Being an Inpatient, part 2

The first couple of days I was in, I was too scared to feel anything. The other people there were mostly very unwell, and some of them were quite frighteningly so. One woman tried to set her room on fire. Another would touch me every time she saw me, so she could ‘read’ me. Some were so drugged out that they were just zombies. I was afraid of the place I had come to for refuge.

By about day three, my terror had begun to subside, and I was able to think about more than just how afraid I was. And the crippling suicidal depression hit me again. I asked my nurse not to let me outside the unit, because I was afraid I would do something to myself. Her reaction stunned me.

Instead of just telling the door guard to not let me out by myself, her first reaction was ‘Oh, ok, let me see what meds we have for you to take PRN (as needed)”. She wanted to give me sedatives so that I wouldn’t be a problem. She was not happy when she found that the only meds I had listed were an antihistamine and an antiemetic. So she called in the duty psychiatrist.

It was 5pm on a Sunday night, during a holiday weekend. The duty psych was probably at home with his family. It took him more than an hour to come in, an hour in which I hid in my room. I didn’t want to be drugged out of my mind. I just wanted to be kept safe until the storm passed.

I told the duty psych that I didn’t want any PRN medications listed, that I just wanted to be safe, and that I thought it was a waste of his time to be called out for this. I don’t remember much of the conversation, except that my nurse was rather unimpressed with my telling him that I thought it was a waste of his time. I did not have any medications added to my chart.

I did have one excellent experience with a young nurse, who did all his medication rounds and so on, then came and talked to me for a half-hour or so. He listened, he suggested different strategies for coping, and he made me feel more human, and less of a number.

I waited for proper assessment and treatment til Tuesday, because a holiday weekend means that there’s only bare-bones staff on. When the next working day rolled around, all I wanted was to get out. I think that I would have lied through my teeth to get out at that point, no matter how I was feeling. I was still down, but by that time I had figured out a couple of different ways to kill myself using only the items provided in my room, so I figured I wasn’t really safe in there anyway. I was sent home.

My stay in the unit was eye-opening. I saw some very very sick people. But I saw some horrors that were very little to do with mental illness, and a lot to do with a dysfunctional system. I saw nurses pulling double shifts because there wasn’t enough staff. I saw people being doped into chemical stupor – maybe because they needed it, but maybe because the place was not equipped to deal with even minor problems. I saw people in desperate need being thrown out because the ward needed the bad, and they were not sectioned so they could be moved out.

Talking to the other people in there was eye-opening. It was supposed to be the acute inpatient unit, but most of the people I met had been there for months, even years. The closing of long-term mental health facilities has had an awful effect on acute care facilities – they can’t deal with acute patients because they’re overfilled with long-term patients.

There was a weekly planner on the wall with the activities for each day, but when I asked around, it was pretty clear that none of them had run for a while. It was not a treatment centre so much as it was a storage unit for the mentally unwell, and the primary form of therapy was chemical. I think the idea was that as soon as each patient could be stabilised on some medication, they could be released into the community to be dealt with by community mental health.

I think that the current system of inpatient mental health treatment is fatally flawed. Acute units are trying to deal with long-term residential patients, and there is no therapy of any kind offered (I could be wrong, as I wasn’t in very long, but that’s what the others that had been in longer said).

Tomorrow: How I think the system could work better.

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