Keynote: Anyone could experience a mental health condition or hospitalization.
Inpatient mental health treatment is offered when a person needs a higher level of care.
Most stays in psychiatric units are short, between three to seven days.
Gaining the most from inpatient care often means keeping an open mind.
I remember running my fingers through my blonde, 13-year-old hair as my mother's car approached an intimidating building. Instantly, I wanted to go home. My mother had told me we were going to see a doctor. Something felt off. We walked through a set of large doors and clicked a buzzer.
Gesturing to me, my mom said, "I'd like to have her admitted." I had no warning of this beyond a few notes on scratch paper I had found with the hospital name sitting on a desk at home.
I think I cried more tears that evening and night than ever in my life. My understanding of psychiatric hospitalization came from soap operas and Batman. I didn't know why I was there or how long I would be there.
Yet, I met teens who were not too much unlike me. One roommate showed me how to dry my hair through headbanging. We had access to a gym and time outside. Music therapy, activity therapy, and groups all day long. The food was surprisingly better than the food I had at home.
There were some anxiety-provoking pieces. The level of control in the space was wild. Other people decided when I got up, what I could wear, who I could talk to, whether or not I could leave the unit, what I ate, and almost every other aspect of my life for the time.
I found the realities of restraint, sedation, and seclusion used in the hospital to be frightening. I watched another teen pulled to the ground and carried to the "quiet room" after trying to run for a door. She emerged from sedation the next day. Today, I still advocate against these practices.
Some staff did seem to care, knowing that most of us, though young, had complex lives. I still remember one particular staff member by name who shared about his own life, joked, and gave motivational tidbits. He brightened my days a bit.
I learned about my mental health condition and began a journey toward recovery. Though the experience was painful, it sparked compassion. The youth came to the space for a myriad of reasons—self-harm, substance use, depression, psychosis. I became aware of a world of suffering I did not know existed and wished to help. Though I wasn't sure how, I hoped that once my mental health improved, I could find a way to show up for others.
In 10 days, I returned to life outside the hospital.
I wish I had known about psychiatric hospitals before my turn in one. I think it would have made the experience less frightening.
"Mental Institutions and Asylums"
Recently, in a debate, former president Donald Trump invoked the words "mental institutions and asylums" as he described where immigrants were coming from. These words accompanied others such as "prisons" and "terrorists"—lumping all into the same category. Are psychiatric hospitals dangerous places full of dangerous people?
As a therapist who has worked and interned within inpatient environments at times, as well as a former patient myself, I would say no.
People seek inpatient mental health care when coping with a mental health crisis or when temporarily needing more rigorous care for a mental health condition. One person might go to the hospital at the advice of their doctor during a particularly nasty turn of depression during which they have struggled with thoughts of suicide and tasks of daily living. Another person might find themselves hospitalized in an emergency room where they have come due to hearing painful voices or in an altered state.
Many people find themselves needing inpatient mental health care at one point or another. Among these individuals are neighbors, friends, mothers, teachers, lawyers, and people from many sectors of our community. Anyone can face a mental health challenge requiring hospitalization.
Acute psychiatric hospital stays tend to be short: three to seven days on average, depending on response to treatment and case details.
To learn more about psychiatric hospitalization today, I spoke with Brittany Burke, a licensed master social worker and intake clinician. She is an expert on mental health and an individual with lived experience of recovery herself. Together, we defined five things everyone should know about psychiatric hospitalization.
1. There Are No Crazy People
The people in psychiatric units are representative of the general population. While inpatient units are secure, it is not due to the outlandish nature of the people inside. Rather, as some individuals come to the hospital due to suicidal crisis, these spaces are designed to prevent anyone from harming themselves. When I asked Brittany to describe the space of an inpatient unit, she replied, "A safe environment." In America, most inpatient units are secured with unique rules compared to the outside, giving a sort of bubble away from the rest of the world to focus on one's mental health above any distractions.
2. Healing Often Takes an Open Mind
Most people do not wake up one day and think, "You know what sounds fun? Going to the hospital." Going to a psychiatric hospital often involves a host of new experiences. It can feel somewhat tense, and it may be tempting to withdraw or try to find a way out. Brittany recommends being "open" when approached with opportunities like group therapy. She shares the importance of being "willing to learn coping skills" and communicating openly with staff. Whether someone comes to a hospital for physical or mental health concerns, people go to a hospital to get better. We have to be willing to accept help if we want it.
3. The Low Point of a Hospitalization Can Be a Turning Point
Brittany shares that the mental health symptoms leading to hospitalization might leave someone feeling "hopeless," "without purpose," or with a compromised "sense of self." In psychiatric hospitals, there usually are some therapeutic components. Utilizing these therapies and experiences to grow and find meaning in a dark time.
4. If Going to Hospital, Ask What You Can Bring
Due to constraints meant for one's safety, some items, like shoelaces and hairspray, are not usually allowed in hospitals. Yet, if you are going to a psychiatric unit or know someone who is, you might be able to bring some comfort items. When I asked Brittany what items she recommends asking about, she said, "Books." Although the days in a psychiatric hospital usually involve group therapy, meals, and recreation activities, there can still be a lot of downtime. Having a book can give some added sense of normalcy.
5. There May Be Other Options
While inpatient stays are some of the most intense mental health treatment options, sometimes a person might not need this level of care. In many areas, alternatives such as crisis centers or intensive outpatient may be available to someone needing more help than traditional outpatient care but who is not at a level of distress where they need the supervision of psychiatric hospitalization. Intensive outpatient therapy involves going to a clinic during the day to attend group and individual therapies like Dialectical Behavioral Therapy or Cognitive Behavioral Therapy while still keeping the liberty to go home at night. Crisis centers offer mental health care in a space where someone might stay for a few hours or a few days with 24-hour support, but usually without the medical presence of a hospital.
Closing
Psychiatric hospitalization is an option for treatment when someone needs a higher level of care than what is possible in an outpatient setting. The security of a psychiatric hospital is meant more to prevent individuals from harming themselves rather than to protect others. Anyone can have a mental health challenge that leads them to require inpatient psychiatric care, and willingness to seek this out in a time of need is a sign of strength.
Note: This article originally appeared on Psychiatric Times.
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