Asylum: Psych Wards and Mental Hospitals in EP

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jKaiser jKaiser's picture
Asylum: Psych Wards and Mental Hospitals in EP

Yup. This is gonna be a cheery one.

Mental health is essentially the only health measures that matter long-term for most characters in Eclipse Phase, but a cursory re-read didn't give me much insight into what the recovery options actually look like. And I don't mean the recovery options mechanically. I mean, what do mental health wards, simul-asylums, mental hospitals, and so on actually look like in Eclipse Phase, and in various locations across the system?

And building off that, how can those be twisted into something fitting a horror game?

My reasoning for that is pretty simple and two-parts: as someone who has had a lot of stays in various mental facilities, there's always been a perverse fascination with them for me, and they're a very potent setting for drama in any game where mental health is a factor. The kick off is that it's a chance for very hard challenges to be faced that serve as a break from the usual sort of gameplay you'd see in EP. Being institutionalized -- and have it go wrong -- is a fantastic way to explore a character's psyche and vulnerabilities, bring in more sinister conspiracies, or just hammer in the grimdark to your heart's content if you happen to have read/seen One Flew Over the Cuckoo's Nest recently.

A few things that occur to me for what these would be like, though I very much want to open it up to in-depth discussion. For simplicity, I'm calling every location that serves the purpose of healing Stress Damage by the umbrella term of an "Asylum." I know it's not accurate for things like outpatient mental health clinics, counselors offices, etc., but it's simpler and helps evoke the mood I'm going for. I'm operating under the assumption that most people will view reverting to a backup as a last resort or will not have the option to do so.

Asylums are common across the system, often attached to resleeving clinics and backup banks as a matter of course. Mental health is going to be very much more in the public consciousness due the proximity of the Fall chronologically and the constant decanting of people from Dead Storage throughout the main population hubs. Everyone knows someone who knows someone with PTSD at least. (Really sobering to think about...)

You cannot have purely simulspace asylums. If someone incurs significant stress while in a physical morph, needing to resleeve into an infomorph puts them at risk of continuity and alienation failure, which, if they're close to the 2x LUC limit, is a serious threat to their existence. And in-universe (and in reality, honestly), major changes to someone already stressed out is a bad idea in general.

Those asylum simulspaces cannot be time accelerated all the time. At bare minimum, they need to be at realtime to mitigate risks with any psychosurgery.

More of the decorations would need to be realspace in the physical asylums rather than AR, to again, mitigate the risk of compounding characters with dissociative, schizoid, psychotic, or otherwise compromised perceptions of reality. As a corollary, these spaces would need to be as big as habitat size and funding allow.

While mental health practices have had a century and some to mature, the sheer amount that EP can do with the brain, and the explicit statements that the brain remains at least partially blackboxed and dangerous to work with mean that asylums may be more efficient and effective, but they are by no means near a panacea for many mental illnesses or traumas.

Many of these locations are going to be corp-funded. Cognite is a big name in brain matters of all sorts, but minicorps specializing in mental health care are likely, particularly on otherwise self-sufficient habitats.

For the good Asylums, I'm envisioning the Eclipse Phase version as avoiding the white walls that are probably common anywhere AR skinning is standard, instead favoring the best physical decoration in the "calming and safe" spectrum possible. (Horror seed: overdoing this gets unsettling and frustrating very quickly). There are probably a good lot of Ayahs staffing these places, likely run by humanities AGI (though with human [or uplift, where applicable] staff too, for again the reasons of reality discernment complications above) (Horror seed: AGI/AI complications/hacking). It goes without saying that these are places absolutely forbidding weaponry or armor, and dangerous/combat morphs suggest to me that there would be at least a handful of speciality wards ("Dr. Connors, to the Reaper Wars, please, Dr. Connors..."). Physical asylums (and simulspaces modeled after them) probably share the same basic layout we have today, with rooms for patients, common rooms, exercise chambers, counseling rooms, general purpose rooms, etc.

I'm honestly unsure what differences to expect in various parts of the system. Inside Venus-Sol, it's probably pretty sparse and barebones like everything else is. Venus and Titan are probably the shining stars of mental health care, though Titan in particular has to be strained to the limit or beyond by the sheer number of souls being resurrected there. Earth orbit/Luna/Earth-Sol, if you have a decent job, you probably have access to good healthcare in general, and the proximity to Earth and the number of reinstantiated means that there's at least a huge demand for mental health care. I dunno. Most of the LLA and PC are easy to typecast as being corrupt and evil and uncaring, but even if you want to go with that, the goodwill PR and potential loyalty payoff toward ensuring people get the help they need is potentially pragmatic enough even there. Even if you have a much lighter PC or LLA (or whoever, really), someone has to provide funding and train personnel, so the corps are, as always, going to be the variable there.

I actually think Jupiter would be pretty good in terms of at least attempting to provide for its own. Say what you will about xenophobic facism, but there's a strong "care for your own" mentality there, and the real question to me is less about intent and more about space and equipment concerns.

The Autonomists...well, if you're on extropia and have a mental breakdown and don't have some kind of contractual safety net, good luck. Communalist/collective autonomists are amusingly closer to Jupiter in this case, being less a question of intent and more of practical ability (their smaller typical populations also raise staffing/resource questions). It would be interesting to see how one's rep score reflects a mental breakdown or similar.

Urthdigger Urthdigger's picture
As a boring aside, all the

As a boring aside, all the games I've participated in had the muses use their psychology skills to repair mental stress whenever there was downtime. Since probably 90+% of the population has muses, that'd render such institutions meaningless.

I wonder how one would go about making it have an impact to where mental health practices ARE needed beyond "spend a couple hours in time-accelerated simulspace.

uwtartarus uwtartarus's picture
A psychosurgeon takes a fork

A psychosurgeon takes a fork of the person, uses time accelerated simulspace (no need for infomorphs), repairs the stress, and then the fork/ego is resleeved into the body, minor stress but not a lot because it is the same morph, boom! Mentally healed?

Or so I would guess. Otherwise, lots of counseling from the Muse constantly.

Exhuman, and Humanitarian.

jKaiser jKaiser's picture
I'm sure muses help, but I

I'm sure muses help, but I don't buy that they render places of help meaningless, and it's explicitly stated in the mental health rules that psychotherapy takes time and dedicated specialists. AI are mentioned as an afternote, so I don't believe muses are the panacea. And you still need to earn a living during that downtime, which significant stress and disorders can render impossible.

And tme-accelerated simulspace isn't something you can rely on for severely traumatized people. I'm not talking standard lucidity damage from hunting an exhuman hive, I'm talking characters, PC or NPC, who are severely mentally troubled who need a safe place. Eclipse Phase is explicitly a horror setting. Horror dies if the mental scars that fuel so much fiction and nightmares is as easily taken care of as "my muse is helping me out."

Besides. Who does the muse call when their owner is behaving irrationally and self-destructively because of a severe mental breakdown?

jKaiser jKaiser's picture
Corebook 215 wrote: Stress is

Corebook 215 wrote:
Stress is trickier to heal than physical damage. There are no nano-treatments or quick fix options (other than killing yourself and reverting to a non-stressed backup). The options for recuperating are simply natural healing over time, psychotherapy, or psychosurgery.

Emphasis mine. There are creative treatments, but again, no panacea.

Corebook 215 wrote:
Psychotherapy is a task action, with a timeframe of 1 hour per point of stress, 8 hours per trauma, and 40 hours per disorder. Note that this only counts the time actually spent in psychotherapy with a skilled professional.

Emphasis mine. And again, I'm not talking "damage taken during a typical game session." PCs are a cut above the majority population as it is, or at least that's my assumption by dint of them being defaulting as Firewall operatives. The majority of people aren't as resilient or have that kind of resource network.

Corebook 229-230 wrote:
Each psychosurgery option lists a Stress Value (SV) that is inflicted on the subject regardless of the tests’ success or failure. If the psychosurgeon achieves an excellent Success (MoS 30+), this stress is halved (round down). If the psychosurgeon rolls a Severe Failure (MoF 30+), the stress is doubled. Alternately, a Severe Failure could result in unintended side effects, such as affecting other behaviors, emotions, or memories. If a critical success is rolled, no stress is applied at all. If a critical failure is rolled, however, an automatic
trauma is applied in addition to the normal stress. Some psychosurgery conditions may also affect the SV, as noted on the Psychosurgery Modifiers table.

And pulling from that table, simulspace acceleration is a -20/+2 penalty. That's not insignificant. That's something a psychosurgeon is going to be very cognizant if someone with severe trauma or disorders comes their way.

I also don't see forking/merging as being a good choice due to the aforementioned time commitments potentially resulting in significant divergence...and if you can heal the fork, why not heal the original mind? It's also mentioned [275] that you need psychotherapy for bad merges anyway. Also:

Transhuman 159-160 wrote:
If a fork has been separate enough to improve new or different skills, gain or lose traits, or even change their aptitudes, those differences are normally lost during merger as only the memories are prioritized for retention. It is possible for a gifted psychosurgeon to also transfer the skill, trait, or aptitude development, however, but not without cost.

EDIT: crap, meant to edit my last post. Sorry for the double.

uwtartarus uwtartarus's picture
I meant that the

I meant that the Psychosurgeon took the mind out of the morph (like resleeving), and then using Psychotherapy without the ego being sleeved or active, operating on it, undoing the damage, and then putting the now saner ego back into the body. So there wouldn't be any merging, though continuity would be the hour out, the hour in, and the time between, which would be when the Psychosurgeon would want to use Time Acceleration, but the patient ego would not be active during this process, so no infomorph sleeving or time acceleration stress. The Time Acceleration stress I assume is for when an ego uses a simulspace (which is used regardless of morph I though, sort of a VR-coma), and does a Task Action like Programming, sort of condensing a month of labor in 30 hours in VR. During that time the ego takes stress. Or the Psychosurgeon himself would take stress for using TA but not the ego he is healing.

But you make good points about Muses not being the best solution, just a temporary one maybe?

EDIT: oh psychosurgery done with TA is more stressful and penalized. Got it. Still reduces the Continuity stress?

So sounds like psych facilities would be useful.

Exhuman, and Humanitarian.

jKaiser jKaiser's picture
My read on it is that muses

My read on it is that muses are akin to your best friend who has a B.A. in psychology but no practicing licence; they know enough to be a huge help and ensure you're never alone, but they have hard limits on what they can do, both practically and likely legally. And a muse can't physically restrain someone or help them open a tube of comfurt if their hands are shaking too badly. Or give them a much-needed hug. All these things require someone else to call.

This is actually giving me ideas for specialist muses and morphs. The latter being a heavily modified version of the Freeman or something (or an Eidolon equivalent, pragmatically speaking), with mind-comforting implants/software for long-term psychological care.

uwtartarus uwtartarus's picture
I need to design hugging case

I need to design hugging case morphs with a skin mask for AI to sleeve into... later some horrors when these AI get hacked.

Exhuman, and Humanitarian.

jKaiser jKaiser's picture
Looking at the stress chart,

Looking at the stress chart, "witnessing a psi-epsilon sleight" sent a chill down my spine. You literally saw reality change before your eyes in a lot of cases. Imagine how hard it is to get that out of your head in the EP universe, where so many things are convincing AR.

uwtartarus uwtartarus's picture
jKaiser wrote:Looking at the

jKaiser wrote:
Looking at the stress chart, "witnessing a psi-epsilon sleight" sent a chill down my spine. You literally saw reality change before your eyes in a lot of cases. Imagine how hard it is to get that out of your head in the EP universe, where so many things are convincing AR.

The WILL x 3 roll, the sanity mechanic likely represents the ability of the transhuman mind to hide from the truth. Success versus such an exposure likely means "it is probably just an AR illusion, or my mind playing tricks on me, don't think about it."

But that makes me think of the reverse, having AR illusions horrifying enough to cause SV. How do we stat those up?

Exhuman, and Humanitarian.

ShadowDragon8685 ShadowDragon8685's picture
Well, I would imagine that it

Well, I would imagine that it depends on where you are.

In the Planetary Consortium/LLA/Morningstar Alliance?
Are you rich?
Congratulations, the very best psychiatrists, psychologists, psychosurgeons, spiritualists, religious icons, quacks, frauds, and lunatics are at your disposal. Depending on which of that list you choose to visit, you may even be able to get fixed! If you're too brainblasted to choose wisely but not sufficiently brainblasted to be declared mentally incompetent and have someone else choose for you, you may just make matters worse.

You're not rich? Are you poor?
You're not poor?
Welp, I have good news and I have bad news for you. The good news is that you can pay for the mental healthcare you need to patch your mind up from the horrors of the Fall. The bad news is that it is going to break you, and your all-new financial woes will give you entirely-new forms of stress, what with the threat of being forced to indenture yourself or sell your morph looming high over your head like the Sword of Damocles.

You were poor, or getting mental healthcare while not-rich made you poor?
Wow, looks like you picked up a case of the brianfuck there, buddy. Can you still think straight enough to sort files without stegangraphically encoding your baggage into them? You can? Then I have the solution for you, buddy: Indenture yourself for a year or two's work, and we'll pay for a barely-qualified shrink to do the bare minimum required to file the paperwork saying that you're showing improvement!

Too brainfucked for that?
Got a backup left from pre-brainfuck you? Well, time to instantiate and indenture him and delete yourself.

No old backup?
Back into cold storage with you, we'll bring you out on the 31st of February when we've become a charity and can pay to fix your brainpan woes.

On a Scum Swarm?
What, you've picked up some troubles can't just smoke/drink/inject/execute/fuck away? Well, that's okay, we've gotta have some mental health experts booting around here somewhere. Send 'em a message and see if they can take some time to help you. Of course, this is a Scum Swarm, so if your mental health buddy is living in a simulation of Victorian London and spends their spare time tracking down dastardly criminals with Sherlock Holmes and John Watson, don't be surprised to find yourself sitting on a chase lounge across the street from 221b Baker Street talking out your troubles with an Ayah in a period dress.

That wouldn't even be particularly weird by our standards.

On Titan?
Lots of mental healthcare available, but even with a well-resourced, fully-staffed mental healthcare system, there's not going to be enough time in the day for the system to go out and find you if you need help but are too timid/proud/nervous/afraid to ask for it. If you're bad off enough, and you have friends, they may suggest you get help, and your muse may suggest you get help, and if you get so bad that they feel you may become a danger to yourself or others, you may be forced to get help.

If you're not great but not bad and too proud/stubborn/timid/afraid to ask, though, you're in trouble, because there's no time for them to come to you.

Eh, I'm sure other folks can come up with some more.

Skype and AIM names: Exactly the same as my forum name.

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ShadowDragon8685 ShadowDragon8685's picture
Ooooh, I forgot one.

Ooooh, I forgot one.

In Firewall?
If you have a good server staffed with good, competent proxies, they will arrange to get you the help you need, one way or another. Quite simply, you're an investment, one they can't afford to let fail because you eggs are getting scrambled by all the shit they're sending you to deal with. Of course, this is a double-edged sword, because your shrink will also be a Sentinel at the very least, and there is no such thing as patient confidentiality when illegal conspiracies are concerned, so if you're getting stressed out because you've lost faith in Firewall, your ass is in deep shit.

If you have a bad server, on the other hand, any or all of the following might happen to you:
1: You might be reverted to an earlier (more stable; more useful) backup without your consent. (Depending on what you've seen between then and now, this may or may not be a net gain for you.)
2: You might simply be eliminated.
3: They might brainwash you to erase all memories of Firewall and sell you to the ID Crew to fund other operations.
4: They might grab you and brainwash you into an Erasure Squad killing machine.

Skype and AIM names: Exactly the same as my forum name.

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Trappedinwikipedia Trappedinwikipedia's picture
Healthcare is generally free

Healthcare is generally free in transitional economies. Between that, having a PHD psychiatrist riding shotgun in your head, basic biomods providing immunity to neurochemical imbalances, the cheap (generally free) availability of tailored meds, and there's really not a large personal cost to personal health care.

Beyond a stress free environment (in EP mechanical terms) stuff like external shrinks, armies of psychiatrists are about as anachronistic as talking about the high cost of humour balancing in modern medicine. A muse alone can handle most of the work, especially as they're always on call, so they can begin working before things get dire. For whatever is left, and this will mostly be people in particularly straining lines of work, such as Firewall's or perhaps certain isolating or non-humannormative work, more might be required, but this describes a tiny percentage of people.

I disagree entirely with your assessment of inner system health care shadowdragon.

UnitOmega UnitOmega's picture
I believe that the Muse has a

I believe that the Muse has a special rule in that it is able to Heal stress using Academics: Psychology for it's user only, something that otherwise requires long sessions with Profession: Psychotherapy or an extended simulspace Psychosurgery session. So to this end, the Muse is your first line of mental health (as well as physical health, since they're sitting on your biomed sensors in your mesh inserts). For the average post-Fall Eclipse Phase person, this is probably enough to manage your daily stress, keep your low end (or perhaps "low impact" is a better term) psychological disorders in check and make sure any prescription medication you require is properly, filled, delivered and taken on time.

Past that level, for people with unfortunate experiences, high stress/high psych impact jobs or those unlucky enough to have acquired more complex mental disorders, say, through neurological damage or "neurodiversity" of a morph, well... I'd have to check in the other thread recently we had about day-to-day experiences which quoted Panopticon on medical centers - if they had mental health functions. Even if not explicit, I imagine most habitat-operated medical centers have a psychology provision for therapeutic simulspace access, comfurt dispensers and a place where one might find a therapist to talk to. If you happen to live on a small autonomist torus or cluster (or, Godlike AI forbid, are a Brinker, Out'ster or other Isolate clade living in a Tin Can) and do not have access to a large-scale medical center? Well, better hope you have a psychiatrist in your social circle, or your fellow citizens like you enough to let you burn "international" mesh bandwidth calling out, otherwise it's the slow train of therapy where you sit in a quiet room with a blanket around you while you eat yogurt and your Muse speaks to you in a calm voice.

To Shadowdragon's point, I actually think that, say for the known "healthy" middle class of the Planetary Consortium and some outside in Inner System polities the whole "crippling debt" problem might not be as bad. Organic Damage is typically a pretty menial fix, and mental health is much more important and lasting. I would imaging that for those who get paid a decent wage (which mind you, is not the same as "rich"), "mental health insurance" isn't unheard of, though obviously depending on who you're dealing with when your quality of care might just be "throw drugs at the problem" or "talk to this AGI knowledge worker we built to handle your (as in people like you) problems and then forked 10,000 times because it's property". Indenture contracts may similarly have mental health considerations, but like all contract work, watch who you bargain with and read the fine print, or you may find yourself re-instanced from backup a few times, and you're caught holding the bag for the reinstantiation fees! I think I remember something about Morningstar offering out-going (or perhaps in-going) psych counseling for indentures though. Or did I make that up for a randomly rolled PC?

Now, to the original point of Mental Hospitals and Asylums, I designed a Lunar mental hospital (The Van Pelt Institute) for a scenario involving various themes I may or may not one day finish. It was designed kind of like some people have suggested here. There are spaced for group or individual therapy, psychosurgery stations, simulspace servers (including dedicated servers for Infomorph patients). The default look was that clinical white, but you could always pick an approved AR skin to replace it. Of course, being an EP scenario it had it's sinister elements. Mesh access was bottlenecked and filtered (to prevent "harmful stimulus"), patients were monitored 24/7 and has restricted personal items and their incoming "mail" (i/e physical goods) were all monitored and searched. Also some of the burly orderlies and nurses are actually burly security guards. And is that knockout gas projectors in the isolation rooms?

The real sinister kicker is that the Institute was actually backed by Cognite funding, who maintain a "Research Wing" in the basement. It's supposed to be shut down, but why are there scientists on it's staff?

H-Rep: An EP Homebrew Blog

Trappedinwikipedia Trappedinwikipedia's picture
There is no special rules for

There is no special rules for a muse, Academics: Psychology is simply one of the skills used to treat mental stress (along with Medicine: Psychiatry and Profession: Psychotherapy). Even if you assume that having a muse always on doubles or triples the time taken due to distraction, it still only takes a few days to recover from the lesser mental problems (RAW-wise anyway) so it should take significant trauma over a short time period to cause a disorder.

I don't imagine that mental healthcare in the inner system is phenomenal, but I don't agree that its expensive. Getting really good mental healthcare, or some psychosurgery probably is, but I don't agree that it takes a lot of money for middling services.

mellonbread mellonbread's picture
Anders Sandberg did a pretty

Anders Sandberg did a pretty good piece about mental health in the Eclipse Phase setting a while back, surprised nobody has mentioned it.

Did you hear the one about the guy who became a fence?

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VictoryRPG VictoryRPG's picture
I've had an idea related to this

In our everyday life, certain personalities, pundits, celebrities and others are pressured to undergo plastic surgery to become or remain appropriate for their position. In EP I can definitely see socialites or even important Scions being sent to institutions to have "personality lifts."

What entertainment hypercorp wouldn't want their XP star to be a "quirky and different" Jennifer Lawrence type? Have everyone convinced that she's "like, really authentic," and do it without script writers and wardrobe teams.

Mental illness is defined by its social context, so for certain performers individual personality traits or moral hangups could be considered destructive or harmful in the context of their environment.

I've considered running a series of scenarios wherein the players "liberate" some egos (with or without morphs) from one of these facilities and have to escape as Oversight attempts to liquidate them.

jKaiser jKaiser's picture
The PC does have eugenics as

The PC does have eugenics as one of its stated objectives. I'm sure they officially mean through genehacking and such, but you're right, undesirable mental traits are within their grasp too. That's horrifying.

I love it.

uwtartarus uwtartarus's picture
Transhuman Space incorporated

Transhuman Space incorporated a lot of the sort of "go to a clinic and fix your personality" type of psychosurgery, like plastic surgery for the mind.

Exhuman, and Humanitarian.

Kremlin K.O.A. Kremlin K.O.A.'s picture
In regards to Scum Swarms. I

In regards to Scum Swarms. I suspect they have a goodly supply of psychosurgeons.
Well, when you resist stress too often, you get hardened, or jaded, to it.
This means that extreme pleasures eventually get dull and boring.
But reversing that is a known psychotherapy, and psychosurgery, procedure.
That is how the Scum keep from getting jaded.

Pyrite Pyrite's picture
I really disagree that

I really disagree that asylums will feature much in the way of physical space. The advantages of simulspace are so great that most institutions would be eager to get their patients into one, and would do so as soon as they thought the patient was stable enough to handle the transition.

'No language is justly studied merely as an aid to other purposes. It will in fact better serve other purposes, philological or historical, when it is studied for love, for itself.' --J.R.R. Tolkien

Noble Pigeon Noble Pigeon's picture
Pyrite wrote:I really

Pyrite wrote:
I really disagree that asylums will feature much in the way of physical space. The advantages of simulspace are so great that most institutions would be eager to get their patients into one, and would do so as soon as they thought the patient was stable enough to handle the transition.

Yes but that's also boring from a GM's point of view. If there's little to no physical asylums left then you can't have creepy scenarios in them anymore, only on boring virtual spaces that the hacker can easily subvert and make everything not as creepy.

"Don't believe everything you read on the Internet.”
-Abraham Lincoln, State of the Union address

jKaiser jKaiser's picture
True...though in theory,

True...though in theory, couldn't simulspaces have lock-in protocols for court/arbitrator-mandated psychiatric stays? That could be a unique take on the "trapped in the asylum" trope (which is honestly what I'm trying to get at with this thread), where an infomorph or otherwise digitized patient is trapped just as assuredly in a simulspace asylum as in a physical place.

My thinking is that normal psych hospitals and asylums have, strictly speaking, very restrictive rules and limitations placed on patients. The context is different, but many are essentially the same rules as you'd see in prisons. Restricted mesh access or some other kind of block that you'd never see in a public or most private mesh domains seems like something you'd see in a place of that nature, making it vastly harder for anyone to hack into the thing.

ThatWhichNeverWas ThatWhichNeverWas's picture
Ahh, madness.

Loving this thread, even though I have pretty much nothing to contribute :P
One thing I will say though;

jKaiser wrote:
This is actually giving me ideas for specialist muses and morphs. The latter being a heavily modified version of the Freeman or something (or an Eidolon equivalent, pragmatically speaking), with mind-comforting implants/software for long-term psychological care.

I don't think you really need to make variants at all, as this is a perfect place where Slave Eidolons and Freeman morphs can exist "legitimately".

In the past we've had to compensate for weaknesses, finding quick solutions that only benefit a few.
But what if we never need to feel weak or morally conflicted again?

Trappedinwikipedia Trappedinwikipedia's picture
I would think that morphs or

I would think that morphs or eidolons which enhance willpower rather than reduce it would be bettor for that kind of thing. Those are kind of rare rules wise though, as the Futura is probably the most notable of them.

ThatWhichNeverWas ThatWhichNeverWas's picture
Ductility is both a blessing and a curse.

Remember that most morphs have a user-defined attribute bonus or two, so a splicer with +WIL wouldn't be that hard to find.
Willpower is really a mixed blessing. Putting the patients in +WIL morphs would make them more resistant to trauma, but also make them more resistant to psycho-surgery and other effects which would be used to heal them.

In the past we've had to compensate for weaknesses, finding quick solutions that only benefit a few.
But what if we never need to feel weak or morally conflicted again?

jKaiser jKaiser's picture
So in all likelyhood, any

So in all likelyhood, any asylum-specific morphs would at minimum have some specially designed implant that maximises their willpower except when acted upon by a specific key. By god, it's tech-assisted hypnotism, and if that isn't psych-horror gold.

MrWigggles MrWigggles's picture
I'm not sure that I buy into

I'm not sure that I buy into pych wards being a thing... Especially the further you out in the system.

Having an entirely disabled person, not in storage, is probably the most expensive thing that habitat can be doing.

SO maybe... Pych Wards, would be pretty concentrated and pretty rare through out sol? Except for the Jovians, because whenever you can shit on the Jovians, you shit on the Jovians.

jKaiser jKaiser's picture
I disagree. The Jovians would

I disagree. The Jovians would probably be surprisingly high in the mental health rankings, because a huge portion of their mentality is fixing what's broken rather than replacing it from the nearest nanofac. Less hyperbolic, the Jovians have standing incentives for people in their original bodies to join up. It's not hard to see how a mental health care package would be part of the deal, and given the stated eugenics agenda elsewhere in the system, there would be a greater (albeit state/church-funded) impetus towards ensuring people have more natural and non-psychosurgery care. Ergo, better physical mental health wards.

I don't want to bank on the physical asylums too much, though again as Noble Pidgeon mentioned, err on the side of interesting/useful for the GM. But I also take issue with the "entirely disabled" mentality. Someone who needs psychiatric care to function can still produce art at the very least, which is even today often very poignant and compelling. I've spent some time in anorexic wards, and the art produced there, while not exactly uplifting most of the time, has a rawness about humanity and pain that I think would be very attractive toward EP-era connoisseurs. And "entirely disabled," while a useful metric for actually building asylums, be they realspace or virtuality, isn't going to be indicative of the majority of people housed in such places.

However, you've a point out-system. If nothing else, resources are slimmer, and physical space is at a premium. But there's also the more esoteric limitations coming with Brinker and other social groups, who may not cleave to the idea of mental care as recognized by the rest of the system. And there lay many stories of alternative health care or escape from well-meant bondage.

R.O.S.S.-128 R.O.S.S.-128's picture
Primary Functions

Taken at face value, physical wards do seem to be fairly impractical given the capabilities of simulspace and psychosurgery. With the exception, of course, of biocon polities that adamantly oppose resleeving/uploading.

However, who's to say that the facility's stated function and primary function must be the same? A physical "psych ward" could easily act as a front for other activities that may require gaining access to people still in their morphs, preferably people who will not be missed and whose claims won't be believed. If the ward should happen to actually help most patients with only a few, easily smoothed-over disappearances, all the better for maintaining the facade. And of course, such a front-operation is just the sort of more interesting thing that would make material for an RPG adventure, as opposed to an ordinary facility where you just go in, get your treatment, and get out.

So as a result it's not truly the needs of the patients that are dictating the form the facility takes. It's the needs of the likely less-than-savory operation that the facility is a front for.

Although I suppose that runs into the problem of deflecting suspicion, since if physical wards are rare and largely unnecessary, people are sure to have some questions about why your facility is so heavy on hardware...

End of line.

Godofgallows Godofgallows's picture
Well, an interesting question

Well, an interesting question.

For certain psychological problems, we know that they are sometimes strongly based on genetics (antisocial personality disorder or schizophrenia are known to have strong genetic components as far as my knowledge goes). It is very likely that these factors are identified and eliminated in splicers, though they may still be present in flats. So splicers and more advanced morphs probably have no genetic predisposition towards mental disorders or may even be designed to be more resilient physchologically compared to baseline humans.

The other important factor is upbringing, especially early childhood experiences. Let me stress the importance os muses here. Muses basically provide affordable, instantly available psychological counseling and early warning. Even though little children are probably not born with an active muse in most habitats (though I guess it would be possible tehcnically), their parents probably have one. Muses being fairly good in psychology, they can probably offer advice to parents in order to avoid damaging children psychologically.

Also, having children probably means you are wealthy in eclipse phase. Living space is very expensive in most habitats, not to mention you also have to be able to afford copyright costs unless you are living in a flat.

All in all, I believe that the accessibility and quality of psychological counselling is insane (forgive the pun) compared to this age. That compared with genetix fixing means that probably there are very very few people around (in the middle or upper classes, so to say) who have to be institutionalized in some kind of medical facility. Imagine it to be uncommon enough to be dealt with on a one-on-one basis.

I imagine basically the last settings in which these problems are still prevalent are indentured (especiall infomorph server farms) work and perhaps the clanking masses. In the former cases I find it very likely that there is a team of company psychologists and psychosurgeons that monitor indentured workers and quiyckly pluck trouble elements from the rest before they cause trouble. Being very efficient and not very humane, I imagine they just quickly patch up a person in accelerated simulspace and dump them back to work.

The clanking masses would be affected in two ways. Firstly because that is were all the poor indentured workers end up who have been psycho-patched enough only to hold together until the end of their contract. Secondly, because living in a low quality synthetic shell can be a scarring experience and there is only so much a muse can do to alleviate that.

Sadly, the clanking masses are also very poor and can do very little to help themselves. Which leaves you with four options if you happen to belong to them.

1. If you are lucky enough, you may receive psyhological and psyhosurgical assistance pro bono, for example in an anarchist habibtat. That is probably fairly rare and handled on a one-on-one basis. I would guess simulspaces are used.

2. You do not receive treatment and wander in a slum and a mad robot hobo. Something similar happens in several parts of the world today. Probably part of the "clanking masses" stigma.

3. In modern healthcare if you don't have insurance, you may receive life-saving intervention but not much else beyond that. Abd of course you will get the bill. The Eclipse Phase version would probably be putting an ego with a very serious psychological problem (one that renders it unable to function as a member of society or even dangerous) and no resources to pay for treatment into cold storage. It doesn't hurt the ego, postpones the problem indefinitely and frees up space. Perfection. :P

4. You can get quality psychological treatment from a hypercorp. Again, I guess they have accelerated simulspaces for that. It's decent treatment, you will probably end up as a person reborn and ready to be a productive member of society. The Catch? Indentured work, probably. So releasing psychologically unhinged people from indentured work finally pays off, as the corp is able to reabsorb some of them. Profit.

The most commonly used method seems to be simulspace, accelerated simulspace, probably in combination with psychosurgery. Time and space efficient and offers complete control over the environment. Psychological treatment simulspaces are probably extremely high quality so they are also quite expensive to program and maintain. I imagine that a simulspace server is probably used by a team of psychologists unless we are talking about lots of money.

Sorry for the extreme length if you got to this point :D

jKaiser jKaiser's picture
The more I think about it,

The more I think about it, the more I believe there would be physical locations, most commonly rolled together with research institutions, universities, and the like. Neuroscience is big, big business in EP given the keystone tech that runs though the whole setting, and the brain is explicitly still part blackboxed mystery. Abnormal psychology is and will remain a crucial part of understanding how the brain works, and with space being at a premium in most habitats, it makes sense that your neurological research complex would also serve as an asylum, possibly helping abate costs for patients and inmates in exchange for participation in tests and trials. It also necessitates meatspace, if they're directly studying the brain.

It's very, very easy for this to yield both a lot of research and a lot of controversy. But people with severe mental disorders can get very desperate for treatment or even hope for a cure, and someone with a particularly brutal case of, just to pick the big one out of the pile, paranoid hallucinatory schizophrenia may well, in a lucid moment, jump at the chance to have a place at such an institute. Ideally, such practices would remain humane, but even if you prefer a more sinister side to things, there's genuinely gutwrenching horror to well-intentioned help making things worse. Accidents happen, and if you as a patient wake up and are informed that you've been reverted to a backup again...

Naturally, if you want more GRIMDARK, as others have mentioned, just play up the soulless business side to this sort of thing, or have a brilliant doctor prove to be a sociopath more interested in raw science than patient welfare, or have a patient's mental troubles turn out to be a sleeper exsurgent strain. Routine psychological care, things like therapy and counseling, sure, simulspace. But anything that's poorly understood or for which the current psychosurgical treatment still holds significant risk (read: all of them, by the rules) has significant benefit to being kept in meat or metal. You might even have the scenario where a patient is indeed forked, the fork undergoing standard, riskier treatment and writing off their original self and morph as part of the payment, and just trying to convince themselves that the them they left behind is contributing for making future treatment easier, and hasn't come to hate them for abandoning them to suffer.

UnitOmega UnitOmega's picture
If we're taking the research

If we're taking the research angle, Panopticon does not that "Research" is a major function done by medical centers - and all that can't just be spent on getting another .01% efficiency out of nanobandages. Personally, this is why I think psych wards would be attached to regional medical facilities (if your hab is big enough to warrant such a section), is again, mental health is far more permanent than physical damage, and if nothing else, you need physical space to store simulspace servers, run fiberoptics and have simulspace couches. A virtual space still takes up physical space. I mean, somebody getting a degree in psychosurgery eventually has to test it on people, right?

On a more sinister angle, Cognite is at least a company going active research into mind-related pharmaceuticals and psychosurgery. One has to assume they pull "patients" from somewhere to do R&D.

H-Rep: An EP Homebrew Blog

jKaiser jKaiser's picture
They had to get the egos for

They had to get the egos for Futura from somewhere, yeah.

UnitOmega UnitOmega's picture
Technically, I think Futura

Technically, I think Futura was a zero-state, you start with brain slaved to the Simulspace Server in the growth tank and go from there, but since you can ego merging and pruning to make children who knooooows~.

n.b. Spooky hand gestures on the last word optional.

H-Rep: An EP Homebrew Blog

uwtartarus uwtartarus's picture
UnitOmega wrote:Technically,

UnitOmega wrote:
Technically, I think Futura was a zero-state, you start with brain slaved to the Simulspace Server in the growth tank and go from there, but since you can ego merging and pruning to make children who knooooows~.

n.b. Spooky hand gestures on the last word optional.

Not sure what this means exactly:

Futura began immediately in the wake of the Fall with an initial seed population of test subjects culled from extant genetic material and gestated to between 1 week and 6 months after birth. Of these, less than 10% were live births from either a surrogate or genetic birth mother who had perished during the Fall. The majority came from our Lunar and Martian labs and were brought to term within an exowomb.

Exhuman, and Humanitarian.

jKaiser jKaiser's picture
Futura is obviously an

Futura is obviously an extreme version, and one without a mental health institute piggybacked on as far as we know from the books. However, that arrangement is honestly pretty likely. Having that dual arrangement is a hell of a lot of goodwill farming against Futura-like fallout. Having the legitimizing presence of an asylum would buffer against any controversy with regards to neurological research, particularly if you can get some high profile subjects.

Though that again leads to an uncomfortable place. The obvious choices here are morph downgrade (e.g. ex-mentons), Fall vets, and uplifts, clear sympathizing pity-pieces that make for good news mini-bioptics. Good PR points that will sway the majority of inner system people into feeling good enough about themselves for their sympathy that nothing else needs to be done. The lack of that kind of high-profile sympathy farming is a part of why Futura was so demonized, since all it had to present to the public was a psychopathic crop of murderer children -- and that's with the public being ignorant of the whole psi thing. Anyone wanting to build one of these hybrid help/research houses are going to take the lessons from Bethlem Royal and make sure that whatever controversy they drum up and try to keep themselves, also like Bethlem Royal today, at the modern forefront of humane treatment.

Which leads to a lovely problem for any PC or NPC in one of those situations. A canny PR campaign can make anyone subjected to abuses and the like face one hell of an uphill battle. Obviously being forcibly resleeved into a modified freeman is questionable, but if it's court/municipally ordered and the institution has a well-cultured history of such helpful treatments. You become the suffering outlier to the cultivated PR trend, which is a social horror all by its own.