Getting Admitted

Your experience at the hospital will vary depending on your insurance, the hospital, the time of the day, your symptoms, if you are admitted involuntarily and if you are already on medications. But just because you make it to the hospital does not mean that you or your loved one will be admitted. For example, if you are already on medications, the hospital staff may call your outpatient treatment team for information, make adjustments and send you home with a follow-up appointment. However, while at the hospital waiting to be seen keep a few things in mind (again this list will vary).
1.You may be seen in the emergency room first unless previous arrangements were made or you are in a place like the District of Columbia that has a comprehensive psychiatric emergency admission hospital.
2. You may have a long wait (but don’t let that discourage you)
3. You will be asked many questions so be patient and if possible know what medications you or your loved one is taking
4. The first Doctor you may see may not be a Psychiatrist, many times the Psychiatrist will have to be called to the emergency room for an evaluation. So be prepared to tell your story more than one time.
5. Even if you feel that you or your loved one is experiencing a mental health event that requires admission into a hospital, the doctor at the hospital may not feel the same way. So be prepared to make a case. Yes, sometimes you have to make a case for admission. If there are very few beds, if the Doctor thinks that you or your loved one can be stabilized with a medication change and sent back home the same night or you have insurance issues, then you or your loved one may not be admitted.
If you feel that admission is needed, then say so, but be prepared to speak to why you are seeking help. Describe the symptoms you are experiencing and explain how those symptoms are negatively impacting your life. In the case of a loved one be able to speak to what you have seen. Unfortunately, many people feel that the only way for them or for someone that they love to be admitted into the hospital is to wait until things get bad or to say that they are suicidal, while this is still very true in some cases, know that there are other ways.
For example, if a person already has a chronic health condition, are the symptoms associated with the psychiatric illness such as not taking their medications keeping them from recognizing the need to take their diabetes medication? Are the symptoms of their mental illness causing disruptions to the neighbors or strangers in the area to the point that if not managed could cause harm to your loved one? Is your loved one sleeping and if not what are they doing when they are awake? Are they losing weight? Are they not eating? Do you or your loved one already have a Psychiatrist in the community who could call and coordinate a direct admission on your behalf? Do you have a crisis team in your area (a group of mental health professionals who will respond to you at your home or your location)? The Crisis team can help you to process your symptoms and help to navigate you through the mental health services in your area.

If you are a family member of a loved one, who is currently on a psychiatric ward, visit and be involved. Get to know the treatment team to include the Attending and treating Physician (may or may not be the same person). If possible, ask for a meeting with the Social worker and or Doctor. If a date for a team meeting (a meeting in which all of the professionals involved in your loved one care meet to discuss his or her case) has been set, try to attend. Your input is valuable and can help ensure that the treatment team is focusing on the right goals (your loved one may not be able to articulate their needs clearly). Ask questions about the diagnosis, about the medications, inquire about the discharge plan and if you have concerns, share those concerns with the team. For example, you may feel that your loved one should be in the hospital for longer than two days. If that is the case be prepared to share with the team why you feel that way, let them know what you have been observing. Please understand that the goal of an inpatient hospital stay is to stabilize not to warehouse. Today many inpatient hospitals do not have enough beds to keep people long term and many of the newer psychotropic medications work faster so people can stabilize and can go home quicker. However, you live with your family member, and you know the challenges that you and your loved one will have to face once he or she is discharged. So share those challenges with the team and ask them to help you to develop a realistic plan that takes into account those challenges. For example, if you know that there are limited mental health supports in your area and that the earliest your loved one can get a mental health appointment in the community is three weeks from the discharge date advocate with the inpatient doctor for enough medications to cover the time.