In late 2008/early 2009, my husband spent a total of 16 days in a mental hospital due to a psychotic break. I recently came home after spending nearly five days in the hospital due to an emergency appendectomy during pregnancy. I feel compelled to share a few keys differences between our experiences.
- During my hospitalization, John was allowed to stay with me 24/7. The regular hospital makes it easy for family members to provide comfort and support to sick loved ones. Not only was John permitted to hang out with me all day, but my room even had a pull-out chair that transformed into a cot so that he could sleep over at night.When John was in the mental hospital, visiting hours were very restricted. I could only see him for 90 minutes a day, usually between 7:00 and 8:30 pm, or 1:00 to 2:30 pm on the weekends. I wasn’t allowed to join him in his room or even walk onto the ward’s floor. Instead, I was confined to the visiting room.
Although the limited access was almost certainly a safety precaution, that knowledge was cold comfort on the day John left the visiting room weeping and I couldn’t follow him to reassure him that everything would be okay. When someone is as confused and disoriented as John was when he first entered the hospital, having a loving spouse present would go a long way toward keeping him/her calm.
- During my hospitalization, the nurses rallied to get a hold of John when I couldn’t reach him. John had gone home to get some clothing when the surgeon came into my room and explained that I needed to have an appendectomy, and I needed to have it now.In a panic (the surgeon had also told me that my OB would be in the room in case they needed to perform an emergency c-section at 28 weeks), I tried calling John, but after reaching his cell phone voicemail and our home voicemail, my cell phone died. I tried calling from the bedside phone, but I couldn’t remember our home number and my husband’s cell phone is long distance and the call wouldn’t connect.
When a nurse walked into my room to get me prepped to go down into surgery, I burst into tears. Not only did she let me use her cell phone to try to reach him, but she then recruited three or four other nurses to start calling him. She also dug out my file and found our home phone number so that the nurses could alternate trying John on the two numbers. Thanks to the nurses’ persistence, I spoke with John just before I went into surgery, which was a huge relief.
The morning after John checked himself into the mental hospital, he wanted to call me. He didn’t have his glasses, so everything was blurry, he didn’t really understand where he was, and the neurologist had evaluated John while he was half asleep, and in his psychotic state my husband had interpreted the exam as a beating.
John wanted to call me to find out what was happening, but he couldn’t remember my cell phone number, nor did he have any quarters for the pay phone. When he asked the nurses to help him call me, they refused. After that, he became agitated, and they ended up giving him a shot of Haldol and transferring him to the intensive treatment unit.
I might be completely off base here, but it seems to me that if the nurses had helped him call me, those last two steps (the Haldol, the ITU) may not have been necessary.
- During my hospitalization, the staff proactively communicated with John. During and after my surgery (the only two times we were apart), the doctors and nurses made sure that John was apprised of my status. In fact, one of the nurses actually spent a fair amount of time just sitting with John and waiting with him. I never had to sign a HIPAA release form consenting to allow the doctors and nurses to communicate with my husband; they simply did it.When John was in the hospital, I spent two days waiting by the phone for the doctor to call me and explain what was happening to John. This, of course, was after John had signed his HIPAA release form, because without it, it was guaranteed the doctor wouldn’t call. I was told I couldn’t meet with the doctor face-to-face, and when I asked for his office number, the nurses told me they didn’t have it. The best they could do was put a note on John’s chart asking the doctor to call me when he came in for his rounds.
As a family member, I was treated more like a nuisance than a vital support person, or even someone who deserved to know what the heck was going on.
A recent post on the Bipolar Advantage blog discusses how to better help people during mental health crises, and proposes that “much of the hostility that [people who are part of the anti-psychiatry movement] have comes from bad experiences when in crisis.” I would absolutely agree.
When John had to enter the hospital a second time two weeks after his first, week-long stay, it was a real struggle to convince him to go because his first experience in the hospital had been such a negative one. I, on the other hand, have only gratitude for the people who helped me during my hospital stay.
It seems to me that mental hospitals could learn a lot about how to handle mental crises from the way general hospitals handle physical emergencies.