Last time we spoke of stigmas, fears and what to expect when getting help for mental illness. This next article is very important to me for many reasons, the biggest of which is to shed accurate light on help for mental illness – psychiatric hospitalization. We don’t like to talk about that, do we? It’s unpleasant…scary, unfamiliar. It’s the big unknown but it really does need to be talked about. I say enough with fear, judgment, and of course, the ongoing stigma regarding needing to go to a mental hospital / psych ward.
It. Is. Not. a Horror Movie.
I’ll be the first to admit that historical treatments / methods of hospitalization for people with mental illness were barbaric, dehumanizing and extremely unethical when experiments were done. That aside, my experiences have not been like this. I can’t speak for every institution, but I can help educate in an attempt to sweep away the lingering fears and misconceptions. Here, you’ll get it straight. I’ve been at the Douglas twice and in a hospital psych ward 3 or 4 times. A week, 3 weeks, a month, almost 2 months…yeah…one might say I’m qualified.
Hospitalization Facts – True or False
- Dark cement hallways with dim lighting? No. There are windows, lights and sometimes even poster-paintings and artwork done by the patients themselves.
- Dirty unhygienic rooms and disgusting toilettes and showers (with a lack of privacy)? Not really. Cleaning is regular and the toilettes are more thoroughly cleaned than most restaurants. Depending on the institution you may have a whole room to shower with no one else in a small ward. In larger institutions you will probably have stalls in a communal bathroom / shower area that resembles public pool showers minus the noise, cramped area, less frequent cleaning and ridiculous shower curtains that make you very uncomfortable. Did I mention that there are actual, lockable doors? Mhm. You can preserve your dignity and privacy to a great degree considering the circumstances. I thought this would be a nightmare but I was actually ok with it.
Pro tip: It’s great when there’s a curtain within your stall so you can shower and keep your clothes dry, but I learned that having a bag to put my dirty stuff in and another for my clean stuff kept things really dry. If you have glasses, a watch, etc., protect them! Oh and bring at least 2 towels from the cabinet (you don’t need to bring towels); one to dry off and one to stand on so you can put on socks and shoes without getting them wet. Oh yeah, keep your shoes off the floor as well! (Come to think of it I have no idea why we were allowed plastic bags…maybe we weren’t?)
- The food is terrible. Well….ok. I’m not gonna say it’s really good, but it’s not horrible. You actually have a bit of choice to some degree or other. A lot of people looked forward to desert, if that’s an indication. They were probably the most interesting…not that I ate them…I only had a bit during my ‘food rehabilitation’ hospital stay. But seriously, even if you’re vegetarian sometimes you can get lucky and have some interesting-ish options. The menu may be redundant but you can request double portions, have a coffee (or a sad proximally, I should say), juice, tea, etc. Obviously no alcohol or drugs! (Although at the Douglas some people smoked weed outside on the large grounds.) In smaller wards contained in a hospital you can get lucky if they have a good cafeteria because I got to have interesting bean salads, pasta salads, etc. as my dinner.
- Co-ed or non co-ed? While the hospital / ward is co-ed, the bathrooms with showers are not. If there’s a single bathroom or shower, it’s just one at a time, when 2, 3, or 4 people share the same room it’s always all women or all men. At the psych ward I went to everyone had their own room (except for two rooms which had curtains separating the two women or two men.) The others had their own small room with a sink and an adjoining washroom to another room. This toilette can be shared between men and women but there’s a locking system for only one at a time. (If you’re me, your side is locked for an hour after meals unless you really have to go, in which case you sit awkwardly with a person listening right outside. Fun.) Solo rooms are great though, because no one snores and you can retreat to a little haven of privacy when you’ve had enough or something is going on.
- There’s nothing to do. I have to admit that it is pretty boring, but it’s often ok because people don’t feel like doing much anyway. However there’s a TV, a recreational room if the ward is big enough (otherwise the eating area is used for that), card games, puzzles with missing pieces that seem designed to drive you mad, a couple board games, and some art supplies. Some nurses are kind enough to print mandalas or other colouring pages for you. If you’re thinking that you’re not in Elementary school, let me just say that art therapy is very helpful and yes, adults do colour in the psych ward. It’s very common and keeps people calmer.
Pro tip: I do very very badly when I have nothing to do. I hit times of lying in bed doing nothing, but sooner or later I had to try to do something or else my brain wouldn’t shut up. That’s why bringing or having family or friends bring you things that can occupy your time is so important. Phones, tablets and even laptops are allowed, you just probably won’t be allowed to keep your charging cables so prepare to hand your stuff over to the nurses at night. A dead battery is a BAD day. Trust me. Also they label everything you have and brought so you’re not likely to lose things. Be extra careful though because you sign a paper releasing them of responsibility for lost items almost as soon as you arrive. Long story short, bring books, colouring pencils, art therapy books, headphones, whatever helps you. (If you can, bring wireless headphones because again, no cables and things like airPods can be deemed a choking hazard. Otherwise in some places you can only use wired ear phones / headphones in view of the staff.)
Rules, Guidelines, Processes & Unsaid Understandings
- Voluntary vs involuntary commitment. If you are voluntary, you can be discharged from the psych ward when you want to unless you become suicidal or intend to harm someone else. If you are involuntarily committed like after a suicide attempt or a court order, you don’t get to decide when you leave. (Even when you’re deemed ready you can stay longer if you personally feel that you’re not.)
- If you’re at a metal institution you’ll probably wind up in an emergency ward before you’re placed in a regular ward. This is because security is tighter there. (I still hurt myself and they had to call an ambulance though so the point is a little moot.) In emergency people may be more on edge, loud, angry, etc. depending on their situation. Being in emergency can be scary sometimes, especially if you’re being hit on by someone who doesn’t understand yes or no very well. people can also try to stay by your door but when these things happen and you’re uncomfortable just mention it to a nurse and they will discourage the behaviour. Best of all though is to be assertive enough to gain the respect of those people. (Not easy when you’re crying, anxious and super depressed.)
- Anything you bring will have to be checked. Say goodbye to your laces and drawstrings on pants and hoodies unless they’re really sown in. My advice…don’t bring laced shoes. If you do, don’t let them remove the strings. Just ask them to keep a bag with your ‘prohibited items’ and your name on it and ask your family to bring something without laces. Oh and belts are an obvious no-no so bring pants that don’t require one. On that note…it’s not a fashion show. Most people just want to be as comfortable as possible so hoodies, track pants and that sort of thing are common.
- Jewelry is typically allowed, although it’s a bad idea for theft. I don’t recommend anything other than a watch and a ring if it means a lot to you. (I kept my engagement ring and Apple watch.)
- You can’t go into another persons’ room. Sometimes you can get away with it in bigger wards if it’s woman to woman or man to man, but it’s still frowned upon and smaller wards don’t allow it at all.
- You will often see a doctor at the beginning of your stay and sometimes throughout depending on your situation. Since you’re still technically in a ‘hospital’, prepare to have your pulse, blood pressure and temperature taken twice a day. Oh and you’ll be weighed…regardless of having an eating disorder or not.
- Skipping meals, for any reason, doesn’t help your case. They will be after you and while one or two times may be let go, more than that will make them get on your case when you just want to be left alone. If you’re there for an eating disorder, you can negotiate certain exceptions if you’re making an effort. For example if you’re not able to eat in the common area you may be allowed to eat in your room or quiet area if you promise to do your best to eat enough of it. Don’t expect that to last though.
- They monitor your habits. This means that if you don’t take showers and don’t get out of your room enough, they will be not so subtly encouraging you to do so. Everyone knew that I was very anxious about socializing so they gave me a little bit more breathing room, but still. Just remember that them pushing you to do this stuff is not to be a pain in the butt but is designed to help you diminish isolation tendancies. (Even when that’s exactly what you want to do.)
- There will be visiting hours. These were my favourite, because I don’t do well if I’m on my own for too long. I can be clingy…especially in an unfamiliar environment. Seeing people you love and know can help your moral even if it’s just a bit. In the ward I was at in an actual medical hospital thought that I was visited too much by my dad and needed time to be away and alone. Let’s just say that I put my foot down. (Which is saying something considering that I was almost never assertive then.) The difference between me being alone and me being with family was enough for them in both wards to shut up about that.
- Prepare to feel like the new kid at school, minus the meanness. It’s intimating to walk in, sometimes in a hospital gown and see 10 – 25 others, but it’ll be ok. When you go to eat for the first time bringing your tray to sit down is EXACTLY like finding a cafeteria spot. But guess what? When you’re new most people remember how they felt and will welcome you with open arms. Chances are you’ll be offered a seat and otherwise people will give you a small smile passing by (which is saying something) , or else walk up to you and introduce themselves. I can’t tell you how many kind, generous and supportive souls I’ve met in these hospitals. I cry. And back then I cried a lot. You know what happens? At least one person will check up on you. They don’t want to see you in pain and they’ll stay with you if you need them but will also respect it if you want some privacy. if you’re really anxious but can’t seem to ask your designated nurse for help (like as needed anxiety meds), other patients you become close to will offer to tell the nurse for you.
- I should mention that during the day and in the evening the nurses change shift. We all have binders of info, med records, incidents and vital signs so that all shifts have this information. Your nurse for each shift may stay the same or vary a bit, and each nurse is responsible for a certain number of patients. Get to know your nurse so they are more attentive to your needs.
- You will be watched by the staff, so you might as well get used to it. However there is an unspoken progression of your status. If you show them that you’re trying, don’t try to hurt or kill yourself and generally try to participate, you will increase in ‘rank’. If you earn their trust they’ll give you more breathing room and leave you alone a bit more. The more you prove control of yourself, you’ll begin getting privileges to go outside. They’ll start with letting you out with supervision (from family or staff) for 15 minutes, then half an hour, an hour…. until you can leave the grounds with someone for a few hours and come back. They’ll also let you go out alone once they’re sure you’re ok. Closer to discharge they’ll test you with a day or two during the weekend to go back home and come back. (Leaving and coming back is actually a bit of a shock / re-adjustment so prepare for that.)
- Shaving is allowed, but only with supervision until you can do it alone. (I know. It’s great…but they have to.) And you never get to keep the razor. This is why there’s a room to contain the things that you need but aren’t allowed to keep in the closet of your room. Some places lock your closet at night but leave in unlocked during the day, and other places give you a key to your closet. I like the second better, especially since mine was always locked at one place and every time I wanted to take something out they stood there watching me. I shouldn’t complain, I was always there for bad self harm, a suicide attempt or for my eating disorder. No matter what, I was always considered high risk for the first portion of my stay. I don’t have a good track record…sometimes I’d be good and gain privelidges, but then I would do something that bumped me to high-risk again. Don’t be me.
- Make sure that the staff like you and know you. Seriously this is really important. Psych nurses are busy and sometimes too preoccupied with something to listen to you. (It can be understandable, but other times they’re joking around behind the glass inside their nursing station and won’t give you eye contact even though they saw you.) In other words even though you’re there for help and support, you still need to build a good enough reputation. This is why people who get angry and/or yell have a disadvantage even though it could well be part of their illness. Being a ‘model patient’ goes a long way. Aside from my self-destructive tendencies, I was viewed as a non-trouble maker, quiet, listening and innocent. (I know! Innocent! It must be my baby face and glasses…) They appreciate knowing that they can count on certain patients being obedient. Whatever that means.
As a funny side note I’d like to mention that my perceived innocence let me get away with a lot. I’m not condoning or encouraging anyone to do this…but everywhere I was I was able to vape inside. Yes, bad girl. But hey…the nicotine patches and gum they provided didn’t work and my anxiety was somewhat reduced since I could vape in the bathroom, shower, and even in my room once I was allowed to partially close my door! Risky? Yes. Did I get caught? No, not while smoking. I got caught having it and another time having cigarettes in my possession since they’re supposed to be in the nursing station at all times except when you can go out alone or with a smoking group. One nurse didn’t like me, had no sense of humour and was harsh and fairly judgmentaL. (You will encounter some nurses that shouldn’t be working in healthcare with their attitude, but there are also many kind nurses who even go the extra mile.) This said b-i-t-c-h had something against me and payed special attention. When I forgot to give back my cigarettes (which I kept for outside), she was always extra on my case even though it was an accident. And when she somehow saw my Juul at one point she took it away. I had a way of talking the next shift of nurses into giving it back to me thought because they didn’t have the time to figure out what it was. HAHAHA. Someone I didn’t really know thought they saw smoke / vapour once from my window and reported it, but the nurse who came by took one look at me innocently reading a book and dismissed the idea. “She would never do that.” I feel manipulative, but…I’d do it again. Sorry…not sorry. It’s not like I exposed anyone to second hand vapour after all. I’m not that selfish! I also got good at using my bra and upper side of my shoe to hide it.
- If you’re in a psych ward chances are you’re on medication. (Medication you were on before, or new / adjusted meds.) There will be medication times like 8 or 9 a.m. and 8 or 9 p.m. It’s usually after vitals and breakfast and after vitals and dinner. Some people have meds in between and others need to take as-needed medication as well. In some places lining up early will get it over with sooner.
- If you see someone doing something they shouldn’t be, don’t tell on them unless it’s something they could or are hurting themselves with.
Ex 1: If someone decides to smoke in the bathroom and you know about it, don’t be an ass. Even if the fire alarm gets triggered and you know who it was but the staff doesn’t, don’t blab about it. If someone brings food to their room in an institution that doesn’t allow that, again, don’t blab. They probably just get hungry in between mealtimes which is very understandable.
Ex. 2: The last day of one of my stays, a woman kept going through the things in my room. I was leaving so I was allowed to pack up things like shavers, cords, etc., but I had to tell the nurses because I was deathly afraid of her harming herself. In other words you are a patient, but staying responsible with your things is also required to protect other patients.
The Take-Away & Some Surprising Funny Moments
To encapsulate, I’d like to mention that while no one enjoys being in a hospital, being in a psych ward is easier than a typical room. At least you can move around, not eat in bed, and you’re usually not connected to medical equipment. It’s hard to be in this position of needing to stay, but overall it’s not as bad as people make it out to be. Where I went there was no group therapy though, which was odd and would’ve been helpful. Wards however can really help stabilize you when your life is completely out of control. It’s like hitting a huge pause button and in a way that can be a tremendous relief. I find there’s a love / hate relationship and while I often wished I was at home instead, I did experience some benefits. Not having to make decisions and having to follow a certain schedule instead of being in bed all day takes pressure off. If I’m being honest, when I feel really bad I miss the simplicity of staying in these ‘all inclusive spa retreats’. Hahaha. I’m not kidding though, it’s scary but becomes surprisingly comforting and since I’ve been so many times I really know the ropes.
One might think that a psych ward / hospital is really lonely and maybe you actually want to stay away from others out of anxiety or a desire to be on your own. However the truth is that these places can broaden your mind and you can form meaningful relationships if you allow it. Now I’ve pretty much always been the youngest adult of the group, and that made other patients protective of me. Nurses too actually. But there were also strong bonds between older adults. You may find that you relate to the others more than most people outside the hospital and there’s very good reason for that. If you’re there, chances are that most social facades have disintegrated and there’s a higher level of compassion and understanding. These people you’re with have hit bottom too and have learned the hard way that a lot of the ways we act in ‘outside’ life is trivial compared to the sanctity of our minds that we so desperately want to regain. You’ll encounter people who will offer to share their art supplies if it’ll make you feel better. They’ll sit with you during meals and encourage you to eat even if you feel like the fattest cow and every forkful is a challenge. They’ll ask if you want company and engage in conversations both about and not about mental illness. Even in a smoking group you’ll hang out outside and stick together. In other words, you’ll make some great friends. You can even organize a yoga time where someone with experience leads other patients through the movements. That’s actually how I got started with yoga! When someone leaves, a communal card is sometimes written and you can be guaranteed a warm, encouraging goodbye that is actually bitter-sweet.
On another note it’s funny because even though people usually really get along, in larger wards there can be a bit of drama. Not the same as outside, but my best friend during one long stay had an ongoing problem with another woman that turned into a girl on girl fight once, if you can imagine. It’s rare, but my friend wasn’t timid, didn’t take crap from the nurses and was always ready to challenge something she disagreed with. It was nice to have her on my side and when not in those situations she was sweet, encouraging and funny. When she cried I gave her hugs and tried to comfort her, and when I was empty inside she’d hug me and push me to do something with her.
Also, crushes happen. Maybe it’s because we crave human connections and focussing on a crush is a nice distraction, but yes, a few people were deemed ‘hot’. Two of said ‘hot’ guys spoke with me frequently and my friend commented on how I was lucky to be close to those ‘ripped’ patients. (I’m not even kidding…who said mental illness and hotness don’t go together?) I wasn’t attracted to them though…the guy I hung out with the most, who was also friends with the main ‘hot’ guy, well… we did have a thing. I don’t know what and I would never cheat, but it was something special that I will remember. I’ll always remember him because at first he payed special attention to me but the nurses saw him as a trouble maker and someone to watch. The intenseness of his character combined with his attention made me afraid and the nurses were cautious and tried to keep him away. Again though we see that things are not the way they appear. Why? Because while many left him alone due to his intense nature, specifically his piercing gaze, gradually spending more time with him allowed me, and only me, to see the softness of his soul. While physically intimating, I could see no mean bone in his body. He was a little broken too but he never treated me like I was broken; in fact being with him made me feel stronger. We spent a lot of time together.
Prepare to compare medications, side effects and experiences with the others in the same way as budding psychiatrists. I’m not kidding…we knew our stuff. Lingo, dosages, and fake competitions about how many meds you’ve tried before finding a good one. (Yours truly – Lyrica, Prozac, Zoloft, Effexor, Seroquel, Trazadone, Rivotril, Divalproex, Lamictal, Cipralex, Ativan, Zyprexa, Latuda, Risperidone…if I’m not missing any.) This is NOT uncommon.
Interesting things happen that you may never have expected. For one, I got to keep my new skateboard under my bed and learned how to skate on the roads around the Douglas! I literally learned from some nice guys. I was allowed because at the Doug all the nurses knew that I was better if permitted to get out some anxiety and emptiness with physical activity outside. The other thing I’ll always remember, is me somehow being included in the ‘bad ass’ group. I know it sounds like high school…but that’s how the nurses saw them. Trouble makers and pretty rebellious. No nurse understood how I got tight with them and the others who were calm. Reminder: I was 5’4″, small-ish, innocent looking and wearing glasses. And yet I’d go out on the grounds with these 3 big ‘trouble makers’ and we would pass a joint around. (Yes, me too…I’m not condoning it for others but personally weed has and continues to really help. It’s great that it’s legal here and not adulterated with other drugs. I did however make the wrong call and nearly got addicted to speed. Another example of please don’t be me.)
My Own Prejudice
The first time I was forced to go to the Douglas after my Tylenol suicide attempt, I was terrified. I thought I’d be surrounded by, well, people who could be potentially violent and worse than me. (Seeing that I was only internally violent.) I felt like I didn’t need to be there and didn’t belong. Little did I know that I was falling into the same prejudice that I am so currently against. My experiences have changed my perpective on many things, for which I am extremely grateful despite the horrible circumstances. (It takes time and distance sometimes to realize this, but it will eventually come.)
A New Perspective
If you need the kind of help that can only be provided by inpatient, don’t avoid it because you’re afraid, don’t want to be viewed differently, are ashamed, etc. As I say so often, we all need and deserve help, in whatever form that may be! If people have a problem with it, the problem really lies with them and not you. I guarantee it. And you know what? I haven’t been nearly as judged about that as I thought I would be. Granted, very few people know, until now I suppose. This goes to prove that I am pushing myself out of the shadows as I recommend for you. I may face those fears of judgment from time to time, but in my rational and determined moments such as now, I am firm in my belief of not letting us continue to be judged and misunderstood. If someone has a problem now, I don’t think I’ll stand for it. My real, full name is here for anyone to see, and my mantra?
I will NOT be ashamed! I will NOT let silent killers get swept under the carpet. I am here to show that ANYONE can be affected. This blog? It’s me. It’s a representation of US. But it can also be THEM. And EVERYONE needs to know that!
Click here if you’d like to read about Getting Help for Mental Illness – Stigmas & Fears