So I'm going to start day hospital treatment on Monday and I just wanted to know what to expect.

I've been told a bunch of information while I was IP and it helped a little but I want to know from someone who's been in day hospital treatment. I'm just nervous about it. I was told that I'd be going to say treatment for the next 2-3 months. Is that the usual time for day treatment?

Any advice would be greatly appreciated!

[Grey Matter]

Hello my dear Kori.

I was in Day Hospital (Partial Hospitalization... they confused me everyday) and to be honest, it is a lot like IP, you just have more freedoms.

For example, my day went like this. If this helps at all.
- 6:30am, a taxi would pick me up and bring me to the DH location.
- 7:00am, I'd sign in and one of the nurses would take my vitals and ask me how I was feeling both mentally and physically and write them on the chart.
- 7:30am, I would go to the group room for morning group. Which was really just an over-view of what was going to go on for the day. Like what groups would be offered (usually there would be three a day and you could pick which you'd want to attend, though you NEEDED to attend at least one). Also breakfast was served at that time. It was really a "wow lets all wake up a bit" time.
- 8am, I saw my social worker. There was really nothing therapeutic done there. We went over payments and insurance and stuff.
- 8:30am, I had a one on one talk therapy session with one of the staff therapists.
- 9am, you'd either go to a group or do your one on one or, if in school (high school, college) you'd have time for homework and coursework.
- 11am, lunch. Which was delivered to us by the hospital.
- 11:30am, if you moved up a level (sometimes there are levels, sometimes there aren't, depends on the program) you were allowed to go outside, walk to 7-11 and get a drink, smoke, just sit outside until 12pm. You had to sign in and out. If you didn't come back, you'd be either found or kicked out of the program and put back in IP.
-12pm Group
-1pm Group/ OR family therapy. I had about ten family therapy sessions during my months in DH.
-2pm Meds if you needed them during the day (this included needing anxiety medications for sudden panic attacks, anxious thoughts, etc)
-2/3pm psychiatrist med check. They'd go over my chart and ask questions about how I was feeling, if I was getting any bad side effects, if I needed refills, etc. Any med issues were discussed there.
- 3:30pm, "goodbye" group meeting. We'd go over the day, they'd make sure everyone was okay to go home. If anyone had any complaints about staff or other patients, it was the time to bring it up and deal with it.
- 4pm, Signing out. Now I don't know if this is how it is in every DH, but every time we signed out we had to sign a paper that said something along the lines of "I promise I will not harm myself after leaving the program. I promise that if I feel like harming myself, suicidal, etc, that I will call the 24 hour crisis nurse."

Then we'd all go home.

My treatment lasted for three months. This is when my MDD and Anxiety were out of control and I couldn't function, but they decided I'd be better off in a partial hospitalization program than in IP.

One thing to keep in mind; it's NOT easier than IP. You have to work. You have to work to be open and honest and willing to participate in groups. You are held accountable for everything, and if you fail to sign in/out it is held against you and there are consequences. (I failed to call my crisis nurse and SH'd and I was moved down from a level 3 to a 1 which meant no leaving all day). It takes work and time and they don't expect you to be open the first day. They treat new patients gently and introduce you to your doctors, nurses, Pdoc's, etc. They will walk you through the day and if you have any questions someone is always there to answer.

It's okay to be nervous. I was terrified. But you will be okay. It was nice going because I met people my age who understood what I was going through and how hard it was. My meds were never adjusted better than they were when I was in PH. I loved how everything was scheduled and there were no surprises. The first few days are hard, but soon you get into the swing of things and you begin working and things start getting a lot easier.

Feel free to bring a book, a notebook, etc as they encourage journaling. If you're going to bring your own drinks, make sure you don't open them until you are there as some people do try sneaking in alcohol (and usually fail). They do not allow use of cellphones, computers (unless campus computers) as you are in a medical facility and HIPA laws and to keep people focused.

I think you'll be alright, Kori. Take it day by day.

[MotownJohnny]

They're probably all different. The one I did for a couple of weeks last year was 9-3:30, with an hour and ten minutes off for lunch. No locked doors, no restrictions, you could come and go as you wanted to - they kept stressing that this was voluntary. Lunch, for example, they gave everyone a $10 voucher for the cafeteria or food court, which was nice - I checked that out fast, I was so ashamed I wondered if these vouchers were identifiable as coming from the psych dept, but I found out they give them out to all kinds of people, such as visiting professionals there to attend training or seminars. So most days I ate there, a couple of times I needed to get away emotionally so I went to some of my regular lunch places in the area (this hospital is 2 miles from my office).

Similar to above, there was a set routine, a morning meeting, then recreation therapy, then the md's would see patients one to one for about 5-10 minutes, the rest of that hour was down time, then an hour of what they called psych education, then lunch, then group therapy for about 2 hours, then relaxation therapy, then a short wrap up meeting.

I was terrified, broken, and utterly humiliated to go to this. I was never given any information ahead of time, so I didn't know what to expect. I thought it might be like in the movies, they would drug me up so bad all I could do was drool on myself. Of course, considering that people had to drive home, I guess it wasn't realistic to think that. I wan really glad that the program nurse-case manager was really nice. The guy who was the group therapist was brilliant but a little reserved.

There were no restrictions on cell phones or computers, I took both, they just asked that you be courteous, put phones on vibrate, only take calls if really important, etc. No sign in or out per-SE, but the dept. secretary checked you off as you came through the door each morning.

It was weird, I thought it would be really horrible, and I actually enjoyed it a lot in many ways. It did help. I was there a couple of weeks, but one woman was there for4 months, her last day was also my last day, she had to leave because she hit her insurance limit.

[splitimage]

Like Motown Johnny said, I expect they differ from place to place.

When I did Day Hospital it was 8:30 - 3:30 with an hour off for lunch, and 15 min breaks between groups. It was mostly group therapy with some groups meeting every day, and other groups only meeting once a week. Met with psychiatrist 2X a week. Because I'm also an alcoholic, they had me meet with an addictions nurse for half an hour every day. That part was really good.

We could leave the floor on breaks and on lunch - I mostly ate lunch in the hospital cafeteria. Some people brought their lunches and ate in a small kitchen / dinning area where they had a fridge and microwave. I occasionally went off site to a restaurant close by. We were responsible for our own food.

You could bring in cellphones - they just had to be turned off during groups, and they had one computer that we could use to check e-mail on breaks.

My program lasted 3 weeks.

I found it pretty helpful.

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[MotownJohnny]

I was so scared and uninformed the first day, I figured they would probably do a pat down search and possibly have a security guard escort me to the psych floor, maybe even in handcuffs.

Glad that didn't happen.

Thanks so much for the information, everyone!
I just got back from my first day and it was basically a bit of all of what you've all said combined.

I was a bit taken back by the group therapy, I wasn't too sure what to expect, but now I know. I'll probably struggle the most with group therapy. I have a hard enough time talking to an individual therapist, but talking in front of a group will definitely be tough.

But thanks again for the information! I think I will get the hang of how treatent works in another week or so.

[splitimage]

Glad it went well. Yeah, group therapy can take some getting used to, but I really like it now.

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[Grey Matter]

It took me a while to get used to group therapy. Take your time! It will all be okay.