Is the modern psych ward really the cuckoo's nest we've been led to believe it is?
A still from Girl, Interrupted. Via Columbia Pictures
Back in 2005, Laurie Kramer wanted to kill herself, and she had a plan. That was enough for her psychiatrist to send her to the psychiatric ward of a hospital to stay for a week and a half of observation. The following year, during a manic-depressive episode, she was sent away for two weeks, this time to a facility devoted entirely to mental health.
Despite the recent inroads made in legitimizing and de-stigmatizing mental illness and those who suffer from it, the mysterious facilities in which these ailments are treated often still carry negative connotations. With pop-culture representations of these places rarely straying from the clichés of a spooky Victorian-era asylum filled with rusting bed frames and uncaring Nurse Ratcheds, it's not difficult to see why that may be.
I spoke with Kramer about her time in the psych wards to see what her experience was like, and if they're as bad as we've been lead to believe.
This interview has been edited for clarity and length.
VICE: What was a typical day like in the wards? Was it fun? Were you bored?
Laurie Kramer: You get up and change into clothes for the day, and then you make your bed, and then you have breakfast. Then there would be group therapy for a couple hours, and then you'd have lunch, and then you'd have more group therapy.
The second time, I didn't go to the group therapies. It wasn't really part of it. The ward was run differently, and attendance wasn't mandatory. I preferred that one because I hated group therapy. I didn't want to listen to all these people prattling.
At the second hospital, they had an arts-and-crafts room and a stationary bicycle. That would be the "fun time." But I was very, very bored all the time.
Could you leave any time you wanted? If not, when and how did you or the doctors know you were better enough to be released?
No, I couldn't. I was on a locked ward both times. You can't walk out until they clear you.
The first time, I was encouraged to attend the group therapy sessions. You got points for doing stuff, and going to the session got you points. And you wanted those points because they were what got you out.
The first stay, I really hated being there and wanted to get out. I think I did a pretty good job of explaining myself to the psychiatrist why I was ready to go. And I was a lot better, actually.
What eventually cured me, and has kept me sane for ten years now, is one particular anti-psychotic medication. Some day soon, genetic testing is going to make prescribing medications a lot easier, but for now it's just trial and error with dosage. Now I take two antidepressants and two anti-psychotics and that works for me. I took lithium for a while, but that had side effects that were pretty untenable.
While I was sick, I was seeing my psychiatrist once or twice a week. Then, after all that, I would see them every few weeks. Now, just every few months to check in.
Were you given shock therapy? If so, what does it feel like and do you think it helped?
I got ECT [electroconvulsive therapy] three times a week: Monday, Wednesday, and Friday. I had it for a couple weeks after I got out of the hospital, too.
You'd get on a bus and go across the street to this facility for day procedures. There were about six to eight of us who would go. You get changed and go lie down on a table. The anesthetist comes first and knocks you out, and then the psychiatrist comes and applies the electricity to your head. Out cold the whole time. No pain, no nothing.
Waking up, I was confused. And the more ECT I had, the more confused I would be.
It didn't help. It turns out, the first week, they gave me anti-seizure meds, which they sometimes used for psychiatric problems. And that was preventing me from having a seizure, which is the goal of ECT, to induce a seizure.
Were you ever in a straightjacket or padded cell?
No, but, at one point, I was put in four-point restraints. But I'll let my husband explain it because I don't remember any of it.
[Laurie's husband, Phillip, enters the conversation.]
Phillip Kramer: They called to tell me that she was quite agitated and they had her restrained and wanted to know if I wanted to come in. I'm a physician, so I did want to come in, which they seemed surprised by. By the time I got there, they only had her restrained at three points, allowing her one arm to be free. But she was still very agitated.
The room was not padded, though. It's essentially a comfortable bed with straps for the limbs. I've ordered that for a patient in the regular hospital. We try not to do that and there's all kinds of rules about it, but that's the closest thing to padded rooms these days.
Did you ever swap meds with other patients or pretend to swallow your pills to trick a nurse?
Laurie Kramer: Never did or saw anything like that. You have to do it in front of the nurses, and they watch you take it. I wasn't aware of anyone trying to stash it in their cheeks.
How severe were the other patients' conditions? Did you ever feel unsafe around them?
Some of the people there were quite sick. I wasn't well myself but... There were a lot of different characters, both times. There was one woman who was clearly psychotic.
Phillip Kramer: At the first hospital, the people I saw there, at any given time they seemed normal and could have a conversation with you. At the second hospital, you instantly knew something was wrong with them. They were in a different state and clearly mentally ill.
Laurie Kramer: I was too, though. I was much sicker that second time. I was having the ECT, which causes confusion. I don't know if I was ever psychotic, but I was delusional. I thought "they" were out to get me.
Were you able to make friends?
It was tricky. A lot of the other people in that ward weren't—how to put this—as smart as I am. The first time, I made friends with two or three of the women, and we really hit it off and were sort of a little clique there for the week.
The second time, I didn't really have someone I could call my friend. There were long days then.
Were there any lucid moments where you were able to see how your sanity was slipping or see the illness from a different perspective?
There was one time where I'd come back from ECT, and I was convinced it was doing nothing for me. I called Phillip and was screaming to him about how it wasn't helping, et cetera, and one of the nurses told me, "I don't like the way you talk to your husband." And it kinda hit me. This wasn't acceptable.
Were the orderlies or doctors ever abusive?
I haven't seen One Flew Over the Cuckoo's Nest, but I know enough about it to say that there was no abuse like that at all. The nurses and other practitioners I saw were pretty nice and understanding.
How do people react when they hear you've stayed in a mental hospital?
That's hard to say. Our friends know it.
Phillip Kramer: It's not as if anyone stopped being our friends or anything. You usually don't tell someone something like this until they've known you a while and, the fact is, Laurie is a perfectly normal so their reactions, if they even have any, are of surprise.
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