The notion of a psychiatric facility, for many, brings to mind ideas of padded rooms and straight jackets. Speaking from personal experience, I can assure you that it’s no walk in the park. It’s also unlike most stereotypes you’ve heard or seen.
There’s been a lot of progress made in mental health care over the past few decades. Yet negative stereotypes of the system that’s supposed to help mentally unstable people are still prevalent. In 2011, I was admitted to two different psychiatric facilities in the course of four months—once for feeling suicidal and the second time when I attempted suicide. My experiences were both helpful and surreal.
Below are a few lessons I learned from my time while in inpatient care, just in case you find yourself there at some point, or return there hoping for a better experience than the last. To get a professional opinion from the other side, I spoke with Susan Szulewski and Diane Bedell, medical director and program director, respectively, at the Clinical Evaluation Center at McLean Hospital in Massachusetts.
Do some research.
To find an inpatient facility, start by looking at which ones your insurance covers. Ask your therapist or psychiatrist for advice. (Even if you don’t ask them, let them know where you’re going.) Bedell says, “If you’re coming in voluntarily it may not be a possibility to choose…because there may not be a bed in the hospital you want.” Research is also important for knowing what to pack. Some facilities have information on their website that states what you can and can’t bring. If you don’t see such a list, it doesn’t hurt to call (or have a friend or family member call) to find out. Even if you don’t end up at the hospital you want to go to, most places have similar lists of what to what to bring.
You may see some things you wish you hadn’t.
Depending on the hospital, you might see strange shit. Like, uncomfortable shit. Or, in my case, actual shit. The first hospital I went to housed a handful of people with whom I couldn’t engage in conversation; they were catatonic or going through detox. I also saw a woman who was trying to throw her feces at staff until orderlies sedated her. I talked to other patients who had hundreds of self-inflicted cuts on their bodies. These included ones inflicted in the hospital, using whatever they could find. I also saw a guy who had a bruise around his neck from where he had tried to hang himself a few hours earlier. At the second hospital I went to, everyone was really chill. Go figure.
Keep as busy as possible.
“When I’m talking to patients that are coming into the hospital,” Szulewski says, “I like to tell them that this is time for them. While they’re here, there will be structured programming…but there will also be some downtime where they can do things they haven’t taken the time to do.” That might be reading, meditating, or as Bedell notes, taking time to speak with fellow patients, which can be helpful—it reminds you there are people who are having similar experiences.
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When I was in the hospital the second time, I had but a few moments for myself, which was a good thing. Planned activities kept me from thinking too much about suicide. Group and personal therapy reinforced skills that were helpful in my recovery.
The first hospital I was in had too much downtime. I was there over a weekend, too, when there weren’t many activities or any doctors checking in with you (unless it’s an emergency). I filled my time at the first psych facility by doing a lot of crossword puzzles, reading books my partner brought me, and writing. I also watched the TV-edited version of Goodfellas. It sucked, FYI.
Engage with doctors, even when you don't feel up to it.
Be honest and open with your doctors. Szulewski points out it’s important to make a list of what it is you want to achieve through your sessions with your treating psychiatrist. Engaging with your doctors and others in therapy and at activities is the best way to get out of the hospital sooner rather than later. Try and take part even when you don’t feel like it. It shows that you’re making progress. It also gives staff and doctors an opportunity to evaluate your emotions and actions.
The first time I was in the hospital my partner visited twice. She brought books and gave me letters she had written while I was inside. Her visits provided encouragement and hope. The second time I was in the hospital no one came to visit me, which is, in hindsight, one of the saddest things ever. This hit me even more when I saw so many people who had loving families around them. I saw patients’ faces light up when loved ones came to visit.
Szulewski says the prognosis is better when “there’s a support network around the person while they’re here.” Having loved ones around you can also “make sure everyone’s on the same page of what is going on…and makes everyone aware of what the next steps are” when you get discharged.
Know that discharge from the hospital is just one step along the way.
When you do leave, you may not feel all better. My first time out of the hospital I bawled my eyes out in my therapist’s office two days later and thought I’d have to go back to the hospital. What I’ve learned since my hospitalizations is that inpatient psychiatric care is not meant to cure your problems. Rather, as Bedell told me, inpatient admission is “just to stabilize someone who’s in a more acute crisis.” Give it some time, keep in touch with your therapist, and stay on the med schedule (if you have one) that you and your physician feel comfortable with.
“The actual discharge process that happens is one step in the transition back to what would either be an interim-level care or an outpatient-level care where they are following up with their previous provider,” Szulewski says.
There have been many positive changes over the years in mental health treatment. Yet Bedell and Szulewski say the biggest misconception is that people are mostly unwillingly admitted to inpatient units. Or, something I’ve heard is that people get locked away forever. It's quite the contrary, Szulewski says. “It’s a collaborative process. We always work together with the patients to make sure we’re doing what’s best for them.”
If you are experiencing suicidal thoughts or know someone who is, call the National Suicide Hotline at 1-800-273-8255.
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