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Thursday, March 23, 2017

Week of March 20-24: Throwback Thursday-A Typical Day In A Psychiatric Ward

When people hear about someone having gone to a psychiatric hospital or ward of a hospital they may picture some horrific scene of the past--something scary. As I have mentioned before here, I was in a behavioral hospital twice and in the psychiatric ward of a hospital 4 times. The worst thing I ever saw was a guy stealing pants from another patient's room, acting strange and then got belligerent. So he had to be subdued, but not in a violent way. So, it really wasn't as bad as one might imagine.

I thought I would go through a typical day of routine in the psychiatric ward I was at, what patients were told or thought about certain things so you have some idea. I am not saying that this is the same routine that all such places follow, but this is what I experienced.

The day begins with everyone having to get up between 8:00 and 8:30 to eat. There are about 3-5 counseling sessions during a typical day and nothing on the weekends. They vary on discussion, but are all related to depression or coping skills or discussing care management once the patient is released. The first session starts at about 9:30 or 10:00. There would typically be two sessions before lunch and then two afterwards until about 3:00 or 3:30. Everyone gets about a 45 minute break between sessions. A lot of the counseling sessions include getting handouts which I still have on various subjects. Some are more of a teaching session while others are group discussion. The rumor among the patients was that if you didn't attend the group sessions then the your insurance would not pay for the inpatient care. It turns out after I had gotten a copy of my medical records that the staff did note whether patients attended sessions and participated in what they were asked to do. All of that went in the file. It was a way for the doctor and social workers to judge the behavior of the patient and was a deciding factor sometimes on whether a patient was improving, or not. There were lots of times I didn't want to go to counseling sessions and wanted to go back to bed and sleep, but they didn't want patients doing that. It doesn't help them to go back to bed and sleep the day away like they could at home. They want patients to learn how to cope and care for themselves when they get home.

At different times throughout the day a staff member will ask how you're feeling or sit down with you and ask a series of questions from a form which I learned later goes into your medical records. Visits from psychiatrists occur off and on during the week, but again, nothing on weekends. The weekend is rather lonely because there is nothing to do, no one around except for basic staff. The patient who arrives on a weekend is usually at a disadvantage, in the environment I was in, when you're at your most vulnerable in getting help because there are no doctors to see, no social workers to visit with. So, you have to wait until Monday rolls around and hope you get to see a doctor soon.

The social workers are a huge help in facilitating the care in a patient's recovery. They have more time to spend with the patient than the psychiatrist does, but they relay information back to the doctors for their consideration in treatment. Social workers will also sometimes arrange a meeting with the parents or guardian present to work through issues where a mediator is needed. Sometimes they offer an open discussion meeting where parents of any patient can come in a group setting and talk about mental health care. The patient has to be the one to invite family member(s). I always had my husband and/or mother come to these sessions so they could learn and hopefully understand a little better what I was going through.

Individual patient laundry had to be done by the patient if he/she was there for an extended period of time and only had limited clothing. The rooms (2 to a room) were shared with another room and a bathroom in between. Obviously, shared rooms had to be of the same gender. Clothing, such as robes were provided for those who didn't know they would be kept in the hospital psychiatric ward. 

Once a patient reached a certain level of improved care, they were allowed to leave the psychiatric ward during meal time and go eat in the hospital cafeteria which was a treat. Dinner was usually at 5:00. Then after that was free time until bedtime. Medication had to be taken around 8:00, I believe. Medication was also given in the morning and sometimes at lunch time, depending on what meds you were taking. The doors to the rooms can never be closed during the night. The staff did night checks by peaking through the crack of the door to make sure everyone was sleeping.

It was made obvious to me and my family during one of my hospital stays in the hospital ward that I was no longer able to work. I had been working full time when all my mental issues started. I moved down to a 75% work schedule. I quit my stressful job and got another job I thought I could handle and thought was less stressful. That didn't work either. I was still having mental breakdowns and couldn't handle any stress. I would get overwhelmed and then I'd crash. As I've mentioned before, it took a long time to find the right medications that worked together for my chemical makeup. Everyone is different. So what works for me may not work for someone else.

Once I was ready to be discharged--I would be moved into outpatient care where I would come in to the same psychiatric ward to attend the counseling sessions, have lunch, finish the other sessions and go home. I did everything that was asked of me. I just wanted to get better and be able to function at home full time.

Most of the patients I met where bi-polar. Only once did I meet a patient who was OCD like me and clinically depressed. It was actually comforting to talk with the patients because they knew what depression felt like, they understood those thoughts, those feelings. I met one person who was schizophrenic and he was so nice--a young man, about 20 years old. His medication had gotten out of wack and he was there to get stabilized and get back on track. So, his first 2-3 days were spent sleeping. He would go to the counseling sessions and sleep because he couldn't help it. That's the main thing doctors want patients to do well while they are there--sleep, especially while they are getting their meds worked out. Once he came around, he was so nice to talk to. But I felt so sorry for him that a young man had to experience and live his life with schizophrenia. His mother was very supportive and even came to one of the family support group meetings.

Unfortunately, this wing of the local hospital where I live was closed and made into something else about 5 years ago. There is a new behavioral hospital being built where I live to open in October of this year. It will be a big help to the community, hopefully.

I hope, if anything, that sharing this has made it sound less scary to those who perhaps NEED to go into a hospital setting, if suggested by your doctor. It's not scary at all. And hopefully, there is a deeper understanding of mental health patients that maybe you didn't have before that will soften your heart and lessen your fear.