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  • Eli Stuart (they/them)

An Inpatient Deep Dive (Mental Health Hospital)

Updated: Dec 6, 2021

[Image Description: Cover Image is of the entrance to the inpatient unit at the Mills-Peninsula Health Service, with white walls with the first set doors labeled with "Mental Health Inpatient Units" above them. The first two set of light brown, wooden appearing doors are fully opened and against the white walls, with the last set of doors closed, with a rectangular window on each door. (Photo credit to Veronica Weber)]


Note: This is on mental health hospitals, but this does not cover the various types. Generally, there are 3 types of hospitalization: Residential, Inpatient, and Outpatient. Residential is long term, stays are for at least a few months, done generally as a “last resort” (ie: previous Inpatient and Outpatient stays have not worked and mental health is still in a really bad place). Inpatient (the topic of this article) is used as a stop gap during a crisis to determine where to go from there (ie: therapy programs, meds, etc). Outpatient is a therapy program that is still rigorous, but people go home after the day is done (the step that usually follows inpatient.


CW/TW: This mentions mental illness, including mentions of suicide and hospitalizations. There are also photo below of blood (in a vial)m medical supplies, and a bedroom at an inpatient hospital.



What is Inpatient (or the Purpose)?

Inpatient (as said above) is used as a place immediately following a crisis that works to achieve some level of stabilization so the person can continue treatment outside inpatient. Most people end up in inpatient following a suicide attempt. This includes people who were in a medical hospital due to their attempt and people who told or was otherwise found to have attempted. People can also come if they/guardians believe they are harm to themselves or others.


Length of Stay

Inpatient stays are pretty sure, with an average of 5 days, with the longer stays being 7-10 days and the shortest being 3 days. This varies person to person depending on things such as future treatment plans, if the person is in danger of harming themselves or others, and if they went to groups, took meds, etc. (basically took steps to treatment). The general exceptions for staying longer than 10 days are custody issues (ie: person is in foster care) or shelter issues (ie: person is homeless).


Staff

There are various staff members who you’ll interact with directly including…

Techs

These are the people you interact with the most. They are the ones who wake you up, take you to group, take you outside, take you to meals, watch you during free time, and send you to bed. Your most direct requests or concerns go to them. In the morning, they take vitals (blood pressure, heart rate, and temperature) and make sure you get out of bed and go to the “Day room” (the place where you spend most of your time when not in group). They may do a little check-in. For example, my last stay they had sheets to share your current mood, stressors/biggest concern, and goal you had for a day. At the end of the day, the techs would go through them to hear how the day went and if they met the goal and if not why.


[Image Description: There is a close up on a stethoscope in the upper left corner, with a vial labeled "blood" below the bell part of the stethoscope (the part put on your chest/back). There is the back half of a white syringe visible, with the plunger end resting on the blood vial. There are some red numbers visible on the clear part of the syringe (where medication would go) as measurements in ml. These objects are resting on forms, the bottom most being white with no clear labeling. On top of that form is a yellow-orange form labeled "Immunology Request Form". Finally, the top form is pink with the labeling reading "Blood (unreadable/covered word) Request Form".]


Nurses

Generally, you only meet with nurses to get medication. They may also have a quick check-in and ask the routine questions (ie: “Do you have thoughts of harming yourself or others?” “Are you hearing or seeing things others can’t see?”). If there is something that for some reason the tech can’t get, you’d go to them (ie: getting items brought in for you).

Therapists

The therapists who run group are generally only available during that time and do not act as individual therapists. Some places may have group not focus on talk therapy and focus on teaching a skill or addressing a specific topic. There are also (to my understanding) select individual therapists who run one family therapy session. Before you are discharged, you must have a family therapy session regardless of family dynamics before the hospitalization. If parents are divorced/apart, they generally allow separate sessions.

Doctors

Will mostly meet in the beginning and not much after. They are the ones who prescribe medications and check-in to see if it is working and has a more complete history than individual techs, nurses, and therapists.



What do you do during the day?

While the programming differs from hospital, generally there are various therapy groups you are supposed to go to. These could be talk therapy, learning skills to address negative thoughts/behaviors, art therapy, recreational therapy, pet therapy, and music therapy to name a few. Going to group is seen as a requirement and trying to skip group leads to staying longer.


[Image Description: The image shows a white, open room with windows with gray frames with 5 people in chairs. The chairs are gray and look like folding chairs. The seated people from left to right: A woman with brown hair and white skin, with a sweater that is white with black, horizontal stripes. She is wearing blue jean pants with black, ankle-high boots; A woman with long, darker brown hair and light brown skin. She has rounded frame glasses and is wearing a long-sleeve, blue button up shirt, with the top 1-2 buttons undone. She is wearing light blue jeans rolled up and has white sneakers ; A man with dark hair that is shaved on one side and short on the top and has tan skin. He is wearing a plaid, flannel shirt with the sleeves rolled up to his elbow over a gray t-shirt. He has black pants and black dress shoes; A women with long, brown hair and white skin is wearing a white long-sleeve shirt with the sleeves rolled up some over a black t-shirt. She is wearing black pants (appear to be looser leggings or yoga pants) with white sneakers; A man with lighter brown hair with shaved sides and longer hair falling to the right on top with a trimmed beard of the same hair color. He is wearing a dark blue jean jacket over a white t-shirt. He has light wash jeans and is wearing white sneakers. All of the people are looking at the 2nd woman (with the light brown skin and long, dark brown hair) as she is talking. She is looking out into the group, gesturing her right hand outwards.]



When not in group, most people play cards (using a regular playing deck). The other most common activities are reading and drawing. Sometimes you get to go outside, however, that is everyone going outside with the techs. In the evening, there may be a movie or karaoke or some other special activity. Nurses check-in ever so often at night to make sure the patient is safe, where they are supposed to be, or to help if they really can’t for some reason.


Visitation

Protocols can vary from place to place. The first place I went, visitation happened every 2-3 days, with phone calls available on days with no visitation. The second place I went to had visitation every day. Generally, guests had to be 1) family and 2) at least thirteen. If you have divorced/separated parents, the time can be split between them (ie: Mom comes in first, half-way through, dad is brought in for the second half while mom leaves).


Food/Meals

Again, how it is run can differ from place to place. The first place I went to had you choose it from a cafeteria line while the second place you choose your meals from a sheet of options at the start of the day. If someone came in underweight or avoided eating due to an eating disorder, they were also given Insure, which helps put on weight and avoids chewing. In one case, someone got double portions due to being malnourished not from an eating disorder. You are not allowed to go to the bathroom at least 30 minutes after a meal to prevent purging.


Other Rules

This is the other rules/procedures that didn’t seem to fit anywhere else:

Tests at Intake

Part of intake is a blood and urine test. They may look for various things such as drugs in the urine test and thyroid imbalances in blood tests (thyroid issues can contribute to depression).

Items Allowed

There are strict protocols on what you can and can’t have. You’re not allowed laces, drawstrings, belts, etc for safety reasons. Other objects like markers may be kept at the nurses desk that you can ask for and then return. Some books may not be allowed as well as other items that could be possibly unsafe. When parents bring in clothes or other items, they have to be checked by the hospital.


[Image Description: Picture of an Inpatient Room at Georgetown Behavioral Hospital, the walls are white and bare excluding the back wall that has two rectangular windows with cordless blinds on the left and a small,square picture or painting of some flowers on the right side of that wall. On the right wall are two beds. Each bed has a dark brown wood-appearing bottom, with two hollowed out spaces that can be used as storage. They have blue mattress and one white, rectangular pillow on each bed. On the left wall, there is are two dark brown wood-appearing bookshelf. Between the bookshelves are a small table surface with a plastic black chair.]

Rooming

Rooms have two beds, so there is a high likelihood of having a roommate at some point or another. There is a bathroom (with no look and has space from the ground) that you share with a toilet, sink, and shower. The only times you’re allowed in your room is to shower and sleep. Everyone is woken up at the same time and people are not allowed to sleep in or choose to stay in their room EXCEPT for people who were admitted in the early hours (1am-5am). In that case, for just that day, the person may sleep in, but they are not allowed to sleep indefinitely and will have to leave the room.


A very long, in-depth look at Inpatient, but hopefully helpful all the same. Stay safe



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cutiebunnyhophop
cutiebunnyhophop
2021年12月06日

Could you also CW for blood/medical supplies?

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