Last week, PatientsLikeMe released a new report highlighting patient experiences and tips regarding how to make the most of inpatient psychiatric treatment. PatientsLikeMe.com is an online community for people with significant, life-changing conditions that emphasizes the sharing of health care data and information publicly. It is thought by sharing such information with one another and for research purposes, we can learn more about health and mental health concerns, more quickly and in a real population than could otherwise be done.
Inpatient psychiatric treatment is not all that common (most people who get treatment for a mental health concern [or “mood condition,” as they call it] do so in an outpatient setting). But because it’s fairly uncommon, there are a lot of misconceptions and misinformation about it. So I found the tips and questions the report contains potentially valuable for someone considering inpatient care.
The report summarizes patients’ positive experiences with hospitalization from discussions by participating patients in their mood conditions community. The report highlights four areas patients who are considering inpatient treatment should be aware of, and recommends a set of questions that helps a patient answer pertinent questions in each of these areas. Remember, these are patients’ own recommendations — people who’ve actually gone through the experience.
1. Set clear expectations/goals
Of the patients who reported having a positive inpatient experience, many say they found it helpful to define what they hoped to achieve during hospitalization.
- What is the goal for my time in inpatient therapy?
- Am I here to be stabilized and then immediately released? To learn skills? To take a break?
- Do I need my medication adjusted? If so, do I have a list of the medications I’m taking and their side effects?
- What criteria will I need to meet to be released?
2. Develop new coping skills
This is also a major theme among those who have had a positive inpatient experience, with specific dialogue regarding learning new coping skills during their hospitalization and strategies for dealing with stress and other triggers later on.
- What types of therapy (individual and group, art and music, etc.) are available to me?
- Are there any tools to help me remember what I’m learning (e.g., journals, worksheets, etc.)?
- What new skills can I practice while I’m in inpatient therapy?
- How will the new skills I learn help me in the real world?
3. Coordinate care with your outside therapist/health care team
During and after hospitalization, coordination of care with their own personal psychiatrist, therapist or doctor was another contributing factor to a positive experience for patients. For those patients who didn’t have that relationship prior to hospitalization, many reported developing therapeutic relationships during their stay that continued after their release.
- Will my current therapist see me while I’m getting inpatient care? If not, will the hospital contact my therapist to coordinate care?
- Can I develop a new relationship that will continue after discharge?
4. Create a transition plan
Patients say planning your transition back to the stresses of everyday life is just as important as your actual time in the hospital. Successful planning for this transition may reduce the need for future hospitalization. Many members recommend making a schedule of how you will spend your days at home to provide structure as you move from your inpatient program back to everyday life.
- What kind of support will be in place when I leave? support groups ? Intensive outpatient programs?
- What will my schedule look like when I return home?
- How will I explain my absence to family, friends and colleagues?
Want to learn more or be a part of future patient research efforts? Check out PatientsLikeMe.
10 comments
great article.
This article has a wonderful upbeat feel to it. It makes it sound as though it’s quite an easy simple life being in a psych hospital. It’s not.
When you are on the wrong medication and you have a psychiatrist who refuses to listen to what you have to say it can be a nightmare.
This is a good article. I have worked in emergency services for 15 years, and it is difficult to give clients and their families a good sense of what hospitalization can, and cannot, do for people who are suffering. When I first started, it was possible to get excellent treatment inpatient. Now, not so much. There is tremendous pressure to get people out in order to satisfy health insurance requirements, and therefore cover their own costs. I have sometimes found that people with a supportive social network of family and friends can get more support and supervision that way, than inpatient at this point. It is important to know what you are expecting from inpatient treatment, and what is available, vs. what a particular person needs at that moment in their lives.
I agree with Sonia and Jane. I was hospitalized for postpartum depression, not voluntarily. It was the most agonizing three days of my life. My depression plummeted even further and my anxiety spiked while I was there. I was secluded from my family and my baby, and I felt like a prisoner. There was NO ONE to talk to there, no therapy, no counselors, no nurses. I begged a nurse to come talk to me because I was feeling so anxious and she came for 5 minutes and then left, while I was still crying. I saw the psychiatrist for a total of 4 minutes the whole 3 days. So sad. I had a ton of family and friends that stayed with us and supported us at home, which was much better than the hospital. I went to the ER to get my medication changed because I was starting to have suicidal thoughts. I am appalled at how horrible mental health in-patient treatment is and think it is awful that there is not more support for people who are suffering.
I also want to add that if there were some ‘professionals’ there that actually spent time with the patients, they wouldn’t have released me while I was STILL suicidal.
This is an interesting article, but I must also agree with Sonia. I was myself unable to prepare for my hospitalization, because it started unexpectedly in a severe crisis. This mental state also made it impossible for me to set clear goals. Furthermore, even though I have always been a voluntarily-committed patient, my behavior problems caused staff to be very authoritarian with me (mostly out of misunderstanding for my particular disorder, which they knew little about), which made it even harder for me to get my needs across and impossible to get them met. I had to stay, for various bureaucratic reasons and some of my own wrong choices, on a locked, acute ward for 16 months, and could move to my current ward (open resocialization) only four months ago. I am finally learning to take a role in my own treatment other than just defying whatever the clueless staff suggest, but it is still difficult.
I wanted to share my experience of being hospitalized for severe Postpartum Depression. I was admitted inpatient for 4 days and I must say my experience was a great one. I found the staff very supportive and attentive. I participated in numerous therapies and activites and got what I needed most: sleep and a safe environment to heal.
I too had a wonderfully supportive family and the stay helped them understand how ill I really was. Honestly, if I had remained at home, I would have felt compelled to continue on as mother and wife (regardless of family support )and not gotten the rest I needed.
My husband asked all the of questions mentioned above so we understood my treatment plan from the beginning.
I understand that different people have different experiences but for me inpatient hospitalization was the starting point of my healing.
hey does anyone know how to bring someone out of their flashbacks? Becouse my boyfrriend has ptsd and it scares me so bad becouse i don’t know what to do. please help me!!!!!!!
Hello Everyone,
I don’t even know where to start. Psychiatric inpatient ruined my life. I actually was diagnosed with PTSD from the things done to me. I have been in and out of them since I was 10 years old. Although the ones from age 10-18 were punishments thanks to my mom.
Instead of punishing me for something herself, she would call the children’s psychiatric hospital and lie, saying I tried to kill myself. I was automatically taken in restraints to the hospital no questions asked. Each stay as a kid was 3-14 days. Most stays were a week or more.
The one I was in when I was 10, I was put in the solitary room for not wanting to play basketball. I had gotten back from being checked out on a day pass to eat Thanksgiving dinner. I was out long enough to eat dinner and was taken back. All of about 2 hours. I was really upset and didn’t feel like playing basketball. I was told if I didn’t want to play, that I could go back to the unit. I choose to go back to the unit and maybe lay down. As soon as I got back on the unit I was taken by the arm and led to the restraint room. I was pushed in.
When I asked why, I was told that if I wasn’t going to take part, that I had to spend the time in solitary. She closed the door, locked the dead bolt and the 3 slide locks (one at the top of the door, one just below the dead bold and another about a inch from the bottom of the door. WAY overkill to keep a kid in a room. I wrote about my experience in there on a site called Hubpages. Here is the article: http://hubpages.com/hub/20-Years-Later
Although threatened, I wasn’t actually sent to the hospital again till I was 16. My parents divorced at age 12, and my mom didn’t get custody back till I was 16 which explains the gap of psych ward stays. When the hospital stays started up again, so did the injuries.
Let’s see, I was brought in one time and shown my room. As I was getting settled 3 staff came running into the room. I was grabbed and slammed down and bent over my bed. They took my right arm and pulled it behind my back and pulled it up toward my neck. Apparently I was on suicide watch and they wanted my laces. I didn’t even have the chance to give them up. They just attacked.
So after they got the laces, they let go and let me fall to the floor as they walked out. They had pulled the muscles in my right shoulder. I couldn’t use my arm for 2 days due to the pain from the pulled muscles. I made a sling out of one of my shirts.
Another time I was making a phone call to ask why my mom had me committed again and hung up after telling her off. I was walking back to my room to lay down in the bed and cool off from the call. The staff member who was sitting in the desk a few feet from the phone told me I need to go to “time out†and cool off. I said I didn’t need to and went to my room and layed down.
About 5 minutes later 2 guys rushed into the room and grabbed me one guy on each arm and took me to the solitary room. They held me against the wall, pulled down my pants and injected me with Thorazine. Then I was layed on the bed and placed in 5 point leather restraints. Tan leather. I can smell it just fine in every single flashback and nightmare. I can still feel the thin cotton hospital sheets on the blue hospital mattress in the restraint room. Anyway, I passed out not long after. Several hours later I woke up back in my room with no memory of how I got there.
I walked out to see where I was as I was confused. I was told to go to the med window for my medication. I was confused about that as I wasn’t on any. When I got there I was handed a cup of pink liquid. I asked what it was and was told it was liquid Thorazine.
I placed the little cup down and said no thank you and walked back to my room. 5 minutes later I was rushed again and taken to the solitary room. I was again held against the wall and injected with the Thorazine.
I didn’t pass out this time. But I was tired. I was left in the room from 7:30pm-8:30am with no lights on. I sat in the corner of the room all night huddled against the wall by the window where a slim shaft of moonlight was shinning down between the two buildings and into the room. I freaked out and began crying. They broke me.
Ever since that night, I have been terrified of the dark. I have nightlights in every single room of the house and in all the hallways. In my room is a lamp that is on 24 hours a day. I can’t handle the dark and forget blackouts. I totally freak.
Another time as a teen I wanted to check out and go home to solve a family crisis. Because of one of my mom’s lies to get me in the hospital, child services got involved. They wanted to take my brother. So my mom calls me at the hospital and tells me about child services and says “If they take your brother, I will never forgive you†and hangs up. Of course I was upset.
Anyway, on the way to the door, this staff member caught up to me and asked me where I was going. While crying, I said I had to go home and fix things. Of course it was a locked ward. I wasn’t going anywhere even if I got to the locked door. The guy stopped walking next to me, and came up from behind me.
Instead of simply trying to talk to me, he grabbed me from behind and slammed me to the floor. He then put his knee onto my lower back right on my spine. He then applied his weight. He actually lifted off the floor.
There was a series of loud cracks from my back and then nothing but severe pain. I screamed out in pain. They assumed I was just “going offâ€. I was just injected with more Thorazine and put in restraints in the solitary room.
I was popping Tylenol for the injury till I was about 20, then I saw a doctor for the first time for it and have been on 2 Vicodine, Methadone (Similar in strength to Morphine) and Flexiril and barely makes the pain tolerable. Some days, the medication just isn’t enough to take away the pain.
The spinal injury also caused the bed wetting to become worse including day time accidents. I will be in diapers for the rest of my life. The kids at school had a field day with that one when they found out about the diapers.
My mom assumed I was lying about the spinal injury to get out of the psych ward. She still didn’t believe me even though I was still popping Tylenol on the outside. She didn’t believe me till I was about 23 when she read a form I faxed her about the doctors finding of the injury. I still don’t know why I felt I needed to prove anything to her at that point. It didn’t change anything anyway.
And the one time my mom did come to visit me in that place she was freaked out. They had me high as a kite on Thorazine. I was escorted into the visitors room where my mom, her boyfriend and my brother was sitting.
I was so tired from the Thorazine. They asked how I was and all I said was “I am doing O….†then I passed out and my head hit the table. I don’t remember anything else. I just remember waking up in my room several hours later. Apparently my mom freaked out. She “claims†she had no idea how much Thorazine they had me on. She never came to visit me in there or anywhere else again.
There were many more abuse incidents that occured in the psych ward as a child. But those are a few examples. But it got worse in the adult units. In the adult units they did whatever they wanted. There was no parent protecting me, not that my mom stopped them from doing anything in the child wards anyway.
My first taste of the adult ward came in 2001. I used to be employed there as a security guard. That post was the reason for my break down and suicide attempt. At the time, it was the only full time post open within the security company. The very first day I put in for a transfer. 6 months later, nothing.
Then it happened. I was fired for refusing to put a 10 year old in restraints. I walked out. The child was brought in because he was “hyperâ€. His mom wanted him put on Ritalin. When he tried to leave, begging his mom not to leave him there, that he would be good. I was ordered to take him to the locked ward. When he wouldn’t stop trying to open the door, I was ordered to put him in restraints. The restraints wouldn’t fit his limbs. He was a kid, and thus too small.
So the staff got those Kotex pads to take up the extra space. The kids was scared and crying. I flashed back on what they did to me when I was hit age. I couldn’t take it and it all came flooding back. Exactly what I was afraid of happening happened. I was fired for refusing to take orders. I tried to kill myself and was thus taken there.
The staff assumed I was coming there to hang out with the staff. That place was the last place I wanted to be. Anyway, the treated me like crap. When I discreetly asked for a diaper, they took it out of my bag, held it in the air and yelled down the unit to anther staff member “Can Stanley have this?â€. The staff member asked what it was. He yelled back “It’s one of Stanley’s diapersâ€. I was beyond embarrassed. I got it, but I was very angry about how that was handled.
Another time I was brought in there, a staff member who told me he was gay from when I was working security there wanted to do a strip search. I calmly told him I wasn’t comfortable with him doing it. He said there wasn’t anyone else. I said I had no problem waiting in the secure holding area till another staff member was available.
He left and came back with 3 more staff, clearly there were other staff available or they wouldn’t be there with him. I was dragged to the solitary room and put in restraints. They injected me with Haldol and left. I didn’t pass out.
Apparently I was allergic. It made me see things. I was left in restraints for 14 hours straight. No food, or water. About 2 hours into it, the same gay staff member came in and checked my diaper. It was wet, but I told him to leave it alone, that I didn’t care. He left and then came back about 5 minutes later. He began to unbutton my pants. I told him to stop and leave me alone. He didn’t stop. He pulled my pants to my ankles and began taking off the diaper. Again I told him to stop, and again he didn’t.
He took the diaper off and left me laying naked from the waist down with the solitary room door open while he went and got another diaper. He came back with what was just a chuck with tapes on them. It was thin as tissues. They were only 36 inches square. Not even close to fitting me. So he put one between my legs and the other across my waist, pulled up my pants and left. This whole time I kept my eyes closed. I just wanted this to be over. And as I thought, the so called diaper leaked during the first accident.
12 hours later I was finally let up. When I got up off the restraint bed, I had been laying in a two inch deep pool of urine. Their so called diapers didn’t hold anything. They totally missed any of it. I told him I had my own diapers with me. They didn’t listen or bother to use them. The urine poured off the bed, onto the floor and pooled under the nurses desk. A little revenge? Wasn’t enough for me anyway.
Finally a new staff did the strip search. Turned out that the 12 hours after the change was unplanned. They forgot I was in there.
Another hospital visit out in New York was just as bad. I have issues with low blood sugar. I told them as did my agents on my health care directive that I have low blood sugar problems and need to have something about every 6 hours.
Midnight came around and I was told to wait till morning. 2am I had already begun to start getting light headed and sweating. I figured if I layed in bed it might help conserve energy. It didn’t 5am I was finally allowed to place a phone call. I called my health care agent. I was extremely weak and my vision was now starting to go. My sugar was bottoming out fast.
My Health care agent hung up with me and called the nurses station. It was too late, I had lost my sight. Two staff were called. I was carried into the dinning room and I had to feel around for the food. I was helped back to my room and slept for several hours. Thankfully when I woke up about 11:30am my sight had returned. It was very scary.
Then another time I was brought in around 11pm. Too late for anyone to bring me anything. I needed diapers. I was told I would have to wait for visiting hours in the morning. I was wet but tried to wait it out. But the diaper was too wet. So I asked if they had anything.
A nurse went to a closet and came out with a size 6 Pampers diaper. I was really confused. First, I didn’t know why in the world a adult psych ward unit had baby diapers on it. And secondly, how they even remotely expected me to fit in a baby’s diaper. I ended up just sticking it in the adult diaper I had on and used it as a booster pad. 8Am visitors time couldn’t come soon enough. I ended up with diaper rash. It was a very uncomfortable stay.
I was brought back again for self injury, cutting. Nothing major, very shallow. They took me to the psych ward for it anyway. And I had wrote a note that never should have been found. My friend thought he was helping me by showing it to the doctors. It didn’t help. Now they wanted to keep me for a long time. I told them I just wanted to go home.
2 days later he came to me after morning rounds and told me that I was going to stay another two weeks. He told me that my health care agent said they wanted me to stay for two more weeks. I knew it was a lie as soon as he started to say it.
I walked right to the pay phone and called them and told them what the doctor had said. And I was right, he lied. His goal was to get me angry at having to stay for another two weeks and fire my health care agent. At which time he would then find me incompetent and do what they wanted. That didn’t happen.
I was released to go home 2 hours later after a heated phone call from my health care agent. But not before being told that if I ever came back again, they would do shock treatment on me whether I wanted it or now. I went home, packed my things, saved up and 2 months later packed what would fit in my mini van and moved out of New York to California.
But the abuse still doesn’t end there. Mental health refused to take my insurance. They told me if I wanted a therapist bad enough, I would get off of SSI (disability that I was on for depression/bipolar, Self Injury, PTSD from the hospital abuse among other things that kept me from working) and get a job and pay for a therapist. That no matter how much I came there for help, they would just tell me the same thing and send me home. And they did.
I have been brought in by the police on a 5150 (California code for a 72 hour involuntary hold). Mental health just overturned it and sent me home still suicidal. They said that even a 5150 hold won’t get me help through them. That when I want a therapist bad enough, I will got off SSI and get a job and pay for it. Did I mention I have both Medi-cal and medi-care? They refuse me service, and won’t even let me pay cash for their buy in program that is $76.00 a year or $6.00 a month.
The ER’s did their own abuse. I came into the ER to ask for help for the PTSD since mental health wouldn’t do anything. Well they had to call mental health to come to the ER to do a evaluation. 6 hours later I got a call from my roommate, he was being released from the hospital after a weeks stay for a lung infection. He had cystic fibrosis. It was serious. He was on oxygen and couldn’t take the bus home from where he was. He could barely walk to the car, let alone a bus stop. And I am the only driver.
So I told the nurse I had to go get a friend from the hospital and take him home and then would be back. They said if I left they would call the police. I had no choice, I had to leave.
I picked him up and took him home. I grabbed a quick diaper change and was getting ready to go back to the ER to finish waiting. But before I could leave, up pulled 6 police cars. I am not even kidding. 6.
They came inside my home and got me, placed me in handcuffs and took me back to the ER. I was told I had to be evaluated before I could go home. The cops said they would even take me back home after word. They lied. So in comes the nurse who asked me where I went.
I explained again that I had to take a friend home from the hospital. And that I was coming back. Well he says “Now your ass isn’t going anywhereâ€. I was left handcuffed behind my back the entire time. Then I am told that mental health isn’t going to come and that I can leave. No evaluation. So I brought back to the ER for nothing. I called the cops for the ride home, I was told to take the bus. Thankfully a friend came and picked me up.
Another ER visit, I was brought in by the cops for calling a hotline as a makeshift therapist since I couldn’t get one. The hotline called the cops. I had already been told by the cops that every time I will be not only taken to the hospital automatically, but taken to the ER that harms me because they feel I am doing it all for attention. Please. I can think of a hell of a lot better ways to get attention that does cause me pain and trauma. Anyway, I was led in and un-cuffed.
Then the nurse tells me they want me in a gown. I was wearing shorts and a t-shirt and said that I would have no problem removing my shirt or shorts to get to whatever they needed to look at. But that the gown triggers flashbacks of past abuse. The nurse said the doctor needed to do a exam and that’s the reason for the gown, but that he would talk to the head nurse. While the nurse is gone, I give the urine sample he requested in the little cup. Then I hear a woman say “Get the restraintsâ€. Even the word “restraints†makes my heart rate jump.
5 minutes later in this woman walks with 6 other staff including 2 cops. She starts putting leather restraints on the gurney. When she is done, she tells me if I refuse to put on the gown, I will be held down and put in restraints. That my clothing will be cut from my body, the diaper removed and a catheter put in. And that if I so much as touch any of them, that I will be taken to jail for assault.
I had no choice. I took off my clothing. And as I tried to warn, it triggered the flashbacks. I curled up crying. It was flash after flash of memories.
A half hour later the so called doctor comes in. He starts saying that I must like being treated like this or I would stop coming back. He continues degrading me for a additional 10 minutes and then leaves saying “see you next timeâ€. He didn’t even touch me. No pulse, nothing. The whole reason I was threatened to put on a gown for and he didn’t even do anything.
Not long after, I began having a asthma attack due to the stress from the flashbacks. I asked for my inhaler that they took away. 20 minutes later of struggling to breath they walk in like it’s nothing with my inhaler.
There are countless incidents of abuse/neglect done by the ER’s and psychiatric hospitals over my life. I am tortured with flashbacks of the things they have done to me. Over and over again I am made to relive them. I have tried to kill myself several times just so I can get some peace from them.
I have tried to report the abuse. But I never have any proof. Not that I am believed in the first place about any of it. Even one of my therapists told me that if any of it happened, that it would have been reported. Really? Because none of it ever was. I was told that I am crazy, and lying because I am angry at the staff. Angry, your darn right I am angry.
No one should be abused. I know I didn’t deserve any of the things those people did to me. This country, the US seriously needs to overhaul how they do things. And have camera’s on the staff too, not just the patients. Where is my justice? Or even help for that matter?
-Stanley
These tips for patients in inpatient care will be really good for my sister to know. She’s in school studying to work with inpatient psychiatric treatment, so this will help her to work toward the career that she wants. Setting clear expectations and goals for each patient seems like a good way to get desired results. That seems like an important part of establishing the ground work for developing new coping skills and with knowing how to coordinate the right type of care a patient needs if an outside therapist is necessary. Thanks for posting this!