A Behind the Scenes Look Inside a Mental Health Facility
Note: This post is written from my perspective, as an employee of a behavior health facility.. Not all treatment centers are the same. I’m sharing my personal experiences with you.
Are you still picturing “One Flew Over the Cuckoo’s Nest” when you read about a mental health facility? You might want to think again. According to Dr. Vivek Murthy, the US Surgeon General, loneliness, isolation and lack of connection are a public health crisis. (A link to his article is listed in the Resources section at the end of the post.) Sadly, we live in a time where the need is great for mental health hospitalizations. The cuckoo’s nest image probably prevents many people from getting help for their emotional health. Working as a Behavioral Health Specialist for an inpatient behavioral health unit, I see children and adults admitted scared, or at best, uneasy, due to “the secrets” around mental health care. Let me share with you what it’s really like behind the walls of a mental health facility.
There shouldn’t be shame, fear or dread keeping you from becoming the you that was put on Earth to fill the purpose only you can.
Myths and Truths about our Behavioral Health Care System
Myth #1: All mental health facilities are holding tanks for people who are ill. It’s difficult to get out once you’re in.
Truth: Every hospital is different and all have unique missions but many are short term units. Their goal is to stabilize the patient, oftentimes with medication, provide them with education about their illness, connect them to resources that will help with their long term care, and prepare a plan for a safe return home. Admissions may be between a couple of days or a few weeks.
Myth #2: Patients don’t have choices after being admitted.
Truth: Patients have many choices in their care. They brainstorm medication options with their providers. They attend as many or as few educational or support groups as they’d like. They have options in what they eat and how to spend their downtime. They are able to make and receive phone calls, keep their admission anonymous or welcome visitors.
Myth #3: The primary role of staff is to push meds and maintain order.
Truth: The role of staff varies from job to job but it is everyone's concern to keep staff and patients safe. This is accomplished by maintaining a calm environment, skillfully de-escalating upset patients, providing education and resources, participating in recreational activities and simply being present for patients and listening to their stories and struggles. Yes, medications can be part of the job but they are only one piece of a very intricate puzzle. In my experience, the people who work in this field generally care a great deal about mental health and helping patients work through difficult times in their lives.
Myth #4: The patients in mental health facilities are dangerous.
Truth: Most patients are admitted because they are severely depressed, incredibly anxious or suicidal. Some are wealthy, some are homeless and most are somewhere in between. Some are young, some are elderly. They come from a variety of backgrounds. A small percentage are dangerous, however, the staff are skilled, and go to great lengths to make sure the environment is safe for everyone. It can be life changing when people learn from each other who would never interact outside of a facility.
Some of the best teachers don't look like teachers at all. They masquerade as the homeless, addicts and schizophrenics. Take notice.
A Typical Day in a Behavioral Health Facility
Patients are greeted individually by their daytime nurses around 7:00 am. They update their nurses on how they slept and any needs they have for the day. Nurses relay information to the patients’ providers to ensure continuity of care.
Breakfast is served at 8:00 am and patients have pre-selected their meals from a variety of options. It’s a time to gather together in the dining room, connect with one another and enjoy the bright sunshine that streams through the large wrap-around windows when the weather cooperates.
Free time begins after breakfast. Many patients shower in their own private bathrooms, some read in their rooms, and others chat, watch TV or work on a puzzle in the lounge.. The lounge serves as a comfortable gathering space on the units. It’s rare to walk by and not see people interacting with one another.
Groups begin at 9:00. They range from painting and other creative activities, to group therapy with a psychologist, to groups focused on coping skills that will help them handle stressful situations in the future. Fitness classes and sensory education are also offered. Staff are present throughout the morning to meet individually with patients to answer questions, offer a listening ear, or help patients develop a plan to accomplish their goals. Each patient meets individually with their provider to determine progress, review medications and develop a plan for moving forward.
After lunch and more free time, additional groups are offered. Some meet with a peer specialist to discuss options for overcoming addiction. Others chat with a social worker to assist them in overcoming obstacles that may prevent them from getting home to a safe environment. Outdoor time in the courtyard or gathering in the recreation room to exercise or listen to music are other options. The goal of the groups and individual meetings is to make sure patients are learning how to begin implementing healthy behaviors they can continue when they return home.
Evenings consist of dinner, a mindfulness activity, doing laundry and wrapping up the day with a brief group check in. Night nurses introduce themselves and chat with patients individually. The rest of the evening is open for patients to do what works best for them. Many gather to play card games, board games or to work on puzzles. Cell phones and other electronic devices from home are not permitted in our facility. (This can vary from hospital to hospital.) Many patients, especially adolescents, consider it to be a relief. They find great pleasure in connecting with one another over a tactile activity and with limited distractions.
Throughout the day you’ll hear laughter, witness learning, good food, creativity, fitness, friendships, therapy dogs and fresh air. The majority of patients express appreciation to staff upon discharge for a worthwhile and pleasant stay.
The system is complicated. It’s often hard to access. But please encourage others (or yourself) to take the leap if help is needed. On behalf of those who work in the emotional health field, you’re not alone; we’re here for you. You deserve peace.
My story’s complex. You only see the outside of me. The inside me carries bruises, cuts and fractures you don't know are there.*
Resources
If you or someone you know is struggling, help is available.
Speak with someone today.
988 Suicide and Crisis Helpline
*All three poems are 5 lines consisting of 31 syllables each.