A few months ago I spent three and a half weeks as an inpatient on a psychiatric ward. This is a post about my experiences and opinions. It might be useful to anyone facing a stay as an inpatient, or those who wonder what it’s like… although I must stress, it’s just one personal experience of one ward over a relatively short period of time, and might not be representative.
How did I end up there?
I was having a short course of counselling through a service called Let’s Talk Wellbeing, via the NHS – 6 weekly, hour-long sessions. The first session was spent getting to know one another to work out if it was going to be a good therapy for me to engage with. In the week following I spent almost no time alone, was feeling very depressed and increasingly suicidal. I spent a few days with friends (as I had been frequently at that time), and the next few days were spent between despair and planning my suicide. I decided between speaking to my friend/mentor, M, and speaking to my wife about my thoughts and intentions, that I would ‘come clean’ to my counsellor at my next session. I was worried that there would be no help available for me, and I didn’t want to just be watched, unable to action my plan, but still in such immense emotional despair. I decided if this looked like it was happening, I could probably convince people I was ‘better’ to escape and die, and so I had nothing to lose by finding out what help might be available. I found it difficult to tell her exactly how I was feeling, and ended up thrusting the questionnaire they ask you to fill in before each session at her; a few of the questions are designed to evaluate your ‘risk’ and so from that she knew I was actively considering my suicide, had a plan, had set a date (the next day I was due to be alone). She was worried, no doubt, and was quick to inform me that the service was not set up to manage someone as risky as I was. She called my wife into the session with my consent, and told us she wanted to refer us to the Crisis Team. We left under the agreement that my wife would stay with me to keep me safe until we heard more. Within half an hour, someone from the Crisis Team called me to arrange coming to visit me at home the next day. When they arrived (two Psychiatric Nurses), I was so down and hopeless that I was barely nervous. We talked for a while, they asked a lot of questions, including asking me to tell them my suicidal plan (which I wont go into here, for obvious reasons). They wanted me to see a psychiatrist, but there was nobody available for more than 72 hours. We all agreed I could not guarantee my own safety for that long, so the remaining option was going into hospital. They left to make the calls, find me a bed.
I arrived at the hospital in the evening accompanied by my wife. I’d bought with me a change of clothes, pyjamas, basic toiletries needed for an overnight stay. My bag was taken by the staff to be checked over, and we were shown around the ward – communal areas, nurses office, dining room, visiting rooms, and my room. All the bedrooms were single occupancy with en suite (although you could only press the shower button three times – you learn to shampoo fast!). I was the 18th patient, which made a full ward, including two beds borrowed from the adjoining male ward (separated by permanently locked doors). I was able to keep all of my belongings, except for an alcohol-based handwash, my cigarettes & lighter, and my phone charger (although I had my phone). My wife left after about an hour, as the duty doctor arrived to see me. It was late into the evening, so this doctor was not one based on this ward, or one I’d see again. She asked a lot of the same questions as the Crisis Team, took blood, gave me a physical check over. After that I was told I would be checked on by a member of staff every ten minutes, and was not able to leave the ward. Cigarette breaks were on a schedule (about every 60-90 minutes) for those of us unable to leave unescorted, and these were my first real interactions with other patients. The first night, I slept incredibly badly – not least because I had someone checking on me every 10-30 minutes by flicking my overhead light on and looking through the window. The mattress was plastic-covered, and the bedding flame-retardant, which meant I sweated and stuck to the bed. I’ll never take my own bed for granted again!
It was, as you might expect, a mixed group. I had been warned that psychiatric wards can be frightening places, although the staff felt the ward was quite relaxed in general at the time of my arrival. I was never afraid – the staff were vigilant, observant, quick to respond to any incident or agitation appropriately. There were a handful of other patients who were sociable and I felt able to hang out in communal areas within a few days, or chat with during a smoke break. I am naturally very shy and reserved, so I spent a good deal of time with a book in my hand and headphones around my neck ready to escape socially at a moment’s notice (hanging out alone in my room was not, it was discovered very quickly, helping my agitation or suicidal urges). Quite quickly I learned who was able and willing to converse. Some of the women were delusional or psychotic (I never asked or cared about others’ diagnoses – this is just a best guess) and so would talk happily to you about things you couldn’t always follow. Some people had their own routines – Isla was delicate of a morning, and needed mostly to be left alone until later in the day. I learned to recognise the patient who had a habit of spilling/throwing the contents of cups around, and avoid accordingly. Some patients had preferred seats – all these things became part of negotiating living alongside each other. Between the smokers we organised the lending/giving of cigarettes to patients who had run out, or had no money. I also found out who made a decent cuppa, and who I could seek out on the rare occasion that I needed a hug/not to be alone. I’m still in touch with a few people I met on the ward. These people have a unique understanding of me, and whilst going through their own mental health difficulties, were support to me in a way which undoubtedly made my stay a better one.
The Staff & My Treatment
Another mixed bag, sadly. I was told by the doctor on my first night I’d see a ward doctor the next day. I didn’t see them for 5 days, and even then it wasn’t my consultant, who I was told I’d only see once a week, during my review. In that first review, a timescale of 3-4 weeks was suggested for my stay as an inpatient, including the week I’d already been there. This felt entirely random; I didn’t know what I wanted, or expected, but setting some arbitrary date did not sit well with me. I had begun to feel safe on the ward – safe from myself, from my own spiralling, racing thoughts and compulsions to end my life. My consultant and I felt differently on a lot of things, and ultimately I don’t rate my experiences in those review meetings. In my first one, I went in alone and there were six other people in there – my consultant, a junior doctor, my case worker (one of the ward nurses – and this was the first time I’d met her as she’d been on holiday), and three student doctors. Daunting wasn’t even the word. My social anxiety kicked in, I answered every question as concisely as possible, sat statuesquely still, and wanted the whole thing to be over with. To my next review, I asked my wife to attend with me, which she did my third also. Despite raising my concerns to the nursing staff about the number of people staring at me in that room (it felt like a panel!), it took for my wife to ask the people who weren’t necessary to leave. I did get a really good change of meds during my stay, from one anti-depressant to another, and they were able to increase my dose quite quickly as they could monitor me. The doctor also prescribed an anti-psychotic, designed to relieve anxiety, or “take the edge off” – in their words. They made me feel horrific – drowsy, slow, foggy. I’ve since stopped taking them and feel physically much better and mentally not much different at all. There was no accessing any kind of therapy during my stay, which is what I felt I really needed, and was told I wouldn’t be there long enough to see the psychologist on staff either.
The nurses and HCA’s were largely bloody great. My only real bugbear was the lack of time they had available talking to patients – but I imagine that’s a staffing issue. The other problem this brings up is how their limited resources are spent. I was once accused of not really talking to the staff, or opening up to anyone. The truth of it was, it didn’t occur to me to. If you scream and shout, wail, throw things, that got the attention of staff pretty quickly (rightly so). But I didn’t do that when I was hurting… and I didn’t talk to people because I didn’t know how, or what to say. I’m amazed that even in that place, that was mistaken for not engaging, or coping.
There were often student nurses around in the week, and they were pretty keen to talk to you about anything and everything – from advice on how to handle my review & help contacting other services for patients, to feminism & punk.
So, Did It Help?
Someone asked me this recently, and I was stumped. I went in 90% sure I was going to commit suicide, and came out (albeit scared and still distressed at times) thinking maybe I’d find a way through that didn’t involve my death. So, that’s something. I got better meds, too. I felt hugely lucky to be able to keep my phone to hand, as I was reliant on M from across the pond for our own brand of therapy, and I certainly wasn’t accessing any therapy during my stay. So, as I often do when stumped, I asked M – was my hospital stay helpful? Her answer was that in the big picture, overall yes, although severely lacking.. and (as always) I think she summed it up perfectly.
Edit: If you have any questions about this, feel free to leave a comment, and I’ll answer if I’m able.