Psychiatric Hospitalizations

In this episode, Wendy discusses psychiatric hospitalizations, sharing both info and personal experiences.

Wendy's novel on psychiatric hospitalizations is out on Amazon! It's called "Involuntary Hold." Check it out~ There is a plot twist you won't see coming!



International Helpline Info

 For those living outside the United States, I finally found some helpful information. The International Association for Suicide Prevention has a directory of crisis centers and helplines for over 50 countries! 

Just got to the internet and type in:

       findahelpline.com/i/iasp

 And it will bring you to a drop-down menu where you can input your country and region, and it will give you the information for your location. Granted, it doesn’t cover everywhere, but it’s a start!

** Remember if you, or a loved one, is in emotional crisis... Help is just a phone call away. Simply dial 9-8-8 for the Suicide and Crisis Hotline, or text "HOME" to 741741 to chat with someone via text 24/7 across the United States. **

Please contact us at bipolarforlife@myyahoo.com with any questions, suggestions, or comments.

Transcript

                                                Bipolar for Life

Episode Two: Hospitalization

Tonight, as promised, we’ll be discussing psychiatric hospitalizations. I’m not sure why I’m talking about such a serious topic so soon in our relationship… but I’ve noticed a rise in questions about hospitalizations online. Since we’re entering a difficult time for people with bipolar disorder, Winter, it feels like the right time to address it.

First, let me say that the experiences I share here are mine alone. Your hospital experience may be entirely different from mine, for so much depends on why you’re there, the facility itself and the staff.

Second, please know that a psychiatric facility IS actually the safest place for you if you are in a mental health crisis — It’s the only place you can get help 24/7 and you’re safe. 

If you find yourself, or someone you know, battling with suicidal thoughts, please reach out to the 988 Hotline. 

The 988 Lifeline is a national network of crisis centers that provide FREE and confidential emotional support to anyone in suicidal crisis, or emotional distress. It’s available 24 hours a day, 7 days a week across the U.S. 

Just dial 9-8-8 and speak with someone who cares.

I admit to having scars from my psychiatric hospitalizations, but I also KNOW that had I remained where and how I was, I would not be speaking with you today! So, while they are scary and difficult to deal with, a psychiatric hospital stay CAN save your life!

In our discussion of psychiatric hospitalizations, I think it’s best to break it into the two ways you can enter a psychiatric facility – voluntarily and involuntarily. I will be speaking from the voluntary perspective, for I was never involuntarily committed, (although I believe I would have been had I not agreed to go.)

Before we break off into our discussion of how one gets into a psychiatric facility, let’s talk about the fact that psych ward and psychiatric hospitals are not the same thing. They are two different types of facilities. 

The Psych Ward, or the Behavioral Health Unit, is usually found in general hospitals and provide short-term services for patients who need immediate evaluation and treatment. 

Psychiatric Hospitals (sometimes called Mental Health Hospitals) are separate facilities that provide long-term care for patients with severe mental illnesses, that need close observation and medical attention.

All of my hospitalizations were on psych wards. In fact, in preparing for this episode, I realized that I’ve actually been on four different psych wards, not just three. 

I tend remember things emotionally, not by date.. so, if I get things a bit confused as I recall my experiences, please forgive me. 

There are a few ways you can commit yourself to a psych ward if you feel out of control, or are on the verge of killing yourself. 

First, just go to the emergency room. Let them know you are in a mental health crisis. They will evaluate you, and if you meet the criteria and a doctor agrees, they will admit you.  The criteria for a voluntary hospitalization are:

1) Outpatient treatment is not a high enough level of care for you.

2) You require inpatient treatment under the care of a psychiatrist.

3) You have a confirmed mental health disorder.

4) Inpatient treatment will improve your level of functioning or prevent further decline.

5) Or you meet all the legal criteria for Involuntary commitment, but you agree to being hospitalized.

Voluntary patients will usually spend 10 days to 2 weeks in a mental health facility. The patient that goes in for treatment voluntarily is likely to be discharged sooner than an involuntary patient. So, it’s always better to go voluntarily. 

Also, a voluntary patient can technically leave whenever they are ready, even if it’s “against medical advice.” However, if the doctor thinks you are not well enough to leave, or a risk to yourself or others, they can detain you for 72 hours. It’s called a 5150 Hold. They do that because 1 in 5 patients with bipolar disorder actually complete suicide. 

In fact, there are about 90 suicides every hour – That’s nearly 2,200 people a day, or 800,000 people a year die by suicide, and 90% are related to mental health disorders.  So, if they think you’re at risk, you won’t get to leave even if you are a voluntary patient. 

If you find yourself battling suicidal thoughts and don’t want to talk to anyone, I found out you can text instead! The Crisis Text Line is free confidential crisis counseling 24/7. All you have to do is text “HOME” – That’s H-O-M-E (all caps) to 741741, and you’ll have someone to chat with. You are not alone, even if you don’t feel like talking!

Another way you can commit yourself to a psychiatric hospital is to contact your doctor when you’re feeling suicidal or out of control. Let them know what’s happening and they can start getting everything ready for your arrival at the hospital. 

This happened to me when I told my therapist over the phone that I needed some physical pain to put my head right… She didn’t like the thought of my putting a sword through my foot. Today, that does sound a little extreme, but at the time… it seemed like a reasonable solution to my problem… Yes, I was voluntarily committed, and my medications were replaced. It turns out that the efficacy of mediations can change over time, and getting your meds regulated at the hospital is the safest way to deal with possible side effects or allergies.

 As I said earlier, I really can’t speak to Involuntary Commitment. I had several friends on the ward who were involuntary, but it never actually happened to me. Most of those who were involuntary came into the hospital via the back of a police car or an ambulance.  

There are only 3 criteria for meeting the requirements for involuntary detention:

1) You present a danger to yourself.

2) You present a danger to others.

3) Or you are incapacitated to the point of being disabled. You are unable able to provide for your own food, clothing, and shelter OR you cannot make use of the food, clothing and shelter available to you. 

Any of those criteria alone, or in combination, are enough to get you a 5150 Hold for 72-hour evaluation. After the 5150 has expired, the doctor can petition for a 5250, which is an additional 14 days of treatment. It’s at this point you will have a hearing and the legal eagles get involved.

That was the only difference in treatment between the voluntary and involuntary patients that I saw; having to deal with the legal system. There’s another reason to go to the hospital voluntarily, you don’t get caught up in any legal battles. You can leave when you’re ready, not when the court says you can.  

Both voluntary and involuntary patients roam the ward freely. The involuntary designation simply means you can’t leave when you’re ready, and there will be more than just your doctor to deal with. 

But from what I could tell, the actual treatment of patients was the same, no matter how you got there. 

Everyone has to go through the humiliating admission process where they go through all your belongings and remove anything “harmful.” They take everything; your shoelaces, your belts, anything with a string, anything you can choke on, and anything that might be the least bit sharp. They usually take your clothes and put you in a stylish hospital gown, just to make you feel at home. You get your clothes back when you get privileges, and when that happens depends on the ward regulations.

The kinds of programs you get on the psych ward depends on how well mental health is funded in that community. At Johns Hopkins in Baltimore, Maryland, they were well funded and there were a myriad of programs to keep you in therapies all day. But most psych wards are not as well funded, so they have only a few programs. Therefore, most of your day is filled with free time. 

Basically, you are waiting for your new meds, or other therapies, to kick in and stabilize you enough to leave. It has been my experience that no one gets off the psych ward without some kind of meds.

The days on the ward are regimented by mealtimes and doctor’s visits. There is an early wake-up time each morning and a staunch bedtime every night. Meds and treatments are also a main focus on the ward.  

I found most of the nurses on the psych wards I visited were extremely nice, and very helpful. They were caring, yet busy. You will run into the odd person having a bad day, but on the whole, I’ve never met a Nurse Ratched. 

I do know that psych ward nurses are a special breed. I have a nurse friend who won’t go near psychiatric duty because of the emotional toll it takes on you. It requires an extraordinary person to deal with all the problems on the psych ward; it’s a very emotional place!

I think, that, was the thing that affected me the most when I was there on the wards. The fact that there was so much emotional pain! There were loads of tears and some screams…  

In fact, there was one night, through all my experiences, that will, to me, forever exemplify the depth of anguish that can be felt by the human soul. 

At a hospital in Virginia, my room was next to the Quiet Room, which is where they confine the out-of-control patients. One night, a blood-curdling scream sent me bolt upright in bed, out of a deep sleep. In the dark, it sounded like someone was being tortured next door! I couldn’t imagine what could make a person scream like that. The piercing shrieks reverberated off the walls. Whoever was next door was pissed about being in there, although no intelligible words ever made it to my ears. Quickly, the anger turned to misery. The howls continued for a while, and all I could do was cry as I felt my own heart bleed for the person next door. Such pain, and torment… would it never end?!

 Then, as abruptly as they began, the screams stopped. There was dead silence… although, the wails echoed in my ears for a long moment. They had sedated the person in the Quiet Room. 

I’ve never heard such emotional torture in my entire life, and I pray I never hear another soul in such agony again! That night is forever seared onto my soul.

I have written a book about my experiences on the psych ward and added a mysterious twist to make it an interesting story as well. It’s called Involuntary Hold and will be coming out in December on Amazon. It’s basically a look at daily life on the psych ward. So, if you or a loved one, are curious about what it’s like to live on the ward, Involuntary Hold is the book for you. More details as they become available.

SFX MAILBOX DELVERY

Oh! That means mail! Let’s see what we have today.  If you’d like to reach us, please drop a note to bipolarforlife@myyahoo.com with any tips, wisdom or questions you may have. 

SFX OPEN BOX

Sadly, we only have time for one note again today. I’ve got to stop talking so much! 

Here’s a note from Phoebe in Utah. Phoebe writes, “What happens to someone with bipolar disorder who doesn’t take their medication?”

That’s an excellent question, Pheobe, and one that rolls right into our discussion tonight. 

It seems to me, that if someone with bipolar disorder stops their meds, it’s usually in mania. You feel so good; that you question the need for any meds at all. So, you just stop taking them. You’re good for a while, but then the inevitable change comes. And the depression will hit hard, because there are no longer any meds in your system. You’ll have to start all over and wait for them to become therapeutic again. Untreated depression, or mania, can land you in the hospital. 

So, STAY on your meds! They not only can save your life, but also save your relationships as well.  

Why? Because off your meds, you become irritable, incommunicative, and unpredictable which adversely affects the people around you.  So, if you can’t take the meds for your own sake, PLEASE take them for your loved ones.

Thank you for your question, Phoebe.
 
As always, you can reach us with questions or issues on your mind at bipolarforlife@myyahoo.com, perhaps we’ll read your note on the air. 

Tonight, the thought that I’d like to leave you with is, Meds are so important! They can always be fine tuned for whatever is happening in your life, but no meds means untreated moods swings, which is how you end up in the hospital. So, stay on your meds and tell your doctor of any major mood changes as soon as they begin. 

I’m your host, Wendy Foard. Thank you for being with me tonight. There is still so much to say about hospitalization, and perhaps we’ll revisit the topic in the future. 

However, tonight, I invite you to join me next week when our topic will be … Suicide. We’ve began our discussions with the hard stuff, so let’s just go straight to the hardest; the one that people don’t like to think about… The societal taboo…  

That’s next week on Bipolar for Life, Thursday nights at 8 pm.  

Talk to ya’ then!