There are state hospitals that have forensic units, for those who are criminally insane, incompetent to stand trial, etc. Those are places where serious sex offenders are sometimes held if they have a major mental illness that makes them also insane or incompetent to stand trial. There are also state hospitals that are like the place of last resort. They sometimes have patients who act out their mental illness with sex offenses (and in other violent ways) on the same co-ed units with PTSD suffers. It's a very very horrible thing.
My mother took me to a state hospital after I became extremely dissociative (almost catatonic) after a traumatic event as a teenager. She told a psychologist who knew my family personally. He immediately got in his car and came to the state hospital and refused to leave until my family took me to the local private hospital. He knew me well enough to guess that I had PTSD and was very concerned I would be retraumitized there. My mother didn't take me to the state hospital over the other hospital on purpose - it simply was the closest place and she didn't know what to do. The 8 hours I was at the state hospital was horrible. I witnessed a traumatic event there that I have only now begun to talk about in therapy many many years later.
I have had trauma therapists and psychiatrists say that even private general adult psych units are generally good for one thing - keeping someone alive. Which is a very good thing when that is needed. But they have all highly recommended that if I had to go inpatient, that I try to go to a specialized hospital treatment program that focuses on PTSD, of which there are only a few in the US. They were concerned that going to a private hospital would be traumatizing for me because of the trauma I saw in a state hospital. Some of the specialized places do take Medicare/Medicaid, but they don't take people without insurance and are not really set up for acute life threatening crisis as most people who go to them travel there from all over the country. I have gone to one of those, and I may actually go back soon because it was so incredibly helpful.
I am grateful for psych units that help keep people alive when they are in suicidal crisis...
I can also relate to the horror of the conditions of state hospitals in the US - I have been there and briefly seen some of it myself.
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xena21 - I'm glad you posted about this. I'm sorry you know how horrible it can be too. It's something I have really been struggling to sort out this matter in my own life. It helps to know I'm not alone.