I’m sure it’s a question that you might have wondered after reading my blog which mentions numerous stays in the psychiatric hospital. So, because it is actually very interesting, I thought I’d describe what happens when you get admitted. First, to get admitted isn’t easy – I read a quote saying it’s easier to get into Harvard than into a psych ward. To start the process, you have to go to the ER at a hospital. I always go to the one closest to Mesa Vista (one of the psychiatric hospitals in San Diego that my insurance accepts, and the nicest, so I’ve heard). At the ER, they ask you the usual “why are you here” type questions which in my case has always been that I am an immediate danger to myself because of my symptoms. Read the other posts for details on that. They take you to a room, ask more questions, take blood, then set you up in an actual room with a bed and a little tv and a curtain for privacy (which I never close because I want to see the happenings), and they make you wear a hospital gown. It’s very interesting to be in the mix of the ER bustle. Last time I was there, my neighbor was moaning very loudly and persistently because she was having trouble pooping (or that’s what we gathered at least). Every time someone passes by it’s a game of “what are they here for??”
After a while, hopefully not too long, but sometimes hours, a member of the behavioral health team comes in to assess you. They ask a LOT of detailed questions to determine if hospitalization is necessary. “I don’t usually admit people that want to be admitted” revealed Ben (the PET team member who was assessing me) after I exclaimed that I didn’t want to be admitted. So, after a lengthy interview I was admitted. Then you have to wait for them to take you there, because in this case Mesa Vista is a separate building from the main hospital. They take you by ambulance, which is ridiculous because it’s literally around the corner. You could walk in a few minutes. But hey, that’s protocol.
When you get there, be prepared to answer a barrage of questions and have tests done (more blood, urine, etc). There’s a lot of paperwork to sign, and then they need to go through all your belongings to make sure everything you have is safe and allowed (there are a LOT of rules that keep changing every time I am admitted). This time, I was transferred around 2am, so was very tired when being put through the admissions process and just wanted to snuggle up in my penguin blanket with my stuffed bears that I had brought. But nope, no stuffies allowed. No blanket allowed. I had a meltdown by the nurse’s station. It was too late for this and I just wanted a simple comfort from home. “People bring in contraband inside stuffed animals” I was told. I had to pull myself together and remind myself that I am a grown 34 year old woman and can survive a few days without her blanket and stuffies. Needless to say, I don’t think I slept at all that night. It’s loud, it’s bright (there are windows on the bedroom doors) and people are constantly coming into the room to do checks. Every 15 minutes. 24 hours a day. They have a clipboard and write a little number corresponding to your location.
The weirdest things to get used to are the total lack of privacy (even the bathroom doors don’t go all the way to the ceiling), not having access to your cell phone or electronic devices, and the rules about what is allowed in your room, what you can have access to in storage, and what is not allowed at all. Anything metal, sharp, or otherwise deemed “dangerous” is not allowed (belts, shoelaces, or any type or string on clothing is a big no no). For some reason, makeup is allowed in storage, but not in your room. I finally talked one of the nurses into letting me keep my stick of mascara in my room, but that was after a few days and had been initially told no. Tweezers? Forget about it. Jenga? Storage only. You can shave your legs only under staff supervision. Needless to say, there’s a lot of hairy legs on the unit haha. In the rooms, there are almost no flat surfaces or things that people could tie things to. I don’t really know what trouble people can get into with flat surfaces, but I guess people get creative when they are trying to hurt themselves or others. The shower head is this little nub that comes out of the wall and sprays a pathetic stream of water at you, and you need to splash yourself and squeeze up against the wall to adequately wash yourself. The beds are lined with plastic because they need to keep them sanitary, so they are squeaky and not that comfortable. The pillows are the same – those flat plastic lined things that don’t offer much support or comfort. The blankets are thin and scratchy (and so are the towels). But that’s just a minor inconvenience.
Meals are excellent – they feed you well and often. I swear, I always come out of there 5 pounds heavier. The last few times I had been in, the highlight of my day was filling out the meal card. You got to pick what you wanted for breakfast/lunch/dinner the next day from a little menu card. This time, our meals were served in more of a buffet style system. I liked that better because I could control my portions better without wasting food.
The wards themselves (I have stayed in two different ones, each with its own benefits) have community space for hanging out, watching tv and using computers, a room for dining and having groups (psychology or recreation therapy or crafts), a nurses station, bedrooms, a medication room, interview rooms for when you meet with the nurses/doctors, and an outdoor space. The doors to the ward are kept locked and only accessible with a special fob that the staff all have. No escaping for us. Not to mention they’d notice pretty quickly with all the checks they constantly do. It’s funny, you stop noticing the nurses with the clipboards hovering in the background fairly quickly.
You meet with your psychiatrist daily to go over your treatment plan, update on medication, and talk about how the symptoms are changing if at all. It’s usually a pretty quick visit. This time, because of my non-compliance with medication, it was decided that a slow-release injection of Haldol was a better option for me. Not only would it ensure that I would get my medication consistently, but it is better for me mentally to not have to be a slave to pills every night. I agreed to this course of treatment.
Oh another thing they LOVE to do all day is take your vitals. Each morning between 6:15am – 6:30am they wake you up, take your blood pressure and temperature, then let you go back to sleep. They do vitals like TWICE more throughout the day. First sitting, then standing. Because I guess there’s a difference. I’m super good at vitals and always have perfect blood pressure. I did learn that my heart rate runs naturally high though. A debate started when my brother visited and he had a fitbit that showed his heart rate under 60bpm. Mine ran over 110 usually (resting rate). We had to call a nurse over to settle the score of “who has the normal heart rate”. Apparently normal is between 60-100bpm, so neither of us won that one.
You can pretty much do what you want all day, except they turn off the tvs when it's group time to encourage you to go. The remote for the tv is also literally the size of an ipad. It’s the weirdest thing. When I saw it for the first time, I was alone and wished someone was around so I could have looked at them and laughed and said “amiright??” You can nap, eat, not eat, hang out with other patients, read, color, go to groups, not go to groups, whatever you want. There are also snacks in the fridge so if you want pudding or cheese you can have that whenever you want. Not bad, right? Then you remember you are locked in.
The other patients are a whole other story – some are cool, some are weird, some are just plain annoying. I met a guy once who claimed to be a musical savant and told stories of his life. He had a gross leg wound and the bandage kept coming off. Eeew. Some patients have bipolar, depression, alcoholism, or who knows why they are there. Some are court ordered. Some are on involuntarily holds (meaning by law they cannot check themselves out) and others are voluntarily. I have been mostly there voluntarily, although one time I was on a 51-50 hold. That’s what they call it and it lasts 72 hours. Then you are considered voluntary after that if they think you don’t need to be legally held any longer. If they want to extend it, they have to have a hearing with a judge and stuff. I’ve never had to do that.
Then, after your symptoms have stabilized and you feel safe to do so, they usually release you. I’ve been held longer than I wanted to stay many times because I was still experiencing symptoms even thought I didn’t feel like a danger to myself anymore. So, eventually, if you want to get out, you tell them what they want to hear: “nope, no more voices!” And then you are set FREE!! And you have to do a whole bunch MORE paperwork and discharge stuff. That’s boring though so I’ll skip that.
The best feeling in the whole world is driving out of that parking lot back into the world. Never am I more happy to stop at red lights or get stuck in traffic. It’s like getting drunk on freedom. First stop? Starbucks.
Hopefully this helps eliminate some of the mystery of the mental ward. It’s not such a scary place, and certainly necessary for me from time to time. I always am super reluctant to go in, but leave knowing it was the right decision. This is also only my experience at one hospital. I’m sure there are awful places out there, but I’ve always been lucky with Mesa Vista. If you have any questions about any of this, feel free to ask!
