Thursday, June 29, 2006

The Not So Scary Hospital - By Terry Coyier

Fear of the unknown is a very universal fear. Fear of the unknown hospital is a very universal fear among the mentally ill. Actually, many people have a fear of hospitals even if they are not mentally ill. Even without a harrowing experience, most people don't view the hospital as somewhere they want to visit, unless they're there to visit another patient. Add to that the horror stories of generations gone by and the imagination of Hollywood and it's amazing that the psychiatric hospitals have any voluntary patients at all to treat.

Fortunately, times have changed and so have most hospital environments. Sure, a few archaic practices still exist, as do a few unenlightened doctors, but the overall philosophy of confining patients to a hospital for years, or even a lifetime, has evolved into a philosophy of helping patients become productive members of society. The concept of transforming the mentally ill into productive, functioning members of society is not a new one but actual implementation really only began in the 1960’s. Today, with the limits most insurance companies impose, treatment is often limited to a few weeks of in-patient hospitalization per year. Hospital staff and the psychiatrists must medicate, educate and reintegrate patients back into the community in the quickest manner possible.

Now, the hospital itself is usually not the root of our fear. Who’s afraid of four walls, some worn out furniture, old magazines and games, maybe a television, a community phone and a counter that the staff gathers behind? For me, the fear was being confined to a place and not being allowed to leave when I was ready. The locked doors and windows can easily bring on a panic attack in even the calmest of sane folks, no less the mentally ill. For some, the fear of being away from family and friends makes the hair on the back of their necks stand up. For others it’s the reaction of family, friends or even co-workers that makes them nauseous. Some fear the loss of a job. Some fear the social stigma that still exists in the smallest of minds in cities and towns across the nation. Whatever the fear is, it will not subside until it is confronted head on and beaten into oblivion with the facts.

Each hospital has its own unique procedures and funny rules, but some guidelines seem to be consistent from place to place. Even though I’ve only been hospitalized three times, you hear all the stories about other places from the patients who are comparing notes. The following is a list of things that I have seen firsthand and have heard others mention as well.

* Absolutely no “Sharps” except the few things allowed which remain locked up and can be checked out during an appointed time. “Sharps” are: razor, toothbrush, toothpaste, mouthwash, shampoo, comb, brush, blow dryer, curling iron (if allowed), soap, make up, lotion, glasses, contact solution, etc. Perfume, after-shave, scissors, tweezers, etc. are not allowed. If the substance abuse program is part of the unit, some facilities will not allow any products with alcohol.

* Clothing is a whole issue in itself. Some only allow a certain number of pairs of underwear and socks. They require that you wear a bra if you are a woman, but some will not allow the under wire type (unless you are like me and they don’t make my size without an under wire). You must have sleeping attire that consists of a top and bottoms. You are usually not allowed in the common areas in your sleeping attire. By the way, no shorts or sweats with a draw string. I’ve heard some places don’t allow shoelaces either. No ripped or holey clothing either.

* The first day and night you are usually on what is referred to as “SPs” (Suicide Precaution). This means that someone must check on your whereabouts every ten to fifteen minutes to make sure you aren’t trying to end your life prematurely. They do this while you are trying to sleep too, which usually wakes you since you are too scared to get any decent sleep the first night. As long as you remain on SPs, you cannot check out your sharps alone. One of the staff must be with you while you are brushing your teeth, taking your shower and doing your hair. Facilities that have a separate cafeteria area will keep you confined to the unit for meals as well. The psychiatrist takes you off SPs as soon as they are sure you won’t be stealing anyone’s shoelaces to inflict bodily harm on yourself.

* Smoking is a considerable issue for some patients. Some facilities do not allow smoking and some have a designated enclosed area. Even though I’m not a smoker, I enjoyed being able to go outside into the little enclosed courtyard and see the sunshine or the stars and hear the birds chirping. Plus, the smokers always had all the scuttlebutt from the unit. It was also interesting to hear the ravings of the patients who were experiencing psychosis and they always seemed to come outside and share their latest vision or message from God.

* The community phone is always an interesting situation. One unit I was on had two phones but that seems to be rare. Usually there is a time limit on phone calls and one person who always seems to abuse it. The phones usually allow calls in as well as out. During the day when there is therapy or classes being conducted the phone will most likely be taken off the hook. And just so you know, the staff does not take messages!

* Speaking of therapy and education…it seems to vary tremendously from unit to unit and from facility to facility. The first hospital I was in provided only the very basic information. It was so elementary that a 7-year-old would have been a capable instructor. The second hospital I was in about two years later was far more advanced with their program. They had numerous therapists, verses only one like the first facility. They taught useful things like coping skills and effective anger management. They promoted group discussion, unlike the first hospital that merely lectured to you until you nodded off from the drone of their voice.

* Eat, drink, eat some more and be merry! That seems to be an overall philosophy among the psychiatric community in general. If they’re mentally ill give them all the food they can eat and don’t be chintzy on the drinks (non-alcoholic, of course). The units I’ve been on have always had really good food as well, so you wanted to eat. One unit had a great salad bar. They both had a refrigerator that was stocked with juice, milk, chocolate milk, jello, pudding, fruit and some sandwiches. There was also a microwave and plenty of popcorn and instant soup. They also stocked those cereals that come in their own bowl. So, not only do most of the meds make you hungry, they supplied enough sustenance to outgrow your clothes while you were there. They also keep track of how much you eat, although you won’t see them doing it openly. I think it’s kept under wraps for the most part, although I cannot imagine why.

* On to the issue of medication. Most of your conflicts seem to be centered in this area. There are patients who refuse to take the prescribed meds. You have the right to do this, although I personally don’t suggest it if you want to get better and get out.

Overall, I felt like I was at camp. I’ve been somewhat lucky in the fact that all of my hospitalizations were positive experiences. I went in wacky and came out with a corrected medicine regime and a renewed attitude towards life. Of course, I’ve never gone in against my will and I’ve always been one to follow the rules. Each patient has a choice about the attitude they adopt when it comes to being hospitalized. You can choose to learn something during the course of treatment or you can close yourself off to anything positive, convinced that you won’t get better. I realize it’s tough to be positive sometimes, especially during an episode of depression, and some people are natural pessimists. The course of recovery is up to us as well. There isn’t a cure for mental illness yet.

Maybe someday soon there will be a cure or at least a more exact method of prescribing medications. Until then, if you have a mental illness you owe it to yourself to fight, to the best of your ability, to increase your control over your disability. This means finding a competent psychiatrist with knowledge of your illness to treat you and administer your medications. It means going to therapy and changing your flawed ideas of life and its many challenges. It means reading, investigating, asking questions, building a strong support network, making changes, taking courses, talking and yes, it means enduring a stay at the hospital, if that’s what it takes.

Terry J. Coyier is a 37-year-old college student studying for an Associates of Applied Sciences degree. She is also a freelance writer who writes about bipolar disorder and other mental illnesses. Terry was diagnosed with bipolar ten years ago. She lives with her son in the Dallas/Ft. Worth Metroplex. Terry is an author on http://www.Writing.Com/ which is a site for Writers and her personal portfolio can be viewed here.

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