This is a guest post by Ozy Frantz about recent personal experience in a mental hospital for severe depression after a suicide attempt. If you have trouble reading about those topics, the cut it’s behind is for you.
Mental hospitals are not scary.
I should know, I was in one. A few months ago, I became deeply depressed and decided to swallow a handful of Tylenol. (Side note: DO NOT try to kill yourself with Tylenol. Well, don’t try to kill yourself with anything, but definitely not with Tylenol. It is a long, slow, painful, awful death that will give you plenty of time to regret every wrong thing you’ve done in your life, starting with deciding to swallow a handful of Tylenol.) A few hours later, I realized that while suicide had many good points viz a viz not feeling pain anymore, it had the slight side effect of being dead.
At the hospital, it turned out I was never in any danger of dying, despite taking a fucking ridiculous number of pills, because my liver deserves some kind of medal for service above and beyond the call of duty. So after a few hours they put me in the mental hospital for seventy-two hours of involuntary confinement.
Throughout this article, I’m mostly going to be talking about my own experience, which is necessarily limited and privileged. My mental hospital was attached to a hospital and used for emergencies and short-term crises, so I don’t know much about longer-term hospitals. I have class privilege, so I could afford to go to a very good mental hospital. The worst thing that happened to me was constant misgendering and being too depressed to educate people about being nonbinary; many people have experiences far worse than mine. I encourage people to share their mental-hospital in the comments, especially if theirs was different than mine.
Hospitalization is never particularly fun. It’s boring, the clothes are terrifically unfashionable, and the food makes school cafeteria food look delicious. If you’re a member of a marginalized group, it sucks worse, because they won’t let your lover visit or you have to worry about how you’re going to afford all this. Most of all, your leg is broken or your appendix has burst, so you’re in pain and miserable because of it. Here’s the secret: mental hospitals are exactly the same.
Before I went in the mental hospital, my idea of the mental hospital was based pretty much on One Flew Over the Cuckoo’s Nest and similar depictions. They’re going to dope me up with medicine without my consent! I’ll end up in a straightjacket in a padded room! I’ll be surrounded by people who think they are Napoleon! Nurse Ratched will torture me! They’ll try to keep you there against your will!
Nope. Of course, sometimes abuse can happen, just like abuse can happen in any kind of hospital, particularly to people who are too weak to fight back. Even though you have the constitutional right to refuse medication, sometimes you’ll be pressured into taking medication you don’t want to take. But all of these are hospital-problems, not mental-hospital problems; if you wouldn’t be scared of going for treatment for cancer because of the risk of abuse, you shouldn’t be scared of going for treatment for depression for the same reason. The only thing I can think of that’s unique is restraints (not straightjackets or padded rooms, both of which are not in use): if the doctors are competent, they’ll only use them if you present a direct threat to yourself or others.
When you check in to the mental hospital, a nurse will take a basic medical history, mostly focusing on medical conditions you currently have that they might have to treat, and a rather more in depth mental health history—what medications you’ve taken, what diagnoses you’ve gotten, what therapists you’ve gone to and when. They’ll ask you about dietary restrictions for no readily apparent reason, given that the cafeteria does not seem to hear about them; you also might get the option of talking with a chaplain, which as an atheist I did not take. My nurse, commendably, asked whether I wanted my parents to be able to contact me, which is a pretty decent level of sensitivity to abuse survivors. You’ll be assigned a room, which you’ll probably share with at least one other person.
Probably during your check-in, you’ll be told who your mental health help is. I was assigned a psychiatrist and a social worker, which I think is pretty ordinary. You’ll meet with them regularly; I met with mine every day. These meetings are not scheduled and will inevitably happen when you’re in the good part of the book you’re reading. You may have to give them another mental health history. Their primary concern is stabilizing you, which usually means some combination of medication, finding you a therapist for after the hospital, and waiting for you to get saner.
Most people in mental hospitals are either suicidal or undergoing a psychotic break. Some people are regulars who check themselves in when they feel very depressed. A few are there for other reasons—when I was there one woman was undergoing electroshock therapy and another was anorexic. They often have an acute ward for people who are very ill; I never wound up in that one, so I can only speak about the regular ward. They also have an adolescent ward, often: the adolescent ward tends to have more rules (including absolutely arbitrary ones like “no doughnuts”) and, I am told, is more miserable.
In general, on the regular ward, people are sad, gentle, and very kind. At least one person will sleep all day, either from depression or as a side effect of medication. Everyone will talk about what they want to do when they get out: see their children, play with their dogs, eat Mexican food, write a book. Most people will be quiet and too consumed in their own problems to pay much attention to you, but if you engage them in conversation many of the people are interesting. I met one person who was a geek, but due to depression hadn’t been able to keep up with anything geeky post-2000; it was fascinating to talk to someone who didn’t know New Who or Firefly.
Mostly, the mental hospital is boring. There’s a routine, which is comforting to a lot of people with mental illnesses: everything is utterly predictable, to the point that there is often a written schedule. They’ll wake you up fairly early. You’ll get meds, if you’re taking them, and have your blood pressure and other vitals taken. There are three meals, plus snacktimes, a day. Crafts are fairly common: I still have a vague suspicion that the sole purpose of art therapy is to entertain bored mental patients. You’ll have about an hour, usually in the evening, for visitors. Mine didn’t allow more than two visitors at once. You can also receive phone calls from people you’ve given permission to call you; although my hospital allegedly limited phone calls to ten minutes, it was roundly and gleefully ignored. Most of the day you’ll have nothing to do but play cards, talk to the other patients, sleep, read, or watch television.
My hospital had group therapy several times a day, which I think is more than most. One social worker moderated the group therapy sessions; he didn’t quite understand the concept of “atheist” and insisted I had to believe in some manner of Great Universe Spirit Thing in order to become undepressed, which was irritating. The social worker tried to make sure that everyone spoke once, but if you refused to speak they didn’t push it. People could and did skip group therapy sessions regularly and no one seemed to object much. They’ll often pick a topic of discussion, which may or may not be relevant to your life: for instance, I had incredibly supportive partners, so all the discussions about what to do when dating or married to an ableist asshole didn’t help. To me, despite my social phobia, it was oddly easy to be honest during the discussions, because the environment was very nonjudgmental and everyone was going through the same shit I was. I didn’t realize how lonely I was, feeling like I was the only crazy person in the world, until I met other people like me.
The book selection is shit, mostly composed of romance novels and book three of a fantasy series. The coffee is decaf. You will probably not be allowed to smoke, although they have nicotine patches. My hospital had a ton of Alcoholics Anonymous and Narcotics Anonymous pamphlets. At least at my hospital, you couldn’t go outside; there was an enclosed patio with some dying plants on it, and if I tilted my head enough I could see the sun.
The best tip I have, if you have a friend who is going to end up in the mental hospital, is to pack some things for them to take with them. Include a few changes of clothes, books, maybe a deck of cards, and something like a stuffed animal or a picture that will remind them of home; the hospital usually provides toiletries, but they’re awful, so you might want to include some of those too. Don’t include medicine, razors, anything with a drawstring, or anything a sufficiently creative person could use to kill themselves; the hospital won’t let them have it anyway. Ideally, get the bag to them before they check in, so they don’t have to wear crappy hospital clothes their first day. This advice also goes for the people who are going to the mental hospital themselves, but generally when one is going to the mental hospital one is not in a state to pack things.
Also, call and visit your friends as much as you can. Every day, if you can swing it. The mental hospital can be lonely and you get disconnected from the outside world, especially since lot of depressed people are already prone to believing that no one cares about them. Be supportive and don’t judge; if your friend’s in the mental hospital, they’re probably in a vulnerable state. It’s generally not a good idea to talk about how scared you are or complain about how you wanted to travel the world and this silly ‘depression’ thing is getting in the way.
My best advice for people who may end up in the mental hospital is that, if you’re planning a suicide or otherwise in desperate need of help and you can afford it, go. You might be unhappy in the mental hospital, because you are in emotional pain and that tends to make people unhappy. But the mental hospital can stabilize you and set you up with a treatment plan for once you leave; it’s a zero-stress environment where all you have to do is get better. I was terrified when I went in and by the end burst into tears at the idea of leaving.
Ozy Frantz is a student at a well-respected Hippie College in the United States. Zie bases most of zir life decisions on Good Omens by Terry Pratchett and Neil Gaiman; identifies more closely with Pinkie Pie than is probably necessary; and blogs at No, Seriously, What About Teh Menz?“