The Reality of Psychiatric Hospitals Part 3

This is part 3 of a series of what a psychiatric hospital is really like. This section we will focus on the daily schedule and the therapeutic aspects of being in a hospital.

The daily schedule of the hospital also varied by the hospital but most had the same framework. First thing in the morning was vitals. Vitals were taken every morning, usually 6am in most places. Some places you had to get up to get your vitals taken and others were done in your room where you could lay in bed. From there came breakfast. Some places you were given a mandatory wake up call for breakfast, others you weren't. Food quality ranged depending on the hospital. Some hospitals food was good, others it was pretty bad. How it was served also varied. Some hospitals you were given individual trays and others you got to pick what you wanted. Some places you were allowed seconds and others you weren't. Some places had vending machines where you could buy food, candy and drinks and other places didn't. It just depended on the place. 

After breakfast, it was medication time. This usually meant a long line where you had to stand to wait to get your medication. One place made you go to your rooms and they came around with a cart, but most places there was a med station and you waited in line to get your medications.
Groups began after medication. Usually this started with either a goals group or a morning meeting or a combination of the two. This group would go over the rules of the unit and review what the unit was having issues with. For the goals portion, they would go around the room and everyone would give a personal goal for the day for something they could work on themselves. This varied from person to person but included things like going to every group, talking to the doctor, getting discharged, working towards discharge, talking to the social worker, a wide variety of things. 

After morning meeting or goals group, the first main therapeutic group. In some hospitals, this was a process group where you were able to talk about and process why you were there. In other hospitals, these were topic based groups that focused on a specific issue. Sometimes groups were a combination of the two. Topics of groups could include things like boundaries, coping skills, and self-esteem. They were all designed to help address issues that led you into the hospital. 

Some hospitals had more groups than others. Some hospitals gave you a schedule of what groups you were going to be going to and some you just went to assigned groups. Groups for the day could vary from 1 to 4 or 5. 

During this point in time, you would also see the doctor. The doctor would call you out of group and bring you into an office. They would check in with you about your symptoms and how you were feeling. This would lead them to decide whether or not to make a medication change and when they think they should discharge you. They would ask about things like suicidal thoughts, anxiety and sleep. They would ask you about side effects from the medications. From this conversation, they would determine how long you needed to stay. If you were committed, you had to stay at least three days and then they could remove the commitment if they felt that you were safe enough to leave. If you were not safe to leave or they felt that you would try to leave if they removed it, they could extend it. Some doctors would have conversations with you about your discharge date and some would just make executive decisions about your discharge date and set it up for you. It just depended on the doctor. 
One of the groups of the day was recreational therapy. This therapy focused on a variety of concepts including art, music, writing, poetry, and many other things. Generally, recreation therapy was an enjoyable time away from the unit and included a variety of activities. 

Lunch happened between groups and varied based on the facility. Some places you could have seconds on your meal and some places gave you a tray to eat and that's all the food you were given. Some places there were choices, others there were not. It all depended on what the facility was set up like. 

Dinner was the same set up as lunch. 

After dinner, there was free time. This allowed the different patients to interact with each other and do things like play games such as card games or apples to apples or other things like color. Many times just being in a group and sitting around telling stories was just helpful because it made you laugh and gave you a bit of a break from all the intensities of the hospital. Some of the best parts of being in the hospital were the friendships you made with people during these times. Sometimes visitation would be during these times and you would get to use the phone. 

At the end of the day, there would sometimes be a closing group going over if you met your goal for the day or not. Some hospitals would have a group on the weekends where an organization like the National Alliance on Mental Illness would come in and do a presentation. 

Around 9pm at most hospitals, medication time would start for nighttime medications. This would generally include a long line to try to get your medications for the evening. It ran the same way that your morning medications did. 

At the end of the day, you would return to your room to sleep. At most hospitals, they had people who checked on you every 15 minutes to make sure you were okay. This annoyed some people because it included flashing a light to make sure that you were still breathing. It was a hospital requirement so eventually, one just got used to it. 

That is the summary of a day in the life of a psychiatric hospital. Hopefully this 3 part series has given you a more realistic look into how psychiatric hospitals are run.