Welcome to Inpatient Mental Health

The first hours of a voluntary inpatient psychiatric unit admission

Photo by Catherine Kay Greenup on Unsplash

Hi, and welcome to our unit. It’s nothing like the movies here. It’s unfortunate how movies portray inpatient psychiatric care because I think it scares a lot of people from getting the help they need. We’re glad you came, and we’re here to help you. People come to inpatient mental health when they need around-the-clock nursing support for their mental health in a safe environment. My name is Michelle, and I will take you through the admission process.

First, we’re going to get you signed in. We need to get your signatures to complete this big stack of paperwork. This first one is your consent to treatment. You can see that it specifies that you are a voluntary patient. In this state, that means you can leave anytime you want. You should be aware that if you do decide to be discharged unexpectedly, and we have reason to believe that you might be doing so to harm yourself or someone else, we could prevent you from leaving, in which case you would become an involuntary patient.

This next sheet lists your rights as a patient. I will give you a minute to review it. I want to highlight that you have a right to know what medications you are being given, and a right to refuse any and all medications. The only way that we could give you medications against your will would be in an emergency where you were at risk of harming yourself or others.

That was a lot of papers to sign. Thank you for bearing with me. Now we’re onto the contraband. This is where we check you and your belongings for anything unsafe. We’re looking for sharp objects, substances or medications, strings, belts, plastic bags, or anything that could be used to harm yourself or someone else. We’ll start with what you’re wearing. We do allow you to keep your clothes on this unit. I’ll need to check all of your pockets and do a pat-down. I will need to look at the cap you are wearing and your shoes. Could you pass those to me now, please? Thank you. Your shoes are okay except for the shoelaces. Is it alright if I remove the laces? If not, I have some slipper socks I can give you to wear. I’m going to need your belt as well. If you don’t think your pants will stay up without a belt, I can sign out a pair of scrub pants for you. Yes, it’s true we don’t allow underwire bras for some people. In this unit, we decide who that applies to on a case-by-case basis. I’m glad you thought ahead and brought bras that don’t have an underwire, so that isn’t something we have to try and figure out.

Next, I’m going to snap a quick picture of you. This ensures we give the right medication to the right person. We won’t be putting it anywhere except your electronic chart. I also need to put this identification bracelet on your wrist. It’s also to help ensure we give the right medication to the right person. The nurse will want to scan this before giving you your medications.

Your nurse is going to meet with you next. She will review your health and social history, ask why you came, and set some treatment goals with you. Some of the questions might be the same as what you heard in the ER. We read what you said there but will need to review it again and ask some follow-up questions. This is how we get an understanding of your situation, which helps us know what we can do to help you best. The nurse will review all of the medications you currently take. This part will take about an hour. I will come and get you once it’s done.

How are you holding up? Do you need a break? We’re taking the patients out to the courtyard for 10 minutes of fresh air. We can continue after the break if you would like.

Photo by sydney Rae on Unsplash

Welcome back. I hope you enjoyed the fresh air. Now we’re ready for the unit tour. We’ll start with your room. You can see that I brought over your belongings while you were talking to the admission nurse. You’ll be sharing this room with a roommate at some point, but right now, that bed happens to be empty. You are free to lock your door if you would like. Staff members have keys, so we can still get in and out. I see you noticed that someone just peeked their head into the room to look in on us. We check in on you several times an hour to ensure you are okay.

From here, we’ll head to the common area. You’ll notice we have a television for patients to use. You can use it anytime there isn’t a group or mealtime, between 8 am and 10 pm. Television shows have to be appropriate for a mental health unit. There can’t be much in the way of violence and nothing that glorifies drug use.

Next to the common area is where we serve the meals. In this unit we have everyone eat lunch and dinner together. Breakfast you can get whenever you are ready between 7:30 and 9 am.

Next, we’ll peak into the group room. You’ll see that we have it arranged so the tables are in the middle and everyone sits around the outside of them. We change the setup around as needed for the group that is happening. Anytime you see a group happening on your schedule, this is where it will be.

Groups are a mandatory part of the program here. Many people fear them because they think they will have to talk about the problems that brought them here, or hear about other people’s problems. That is not what happens in groups on inpatient units. Most of these groups are skills training and skill practice groups. We’ll teach you skills such as cognitive reframing, distress tolerance, interpersonal effectiveness, and many other skills. There are also some more laid-back fun groups. You don’t have to speak if you don’t want to. If it’s your turn to speak and you don’t want to, you can just say “pass,” and we won’t keep pushing.

Next, we’ll head over to the nurses’ station. If you need a staff member, this is where you can find someone. There is a board next to the nurses’ station with the staff assignment that we update every shift. This is where you look to see who your contact person is for that shift. That will be the person who is knowledgeable about your case and will be asking to check in with you at some point during the day. And right here is the place where the medication room is. This is where you will get your medication when it’s due.

We are just about done. I just want to go over a few unit rules. We don’t allow patient contact on the unit, so you can’t hug other patients. I know it seems like a lot, but there are some mental illnesses where people don’t understand boundaries, so this protects you. Some people are also traumatized and really can’t deal with being touched. Also, no war stories. If you have used substances, please don’t talk about that with other patients as some people are in their first days of recovery. This includes talking about alcohol. Please don’t go into details of any trauma you have experienced with other patients either. If you’re not sure if something can be said in front of other patients, run it by staff first.

You’ll meet with your whole treatment team tomorrow and every day you are here to see how you are doing and make any necessary treatment adjustments.

That’s it for unit orientation. It was a lot. Nobody ever remembers even half of it, but don’t worry, we don’t expect you to. Feel free to ask us questions at any time if there is something you want us to clarify.

Originally published in Medium. Click here to go to original article.