Last year I talked about my bipolar disorder diagnosis, but I didn't really touch upon my hospitalizations. With psych ward RP being so popular, and soooo many misconceptions floating around out there, I thought I'd clear some things up and provide some insight. I do feel the need to specify that I have never been institutionalized or placed in a long-term mental healthcare facility. My hospitalizations were in acute wards with stays of less than two weeks at a time. That said, there is a lot of crossover in terms of policy, so much of what I say about day to day safety and overall operations will be applicable to both. Additionally, "acute," while accurate, can be a bit of a misleading indicator, as there were often patients in the ward with me who'd been there for months.
Your mileage may vary depending upon your diagnosis and care needs, as well as your insurance policy and the availability of beds in your area. Additionally, some hospital wards may be stricter than others depending on the necessary care level of the majority of their patients. Please note that while underage wards exist, mine were primarily occupied by those over the age of 18. I did have a 17 year old roommate at one of my hospital stays, but this was not common. Minors are generally not kept with adults where I live.
To specify, I live in the US, so this info is through the lens of an American experience.
A disclaimer: Nothing I say in this thread is meant to be medical advice. If you think that you are a danger to yourself or others, or that you need a higher level of care, please reach out to a crisis hotline so that a professional, compassionate listener can walk you through the process.
My initial stay was 10 days. This was primarily because they needed to make sure that I was safely out of the manic episode, and that I was well enough to live without the 24/7 support structure of inpatient. Honestly, the worst part of inpatient is simply the boredom. We're all used to being constantly connected to other people at this point thanks to the internet, so being cut off from that definitely sucks. It is always 100% worth it for safety, though, and when I need to go, I do so.
Something I see come up in psych ward RP a lot is the idea of restraints. I want to note that, at least in my experiences, physical restraint is extremely uncommon. Mostly, the staff will do their best to verbally deescalate the situation and provide comfort and empathy to the patient. Restraint only exacerbates a state of distress and makes things worse, and their ultimate goal for each patient is wellness. They're there to help you, not cause you intentional harm.
I have only seen one patient restrained in my time in wards, and it was awful. She screamed for what felt like hours until exhaustion and sedation eased her into calm, and even ear plugs didn't help. Staff felt terrible. No one was happy about it. Unfortunately, she was a danger to herself in that state, and the last resort became the only option. When it was happening, we were all encouraged to stay in our rooms or in common areas that were out of the hallway, to minimize trauma for the other patients.
Ask me anything!
Your mileage may vary depending upon your diagnosis and care needs, as well as your insurance policy and the availability of beds in your area. Additionally, some hospital wards may be stricter than others depending on the necessary care level of the majority of their patients. Please note that while underage wards exist, mine were primarily occupied by those over the age of 18. I did have a 17 year old roommate at one of my hospital stays, but this was not common. Minors are generally not kept with adults where I live.
To specify, I live in the US, so this info is through the lens of an American experience.
A disclaimer: Nothing I say in this thread is meant to be medical advice. If you think that you are a danger to yourself or others, or that you need a higher level of care, please reach out to a crisis hotline so that a professional, compassionate listener can walk you through the process.
I'll begin by telling you about the first of my seven hospitalizations, to give you an idea of what it was like with fresh eyes.
I'd been struggling with depression and anxiety, so about five months prior, I'd started therapy with a wonderful therapist, and began to get medication from a less wonderful provider within the same agency. The latter was not great because any concerns I had about side effects were brushed over with dose increases and additional medications. (Big red flag! Make sure you find a provider who listens to your concerns!) I had just about every single bad side effect of this particular medication, and spiraled into what was later identified as a manic episode (I was undiagnosed as bipolar at the time). At the urging of my therapist, I agreed to go to the hospital because I was so wound up, I could only cry any time I opened my mouth.
I had been about to go to work after the appointment, and I was a manager at the time. I went into my place of employment and told them I was going to the hospital, then went straight there with my briefcase and suit and nothing else. Not knowing what else to do, I went up to the reception desk in the local ER and informed them that I was suicidal (which was somewhat true, but mostly I just couldn't form a coherent thought, and it seemed the best way to underscore a mental health crisis).
From there, I was guided into triage, and then brought into a room in the ER to meet with a crisis counselor. It only took them a couple of minutes to verify that yes, I absolutely was in crisis. My understanding is that it is generally policy for hospitals to have someone who will do this evaluation, whether a third party or hospital employee, because a crisis eval is necessary for the next step of the process.
After the eval, I was admitted to the ER and placed on something called "bed search." This process involves the hospital calling around to find placement within as local a ward as they can find who is ideally covered by your insurance. Not having insurance doesn't prevent you from getting a bed, but they do try to make sure you're covered. Bed search can, and often does take even longer than waiting to be triaged in the ER. On that particular stay, they rushed me into the emergency department, but then came the long wait. They took my briefcase, and all of my belongings except for my phone. (Some hospitals will take your belongings in the ER, some won't. Your mileage may vary.) The ER was overfilled, and I spent 12 hours sitting on a gurney in the hallway waiting to be admitted to the psych unit around 11pm. During this time, I also had to have blood work done to verify that the cause of my breakdown was not medical in nature/caused by substances in my system.
Luckily on that occasion, they found me a bed at the same hosptial, and I didn't have to be transferred by ambulance to another (I have had that happen a few times). Completely exhausted and disoriented, I was loaded into a wheelchair and moved through the hospital to the unit on the top floor of an older part of the hospital. Everyone was in bed, the hallways were dark, and a very kind nurse took me through the intake process. My phone was taken from me, placed with the rest of my belongings in a secured room.
I was given a small assessment. I was weighed, temperature taken, asked questions about my medical history, including the medications I was on, diagnoses I had, and any allergies or intolerances so that I could be provided with an identifying bracelet to pair with my patient ID one. Then I was given a dose of an antipsychotic that would help me sleep and sent to bed.
Our rooms were two beds, although I was initially alone in mine. As part of bed search, they attempt to pair people with others who will get along with them peacefully. If you have an issue with your roommate where you feel unsafe or are contributing negatively to each other's stay, you are shuffled to a different bed as soon as possible with your consent (I had to do this at a later stay). I got a roommate a few days later who was very nice.
My first full day, I saw a doctor and was given a proper diagnosis of bipolar disorder. I was also given a prescription for a couple of new medications. You are given the opportunity to refuse medication, generally, although in my case I was a voluntary admittance, and therefore not under the same kind of control as an involuntary patient might be. My roommate was an involuntary patient, and I know that they were more rigid in trying to get her to take medication and participate in group activities before they would consider releasing her.
Day to day structure is extremely relaxed. There are group activities throughout the day, ranging from yoga, to trivia games, to art time. You are welcome to attend or not attend whatever ones you prefer. You are never forced or punished for noncompliance, although not participating can extend your hospital stay if they feel that you are not stable enough for reentry into society. All of these are supervised, and of them, art was hands down my favorite. I was even given colored pencils and watercolors to use in my room, though your mileage may vary with that, and at a later stay this was not allowed due to policy changes, as the pencils were considered "sharps."
A sharp is anything that you could potentially injure yourself with, either as-is, or if broken. We were not allowed to take the plastic knives from the dining room if we decided to eat in our rooms (although we were allowed to take plastic forks??? Again, your mileage may vary, but this was the case at both of the hospitals I've been to). I've had even debit cards confiscated because they could be sharp plastic if broken. We were given an hour of supervised electronics time on our phones three times daily at one of my hospitals, but not at all at another because the screens could be broken and become dangerous sharps.
Strings are also not allowed. If you don't have clothing to change into, you are provided with hospital gowns and pants that snap rather than tie. You are also provided with a pair of non-slip socks and ear plugs to help you sleep. Extra blankets and pillows are also available. All of these were kept freely accessible 24/7 on shelves in common space.
One of the things that required adjusting to was the total lack of privacy. The only time I was ever behind a locked door was when I was in the shower, which could only be accessed by staff opening it for you. The bedroom and even bathroom doors were all without locks, and every 15 minutes, a staff member had to get eyes on you. If you were in the shower or bathroom, they would knock and verbally confirm your safety. At night, they pop in just enough to see you in your beds before marking it on a clipboard. These are called "checks."
Phones are available 24/7 in the common space, although they do not ring between certain hours at night. In many cases, these are your only connection with the outside world, although one of my later hospitals actually had linux laptops that we were allowed to use generally at all hours, which was nice -- and uncommon. This was definitely an exception to the rule. They were also kept in a metal case with shatterproof fiber glass over the screen.
I'd been struggling with depression and anxiety, so about five months prior, I'd started therapy with a wonderful therapist, and began to get medication from a less wonderful provider within the same agency. The latter was not great because any concerns I had about side effects were brushed over with dose increases and additional medications. (Big red flag! Make sure you find a provider who listens to your concerns!) I had just about every single bad side effect of this particular medication, and spiraled into what was later identified as a manic episode (I was undiagnosed as bipolar at the time). At the urging of my therapist, I agreed to go to the hospital because I was so wound up, I could only cry any time I opened my mouth.
I had been about to go to work after the appointment, and I was a manager at the time. I went into my place of employment and told them I was going to the hospital, then went straight there with my briefcase and suit and nothing else. Not knowing what else to do, I went up to the reception desk in the local ER and informed them that I was suicidal (which was somewhat true, but mostly I just couldn't form a coherent thought, and it seemed the best way to underscore a mental health crisis).
From there, I was guided into triage, and then brought into a room in the ER to meet with a crisis counselor. It only took them a couple of minutes to verify that yes, I absolutely was in crisis. My understanding is that it is generally policy for hospitals to have someone who will do this evaluation, whether a third party or hospital employee, because a crisis eval is necessary for the next step of the process.
After the eval, I was admitted to the ER and placed on something called "bed search." This process involves the hospital calling around to find placement within as local a ward as they can find who is ideally covered by your insurance. Not having insurance doesn't prevent you from getting a bed, but they do try to make sure you're covered. Bed search can, and often does take even longer than waiting to be triaged in the ER. On that particular stay, they rushed me into the emergency department, but then came the long wait. They took my briefcase, and all of my belongings except for my phone. (Some hospitals will take your belongings in the ER, some won't. Your mileage may vary.) The ER was overfilled, and I spent 12 hours sitting on a gurney in the hallway waiting to be admitted to the psych unit around 11pm. During this time, I also had to have blood work done to verify that the cause of my breakdown was not medical in nature/caused by substances in my system.
Luckily on that occasion, they found me a bed at the same hosptial, and I didn't have to be transferred by ambulance to another (I have had that happen a few times). Completely exhausted and disoriented, I was loaded into a wheelchair and moved through the hospital to the unit on the top floor of an older part of the hospital. Everyone was in bed, the hallways were dark, and a very kind nurse took me through the intake process. My phone was taken from me, placed with the rest of my belongings in a secured room.
I was given a small assessment. I was weighed, temperature taken, asked questions about my medical history, including the medications I was on, diagnoses I had, and any allergies or intolerances so that I could be provided with an identifying bracelet to pair with my patient ID one. Then I was given a dose of an antipsychotic that would help me sleep and sent to bed.
Our rooms were two beds, although I was initially alone in mine. As part of bed search, they attempt to pair people with others who will get along with them peacefully. If you have an issue with your roommate where you feel unsafe or are contributing negatively to each other's stay, you are shuffled to a different bed as soon as possible with your consent (I had to do this at a later stay). I got a roommate a few days later who was very nice.
My first full day, I saw a doctor and was given a proper diagnosis of bipolar disorder. I was also given a prescription for a couple of new medications. You are given the opportunity to refuse medication, generally, although in my case I was a voluntary admittance, and therefore not under the same kind of control as an involuntary patient might be. My roommate was an involuntary patient, and I know that they were more rigid in trying to get her to take medication and participate in group activities before they would consider releasing her.
Day to day structure is extremely relaxed. There are group activities throughout the day, ranging from yoga, to trivia games, to art time. You are welcome to attend or not attend whatever ones you prefer. You are never forced or punished for noncompliance, although not participating can extend your hospital stay if they feel that you are not stable enough for reentry into society. All of these are supervised, and of them, art was hands down my favorite. I was even given colored pencils and watercolors to use in my room, though your mileage may vary with that, and at a later stay this was not allowed due to policy changes, as the pencils were considered "sharps."
A sharp is anything that you could potentially injure yourself with, either as-is, or if broken. We were not allowed to take the plastic knives from the dining room if we decided to eat in our rooms (although we were allowed to take plastic forks??? Again, your mileage may vary, but this was the case at both of the hospitals I've been to). I've had even debit cards confiscated because they could be sharp plastic if broken. We were given an hour of supervised electronics time on our phones three times daily at one of my hospitals, but not at all at another because the screens could be broken and become dangerous sharps.
Strings are also not allowed. If you don't have clothing to change into, you are provided with hospital gowns and pants that snap rather than tie. You are also provided with a pair of non-slip socks and ear plugs to help you sleep. Extra blankets and pillows are also available. All of these were kept freely accessible 24/7 on shelves in common space.
One of the things that required adjusting to was the total lack of privacy. The only time I was ever behind a locked door was when I was in the shower, which could only be accessed by staff opening it for you. The bedroom and even bathroom doors were all without locks, and every 15 minutes, a staff member had to get eyes on you. If you were in the shower or bathroom, they would knock and verbally confirm your safety. At night, they pop in just enough to see you in your beds before marking it on a clipboard. These are called "checks."
Phones are available 24/7 in the common space, although they do not ring between certain hours at night. In many cases, these are your only connection with the outside world, although one of my later hospitals actually had linux laptops that we were allowed to use generally at all hours, which was nice -- and uncommon. This was definitely an exception to the rule. They were also kept in a metal case with shatterproof fiber glass over the screen.
My initial stay was 10 days. This was primarily because they needed to make sure that I was safely out of the manic episode, and that I was well enough to live without the 24/7 support structure of inpatient. Honestly, the worst part of inpatient is simply the boredom. We're all used to being constantly connected to other people at this point thanks to the internet, so being cut off from that definitely sucks. It is always 100% worth it for safety, though, and when I need to go, I do so.
Something I see come up in psych ward RP a lot is the idea of restraints. I want to note that, at least in my experiences, physical restraint is extremely uncommon. Mostly, the staff will do their best to verbally deescalate the situation and provide comfort and empathy to the patient. Restraint only exacerbates a state of distress and makes things worse, and their ultimate goal for each patient is wellness. They're there to help you, not cause you intentional harm.
I have only seen one patient restrained in my time in wards, and it was awful. She screamed for what felt like hours until exhaustion and sedation eased her into calm, and even ear plugs didn't help. Staff felt terrible. No one was happy about it. Unfortunately, she was a danger to herself in that state, and the last resort became the only option. When it was happening, we were all encouraged to stay in our rooms or in common areas that were out of the hallway, to minimize trauma for the other patients.
Lastly, here are a few of the paintings that I did while I was in my first inpatient stay, just in case anyone's curious.
Ask me anything!
This was a very interesting read! Thank you so much for sharing
- Were you permitted to watch TV?
- Were you permitted to have guests, and what restrictions were there?
- What would you estimate the ratio of men and women patients were?
- Were you permitted to watch TV?
- Were you permitted to have guests, and what restrictions were there?
- What would you estimate the ratio of men and women patients were?
Were you permitted to watch TV?
We had two common rooms that had TV on during the majority of the day - the dining room, and then a kind of lounge space. We could control the channel and were able to pretty freely watch what we wanted, although if it was deemed to be too stressful or scary, the staff might change the channel/ask us to pick something else. Any patient could change the channel, but it was common courtesy to kind of check with the rest of the room.
Were you permitted to have guests, and what restrictions were there?
During daytime hours, until I think about 5pm, we were permitted to have guests. They had to be over the age of 18, and anything brought with them had to be searched by staff for the safety of the patients. My friends brought me a sushi roll, but I had to be supervised since it came in a metal tin. If I hadn't finished it in a sitting, it would have had to be kept by staff when I wasn't nibbling.
What would you estimate the ratio of men and women patients were?
Pretty 50/50! I never noticed the population skewing in any particular direction. Roommates were paired with the same gender, and transgender patients were not limited by their AGAB. I have seen NB patients get their own room or be paired with others with binary genders. It depends on their personal feeling of comfort and safety.
We had two common rooms that had TV on during the majority of the day - the dining room, and then a kind of lounge space. We could control the channel and were able to pretty freely watch what we wanted, although if it was deemed to be too stressful or scary, the staff might change the channel/ask us to pick something else. Any patient could change the channel, but it was common courtesy to kind of check with the rest of the room.
Were you permitted to have guests, and what restrictions were there?
During daytime hours, until I think about 5pm, we were permitted to have guests. They had to be over the age of 18, and anything brought with them had to be searched by staff for the safety of the patients. My friends brought me a sushi roll, but I had to be supervised since it came in a metal tin. If I hadn't finished it in a sitting, it would have had to be kept by staff when I wasn't nibbling.
What would you estimate the ratio of men and women patients were?
Pretty 50/50! I never noticed the population skewing in any particular direction. Roommates were paired with the same gender, and transgender patients were not limited by their AGAB. I have seen NB patients get their own room or be paired with others with binary genders. It depends on their personal feeling of comfort and safety.
Those are all great to know! Thank you so much for your answers
Happy to spread the knowledge! I think more people need to know how chill and mundane psych wards can be.
Isn't it stressful to have to share space with other people, like having to deal with what others want to watch instead of being able to do what you want?
Can you leave or are you forced to stay? Do they force you to take medication?
Did the patient who had to be restrained ever recover? Do you know what happened to her?
Can you leave or are you forced to stay? Do they force you to take medication?
Did the patient who had to be restrained ever recover? Do you know what happened to her?
Since you make it clear this is something that's happened multiple times: Are you able to give some sort of description or something of how you know when you should go in for this kind of help? Or do you generally go by when a therapist suggests it?
Aardbei wrote:
Isn't it stressful to have to share space with other people, like having to deal with what others want to watch instead of being able to do what you want?
To be honest, I don't really care about TV. I was usually reading or drawing or playing with whatever large puzzle was spread out on a table at any given time. The environment is extremely relaxed, so if you don't feel like being around people, you can go to your room or one of the quiet spaces around the ward. There's usually somewhere to get away from other people if you're feeling stifled.
Aardbei wrote:
Can you leave or are you forced to stay? Do they force you to take medication?
The ward is locked, and you cannot leave until you are discharged. That said, the hospitals that I have stayed in do a daily walk around the grounds, which you can participate in if you've been cleared by a doctor (meaning that it's medically safe for you and also that you are not a flight risk).
I mentioned above that medication was never forced upon me. I have never seen someone force-fed medication, but it does prolong your stay if you are not following a treatment plan meant to stabilize you. That said, if a medication really is not working for you, they'll find you another one.
Aardbei wrote:
Did the patient who had to be restrained ever recover? Do you know what happened to her?
The patient who was restrained was fine the next day, bright and cheery like nothing ever happened and back mingling with the rest of us with her episode behind her.
Zelphyr wrote:
Since you make it clear this is something that's happened multiple times: Are you able to give some sort of description or something of how you know when you should go in for this kind of help? Or do you generally go by when a therapist suggests it?
I'm not sure how it is for other outpatient care agencies, but the one that I get my therapy and medication management through annually contracts what is called a "safety plan." This plan involves steps you can take to keep yourself from harming yourself or others. If I start to feel self-harm urges or experience passive or active suicidality, I go through it like a checklist. I am very, very good at sticking to my safety plan, and have refined it over the years with my clinician (therapist)'s input. Having concrete steps to follow in a tricky situation helps me to kind of autopilot into safety.
Here is my plan:
- Listen to music
- Play a puzzle game
- Take my appropriate PRN (as-needed medication - I have one specifically for manic episodes, and one for anxiety/PTSD symptoms)
- Take a hot bath and either continue a puzzle game or watch a show (or both at the same time)
- Reach out to my online friends to chat and distract myself
- Reach out to local friends to possibly spend time together in person if feasible (my neighbor across the hall is one, and I have other friends here in town who would come pick me up if need be)
- Call the crisis hotline managed by my outpatient agency for a crisis evaluation (these are the same people who do so in the hospital, so this would replace that step and immediately put me on bed search if admitted to the ER)
- Self-report to the ER (there is a hospital less than 5 mins from my house, this was intentional when I was moving last)
Sometimes, depending on the severity of my crisis, I may skip steps, such as taking my PRN as a first line of defense. I may also skip seeing IRL friends and go straight to calling crisis if the danger is severe enough.
I have had circumstances where I've been in outpatient therapy and have been urged to go to the hospital. In those cases, my therapist has put notes in my chart for the crisis evaluators that I am unsafe and that inpatient may be necessary. Because the crisis team is part of the same agency, they have access to all of my therapy notes.
It's good that they got through that experience.
So if a patient specifically requests to leave, they just aren't allowed? How are people treated if confinement only causes them further stress?
Do you know if patients have recourse to appeal their own confinement? What kind of accountability are facilities like this held to, to ensure no abuses or mistreatment is taking place?
Was the place you were staying at evaluated by some higher agency regularly?
So if a patient specifically requests to leave, they just aren't allowed? How are people treated if confinement only causes them further stress?
Do you know if patients have recourse to appeal their own confinement? What kind of accountability are facilities like this held to, to ensure no abuses or mistreatment is taking place?
Was the place you were staying at evaluated by some higher agency regularly?
Aardbei wrote:
So if a patient specifically requests to leave, they just aren't allowed? How are people treated if confinement only causes them further stress?
I feel like it's really imperative that I reiterate that people who are in inpatient are in imminent danger. If you're confined to a ward, it's for safety reasons. People there are given 24/7 support from staff to receive comfort and counseling at any hour, daily medication monitoring, and the confinement does not, at least in my experience, exacerbate stress and hinder treatment. If I'm at the point where I need that level of care, it is honestly a relief to be there, tucked away from the world. I can only speak to my own experiences, but confinement serves a legitimate purpose. Additionally, it's important to note that most people who were in the wards with me were there voluntarily. Involuntary commitment was less common.
Simply put, people who are in a ward are there because they may not be able to keep themselves alive otherwise. Commitment, voluntary and otherwise, is not something that is done lightly, which is why people are always given a thorough crisis evaluation before the process can even begin. Only people who really need the help are placed in a ward.
I can't really tell you how it's handled when people really do not do well with confinement because that was not my experience, and it never needed addressing for me. I do know that the staff were unfailingly compassionate with offering support, and the daily walk around the grounds helped a lot with restlessness, plus the freedom to come and go in any room without restriction.
Aardbei wrote:
Do you know if patients have recourse to appeal their own confinement?
All patients are assigned a social worker upon arrival, and they are scheduled to meet with them regularly, or can reach out if they have concerns between those appointments. You coordinate with your social worker and your doctor to work out a discharge date when you've been medically cleared/deemed safe enough to leave the 24/7 support of inpatient. Part of this process is working out and committing to an ongoing treatment plan, often with outpatient therapy or intensive outpatient/partial hospitalization as a step down from inpatient. IOP/PHP is generally about a two week program where you self-report to a daily group counseling setting for several hours. (I have done it before, but group settings are generally not conducive to healing for me due to the large volume of dual diagnosis/substance addiction patients in my area and my trauma history.)
Your social worker is who you would speak with and work with when you want to get out of the ward. In the case of involuntary commitment, there is a 3 day minimum hold in my commonwealth before the hospital will discharge you.
Aardbei wrote:
What kind of accountability are facilities like this held to, to ensure no abuses or mistreatment is taking place? Was the place you were staying at evaluated by some higher agency regularly?
I'll be honest, I don't have an exact answer for you because this isn't information I've ever pursued beyond a surface level, but it suffices to say that there are departments at the state level that work to accredit and oversee operations to make sure that all laws and codes of ethics are being followed. There is lots of accountability, both internally through the hospital, and agencies responsible for mental healthcare in my state.
Additionally, patients are given an evaluation of the staff upon discharge that can be submitted anonymously to the hospital.
I appreciate you talking about this, for the record. I don't engage with a lot of "psych ward" fiction, but my read on it from the outside looking in is that a lot of people focus on the parts of it that are a perceived - and usually involuntary - loss of personal agency. It either becomes like prison, except with far more potential for abuse and "horror", or it becomes... a way for people to play with very unbalanced power dynamics in more adult themes.
I think this is born from the perception psych wards have, and given the history of mental health treatment in the past, the reputation is not entirely undeserved. But it is important, I think, to talk about how mental health has progressed and continues to progress.
Admittedly, I have my own fears about psych wards, especially because friends/relatives have been forcibly admitted for the 72-hour period, and they came away with horror stories. But the most recent of those was 6 years ago and I do live in a 'behind-the-times' part of the US. Mental health care is a bit further along in other parts of the world, or even the USA, as I understand it from talking to people from other places.
This has been an interesting thread for me to confront some of my own fears.
Having said all that, my last question would be: When you started your treatment, did you have similar fears or attitudes about being admitted? Did you confess them to your doctors, if you did?
I think this is born from the perception psych wards have, and given the history of mental health treatment in the past, the reputation is not entirely undeserved. But it is important, I think, to talk about how mental health has progressed and continues to progress.
Admittedly, I have my own fears about psych wards, especially because friends/relatives have been forcibly admitted for the 72-hour period, and they came away with horror stories. But the most recent of those was 6 years ago and I do live in a 'behind-the-times' part of the US. Mental health care is a bit further along in other parts of the world, or even the USA, as I understand it from talking to people from other places.
This has been an interesting thread for me to confront some of my own fears.
Having said all that, my last question would be: When you started your treatment, did you have similar fears or attitudes about being admitted? Did you confess them to your doctors, if you did?
I'm so sorry that people you care about have had negative experiences in psych wards. Involuntary commitment certainly comes with trauma, and my experiences as a voluntary patient are probably a pretty stark contrast. When I go in, I definitely want to be there and am grateful for the security. The hospitals that I've been to have also been extremely well-funded and modern, and I do feel as though mental healthcare is prioritized pretty well where I live. Massachusetts has a pretty high standard of healthcare in general, in part because of how good our Medicaid programs are.
I went into my initial stay in 2014 not really knowing what to expect. I'd had friends who had been to private mental health institutions that provided a very high quality of care, and my mother actually worked at one during nursing school, so I think that I had a sense of safety about it. I felt pretty confident that I'd get help, even though I wasn't quite sure what it would entail, and I trusted my therapist very much and valued her recommendation to go in. When I self-reported, I expected a very short stay, thinking I'd be released in 24 hours, only to have a 10 day stay, so that definitely resulted in a bit of shock. I was very surprised by how much freedom we had with our daily structure, though, pleasantly so.
I think that, at the time of my admittance, I was so disoriented and confused in my manic episode that I wasn't really reflecting on what my experience would be like. I will say that I had actually desperately wanted to go to one when I was in high school and experiencing undiagnosed bipolar disorder mood episodes that came with psychosis (to the point where I'd have out of body experiences and hear voices). I'd known for a long time that I needed a higher level of care, but even in my early 20s, when I had a severe concussion, I was told bluntly that my family would not help pay for hospitalization for any reason (my family was... not great, but that's a trauma tangent). I think my greatest concern about inpatient was that it wouldn't be covered, and I'd be turned away, but in the end I only had a $250 copay (my first stay was on private insurance -- I had no copays moving forward on medicaid and medicare).
It was an extremely surreal experience the first time I went in because it was so far outside the realm of my experiences in life thus far. I actually ended up using FMLA leave from work and burning through my paid time off to give myself time to readjust to life outside the ward. Now it's kind of like an overnight camp. I pack a comfy pillow, PJs, and a few comfort items in a "go bag," and head to the ER. I go into it fully knowing what to expect.
Thank you for your questions and for confronting your own fears and bias. I hope I was able to provide some good insight!
Aardbei wrote:
When you started your treatment, did you have similar fears or attitudes about being admitted? Did you confess them to your doctors, if you did?
I went into my initial stay in 2014 not really knowing what to expect. I'd had friends who had been to private mental health institutions that provided a very high quality of care, and my mother actually worked at one during nursing school, so I think that I had a sense of safety about it. I felt pretty confident that I'd get help, even though I wasn't quite sure what it would entail, and I trusted my therapist very much and valued her recommendation to go in. When I self-reported, I expected a very short stay, thinking I'd be released in 24 hours, only to have a 10 day stay, so that definitely resulted in a bit of shock. I was very surprised by how much freedom we had with our daily structure, though, pleasantly so.
I think that, at the time of my admittance, I was so disoriented and confused in my manic episode that I wasn't really reflecting on what my experience would be like. I will say that I had actually desperately wanted to go to one when I was in high school and experiencing undiagnosed bipolar disorder mood episodes that came with psychosis (to the point where I'd have out of body experiences and hear voices). I'd known for a long time that I needed a higher level of care, but even in my early 20s, when I had a severe concussion, I was told bluntly that my family would not help pay for hospitalization for any reason (my family was... not great, but that's a trauma tangent). I think my greatest concern about inpatient was that it wouldn't be covered, and I'd be turned away, but in the end I only had a $250 copay (my first stay was on private insurance -- I had no copays moving forward on medicaid and medicare).
It was an extremely surreal experience the first time I went in because it was so far outside the realm of my experiences in life thus far. I actually ended up using FMLA leave from work and burning through my paid time off to give myself time to readjust to life outside the ward. Now it's kind of like an overnight camp. I pack a comfy pillow, PJs, and a few comfort items in a "go bag," and head to the ER. I go into it fully knowing what to expect.
Thank you for your questions and for confronting your own fears and bias. I hope I was able to provide some good insight!
I just wanted to say I appreciate this topic and reading about your experience.
I live in the Detroit area and unfortunately many of the hospitals and inpatient psychiatric hospitals are known for their abuse and mistreatment, especially of LGBTQ+ and black patients. This is in part due to lack of funding, over worked staff and lack of prioritizing hiring staff that does not have dangerous beliefs that effect how they treat people.
It is good to spread that this is now how it should be and not how it is everywhere. 💚
I live in the Detroit area and unfortunately many of the hospitals and inpatient psychiatric hospitals are known for their abuse and mistreatment, especially of LGBTQ+ and black patients. This is in part due to lack of funding, over worked staff and lack of prioritizing hiring staff that does not have dangerous beliefs that effect how they treat people.
It is good to spread that this is now how it should be and not how it is everywhere. 💚
There are ABSOLUTELY abuses in the system, and my experience is far from universal. My goal was primarily to counter the perception that all psychiatric units are like that. Good ones definitely exist! I do have to say that the support for LGBTQ+ patients was incredible in the wards I have stayed in. I would feel very comfortable being out about being non-binary in them because I always saw pronouns being respected, and I felt safe being out about being bisexual.
Overworking hospital staff is a for real problem. My mom was a nurse for over 20 years, and they are underpaid and abused by a majority of hospitals. There's a nationwide nursing shortage in the US due to the absolutely horrible working conditions. I'm lucky in that the hospitals I've been to didn't seem to have that issue as much, and the staff I encountered were both good at their job and compassionate toward patients.
Overworking hospital staff is a for real problem. My mom was a nurse for over 20 years, and they are underpaid and abused by a majority of hospitals. There's a nationwide nursing shortage in the US due to the absolutely horrible working conditions. I'm lucky in that the hospitals I've been to didn't seem to have that issue as much, and the staff I encountered were both good at their job and compassionate toward patients.
Hopefully in future, all facilities do follow suit. I experienced some negligence and borderline abuses by the medical system as a child, and I only became aware of it as an adult, well after a lot of damage had been done. It is especially hard for kids to talk about their needs and experiences, and specialized schools or facilities set up for kids are... well, at least around here, a lot like juvi. 
Being sent to one of those places became a threat used against me in middle school, on top of everything else...
I think in the early 2010s, there started to be some sentiments among the better doctors that diagnosing children with psychosis disorders is a very shaky thing to do, specifically because children have such difficulty communicating and their self-reports can be wildly inaccurate. I don't think it's that kids lie, but more that they don't really have the range of vocab and experiences to draw relation from that adults do. I also, because of my own experiences, ran into people who really did have issues like bipolar disorder, and the way they report their treatment as children is not always good even if the diagnoses was accurate from the start.
Being sent to one of those places became a threat used against me in middle school, on top of everything else...
I think in the early 2010s, there started to be some sentiments among the better doctors that diagnosing children with psychosis disorders is a very shaky thing to do, specifically because children have such difficulty communicating and their self-reports can be wildly inaccurate. I don't think it's that kids lie, but more that they don't really have the range of vocab and experiences to draw relation from that adults do. I also, because of my own experiences, ran into people who really did have issues like bipolar disorder, and the way they report their treatment as children is not always good even if the diagnoses was accurate from the start.
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