The Reality of Psychiatric Hospitalizations Part 2

This is a continuation of my previous post about psychiatric hospitals. Many people don't understand the realities of psychiatric hospitals and what the experience is truly like. So this is my way to help shed some light on the reality. In my last post, I outlined the process of getting admitted to a psychiatric hospital and the sometimes difficult process it can be. This post will focus more on what happens once you are admitted to the psychiatric hospital. Once you enter the hospital, the paperwork pile begins. Paperwork includes another evaluation once you are admitted (you probably go through 3 more after being admitted). This includes explaining why you are there and what led you to be there. This can include things like a suicide attempt, suicide thoughts, self-harm, family member's concern, hearing or seeing things and being delusional. It can also be simple things like you need a medication change and feel more comfortable doing it in a hospital setting. It also includes going through your history (previous hospitalizations, previous suicide attempts, family history and so much more). They also go over your medications and allergies. Usually included is taking your weight and giving your height. Probably the worst part of the entire thing is what is known as the "skin check". That is exactly what it sounds like. It is a check of all of your skin. They document any marks you have on your body including scars, birthmarks, acne, stretch marks, cuts, scrapes, bruises, everything. This is the most humiliating part of the entire process. Some places do it for security, others do it to get an overview of your physical condition when you are admitted. It can be equated to a strip search anywhere else.
       Once the physical check is done and a basic evaluation is done, rules and regulations are gone over. Most places give you a packet that includes these in it. Also included is a schedule. The schedule goes over when the groups are held, when meal times are, what meal procedures are, and when free times are. Additionally are a list of phone times and TV times (more on this soon). Once you go through the packet of information and the search, then your personal belongings are gone through. Sometimes this is done in your presence and sometimes it is not. Essentially, staff goes through everything you brought in to check for anything you may not be allowed to have. This includes sharps (you are not allowed to have a razor to shave with; if you want to shave you have to ask for permission and be observed the entire time to make sure you don't hurt yourself), strings or ties (so you can't try to hang yourself or hurt anyone else), medications (those are all controlled by the nurses there), any toiletries that may contain alcohol and anything else that could be considered hazardous. One surprising thing you aren't allowed to have are pens or pencils with erasers. They usually give you short pencils, often called golf pencils or what are known as flexipens which is the ink part of the pen covered in plastic (they don't work very well) and that is what you use to write with. Some places allow you to have your own personal pillow and blanket. Other places do not. Some places let you bring in coloring materials. Other places do not. Some places let you bring in your own toiletries including makeup. Some provide them (they are usually the cheap kind if they are provided). The hospital is who determines what you are allowed to have. Many times certain items require a doctor's note for you to have. For example, I wear wrist and ankle braces. For me to be able to wear them, I have to have a doctor's note from my assigned psychiatrist. If the doctor doesn't agree to write the note for them, then I don't get to have them and I suffer through excruciating pain. This has happened at many hospitals. One hospital I went to didn't allow you to have hard covered books or journals. Most that I have went to have allowed that. It varies by hospital policy.
        Once your personal belongings have been gone through and thoroughly searched, you are then usually brought to the room you are assigned to. This is another thing that varies by hospital. Some places you have your own room. Other places you have to share a room with someone. One hospital even had 3 people to a room. Bed quality is another thing that varies by hospital location. Some hospitals have hospital type beds that you can adjust up or down. Others have thin twin mattresses on a bed frame that's usually solid wood. The rooms usually have a place for you to store your clothing and personal items. Some places had a chest of drawers and then a nightstand. Others had a couple of shelves to put your things in. One place had each bed assigned to a wardrobe that had shelves in it but could be locked and you were given a key on a rubber band to use to lock and unlock the wardrobe. Some hospitals have a desk in the room, others don't. There aren't usually any useable electrical outlets (as people would try to use that to hurt themselves) and you aren't allowed anything with cords in the rooms. A couple hospitals I stayed in had adjustable heaters/coolers in the room that the patients could change the temperature as they wanted. Many did not. The beds are usually equipped with a set of hospital sheets (which are rarely comfortable) and then some sort of blanket or comforter. These can be thin in nature so many times patients required extras to stay warm during the night. The pillows were usually plastic on the outside for easy cleaning with a cheap pillowcase over it. The beds were rarely comfortable. The bathroom situation can also vary by hospital. One hospital I stayed at, 2 rooms shared a bathroom, meaning up to 4 people could be assigned to use a bathroom at one time. One hospital I was in had 2 showers and bathrooms for the whole unit to share. The bathroom was usually equipped with the basics of shower, sink and toilet. Most bathrooms had the handrails attached to the wall. However, unlike normal handrails which have a gap between the wall and the rail, these rails are covered on the bottom with a piece of metal, making it to where no one could use anything to try to hurt themselves. Some bathrooms had a door that you could shut. Others had just a curtain for the door. The showers also varied. One place had a shower that was a button. There was no temperature control and after a couple minutes, it would shut off and you would have to press the button again to get the water going again. Some showers didn't have a shower curtain and you just got extra towels to put on the floor when showering. Sometimes the bathrooms were really small and cramped and other times they had more room to move around. This is what the rooms were generally like.
      After putting your belongings in your room, you were usually let to roam around the unit a little. Each unit you were on depended on what it looked like. Some had group rooms on the units, some were off the unit. The day room or main area to congregate usually included a TV that played during certain times of the day. Sometimes patients were allowed to control the remote. Other times they weren't and staff controlled it. Usually there were tables and then chairs or couches to rest on. Day rooms also included phones. When using the phone in a psychiatric hospital, there were certain times you could use the phone throughout the day. If it was time for group, phones were shut off. Once a certain hour in the evening came, phones were shut off. When you did use the phone, your phone calls were supposed to be only ten minutes long and no more. Some places even limited you to a number of phone calls per shift. If the phones were on, friends and family could call you on that line but wouldn't always get through depending on if the phones were being used or not. It was definitely a difficult process only having limited phone time and thus limited contact with the outside world. One hospital I stayed in had pay phones on the unit and you could only make phone calls if you had the money to pay for them. Otherwise, you were given one phone call a week with your assigned social worker. It definitely made it difficult to keep any real connection with those on the outside during the time in the hospital. The other way you had contact with people from the outside world was through visitation. This also varied by the hospital. One hospital I was in had visitation every day (probably to make up for the pay phones) while others had it two to three times a week. The times are specific to the unit you are on and usually visitation lasted for an hour on those two to three days. Rules for visitation also vary by place and where visitation took place varied by hospital. Some hospitals had visitation on the unit (but not in patient rooms) while others had it in the cafeteria. Some allowed children to come visit with an adult, others wouldn't allow visitors under the age of 16. Visitors usually weren't allowed to bring their personal belongings like their cell phone or purse back so that they couldn't give anything to the patient that wasn't allowed (though we managed to sneak things in anyway). Visits are always supervised by staff, meaning there is usually a staff member in the room. The one major rule behind both phone calls and visitation was that if staff deemed them non-therapeutic, staff had the right to end them. I have seen this happen and had it happen to me.
       These are the basics of the admission process into a psychiatric hospital and some basics of the environment. Part 3 will go over what the daily schedule is like and the therapeutic aspect of it.