What Will Happen Once You Are Admitted to a Psychiatric Unit

Here is the second article I posted on EzineArticles.  I basically wrote answers to

Issues in Mental Health Nursing

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thequestions I hear quite frequently from the family members of my patients.  This is usually a chaotic and frightening time for them, and many have absolutely no idea of what to expect.  These articles I wrote were to help them and prepare them for what was to come.

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By Shirley K Williams

Hopefully, this article will help shed light on this tricky subject and help people to understand what can and cannot happen in a psychiatric hospital.

If you or a loved one are dealing with a mental illness, it is probably likely that you are familiar with hospitalization. But if you are just beginning this journey, you may have a misunderstanding of what to expect once you or your loved one enters the psychiatric hospital.

Mental illness is a chronic, life-long illness. It does not go away but only gets better for a while. Just like many chronic illnesses, treatment may include inpatient and outpatient services to manage the ongoing symptoms. Going into the psychiatric hospital is not going to “fix” the problem. The actual goal of inpatient hospitalization is to stabilize symptoms and keep the patient safe. Medications will be utilized to bring the patient back to a functional state so that outpatient services can step in and take up the care.

Why do you get put into a psychiatric hospital?

Most people end up in a facility when they exhibit symptoms that appear to create a danger to themselves or to others; or they show a decrease in their ability to care for themselves and have no support system.

Access to the facility can be voluntary or, in most cases, it may be involuntary. Maybe the police had to intervene to protect people from harm; maybe the family was afraid for the loved ones well-being. No matter the reason, if there is a danger to self or others an admission to a facility will probably take place.

What do you expect to happen when hospitalized?

Most people still believe the old way is true: you get sick and go into the hospital to get well. That used to be the norm but today that is not even true for physical illnesses. The actual fact today is you are managed at home until your condition deteriorates enough to require hospitalization. You are admitted and stabilized; then you will be returned home with follow-up care instructions. This is a sad state of affairs, but this is how it currently works. This description also works for the mentally ill patient.

If you expect that admission to a facility means you can be held indefinitely, or that you can be made to participate in your care, you are mistaken. Only the courts can take away patients rights, so until the court steps in or until the patient begins to participate in care, all that can happen is for the facility to maintain your safety and monitor you closely for worsening symptoms.

How can you be given medications if you do not want them?

Everyone has the right to refuse treatment and to refuse medications. For a mental health patient, that does not necessarily mean the right to leave the hospital. If there is any reason to be concerned for the safety of yourself or of others, you can be held against your will until the court is made aware and becomes involved.

Even when held against your will, you can still refuse to take medications. However, if your behavior becomes dangerous to yourself or others–you become aggressive or physically assaultive–the doctor can order emergency medications to be administered to calm the situation down and to bring the patient back to a calmer state where they can exhibit more control over their behavior.

This is one of the only times a person can be given medications against their will and requires a physician’s order to do so. Another way that medication can be administered against the will of the patient happens when the court orders medication to be administered. This requires a special filing and a great deal of information to support the rationale that medication needs to be administered.

When will you be ready for discharge?

The normal length of stay in a psychiatric hospital today is quite short; just like in the medical hospital. The goal of any hospitalization is to identify the problem and to stabilize the condition in such a way that the patient can participate in outpatient care. For the mental health patient, this means stabilization on medications, resolution of aggressive, suicidal, or depressive symptoms so that the patient can again take charge of their own aftercare and follow-up treatments. Unfortunately, mental health patients do not always agree with the doctor as to when this point is reached.

The bottom line is you can be discharged only when the treatment team, which includes the doctor, the social worker, the nurse, and any other therapists involved in your care, all agree that you can resume responsibility for your own care and have the ability to participate in your aftercare treatment.

Will you be “fixed” when you leave the hospital?

As stated before, you or your loved one will be dealing with this chronic illness for their entire life. Depression can go away, but once you experience depression, you may experience it again if situations become too stressful or unpleasant. Hearing voices and seeing people and things others cannot see will resolve with the proper medications, but may return if the medications are stopped or taken incorrectly.

Violent aggression and physical outbursts can occur in the healthiest person if the situation is set up correctly. These are not a specific sign of mental illness, but can be an indicator of the severity of the ongoing illness.

When you are discharged, you will receive aftercare plans with follow-up appointments. It is up to you, the patient, to take control and seek out ways to manage your mental health once you are discharged. Many patients fail to do any follow-up and this usually ends in a recurrence of the behavior that sent them to the hospital in the first place, so another admission may be required.

The truth of the matter is that we may all be in need of some type of mental health care in our lifetime. Mental health issues knows no boundaries. Movie stars, authors, scientists, teachers, athletes, and the average person can all be laid low when mental health issues appear. The problem is not how to get rid of these issues, but rather how to deal with them in a fair, honest and nonjudgmental way so that we all can live life to the fullest.

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