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Locked room in a psychiatric unit

It all happened so fast. One minute I was having a normal day at work, and the next I was in an ambulance on my way to the hospital. What had started out as a normal panic attack, very quickly turned into a full mental breakdown that was extreme enough to get me screaming in fear and hyperventilating in a fetal position on the floor. I didn’t know it at the time, but my entire life was about to be flipped upside down.

I barely remember riding in the ambulance, or even the full admission process, but I do remember my first step onto that ward. When I first arrived, the building seemed really nice. It was a building on its own, kept separate from the regular hospital campus, with a beautiful lobby and friendly staff. I remember thinking to myself how amazing it was that they had such a nice facility just for psychiatric patients! After waiting for a couple hours, I was eventually called into a small room to speak with a social worker and admittance counselor. They ask you why you are there, what your problems are, and basically determine which patients truly need their help and which ones don’t. You would be amazed at how many people think they need inpatient psychiatric help when in all reality they just need a good nights sleep and a decent therapist recommendation. This facility was especially exclusive, considering it only had one 20 bed unit for psychiatric patients and another 8 bed unit for patients struggling with addiction.

About 5 hours have gone by at this point, and I am just now entering the 20 bed unit to start the second part of the admission process. Before my stays in the psychiatric hospitals, I had absolutely NO idea how many items could be used for either self-harm or harm to others. For example, did you know that the little plastic stick inside the wax of chapstick can be used to stab someone in the eye socket? Or did you know that in shampoos/conditioners, as well as some deodorants, there is a certain type of alcohol in the ingredients that can technically get you drunk? Yeah me either, until I was getting my chapstick confiscated and started hearing stories about patients eating blocks of gel deodorant then projectile vomiting blue goo for days. I didn’t know whether to be more impressed by the innovative ideas, or disturbed that people thought in these ways.

After they confiscate your items and do a full strip search (no cavity search luckily) you finally get to go to your room. Every psychiatric hospital is completely different, especially when it comes to the layout of the ward and the patient rooms. Depending on each patient’s individual issue(s), they try to place you accordingly. For example, for patients with addiction and violence issues, they might have you sleep in a room by yourself. They don’t usually want patients like that socializing (at least where they can’t be supervised) for both the safety of that patient and the other patients. However, if you are viewed more stable, then you are generally assigned a roommate. This is not only due to the extremely limited space and resources, but also the fact that socialization is a vital skill most psychiatric patients struggle with.

After exploring my tiny little room, with the “beds” being cheap pieces of 2" foam on a platform and covered with a sheet, and my shared “bathroom” being a shower curtain, a little shower that never had warm water, a toilet without a seat, and a sink without handles that barely worked. Not to mention it was directly up against the wall to the dayroom so everybody heard you doing your business. I wasn’t even able to get full size pillows because apparently the pillowcases for full size pillows are long enough to hang yourself with. The towels were smaller in size as well for the same reason. So here I am, in this tiny little room, in this tiny little unit, in this tiny little psychiatric hospital, just trying to come to terms with my new surroundings. Once you are placed in the locked unit and settled, you may as well be a ghost as far as the staff is concerned. They could care less about you or your well-being and generally look at their psychiatric patients as no better than animals. Now, since this was my first experience in a psych ward, I didn’t really think about how seriously they would take security. I looked at it as we are just people with mental disorders, not criminals, so I never would have guessed the extreme measures they will take to keep you in the ward. As I was trying to figure out my new surroundings, I got more and more freaked out, and nobody was doing anything to comfort me. So, I figured that I would sit by the locked entrance door to the ward, and beg the next person who came through it to let me out. I just sat in a ball on the floor, pulled my knees up to my chest, and started bawling because I was so scared and had no idea what I had agreed to when I was admitted. After an hour or so, I guess the staff picked up on the fact that I was missing, and I hear footsteps just running down this hallway. The next thing I know, I’m having this male nurse getting in my face, screaming at me, telling me if I ever tried that sh*t again he would call security, sedate me, put a straitjacket on me, and have me strapped to a gurney so I could never try to “escape” again. This obviously only traumatized me more, and if it weren’t for another patient stepping in, those threats would have quickly turned into reality.

Whenever I talk about the pscyh ward, one of the first questions I always get is what it’s like staying in this environment. Now, I have had both stays with a roommate and stays without, but unfortunately this was one of my stays where I had multiple. My first roommate was SUPER chill and I liked her a lot. She was 28 years old and was overcoming an eating disorder which made it really easy to relate to her. Unfortunately, she was discharged on my 2nd day, and my next roommate moved in. This lady could not be more different from my old roommate. She was probably in her 60s, had hair sticking in so many directions she looked like she just got zapped by electricity, and was mildly schizophrenic. I’ll never forget the first night they moved her in. I was already asleep (patients get admitted all hours day and night) when they flipped on the lights and quickly introduced us. They got her settled and in bed, and just as I was falling back asleep, I start hearing sounds like someone is having an exorcism performed on them. I shake myself awake and look over at my new roomie who is in almost a hypnotic trance just yelling how she was going to hell (in between her non-stop wailing, moaning, and animalistic growls). I was hoping she would run out of energy or snap out of it but she just wasn’t stopping. At this point she had woken she entire unit. I managed to endure this for maybe an hour (since I knew it truly wasn’t her fault) before I turned to her and tried to help her myself since the staff had turned up their noses. It was bedtime so they could just put in their headphones and didn’t have to hear it or deal with it. I talked with her for hours and finally got her to calm down enough for both of us to go to sleep. Come to find out, after just one conversation with this woman, that she was an extremely sweet lady who really didn’t have much in life but her relationship with God. Her children only viewed her as a burden and had abandoned her long ago, apparently she was a recent widow, and truly just did not have anyone to help her in life. The next day, it was like a brand new woman woke up next to me! All she needed was someone to listen, validate her experiences without making her feel like a freak of nature, and overall just someone to remind her that she matters and is cared about. She was totally with it, she was confident, she had combed her hair, she was opening up in group, and she was even making friends!

Life in the psych ward isn’t exactly what you might expect. You don’t get to just wander aimlessly around and do nothing all day. There is a very strict schedule, among other things, that you must adhere to if you ever want to go home. Every single day, you wake up at 8 am (if you want to eat breakfast that day), wait in line to get your vitals taken, wait in a VERY long line at the medication counter, fill out a survey that asks everything from if you see/hear things to when your last bowel movement was, and then turn it in to the staff so you can get finally get your breakfast. At 9 am, group therapy starts and you are shuffled along with all the other patients into a tiny 12 x 12 room that has literally nothing but chairs. These chairs are set up side-by-side around the outside of the room facing inwards, and are so close together that you are pretty much right on top of the people next to you. A clinician (or therapist) sits in a chair alongside the patients, and starts to lead the group, where a subject is brought up and one-by-one each patient has to then reflect and share with the group. If you choose not to share, regardless of reason, it is notated and you stay in the hospital even longer. Each group session lasts either 30 minutes or 1 hour, and the subject of each group is displayed on a giant whiteboard posted in the day room. Sometimes the groups are fun (you may get to do a craft or get a little exercise) but often it is nothing but sitting in that tiny little room listening to each other share our stories for hours on end. A couple examples of some group subjects are: Anxiety, Grief & Loss, Addiction, Medication Management, Depression, Anger Management, Relationships, Art Therapy, CBT (Cognitive Behavioral Therapy), DBT (Dialectical Behavior Therapy), Triggers, Accountability, Self-Esteem, Positivity, etc. Even if the group didn’t apply to you (like addiction or grief/loss), you still had to go and actively participate. At noon, lunch is finally served, and you get a break from being in that tiny group room. After your hour of lunch/personal time is over, you are back in that group room at 1pm on the dot, until you are dismissed at 5pm or 6pm for dinner time. Luckily, at this point in the day, you are usually done with group therapy and are given personal time until 9pm when you get your nighttime meds and more vitals taken. At 10 pm it is lights out and you are forced to go into your room, even if you can’t sleep. The most the staff will do is give you Trazodone or Melatonin and send you on your way. There were many nights I just laid awake with my mind racing until the light broke in the morning.

The dining area is generally the same as the day room, and everyone eats together because having any food in the room is prohibited (there are room searches daily). In between groups and during meals, the staff turns the phones on for you to talk to your loved ones. All calls are monitored and there is usually only 1–2 community phones that everyone must share, which means that you have about 10 minutes tops per day to call everyone you need to. If somebody wants to call you, they have to have your 4 digit code given to you during the admission process, and if they don’t (regardless of who they are) the staff will refuse to even confirm that you are a patient there. This means that if a distraught mother is trying to reach her child, who overdosed and was taken to the hospital, the staff is unable to give her ANY information. Even in jail they can confirm that someone is an inmate at that jail, but because of privacy laws and the general over-protective atmosphere in a psychiatric hospital, the staff is unable to do so. Due to this, the poor mother now has to sit there sick out of her mind just waiting to hear if her child is even alive. Keep in mind, all adult units are only for patients 18+ so when the term “child” is used I do not mean an ACTUAL child, just the familial relationship.

Visitation in the pscyh ward is a lot like visitation in jail. You check in via ID at the front desk, have your personal items confiscated, get a special sticker that has your name on it and MUST be worn at all times, and are escorted to the visitation area. This is where some differences really start standing out. For starter, nobody under the age of 18 is allowed on the unit. It does not matter if it is your newborn baby, or your grown teenager, you are not allowed to have your children come visit. Occasionally, I have seen security or police officers escort patients out into the hallway for a 5 minute visit with their children, but only in extreme cases when it was deemed vital to the patient’s recovery or in complicated legal situations. The second difference is the fact that visitation is pre-scheduled to be at the same time for everybody (either 2 or 3 times a week) and is only an hour long. They also don’t always make the hours convenient for visitors, which makes it really hard for anybody who has a full time job to come visit. The third difference is visitors are allowed to actual come onto the unit, which usually means visitation in the day room since nobody is allowed in the patient rooms. Since space is extremely limited, you generally have to share your table with other people, which means having to talk about extremely private matters in front of complete strangers. It is one thing to talk about personal issues with other patients, but it is entirely different when their friends and family are around.

One of the most important (and in my opinion) completely flawed parts about staying in the psych ward, is the medication regime. If you are one of the more severe patients, you got to see the psychiatrist once a day. If you were one of the patients who had a less severe case of mental illness, or maybe just had a mental breakdown from an acute life event, then you got to see the psychiatrist once every 2 days. There was one thing in common, however, and that was the fact that the psychiatrists only had about 5–10 minutes to spare per patient and chose medication completely randomly. Even if you have taken medication for years, there is a chance that the doctor in the psych ward would change it up. One time when I went into the pscyh ward, they took me off a medication that I had been on for over 10 years, and put me on a random anti-psychotic. Basically, the medication that worked for me, was switched for one that not only didn’t work, but actually made me projectile vomit and get so angry that I punched the reinforced cement walls and ended up breaking all my knuckles. I was quickly switched back to my old medication. Another time when they switched my medication on me, I was freaking out so much that I was actually injected and sedated with Haldol. I was out cold for 12 hours after that.

I could go on and on about what it is like in a psychiatric hospital, but unless you are actually in one, you can never truly understand. It’s more than just a change in environment. It’s a change in lifestyle. It’s a change in how you are treated as a person. It’s a change in your diet. It’s a change in your personal relationships. Most importantly, it’s a change in yourself. If you can ever help it, I recommend not going to a psychiatric hospital. If you are suicidal or are in desperate need for help, then it will always be a place you can get the help you need. Do not let my experiences affect a decision that could save your life. For me, the psych wards didn’t work due to a combination of my complex trauma, severe mental illness, and having borderline personality disorder. For most people, however, they have really good experiences in the psych wards and almost always find the answers and resources they need to get better.

Trauma Survivor & Mental Health Advocate