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What the Journey to a Psychiatric Hospital Is Really Like

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I would guess most of you have seen some sort of representation of a psychiatric facility in a book or movie, but have you ever wondered how accurate the portrayal is? Usually they’re portrayed as being scary, dark, creepy buildings that look like they really should belong in a horror movie. Insane asylums — that’s what the media tries to portray these hospitals as, and that really isn’t the case (at least most of the time — I’m not going to pretend to tell you that all these hospitals are good, because they’re not). Usually they look just like any other hospital unit, just laid out a bit differently because of the safety rules.

I have struggled most of my life with some level of mental illness, and at age 18 things took a turn for the worst. The next year and a half of my life was spent in and out of the hospital, a total of three stays (that equaled about seven weeks), and more outpatient programs than I would’ve ever expected. I stayed in a different hospital each time, and although the first two were similar it was a very different experience each time.

There are a few different ways you can be admitted to an inpatient unit — someone with authority can make the decision that you’re a risk to yourself or others, and place you on a 5150. This is a legal hold of 72-hours in the unit, at minimum. You and your doctor can decide you need to be admitted, and if your doctor is affiliated with one of the hospitals you may be able to be admitted directly into the hospital instead of going through the ER process. In my situation, all three times, I made the choice that I wasn’t safe and needed to go inpatient. Like I said before though, I had to go through the ER first. And here’s where the real adventure begins.

First things first, you go through triage like any other ER patient. Because of the safety issue, you’re usually brought back pretty quickly. Once you’re on the legal hold you have to be watched by staff at all times. All your things are taken away, you’re lucky to keep your own underwear. Where I was, 5150 patients are given a different type of hospital gown than the other patients: normally the gowns have ties on them, and that would be breaking the safety restrictions. Metal snaps it is. They draw blood, you do a urine sample, get seen by the doctor and then… the waiting.

Once you’re on the 5150 you are going to an inpatient unit, but if they don’t have an open bed you’ll be camped out in the ER until they do. You won’t necessarily be admitted to the hospital attached to the ER either — they’ll be calling around to the other hospitals to see if someone else has an open bed. After waiting for god knows how long (at least you do get to have one to two visitors with you during that time!), a paramedics team will show up with the classic ambulance stretcher to transport you via ambulance to the inpatient unit you’ll be admitted to; either at that hospital or another.

The drive can feel long (although I was zonked out on medication for the first one and I don’t remember it at all!), especially if you’ve never been inpatient before and you don’t know what to expect, but during my experiences, the paramedics have always been friendly and try to help you feel as calm as possible. The ambulance pulls into the emergency bay, they wheel you out and into the hospital you go.

A nurse meets you and the paramedics outside the door of the locked unit, and they do the trade-off. A bag with all the items taken away from you, if your visitors didn’t take them, is handed to one of the staff who goes and inventories it to decide what you can have on the unit, what you can have under supervision and what will be locked up till your discharge. The nurse takes you into the consulting room where the doctor sees patients, and now get ready to sign some papers! By some I mean a lot. And then more. This intake process can be long and exhausting — you’ve already had to explain your situation to the triage nurse, the ER doctor, now this nurse, and soon your unit psychiatrist as well.

This next part I find to be the most dehumanizing part of the whole experience — you’re made to remove the hospital gown, and they inspect your whole body for wounds, contraband, everything. In my experience, if you do have self-inflicted cuts or burns, they pull out a camera and take several pictures of the wound to “track the healing process.” If you’re lucky like me, you arrived in the middle of the night. They might offer you some cereal (as well as clothes of some sort), but then you’ll be taken to your room where your new roommate was sleeping and now is angry that they got woken up by the nurse bringing you in. “Goodnight” the nurse tells you; “Close the !@#$%^& door all the way, idiotic nurse!” the roommate hollers at the door. You curl up under the barely-counts-as-blankets and cry silently, terrified of the unknown person next to you and the building surrounding you, until you become so exhausted that your body takes over and you fall asleep.

Wake up, confused, and then you remember. There’s a nurse dragging you out of bed at 5 a.m. to draw more blood. She doesn’t know what she’s doing and you end up with both arms bruised. You’re too awake to go back to sleep, so you take a quick look around the unit. The halls are lined with doors leading to patient rooms, the nurses station, a deadlocked medication room and the day room. The day room is where you’ll end up spending most of your time, although you don’t know it yet. There’s a TV, puzzles, maybe a deck of cards if you’re lucky.

There’s a massive schedule written on a whiteboard in the day room — breakfast isn’t until 8. You see that there are lots of different groups: check-in, process group, mindfulness, expressive arts, maybe some cognitive/dialectical behavior therapy… There’s lunch, outside time, dinner, and the best part of all: visiting hours. Maybe your parents will come see you, or grandparents, or a friend. Maybe nobody is coming today — you’ll get to spend time with the other patients instead. You also see that there’s a telephone or two along the walls for patients to make phone calls. This seems like the perfect time to call your dad to tell him how you’re doing since they had to leave you when you left the ER.

Welcome to your first real day in the psych ward, Unit East B. Let’s see what the rest of the day holds. Stay strong, you’ve got this!

How did this compare to your own experience? Tell us in the comments below.

Getty image via Chad Baker/Jason Reed/Ryan McVay

Originally published: May 9, 2019
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