How to survive a psychiatric ward

Having now been through the worst crisis of my life and coming out the other side of a two psych ward stay I have some more advice. Although it may seem humorous I am in all reality, very serious. I was put in restraints twice and given "the shot" twice. I've never been in restraints before.

So here's my advice...

1. If staff asks you to stop banging your head against the wall, please do stop. Otherwise they break out the restraints and that can and does provoke traumatic memories.

2. Understand that many patients in the psych ward say they are suicidal as an attempt to gain attention. If you are seriously wanting to act on your suicidal thoughts make it perfectly clear that is what you are wanting to do. Otherwise staff may brush you off as attention seeking (especially if you are consistently suicidal).

3. Know that the staff play mind games with you to see how you will cope with things. I know this sounds paranoid but is oh so very true. Many times in my experiences there have been nurses that are not suited for nursing and have no compassion. Some nurses feel it is necessary to tell you things as they see it. Remember that these nurses have only seen you at your worst and their interpretation of you and your behavior is limited to their experience.

4. Remember the nurses are human and have issues just like you and I have issues. If you run into a control freak just let her be otherwise she'll start messing with you intentionally to piss you off. Like one nurse I knew this last stay. I ordered diet coke every day (I need the caffeine once a day to keep headaches at bay). Three days in a row she went to the cafeteria as soon as she got on shift. She crossed out my order for diet coke and wrote caffeine free diet coke even though I had a caffeine order!

5. This one is funny! If you have a cleptomaniac for a roommate (as I did) hide your toothbrush, otherwise she will use it and God only knows what for.

6. Don't be afraid to ask for what you need. I kept asking for therapy and was refused at the first hospital. They ended up giving me a twenty minute session in the 15/16 days I was there! The second hospital said my insurance approved an hour a day and that therapy is what really made a large difference.

7. Don't be afraid to refuse what you know doesn't work. Whether it's a med or a stupid packet on self-harm prevention. For me, I checked myself in and that means that I had the ability to take the necessary steps to prevent self-harm and did not need to spend time spinning my wheels with a stupid packet that was "fill in the obvious blank" I don't care if they label me non compliant. Ultimately I know myself better than the staff know me.

I might add more later, but this is what is coming up right now.

Love and hugs,
Tara

There are some darker one's that is not mentioned here!

Take contraception with or drink the one's they give.

Make sure you have a hard headed friend on the outside that will not be lead around by his or her nose by the people running this type of institutions. "Someone that will check on you and not forget you and that will get help if things don't sound or look right."

True prevention methods that are consistantly ignored.

1. A patient has just been amitted to the Psychward because they feel or even state that they may be seriously considering ending their life. And within that moment of admission they need to feel that they have truely been recognized that there is an urgency for comfort and understanding and that they are truely in an environment that will allow them to stop and get THE ATTENTION THEY TRUELY NEED.

2. When a patient is admitted the staff must take every step to allow help the patient feel that he or she will not be punished or controled for their admission and that patient is in serious need of therapy and guidance and someone who can help remove the immediate sense of overwhelming confusion, anger, frustration and fear.

3. That the staff understands that there is a true sense of powerlessness in the psychological state of the patient and to further add to any sense of powerlessness will be extremely detrimental to the patient. And that if the staff aquires the attitude of providing a cold and insensitive procedural atmosphere for the patient the patient may even get worse to the point that they have now put the patient in further extreme distress. If the staff has to use a restraint system it means the patient has not received the proper environment to stabilize them at all. But instead the environment has proven to be a hostile atmosphere and the patient is truely frightened and is being further punished for admitting they are unstable to begin with.

4. If a patient has a simple request, like a can of coke that has caffine, perhaps the patient has a simple but important request that should not be denied. That if a patient presents a request it should be considered a step towards a willingness to assume some action towards the capacity of making even a small decision that can be used to build on encouraging that patient to gain the ability to present more requests and include themselve in a rehabilitation process.

5. The term STABILIZING should include doing everything necessary to allow a patient to feel true release and comfort within this enviornment so that whatever is overwheming them can be put on hold and they are now permitted to relax and know that COMFORTING HELP IS ONE OF THE THINGS THAT THEY CAN COUNT ON. And the patient is in no way provided ANY SOURCE OF PUNISHMENT FOR ADMITTING THEY ARE TRUELY TROUBLED AND IN DESPERATE NEED OF IMMEDIATE HELP.

6. It shall be understood that when a patient is presented that patient already knows that their state of mind is already irrational and they have many emotions including, anxiety, anger, fear, and complete exhaustion and that their treatment should include a presentation of focusing on COMPLETE REST AND RELAXATION AND A SENSE OF OVERALL ACCEPTANCE OF THEIR CONDITION AND THEY CAN NOW TRUELY FEEL A HAVEN OF REST AND UNDERSTANDING THAT THEY SO DESPERATELY NEED. And it is already understood that the patient has punished themselves enough and further punishment WILL NOT HELP A PATIENT STABILIZE IN ANY WAY.

7. The patient is then quietly, respectfully addressed and the procedure is to provide the patient a vigil to gain rest and protection with a goal to allow the patient to feel that within that time they are going to get rest and understanding and THERAPY to help them SLOWLY ADDRESS THEIR SENSE OF OVERWHELMING ISSUES.

8. It is the prime goal for the psychward to allow the patient a haven where the patient will be able to express their concerns and there is a true place to get help in finding a path or program that the patient can get the help they need to address their issue and that there is a qualified group of individuals that will listen to the patient and the group and patient can then plan a direction where they will get the help they need according to their personal issues that they have not been able to address on their own. That the purpose of the visit is to HELP the patient take the necessary steps to gain the POWER AND SUPPORT TO "SAVE THEMSELVES" by learning new skills and getting to the next step to functioning on an out patient process that will be set up with them, for them, so that they can continue to get the SUPPORT THEY NEED TO CONTROL THE OVERWHELMING ISSUES THAT BROUGHT THEM TO THIS PLACE TO BEGIN WITH.

Open Eyes

There is a disclaimer for this: If this place really did exist, it would have to use a form of crowd control and perhaps the current methods are to do just that. This proposed method has already been deemed an irrational request in my medical file and perhaps may be considered a Cluster B trait witch entails illusions of grandure but also in my case it was considered to be a narcissitic personality disorder. LOL but true. And insurance companies would never approve this because that would mean that they would actually be forking over more money than they want and the hospitals don't want this either because they never want to be considered a resort in any way.
They would much rather disassociate altogether and deem patients as merely numbers and those number are to be lowered as quickly as possible, in other words "Next number please?"

And personally, when I did finally get to the outpatient process the therapists admitted that the psychward was defintely the wrong place for me to go and that I was only sent there because I spoke not only the words but a plan. I was finally relieved to find out quietly that the disorders that were given to me did not apply to me. Unfortunately it cannot be written down because that would give fuel to the fact that an error of judgement was made and that would lead to admitting error that could be addressed by a lawsuit and the insurance companies have already explained to doctors and facilities that any wordage that can be acknowledged as admitting error is not to be used.

So tara, perhaps that grumpy nurse resents the fact that the system is truely flawed and makes every attempt to distance herself from actually having any compassion for any patient that is admitted. Perhaps she has learned thru experience that total denial is protocal and she is expressing that in all her actions. One has to consider the fact that a person who feels guilty often tends to address distaste for the victim. Ofcourse one has to understand that often the guilty party is truely not aware of this cause and effect that they display. In my experience there was one nice, kind nurse. She was young and fairly new and had not been there long enough to revert to the cold mannerisums of the other staff that has stayed for a length of time. It would be interesting to know if that nice young nursed stayed or left due to the atmosphere.

The other thing to consider is that I do have a relative that was a nurse for many years and she was also a head nurse. When she retired she admitted that it took her time to adjust to allowing herself to feel compassion once again in a regular family and social atmosphere. She had not realized how truely desencitized she had become over the years of being a nurse.

Open Eyes

OpenEyes, thanks!

The second psych ward I went to was actually the only psych ward that has had a positive impact on my life. Most of the nurses there (two exceptions) were extremely compassionate. It was there that a nurse spent at least an hour sitting with me talking me through a suicidal crisis. Normally I just get handed a safety consent to sign and am left in my room alone. Anyway, back to the positive ward. They talked to my insurance and I got approved for an hour a day with a therapist! That means that the previous psych ward that only gave me one twenty minute session in the 15/16 days was not due to my insurance not approving therapy but rather the policies of that hospital! I was moved from the closed ward to the open one. I have never been on an open ward before.

My belief is that most psych wards are warehouses. They are just there to store the patient in a safer environment than what they have on the outside. When the suicidalilty eases then they release the patient. Because they have failed to actually teach the patient coping skills or do anything that can be remotely interpreted as positive the patient then starts taking part in the revolving door that many psych wards have. They return time after time after time thereby creating more and more income for the hospital. Of course this is a highly negative view of psych wards but 6 out of 7 times for me this is what has happened. The last psych ward actually had a full time staff member dedicated to marketing. If you think about it they had to have him because they were actively working to heal their patients and so the majority of them would not be returning for a while if ever.

Love and hugs,
Tara

Oh, I can believe that, it is all about business isn't it? Well at the very least you now know the best place to go if you need it. Hopefully you have a therapist that can help you so that you don't get to that point again.

I know that sometimes is can be difficult to find a good therapist as well. I can raise my hand on that one. I am glad to hear that you did get treated nicely, gives me hope that perhaps things will change for the patients that really want help. I could see that in my own stay at the psychward I was in, I really felt sorry for those patients, they were trying and lost. And I do wonder from time to time how they are doing now, and if they got help, I really felt good therapy was in order for some of them and it was what they really needed. And you have expressed your own interactions with patients, it was proof that you do have a kind heart, even as you struggle yourself.

I was hoping there was a local support group but this site is all I could find and it took me time to find my way around. I hadn't even realized it was a world wide site in the beginning. But it does make it interesting. And I actually like the way I can just come to my computer and write when I get overwhelmed and out of sorts don't you? And there are always these little replies that can be so comforting.

I also like to have a place to come and just open my thoughts up verses having no other real place to do that where a person not only knows you but now knows all about you. I actually like the fact that I have the ability to just be Open Eyes and
not be judged by anything else.

And I don't know about you but it has also been a good barometer for me as I have my statistics that allow me to revisit what I have written and see if I made sense during that very stressful time when I wrote it. LOL, let me see if I rambled or made sense that day at all.

Very interesting thread tara, gave me a chance to address what I went through and how it could be improved.

Open Eyes

I like the more recent ones too! Even if they aren't meant to be funny... They're honest and will help people greatly facing admissions!

Hollywood showers. Forget about taking time taking a shower and getting ready. We would be woken up after a night of 15 minute checks at 6:00 and have to get our stuff out of lock up, get ready and take our meds before our 6:30 group. Fun!

At least you were able to get your stuff out of lockup. Last time I was hospitalized the nurses told me they wouldn't give me my stuff (blow dryer, curling iron, hair spray) unless I had to go to court. (I was under a court commitment for suicidality.) Then the reports my shrink wrote said I looked disheveled. WTF??

I finally found a kind nurse who let me have my stuff in the morning. I think that's already been mentioned in this thread: Some nurses are Nurse Ratchets; others actually seem to have some compassion.

wow. Reading everyone's posts about psych wards makes it sound like a nightmare or hell or prison. I have very negative feelings toward the way the healthcare system treats people period. Doctors and nurses scare the crap out of me, no matter who they are really. With the exception of a few.

Caffine free diet just because she doesn't want to keep getting a coke for someone? That is just plain mean and wrong. She is thinking of what is convenient for her and not caring about the ill person's needs. That's terrible. It sounds like these staff are trained to think that the patients are being like naughty little children unless they cooperate and do everything the nurses tell them to even if they don't want to, no matter the reason? I'm so glad I stopped going to therapy. I'd never want to end up in a hell on earth place. I know I would be trying to escape 24/7 and I suppose they'd just strap me down and inject poisonous chemicals into my veins to keep me sedated.

I don't understand how psych wards can make people get better. From everyone's posts, it sounds like I'd get much worse!

I hope I don't offend anyone...

O-Dawg

It kept me alive. I think that outpatient treatments such as partial hospitalization and individual therapy are most helpful, but sometimes you need someone to keep you safe.

At least you were able to get your stuff out of lockup. Last time I was hospitalized the nurses told me they wouldn't give me my stuff (blow dryer, curling iron, hair spray) unless I had to go to court. (I was under a court commitment for suicidality.) Then the reports my shrink wrote said I looked disheveled.

I didn't get anything like that. I'm talking about the basics. Shampoo, comb and toothpaste were the stuff.

I don't understand how psych wards can make people get better. From everyone's posts, it sounds like I'd get much worse!

My trip, while very boring, gave me a safeplace to get my meds adjusted which was life saving. They aren't meant to be fun or anything like everyday life. It's supposed to be a place to be stabalized to a point of being able to begin to see somewhat straight. They can't fix you, make you all better or solve your problems, but are a safe place where hopefully you can learn a tool or two to try and cope on the outside. If they make it fun, it defeats the purpose. Life has problems, is boring sometimes and definitely can get out of control. That happens everywhere, even psych wards.

Oh, OK! At one place where I was hospitalized, we had to sign out the shower heads from the front desk, which seemed really strange to me, until a nurse explained that some patients had unscrewed them and thrown them at staff. (Yikes!)

That's a good analysis, IMO. Hospitalization is boring as heck, IMO, but it does give you a chance to try to just get your bearings back.

I recently visited a state psych hospital as the petitioner for someone who had come to my workplace very inappropriate for the program there - it's a non-locked short-term (crisis) residential program - a step below inpatient, basically. And this person was quite clearly not safe for such a setting. So, after going to a local inpatient facility, this person was sent to the state facility - seemingly the person was also inappropriate for the level of care at the local place. I've been a patient in this local place before, and don't remember seeing patients like this one much in there, and that was in the ward for those of us with "severe and persistent mental illness" - basically. (I was severely depressed and persistently suicidal for a long period of time, though never psychotic.) So I guess the most out-of-it patients get sent to the state facility, and that fits with what I saw there. It was really interesting. The hospital is really old, built in the predominant style of the institutionalization period - which means it's intimidating and looks like ones from movies. I saw part of one of the wards, which seemed to have a common room of beds with nothing but curtains between - from its' position I think it may have been a quiet room - a much higher capacity quiet room than those I've seen in other facilities! The patients I saw appeared much lower-functioning than anyone I usually see, suffering from psychosis and/or heavy medication effects. I think there were average 1-2 person rooms beyond where I saw, too. I also saw a chair in there with straps which was apparently a restricting device. Not the kind of place I'd want to be. At least in my area, it appears the system does a pretty good job of placing people in the "least-restrictive setting", so only those who really can't be treated in other places end up there.

Uhh...I don't think I'll ever be mentally sever enough to go to a mental psych ward but thanks for the tips

That's true, especially if someone is violent and uncontrollable.

Avoid ECT at all costs and make sure someone from the outside comes for a visit to make sure you are ok. Don't let them over medicate you, and try and do some stuff to make sure you are improving. Exercise and participate in the group activities. You may even end up liking making pottery or painting!!

Try and get out as soon as you can. Relapses happen in hospitals.

Remember this: As strange as it sounds in a place devoted to mental health, expressing your emotions is the worst thing you can do if you want to be released any time soon. The more you hold your feelings inside, the faster the discharge.

I have to heartily second this.

I'm sorry, but I have to heartily disagree with this. Sure, you can get out faster, but be prepared to go right back in because you haven't accomplished anything but racking up expensive medical bills. Use the time in the hospital to process your emotions and get the help you need and then maybe you won't need to go back and can move on with your life. Nobody said it was going to be easy or pleasant.

As for people who are reading these posts and becoming frightened of going in, your hospital and experience may be much better than some of those posted here. Don't put yourself in a dangerous situation out of fear.

Well, it depends on the quality of the facility. I've been in several of them, ranging from hell on earth to five-star rating. In a good facility, expressing and processing your feelings is encouraged, but in a substandard one, the very minute a patient so much as starts crying or utters a single four-letter word, I've seen staff members' hands go right for their key rings--which, of course, is an implied threat of seclusion. I have heard patients, including but not limited to myself, threatened with removal of their phone privileges because staff heard them crying, either while talking on the phone or immediately after hanging up. And if anyone begins crying for any reason while they have a visitor, staff immediately makes the visitor leave. No questions asked.

In my case, I was upset because my now deceased husband (not the one I'm married to now) also had a depressive illness. I was the one hospitalized at that time, but while he was talking to me on the phone, he told me he was feeling SI himself and was afraid he might not be safe. And I wasn't there to help him. Of course I was upset! But when I went to a nurse about it, I got as far as, "I was just talking to my husband on the phone, and..." when she cut me off. "If talking to your husband upsets you, then you shouldn't talk to him." And then she walked away.



I had to keep trying until I could find a staff person who would hear me out and help me help my husband. (Before anyone worries, my late husband did not follow through on the SI. He died several years later of natural causes.)

In a place like that, it hardly does any good to go ahead and show your emotions at the risk of staying longer. The quality of any help you get isn't worth the trouble. There are next to no groups, you talk to a doctor once during your entire stay, and you spend the bulk of your time putting together jigsaw puzzles, coloring pages, or playing cards. People in jail have more privileges.

No, not all facilities are like this. Thank God.

Edited to add:

I've noticed, Dragonfly, that you are in New England. I've never been to that part of the country, but I've lived in many states, with a lifelong illness, and have experienced the psychiatric systems of more than one of them. The worst were in the Southern states. Here in the Pacific Northwest, where I now live, the facilities are excellent. Maybe the part of the country someone is in has something to do with the quality of their psychiatric care. (Texas is hands down the worst, with Florida second and Kentucky third. Ohio and Nebraska are among the better states.)

I also have been in a number of different psych wards. I end up there when I am too depressed to make good rational decisions. Some are awful and just send you back home without getting stabile on meds or time to get a clearer head. But usually I end up at home too soon because it's so boring and hopeless that I lie to get out. Right now I am so tired of keeping myself safe and so lonely from staying away from people for fear I would say something that they would have me locked up. It's a big catch 22 for me. Lately I think maybe I should just let go and get locked up forever.

I've had excellent inpatient care in Texas, so try not to generalize. What is unfortunate is that until you have to be inpatient, you really don't know anything about the particular facility you will be in. In retrospect, I would become familiar with the facilities available to me under my insurance plan. I know the hospital I have been in many times is quite willing to talk to you ahead of time about their program and even will show people around their psychiatric floor. That's an excellent sign that they take pride and care in their work and have "nothing to hide".

I am sorry to hear of what you and your husband had to go through. It's unfortunate and tragic that the staff was permitted to behave that way.

It absolutely depends on the quality of the facility. I completely agree with you there. I have been in five different hospitals, with only one truly bad experience. Three of the hospitals were in New England and the other two were in Utah. The bad experience was in one in New England. The majority of them have been very helpful and have saved my life every time. I have learned new skills at each, as I was ready to learn them. There may very well be vast differences depending on what country, or part of the country, the hospital is in. I just didn't want people who may need to be in the hospital refuse to go because they are afraid that their experience will be a horror show like some have described here. I know the bad facilities are out there, but there are, IMO, vastly more facilities that do care and help many people.

On that we agree. Might I add, my last few hospitalizations have been in very good facilities, with excellent aftercare, so good that I have not had a hospitalization or even an emergency psych eval so far this year. It's common for me to have to become inpatient as many as two or three times in one year, but here it is almost the end of July, and I don't see one coming any time soon. Therefore, logical to conclude the system here has been very helpful to me.

I'm glad to hear that you're in a good place right now. I hope this stays with you for a very long time.