A Typical Psychiatric Hospitalization

Most people will go to their Family Doctor to seek relief for their depressive symptoms. The Doctor will rule out potential physical problems first.

The Doctor will assess you for lethality which means if you are a danger to yourself or to others. If you are lethal, (homicidal, or suicidal) expect to be hospitalized. Your Doctor will place you on a three day writ and you will be escorted to the nearest psychiatric hospital by police or ambulance. You will be admitted against your will for 72 hours. Holidays and weekend days are excluded during the 72 hour period.

This gives the psychiatrist, social worker, and nurses time to do a thorough psychiatric assessment. The presenting problem, past medical and psychiatric history, family history, life situation, and the ability to function in the community are all evaluated.

If you are started on medications the adverse side effects are monitored as well as the benefits to the drugs.

The social worker will help connect you back into your community. The social worker will typically find an out-patient psychiatrist and other community resources that you might need for your follow-up care. The psychiatric team will work hard to comfort you, provide information/teachings pertinent to your situation, and to keep you safe until you can take over.

You can enter a psychiatric hospital voluntarily or involuntarily. A voluntary admission means you willingly place yourself on the psychiatric locked unit. An involuntary admission means you are admitted to the hospital against your will. You will be placed on a Writ of Habeas Corpus. The psychiatric team has nick names for a writ. You might hear the words like: he/she is on a pink slip or he/she is involuntary. There are 3 reasons why a psychiatrist can keep you in the hospital against your will:

1) If you are a danger to yourself.

2) If you are a danger to others.

3) If you are unable to care for yourself. That’s it.

If you are unsure why you ended up on a psychiatric hospital unit ask your doctor why you are there. You have the right to know everything about your care and your case. If the doctor does not give you a clear answer as to why you are there, ask again until you understand.

Some doctors think they are the greatest thing since sliced bread. They are not. They are people, just like you and me. A doctor/patient relationship is collaborative. If your doctor leaves you out of the loop or is disrespectful to you in any way, CHANGE DOCTOR’S! it is your right, as a consumer of American health care, to have a competent and caring doctor.

Once you arrive on the psychiatric unit the psych tech or nurse will search you. We take things away that could be used to harm yourself or others. We take belts, some jewelry, shoe strings, some plastics, glass, metal bound notebooks, pocket knives, make-up cases with mirrors, any item with alcohol in it like mouthwash, we take knee socks, stockings or hosiery, computers and cell phones. Most hospital staff members will take anything that could potentially be used to harm yourself or others.

After you have been searched, a nurse will perform an assessment of your medical and psychiatric history. He/she will determine your dietary status. You will be provided a meal with plenty of fluids. You will get an orientation of the unit, the unit schedule, and unit rules. You will have access to a unit phone. You will be allowed to have visits from your loved ones. Most hospitals today disallow cigarette, cigar, and pipe smoking. The doctor will provide nicotine replacement products to help comfort your addiction to nicotine.

Most psychiatric units are set up for socialization. Typically, your bedroom will be bare. It will have a bed, maybe a bathroom, and possibly a desk. The TV, stereo, and exercise equipment are all in a central room. There are many reasons the rooms are set up like this. If you need to rest or if you just need to be quiet, your room is a good place to go. On the other hand, your bedroom is designed to encourage you to leave it and join the others in the central activity room. You will be provided 3 meals a day along with snacks. Generally most psychiatric hospitals have a central dining area in which you will be encouraged go to while you eat your meals.

Most hospitals provide group therapy, teaching sessions, private counseling, and art and occupational therapy during the day. You will also visit with your psychiatrist, social worker, and the nurses every day. The focus in these meetings will be your progress and discharge planning.

If you are placed on suicide precautions you will be checked on every 5 to 15 minutes throughout the 24 hour period. If you are placed on homicidal precautions you will be checked every 5 to 15 minutes and we have a duty to warn the person or people you want to kill. We do not let homicidal patients go until the homicidal thoughts, intent, and plans are gone.

Most psychiatric hospitalizations may last 3 days through 4 weeks. It all depends on your condition.

A phenomenon I have noticed while working my many years in psychiatric nursing is that patients on the unit tend to migrate to one another. After participating in various lectures, groups, and meals together you may see you have a lot in common with another patient. The patient you may be attracted to, may not seem all that sick in your eyes. Well, I promise you, nothing good will come of any type of relationship you may have started on a psychiatric unit. I really, really, really, promise!

There are so many reasons people create relationships on the unit. Some people are lonely and starved for attention; they find great comfort in conversations with another person who can relate to their situation.

I understand why you would want to continue your friendship on the outside of the hospital. The relationship and conversation decreases your emotional pain. Please remember, in the hospital you are in a structured and controlled environment. Outside the hospital, is your life with all the stressors you left behind.

You are in the hospital for you. I believe you need to be stable for at least one year before you continue a relationship from the time period when you were initially in the hospital.

I have good reasons why I am giving this advice. I have seen women and men come back to the hospital because they were beaten by their new friend. I have seen people come back because their new friend stole all their money, medications, and other valuables. I have seen men and women return because they were raped. I know stories of people committing suicide because of their new friend.

Because we are human, it is rare for anyone to do anything which does not ultimately benefit us in some way. When you add various psychiatric diagnoses including socio-pathology to the above concept you may see why I caution you to take care of yourself.

By participating in your care during your hospital stay, you will know when it is time to leave the hospital and jump back into your life. The patients have a new sense of themselves. They have more energy. They seem to ready to tackle anything. The transformation is sometimes breath taking for the mental health workers to see. Once you reach that energy level you will be released from the hospital and then the fun begins! We give you so much information in such a short span of time. By the time you leave you will have a large booklet of information. It is up to you to assimilate the information. Discard what does not apply to you and implement the information that does apply to you.

It is very hard to change behavior; however, it can be done. It is completely up to you. How bad do you want a healthy lifestyle? Are serious about wellness?

I promise, the effort you bestow upon yourself will pay off.

Returning to the hospital is not a failure. I see it as a re-tread! Don’t ever be afraid or too proud to ask for help.

I just described in very basic terms how your psychiatric hospitalization may proceed. Please remember, there are so many variables. Everybody’s situation is unique and that is exactly how you are treated.

Tags: coping skills, help, what to expect