decide so, things are a bit different for those who are forced to stay there (and it's pretty easy to be switched from the first to this group). In the university clinic of Jena, Germany was no distraction at all, no books, TV only from 5-9 pm, no exercise room, no walking, and if you wanted something they told you to shut up and let them eat/smoke/have fun because they let you too sit around the time before. Yeah, taking the meds is elementary in those wards, only in the addiction ward of Zuerich (they kick you out after 5-6 weeks because of insurance stuff even if you don't have a place to go, this is a real downside - when I was there two ex-patients camped in the local forest, but otherwise it's among the only places which I could actually recommend) you are free to deny each and any med and the docs don't hesitate to give you the nice stuff (opiates and stims; even Xyrem/GHB titration is offered) if you want it. But when you're on a psychosis or acute station denying the meds is usually a ticket for more of them and possibly by injection, and/or isolation for to torture you rethink your behavior.
Some of the people I saw were seriously and definitely over-medicamented, could barely walk and. slept 23h/day, some had to be forced to shower or eat and according to the majority of sleepy patients again no distraction offered besides one PC for like 18 people and TV in the evenings. At least I was free to go walking if I wanted (limited to 1h/day though). Food was always low quality stuff and I was surprised how good the food was when once I had to spend two days in a regular hospital. They had fresh chicken and vegetables etc. like in a restaurant but in psych ward the food was probably worse than in jail. Hmm, similar when I remember what I got there. They made a competition about the job of supplying food to the ward and selected the cheapest offer (like 2.50$/patient and day if I'm correct). Also the stuff in the wards, from the books over plants to the kitchen's stuff and tables and chairs, most was old and very used. Internet is still a rarity if you don't have a smartphone, and in one place they confiscated the charger of my laptop because one could strangulate himself with it. E-cig wasn't allowed either because of possible drugs in the liquid (I wonder why nobody checks brought-in cigarettes for drugs) but this changes, last time I saw people vaping.
Under the line it's against human rights if you ask me, and specially the nurses and doctors contribute their own bit, out of all the countless nurses I experienced there is exactly one which I remember truly positively and last time she didn't work there anymore, don't know if she or they decided her to leave. The majority is pretty stressed out and some overworked and most pass their mood on to the inpatients. Somehow I found it very irritating when they laughed open- and loudly in their office but reacted negatively to a legitime demand like said charger or to open the door etc. Some doctors, fresh from the university, see the ward as a possibility to experiment with various medicinal cocktails while other use them to experience power and superiority.
