How to Support a Friend or Loved One Staying in a Psychiatric Hospital

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A white man reclining in a hospital bed. Credit to flickr.com user JD Harvill. Used with permission under a Creative Commons license.

Sometimes, people just need a little help. There may come a time in your life where a friend or loved one is committed to a mental hospital. When I suffered a postpartum breakdown after the birth of my first child, I committed myself. I was fortunate enough to have the support of a loving, devoted husband, who cared for our newborn and for me while I was struggling with a psychotic manic episode. If you have a friend or loved one spending time in a psychiatric ward, here are some tips on how to best support him or her. If you have a loved one staying in the mental hospital and have other people ready to support him or her but don’t know how, then feel free to print this article out and hand it to them.

The “DON’Ts” of Visiting a Friend or Loved One in a Mental Hospital

  1. Don’t show up unannounced. Make sure you call ahead of time before visiting your friend or loved one in a mental hospitlal. I am sure he or she would love visitors, but being hospitalized is exhausting, and sometimes your friend might not be up for a long visit, or even one at all that day. Also be sure to check when visiting hours actually are.
  2. Don’t be afraid. Mental hospitals may seem like scary places, and it might feel natural to be afraid while you’re there. Patients talk to themselves, are in pain, and are sometimes unpredictable. But your fear contributes to stigma. These patients are normal people who are struggling with mental and/or physical illnesses. The nurses can manage the patients, who are unlikely to be violent. Conquer your fear and don’t worry about visiting your loved one.
  3. Don’t act like you’re going to catch mental illnesses. When I was committed, a fellow patient introduced me to her family. They were very reluctant to shake hands with me, and leaned back from me, presumably so I wouldn’t breathe on them. Their behavior, where they acted as if I were contagious, was insulting and demeaning. You cannot catch crazy. Do not even act as if people in pain are contagious.
  4. Don’t pity the patients. Sympathy is good, empathy is even better, but pity is terrible for anyone suffering from a mental illness. Pity contributes to feelings of low self-worth and depression, and just feels bad. Try to empathize with your friend or loved one stuck in the hospital, but don’t pity or blame him or her for being there.
  5. Don’t abandon your friend as soon as the hospital stay is over. After the hospital stay has concluded, check in with your friend and see if there’s anything he or she needs, be it a cup of coffee or help cleaning the house. Just like a physical illness, mental illnesses take a long time to recover from, especially when a hospital stay is required. Your friend will need you more than ever when they leave the hospital. Continue being a good friend and supporting him or her.

The “DOs” of Visiting a Friend or Loved One in the Mental Hospital

  1. Do visit. One of the best ways to support a friend or loved one who is staying in a psych ward is to show up and be there for them. If you can leave your judgments at the door and offer a compassionate listening ear, you can help buoy him or her and even aid in his or her recovery. Visit as often as you can and the hospital allows.
  2. Do bring something to do or talk about. One of the surprising aspects of the hospital is how boring a stay can be. Patients have very little to do other than color and read old copies of Reader’s Digest, or whatever the hospital has on hand from prior donations. A person staying in the mental ward may face crushing boredom; do your best to alleviate that.
  3. Do write and call. If you can’t visit, dropping your loved one a note or calling him or her up will be very much appreciated. Knowing that people on the outside haven’t forgotten him or her is extremely helpful to a person staying in the psychiatric hospital.
  4. Do offer your loved ones the same respect you give them when they are well. The best way my husband was able to support me was to treat me as if I were the same person he’d always known, and play with me as if I weren’t in a hospital setting. Treat your loved ones with respect; even when psychotic, I was able to tell when other people were mistreating me.
  5. Do acknowledge your loved one’s pain. Validation is one of the most powerful tools you have at your disposal to relate to your loved one. Rather than responding with something like, “You’ll get over it,” or even “Hang in there,” to their depression, acknowledge that he or she is hurting. Even saying, “That sounds really difficult,” will put your loved one at ease.
  6. Do advocate for your friend or loved one. Ask the person you’re visiting whether they think their treatment team is treating them properly, and keep your eyes open for any problems. The likelihood of your loved one being abused is low, but he or she still might not be able or willing to speak up for himself or herself, even for something as simple as asking for an extra blanket or a clean set of sheets. Keep in mind that your loved one may not be the most reliable narrator; anger at the nurses is common in a mental ward, especially at the beginning of one’s stay, so your loved one might take the chance to rail against their “tormentors.” But don’t hesitate to bring up your loved one’s concerns with the nurses. If the mistreatment is real, you will need to advocate for your loved one and ensure he or she gets proper care.
  7. Do establish boundaries. If you are overwhelmed by your loved one’s negativity, change the subject. Try not to cut the visit short unless he or she becomes too agitated to speak or becomes violent, as some patients might think you’re abandoning them. But healthy boundaries are important when visiting a friend in the mental ward. Take care of yourself and make sure to do something relaxing for yourself as soon as the visit concludes.

Final Thoughts

There are several dos and don’ts when supporting a friend or loved one staying in a mental hospital. Having gone through the experience of committing myself, I can strongly suggest that you visit as often as you can and the patient allows, as that will aid in his or her recovery. The feeling of being forgotten while staying in a psych ward is very real, and is crippling. Try to be in tune with your friend’s needs, and don’t abandon them after the hospital stay is over.

I wish you well.

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Book Review: Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry

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The front cover of Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry (affiliate link*), by Lynn Nanos, featuring a police car shining its headlights on a sleeping homeless person wearing a green hoodie. Credit: Lynn Nanos.

*Disclosure: Some of the links below are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase. Thanks for supporting the work at The Bipolar Parent!

America’s mental health system is broken. It has failed millions of people suffering from mental illness and will continue to do so unless sweeping changes are made. That’s the premise of Lynn Nanos’ Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry (affiliate link*).

I was offered a copy by the author in exchange for an honest review, which after reading the book, I am thrilled to provide. Nanos is a clinician in the field of emergency psychiatry in Massachusetts with over twenty years of experience in the field. She is uniquely qualified to write this book, having spent much of her life caring for the sickest of the sick.

According to Nanos, there are three core problems in the broken psychiatric system: a lack of inpatient beds due to deinstitutionalization; malingerers, who falsify claims of mental illness to request inpatient treatment; and that patients are “dying with their rights on.” The latter means that a prioritization of patients’ rights causes people suffering from psychosis who refuse treatment due to a lack of insight into their mental illness to be discharged from hospitals too early. These patients are often homeless and vulnerable to being attacked on the streets. Nanos’ solution to these problems is to promote a program called Assisted Outpatient Treatment (AOT), a court-ordered program which forces patients suffering from psychosis to comply with treatment when living in the community.

Nanos describes a condition called ansognosia, where patients have a lack of insight into their mental illness. This book has special significance for me because I have bipolar and have endured psychosis, like the patients in the many case studies Nanos covers in Breakdown. When I suffered a psychotic break, I had no insight into my mental illness, like many of the patients suffering psychosis that Nanos describes. I was fortunate in that, as I complied with treatment, I gained such insight and was able to take steps towards recovery before I left the hospital. Like Nanos points out, this is not the case with the majority of others.

What Doesn’t Work Well in Breakdown

Because I don’t want to end on a negative note, I’ll start with one item that didn’t work well for me in Breakdown.

  • Disclaimers: The opening chapter is full of disclaimers about what the book does and does not cover. These disclaimers are vital to understanding how the rest of the book works, but they make for dry reading, especially for a first chapter. However, I don’t know how else Nanos would have structured this. These disclaimers are necessary, and they need to be placed upfront.

That’s it. That’s all I didn’t like. If a reader can get past the tedious first chapter, the meat of Breakdown is brilliant.

What Does Work Well in Breakdown

As promised, here’s what does work well in Breakdown:

  • Fulfilled Promise: In the opening chapter, Nanos promises a solution to the issues she raises later on, and she delivers on this promise. The writing is accurate and engaging, with case studies of patients offering an emotional look into people who suffer psychosis and their mental illnesses. The book is a blend of clinical information and painfully personal writing, which is another part of what Nanos promises and delivers.
    Research-Backed Opinions: Nanos’ commitment to scientific research is admirable. She cites approximately 300 studies, and the last chapters of Breakdown are especially filled with mental health statistics, which back up her claims.
    Professional Formatting: Despite being self-published, Breakdown is professionally formatted. The cover, featuring a presumably homeless man being confronted by police while lying on a sidewalk, is well-drawn and fabulous. Not that I’m saying to judge a book by its cover, but Breakdown is visually pleasing inside and out.
    Case Studies: The most arresting parts of Breakdown are the case studies. Nanos demonstrates why psychotic patients need treatment through the examination of her encounters with them in a clinical setting. Some examples are: a woman who traveled from Maine to Massachusetts because a spirit called “Crystal” ordered her to, a man who smeared dead insects on his neighbors’ doors to help purify toxins in their apartments, and Lily, a woman who delivered dead dogs to strangers, among other stories. Most of these people refused adequate treatment due to ansognosia. A great number of them bolted before Nanos was able to arrange for transportation to hospitals. Some of them were violent, and a few went on to assault their loved ones, with two specific cases ending in death. The case studies are the most effective parts of Breakdown, and demonstrate why the AOT program is so important.

Final Thoughts

Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry (affiliate link*) is a fascinating book. It’s professionally written and formatted, research based, and effectively delivers its message. The case studies were especially enlightening, and are the heart of Breakdown.

Mental health issues affect all of us, whether we suffer from mental illness, have loved ones who do, or are impacted by the mentally ill people all around us. Read this book and see how you, too, can join the mental health discussion.

*Disclosure: Some of the links above are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase.

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How to Get a Psychiatric Evaluation

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Credit to flickr.com user Lisa Brewster. Used with permission under a Creative Commons license.

Mental illnesses are common–roughly 1 in 5 American adults have one–but people with depression or bipolar disorder can sometimes take up to ten years before they seek out care for themselves. Are you ready to take the first steps towards getting a potential diagnosis? Read on to find out where to seek help.

 

Where to Find Help

  • Ask your primary care physician for a referral to a mental health professional. Other people who can refer you are crisis centers, or a local Mental Health America office. Ask for more than one doctor, so you can comparison shop.
  • To get an evaluation, try the psychiatry department of a university. Psychiatrists at a college will be up-to-date on cutting-edge research, and be more willing to stick with proven drugs such as lithium because they’re well-researched.
  • Contact your health insurance plan to find providers covered under your plan.
  • If you are a veteran, try the U.S. Department of Veterans Affairs, located online at www.va.gov/health. You can also call 1-877-222-8387. Veterans who already have benefits through the department can visit www.va.gov/directory to find a mental health professional covered under the VA’s plan.
  • The Substance Abuse and Mental Health Services Administration is also a great place to check for mental health professionals. The department is located online at http://www.samhsa.gov/treatment. You can also call 1-800-662-HELP (4357).
  • If you work for a large company, you may have an employee assistance program (EAP) available. Contact Human Resources to find a provider under the EAP.
  • What about Medicare and Medicaid? Check Medicare at www.medicare.gov. Mental health professionals who accept Medicaid might be listed by your state’s Medicaid office. Click on the name of your state at http://www.benefits.gov/benefits/browse-by-category/category/MED.

What to Expect

You will first talk to your referred mental health professional on the phone. Ask them about how they like to approach therapy and medication. Make an appointment if you feel comfortable with them during the phone interview.

At the appointment, your psychiatrist or psychologist should refer you to a lab to check your thyroid levels and rule out other physical causes of mental illness symptoms. Your doctor will ask you why you called him or her, what you think the problem is, and about your job and living situation. You may be given a few questionnaires to evaluate your mental health and any adverse symptoms. This testing can take hours.

Sometimes, a mental health professional may want to interview your family and friends. Your doctor cannot interview them without your consent. Consider asking your loved ones if they’d be willing to submit to an interview.

After that, be patient! Getting a diagnosis–and an accurate one, no less–takes time, but it’s an important part of developing a treatment plan, including therapy and/or medications.

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