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Surviving on the Unit

Surviving on the Unit

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Have you lost all control in your life, or does it feel that way? This article explores the feelings and thoughts associated with experiencing an inpatient hospitalization. While not intended to override the guidance of your treatment team. Please discuss the tools here with your clinicians before implementing them and, as always, safety first.

If you have a chronic mental illness you are no stranger to the hospital. Sometimes people are hospitalized so often they cannot remember each admission or maybe so traumatized and would instead not remember the experience altogether. There are many perspectives, feelings, stigmas, and thoughts people with and without diagnoses have on the inpatient psychiatric hospitalization.

Some of them include:

1) Do I need to go in?

2) When is it the right time?

3) How long do I need to be here?

4) How will people at work and my friends think about knowing I’m here?

And so on…

None of these are fun topics to think about to discuss with your therapist or supports. Nevertheless, they are some of the most important questions to start an ongoing dialogue about when you live with chronic mental illness. Knowing when hospitalization is necessary is not the first step in giving up the fight against mental illness, it is the first step you can take towards your recovery.

People with a mental health diagnosis should not fear hospitalizations. At the same time, this sounds true for an outsider or a person without a diagnosis. People in mental health and those with a diagnosis understand the hospital’s usefulness as both controversial and questionable in terms of its purpose in community mental health. Hospitalizations and the work put in by patients towards their recovery upon admission until there final discharge must be celebrated by everyone in the recovery process, including supports, family, and friends.

Preparing for a future hospitalization is something to be done once you are first diagnosed with a mental health condition. Waiting and putting off planning for a possible admission is the worst thing you can do if you have a chronic mental illness. You are not only ruling out the safest possible space when you are at imminent risk of harming yourself, but also you are limiting your choices for how to proceed with your recovery at the most challenging time in the course of your treatment. There is no reason to put yourself at further risk of harm when you are so far from baseline; even your therapist and closet supports are worried about you and your safety in your living environment.

Getting to know your local hospitals is vital in maintaining your mental health over the long term. Identify phone numbers to local emergency rooms and the best transportation routes to get there when you aren’t feeling safe. Provide this contact information and your plan to go into friends and family. Getting adjusted and feeling safe in the hospital will make each subsequent hospitalization that much more comfortable and organic to everyone involved in your recovery.

By reducing the stigma associated with your “first admission,” as the process becomes normalized as just another step, you’ve taken towards your recovery. It is also a giant step to reduce your risk at hospitalization in a state facility because you’re so far from your baseline that you are unmanageable and unsafe at a local hospital and require the resources of state-level long term care.

Surviving a hospitalization requires several strengths. The ability to listen, reflect, re-learn habits, adjust and master a new environment, and cultivate safety during episodes where you’ve lost your feelings of control in most aspects of your everyday life.

Mastering self-reflection and rediscovering your inner strength to move beyond your immediate challenges will help regain the power needed to move closer to discharge. Remember that you are escorted on to a unit by security in the hospital. This moment does have to correspond to you surrendering your self-control. Instead, it IS the point of departure into your ultimate recovery.

This article explores three necessary skills needed for inpatient hospitalization experiences. 1) interacting and with staff and understanding them as a resource not a roadblock in your recovery 2) self-reflection and care 3) rediscovering your inner guidance system as a resource to regain self-control

The staff is there to support you in your recovery. Always remember staff members are people too. They are there to assist in evaluating your mental status at all times. This level of observation may evoke some paranoia, but be aware of mastering your behavior and interactions with staff will only prepare you further for interacting with people in your life.

If you find yourself agitated with the unit’s rules and the staff’s enforcement of them, you should reflect on your readiness for discharge. Reporting your mental status to staff is not a step towards keeping you hospitalized longer; it is a step in reworking roadblocks in your treatment that may prevent you from moving toward recovery.

A tremendous opportunity to reclaim time for self-care is during an inpatient hospitalization. Practicing self-care in a controlled space is enormous practice for when you are discharged. If you are having a hard time staying clean and hygienic on the unit, it may be an indication you are not ready to do these things on your own—this is the time to master your coping skills, not just learn new ones.

The time between rounds should be an opportunity to practice them. Always discuss outcomes with your treatment team and ask for recommendations to revise and rethink your strategies for making these self-soothing activities the most helpful in your recovery.

Before you’re ready to go home, ask yourself, do you feel safe? As always, knowing yourself and trusting your inner guidance system is the most crucial step in regaining control. Use the time in the hospital to test your doubts, reflect on them, and practice troubleshooting instances when these doubts are put to the test upon discharge.

Call people and stay connected to your social world. Don’t forget that you are re-entering your social world upon discharge. If your behavior before upset admission folks in your social circle, discuss with them on the phone before your release how your mental health has improved after this time of self-reflection in the hospital.

About the Author

J. Peters

Bold 10 Under 10 award recipient Jacques Peters ’08, MSW ’12 . Through his work as a Licensed Clinical Social Worker (LCSW), therapist and disability rights advocate, Mr. Peters fights for those without a voice in various systems of care, such as the New York City Department of Social Services, the New York State Office of Mental Health or the city’s Department of Corrections. Jacques is the author of University on Watch: Crisis in the Academy, which he published under the pen name J. Peters in 2019, and First Diagnosis, published in 2020. Jacques refers to his stance on recovery in his journal articles as “Too big to fail.” No obstacle too big, no feat out of reach, Jacques let nothing stop him in his path to recovery and healing.
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