mental health

Five Things I’ve Learned About Going To An Emergency Room At A Psychiatric Hospital

I was recently reminiscing about the many times over the past few years that I have visited my local psychiatric hospital in a state of crisis or emergency. My relationship with the hospital started when I was in the midst of a severe episode of depression over three years ago, a few months before I received my diagnosis of bipolar disorder in June 2014.  I want to clarify, first and foremost, that I mostly hold very positive feelings towards this specific hospital for their hard work in addressing mental health in my city and country.  They are doing a lot to improve access to care and to eliminate the stigma surrounding mental illness. However, I just wanted to share certain experiences that I feel might be universal to any mental hospital, based on my research and after learning from other people with mental illness. Often, people don’t know what to expect when they are thinking about going to a psychiatric hospital. They avoid going because they are overwhelmed or frightened.  These personal insights into what has been like for me might help paint a picture of what you can expect. Of course, a person’s experience might be different based on a variety of intersecting factors such as race, sexuality, gender identity and more. However, I think that these lessons can help everyone in some capacity.

1. You Might Feel Like You Are Being Treated Like A Criminal

Most mental hospitals will search you and your belongings. I have been patted down and searched with a metal-detecting wand. They will also take your belongings into their position until you leave the building if you have any materials that they deem dangerous. This includes sharp objects, as well as long wires like phone chargers. I completely understand why hospitals do this, but the experience is still hardly pleasant even when equipped with this knowledge. Additionally, once you are in the waiting room, you can’t necessarily just walk off and leave. You need permission from a psychiatrist. This can definitely make you more anxious if you have a history of anxiety. At times, I felt a bit trapped, to be honest. I get that they want to make sure you will be safe enough before you leave. It just doesn’t feel great. What works for me in dealing with this lack of control is to focus on convincing myself that I am prioritizing my health and that I made the right decision in seeking help. By doing so, I am allowing myself to remember what’s important and to remember that I need to comply with hospital rules so that they can help me as best they can.

2. It Could, and Will Most Likely, Be Triggering

For most people, hospitals are not their favourite place. We aren’t typically excited to go to the hospital since as a patient, that usually means something is wrong. And as much as the administration tries, a hospital isn’t a positive environment. Most people who are in a hospital have serious health issues and need a lot of care and attention. So you can imagine that it would be similar for a specialized psychiatric hospital. A lot of the people in the hospital are experiencing severe symptoms of their mental illnesses. They are typically in an acute crisis. So it can definitely be scary for someone to enter into that environment. When I’ve been at the hospital as a patient, I’ve been at my most vulnerable. It can be overwhelming to be surrounded by people who are screaming, behaving erratically or possibly acting violently. Sometimes, there are people in handcuffs. I’m not saying that everyone in crisis acts this way, but this behaviour has definitely been a hallmark of many of my visits. I also want to reiterate that people with “difficult” behaviour definitely do not deserve to be stigmatized, criminalized or discriminated against for their symptoms. However, for a patient who is not a trained mental health professional, it can definitely be scary to deal with this. This is why the doctors will often send you home to get care as an outpatient if they believe that you will not harm yourself or others, and if you have the right support at home. However, PLEASE do not let this alarm you or scare you away from visiting. There are so many benefits to going to the hospital that outweighs these issues. I prepare myself to handle these potential incidents by reminding myself that I will be taking significant steps in handling my bipolar disorder by visiting the hospital.

3. You Will Have to Talk A Lot

If you want to visit the emergency room in a psychiatric hospital, you should be prepared that you will need to talk a lot and share intimate details about your mental health history.  It can be an intense and draining experience. Depending on the hospital, you might need to speak to 2-4 health professionals. This could include an intake/triage nurse, medical students, residents, and psychiatrists. In these conversations, you will likely have to repeat information that you shared in the previous discussion. You will be asked about everything from self-harm and suicide attempts to disclosing whether you have had psychotic symptoms such as hearing voices or seeing visual hallucinations. Some of the conversations I have had lasted for almost an hour. Depending on the person you are speaking to, they might be very clinical and formal while spending much of their time distinctly NOT looking at you but instead focusing on their computer or pad of paper. They might also be dismissive, patronizing or make inappropriate jokes. However, many mental health professionals are very sympathetic, supportive and encouraging when they engage you in conversation. They have a lot of experience and knowledge about most mental illnesses, so they understand what you’ve been going through and can help you identify how you are feeling. It is totally worth it to put in the emotional labour to share your story in these settings because you might actually receive the care you have been seeking for too long.

4. You Might Be Disappointed in the Results

It’s interesting because, during most of my visits to the emergency room at the psychiatric hospital, I have specifically been asked what I am hoping to get out of the visit. For me, I typically always have the same reason for visiting. It is because the symptoms of my mental illness are so severe that they are unbearable and I cannot handle it anymore. I usually want to be admitted to the hospital because I want to escape from my life and I want someone to give me a “silver bullet” solution to my problems. So most times, I am disappointed when the psychiatrist tells me that I will not be admitted and I will be sent home. And I feel that most people might be disappointed because they do not know what to expect from the hospital and what the hospital can do for them. Unfortunately, there is just not enough room for everyone in crisis, so they will typically only admit people who are a danger to themselves or others. However, in my experience, they will also typically direct you to resources that can help. These resources and solutions might take some time to work, but as I am starting to learn, there is definitely no quick-fix to mental illness. Which leads me to….

5. You Might Finally Get Connected to the Right Resources

I have learned that there are definitely not enough mental health resources in my community and in many communities around the world. There ARE many amazing and helpful initiatives and programs in hospitals and community health centres, especially across my own province of Ontario, Canada. However, it is often incredibly difficult to access them, either because they aren’t highly visible or because there are extremely long wait lists. Many family doctors do not receive adequate training around mental illness and many are not even comfortable prescribing medications for mental illness. They usually provide referrals to psychiatrists and other specialists, but people can wait for months, even years before they are seen. This is why it usually feels like a never-ending battle to treat your mental health. And why people are often only really helped in a crisis situation.  The fact of the matter is that I only started getting proper, consistent care for my mental illness when I visited the hospital’s emergency room. They directed me to a crisis clinic where I was given an appointment in less than a week’s time. So if you are feeling symptoms of depression, please visit. You don’t have to be suicidal – if these symptoms are impacting your daily life, it’s time to get help.

 

What do you think? Have you been to a psychiatric hospital emergency room? Or just any hospital’s emergency room for a mental illness-related reason? If you are comfortable, please share with me below in the comments!

 

 

4 comments on “Five Things I’ve Learned About Going To An Emergency Room At A Psychiatric Hospital

  1. This is a really interesting post.

    Liked by 1 person

  2. Harley Quinn

    I’m not sure if it’s because we live in different countries (US for me), or if where I live now just doesn’t have enough people in crisis, but I have been to my local Hospital 3 times. And once more, but we were set in the main waiting room for 5 hours, finally got a room, waited another hour for the doctor to come, who was seriously belittling me, and then was told that I would have to wait for about another 2 hours for the crises counselor to see me. In that case, regardless of the fact that I was in an extremely psychotic state and should get help, we then walked out Against Medical Advisement since i was not in danger to myself or others and they couldn’t stop me. That whole experience was absolutely horrible. To make matters worse, if I did get admitted I would be letting down a friend bc I had promised to watch her cat. Mom let me go there… I was a little bit more calmed down, and she made me call her every hour for two whole days.

    But that was an anomaly. All three of the other times were pretty much the complete opposite (and I think the only variable was that the first time I was admitted, I was completely terrified).

    So, in general, I went to triage, described what was happening, given a wrist ban and told to take a seat in the waiting room. A little less than an hour later I was taken back into the actual waiting room. I actually had to be on a cot in the middle of the place bc there were no beds available, but they wanted to get me seen (the other two times I had a bed). Nearer 2ish hours later I was being taken away to the 7th floor… the psych ward. Before this, I obviously had to answer questions, get my blood tested, get my urine tested, been checked for any new scars (and one of the aides told me she really liked my bamboo tattoo lol), etc.

    Then, once I got to the 7th floor, they took all the bags I had, my clothes, checked again for scars, noted where and what all of my tattoos were, made me change into a hospital gown until they could make sure I didn’t have anything in them, and apparently had already told my moth
    er what kind of clothes I could wear, what was unacceptable, no electronics, my own shampoo, as long as it was in trial size, shoes without laces, etc.

    I get shown my room and everything that we had to do every day. Basically it was this:
    -Meds at 8am
    -Breakfast from 8:30-9:30am
    -Free time from 9:30-10am
    -First group therapy 10am
    -Free time 11:30am-12 noon
    -Lunch from noon-1pm
    -Activities from 1-2pm
    -Free time from 2-4pm (it was usually in this time frame that the psychiatrist would see you if he wanted to)
    -Second group therapy- 4pm-5:30pm
    -Dinner 5:30-6:30pm
    -Visitors 6pm-7pm (yes, that and lunch overlapped.)
    -Free time – 7pm-8pm
    -Meds 8pm
    -Third group therapy 8:30-9pm

    honestly, all the group therapy stuff was the same thing ALL the time. We wasted more time telling everyone what our names were, why we were here, and something that we want to accomplish. (Third group of the day replaced “something that we want to accomplish” to “Name one good thing that happened to you today”) Seriously, they were so repetitive that people would just not come. I spent one Second group therapy time sat in front of the psychiatrist office because I hadn’t seen anyone yet (it had been 3 days since I was admitted), then got told that another doctor would be seeing me tomorrow. They had no therapists at all, 2 psychiatric nurses, 2 crisis counselors, 1 social worker, and 1 “peer specialist” (that’s who ran group. She has a mental Illness too, but she is well managed on meds, so this was where they put her). Psychiatrists? 6. So you wouldn’t know who you were even seeing. And then the next time you saw one, they would be completely different and changed my meds around again…. yeah. I honestly don’t ever want to go back there just because nothing was really “done” to help us. The last time I went in, I pleaded with my Psychiatrist that I know I needed to go somewhere bc i was suicidal, but to PLEASE not send me there. Unfortunately, even though he agreed, protocol was to call them and see if they have a bed. They did. I wanted to go to a reputable psychiatric inpatient hospital. After my suicidal thoughts lifted the day after I came there (bc they took me off of haldol.. I knew that was the problem) I signed a release form, but that was to stay 3 more days, than leave. This time, I hounded them. I told them what was wrong and how it had been fixed. I told them I didn’t want to even hurt myself, let alone take my life. I gave them my entire psychiatric history, in detail, and including what meds I was on and what my diagnoses was at the time (when I’m clear headed I can do that shit lol). They let me go early.

    eep! so sorry for the long response!!!!

    Like

  3. I identify with all of these things that happen at an Emergency Room at a Psychiatric Hospital. Thanks so much for sharing these thoughts.

    The part that you said about having to talk a lot is exceptionally true. The whole triage process takes a long time, and unfortunately you learn through the process how to tell your life story in a succinct manner. The being searched is not fun and it does make you feel a bit like you are a criminal. It makes you wonder if there is a more humane way to deal with acute psychiatric issues. However the one thing that I would stress is that it is not as scary as people make it out to be in the movies. It won’t be like you are going through an episode of American Horror Story: Asylum. And often the best part is when you are done with the process and can actually meet other people who are struggling with similar issues. There is strength in knowing you aren’t alone. Sometimes you can feel very isolated in your home environment because of the lack of people who face similar issues.

    Like

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