Psychiatric hospital

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Psychiatric_hospital 

Traverse City State Hospital, Traverse City, Michigan

Psychiatric hospitals, also known as mental health hospitals, and mental health units, are hospitals or wards specializing in the treatment of serious mental disorders, such as major depressive disorder, schizophrenia and bipolar disorder. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialize only in short term or outpatient therapy for low-risk patients. Others may specialize in the temporary or permanent care of residents who, as a result of a psychological disorder, require routine assistance, treatment, or a specialized and controlled environment. Patients are often admitted on a voluntary basis, but people whom psychiatrists believe may pose a significant danger to themselves or others may be subject to involuntary commitment and involuntary treatment. Psychiatric hospitals may also be referred to as psychiatric wards or units (or "psych" wards/units) when they are a subunit of a regular hospital.

The modern psychiatric hospital evolved from and eventually replaced the older lunatic asylum. The treatment of inmates in early lunatic asylums was sometimes brutal and focused on containment and restraint. With successive waves of reform, and the introduction of effective evidence-based treatments, most modern psychiatric hospitals provide a primary emphasis on treatment, and attempt where possible to help patients control their own lives in the outside world, with the use of a combination of psychiatric drugs and psychotherapy. An exception is in Japan, where many psychiatric hospitals still use physical restraints on patients, tying them to their beds for days or even months at a time.

A crisis stabilization unit is in effect an emergency department for psychiatry, frequently dealing with suicidal, violent, or otherwise critical individuals. Open units are psychiatric units that are not as secure as crisis stabilization units. Another type of psychiatric hospital is medium term, which provides care lasting several weeks. In the United Kingdom, both crisis admissions and medium-term care are usually provided on acute admissions wards. Juvenile or adolescent wards are sections of psychiatric hospitals or psychiatric wards set aside for children or adolescents with mental illness. Long-term care facilities have the goal of treatment and rehabilitation back into society within a short time-frame (two or three years). Another institution for the mentally ill is a community-based halfway house.

History

The York Retreat (c.1796) was built by William Tuke, a pioneer of moral treatment for the mentally ill.

Modern psychiatric hospitals evolved from, and eventually replaced, the older lunatic asylums. The development of the modern psychiatric hospital is also the story of the rise of organized, institutional psychiatry.

Hospitals known as bimaristans were built in Persia (old name of Iran) beginning around the early 9th century, with the first in Baghdad under the leadership of the Abbasid Caliph Harun al-Rashid. While not devoted solely to patients with psychiatric disorders, they often contained wards for patients exhibiting mania or other psychological distress. Because of cultural taboos against refusing to care for one's family members, mentally ill patients would be surrendered to a bimaristan only if the patient demonstrated violence, incurable chronic illness, or some other extremely debilitating ailment. Psychological wards were typically enclosed by iron bars owing to the aggression of some of the patients.

Western Europe would adopt these views later on with the advances of physicians like Philippe Pinel at the Bicêtre Hospital in France and William Tuke at the York Retreat in England. They advocated the viewing of mental illness as a disorder that required compassionate treatment that would aid in the rehabilitation of the victim. The arrival in the Western world of institutionalisation as a solution to the problem of madness was very much an advent of the nineteenth century. The first public mental asylums were established in Britain; the passing of the County Asylums Act 1808 empowered magistrates to build rate-supported asylums in every county to house the many 'pauper lunatics'. Nine counties first applied, the first public asylum opening in 1812 in Nottinghamshire. In 1828, the newly appointed Commissioners in Lunacy were empowered to license and supervise private asylums. The Lunacy Act 1845 made the construction of asylums in every county compulsory with regular inspections on behalf of the Home Secretary. The Act required asylums to have written regulations and to have a resident physician.

At the beginning of the nineteenth century there were a few thousand "sick people" housed in a variety of disparate institutions throughout England, but by 1900 that figure had grown to about 100,000. This growth coincided with the growth of alienism, later known as psychiatry, as a medical specialism. The treatment of inmates in early lunatic asylums was sometimes very brutal and focused on containment and restraint.

In the late 19th and early 20th centuries, terms such as "madness", "lunacy" or "insanity"—all of which assumed a unitary psychosis—were split into numerous "mental diseases", of which catatonia, melancholia and dementia praecox (modern day schizophrenia) were the most common in psychiatric institutions.

In 1961 sociologist Erving Goffman described a theory of the "total institution" and the process by which it takes efforts to maintain predictable and regular behavior on the part of both "guard" and "captor", suggesting that many of the features of such institutions serve the ritual function of ensuring that both classes of people know their function and social role, in other words of "institutionalizing" them. Asylums was a key text in the development of deinstitutionalization.

With successive waves of reform and the introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment; and further, they attempt—where possible—to help patients control their own lives in the outside world with the use of a combination of psychiatric drugs and psychotherapy. These treatments can be involuntary. Involuntary treatments are among the many psychiatric practices which are questioned by the mental patient liberation movement. Most psychiatric hospitals now restrict internet access and any device that can take photos. In the U.S. state of Connecticut, involuntary patients must be examined annually by a court-appointed psychiatrist. Patients may also apply for release at any time and receive a full hearing on the application.

Types

The Republican Vilnius Psychiatric Hospital in Naujoji Vilnia (Parko g. 15), is one of the largest health facilities in Lithuania; built in 1902, it officially opened on 21 May 1903.

There are a number of different types of modern psychiatric hospitals, but all of them house people with mental illnesses of widely variable severity.

Art Nouveau styled Röykkä Hospital, formerly known as Nummela Sanatorium, in Röykkä, Finland.

Crisis stabilization

The crisis stabilization unit is in effect an emergency department for psychiatry, frequently dealing with suicidal, violent, or otherwise critical individuals.

Open units

Open units are psychiatric units that are not as secure as crisis stabilization units. They are not used for acutely suicidal persons; instead, the focus in these units is to make life as normal as possible for patients while continuing treatment to the point where they can be discharged. However, patients are usually still not allowed to hold their own medications in their rooms because of the risk of an impulsive overdose. While some open units are physically unlocked, other open units still use locked entrances and exits, depending on the type of patients admitted.

Medium term

Another type of psychiatric hospital is medium term, which provides care lasting several weeks. Most drugs used for psychiatric purposes take several weeks to take effect, and the main purpose of these hospitals is to monitor the patient for the first few weeks of therapy to ensure the treatment is effective.

Juvenile wards

Juvenile wards are sections of psychiatric hospitals or psychiatric wards set aside for children or adolescents with mental illness. However, there are a number of institutions specializing only in the treatment of juveniles, particularly when dealing with drug abuse, self-harm, eating disorders, anxiety, depression or other mental illness.

Long-term care facilities

Vienna's Narrenturm—German for "fools' tower"—was one of the earliest buildings specifically designed for mentally ill people. It was built in 1784.

In the UK, long-term care facilities are now being replaced with smaller secure units (some within the hospitals listed above). Modern buildings, modern security, and being locally situated to help with reintegration into society once medication has stabilized the condition are often features of such units. Examples of this include the Three Bridges Unit, in the grounds of St Bernard's Hospital in West London and the John Munroe Hospital in Staffordshire. However, these modern units have the goal of treatment and rehabilitation to allow for transition back into society within a short time-frame (two or three years). However, not all patients' treatment can meet this criterion, so the large hospitals mentioned above often retain this role.

These hospitals provide stabilization and rehabilitation for those who are actively experiencing uncontrolled symptoms of mental disorders such as depression, bipolar disorders, eating disorders, and so on.

Halfway houses

One type of institution for the mentally ill is a community-based halfway house. These facilities provide assisted living for an extended period of time for patients with mental illnesses, and they often aid in the transition to self-sufficiency. These institutions are considered to be one of the most important parts of a mental health system by many psychiatrists, although some localities lack sufficient funding.

Political imprisonment

In some countries the mental institution may be used in certain cases for the incarceration of political prisoners as a form of punishment. A notable historical example was the use of punitive psychiatry in the Soviet Union and China.

Secure units

In the UK, criminal courts or the Home Secretary can, under various sections of the Mental Health Act, order the admission of offenders for detainment in a psychiatric hospital, but the term "criminally insane" is no longer legally or medically recognized. Secure psychiatric units exist in all regions of the UK for this purpose; in addition, there are a small number of Specialist Hospitals which offer care and treatment with high levels of security. These facilities, run by the National Health Service, provide psychiatric assessments and can also provide treatment and accommodation in a safe hospital environment where patients can be prevented from absconding. As a result, the risk of patients harming themselves or others is greatly reduced.

These secure hospital facilities are divided into three main categories and are referred to as High, Medium and Low Secure. Although it is a phrase often used by newspapers, there is no such classification as "Maximum Secure". Low Secure units are often incorrectly referred to as "Local Secure", as patients are detained there frequently by local criminal courts for psychiatric assessment before sentencing.

In the Republic of Ireland, the Central Mental Hospital in Dublin performs a similar function.

Community hospital utilization

Community hospitals across the United States regularly see mental health discharges. A study of community hospital discharge data from 2003-2011 showed that mental health hospitalizations were increasing for both children (patients aged 0–17 years) and adults (patients aged 18–64). Compared to other hospital utilization, mental health discharges for children were the lowest while the most rapidly increasing hospitalizations were for adults under 64. Some units have been opened to provide "Therapeutically Enhanced Treatment" and so form a subcategory to the three main unit types.

The general public in the UK are familiar with the names of the High Secure Hospitals due to the frequency that they are mentioned in the news reports about the people who are sent there. Those in the UK include Ashworth Hospital in Merseyside, Broadmoor Hospital in Crowthorne, Berkshire, Rampton Secure Hospital in Retford, Nottinghamshire, and Scotland's The State Hospital in Carstairs. Northern Ireland and the Isle of Man have their own Medium and Low Secure units but use the mainland facilities for High Secure, to which smaller Channel Islands also transfer their patients as Out of Area (Off-Island Placements) Referrals under the Mental Health Act 1983. Of the three unit types, Medium Secure is most prevalent throughout the UK. As of 2009, there were 27 women-only units in England alone. Irish units include those at prisons in Portlaise, Castelrea and Cork.

Criticism

Hungarian-born psychiatrist Thomas Szasz argued that psychiatric hospitals are like prisons unlike other kinds of hospitals, and that psychiatrists who coerce people (into treatment or involuntary commitment) function as judges and jailers, not physicians. The French historian Michel Foucault is widely known for his comprehensive critique of the use and abuse of the mental hospital system in Madness and Civilization. He argued that Tuke and Pinel's asylum was a symbolic recreation of the condition of a child under a bourgeois family. It was a microcosm symbolizing the massive structures of bourgeois society and its values: relations of Family–Children (paternal authority), Fault–Punishment (immediate justice), Madness–Disorder (social and moral order).

Erving Goffman coined the term "Total Institution" for mental hospitals and similar places which took over and confined a person's whole life. Goffman placed psychiatric hospitals in the same category as concentration camps, prisons, military organizations, orphanages, and monasteries. In his book Asylums Goffman describes how the institutionalisation process socialises people into the role of a good patient, someone "dull, harmless and inconspicuous"; in turn, it reinforces notions of chronicity in severe mental illness. The Rosenhan experiment of 1973 demonstrated the difficulty of distinguishing sane patients from insane patients.

Franco Basaglia, a leading Italian psychiatrist who inspired and was the architect of the psychiatric reform in Italy, also defined the mental hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents, and patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism. American psychiatrist Loren Mosher noticed that the psychiatric institution itself gave him master classes in the art of the "total institution": labeling, unnecessary dependency, the induction and perpetuation of powerlessness, the degradation ceremony, authoritarianism, and the primacy of institutional needs over those of the persons it was ostensibly there to serve—the patients.

The anti-psychiatry movement coming to the fore in the 1960s has opposed many of the practices, conditions, or existence of mental hospitals. The psychiatric consumer/survivor movement has often objected to or campaigned against conditions in mental hospitals or their use, voluntarily or involuntarily. The mental patient liberation movement emphatically opposes involuntary treatment but generally does not have any issue with any psychiatric treatments that are consensual, provided that both parties are free to withdraw consent at any time.

Political abuse of psychiatry

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry 

Political abuse of psychiatry, also commonly referred to as punitive psychiatry, is the misuse of psychiatry, including diagnosis, detention, and treatment, for the purposes of obstructing the human rights of individuals and/or groups in a society. In other words, abuse of psychiatry (including that for political purposes) is the deliberate action of having citizens psychiatrically diagnosed who need neither psychiatric restraint nor psychiatric treatment. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience. As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances. Nowadays, in many countries, political prisoners are sometimes confined and abused in psychiatric hospitals.

Psychiatry possesses a built-in capacity for abuse that is greater than in other areas of medicine. The diagnosis of mental disease allows the state to hold persons against their will and insist upon therapy in their interest and in the broader interests of society. Psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. The use of hospitals instead of jails also prevents the victims from receiving legal aid before the courts in some countries, makes indefinite incarceration possible, and discredits the individuals and their ideas. In that manner, whenever open trials are undesirable, they are avoided.

The political abuse of the power entrusted to physicians, and particularly psychiatrists, has a long and abundant history, for example during the Nazi era and the Soviet rule when religious and political dissenters were labeled as "mentally ill" and subjected to inhumane "treatments". In the period from the 1960s up to 1986, abuse of psychiatry for political and ideological purposes was reported to be systematic in the Soviet Union, and occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. The practice of incarceration of religious and political dissidents in psychiatric hospitals in the Eastern Bloc and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Political abuse of psychiatry also takes place in the People's Republic of China.^[1] Psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the USSR were used for political purposes.

By country

Canada

The Duplessis Orphans were several thousand orphaned children that were falsely certified as mentally ill by the government of the province of Quebec, Canada, and confined to psychiatric institutions.

Donald Ewen Cameron's operation was running from what is today known as the Allen Memorial Institute (AMI), part of the Royal Victoria Hospital, and not to be confused with the non-governmental organization based in Montreal, AMI-Québec Agir contre la maladie mentale.

China

In 2002, Human Rights Watch published the book Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era written by Robin Munro and based on the documents obtained by him. The British researcher Robin Munro, a sinologist who was writing his dissertation in London after a long sojourn in China, had traveled to China several times to survey libraries in provincial towns and while he was there, he had gathered a large amount of literature which bore the stamp 'secret' but at the same time, it was openly available. This literature even included historical analyses which were published during the Cultural Revolution and it concerned articles and reports on the number of people who were taken to mental hospitals because they complained about a series of issues. It was found, according to Munro, that the involuntary confinement of religious groups, political dissidents, and whistleblowers had a long history in China. The abuses began in the 1950s and 1960s, and they became extremely widespread throughout the Cultural Revolution. During the period of the Cultural Revolution, from 1966 to 1976, the political abuse of psychiatry reached its apogee in China, which was then under the rule of Mao Zedong and the Gang of Four, who established a very repressive and harsh regime. No deviance or opposition was tolerated, either in thought or in practice.

The documents described the massive abuses of psychiatry that were committed for political purposes during the rule of Mao Zedong, when millions of people were declared mentally sick. In the 1980s, according to official documents, fifteen percent of all forensic psychiatric cases had political connotations. In the early 1990s, the number of such cases had dropped to five percent, but with the beginning of the campaign against Falun Gong, the percentage of such cases increased quite rapidly.

Official Chinese psychiatric literature distinctly testifies that the Communist Party's notion of 'political dangerousness' was institutionally engrafted as the main concept in the diagnostic armory of China's psychiatry for a long time and its most important tool for suppressing opposition was the concept of psychiatric dangerousness.

Despite international criticism, the People's Republic of China seems to be continuing its political abuse of psychiatry. Political abuse of psychiatry in the People's Republic of China is high on the agenda and it has produced recurring disputes in the international psychiatric community. The abuses there appear to be even more widespread than they were in the Soviet Union in the 1970s and 1980s and they involve the incarceration of 'petitioners', human rights workers, trade union activists, members of the Falun Gong movement, and people who complain about injustices that have been committed against them by local authorities.

It also seems that, China had no known high security forensic institutions until 1989. However, since then, the Chinese authorities have constructed an entire network of special forensic mental hospitals which are called Ankang which means 'Peace and Health' in Chinese. By that time, China had 20 Ankang institutions and their staff was employed by the Ministry of State Security. The psychiatrists who worked there wore uniforms under their white coats.

The political abuse of psychiatry in China only seems to take place in the institutions which are under the authority of the police and the Ministry of State Security but it does not take place in those institutions which belong to other governmental sectors. Psychiatric care in China falls into four sectors which are hardly connected with each other. These are the Ankang institutions of the Ministry of State Security; those which belong to the police; those which fall under the authority of the Ministry of Social Affairs; those which belong to the Ministry of Health. The sectors which belong to the police and the Ministry of State Security are all closed to the public, and, consequently, information about them hardly ever leaks out. In the hospitals which belong to the Ministry of Health, psychiatrists do not have any contact with the Ankang institutions, and they have no idea of what occurred there, which means they can sincerely state that they were not informed about the political abuse of psychiatry in China.

In China, the structure of forensic psychiatry was to a great extent identical to that which existed in the USSR. On its own, it is not so strange, since psychiatrists from the Moscow Serbsky Institute visited Beijing in 1957 in order to help their Chinese 'brethren', the same psychiatrists who promoted the system of political abuse of psychiatry in the USSR. As a consequence, diagnostics in China were not much different than those which were made in the Soviet Union. The only difference was that the Soviets preferred 'sluggish schizophrenia' as a diagnosis, and the Chinese generally cleaved to the diagnosis of 'paranoia' or 'paranoid schizophrenia'. However, the results were the same: long hospitalizations in mental hospitals, involuntary treatments with neuroleptics, torture, abuse, all of which were aimed at breaking the victim's will.

In accordance with Chinese law which contains the concept of "political harm to society" and the similar phrase dangerous mentally ill behavior, police take "political maniacs into mental hospitals, those who are defined as persons who write reactionary letters, make anti-government speeches, or "express opinions on important domestic and international affairs". Psychiatrists are frequently caught involved in such cases, unable and unwilling to challenge the police, according to psychiatry professor at the Peking University Yu Xin. As Liu's database suggests, today's most frequent victims of psychiatric abuse are political dissidents, petitioners, and Falun Gong members. In the beginning of the 2000s, Human Rights Watch accused China of locking up Falun Gong members and dissidents in a number of Chinese mental hospitals managed by the Public Security Bureau. Access to the hospitals was requested by the World Psychiatric Association (WPA), but denied by China, and the controversy subsided.

The WPA attempted to confine the problem by presenting it as Falung Gong issue and, at the same time, make the impression that the members of the movement were likely not mentally sound, that it was a sect which likely brainwashed its members, etc. There was even a diagnosis of 'qigong syndrome' which was used reflecting on the exercises practiced by Falung Gong. It was the unfair game aiming to avoid the political abuse of psychiatry from dominating the WPA agenda.

In August 2002, the General Assembly was to take place during the next WPA World Congress in Yokohama. The issue of Chinese political abuse of psychiatry had been placed as one of the final items on the agenda of the General Assembly. When the issue was broached during the General Assembly, the exact nature of compromise came to light. In order to investigate the political abuse of psychiatry, the WPA would send an investigative mission to China. The visit was projected for the spring of 2003 in order to assure that one could present a report during the annual meeting of the British Royal College of Psychiatrists in June/July of that year and the Annual Meeting of the American Psychiatric Association in May of the same year. After the 2002 World Congress, the WPA Executive Committee's half-hearted attitude in Yokohama came to light: it was an omen of a longstanding policy of diversion and postponement. The 2003 investigative mission never took place, and when finally a visit to China did take place, this visit was more of scientific exchange. In the meantime, the political abuse of psychiatry persisted unabatedly, nevertheless the WPA did not seem to care.

Cuba

Although Cuba has been politically connected to the Soviet Union since the United States broke off relations with Cuba shortly after the dictator Fidel Castro came to power in 1959, few considerable allegations regarding the political abuse of psychiatry in this country emerged before the late 1980s. Americas Watch and Amnesty International published reports alluding to cases of possible unwarranted hospitalization and ill-treatment of political prisoners. These reports concerned the Gustavo Machin hospital in Santiago de Cuba in the southeast of the country and the major mental hospital in Havana. In 1977, a report on alleged abuse of psychiatry in Cuba presenting cases of ill-treatment in mental hospitals going back to the 1970s came out in the United States. It presents grave allegations that prisoners end up in the forensic ward of mental hospitals in Santiago de Cuba and Havana where they undergo ill-treatment including electroconvulsive therapy without muscle relaxants or anaesthesia. The reported application of ECT in the forensic wards seems, at least in many of the cited cases, not to be an adequate clinical treatment for the diagnosed state of the prisoner — in some cases the prisoners seem not to have been diagnosed at all. Conditions in the forensic wards have been described in repulsive terms and apparently are in striking contrast to the other parts of the mental hospitals that are said to be well-kept and modern.

In August 1981, the Marxist historian Ariel Hidalgo was apprehended and accused of 'incitement against the social order, international solidarity and the Socialist State' and sentenced to eight years' imprisonment. In September 1981, he was transported from State Security Headquarters to the Carbó-Serviá (forensic) ward of Havana Psychiatric Hospital where he stayed for several weeks.

France

As is standard procedure in all French cases involving the posting of violent online material, in a process designed to establish that the defendant is capable of standing trial under Article 706-47-1 of the French penal code, in 2018 a French court ordered French member of parliament and leader of the National Front Marine Le Pen to submit to a psychiatric evaluation as part of its investigation into her decision to post images of Islamic State executions on Twitter.

India

It was reported in June, 2012, that the Indian Government has approached NIMHANS, a well known mental health establishment in South India, to assist in suppressing anti-nuclear protests regards to building of the Kudankulam Nuclear Power Plant. The government was in talks with NIMHANS representatives to chalk up a plan to dispatch psychiatrists to Kudankulam, for counselling protesters opposed to the building of the plant. To fulfill this, NIMHANS developed a team of 6 members, all of them, from the Department of Social Psychiatry. The psychiatrists were sent to get a "peek into the protesters' minds" and help them learn the importance of the plant according to one news source.

In July, 2013, the same institution, NIMHANS, was involved in a controversy where it was alleged that it provided assistance to the Central Bureau of Investigation relating to some interrogation techniques.

Japan

Japanese psychiatric hospitals during the country's imperial era reported an abnormally large number of patient deaths, peaking in 1945 after the surrender of Japan to Allied forces. The patients of these institutions were mistreated mainly because they were considered a hindrance to society. Under the Imperial Japanese government, citizens were expected to contribute in one way or another to the war effort, and the mentally ill were unable to do so, and as such were looked down upon and abused. The main cause of death for these patients was starvation, as caretakers did not supply the patients with adequate food, likely as a form of torture and a method of sedation. Because mentally ill patients were kept secluded from the outside world, the large number of deaths went unnoticed by the general public. After the end of Allied occupation, the National Diet of Japan passed the Mental Hygiene Act (精神衛生法,, Seishin Eisei Hō) in 1950, which improved the status of the mentally ill and prohibited the domestic containment of mental patients in medical institutions. However, the Mental Hygiene Act had unforeseen consequences. Along with many other reforms, the law prevented the mentally ill from being charged with any sort of crime in Japanese courts. Anyone who was found to be mentally unstable by a qualified psychiatrist was required to be hospitalized rather than incarcerated, regardless of the severity of any crime that person may have committed. The Ministry of Justice tried several times to amend the law, but was met with opposition from those who believed the legal system should not interfere with medical science. After almost four decades, the Mental Health Act (精神保健法,, Seishin Hoken Hō) was finally passed in 1987. The new law corrected the flaws of the Mental Hygiene Act by allowing the Ministry of Health and Welfare to set regulations on the treatment of mental patients in both medical and legal settings. With the new law, the mentally ill have the right to voluntary hospitalization, the ability to be charged with a crime, and right to use the insanity defense in court, and the right to pursue legal action in the event of abuse or negligence on the part of medical professionals.

Germany

By 1936, killing of the "physically and socially unfit" became accepted practice in Nazi Germany. In the 1940s, the abuse of psychiatry involved the abuse of the "duty to care" on an enormous scale: 300,000 individuals were sterilized and 77,000 killed in Germany alone and many thousands further afield, mainly in eastern Europe. Psychiatrists were instrumental in establishing a system of identifying, notifying, transporting, and killing hundreds of thousands of "racially and cognitively compromised" persons and the mentally ill in settings that ranged from centralized mental-hospitals to jails and death camps. Psychiatrists played a central and prominent role in sterilization and euthanasia, constituting two categories of the crimes against humanity. The taking of thousands of brains from euthanasia victims demonstrated the way medical research was connected to the psychiatric killings. Germany operated six psychiatric extermination centers: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein. They played a crucial role in developments leading to the Holocaust.

New Zealand

On 21 October 2018 the New Zealand Member of Parliament (MP) and former member of the New Zealand National Party Jami-Lee Ross was "taken into mental health care", apparently by police. This action sidelined the MP - who had resigned from the Party (the largest represented in the New Zealand Parliament) two days earlier - in his declared campaign against corruption in the National Party. "A National Party spokesman said: 'Over the past several weeks the National Party has taken seriously the mental health concerns raised by Mr Ross and the medical professionals he has been involved with. That has included seeking advice from medical professionals and involving Police wherever necessary to ensure support is made available to Mr Ross. [...]'"

Norway

There have been a few accusations about abuse of psychiatry in Norway. See Arnold Juklerød and Knut Hamsun.

Romania

In Romania, there have been allegations of some particular cases of psychiatric abuse during over a decade. In addition to particular cases, there is evidence that mental hospitals were utilized as short-term detainment centers. For instance, before the 1982 International University Sports 'Olympiad', over 600 dissidents were detained and kept out of public view in mental hospitals. Like in the Soviet Union, on the eve of Communist holidays, potential "troublemakers" were sent to mental hospitals by busloads and discharged when the holidays had passed.

The People's Republic of Romania held to a doctrine of state atheism. Many Christians, including those from the Baptist Church and Lord's Army wing of the Orthodox Church, were forced into psychiatric hospitals where they died.

Russia

Reports on particular cases continue to come from Russia where the worsening political climate appears to create an atmosphere in which local authorities feel able, once again to use psychiatry as a means of intimidation.

Soviet Union

In 1971 detailed reports about the inmates of Soviet psychiatric hospitals who had been detained for political reasons began to reach the West. These showed that the periodic use of incarceration in psychiatric institutions during the 1960s (see the biography of Vladimir Bukovsky) had started to become a systematic way of dealing with dissent, political or religious. In accordance with the doctrine of state atheism, the USSR hospitalized individuals who were devout in their faith, such as many Baptist Christians.

In March 1971 Vladimir Bukovsky sent detailed diagnoses of six individuals (Natalya Gorbanevskaya and Pyotr Grigorenko among them) to psychiatrists in the West. They responded  and over the next 13 years activists inside the USSR and support groups in Britain, Europe and North America conducted a sustained campaign to expose psychiatric abuses. In 1977 the World Psychiatric Association (WPA) condemned the USSR for this practice. Six years later, the Soviet All-Union Society of Neuropathologists and Psychiatrists seceded from the WPA rather than face almost certain expulsion.

During this period reports of continuous repression multiplied, but Soviet psychiatric officials refused to allow international bodies to see the hospitals and patients in question. They denied the charges of abuse. In February 1989, however, at the height of perestroika and over the opposition of the psychiatric establishment, the Soviet government permitted a delegation of psychiatrists from the United States, representing the U.S. government, to carry out extensive interviews of suspected victims of abuse.

The delegation was able systematically to interview and assess present and past involuntarily admitted mental patients chosen by the visiting team, as well as to talk over procedures and methods of treatment with some of the patients, their friends, relatives and, sometimes, their treating psychiatrists. The delegation originally sought interviews with 48 persons, but saw only 15 hospitalized and 12 discharged patients. About half of the hospitalized patients were released in the two months between the submission of the initial list of names to the Soviet authorities and the departure from the Soviet Union of the US delegation. The delegation concluded that nine of the 15 hospitalized patients had disorders which would be classified in the United States as serious psychoses, diagnoses corresponding broadly with those used by the Soviet psychiatrists. One of the hospitalized patients had been diagnosed as having schizophrenia although the US team saw no evidence of mental disorder. Among the 12 discharged patients examined, the US delegation found that nine had no evidence of any current or past mental disorder; the remaining three had comparatively slight symptoms which would not usually warrant involuntary commitment in Western countries. According to medical records, all these patients had diagnoses of psychopathology or schizophrenia.

Returning home after a visit of more than two weeks, the delegation members wrote a report which was highly damaging to the Soviet authorities. The delegation established that there had been systematic political abuse of psychiatry in the past and that it had not yet come to an end. Victims continued to be held in mental hospitals, while the Soviet authorities and the Soviet Society of Psychiatrists and Neuropathologists in particular still denied that psychiatry had been employed as a method of repression. The American report and other pressures, domestic and external, led the Politburo to pass a resolution (15 November 1989) "On improvements in Soviet law concerning procedures for the treatment of psychiatric patients".

Thailand

Following the 2014 Thai coup d'état, there were a few cases where the National Council for Peace and Order (NCPO, the Thai military junta) alleged its opponents, including a protesting schoolchild, Nattanan Warintawaret, were mentally disturbed. In addition, the military junta introduced a systematic process of 'attitude adjustment', whereby hundreds of dissidents were subjected to forcible detention and propaganda until they reformed their views of the junta; the majority did not and were subsequently charged with crimes. While psychiatrists were not employed, a team of psychologists was involved, implying psychological warfare rather than political psychiatry. On July 9, 2020, Tiwagorn Withiton, a Facebook user who went viral after posting a picture of himself wearing a t-shirt printed with the message “I lost faith in the monarchy” was forcibly detained by police officers and admitted to Rajanagarindra Psychiatric Hospital in Khon Kaen. Tiwagorn has stated that he does not wish the Thai monarchy to be abolished but 'loss of faith' may imply lèse-majesté, a serious crime in Thailand. Tiwagorn is quoted as saying, “I well understand that it is political to have to make people think I’m insane. I won’t hold it against the officials if there is a diagnosis that I’m insane, because I take it that they have to follow orders." Subsequent to protests by civil rights groups and media stories, Tiwagorn was released by Rajanagarindra Psychiatric Hospital, on July 22, 2020.

United States

• "Drapetomania" was a supposed mental illness described by American physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity. In addition to inventing drapetomania, Cartwright prescribed a remedy. His feeling was that with "proper medical advice, strictly followed, this troublesome practice that many Negroes have of running away can be almost entirely prevented." In the case of slaves "sulky and dissatisfied without cause"—a warning sign of imminent flight—Cartwright prescribed "whipping the devil out of them" as a "preventative measure". As a remedy for this disease, doctors also made running a physical impossibility by prescribing the removal of both big toes. Cartwright also proposed "dysaesthesia aethiopica" as a mental illness that caused laziness among slaves.
• In the United States, political dissenters have been involuntarily committed. For example, in 1927 a demonstrator named Aurora D'Angelo was sent to a mental health facility for psychiatric evaluation after she participated in a rally in support of Sacco and Vanzetti.
• When Clennon W. King, Jr., an African-American pastor and activist of the Civil Rights Movement, attempted to enroll at the all-white University of Mississippi for summer graduate courses in 1958, the Mississippi police arrested him on the grounds that "any nigger who tried to enter Ole Miss must be crazy." Keeping King's whereabouts secret for 48 hours, the Mississippi authorities kept him confined to a mental hospital for twelve days before a panel of doctors established the activist's sanity.
• In the 1964 election, Fact magazine polled American Psychiatric Association members on whether Barry Goldwater was fit to be president and published "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." This led to the banning of diagnosing public figures when you have not performed an examination or been authorized to release information by the patient. This became the Goldwater rule.
• In the 1970s, Martha Beall Mitchell, wife of U.S. Attorney General John Mitchell, was diagnosed with a paranoid mental disorder for claiming that the administration of President Richard M. Nixon was engaged in illegal activities. Many of her claims were later proved correct, and the term "Martha Mitchell effect" was coined to describe mental health misdiagnoses when accurate claims are dismissed as delusional.
• In 1972 Thomas Eagleton was forced to withdraw as a vice presidential candidate for being treated for depression.
• In 2010, the book The Protest Psychosis: How Schizophrenia Became a Black Disease by psychiatrist Jonathan Metzl (who also has a Ph.D. in American studies) was published. The book covers the history of the 1960s Ionia State Hospital located in Ionia, Michigan and now converted to a prison and focuses on exposing the trend of this hospital to diagnose African Americans with schizophrenia because of their civil rights ideas. The book suggests that in part the sudden influx of such diagnoses could be traced to a change in wording in the DSM-II, which compared to the previous edition added "hostility" and "aggression" as signs of the disorder.
• Clinical psychologist Bruce E. Levine, argues that Oppositional Defiant Disorder, which can be easily used to pathologize anti-authoritarianism, is an abuse of psychiatry.
• In 2014, Mercury News published a series of articles detailing questionable use of psychotropic drugs within California's foster care system where bad behavior is attributed to various mental conditions, and little care is provided besides drugs. Likewise, many experts questioned the long-term effects of high dosages on developing brains, and some former patients reported permanent side effects even after stopping the meds.

California

• "5150 (involuntary psychiatric hold)" – There are many instances of usage of California law section 5150, which allows for involuntary psychiatric hold based on the opinion of a law enforcement official, psychological professional (or many other individuals who hold no qualification for making psychological assessment), which have been challenged as being unrelated to safety, and misused as an extension of political power.

New York

Whistleblowers who part ranks with their organizations have had their mental stability questioned, such as, for example, NYPD veteran Adrian Schoolcraft who was coerced to falsify crime statistics in his department and then became a whistleblower. In 2010 he was forcibly committed to a psychiatric hospital.

Plutonium-238

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Plutonium-238  

Plutonium-238, ²³⁸Pu

Plutonium-238 oxide pellet glowing from its self-heating
General
Symbol	238Pu
Names	plutonium-238, Pu-238
Protons	94
Neutrons	144
Nuclide data
Half-life	87.7 years
Parent isotopes	242Cm (α) 238Np (β−) 238Am (β+)
Decay products	234U
Isotope mass	238.049553 u
Spin	0
Decay modes
Decay mode	Decay energy (MeV)
Alpha decay	5.593
Isotopes of plutonium Complete table of nuclides

Plutonium-238 (²³⁸Pu) is a radioactive isotope of plutonium that has a half-life of 87.7 years.

Plutonium-238 is a very powerful alpha emitter; as alpha particles are easily blocked, this makes the plutonium-238 isotope suitable for usage in radioisotope thermoelectric generators (RTGs) and radioisotope heater units. The density of plutonium-238 at room temperature is about 19.8 g/cc. The material will generate about 0.57 watts/gram of ²³⁸Pu.

History

Initial production

Plutonium-238 was the first isotope of plutonium to be discovered. It was synthesized by Glenn Seaborg and associates in December 1940 by bombarding uranium-238 with deuterons, creating neptunium-238. The reaction involves a β⁺ decay of a proton to a neutron, and the escape of another neutron.

²³⁸
₉₂U
+ ²
₁H
→ ²³⁸
₉₃Np
+ 2
n
+
e⁺
+
ν
_e

The neptunium isotope then undergoes β⁻ decay to plutonium-238, with a half-life of 2.12 days:

²³⁸
₉₃Np
→ ²³⁸
₉₄Pu
+
e⁻
+
ν
_e

Plutonium-238 naturally decays to uranium-234 and then further along the radium series to lead-206. Historically, most plutonium-238 has been produced by Savannah River in their weapons reactor, by irradiating with neutrons neptunium-237 (half life 2.144 Ma).

²³⁷
₉₃Np
+
n
→ ²³⁸
₉₃Np

Neptunium-237 is a by-product of the production of plutonium-239 weapons-grade material, and when the site was shut down in 1988, ²³⁸Pu was mixed with about 16% ²³⁹Pu.

Human radiation experiments

Ernest O. Lawrence's 60-inch cyclotron at the University of California Lawrence Radiation Laboratory, Berkeley, in August, 1939, the most powerful accelerator in the world at the time. Glenn T. Seaborg and Edwin M. McMillan (right) used it to discover plutonium, neptunium, and many other transuranic elements and isotopes, for which they received the 1951 Nobel Prize in chemistry.

Plutonium was first synthesized in 1940 and isolated in 1941 by chemists at the University of California, Berkeley. The Manhattan Project began shortly after the discovery, with most early research (pre-1944) carried out using small samples manufactured using the large cyclotrons at the Berkeley Rad Lab and Washington University in St. Louis.

Much of the difficulty encountered during the Manhattan Project regarded the production and testing of nuclear fuel. Both uranium and plutonium were eventually determined to be fissile, but in each case they had to be purified to select for the isotopes suitable for an atomic bomb. With World War II underway, the research teams were pressed for time. While samples of plutonium were available in small quantities and being handled by researchers, no one knew what health effects this might have. Micrograms of plutonium were made by cyclotrons in 1942 and 1943. In the fall of 1943 Robert Oppenheimer is quoted as saying "there's only a twentieth of a milligram in existence." By his request, the Rad Lab at Berkeley made available 1.2 mg of plutonium by the end of October 1943, most of which was taken to Los Alamos for theoretical work there.

The world's second reactor, the X-10 Graphite Reactor built at a secret site at Oak Ridge would be fully operational in 1944. In November 1943, shortly after its initial start-up, it was able to produce a miniscule 500 mg. However, this plutonium was mixed with large amounts of uranium fuel and destined for the nearby chemical processing pilot plant for isotopic separation (enrichment). Gram amounts of plutonium wouldn't be available until spring of 1944.

Industrial-scale production of plutonium only began in March 1945 when the B Reactor at the Hanford Site began operation. However, plutonium handling mishaps occurred in 1944, causing alarm in the Manhattan Project leadership as contamination inside and outside the laboratories were becoming an issue. In August 1944, a chemist named Don Mastick was sprayed in the face with liquid plutonium chloride, causing him to accidentally swallow some. Nose swipes taken of plutonium researchers indicated that plutonium was being breathed in. Lead Manhattan Project chemist Glenn Seaborg, discoverer of many transuranium elements including plutonium, urged that a safety program be developed for plutonium research. In a memo to Robert Stone at the Chicago Met Lab, Seaborg wrote "that a program to trace the course of plutonium in the body be initiated as soon as possible ... [with] the very highest priority." This memo was dated January 5, 1944, prior to many of the contamination events of 1944 in Building D where Mastick worked. Seaborg later claimed that he did not at all intend to imply human experimentation in this memo, nor did he learn of its use in humans until far later due to the compartmentalization of classified information.

With bomb-grade enriched plutonium-239 destined for critical research and for atomic weapon production, it was difficult to obtain for any other use. Highly radioactive plutonium-238 was unusable for atomic weapon fuel, and was instead used in human experimentation more than Pu-239. However, Pu-238 is far more dangerous due to its short half-life, resulting in more damaging emissions. It was also found to be excreted in almost negligible amounts, meaning that virtually all ingested plutonium remains in the body. This would have devastating effects due to the scarcity of Pu-239 for medical experiments.

From April 10, 1945 to July 18, 1947, eighteen people were injected with plutonium as part of the Manhattan Project. Doses administered ranged from 0.095 to 5.9 microcuries (μCi).

Albert Stevens, in experiments referred to as CAL-1, was injected in 1945 with 3.5 μCi ²³⁸Pu, and 0.046 μCi ²³⁹Pu, giving him an initial body burden of 3.546 μCi (131 kBq) total activity without his informed consent. The fact that he had the highly radioactive Pu-238 (produced in the 60-inch cyclotron at the Crocker Laboratory by deuteron bombardment of natural uranium) contributed heavily to his long-term dose. Had all of the plutonium given to Stevens been the long-lived Pu-239 as used in similar experiments of the time, Stevens's lifetime dose would have been significantly smaller. The short half-life of 87.7 years of Pu-238 means that a large amount of it decayed during its time inside his body, especially when compared to the 24,100 year half-life of Pu-239.

Because Stevens survived for about 20 years after his experimental dose of plutonium before succumbing to heart disease, he survived the highest known accumulated radiation dose in any human. Modern calculations of his lifetime absorbed dose give an incredible 64 Sv (6400 rem) total.

Weapons

The first application was its use in a weapons component made at Mound for the Weapons Design Agency Lawrence Livermore Laboratory (LLL). Mound was chosen for this work because of its experience in producing the polonium-210-fueled Urchin initiator and its work with several heavy elements in a Reactor Fuels program. Two Mound scientists spent 1959 at LLL in joint development while the Special Metallurgical Building was constructed at Mound to house the project. Meanwhile, the first sample of plutonium-238 came to Mound in 1959.

The weapons project was planned for about 1 kg/year of ²³⁸Pu over a 3-year period. However, the ²³⁸Pu component could not be produced to the specifications despite a 2-year effort beginning at Mound in mid-1961. A maximum effort was undertaken with 3 shifts a day, 6 days a week, and ramp-up of Savannah River's ²³⁸Pu production over a 3-year period to about 20 kg/year. A loosening of the specifications resulted in productivity of about 3%, and production finally began in 1964.

Use in radioisotope thermoelectric generators

Beginning on January 1, 1957, Mound Laboratories RTG inventors Jordan & Birden were working on an Army Signal Corps contract (R-65-8- 998 11-SC-03-91) to conduct research on radioactive materials and thermocouples suitable for the direct conversion of heat to electrical energy using polonium-210 as the heat source.

In 1961, Capt. R. T. Carpenter had chosen ²³⁸Pu as the fuel for the first RTG (radioisotope thermoelectric generator) to be launched into space as auxiliary power for the Transit IV Navy navigational satellite. By January 21, 1963, the decision had yet to be made as to what isotope would be used to fuel the large RTGs for NASA programs.

Early in 1964, Mound Laboratories scientists developed a different method of fabricating the weapon component that resulted in a production efficiency of around 98%. This made available the excess Savannah River ²³⁸Pu production for Space Electric Power use just in time to meet the needs of the SNAP-27 RTG on the Moon, the Pioneer spacecraft, the Viking Mars landers, more Transit Navy navigation satellites (precursor to today's GPS) and two Voyager spacecraft, for which all of the ²³⁸Pu heat sources were fabricated at Mound Laboratories.

The radioisotope heater units were used in space exploration beginning with the Apollo Radioisotope Heaters (ALRH) warming the Seismic Experiment placed on the Moon by the Apollo 11 mission and on several Moon and Mars rovers, to the 129 LWRHUs warming the experiments on the Galileo spacecraft.

An addition to the Special Metallurgical building weapon component production facility was completed at the end of 1964 for ²³⁸Pu heat source fuel fabrication. A temporary fuel production facility was also installed in the Research Building in 1969 for Transit fuel fabrication. With completion of the weapons component project, the Special Metallurgical Building, nicknamed "Snake Mountain" because of the difficulties encountered in handling large quantities of ²³⁸Pu, ceased operations on June 30, 1968, with ²³⁸Pu operations taken over by the new Plutonium Processing Building, especially designed and constructed for handling large quantities of ²³⁸Pu. Plutonium-238 is given the highest relative hazard number (152) of all 256 radionuclides evaluated by Karl Z. Morgan et al. in 1963.

Nuclear powered pacemakers

Radioisotope-powered cardiac pacemaker developed by the Atomic Energy Commission, the atomic battery stimulates the pulsing action of a malfunctioning heart. Circa 1967.

When plutonium-238 became available for non-military uses, numerous applications were proposed and tested, including the Cardiac Pacemaker program that began on June 1, 1966, in conjunction with NUMEC. When it was recognized that the heat source would not remain intact through cremation, the program was cancelled because 100% assurance could not be guaranteed that a cremation event would not occur.

As of 2007, there were nine living people with nuclear powered pacemakers, of 139 original recipients. When these individuals die, the pacemaker is supposed to be removed and shipped to Los Alamos where the plutonium will be recovered.

In a letter to the New England Journal of Medicine discussing a woman who received a Numec NU-5 decades ago that is continuously operating, despite an original $5,000 price tag equivalent to $23,000 in 2007 dollars, the follow-up costs have been about $19,000 compared with $55,000 for a battery-powered pacemaker.

Production

Reactor-grade plutonium from spent nuclear fuel contains various isotopes of plutonium. ²³⁸Pu makes up only one or two percent, but it may be responsible for much of the short-term decay heat because of its short half-life relative to other plutonium isotopes. Reactor-grade plutonium is not useful for producing ²³⁸Pu for RTGs because difficult isotopic separation would be needed.

Pure plutonium-238 is prepared by neutron irradiation of neptunium-237, one of the minor actinides that can be recovered from spent nuclear fuel during reprocessing, or by the neutron irradiation of americium in a reactor. The targets are purified chemically, including dissolution in nitric acid to extract the plutonium-238. A 100 kg sample of light water reactor fuel that has been irradiated for three years contains only about 700 grams of neptunium-237, and the neptunium must be extracted selectively. Significant amounts of pure ²³⁸Pu could also be produced in a thorium fuel cycle.

The United States ²³⁸Pu inventory supports both NASA (civil space) and other national security applications. The Department of Energy maintains separate inventory accounts for the two categories. As of March 2015, a total of 35 kilograms (77 pounds) of ²³⁸Pu was available for civil space uses. Out of the inventory, 1 kilogram (2.2 lb) remains in good enough condition to meet NASA specifications for power delivery; it is this pool of ²³⁸Pu that will be used in a multi-mission radioisotope thermoelectric generator (MMRTG) for the 2020 Mars Rover mission and two additional MMRTGs for a notional 2024 NASA mission. 21 kilograms (46 lb) will remain after that, with approximately 4 kilograms (8.8 lb) just barely meeting the NASA specification. This 21 kilograms (46 lb) can be brought up to NASA specifications if it is blended with a smaller amount of newly produced ²³⁸Pu having a higher energy density.

U.S. production ceases and resumes

The United States stopped producing bulk ²³⁸Pu with the closure of the Savannah River Site reactors in 1988. Since 1993, all of the ²³⁸Pu used in American spacecraft has been purchased from Russia. In total, 16.5 kilograms (36 lb) have been purchased, but Russia is no longer producing ²³⁸Pu, and their own supply is reportedly running low.

In February 2013, a small amount of ²³⁸Pu was successfully produced by Oak Ridge's High Flux Isotope Reactor, and on December 22, 2015, they reported the production of 50 grams (1.8 ounces) of ²³⁸Pu.

In March 2017, Ontario Power Generation (OPG) and its venture arm, Canadian Nuclear Partners, announced plans to produce ²³⁸Pu as a second source for NASA. Rods containing neptunium-237 will be fabricated by Pacific Northwest National Laboratory (PNNL) in Washington State and shipped to OPG's Darlington Nuclear Generating Station in Clarington, Ontario, Canada where they will be irradiated with neutrons inside the reactor's core to produce ²³⁸Pu.

In January 2019, it was reported that some automated aspects of its production were implemented at Oak Ridge National Laboratory in Tennessee, that are expected to triple the number of plutonium pellets produced each week. The production rate is now expected to increase from 80 pellets per week to about 275 pellets per week, for a total production of about 400 grams per year. The goal now is to optimize and scale-up the processes in order to produce an average of 1.5 kg (3.3 lb) per year by 2025.

Applications

The main application of ²³⁸Pu is as the heat source in radioisotope thermoelectric generators (RTGs). The RTG was invented in 1954 by Mound scientists Ken Jordan and John Birden, who were inducted into the National Inventors Hall of Fame in 2013. They immediately produced a working prototype using a ²¹⁰Po heat source, and on January 1, 1957, entered into an Army Signal Corps contract (R-65-8- 998 11-SC-03-91) to conduct research on radioactive materials and thermocouples suitable for the direct conversion of heat to electrical energy using polonium-210 as the heat source.

RTG technology was first developed by Los Alamos National Laboratory during the 1960s and 1970s to provide radioisotope thermoelectric generator power for cardiac pacemakers. Of the 250 plutonium-powered pacemakers Medtronic manufactured, twenty-two were still in service more than twenty-five years later, a feat that no battery-powered pacemaker could achieve.

This same RTG power technology has been used in spacecraft such as Pioneer 10 and 11, Voyager 1 and 2, Cassini–Huygens and New Horizons, and in other devices, such as the Mars Science Laboratory and Mars 2020 Perseverance Rover, for long-term nuclear power generation.