[Wants2Fly]

I will be seeing my T tomorrow to ask about this. Hospitalization was not possible where I lived in S. Florida -- no appropriate facilities. I don't know if Louisiana is any better. The psychiatrist didn't suggest it when I had a meds check last Thursday.

I just know that I feel as bad as I can -- short of breath, confused, unable to make decisions or take constructive action of any kind. Seeming to be getting worse rapidly.

When are the signs that hospitalization is warranted?

[hamstergirl]

Up here, they don't hospitalize you unless you are a threat to yourself or someone else. Of course, the last time I was hospitalized, there were no beds on the psych ward, so they stuck me on a standard hospital ward. They don't have available hospital beds in Ottawa Canada for psych...much less anything else. It's like that all over Canada, no hospital beds. A young girl was left held in jail because of lack of psych beds. She had been charged with a criminal offense, but she badly needed psychiatric care.

Years ago, you might have been hospitalized, but there has been a huge movement for patients' civil rights. This has been a good and bad thing. It prevents you from being thrown into the hospital for nothing, but then again, if someone needs help, they are prevented from getting it unless circumstances are extreme.

For example, a friend of mine bumped into me a while back and was telling me a bunch of bizzare things, like radiation from her television set was making her sick and that the landlords of her building were conducting lethal, secret experiments on the tenants. She has been to every government agency under the sun to do something about the radiation and she has gotten rid of her TV.

Father Lindsay suspects she's a paranoid schizophrenic and that she needed to see a doctor.

Unless she turns violent, her friends and family have no way of helping this woman in seeing she gets help with her delusions. I don't even know her family situation. Father Lindsay has advised me to end the friendship if my life or mental health is put at risk by this woman. That was the only advice that he could offer me.

I hope things in Louisiana aren't as bad.

[Wants2Fly]

So far as I know, pretty much the same all over the US, with similar patients' rights concerns. But also because Regan shut down a lot of the facilities, which is why there were so few homeless people when I was a kid -- society took care of those who couldn't do for themselves -- and now they are at every major intersection with hand-lettered signs asking for money. Well, at least I'm not at that low point yet.

Yeah, I guess any kind of help is a longshot.

[Taonuviel]

I couldn't tell you how things in LA are, but here it's pretty good. I've fast become familiar with the hospital, so maybe I can help.
Basically, I believe the hospital is warranted or necessary when your mental illness prevents you from being able to care for yourself - whether by being so depressed you can hardly get out of bed or maintain your and your surrounding's cleanliness or your bills and you need intensive help in finding a helpful medicine, or by being suicidal or homicidal, or by being delusional/having hallucinations/psychosis. Here, I've also seen people in the hospital for a trauma(ptsd, abuse, ect.) program, eating disorders, dual diagnosis(mental illness with substance abuse), and while receiving ECT treatments.
There may also be available to you a partial hospitalization program. This would probably be helpful to you if you're at the point you're considering hospitalization, but it's decided you don't necessarily need to be inpatient. The two I've been to have been pretty good. The best thing is the groups of people who really understand.

But the surest sign is if you're thinking about hurting yourself. That really doesn't need interpretation - it means you need to be somewhere safe so things can get figured out to some extent.

Ummm... maybe that helps?

[dexter]

Might be too late to hear from me now

But everyone else covered it pretty well I think. The most likely need for hospitalization with when you are in danger, suicidal. They hospitalize you for your protection while they stabilize you on medication and give you some skills to cope with the depression.

Often you are released from the hospital once the immediate danger has passed and continue in a Partial (Day) program or an IOP (Intensive Outpatient Program). These programs continue to improve your understanding and coping with the illness and might be the most effective part of treatment.

If you are feeling so very poorly, but are not suicidal, a Partial or IOP program might be a good choice. Partial you spend all day at the hospital but you go home in the evening (usually 6 hours as the hospital each day) so you get the benefits of the therapy and doctor's care but without the need for 24 hour supervision. IOP is less, maybe 3 hours per day, which means you could go to work part-time in the afternoons if you are ready to. Just the structure of leaving the house everyday to attend the sessions is helpful.

As things improve you might even drop down from IOP every day to three times a week, to one day a week, whatever might be necessary and appropriate for you.

These are all intensive forms of treatment for people in serious depressive episodes, think of hospitalization not on its own but as the most intense step of all, for when you are in danger or unable to care for yourself.

Good luck, hope you get the help you need.

[Wants2Fly]

My T suggested a hospital, without me asking about it, but when I got the price tag, I balked. Started thinking about outpatient supervision -- even before reading Dexter's helpful post -- so I'll just keep investigating the options, see what I can come up with. Both this T and my Florida T say I have a kind of post-traumatic stress syndrome from being hit with too much negative change and loss in one year. Even though 18 months have passed, I'm not doing such a good job of putting my life back together. If I'd gotten a job/income pretty quickly, I think I would have mended a lot faster, but unemployment is hard enough even when one hasn't already lost everything that gave one's life meaning and pleasure. So it goes.

Thanks for the feedback everyone.