Scenes from a Psych Ward

Admit it: you’re curious. Is it like in “One Flew Over the Cuckoo’s Nest,” or is it more like “Girl, Interrupted”? Yes to some of both, and a whole lot more.

Psych wards are, for the most part, vastly different now than they were 100, 50 – even 25 years ago. For most institutions, the goal is to treat the patient with dignity and to collaborate on a treatment plan that the patient can actually follow upon discharge. Does it always work? No. Are there revolving-door patients (those who can’t manage to live without chronic, repeated hospitalizations) who can’t seem to shake the Beast that is suicidality? Yes.

I have spent a cumulative of several years of my life in locked units. Instead of bemoaning the parts that weren’t especially fun, I’d like to highlight the fact that I’m still alive – despite the Beast nipping at my heels for, quite literally, decades. Hospitalizations have saved my life on countless occasions.

The truth of the matter is that the last place anyone wants to be is on a psych unit. You give up most of your rights, and it can feel like you’re constantly under a microscope. My hospital of choice used to allow those little golf pencils to write with (pens were too dangerous). I hated them – now they would effectively be a luxury.

Because a patient at another hospital harmed themselves with pencils, they are now considered weapons: we are reduced to using “bendy” pencils (if they were only a little bit longer, you could literally tie them in a knot – they don’t produce anything remotely legible). They even confiscated my journal this last visit. No more hardback books. I’m not kidding when I say you give up many rights/personal belongings that you would never expect to be considered prohibited items or behavior.

There are other things to get used to when you become a patient on a psych ward. There seems to be an unspoken rite of passage on most of the units I’ve been on: you have to push a button to turn the shower water on (you do this multiple times before the water is no longer frigid). You also have to make sure you quickly rinse off all the soap/shampoo/conditioner you’ve used before you push the button one too many times: it can swing from freezing to scalding in an instant.

One of the most common practices that can feel especially onerous and invasive is the “fifteen-minute checks.” Given that many, if not all, patients on a psych unit are suicidal, the staff is responsible for laying eyes on their wards every fifteen minutes to help prevent patients from hurting themselves. While this practice is mildly annoying during the day, many patients find it infuriating at night: many of the doors creak when staff open them, and the light from the hallway floods the rooms when the doors are cracked. Then they take your blood pressure, temperature, and pulse starting around 5:00 am, before shift change. For many, getting back to sleep is impossible.  

Although this is definitely a minority opinion, I have absolutely no problem with the fifteen-minute checks. To me, they are reassuring. I have been suicidal since the sixth grade, and for me, going into the hospital is a sort of reprieve from having to keep myself safe from myself, all on my own. A lot of people rail against night checks; for me, it’s one of the only ways I can finally get some decent sleep.

In fact, one of the first (and major) problems to be addressed when I am admitted to the hospital is my sleep deficit, which is usually significant. I sleep, sleep, and spend more time sleeping when I wind up in the hospital. Sleep becomes key in bolstering my suicide resilience. Eventually, I find my footing and my equilibrium, and I begin participating in therapeutic groups.

There is a practice called “room reversal,” which boils down to a patient’s room being locked during the day, and the patient only permitted in their room to sleep at night. I have an understanding with my admitting psychiatrist: putting me on room reversal would be both unnecessarily punitive and cruel. I cannot properly participate in groups until I can think straight, and thinking straight, in my case, means getting enough sleep. One danger of chronic sleep deprivation is the inability to fully ward off the Beast.

Another decidedly unpopular opinion of mine is the way I look at the groups that are offered on the unit. Most people find them worthless. I have a different opinion: no matter how many times I’ve done a particular worksheet or exercise, I almost always get a new takeaway. And I find the structure the groups bring to my day helpful – at least, I’m generally not embroiled in fighting off the Beast when I’m actively participating in groups.

I’ll reiterate: nobody in their heart of hearts wants to wind up on a psych unit, even if they recognize that it’s necessary for their safety and well-being. For people who are not faring well in their battle with the Beast, a hospital stay can literally save a life. So, if you fear you’re losing the battle, consider what a hospital can offer you: safety, refuge, and a fighting chance at stepping on the Beast’s neck, instead of the Beast getting the best of you. The worst thing that can happen is losing your life if you don’t seek the help you need. No matter how scary or stigmatizing a stay in a mental hospital may seem, it’s nothing compared with taking your life.