Licking Windows in Paper Scrubs

What really happens inside a behavioral mental health psychiatric unit? I'll tell you! I've been to over a dozen different facilities- and I'm here to fill you in.

Let's start with how you get there. Typically if you want to hurt yourself or others you are taken to the ER, where you will be assessed. You are typically in a closed off portion of the ER, with others with similar struggles. So this might not even be an area you have ever seen before even if you have visited the ER with other emergencies. People who were publicly intoxicated/had a drug over dose also end up here for detox.

You are asked to remove all of your clothing, and give all your belongings over to the nursing staff. That means underwear, bras, cell phones, socks, shoes, etc. Everything must go. Some staff don't even allow you to keep prescription glasses if they think you will use them to hurt yourself or others with them. You are then given a gown, you usually have to snap it together yourself and while your standing butt-ass-naked, barefoot, in the nasty hospital bathroom trying to figure out how to do it all, they ask you if you are alright, because you can't be left alone for too long. Now that you have your gown on and you ass sticks out the back, you should remember to ask for socks. They take blood work and a urine analysis also, to clear you medically and send a crisis worker to talk with you.

This is usually a mental health social worker that specifically knows the outpatient routine and has been hired to work in Emergency rooms. They discuss what brought you there and then make a plan. Based on what you share they may admit you impatient whether you want to or not, involuntarily. However it's best to go voluntarily. You maintain a lot more patient rights. For now, lets say you are admitted by choice and are compliant that you need more help- voluntarily. (we'll get to the other option later)

Accurate representation of the bed rooms in a psych ward. It's pretty plan and boring.

If the Hospital you are currently in doesn't have a behavior health psych unit, or all their beds are full, they search near by places for you to be transferred by ambulance. They opporate 24/7-365. You can arrive to another hospital at any time, including 3 am! Where they continue to ask you all the same questions you were asked by everyone at the previous hospital for your new intake.

Mornings routines begin anywhere from 7-9am. They take your vitals typically twice a day (blood pressure, body temp, oxygen intake, Morning/ night.) You see a Psychiatrist every day as well as are expected to attend groups and follow your treatment plan which is pretty much medicine based. Anti depressants, Mood Stabilizers, or Anti psychotics. You discuss with the doctor about your med treatment, but rare are the people who go impatient who don't come out with a prescription of something to take daily. Most facilities are stabilization units- so heavy sedation is key to their, err -I mean- YOUR success!

*Mental Illness is a real thing, and many people need medicine to help live their daily lives and lessen the struggles of their mental health symptoms. There is no shame in taking medicine. There is no shame in getting help. And when something works for you, you should stay on your recommended medicine. That being said, this blog is about my experiences and being forced on medicine that hurts me more than it helps because the facilities most believe in heavy sedation and treat everyone like they have a severe case of psychosis.

So what else happens while impatient? At nicer facilities, you get your own room. The newer/nicer the facility the more likely this is the case. I believe there to be research and safety reasons to NOT share a bed room in a psych unit. But in many older facilities you share rooms. These facilities are built in every way to keep you and others safe. The door knobs, the doors themselves, shower curtains, toilet, and bed room furniture are all built in a way to not provide a way to hang, break, or cut yourself. The furniture is bolted to the floor. The towels are small and short, your personal care products/toiletries are provide by the facility and often no outside comfort items are allowed. Leaving no room for contraband. As many people in these facilities are here detoxing from over doses/addictions. Some places provide you with scrubs- often made of paper like fibers. One facility I've been too even has their own sweat pants out-fits. Bright orange, with black sharpie written on it. Inmate style. The others secures your own clothing, zippers, strings and revealing clothing aren't allowed on the unit.

Visitations are daily, usually longer on weekends, and all persons are checked before entering the facility. No opened or home made foods can be given or kept on the unit. You may bring food for someone to eat- but it must be unopened and sealed and finished during the visitation.

The rules are strict, you of course do not have access to your phone, unless you need it to retrieve important numbers. The unit will have a patient phone, by law they are required- otherwise, I don't think they would provide this. However your access to use it is limited and of course shared with the other unit patients. Most facilities have about 20 patients give or take. I however just came from one that had a max of 45 patients on one unit. (That's over double what is usual). It was absolutely terrible.

As apart of their safety protocol they do 15-30 mins round checks on all patients and what they are doing. There is usual a technician in charge of this for their entire shift. They mark on their sheet, where they saw you in the unit, and what you were doing. (i.e. Bed room, showering. Day room- watching tv) At the best facilities they have roughly 7 groups a day. Morning Goals, community group- to explain the unit rules and expectations, Activities/Art Therapy, Music therapy, Occupational Therapy (OT), AA/NA focused groups on addiction, Solo and group therapies. At the least effective units, they only maybe have 3-5 a day and no one on one therapies.

But do they really lick windows? Yes, I've seen that.

Do they have straight jackets? Padded isolation rooms? 4-point restraints? I've never seen straight jackets at a hospital, but I know in state prisons for the mentally ill they use them. They also don't do 4 point restraints unless you are hurting yourself or others. Which is unlikely, because there isn't much to hurt yourself with there. And then they sedate you with a needle and syringe. They do however have isolation rooms. Some are padded, some aren't.

Have I ever been in one? Ha! Yes, but by choice. to get away from other patients and be in quiet! Most patients who go in those rooms are extremely aggressive or psychotic. They don't even know what is going on or remember what they did. And while in the room, they must have someone watching you at all times. Costing the hospital more for your individual care. It's called a one-to- one. (1:1) Or sometimes a 2:1 or 3:1 Based on your level of psychosis.

Accurate representation of ECT room.

So what about Electric shock? Do they do that? The proper terminology is Electric Convulsive Therapy. (ECT for short) And yes, many facilities offer it. This form of therapy is only offered for those who are treatment resistant to other forms of therapy. (Medicine/ Talk therapy) You are put to sleep with an IV of anesthesia, and them your brain is induced for about a 10 second seizure. This is repeated every other day until your symptoms start improving. 5-6 sessions is fairly common. Side effects are short term memory issues, extremely dry mouth from the anesthesia, migraines. With roughly an 85% success rate- it isn't likely going out of style any time soon.

I haven't forgotten about talking to you about being involuntary committed. Essentially an involuntary stay means that the court will get involved and you will be assigned a public defender unless you already have or would like to pay for an attorney, during your hearing. It is your belief that you should not be committed impatient but a mental health professional does. So you are committed until you can have a hearing. Usually with in 7-10 days of being committed. The worst part? If the judge finds that you should stay, you will be court ordered to stay until the doctor clears you. This can be months, as long as he feels you need help. You also loose your 2nd amendment rights (right to own and purchase fire arms) and this will go on federal security clearance back ground checks. However it wont show up for anything else. But might impede your ability to join the military or something be a body guard for the President.

You can appeal this decision, but it delays you impatient stay even longer. You can even become involuntary if you attempt to "sign yourself out" With a "72-hr release form". Meaning you give the doctors and staff 72-hrs to observe that you are not a harm to yourself or others, and that you have the right to leave. However the doctor still gets say, and will involuntarily commit you and start the hearing process if they feel you are a risk. So inevitably it is best to stay "voluntary" and take your chances.

Our mental health field has constant stigma and false reports. The media aids in preventing our society from progressing with mental health mile stones. If we could have people (1) believing that mental illness is real in those who aren't just "mass murders" who go to schools. (2) people studying and doing live research to provide better treatments and therapies, and (3) people supporting each other after these traumatizing impatient stays- we as a community would grow! We can't just see extremes, call it fact and stay uneducated. We all have knowledge at our finger tips- search engines that can bring you the answers to anything you ask! Chuck what you think you know about mental health and ask your friends and family about their struggles. Immerse yourself in growth and become and ally.

Here are some links to check out. And remember, this is the face of mental illness. (me)

www.nami.org www.bbrfoundation.org www.afsp.org