What to Expect at an Inpatient Psychiatric Hospital
As a counselor at a behavioral health hospital, I find that people often come to a hospital for psychiatric concerns often have no clue what to expect. Even more, I find when I speak with family or friends, they really have no idea what it is I do each day. Here is a general overview of psychiatric hospitalizations that hopefully sheds some light on this level of psychiatric care.
Psychiatric or behavioral health hospitals are a form of high-level care for people at high risk to themselves or others. Some people who are admitted to a psychiatric hospital may:
- have attempted suicide
- be seriously contemplating suicide
- exhibit extreme self-harm behaviors such as cutting
- be experiencing a manic episode with risk to themselves such as extremely erratic sleep or eating patterns or other erratic behavior
- be experiencing acute episode of psychosis that causes severe impairment
- be seriously contemplating hurting someone else
- detoxing from drugs or alcohol
You can be admitted one of two ways:
- Voluntarily- this means you agree to your hospitalization after recommendation of a mental health professional and have completed consent paperwork for treatment.
- Involuntarily- this means that you have been evaluated by a mental health professional or peace officer who is recommending inpatient treatment, but treatment has been refused. If it is still believed that you are an acute risk to yourself, a judge will sign a warrant for a peace officer to transport you to a facility. Your condition will be continually evaluated and recommendation for discharge will occur after safety is no longer a concern.
While at the hospital you will have a treatment team of experienced professionals to care for you which typically includes:
- A psychiatrist to prescribe psychotropic medications as needed to stabilize condition.
- A physical doctor to care for any medical conditions including chronic conditions, acute illness, and injuries related to suicide attempts or other altercations.
- A registered dietician to consult for any nutritional concerns.
- A nurse to administer medication and monitor for side effects and effectiveness. They also provide education on diagnoses and medications to patients and families.
- A therapist to complete a psychosocial evaluation and identify other needs a patient may have in addition to psychiatric concerns. Therapists often conduct group sessions to address therapeutic needs and provide patients skills to prevent relapse. Therapists will also offer sessions to involve family or other support to ensure safety returning home.
- Mental health technicians to monitor for safety and engage patients in treatment.
- A case manager to help plan for services upon discharge.
- A case coordinator to help negotiate insurance concerns.
Once a patient is stabilized and all safety concerns have been addressed including acute harm to self or others and safety returning home, a patient will discharge. Average stays are about one week, but this is dependent on each patient and their treatment progress. Prior to leaving the hospital, your team will recommend a next-level treatment and help make arrangements for you to attend the appropriate program. These options may be:
- Residential treatment centers for patients with ongoing needs and have not responded to other treatments. Residential stays are approximately three months on average, but are determined on individual basis.
- Inpatient rehab to address severe drug and alcohol related concerns. These programs are generally 30 days to ensure all symptoms of detox have subsided, educate patients on skills when having cravings, and finding a sober environment to discharge to.
- Partial hospitalization programs that last on average four weeks. The purpose is to help a patient return to the community while providing intensive support to ensure return to normal functioning, but are not currently functioning at their optimal level. These programs vary by facility, but are generally at least five days per week with at least four hours of programs that include group and individual therapy, medication management, and nursing supervision of medications.
- Intensive outpatient programs that last on average four to six weeks. The purpose is to support a patient who has nearly returned to normal functioning, but may require extra support. These programs vary by facility, but are generally at least three days per week with the hours of group therapy.
- Outpatient services that generally include a psychiatrist for medication management and a counselor or psychologist to provide psychotherapy.
If you have any other questions or concerns, contact Cy-Hope Counseling to help answer any questions or provide care for you after your inpatient admission.
Written by: Kristina Zufall, M.Ed., LPC-Intern