Have you ever been hospitalized for any kind of ailment? Maybe had surgery or were extremely ill. Remember the daily monotony of filling out meal menus, flipping hospital TV channels, being waken up at different times for a medication. The awkward seating accommodations for visitors in the room. Remember the daily visits from your doctor and hoping he will say you can go home today only to be disappointed when he would say not yet. Some of us have been there more than others. Then you finally get that rush of excitement when you are ready to be discharged. Seconds seem like minutes, minutes like hours as you wait for paperwork to be done, prescriptions sent to your pharmacy and for you to be unhooked from all the machines they had you attached to. Yay lets go home and celebrate!!
When you are on a psychiatric unit life is much different. Yes you get to pick your meals but the meals you get on those floors are often bland and do not consist of any type of caffeine. No coffee, no soda, no chocolate. Each day you’d get 2 snacks like you are little kids. One in the morning that consisted of crackers and warm ginger ale and one at night that consisted of a bun, a piece of turkey or ham and a piece of cheese to go along with a small bag of chips or pretzels. This was the hospital stripping you down to your bodies baseline. They wanted no interference with those substances with any medications they are now giving you.
Your room is a hard floor surface with a single size bed. The mattress is thin enough to be folded in half. One pillow, one sheet and one blanket. I’m 6’4 and had to lay in the fetal position to fit on the bed. And to the dismay of many you always had a roommate. You shared the bathroom and shower with this person. You had to deal with their snoring or their obnoxious, suffocating gas. I don’t understand how hospitals expect you to get better when they stick you in the worse possible sleep settings.
Daily life on the floor varied. Every morning you were awaken at roughly 5am for blood pressure and temperature. Sometimes they came and took blood if needed. If you ever want to see something funny and scary watch a phlebotomist come on a psych unit to take blood. Sometimes I wondered if they didn’t send the new people up to practice on us. I had one take blood from a vein in my elbow. 7am was everyone out of bed for breakfast. After breakfast you had about an hour before your first group of the day. After that you had a little time before lunch. During down time people would sit in the group lounge and watch tv or color or do a puzzle which usually had missing pieces. Those hours of down time were boring to say the least. You didn’t want to be in your room because staff would do a bed check every 20-30 min. The more you were in your bed the more negatively it effected your release. Typically in the morning the doctor would arrive and do his rounds. He would spend at most 10 min per person. He would ask about medication effects and mood and sleep. And before he left you’d try to pin him down on when you were going home but it was always a vague answer.
After lunch we would have more down time and then a group session and then dinner. The group sessions whether in the morning, or afternoon were always in a way more of an entertainment than a learning experience. Here you have 15-20 people all with varying diagnosis as well as varying levels of being able to understand the content of the session. So typically the sessions were dumbed down and taught by college age kids who read right out of a book. During the session you’d have some open discussion and a lot of back and forth between people that can’t hear or understand the topic. Let’s say it was a sideshow.
Every evening either NA or AA would come to the floor from 7-8. This was something I went to but I’ve never been an alcoholic or drug addict but went because they locked the TV room and I didn’t want to sit in my room for an hour. It was really powerful to hear some of the messages shared by the guest speakers as well as those who were on the unit for those very reasons. Before the end of the night we gathered for our snack and then reported on our goals for the day and rated your mood. These 2 aspects were always a sham to me. You’d have people who were just admitted saying their mood was a 10. By my 2nd or 3rd stay I realized saying you’re a 10 isn’t going to get you sent home tomorrow. And then you’d have people like me who knew it was a sham and set a goal in the morning of ending world hunger. This was your daily routine for as long as the doctor deemed you needed to be there or until the insurance company decided they weren’t going to pay for another night.
The variance between treatment of those on a psychiatric floor and an inpatient floor is staggering and appalling. The schedules vary from hospital to hospital, the staff size varies, the quality of the group sessions vary and some don’t even have group sessions. Some people may never experience this if they have only spent time in one hospital but I had the honor of spending time on 4 different psych units and likely logged a total of six weeks of time over a period of 5 months. I can walk on a floor and within minutes tell what kind of unit it is. What its strengths and weaknesses are and whether they are going to go beyond serving as a triage to get you stabilized or go further and help educate you on the important topics concerning mental health and what resources are available to you. It is really unfortunate that here in the US that there isn’t a system in place that all hospitals must implement on their psychiatric units. The gaps in service in the hospital lead to bigger issues once the person leaves the hospital.
After you’ve been on a unit for a period of time or from the amount of time you’ve spent over multiple stays you begin to catch on to certain things. For instance I was in for my 4th stay and there was a woman that joined half way through my stay. She informed us all that she downed a bottle of vodka with a bottle of ambien. She also said this wasn’t her first time at the hospital. She stayed all of 72 hours and was discharged. I was angry, befuddled. How in the world was she discharged so quickly? The answer was simple. The doctor had seen enough to know when someone is serious about ending their life and when someone was having a need for attention. He felt he could determine who he could help and who he could not. You also begin to understand which staff member gives a good group and who doesn’t. Patients would be so hard up for caffeine or candy that we would play games with staff members for one small piece of chocolate or a half a cup of coffee.
When the doctor finally reaches the point that he gives you a day that you can anticipate going home your mood immediately changes. You can see light at the end of the tunnel. Your counting the meals you have left before you go home. Your counting how many more nights do I have to sleep with this lethal gas before I can get to my own bed. Thinking about how that first bottle of cold pepsi is going to taste on the way home. Craving a hot shower in your own shower, shaving with a real razor without anyone watching. You are amped up and ready to go! I relate the feeling to being a kid and either being away at a church camp or a summer camp and how rejuvenated you felt when you were about to come home.
You are discharged, the nurse accompanies you through all the locked doors, down the secured elevator and out to the lobby where family is waiting with that ice cold pepsi, a hug and you are ready to go. Only one problem. LIFE DID NOT STOP. While you were in the hospital nothing stopped or disappeared. The bills you had piling up are still there with more added. The troubles in your relationship are still there. They weren’t solved just because you attempted suicide. If your employer knows about the situation its not going to be fun to go back to work. You are starting to process the reality that you are still stuck with the same pile of crap that you had before you attempted suicide. And in most cases its worse because you don’t know how to talk to family about it, you don’t know how to talk to friends and you sure as hell don’t know how to talk to your employer about it.
There is not a MAGIC PILL to resolve your life circumstances that are effecting your mental health. And that high you had coming out of the hospital will disappear quickly. YOU must be diligent in asking for help with the issues that drove you to that suicide attempt in the first place. Yes doctors are prescribing medicines to help with your mood but its not going to pay that outstanding house payment or over due car payment. He’s not calling your mortgage company and paying your bills or fixing your relationships. YOU must ask for and seek help immediately for those life circumstances or like me you will find yourself drowning again and realize you can’t keep treading water and attempt again.
Psychiatric units are not a fun place to be. Nor are they the solution to your mental health and personal life problems. Please listen when I say they are only there to stabilize you and then pass you along to a therapist and or psychiatrist. Please do not think that attempting will get you a 10 day vacation from life problems because all it does is delay the inevitable which is having to face those problems once you are released.
Many communities have clinics or resources that you can reach out to once you are discharged. You can and must reach out to these resources to see if there is any additional help that you may qualify for to help with your life circumstances. Neither the therapist or psychiatrist are going to have those answers nor are they going to be able to solve your problems. And I fully understand the difficulty of asking for help like I discussed in my last blog. You may not feel strong enough to reach out to these resources. Trust me I was there and I didn’t. But what I also failed to do was ask my family to help me get help. I ended up losing my home, my car, my job, practically everything I owned. My head was so far in the fog that I didn’t care to ask for help because I didn’t see myself living to need those things. If you are a friend or a loved one of someone who has attempted please offer to help in any way. When you go from having a nice home with 2 cars, a great job, and annual trips to Disney to living in your sisters spare bedroom living off of disability it doesn’t flash signs of a bright tomorrow. But I’m still here and so are you! Don’t give up!
Remember…. YOU MATTER!