I was denied admission into the hospital.

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Riptide said:
Um.

I am quite confused. Usually your p-doc arranges for a bed if you are not going in via ER. The bed is held for you for usually 1 day to get there. You go in under p-doc's admission.

Even when my p-doc did NOT have admitting privileges or Floor privileges, they worked with another p-doc that did. And it usually happens fairly quickly, like "Rip, you are %#@&#! up. You need to goto the hospital. The sooner the better." or "Rip, if you don't voluntarily goto the hospital tomorrow, p-doc will start an involuntarily hold."

Been there tons of times. Never heard of this.

Unless this is like the SAFE Program (for cutting) in Chicago, where they evaluate you for their program which is months long. But that is not a regular psych hospital.......


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Just thought I would re-iterate. Hospitals are not ONLY for psychotic people and IN FACT, most have several wards for the levels of illness.
Many people are severally depressed, many people have tried to commit suicide, some people are manic, some are schizophrenic, some are withdrawling from substances......but not everyone is psychotic.

I think people should not respond if they have not actually experienced being in a hospital setting, because many comments simply stigmatize it worse.

Also, going to the hospital is not a "break", or a "vacation." It is a serious matter and the people who are there are very sick. I NEVER saw it as a vacation. It was an opportunity to get some help and get better. By calling this "a break" or "a hospital" devalues the importance of the treatment. THIS IS NOT A JOKE. You don't go to get away. People are hurting and seriously ill.

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Riptide said:
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Riptide said:
Um.

I am quite confused. Usually your p-doc arranges for a bed if you are not going in via ER. The bed is held for you for usually 1 day to get there. You go in under p-doc's admission.

Even when my p-doc did NOT have admitting privileges or Floor privileges, they worked with another p-doc that did. And it usually happens fairly quickly, like "Rip, you are %#@&#! up. You need to goto the hospital. The sooner the better." or "Rip, if you don't voluntarily goto the hospital tomorrow, p-doc will start an involuntarily hold."

Been there tons of times. Never heard of this.

Unless this is like the SAFE Program (for cutting) in Chicago, where they evaluate you for their program which is months long. But that is not a regular psych hospital.......


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Just thought I would re-iterate. Hospitals are not ONLY for psychotic people and IN FACT, most have several wards for the levels of illness.
Many people are severally depressed, many people have tried to commit suicide, some people are manic, some are schizophrenic, some are withdrawling from substances......but not everyone is psychotic.

I think people should not respond if they have not actually experienced being in a hospital setting, because many comments simply stigmatize it worse.

Also, going to the hospital is not a "break", or a "vacation." It is a serious matter and the people who are there are very sick. I NEVER saw it as a vacation. It was an opportunity to get some help and get better. By calling this "a break" or "a hospital" devalues the importance of the treatment. THIS IS NOT A JOKE. You don't go to get away. People are hurting and seriously ill.

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Since I actually started this post, I will comment here. Who said that going to the hospital was a joke? I beg to differ-- and I can comment because not only did I start this thread, but I have experience both working in, and staying in, a psychiatric hospital. While it is a serious matter and one goes there in the worst moments of pain, it is also an opportunity to get away and just let the hurting parts of yourself rest. Before you disagree, I did not say that it was a vacation, I did not say it is somewhere to go for fun, but it is an opportunity to deal with your issues while also not having to deal with everyone else in your life.

Unfortunately for me, the last week has proved only more exhausting. It really is ironic. I tried to go to the hospital because I am too %#@&#! exhausted-- and I ended up more exhausted in the process.

My pdoc offered me the support of "doing anything he can do" in order to help be get into the hospital that I tried to get into, or another hospital. I declined. I'm too tired to even do that.

I begin my new job on May 12th. I have to meet with human resources again next week. At this point, time has run out.

And Rip, in my state, your psychiatric cannnot arrange for a bed. Hospitals admissions can be done by pdoc referral, but ultimately they are based on the hopsital intake and, of course, whether or not the insurance is willing to pay. Some hospitals in the area are more willing than others. Unfortunately, one of the most willing hospitals, one that is willing to accept people like myself, is the hospital that I interned at-- so obviously that is out of the question.

It is really a coincidence that this post is here tonite. I just got out of the hospital yesterday and this is the first time I have been online.

I had no idea that the states had different criteria for admission.
For about 2 wks. my T. had been pushing for me to go in to the hospital. He finally called my Psyc doc and he agreed. I was very opposed, but my husband was in agreement. I have suffered from major depression for what seems like forever. However, due to ongoing BIG problems at home, I developed acute stress disorder. I finally agreed to the hospital when I found myself on the floor at the grocery store unable to choose a vanilla ice-cream. I was hysterical and very scared. My swallowing reflex had almost disappeared and I was unable to follow a conversation. Resting pulse of 110.

My insurance company at first said I had to go thru the ER, but my Pdoc had his asst. call and basically after she read them my chart, they agreed. I was lucky enough to be able to go straight in w/out the ER visit. I thought I was going in for 2-3 dys. However, I ended up being in for 15 days.

I will attest that it is NOT a vacation. We went to different group therapies that the doctor ordered thru a lot of the daytime. This hospital has a wonderful activity therapy area. I found the art activities to be as therapeutic as the groups. I HATED being locked up, but I was in the section where people can have their clothes etc. Just no sharps or drugs. I was realeased on a #$%& load of meds, but hopefully it will be short-term.

There were people w/all kinds of problems. Depression, mania etc. My roomate was a therapist who had depression problems. I guess I should feel fortunate that I got in so easily. I had no idea it was so difficult in other areas. I have to say that I am feeling MUCH better. It defiantely was not an experience I wish to repeat though.

I'm sorry Pink that you had so many problems. I'm not sure how I would have made it w/out the help.

tulips

Actually I have found this whole drama ridiculous.

1) People going inpatient are usually functioning so low ,GAF less than 25, that they can not dress themselves, get out of bed, etc. They do not spend weeks or days deciding whether to go into the hospital.

2) If a p-doc arranges for admission, the intake process is nothing but taking a history, and physical. Your p-doc or if he does not have floor priveleges, a co-worker, arranges for a bed and determines if your insurance will cover it. A p-doc admits a patient, they are in.

If there are no beds in one hospital, a p-doc will look for another hospital.

It is just like any other hospital admission. When I admit children to the hospital, I make sure there is a bed, make sure the insurance is notified, and tell the family they have one day that the bed is held. The family goes in for the intake, giving history, etc and they are shown there bed. As a doctor, I have admitted the patient. Check.

3) By arranging for admission to a hospital, the p-doc is saying "this person is serious."

4) If your p-doc did not arrange or think you needed to be hospitalized and did not work on it, going in and saying I need to be hospitalized is then YES, a subjective evaluation of you. In this example, unless you are a risk of killing yourself or others, most likely a bed won't be available and they will tell you goodbye.

5) In most hospitals, the people are functioning at such low levels or they are wanting to kill themselves or have attempted to kill themselves. It is not a get-away. It is hard work. Yes, you don't have the reality of the outside world, but you have the reality of the inside world and dealing with your problems.

I have been in numerous hospitals in various states. Not one did I say it was a vacation. It was hard work and usually required many days to even get to the point of being able to interact with groups. People are in there NOT to get away. People are in there because they can not function. Most did not "decide" over many days or weeks to goto the hospital. Most had no choice because they needed to save their lives.

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Riptide said:
Actually I have found this whole drama ridiculous.

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Hmm, I would appreicate you not referring to my current situation as "drama" and "ridiculous." But thanks for the support.

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1) People going inpatient are usually functioning so low ,GAF less than 25, that they can not dress themselves, get out of bed, etc. They do not spend weeks or days deciding whether to go into the hospital.

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I find it amazing that you can generalize to every person who has gone into a hospital, including even their GAF! Darling, I have been hospitalized before, and I interned as a therapist in a hospital for one year-- many people, including myself when I was hospitalized, are capable of dressing themselves, keeping up their hygiene, etc.

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2) If a p-doc arranges for admission, the intake process is nothing but taking a history, and physical. Your p-doc or if he does not have floor priveleges, a co-worker, arranges for a bed and determines if your insurance will cover it. A p-doc admits a patient, they are in.

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Again, please stop generalizing. My pdoc does not have floor priviliedges, nor does he have a colleague who does because he doesn't not work at the hospitals in which my insurance covers. That is not the way it works around here. There are specific hospitals at which I can stay, none of which are the University of Penn, which is where my pdoc works out of.

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5) In most hospitals, the people are functioning at such low levels or they are wanting to kill themselves or have attempted to kill themselves. It is not a get-away. It is hard work. Yes, you don't have the reality of the outside world, but you have the reality of the inside world and dealing with your problems.

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Well, surprise, surprise.... there are also people functioning at extraordinarily high levels who are in a great deal of emotional pain and need the safety and support of an inpatient treatment.

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I have been in numerous hospitals in various states. Not one did I say it was a vacation. It was hard work and usually required many days to even get to the point of being able to interact with groups. People are in there NOT to get away. People are in there because they can not function. Most did not "decide" over many days or weeks to goto the hospital. Most had no choice because they needed to save their lives.

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Nothing is as black and white as you make it. I also don't need a %#@&amp;#! lecture on psychiatric hospitals because I am quite familiar with how they operate. That is not why I started this thread.

I am in the midst of writing an article on the stigma of mental illness in high functioning individuals. So many people fall victim to thinking that if one looks okay, speaks okay, and isn't laying on the %#@&amp;#! floor all day, that they must not be in enough pain to need help. They are the people who do have dilemmas about going into the hospital because sometimes they are afraid that they very thing that is supposed to save their lives is going to somehow kill them (and that's a metaphor, there).

ok girls....let go of each others hair and settle down

opinions are like a%$holes...everyone has one, and everyone thinks
their's is the golden rule

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pinksoil said:
I am in the midst of writing an article on the stigma of mental illness in high functioning individuals. So many people fall victim to thinking that if one looks okay, speaks okay, and isn't laying on the %#@&#! floor all day, that they must not be in enough pain to need help.

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Exactly. Just because someone is sane enough to know they need help doesn't mean they are too sane to need the help.

Pink, I'm really sorry for how things happened. I completely support your decision that you needed this help now.

Riptide, with all due respect, even if this is your opinion, I really don't think it was appropriate to share it to a person who is obviously in a great amount of distress right now. Your tone was very condescending. Way to make a bad day even worse for someone struggling.

I had a similar issue a few weeks ago, but maybe not as bad. I really needed some "urgent" help, but not "emergency". I was scared to go to the hospital because I didn't want to waste their time. But I couldn't just wait 4 weeks to start seeing a therapist once a week. That wasn't going to cut it.

There really needs to be something in-between. Some kind of intense program to help people who are truly struggling, but perhaps the hospital doesn't have enough beds to take them in.

Just because someone is not psychotic or highly suicidal doesn't mean they don't need immediate help.

In a somewhat personal note: what if the only reason a person hasn't suicided is an unwillingness to harm their friends and family. Does that warrent hospitalization?

In my case my pdoc is trying to arrange day or evening hospital, although the suicidal ideation is not always present it's often present and does include a plan.

Riptide said:

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Actually I have found this whole drama ridiculous.

1) People going inpatient are usually functioning so low ,GAF less than 25, that they can not dress themselves, get out of bed, etc. They do not spend weeks or days deciding whether to go into the hospital.

4) If your p-doc did not arrange or think you needed to be hospitalized and did not work on it, going in and saying I need to be hospitalized is then YES, a subjective evaluation of you. In this example, unless you are a risk of killing yourself or others, most likely a bed won't be available and they will tell you goodbye.

5) In most hospitals, the people are functioning at such low levels or they are wanting to kill themselves or have attempted to kill themselves. It is not a get-away. It is hard work. Yes, you don't have the reality of the outside world, but you have the reality of the inside world and dealing with your problems.


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Actually Riptide, I think you are not quite accurate here. Although I know you have much experience they don't necessarily translate to all other cases. A close family member was admitted to the hospital without a pdoc and without being suicidal or low functioning. I don't know what GAF is. However, he did deliberate and torture himself for months over whether or not to go in hospital. Eventually he made the decision himself and we drove him and sat with him until he was admitted.

1) Um, Pink, you are studying psychology, correct? Well then you should know that in the MAJORITY of cases, people are NOT admitted inpatient when their GAF is greater than 40. And for your reference, I suggest you review Dr. First who is a psychiatrist and also the DSM-IV editor who kindly developed the guidelines. Hospital admission is done in GAF 0-40. And yes, most are listed at 20-30 when admitted inpatient. Look at the studies done on characteristics of inpatients both those voluntarily and involuntarily committed and also at VA hospitals, which use the GAF as a major guideline.
(and please don' throw your "credentials" around, I will trump you)

Additionally, at the higher end (GAF=40) MAJOR impairment is occuring in several areas such as work or school, family relations, judgement, thinking or mood. MAJOR impairment. It is not about whether they can or can't dress themselves, it is about not wanting to do it. You talked about your make-up, etc. Lord, many people can barely think to shower at GAF less than 40.

2) Most "High-functioning mentally ill" become low functioning when they need hospitalization....Read Jamison, or others who are high-functioning mentality ill. When they become hospitalized, their lives are at low levels of functioning and their GAF scores are low.

3) I take offense because this thread made the whole hospital issue sound like a joke...like you were preparing for a spa getaway. This is not a joke. I see kids everyday who hope that the hospital will help them, not being there get away. These kids are dying inside, not capable of thinking about the release of going away.

4) I don't think you need to write that article. There are plenty out there..please look at PubMed. Or ask Kay Jamison or John Nash or look at most Borderlines. They are very high-functioning, usually highly intelligent, but when they decompensate, they become very low-functioning.

I am not saying that people don't need help. I believe everyone needs help.
I am simply saying it makes me sick that you treated this as a joke. Hospitalization is not something to be taken lightly. And most people don't sit around playing for weeks while deciding whether to go or not. Because at the point that they become ill enough to be hospitalized, they can't function.
The people are in pain and many are wanting to end their lives. They aren't thinking they are getting an opportunity to vacation...they are thinking that they want someone to help them save their lives.

I am done with this now.

For folks wondering, there is plenty of scientific literature on GAF, and on characteristics associated with persons requiring inpatient care. There are numerous articles that are top studies that can be generalized to the population. (based on the way the studies were done)

Some are even free and available without having to be connected to a university.

I think somehow this thread has veered from its original post that was one persons experience with not being admitted to the hospital and the effect it had on her. I do not think that any one of us has adaquate information to make the determination whether the hospital made an appropriate decision or not. That really wasn't the intent of the OP anyway. Everyone has their own way of expressing pain. Maybe we can accept that is how they are coping and help them the best we can.

Let's keep the replies on topic and supportive. Someone in this situation is obviously hurting very badly and needs all the support we can give.

New threads can be initiated for discussion of related topics if desired.

BB

pink

Pinksoil, how are you doing now? I hope you're feeling better and that you have plenty of good support IRL (you obviously have a wonderful therapist).

I'd agree that this thread should stay on-topic. Riptide: I think you could have expressed your opinion while still being supportive. That would have been appropriate to a thread where someone is in pain. Everyone has their own opinion about what type of help they need, and it may or may not coincide with what other people think is best. It's possible to disagree without belittling the person asking for help.

Pink, I hope things are better. I'm not on the forum as much as I used to be, but I've been checking in on your threads to see how you're doing.

Sidony

Pink - don't let the BS get you down. You can't argue with idiocy and you know as well as I do that anyone with a little experience and a handful of letters after their name think they know everything. I understand the struggle where you are and I also understand all too well how difficult it is for professionals to acquire the help they need.

Come on over here. . .I"ll hook you up with my guy. The partial was amazing for me, and keeping it separate from my job was important, and something they understood as well. I don't know what my GAF was, but you know what? Sometimes THAT stupid little score isn't an accurate indicator of the need for help anyway. There are issues that people face today that were not being addressed during Nash's time - like self injury without the intent of suicide.

I'm here hon.

Due to the continuation of unsupportive posts this thread will be locked.

BB