Psychiatric Hospitalization 101
So you’re about to save your own life by going to the hospital- here’s what you need to know:
~disclaimer: I am not a healthcare professional nor have I worked in a hospital. I am simply someone who has been hospitalized multiple times. This is about acute, short-term psych hospitalization. My word is not law~
First off, let me tell you the truth. The truth is that being hospitalized is one of the bravest things you can do. You have chosen (or perhaps you haven’t) to save your own life. Not to beat the physical vs mental illness comparison to death, but conceptually this is like going to the hospital with a broken leg to get a cast. You’re treating an acute wound, going to get a tune up, going to a safe place to heal. Unfortunately there is a stigma involved. It’s been decreasing recently and I think you’ll find psych hospitalization is a lot more common than you imagine. But it still exists. You can be proud of taking this step. It will be hard, but you’ve made the right choice.
When to consider hospitalization
Being suicidal is one of the most common reasons for hospitalization. Psychosis, panic attacks, and substance abuse are others. The main factor for choosing to hospitalize is whether you think you can survive the episode you’re having. If you’re even questioning it, hospitalization is probably a good idea. If you’re choosing between your life and the hospital, the hospital is always the right answer even if it doesn’t seem that way at the time.
There are two ways to be hospitalized: through the ER and straight to the unit. The ER is the most common way. Occasionally your therapist or psychiatrist or other healthcare provider will be able to bypass the ER for you and get you straight into a bed on a unit. If you have this opportunity, definitely take it.
If you go the ER route, you arrive and explain why you’re there. You’ll then be taken back into a room- sometimes a private room, sometimes a communal psych room. Sometimes your phone will be taken. A guard will be stationed near you to ensure you do not hurt yourself or try to run away. You may wait for hours. You’ll see a psychiatrist who will determine whether to commit you to the psych unit or send you home. If they decide to commit you, you’ll be wheeled to the unit.
For me, the worst part of the process is the ER. You’re often helped by healthcare professionals who are judgmental of mental illness or are too busy to enact kindness. It can be a very dehumanizing experience. You may regret coming to the hospital, but you did the right thing. Saving your life is always the right thing. It’s okay to regret it for a bit as long as you follow through.
Your belongings will be confiscated upon your arrival but if you have a chance to pack or if you have someone to bring you stuff, consider these:
A warm comfy outfit like sweats (but without a string at the waist!!!!!! take it out or they won’t let you have them!), SOCKS, pjs. Loungewear basically. The hospital provides basic toiletries, socks, and gowns/scrubs/paper pants. They can provide underwear and pads as necessary. Pack a hair brush if you’ve got tangly hair bc whatever they give you will NOT suffice.
You may want to bring your medications just in case the hospital doesn’t have them in their pharmacy but you will not have access to them, all your meds will come from the hospital itself.
Books! Some hospitals have a small library but you can bring your own if they’re deemed appropriate by the staff. They provide stuff like coloring pages, puzzles, games, etc but it can get p boring.
BRING A WRITTEN LIST OF IMPORTANT PHONE NUMBERS. YOUR PHONE WILL BE TAKEN.
You will have to ask to have items you arrived with brought to you from your belongings bag. Occasionally they will be reluctant, but you can self-advocate your way through it.
If you came to the hospital in the evening you may get little sleep that first night. You have to do the intake where they ask you all the questions and you sign a bunch of forms. You must be up for breakfast the next day. That first day you won’t get to choose your own meals but you will fill out a meal card for the next day.
Most of your day will consist of shuffling between different mental health groups. Mental Health Professionals (often social work masters students) run groups on addiction, coping skills, community resources, gratitude etc etc in addition to your stereotypical group therapy. There are 3 meals a day, snacks available, and lots of downtime. There’s also activity hour where you do crafts or play games. During activity hour in my last hospitalization I painted a cackling coffin (it was October). 10/10.
You will have a roommate. My experience is that you both mind your own business while being kind and it’s generally okay.
They will take your blood pressure and vitals at least once a day. It’s annoying but necessary. They may do labs and draw your blood depending on your circumstances. If you have a physical illness as well, it may be a battle to make sure you are seen and treated for that too. All I can say is be your best advocate.
You will not have your cell phone. This will be stressful at first but hopefully nice after a bit. You can call whomever you want using the hospital phones that are on during downtime. You may have to ask the staff to dial if it’s out of the hospital area code. People can also call you if they know where you are. Do what you need to do but also don’t be the Phone Hogger bc we all want to use it too.
Visitors are allowed during certain hours. It’s not like a regular hospital visiting situation where they can just sit by your bed for hours. It’s like once a day for an hour you can get a visitor, no more than two at a time or whatever the rules are. No one can visit or call you without your permission. Visits by loved ones are so so nice and make you feel human again. I would encourage finding someone you trust who can visit you. It can make a world of difference.
“How can I get out faster?”
This is a hack question tbh. I know everything sucks but you are there to heal first and foremost. Generally they release you when the psychiatrist thinks you’re ready to go. The average stay for something like an acute suicidal episode is 3-5 days. That’s enough time in the dr’s eyes for you to stabilize and receive any medication changes. If you are on the unit voluntarily, you can technically leave at any time. I’m not sure I’ve seen anyone insist on it though. Ask your doctors when they are considering releasing you so you can plan. They may change their answer so casually check in now and then.
Go to groups and participate in them. If you’re hiding in your room all day the nurses will notice and they do write that down. There may be many people on the unit, but the nurses are keeping track and taking roll. If you can, be open, honest and compliant with your treatment team. Now there’s a part of me that goes “Fuck The System!!!! Fuck being compliant! I am my own woman and my illness is Me and not something to be stigmatized or hidden. Take me to Bitch Planet, bitch!!!” This is totally valid. You just have to decide what is more important to you- being noncompliant in the face of a judgmental system or getting back to the world. As much I want to rebel, my perfectionism and people pleasing tend to kick in by the second day on the unit.
The aftermath & “what do I tell people?”
When you are being prepped for release, you must have appointments with your outpatient treatment team set up. If you don’t already, the hospital will schedule them for you. If there’s someone who can pick you up, utilize that. Otherwise they may set you up with a cab or something depending on the location. You will be given the bag containing your phone and other belongings upon release.
It is up to you to decide what to tell people about your stay on the unit. You can be honest with whomever you choose, but you don’t have to be. You can say you were out of town or had a family emergency or whatever you want. It is not your responsibility to break the stigma. If you can and want to, go for it! We will all appreciate it. But you don’t have to advocate if you don’t feel comfortable. I tell many of my friends and family the full truth and then tell others that I was “in the hospital.” If they ask questions I say I don’t want to talk about it. This works better than you might think. (It surprised me how respectful people are when you say you don’t want to talk about something.) Most people won’t even ask, tbh.
It’s not all drugged up zombies and Dissociation Time: my last experience was pretty lit. We had morning “stretches” to ‘80s bops. We played Wii bowling. We discussed aliens and conspiracy theories. In a place with such a heavy stigma on it, it was a surprisingly Shame-Free environment. It was comforting to be in a place where everyone Got It. At night we would get our meds and then drift off to bed one by one as the meds hit to goodnights of “ope, the Seroquel’s kicking in.” The variety of people on the unit proves that mental illness affects everyone, from the college student to the 75-year-old retired man to the soccer mom with 3 kids. And they each have different ways of coping, different perspectives on their situation. These other perspectives can be inspiring, even helpful and you may pick up as many tips from your peers as the actual professionals. Respect your peers, don’t be that person who’s like “why am I, Normal Person, locked up with all these Crazy People?” If you’re in there, you’re all in the same boat. Crazy is a slur and no one there is crazy unless they choose to reclaim the term.
The staff can be quite kind as well. I once had a nurse go down to the gift shop to get me a tiny hair brush for my waist-length tangled hair. He didn’t have to put in that effort but he did. This past time I had an MHP sit with me after a session and develop personalized affirmations that she wrote in my journal with her gorgeous, swooping handwriting. It’s small things like these that end up mattering most in an environment that can feel harsh. There can be great kindness there, under all the rules and regulations, you just have to be open to it.
I’ve made a wide range of friends in hospitals. Ones I’d never have even encountered in real life. Even though we haven’t kept in touch, I think of them often. My roommate with terminal kidney failure who got ECT twice a week but took the time to ask how I was. A recent immigrant from Nepal who didn’t speak any English but with whom I communicated anyway. Sandy, my homeless roommate who gave me all of her toiletries instead of taking them with her. Trevor, a young heroin addict who guarded my chocolate cake when I had a phone call. Curtis, a retired professor deep in psychosis whom we taught to Wii bowl. There are so many different lives that tangle with each other on the unit. In this way I consider it a gift, to have a window into all these different worlds that are connected by this one string. I’ll never see these people again, but I’ll never forget them either. I hope they’re all still out there, getting by.
Getting hospitalized can be one of the scariest and hardest experiences but it is also one of the bravest. You saved your own life. Even if you didn’t bring yourself in, your participation saved it. It is a chance to reorient yourself to life, to recovery. It is a second, a third, a 15th chance. It’s like a terrible mini vacation. Responsibilities are lifted so you can focus on yourself. Utilize it if you can.
Again, my word is not law, it is based on my own experiences on the inside and outside of psych units. Please please reply or send asks with your own information. I know I’m not the only one on here who’s been hospitalized. We are legion. We survived. We survive.
**Note from Kat: I am trying to learn graphic design (is my passion™) but the struggle is real and it does NOT come naturally so if anyone wants to help hmu!!!!! Can’t pay obvi but can link!**
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