My experience of psychiatric care

It can be a very scary thing going in to a psychiatric hospital when you don't know what to expect.

It is likely your mind will think up the worst possible scenarios and bring up memories of all the horror stories you have ever heard and movies you have ever seen, the majority of which have it all wrong and completely warped. Not to mention the added pressure of stigma. While all hospitals vary and have their own way of doing things, having been in two, one private, the other public, I can say that they work very much the same.

On first arrival to the private hospital, I was met by the admissions office where I had to fill out a few forms (just a formality; stating my address, contact details of next of kin, signing insurance forms etc.) and from there, after a little wait, although considering how emotional and scared I was it felt like hours, I was met by a registrar nurse ­ – a registrar is a psychiatrist in training who works alongside your assigned doctor.

There was quite a long interview with this registrar detailing all my past medical history and giving me the opportunity to ask any questions regarding my stay and planned course of treatment. This interview process is not one you have to do alone. I was so glad to have my mom there as the tears made it quite difficult to talk and the anxiety hindered my ability to think straight. Having someone who knew me almost as well as I knew myself meant she could answer when I couldn't.

Plus, it was nice to have a hand to hold. After a brief physical exam (nothing invasive) the registrar escorted my parents and I to the ward. Psychiatric hospitals tend to be busy and high­-in­demand meaning beds are not always available on the particular ward you have been assigned to for the duration of your stay and so sometimes you will have no choice but to bunk in another ward until one comes free. In my case, the ward I was supposed to be on had no bed available. I spent my first night in another before being transferred the next morning.

All patients are given a bed in a bay area for the first few nights. This is basically a room with a number of beds located right across from the nurses’ station. It gives the ward nurses a chance to get to know you and see that you settle in alright. After a few nights there, you get assigned your own room or perhaps a twin room.

Also, all wards are segregated meaning males and females do not get assigned the same room. There is generally a common area with chairs and a telly where you can hang out and chat with other patients (unless your ward is female only, this area will not be segregated).

Information that will make your stay easier

The nurses on duty will carry out a ward round every hour where they will check on every patient. In my experience, until you have met with your doctor you would be requested to stay on the ward. However, if you are not confined to the ward and have freedom to move around the hospital, there will probably be a book at the nurses’ station where you will be required to check in and out as you go. There can be a wide range of activities throughout the day like art, mindfulness and yoga. Some hospitals even have a music room where you can play the piano or bang on the drums.

If you are on medications, you will need to hand them up on arrival and the nurses will store them in the meds room. Generally meds are dispensed from this same room at meal times and then again right before people start heading for bed. Unlike the public hospital I stayed in where all patients ate meals in the one hall, in the private hospital each ward had its own canteen and meal times. A set menu would be pinned up in the morning and if nothing grabbed your fancy, you could go to the main hospital canteen and buy something from the buffet.

If you are a picky eater, like me, and only eat chicken for example, be sure to inform the nurses. They can have a member of the catering team talk to you about your options. Depending on your history, your doctor may also assign you a nutritionist. At meal times, the nurses tend to sit in a corner and take attendance. Don't fret like I did and think that they are only watching you and you alone. They're really not.

Then of course the treatment side of things comes into the picture. Every patient is assigned a doctor and once a week you get to meet this doctor on his/her rounds. It can be a long day, as many other patients will also be waiting to see him/her. You will always have the option to bring a family member to this meeting. If you have a problem any of the other days you can go to the ward nurses, your key nurse if you have been assigned one or ask to see one of the registrars.

There are many different treatment programmes available to patients at psychiatric hospitals, none of which I am educated enough on to recommend or advise. But on meeting with your doctor you will both agree on what the best course of action is. If you are a voluntary patient, as most are, meaning you admitted yourself to the hospital, you can essentially choose to discharge yourself whenever you want providing your doctor does not see it as a danger for yourself or others.

Everyone’s experience in a psychiatric hospital is different and although it can be difficult, do try and remember that no two patients are the same. Just because another person has been in hospital 12 weeks, does not mean you will and while one person may have a dislike to one particular nurse/doctor, don't be swayed. Decide for yourself based on your own experience. I am certainly not going to lie, going to a psychiatric hospital is very daunting but hopefully having read this, you might feel a little more at ease.

Some useful terms to know:

PRN

Medication as needed. For example, if I was feeling more anxious than normal, I could ask the nurse for an extra dose of anxiety meds.

MDT

Multidisciplinary Team. This team, headed by your doctor can be made up of registrars, social workers, nutritionists, psychologists, occupational therapists etc. They all work with you to ensure the best possible treatment.

OT

Occupational Therapist. They help you to develop, recover, or maintain the daily living and work skills while also trying to identify and eliminate environmental barriers in the way of you having independence and the ability to participate in daily activities.

Registrar

A doctor in training to be a specialist. They work alongside your assigned psychiatrist.

Special

A term used to describe someone who is under 24/7 supervision. Typically someone is a current danger to themselves and/or those around them.

Rounds

1) ward nurses checking in with patients on a regular basis, generally hourly. 2) Psychiatrist meeting with his/her patients once/twice weekly along with MDT to check on progress, note any concerns and mark out the next step forward.

Bay area

A semi-private room close to the nurses station.