How I Sought and Received Inpatient Mental Health Treatment

To Read Part 1: I’m not Ok – CLICK HERE.

“1st Night: Nervous – how long will I be here? I miss Michael (my son). I miss Facebook. I don’t miss Facebook. I’m glad I did this. Nervous/excited about tomorrow. Ready to work. (Also, I weigh 15 pounds less than I thought!)” Journal Entry, August 22, 2018, 9:15 P.M.

When you first arrive on 4 East, the Behavioral Health Unit of my local hospital, there’s an initial intake process which includes a physical inspection of the patient’s entire body. This happens regardless of the time you arrive, even in the middle of the night. Two nurses who are the same gender the patient identifies as conduct the inspection.

In my case, after a series of intake questions, taking of my vital signs, and a thorough inventory of my personal items (most of which were not allowed on the Unit and had to be locked away until my discharge), two perky women nurses conducted my inspection. One of them looked and instructed me on how to move, bend, lift, and shift; while the other took notes and drew my scars and bruises on a silhouette of the human body.

This was uncomfortable for me because I have a lot of scars on my body, most of which are never seen by other people. The scars are old, but very obvious. And at the time, I believed they had absolutely nothing to do with why I was on the Unit. So, I got a little irritated for the first couple of days when I had to explain, again and again to a new person each time, the old scars covering my body.

I even wrote in my journal that I was sick of getting asked about my old scars, but then I wrote “But isn’t that the point of being here? To deal with old scars?” I decided right then that addressing those old scars could only help my healing. So I patiently played along and told, in great detail, how I got each scar. Doing so did help.

During almost every encounter I had with patients and staff during my first two days on 4 East, I would exclaim something along the lines of “Hey, I’m just happy to be here”. I felt like I had to make that distinction because not every patient on the Unit was there voluntarily. Besides, I really was happy to be there, even with all the rules and restrictions.

There are a lot of little things that make living on 4 East a unique experience, not the least of which is why we’re all there. But, for example, every trash can liner was a brown paper bag, not just because of the hospital’s efforts to be “green”, but also because someone could suffocate themselves with plastic liners. Ink pens could be weaponized, so we were only allowed golf pencils. We used plastic utensils and ate off Styrofoam plates. Even the trays we used to carry our food, cafeteria style, was Styrofoam. If we needed to shave, we had to use carefully distributed razors, and only under close supervision.

In the showers, the water only came on for 45 second intervals. You had to push a button to get it going again. We had no control over the water temperature or pressure, just whether or not it actually ran. It was annoying to keep pushing that button to get wet. But, you get used to it and besides, the water pressure was better than I have at home.

I was nervous at first, like the new kid at a school where everyone already knew each other. And like any new kid who wants to get along, I spent those first hours watching everyone and everything around me. But I did so unobtrusively, because I was afraid of making eye contact with the other patients, at first. This was my first time getting inpatient help and I was afraid to engage anyone. So I kept my head down, but remained watchful.

It wasn’t long before I figured out who the most boisterous and outgoing patients and staff were. I also peeped the quiet ones because, frankly, they made me the most nervous. But the loud ones had huge personalities, and my writer brain couldn’t help but be intrigued by them. It took considerable effort on my part not to get “sucked in” to their stories and focus on myself. I’m not sure if I succeeded, either.

I also got a sense of how long some of my fellow patients had been there. One woman left after only two days. Another man was discharged after one day, but he went to another inpatient facility for substance abuse. And one patient had been there two months when I arrived, with no end in sight.

I’ve always known that mental illnesses manifest themselves differently in different people. But this was my first time seeing these differences up close. Again, the writer in me was fascinated by the different personalities, quirks and foibles. It took a lot of discipline to keep my focus on my own healing.

I spent the first two days observing and getting acclimated. I learned that my individual meetings weren’t really therapy sessions, at all. Instead, they were brief meetings with two doctors: an attending psychiatrist and another psychiatrist; two medical students; a resident; and another person whose title I don’t remember. These meetings never lasted more than 10 minutes, and took place randomly in the mornings after breakfast.

I did have a couple of longer, more detailed meetings with one of the medical students, whom I came to like and respect more than the attending psychiatrist. The medical student used the information I provided to guide the meetings with the entire team. At first I was concerned that a student had so much influence over my case. However, he was skilled at getting to the heart of the matter and, like I said, I liked him more than the Attending.

The most regular and consistent meetings were the different types of group therapies. Patients were assigned to a particular group after an assessment by one of the recreational therapists. I had three daily group sessions: Group Therapy, Dialectical Behavior Therapy (DBT), and Recreational Therapy.

Group Therapy, or Group, as we called it was my favorite time of day. Group is exactly what you think it is: a small group of patients (no more than eight or nine), led by a therapist, where we each took turns “sharing” our thoughts, feelings, and experiences. I loved Group!

Dialectical Behavior Therapy (DBT) got better for me as the week progressed. In these sessions, we learned skills and techniques to help us achieve “balance” in our lives. That’s the way we defined dialectical, as behaving in a way where our “emotional” mind and “rational” mind were in balance, so that we used our “wise” mind. It’s actually more fun than it sounds, and I ended up gaining some valuable skills and knowledge.

Recreational Therapy was my least favorite, even though it was fun. It was exactly as its name implies: recreational activities to engage our minds and enjoy ourselves.

We were done with our groups by 2:00 in the afternoon. With the exception of meal/snack times and visiting times (which only lasted one hour each day), we were pretty free until 11:00 p.m. Of course, there were specific times for showering, and meds were dispensed at planned intervals throughout the day and night. But until the televisions were turned off at 11, patients had A LOT of downtime.
As happy as I was to be there, the downtime got to me. The earlier entries in my journal said things like “Time moves so slowly here”, and “I’m kind of bored. I’m kind of cool with it”.

As a writer, I was tempted to write about the staff and even my fellow patients, because they were all interesting and entertaining. But I was determined not to deflect from my own problems, so I turned inward and, for the most part, kept my entries centered on myself.

So, I spent several hours a day writing on the blank, unlined, scrap paper that was so judiciously doled out from the nurses’ desk. Per the rules, of which there were many, in order to get sharper pencils, I had to trade in my dull ones. I used lots of paper and went through lots of those annoying, little golf pencils.

I should note here that I was on anti-psychotics and anti-depressants, as well as a myriad of medications to deal with my high blood pressure and my out-of-control diabetes. I had my blood sugar tested no less than four times a day, and my blood pressure taken so many times, I lost count. Both my glucose levels and my blood pressure were too high during the first several days on the floor. But since the psych meds had me feeling so much better, I didn’t mind.

Don’t get me wrong. The psych meds weren’t a panacea for whatever ailed me. But they did stabilize my mood and helped me focus. Most importantly, they helped clear the fog of depression that had been bogging me down for at least four years. For the first time in far too long, I felt whole, stable and clear-headed.