Understanding Patient Hospitalization

Understanding Hospitalization for Mental Health

Depression and Bipolar Support Alliance

We’ve been there. We can help.

If you have severe symptoms of illness like depression or bipolar disorder, a brief stay in the hospital can help you stabilize.

This brochure is intended to help you through your hospitalization. Some ideas may be useful to you; some may not. Everyone’s experience in the hospital is different. Use only the suggestions that make sense to you and help you.

When do I need to go to the hospital?

You might need to go to the hospital if you:

■ Are seeing or hearing things (hallucinations)

■ Have bizarre or paranoid ideas (delusions)

■ Have thoughts of hurting yourself or others

■ Are thioking or talking too fast, or jumping from topic to topic and not making sense

■ Feel too exhausted or depressed to get out of bed or take care of yourself or your family

■ Have problems with alcohol or substances Have not eaten or slept for several days

■ Have tried outpatient treatment (therapy, medication and support.) and still have symptoms that interfere with your life

■ Need to make a major change in your treatment or medication under the close supervision of your doctor

How can hospitalization help?

■ The hospital is a safe place where you can begin

to get well. It is a place to get away from the stresses that may be worsening your mood disorder symptoms. No one outside the family needs to be told about your hospitalization.

■ You can work with professionals to stabilize your severe symptoms, keep yourself safe and learn new ways to cope with your illness.

■ You can talk about traumatic experiences and explore your thoughts, ideas and feelings.

■ You can learn more about events, people or situations that may trigger your manic or depressive episodes and how to cope with or avoid them.

■ You may find a new treatment or combination of treatments that helps you.

What do I need to know about the hospital?

■ You are not going to an institution, asylum or prison. Hospitalization is treatment, not punishment. It is nothing to be ashamed of.

■ You may be on a locked ward. At first, you may not be able to leave the ward. Later, you may be able to go to other parts of the hospital, or get a pass to leave the hospital for a short time.

■ You may have jewelry, personal care items, belts, shoelaces or other personal belongings locked away during your stay. You may not be allowed to have items with glass or sharp edges, such as picture frames, CD cases or spiral notebooks.

■ You may have to follow a schedule. There may be set times for meals, groups, treatments, medications, activities and bedtime.

■ You may have physical or mental health tests. You may have blood tests to find out your medication levels or look for other physical problems that may be worsening your illness.

■ You may share a room with someone else.

■ Hospital staff may check on you or interview you periodically.

■ Your prescribing doctor may not be able to see you right away. You will probably talk to several different doctors, nurses and staff members while you’re on the ward. You might have to ask for things you need more than once.

Your time in the hospital

You might want to ask a loved one to help you go through hospital check-in procedures and fill out forms. Ask your  loved one to help you communicate with hospital staff if needed.

You or a loved one may also want to call the hospital in advance to find out about check-in procedures and items you can bring. Ask if you can bring music, soap, lotion, pillows, stuffed animals, books or other things that comfort you. Find out about visiting hours and telephone access. Be sure your family and friends are aware of hospital procedures. Tell them what they can do to help you.

If you sign yourself into the hospital, you can also sign yourself out, unless the staff believes you are a danger to yourself or others. If you are not a danger, the hospital must release you within two to seven days, depending on your state’s laws. If you have problems getting the hospital to release you, contact your state’s Protection and Advocacy agency (see page 10).

You have the right to have your treatment explained to you. You have the right to be informed of die benefits and risks of your treatment and to refuse treatment you feel is unsafe. You also have the right to be informed about any tests or exams you are given and to refuse any procedures you feel are unnecessary, such as a gynecological exam or other invasive procedures. In addition, you have the right to refuse to be part of experimental treatments or training sessions that involve students or observers. Mate sure the people treating you know your needs and preferences.

It may take time to get used to the routine in the hospital. If your symptoms are severe, some things may not make sense to you. Try to get what you can out of the activities. Concentrate on your own mental health. Listen to what others have to say in groups. Keep a journal of your own thoughts and feelings.

You will meet other people who are working to overcome their own problems. Treat them with courtesy and respect, regardless of what they may say or do. If someone is making you feel uncomfortable or unsafe, tell a staff member.

Make the most of your time with your doctor. Make a list of questions you have. Ask your family or other hospital staff to help you with the list. Let your doctor and staff know about any other illnesses you have or medications you take. Be sure you receive your medications for other illnesses along with the medications for your depression or bipolar disorder.

Wellness after hospitalization Know your treatment. Before you leave the hospital, make sure you have a written list of what medications to take, what dosage, and when to take them. Find out if there are any foods, medications (prescription, over-the-counter, or herbal) or activities you need to avoid while taking your medication, and write these things down. Track your medications and moods using the tools on the next pages.

Learn all you can about your illness. Talk to your doctor about new treatments you might want to try. Find out what to expect from treatments and how you know if your treatment is working. If you think you could be doing better, ask another doctor for a second opinion.

Take one step at a time. You might not feel better immediately. Allow yourself to slowly, gradually get back to your routine. Give yourself credit for doing small things like getting out of bed, dressing or having a meal.

Prioritize the things you need to do and concentrate on one thing at a time, “write things down or ask friends and family to help you to keep from becoming overwhelmed.

Set limits. Take time to relax. If you feel stressed or exhausted, you can say no or cancel plans. Schedule time to care for yourself and relax, meditate, take a long bath, listen to music, or do something else that is just for you.

Things that might trigger an episode, such as life events, travel, physical illness or work stress

■ Warning signs such as talking very fast, paranoia, lack of sleep, slowed down movement, excessive alcohol or drug use

■ Things people can say that will help calm or reassure you

■ Things people should do for you such as take away your car keys and lock up anything you could use to hurt yourself

Things emergenq’ staff can do for you, such as explain things, talk slowly, give you space, or write things down for you

■ Reasons your life is worthwhile and your recovery is important

How can an advance directive or a medical power of attorney help me? An advance directive and a medical power of attorney are written documents in which you give another person authority to make treatment decisions for you if you are too ill to make your own. It is best to consult a qualified attorney to help you put together an advance directive or medical power of attorney. These documents work differently in different states.

Resources

The following organizations may provide additional help. DBSA assumes no responsibility for the content or accuracy of the material they provide.

Bazelon Center for Mental Health Law (Provides information but does not give individual legal advice.) (202)467-5730 • wwwbazelon.org

National Association of Protection and Advocacy (202)408-9514 • wwwnapas.org

Treatment Advocacy Center (Explains each state’s hospitalization laws) (703)294-6001 * wwwrjsycbJaws.org

Help DBSA change lives.

We hope you found the information in this brochure useful. Your gift will help us continue to assist people and families with mood disorders.

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