11 Surprising Facts About Psychiatric Hospitalization
Having worked in seven psychiatric hospitals from 2012 to 2021, I’ve come to understand that the reality of inpatient care often diverges from expectations. If you or a loved one are considering psychiatric hospitalization, here are eleven surprising facts that potential patients may find useful. Understanding these can help you make more informed choices and explore alternatives that might better suit your needs.
A note regarding language: I use the term patient here because it best depicts the experience that one might receive in a hospital setting, other terms will likely be preferred in communities that center lived experience.
1. Increased Risk of Suicide
It’s disheartening to know that multiple studies have found an increased risk of suicide following hospitalization. This heightened risk is observed even in individuals admitted without suicidal thoughts at admission.
2. High Costs
The financial strain of psychiatric hospitalization can be overwhelming. Costs can range from $1,000 to $4,000 per day (Wipond, 2023.) This significant expense can be a heavy burden, adding to the stress of managing a mental health crisis.
3. Limited Access to Phones, Computers, and Visitors
Many facilities restrict access to personal phones and computers to protect confidentiality, which can feel isolating. Visiting hours are limited, sometimes to just one hour per day, which might not align with your visitors’ schedules, potentially leaving you feeling disconnected from your support network.
4. Lack of Individual Therapy
Inpatient care usually focuses more on group activities than individual therapy. This can be disappointing if you were hoping for more personalized support. Individual therapy sessions are rare and subject to staff availability.
5. Bait and Switch
One surprising aspect for many is discovering that, even if admitted voluntarily, a patient can be held involuntarily if a doctor chooses. This information often comes as a shock when a patient decides they are ready to leave, adding to the stress and frustration of the experience.
Stackable lightweight plastic chairs typical in behavioral health hospitals.
6. Shared Rooms and Privacy Issues
Privacy can be a major concern in psychiatric hospitals. You may have to share a room and endure frequent safety checks (i.e.. staff opening or looking inside your door every 15 minutes), along with strip searches and inspections of personal belongings. Surveillance cameras are common everywhere, except for bathrooms, which can make the environment feel less comfortable and more intrusive.
Short flexible pens typical in psychiatric hospitals.
7. Restricted Access to Snacks, Personal Care Items, and Art Supplies
Access to snacks and personal care items can be quite limited. Hospitals often have designated snack times, and if you miss these, you might not have access to additional food. Personal care items like shampoo and toothpaste are often distributed by staff at their discretion, which can be inconvenient. Items like full size pens or pencils will often be replaced with golf pencils or short, bendy pens. Art supplies like colored pencils, scissors, and knitting supplies will likely be limited to times where you are being supervised.
8. Boredom
Many patients find the hospital environment to be monotonous. With limited activities available and often only one TV in a common area, there can be a lack of engaging options. Books and magazines may also be scarce, which can contribute to feelings of boredom and frustration.
Molded plastic rocking chair typical on behavioral health units.
9. Limited Access to the Outdoors
Access to outdoor spaces is not always guaranteed. When available, these areas are often shared among multiple units and restricted to about an hour per day. The quality of these spaces can vary from stark, confined enclosures to more serene, garden-like environments.
10. Sleep Difficulties
Getting restful sleep in a psychiatric hospital can be challenging. Shared rooms and frequent safety checks can disrupt sleep. Even if you have a private room, the overall environment—noisy doors and talking or even shouting at all hours—can impact your ability to rest.
11. Compliance with Treatment Plan Can be Forced
Treatment plans are written by staff without patient input. They include the ability to give additional medications called PRNs—pro re nata—Latin for as needed. In situations deemed an emergency by staff, prescribed medications may be administered against your will, even if you have valid reasons for refusing them. In non-emergency situations, medication can also be administered through court orders if you refuse. This process often involves injections while you are restrained by staff, which can be frightening, risky to your physical safety, and traumatic.
Conclusion
Understanding these aspects of psychiatric hospitalization can help manage expectations and reduce surprises if you ever choose to go to one. While hospitals aim to provide safety and stabilization, the realities of enforcing these aims can make the experience less than therapeutic or even traumatizing. Exploring other options and approaches might offer a more supportive and personalized path to mental health care. If you or a loved one are navigating this journey, know that there are alternative routes and resources available that may align better with your needs and preferences.
Sources
Chung DT, Ryan CJ, Hadzi-Pavlovic D, Singh SP, Stanton C, Large MM. Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2017 Jul 1;74(7):694-702. doi: 10.1001/jamapsychiatry.2017.1044. PMID: 28564699; PMCID: PMC5710249.
Council on Psychiatry and Law. (2020, July). Position Statement on Voluntary and Involuntary Hospitalization of Adults with Mental Illness. Washington D.C.; American Psychiatric Association.
Meroni G, Sentissi O, Kaiser S, Wullschleger A. Treatment without consent in adult psychiatry inpatient units: a retrospective study on predictive factors. Front Psychiatry. 2023 Aug 10;14:1224328. doi: 10.3389/fpsyt.2023.1224328. PMID: 37636826; PMCID: PMC10447976.
Wipond, R. (2023). How Much Is an Involuntary Patient Worth? In Your Consent is Not Required (pp. 84–85). book chapter, Benbella Books Inc.