Two years ago, I spoke at length about what my experiences have been in psychiatric hospitalizations (“Inside a Psychiatric Hospitalization” parts one through four). For this article, I’d like to review some of those experiences, as well as the average layout of most psychiatric hospitals.
As is the case in most things in life, there are good psychiatric hospitals and crappy ones. A particular system that is on the cruddier side comes to my mind immediately and the affiliates that it belongs to, but as a NAMI IOOV presenter, we are trained to not give out specifics regarding hospitals we’ve personally been to or medications we are currently on (similar to not mentioning specifics about suicidal-ideation, which is pretty normal for most group settings as well). So, because of that, I have my hands tied on being more particular about those specifically cruddier places.
I am able to say what made those particular places more difficult than others though: dysregulation and non-containment. Not only does the milieu of the hospital matter, but also the people working there in that unit, which groups are offered, as well as the group of people who are patients themselves. Psychiatric hospitals are the hub of intensity. You will meet people there who are at their lowest low, their hardest hardship, and who are varying degrees of ill.
Some people never leave their rooms, some people talk to things that the rest of us can’t see, some will shout and be extremely loud, some hit and punch other patients or staff, and some are on one-to-one’s because they’re either a danger to themselves or others. Some are on fifteen-minute checks (the normal there) and some are on five, again, depending on their safety level. A mental health specialist (or associate in some hospitals) tracks what you do every set increment of time specified in the last sentence: how much you eat, whether you’re awake or asleep, whether you’re socializing or in groups, whether you’re being safe or not, etc.
You can have visitors, specified mainly on weekends and evenings when most groups have been dealt with for the day. Groups vary depending on the hospital—my third hospitalization in 2015 only offered art therapy groups and the black chain-linked fence on the outside of the property was pretty frightening (each hospital has a different level of how strict they are, and this particular one I was at has since been closed down). A lot of hospitals will have art therapy groups, psycho-education groups, SMART recovery groups, therapy groups etc.
You’re not allowed to have shoe laces, anything with strings (most of us walk around with our freshly supplied padded socks), anything with wire spirals (including pens in some places), belts, or electronics. It’s a locked unit so you can’t go outside whenever you want to (and you will want to). Depending on the hospital, the cafeteria may be located on your unit or you may have to travel downstairs with an MHS for it. Some of them have exercise rooms or allow you to go outside when the weather is nice.
Basically, you’re watched in almost every possible way. Listing it out like this, I can recall why psychiatric hospitalizations feel intimidating and daunting.
But, they’re not all bad.
They’re necessary for those of us who are struggling with suicidal or homicidal-ideation (though I can’t speak much on behalf of the latter), self-harm, medication adjustments, or intense emotions, thoughts or behaviors (particularly if they’re unsafe behaviors). Some of the staff, along with some of the patients, you won’t particularly like, but that’s the case in most circumstances anyways.
The last time I was at Unit Z was in January 2018, and I had such a great batch of roommates that we’d often be chatting and laughing together and it felt far more like being on a vacation than a psychiatric hospitalization. I remember one moment where someone was telling a story and I proclaimed how wonderful a color this nude crayon was and that I was promptly going to steal it so none of them would ever see it again.
I have loads of souvenirs from my hospitalizations: coloring pages friends have given me, contact information of fellow patients (with varying degrees of maintaining contact with people outside of the hospital), my own art endeavors, books, ambulance blankets, scrubs, a coffee cup, a bin for toiletries, loads of hospital bracelets, and likely other things that I’m forgetting.
Essentially, the hospital is there when you need it, and I know that one day I may need it again, and that it’s okay. The hospital begins my journey of re-stabilization and the work to do that exists outside of those four walls.
But man, is freedom a fantastic feeling.
Stay safe.