What Is It Like In A Psych Ward

ote: for more on my experiences in hospitals, see here, here

The best analog I have for this very surreal experience is when I got sick last summer. I started the day with some random belly pain, totally bearable, a tiny bit worrying. It got slowly worse and worse, over the course of the day. I tried different medications, different kinds of breathing, everything I could think of. By the time my sister and I got off the river where we’d been tubing, I was basically passed out in the car. Over the course of the evening, nothing got better. It did not exactly get worse, at least not much; it just did not get any better. I thought I could stand it, with support, with a heating pad and a hot bath and some Tums. Then finally, I had enough. It was not one specific thing. It was just that quite suddenly I could no longer bear it. I went to the ER, and it was a saving grace, that medication hitting my bloodstream.

Checking myself voluntarily into a psychiatric unit was much the same My father had died about six weeks earlier. I had thought I could handle it. Every day was hard, sure. I cried a lot, I felt shattered. But I thought I would be okay.

And then one day I just was not okay anymore. I remember it very clearly. I had a snippy argument with a fellow teacher, and I felt it deep inside myself. I could not bear it anymore. Nothing had changed from two minutes before, not a single thing, except this: I could not do it, not for one more second.

I left, and on the way home I called a psychiatric hospital I knew about, a couple hours away. I gave the person who answered some details about how I felt, about how I suddenly knew that I was no longer capable of doing it alone. They told me to come right over. I packed a few things — I packed badly — and arranged for someone to take my dog. And then I left, and drove for a couple hours.

People have asked me what it’s like, and as it’s something many of you will likely not do, I want to tell you what it is like.

I parked and walked in and told them why I was there. They took my phone while I was in the admissions area, so that I couldn’t take pictures. It took hours to check in, because they took blood and urine, and did a physical, and talked to me in great detail. They were very kind.

Someone walked me up the three flights to the young adult unit. (They call them units, not wards, now). The nurse who checked me in was a nice guy, kind of hot, with dark hair. He explained the rules. I was given a folder, a nice green color.

I had my own room. There was only one double on the whole unit. There wasn’t much to the place — there never is. Bedrooms, bathrooms, showers, the sensory room — a round table, a bubbler, coloring stuff, games — the kitchen, and the community room, where we had groups. We could ask to watch DVDs or use the Wii, and a nurse would unlock the cabinet and In the kitchen We could find occasional snacks, though never as many as we needed. Crazy people locked up can always eat. There was a locked laundry room, and we could sign up to use it and ask a nurse to let us in. They kept extra shampoo, soap, combs, toothbrushes in there, too, and we could ask for them. We could request new towels, after we dropped our used ones in the laundry. Needless to say, we were not allowed to shave.

Off-limits to most of us was the segregated part, a couple bedrooms and a sitting room area with a TV. This could be locked, but wasn’t always, depending on who was in there. Generally the people housed there were the sickest, the delusional and paranoid, the schizophrenic. A couple had pregnancies imagined from whole cloth. One thought she was famous. Sometimes they spoke to someone who wasn’t there. It was locked completely once in my time there, for several days, for a man who had been walking around talking about killing someone. He had a 1:1, too, a nurse with him at all times. His meals were brought in, There was another resident there, very briefly, but we never saw him — much to everyone’s chagrin. We just heard he was violent, and that he had 2 nurses with him at all times. He was transferred pretty quickly. This was upsetting. We could always use some excitement.

There were places we could never enter. The nurses station, where the nurses and the Mental Health Specialists all sat behind a desk, eating their lunches with real silverware, working on computers, doing things we did not have the freedom to do. We could lean on the table in front of them when were bored. We were bored a lot. We’d ask them annoying questions, try to trick them into answering. They didn’t care for it.

And the med room. A small room, basically a closet, with a Dutch door. Open for business a few times a day, for morning and midday and evening meds; we’d line up and be given our pills and swallow and show that we’d swallowed. If we needed a med in between — and we did — we had to go track down one of the two nurses on duty and beg. Sometimes they were flat out unavailable. This made us restive.

There were three levels of staff. Lowest — though vital to our day to day — were the Mental Health Specialists.There were a few on every shift, and it was their job to monitor our general wellbeing, hour to hour. They did checks, every fifteen minutes making sure all of us were accounted for (“checks!” someone might yell through a bathroom door, and you had to yell your name back; if you were up in the middle of the night you’d catch a flashlight shining through your door). They ran groups sometimes, the non-clinical kinds. We played Wii Jeopardy, and Pictionary. Sometimes they would play Scrabble or chess with us, and when we flipped through the binder of coloring sheets they’d make us copies. And they walked us to the cafeteria; that was their other big job.

After them was the nurses. We all always all needed something. Can I have a PRN, we’d ask the nurses. I want Xanax, Ativan, Klonopin, something to settle me down. I have a headache, a stomachache, a backache, I feel dizzy. The nurses stood implacably behind the med window while the patients leaned on the bottom half of the swinging door, asking for everything. Yes, the nurses would say, dispensing something in a nice benzo, or a painkiller, or Suboxone. Or, no, it isn’t time yet, we have to call the doctor on call, that medication isn’t prescribed for you. We’d would slump, sometimes argue, but they were not interested. The nurses were the real gatekeepers.

But it was the doctors and the social workers who decided when you’d leave, what meds the nurses could give you, whether you were allowed outside. They were the ultimate authority. Everyone perked up when they came in, the air electric suddenly with promise. Who would be let out today, who would get what they desired.

We each had one doctor and one social worker, and we met with each of them every day. They sat in our rooms, patiently. Mine was a lovely man who listened to me talk for, well, a long time. When I was leaving, and scared out of my mind, he gave me a rooster that served as good luck in his home culture. We complained about them anyway. We had a morning meeting with a MHS where we filled out a sheet about our mood (from 1–10, where were we on depression, anxiety, irritability?) and filled out goals. In the evening we’d review them. A social worker would run a processing group each morning, where we’d talk about our Feelings. We’d have at least one or two more groups, run by the mental health specialists. On weekends, there was a fill-in social worker running the group, and I confess that we often ran roughshod on her. She didn’t know us as well, and so we could fuck with her.

Fucking with people was fun, sometimes. We moved almost as a monolith, those of us who weren't hearing voices or detoxing from heroin. Sometimes we just wanted something to happen, already. We were bored out of our minds, sometimes. If you had energy, really any energy, there wasn’t enough to fill the days. We colored a lot, we played games sometimes, we listened to music, we watched TV, but it was never quite enough. That’s why we were so annoyed that we never saw the violent patient. We wanted something. Anything. Sometimes there was a nurse, usually a young one or one in training, who didn't know how to handle a conflict, and by the end of the night they’d look worn down. The older ones could handle anything, it seemed. “That’s junkie talk,” they’d say dismissively, if we asked for something too often. At a “not a drill” code black, they’d calmly lock the doors and reassure us. During a patient emergency, they’d lock part of the floor and keep us on the other side of the door, waiting to be let back into a slightly more expanded version of freedom.

Some of us were, at least, able to go down to the cafeteria to get lunch, and if it was nice outside we could sit out there. Two MHS would come with us, and we would order our food, sometimes sneak some back. If we couldn’t go down, and for breakfast, we ordered the night before, circling our items in crayon. But going to the cafeteria was a joy. We wandered through the long tunnel, we took our food out, sat together in the sun. I ate a lot of pizza dipped in ranch, a lot of cranberry juice and sprite, a lot of ice cream sandwiches. We all ate a lot of crap. The salad was even grosser than normal salad.

It was the doctors who decided if we could go out, and thank god they usually decided pretty fast, within a day or two. We could go out in the evenings, too, with a basketball and a Frisbee, and I did some handstands sometimes, against the wall. The staff would play Frisbee with us sometimes, arcing the disc through the gloam. We’d walk in circles around the small courtyard, desperate to move.

There used to be walks outside the fence, we were told. But there’d been too many elopements. The only group allowed to go out was the children’s unit, to a nearby playground. Sometimes we could hear them shouting and laughing. It was a melancholy sound. Few things must be as depressing a pediatric psych ward.

The elopements had mostly been the adolescent unit, notarious on the other floors. Every unit had enough mental health specialits that when there was a code somewhere else they could rush to help, and there was a code for the adolescent floor every day. I pictured it down there, a bunch of suicidal, detoxing, self-destructive, sad teenagers, bouncing against each other. And we thought it was hard up here!

I’d been in an adolescent unit, once, and I remembered it as brutal, exhausting to have to keep up with each other, the oneupmanship, the sense of pride I felt when one boy told me I was the furthest along, cutting wise. I was so upset and scared that time that I couldn’t pee for 12 hours (this would be repeated, later, during the McLean Fiasco, but that was even more terrifying and at least my stint at 17 was instigated by a therapist who loved me and saw all of me). That unit was more malcontents than anything else, the anorexic lites, the half assed cutters (listen, was I proud for way too long that I was more a full assed cutter? I was. Luckily, I got over it.) We had the handful of suicide attempts, too. But no real psychosis. There was Theresa, though, the anorexic equivalent of me: we got each other. On that unit was even more of a sense of patients as monolith: we were teenagers. What were we there for but to fuck with adults?

At Brattleboro, though, we were mostly there voluntarily. There were a couple who’d been sectioned in, i think, especially the psychotics, and I think some, mostly the addicts, were court ordered. But the addicts were separate from the crazies most of the time anyway. They came in for a few days, detoxed, and left. Brattleboro has a designated detox unit, but it was always filled to overflowing. On their second or third day, after the hell of shaking and fevers and vomiting, they might come to a group or two, but usually then they’d be gone. I assume most of them relapsed. But maybe not. At any rate, any judgement I had about addicts was basically gone by the time I left the retreat. No one would choose that.

So there was us, the mostly voluntary, non crazy crazies. We didn’t hear voices or shoot up. But we cried in our beds, desperate for something we didn’t know if we’d ever find. We wandered the hallways, day and night, bouncing the stress balls they gave us. We colored frantically. We talked, sometimes. Once I sat next to a girl- woman- in the sensory room and she told me horror stories, stories that are not mine to tell but that, if you close your eyes, you can probably imagine. She lost track sometimes of what she was saying. Her voice got very quiet at times. It was unclear how real some of it was. I looked at her. I did not look away. And later, I shook and shook.

Brattleboro is the longest and best hospitalization I’ve had. I overstayed-purely because none of us could figure out where I should go next- but what made the difference was that I was there because I wanted to be. There are ways in which the dissociative disorders and trauma unit at McLean does things better: access to technology, more trust in patients, walks, scheduled check ins with MHS. But my experiences there were, of course, really awful and genuinely traumatic. The Retreat was different. I went because I knew that I had to, that I had reached the limit of what I could do myself. I knew I had to. Someone else did not try to decide for me (there are lots of arguments to made for sectioning psychotics, schizophrenics, delusionals, and the actively suicidal; this is not the patient profile I mean when I discuss sectioning).

The Retreat was able to be that for me, even as it had its moments of terror and unspeakable sadness as I confronted all I had lost- I felt, at the time, that I had lost everything. Two of those things, my job and more importantly my father, did not come back. Others- the trust of one of my closest friends, my sense of competency, my feeling that no one would ever look at me the same way- those I gained back. That feeling of having lost everything stayed for a long time, but eventually I saw it more clearly, that there were enough ashes that I could eventually rise.

So that was my one retreat, the interruption, the vacation I tried to take from myself. That’s what it was like, for me.