psychiatric hospitalizations

Psychiatric Hospitalizations: How To Support A Loved One

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Kate Earley

Killjoy, PR lover, politico, and I run on caffeine.

A mental health (psychiatric) hospitalization can be an incredibly scary and disorienting experience. Hearing that a friend or family member is being admitted to a psychiatric unit can be confusing. You might not understand everything about what it means, and you might not have a clue about how to support them during this time. I’m here to clear up a few misconceptions about what mental health hospitalizations are, what they consist of, and to address the best ways to help somebody you care about through them.

First things first: you don’t have to be suicidal or homicidal to be hospitalized.

This is the biggest misconception people have about psychiatric hospitalizations. Basic social understanding of hospitalizations tends to center around the discourse of suicidal or homicidal thoughts or behaviors.  While these are reasons somebody might be in the hospital, it doesn’t give you the full picture.

Many people are admitted to psychiatric units because of changes in the frequency or severity of their symptoms, a desperate need for immediate medication changes, or other kinds of sudden changes in symptoms. There are many instances of people who aren’t suicidal or homicidal meeting criteria for hospitalization. This may include: schizophrenic individuals having severe delusions or hallucinations that put them at risk to maintain safety in the community, bipolar individuals experiencing mania who are engaging in risky behaviors, or individuals with severe anxiety having an uptick in symptoms that renders them unable to function in their daily lives. The list goes on and on.

So don’t assume that your loved one is in the hospital because of a suicide attempt — the fact of the matter is, people can be admitted for a variety of reasons.

Secondly, hospitalizations are (probably) nothing like what you’ve seen in movies.

Every unit is different, just like every ER is different! Different units have different rules and operating procedures. Some allow patients to go outside, to use computers, and most allow individuals to wear their own clothes (as opposed to a hospital gown). Others are much more bare bones.

You may be thinking of hospitalizations as horrific experiences where people are strapped down, forcibly medicated, or spend all day wandering around dimly lit hallways. This stereotype deeply stigmatizes hospitalizations and the experiences that patients have in them.

It is absolutely true that some hospitalizations are negative experiences. The things above can and do happen in some units. But by regarding them as the norm, we grant them legitimacy as the “standard of care.” It is important to keep in mind that if a patient is chemically or physically restrained (meaning they are sedated with injectable medications or restrained on a bed), it is for their own safety or for the safety of others. It is, unfortunately, a difficult experience that is done out of necessity. This should not be considered routine for all patients. If you assume that the experience is the same across the board, you create two very problematic consequences: you dissuade people who may need emergency psychiatric attention from getting it, and you dissuade people who do have negative experiences from speaking out by leaving them thinking that it’s supposed to be like that.

Clear out your assumptions of what a hospitalization is going to entail. Instead, follow some of these tips.

Research the unit online – and then ask the patient what they want.

Sometimes, patients are allowed to have some outside materials with them — books, magazines, stickers, etc. Many units allow you to send or bring in items like that. Furthermore, it’s a great idea to get a sense of what contact will be like — are there specific hours where patients can use the phones, or are they available all day? What are visitation hours/days? Is computer usage allowed? You can find some of these answers online.  Others, you may have to call and ask.

Because of HIPAA privacy laws, it isn’t typically possible to simply call and ask to speak to a patient directly. (A release would need to be signed ahead of time) So if you’re wondering what the rules are or what you can do for your loved one, you can ask that a message be passed on to the patient for them to call you. 

Once you have the information and speak to your loved one, ask what they would like you to do. Do they want you to bring something to them? Do they want you to come visit? It’s important to follow their lead. If they want you to call, call! If you are able to visit, visit!

Don’t ask about why the person is in the hospital, unless they volunteer that information to you.

While it is entirely true that people have a variety of reasons to be in the hospital, asking about it if they don’t volunteer that information is a major no-no.

You may wonder why this is the case. After all, isn’t it okay to be concerned?

Some people go into the hospital voluntarily. Others are committed against their will. (You may have heard of the terms 51/50 or section 12, though the name for such a regulation varies state-to-state.) Sometimes it’s because something traumatic happened. Sometimes it’s because of a suicide attempt. Sometimes it’s because they couldn’t take care of themselves. Bringing it up can be upsetting to the patient and can hinder their recovery. Let them take the lead. They’ll open up when and if they’re ready. The reality is that your loved one is in the hospital, and the reason why is less important than the fact that they are receiving much-needed mental health treatment. 

If the patient said or did something hurtful to you during the episode leading up to a hospitalization, this is not the time to bring it up, shame them, or be angry at them.

Let’s remember the main theme in most psychiatric hospitalizations: the person being hospitalized is in psychiatric distress so extreme that it must be treated immediately in an inpatient setting. If somebody had been physically injured so badly that they had to be admitted to the hospital, would you consider it a good time to yell at them, degrade them, or otherwise stress them out? No. You wouldn’t. People in extreme psychiatric distress, in many cases, aren’t in complete control of their actions, thoughts, or words. (That’s actually the reason most people are hospitalized!)

People can begin to feel extremely guilty and bad about themselves for the episode that lead up to the hospitalization. It is, frankly, a horrifying experience to realize you said or did things while completely out of control. You feel violated by your own body and mind. What people with mental illnesses who are undergoing acute psychiatric treatment need is support. 

When you loved one is discharged, make sure they are comfortable and safe.

Some stays in the hospital last only a few days. Others last for weeks. No matter what the length is, hospitalizations are taxing. A person’s first entry back into the “real world” can be jarring, and it’s very important that they feel safe and secure.

Try to be there when your loved one gets out of the hospital. Pick them up or take transit with them. Follow their lead and be there for them. The first few days out are the hardest, and being supportive can make the all difference between someone succeeding and somebody slipping back into harmful or dangerous behavior.

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Psychiatric hospitalizations can be taxing for everybody, but especially for the patient being hospitalized! It’s important to be supportive and understanding of the traumatic nature of these events and to display your commitment to supporting mentally ill people across the board.