The Psychiatric Hospital: Keeping You Safe


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The First Experience

The first time I was hospitalized in a psychiatric unit, I was twenty-nine. The stress in my life along with my mental illness just became too much for me to handle. I was unsafe, I had already cut my arms that week, and I was suicidal. In this state, when someone in a mental health crisis calls 911 and asks for the paramedics to come, they automatically send the police, because they don't know if the person might become violent. Well, the officers weren't very understanding, but the paramedics were helpful. Apparently, there is a new program that helps police understandd and respond to mental health calls. It's like sensitivity training or something. When I heard about that, I was thrilled, because I remembered my first experience with the police and how they handled my mental health situation. I have been hospitalized in the psychiatric unit eight times, and I honestly don't remember how police responded to me, so it must not have been in an aggressive manner, like the first time. Or maybe I was just too messed up to register it. I'm not sure. Like I said, I have been hospitalized eight times for my mental illness, so I know the drill, even though each hospital is a little different. Each hospitalization helped me in a different way; I always learned something. There was one exception: this place called Sundance. The majority of what they did was visual: you know, writing, drawing, etc. and I couldn't participate in any of that, since I couldn't have a computer or notetaker with me. They also screwed up my psych medications as well. However, I learned from every other hospitalization, though. Even though psychiatric hospitalization is hard, because I always feel like I'm stripped of almost everything, it's all designed to keep me safe and help me get well.

What is Psychiatric Hospitalization Like?

Here's how the process works:
  1. The psych safe room in the emergency department: This is where you'll start. You start out in the emergency room because they want to make sure you're physically healthy. A psych safe room has bare walls and is void of anchor points (for hanging) and objects that one might use to harm him or herself. They are also positioned so that staff can easily see these rooms from a distance. However, this article indicates that the current design isn't effective and may actually induce more psychological harm. If you're suicidal, someone may be assigned to sit with you. At some point, you'll be evaluated by a psychiatrist to determine if you need to be hospitalized.
  2. The forms: You'll be met outside the psychiatric unit by a staff member with a form. This form states that you'll be entering a locked unit until the psychiatrist determines that you're ready to leave. You sign this form before you enter the unit. Then you are asked a series of questions about your mental health, drug use, any history of trauma or abuse, suicidality, things of that nature. You're given a copy of the mental health bill of rights. You sign a series of forms before the next step.
  3. The search: This is quite uncomfortable, but it's necessary. At some hospitals, they do a strip search. This is to find any scars, marks, burns, etc. That way, they can tell if you self-injure while you're in the hospital.
  4. Medication: Next, you sign forms allowing the hospital to give you psychotropic medications, as determined by the doctor.
  5. Room Assignment: At this point, you're asigned a room. Hopefully, you'll get a few hours of sleep before the next step.
  6. The physical: At around 4:30 in the morning, you'll be awakened to see the doctor. He or she reviews your medications, asks about any diseases or conditions you might have, listens to your heart and lungs and writes orders for your medications.
  7. Scheduled activities: You attend scheduled activities (meals, group therapy,etc.) until the psychiatrist officially admits you to the hospital.
  8. Admission: Finally, there is your admission to the hospital after your first meeting with the psychiatrist. He or she will interview you, take a family history, ask about your mental health and why you think you need to be hospitalized.

What Do you do at the Hospital?

There are many group therapy sessions at the hospital. Some are based on developing goals. Others focus on discharge planning (what you'll do after you're discharged from the hospital, and how you'll avoid returning). Some group therapy sessions are faith-based, and others are music therapy. Many hospitals have art supplies so that, when patients are feeling anxious or just need something to do with their hands, they can use coloring sheets and crayons. Coloring books with staples and pencils with sharp points are not allowed in the psychiatric hospital. When writing is required, the therapist brings pens or pencils, supervises the activity and collects the pens/pencils at the end of the session. During free time, patients can play card games, dominos, color with crayons and printed coloring sheets, talk on the phone (during certain times), read provided books, write in provided journals or watch television/movies. Most of those things are pretty boring or even impossible for me. When I was in the hospital, I would spend a lot of time thinking and praying and talking with the hospital chaplain if one was available.

I have been out of the psychiatric hospital for eight months, and that's something to be proud of. There have been a few times when I thought I might have to go back, but I have been able to use my coping skills and crisis resources to help me stay out of the hospital. These things can help you, too. Remember that, if you do have thoughts of hurting yourself or of suicide and you can't get relief with coping skills or crisis help, do not hesitate to go to the nearest emergency room or psychiatric hospital. Even though some aspects are a little uncomfortable, it's worth it to keep yourself safe and alive.

Hospital Trip #9

There was a situation at the place where I'm staying, and it led to thoughts of self-injury and suicide. So I called the mental health clinic and asked for an earlier appointment. They never called me back, and two days later, my thoughts were obsessive. I went to the hospital for a test related to my swallowing difficulty, and I told the speech therapist about how I was feeling. I spent about eight hours in the emergency room before they found a place for me. Unfortunately, I've been to that psychiatric unit about five times, and I was embarrassed and ashamed. I always hope that each psych hospitalization will be my last. I just wanted to share some of the things I learned from this hospitalization. First, I'll start with an illustration. One day in group therapy, we were talking about how our family members don't accept our mental illnesses or addictions or whatever. So here's the story:

It's snack time, and K chooses cheese crackers, but a chooses a banana. a throws his banana peel on the floor, and K is so intent on opening his cheese crackers that he doesn't see the peel on the floor. He slips on it and sustains a knee injury. What does he need to get better?
We answered: The therapist continued the story:
He goes to the emergency room, they do an x-ray, scan his cat, and determine that he needs surgery. The orthopedic surgeon performs the operation and gives him a knee brace and some crutches. He's on morphine while he's in another part of the hospital. Then, he's sent back to the behavioral health unit for eight days because he's diagnosed with post-traumatic banana syndrome or something. When K goes home, he needs his wife to drive him, and she helps him get into the house. He needs pain medication and physical therapy, and he's given prescribed exercises to do at home. So, if K needs all of these things for a physical injury and he can't just "think his way" out of the knee injury, why would we expect it to be any different with mental illness? Don't we need medications, support systems, sometimes hospitalization, therapy, etc. for treatment of our mental illness/addictions? We can't just think our way out of depression, anxiety, addictions, or whatever the issue is. We need supports, just like we do for physical injuries.
This was a really funny illustration to prove an important point. My family tells me things like the following:
  1. When you're miserable, you make everyone around you miserable.
  2. Just choose to be happy.
  3. Just let go of the past
  4. I think you go to the psych hospital because it makes you feel safe
That last is absolutely absurd! The psych hospital is a place where I will be safe when I can't trust myself to stay safe on the outside. But I'm stripped of everything: privacy, the comforts of home, my normal recreational activities. Here are some other things I learned during the last week:

I also decided that the man that I have loved for sixteen years needs to be present with me in the moment. We have talked online for sixteen years, and while I was in the hospital, I decided that I didn't want to waste any more time. I don't want to live without him any longer. So…I told him about all these things, completely aware that he might not feel the same way. But he does--what a miracle! He's going to come to the States to visit in December, and then I'll probably emmigrate to Canada, where he's located.

Although I needed a ninth psychiatric hospitalization, I don't see it as a failure. It was just a hiccup in my mental health recovery, and that's okay. Everyone has those in life. Of course, it doesn't mean that I'm not going to make changes; if I don't, I'll end up right back in the psych hospital. I have already done some things to affect changes in my life, and I'm feeling pretty good!

As I wrote on the mental illness page, I have had to be hospitalized four more times. I found a really good facility at Arlington Memorial Hospital, so I went their twice. The first time, they released me too soon. I needed a medication adjustment, and I was going through some situational depression. Remember the man I wrote about in the paragraph above? I found out that he's married! So, I thought all of my dreams were crushed, at least the ones by this young man. And I had planned everything with him: a move to Canada, marriage, children, serving in ministry together, growing old together. All of that was gone. They were also working on adjusting my medications. Before one of the hospitalizations, I had to call the police, and they couldn't get me into Arlington Memorial, so they took me to the county hospital. Tenth floor at JPS is really a horrible place to be. First, the police handcuffed me, even though I was clearly not violent. They said it was policy. So they took me off in handcuffs to JPS, where they put me in a recliner in a room with probably fifty other people, and that's where they left me for thirty-six hours. JPS tenth floor is like an emergency room for mental health patients. It's more of a holding area at a prison. I saw a patient assault a staff member, and I was really scared since noone would tell me exactly what was going on. I just heard a ton of people running around me. There was a paranoid schizophrenic there, and the doctors weren't very attentive to him. I was more than ready to leave JPS, but the next day...

I cut my arm as a method of feeling something. It was in response to some things that were happening at the assisted living facility. So I called one of my really good friends in ATennessee, and she invited me to come stay with her for awhile. I didn't feel I was receiving the right supports in Texas, so I decided there was no reason not to move. I went back to the hospital after I cut, and they sent me to one I had previously been the previous year. I was really let down; that facility wasn't what it had been the year before. So my friend and I planned this trip to Tennessee during the six days that I was in the hospital. It gave me something to look forward to; I wouldn't be just going back into the old environment. When I got out, I had one day to pack my stuff, at least the essentials. I haven't had any mental health trouble since I have been here, and I think that's largely due to the support I'm receiving here. Here's hoping she and her family don't get tired of me.

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