No they have not. Not all of them, anyway. The Quackers' asylums are one historical example. More recently, Satoria houses were very successful for the treatment of schizophrenia in the eighties in California, until the financing was cut off. Similar establishments are still successfully functioning in other countries.
-----------
skpsycho (
http://skpsycho.wordpress.com/)
I think you mean soteria, as opposed to satoria, which is similar to Satori, a japanses buddhist word for that "a-ha" experience (often used in Gestalt psychology)
Soteria is an interesting and I think useful concept, but a far cry from evidence that psychosis is treatable from non-pharmacologic means.
http://en.wikipedia.org/wiki/Soteria
As for their efficacy, the abstract below tends to indicate that they're helpful, and a good adjunct, but in no way a replacement for medication for psychosis. furthermore the research supporting the kindling belief of psychosis would tend to support medication for psychosis-- which is of course a theory, but with a decent body of evidence to support it.
Lindgren, Ingrid. Falk Hogstedt, Margareta. Cullberg, Johan.
Institution Neuropsychiatrical Assessment Team, University department of clinical psychiatry southwest, Stockholm County Council, Liljeholmstorget 7, SE-117 61 Stockholm, Sweden.
[email protected]
Title Outpatient vs. comprehensive first-episode psychosis services, a 5-year follow-up of Soteria Nacka.
Source Nordic Journal of Psychiatry. 60(5):405-9, 2006.
Abstract Three years experience of an outpatient unit for first-episode psychosis showed that most of the patients at some point became hospitalized in a psychiatric ward with discontinuity in care as a consequence. Adding "need-adapted" inpatient care in the form of a small and calm crisis home guaranteed continuity in approach and treatment, as the same caregivers staffed the inpatient and outpatient parts of Soteria. Information on early signs of psychosis was given to other units of the psychiatric clinic and to general practitioners. As the organization was considerably changed from that point of time, the patients could be divided into two separate groups. The aim of the present study was to follow the patients in the two groups for 5 years, comparing the outcome. The results showed that easily accessible need-adapted treatment with integrated overnight care might be advantageous for first-episode psychotic patients. The duration of untreated psychosis was shorter and the outcome better.
------------------------
As for your experience on the adolescent ward, I think we can all acknowledge that the system is flawed and that Child/Adolescent psychiatry has more trouble than many.
1. It's way way underserved. CAPS is actually the most underserved medical specialty in the U.S. That means that often the amount of care child/adolescent psychiatrists can offer is almost more like triaging than optimal care.
2. So much of the influence on mental illness in youth is environmental, including but not at all limited to families or poor socioeconomic status (or high SES for that matter). But once they've reached the point of hospitalization, their pathology/problems have often become so deep seated it's hard to manage, as well as then just having to send them back to these terrible home/living environments. This is really a critique of Western
Society, rather than psychiatry. It's like blaming prisons for having too many criminals. That's probably a really crappy analogy on many many fronts, and I don't want to get into the psych hospital-prison discussion or history either. My point is that mental illness is multifactorial, and many of those factors are too often out of our control. So meds are given in the hope that if the kid can survive psychiatrically intact for a while, they can move their way up, not down the functional path of life, and change those other factors that are contributing to their illness. If we had the power to change the entire social system-- which is a larger philosophical discussion, such as should bad parents have children, and should society allow them to knowing what will happen-- and what of the alternatives? Sterilization, which Oliver Wendell Holmes advocated for people with mental ******ation because "three generations of idiots is enough." I by no means advocate that or anything like that. But I think it's somewhat short-sighted to blame psychiatry for over-medicating individuals, even kids who are legitimately suffering and spiralling out of control when sometimes it's the only intervention we have the power to make.
I had a patient recently with mental ******ation that the power screamed at me over and over and over to keep in the hospital and change his meds to control his behavior. He probably shouldn't have been admitted in the first place, but he was acting out at home, breaking things, near violent, and had been treated on the outside with a strong cocktail to attempt to keep him calm. His perspective was that he wanted to move out to an independent living, that he hated being cooped up in the house, and that it drove him "crazy." Unfortunately no ILF would take him while he was violent at home. So I think in that situation a little extra medication is appropriate, as well as counseling him over and over and over again to try to stay calm at home and teach him ways to do that.
Because sometimes medication changes behavior and allows them to get into better social situations that'll help them further in the long run.
Do these meds have side effects? Absolutely. But again in a risk/benefit analysis, I would rather gamble with giving someone a little anxiety than let someone's mental illness (depression, auditory hallucinations, disorganized thinking) get out of control and they end up dead/in jail. Once someone's in a psychiatric hospital, I think more often than not they're so impaired that the benefits of medications far outweigh the side effects.
I see tons of patients with long-term, chronic depression, without clear exacerbating factors, and no single insight or change will improve that. They end up hospitalized, and we do what we can to improve their suffering.
And for some of these people they just need a little hope. They need the expectation that they can get better, and a new medication might offer them that. Sometimes that's the only thing they'll take hope in. And who am I to deny someone hope?
.
And we make less money than the Pediatricians. 
