You probably have your own ideas of what a mental facility is like. But don’t be fooled by what you’ve seen in One Flew Over the Cuckoo’s Nest. When you enter a psychiatric hospital, there aren’t people running around in hospital gowns with staff trying to restrain them. There isn’t disorder and chaos amongst a sea of straitjacketed patients. What you see is a whole lot more structured, compassionate, and humane.
Of course, treatment options vary from state to state and facility to facility. And unfortunately, many of those who have a severe mental illness don’t end up in psychiatric hospitals — they end up in jail. The Washington Post reports in 44 states, there’s at least one prison that holds more people with mental illness than the largest mental hospital in that state. Though a lot of people are getting the support and guidance they need, this proves many others may not be.
For those who are getting the proper treatment, however, life in the psychiatric unit probably looks a lot different than what you envision. Here’s what it’s really like.
1. You won’t be among the criminally insane unless you’re also criminally insane
Let’s say you’re admitted to the inpatient unit of the psych ward. Perhaps you intend on staying there awhile, but you’re worried about spending your time amongst those who have been deemed criminally insane by the state. We don’t recommend judging any book by their cover, but we get it. The idea may be a bit nerve-racking.
Here’s what you probably don’t know: There are special mental facilities designated for those who have committed a criminal offense. They’re called forensic hospitals, CMS.gov notes, and unless the state has deemed you criminally insane, there’s no reason for you to be anywhere near one.
Stephen Seager, someone who works in one of these hospitals, notes to The New York Times they can be seriously intense. Seager says only a small percentage of the patients in forensic facilities are violent. But these patients often physically assault other patients, or even the staff. And many of these hospitals aren’t prepared to deal with this level of violence in the first place.
2. Yes, electroshock therapy is still a thing. No, it’s not what you think
Therapy and medication are good starting points for many patients, but sometimes, they just don’t cut it. In this case, electroshock therapy is recommended. You definitely have an image in your mind of what this is like, but it’s time to dispel the myth. This is not an inhumane practice that results in the patient turning into a zombie. In reality, electroshock therapy can be quite helpful.
Scientific American notes patients who undergo this procedure in the U.S. are given brief pulses of electricity after they’re given an anesthetic and muscle relaxant. And all vital signs are monitored to ensure the patient is safe. There’s plenty of research to suggest it really does work to alleviate symptoms of many mental disorders, so the idea this practice is barbaric is far from correct. Many patients report it’s about as unpleasant as a visit to the dentist.
3. Most people really want to get the help they need
You probably think most people in psychiatric hospitals enter kicking and screaming against their will. But this usually isn’t the case. Many people choose to admit themselves into an inpatient program to get away from the other stressors of life and put their full focus on their mental health. Not a bad idea at all.
If you want extra assistance with your mental illness without staying in a psychiatric hospital, North Texas Help notes all the other options. Many people try partial hospitalization programs which involve just six hours of treatment a day. Or, you can give intensive outpatient programs a go, which typically meet for a few hours each evening. Finding the best option for you really is key to your treatment.
4. No one really uses straitjackets anymore
Movies depicting life in a psychiatric facility usually have at least one scene involving a character getting manhandled into a straitjacket. Here’s the thing — the American Psychiatric Nurses Association says restraints of any kind will be used when absolutely necessary, but only when absolutely necessary. No one’s throwing anyone in handcuffs if they’re not an immediate danger. And the use of straitjackets just doesn’t really happen anymore, as Robert Evans, a writer who has stayed in mental hospitals, notes to Cracked.
For a patient needing to be restrained in some way, tranquilizing medications are a go-to for many hospitals over anything physical. It’s pretty widely agreed upon in the medical community that no one, staff or patient, wants restraining to be a regular occurrence, as it can be super damaging to the patient’s psychological health and present physical dangers.
5. Misbehaving has really annoying consequences
Maybe you were admitted against your will and have fought against your stay ever since. If you’re acting out violently, restraints may be used. But if you’re just rebelling from activities and not working to better yourself, staff members aren’t going to bully you into complying — but they are going to continuously check on you to make sure you’re OK. As Evans tells Cracked, “Every half hour a staff member will find you and make sure you’re OK. If you’re in the shower, he’ll knock until you shout your own name. If you’re asleep or in group or reading, he’ll just write it down and be on his way.”
The takeaway? The people in the hospital just want to make sure you’re safe and utilizing the tools offered.
6. You’re on a relatively rigid schedule
You’re not in a psychiatric hospital to hang out, occasionally attend therapy, and live your days behind locked doors. You’re there to make progress and learn how to manage your mental illness so you can leave the facility with confidence and a new skill set. This takes work on the patient’s part, which means schedules are involved. A typical patient knows exactly what to expect out of each day in the hospital.
Arjune Rama, M.D., reports the inner workings of an inpatient psychiatric facility are very similar to other medical units, which means a lot of routines are put into place to ensure patients can get the most out of their stay. Their days involve a mix of therapy (group, one-on-one, or even art therapy are common), scheduled meals, and down time to read or rest.
7. The staff don’t want to keep you there for longer than you need to be
Being admitted into a psychiatric hospital doesn’t mean staying there forever — in fact, for many people, it doesn’t mean staying there beyond a week or two. If you enter an inpatient program and you signed yourself in, you can also be the one to choose when you sign yourself out, as long as you’re not a danger to yourself or others, says Mental Health America. Things work slightly differently if your hospital stay was court ordered or you were admitted against your will. In this case, when you think you’re ready to leave, you must complete an evaluation before you’re allowed to go.
Remember — everyone taking care of you only wants what’s best. Not passing an evaluation isn’t the end of the world. It’s just another opportunity to continue growing and learning before you leave.