For many people, particularly those inexperienced with mental illness, the perception of inpatient mental health care in the United States is largely based on popular culture. The stereotypes certainly don’t bring reassurances. From barbaric treatments employed in the early days of mental health to the depiction of disturbed patients in straight jackets, many people, even those who need treatment, have the wrong idea about what inpatient care looks like.
Films like One Flew Over the Cuckoo’s Nest and The Silence of the Lambs explore the idea of psychiatric care, and, unfortunately, do a poor job of it. These kinds of pop culture presentations are far more hurtful than helpful.
In reality, residential mental health treatment is nothing like an old-school sanitarium; instead, it provides effective, customized opportunities for wellness. In modern facilities, there is no flickering lighting, angry nurses, padded rooms, or twisted treatments. Patients can experience compassionate care designed to make a difference.
This is what you need to know about time spent in inpatient mental health treatment.
The Types of Mental Inpatient Care
It is important to note that inpatient care comes in two distinctly different forms: voluntary and involuntary.
Involuntary care is more closely aligned with general perceptions. In these facilities, individuals do not enter of their own free will; instead, they are ordered there by courts or law enforcement professionals.
Numerous states have laws that allow people who appear to be a harm to themselves or others to be committed to a psychiatric hospital, usually for three days, but potentially longer depending on the circumstances. The best known of these laws is Florida’s Baker Act, to the point that it’s occasionally used as a verb to describe involuntary commitment.
These kinds of facilities are generally locked down to prevent patients from leaving and may involve additional protections to keep residents safe, such as surveillance video in every room. These restrictions are particularly needed if they were deemed to be a danger to others or themselves. In some cases, care may be provided contrary to a patient’s wishes.
Some facilities have very strict rules, including the prohibition of electronic devices and anything that could be considered a weapon. Schedules are generally very structured, and loved ones can only visit during preset hours.
The extent of the restrictions in place in a facility can vary greatly depending on the specific nature of an individual’s admission. Oversight is very common as well; it is rare to have time alone, and most patients are heavily monitored at all hours of the day.
Unlike involuntary care, voluntary care is entered into willingly. When an individual determines that their mental health is interfering with work, school or relationships in an unsustainable way, entering into a program may be the best option. These treatment centers help patients address mental health concerns without the stressors of daily life in a safe, secure and supportive environment.
Voluntary programs are less regimented than involuntary programs, but the structure is similar. When the goal is recovery, the journey understandably follows the same general path, so options like counseling and encouraging healthy habits are promoted during voluntary as well as involuntary treatment.
In a voluntary facility, patients can leave of their own volition. This is discouraged, particularly when in the midst of a course of care, but there is no way to stop residents from checking out against medical advice. Some states require a case petition before permitting such a leave.
What to Expect in Inpatient Mental Health Treatment
Inpatient mental health programs differ in treatment options and exact methodology, but some things tend to be similar from one program to another, both voluntary and involuntary. In general, this is what happens in a mental hospital.
Structure and Scheduling
Structure is very important in treatment programs of all kinds and tends to be featured heavily in inpatient mental health care. To facilitate results, residents are held to a strict schedule during the day in a mental hospital.
The day usually starts with time to shower, get dressed and get ready for breakfast. After breakfast, residents may engage in quiet time to read, journal or participate in a group therapy session.
TV time or an exercise break may occur before lunch. After lunch, residents may engage in another group session, individual counseling, exercise or recess, a meeting with a doctor or more quiet time. Some programs incorporate holistic treatments such as art therapy, yoga or music lessons, so these may be featured on the schedule as well.
After dinner, most programs allow for recreational time, like watching TV or movies, before bed. Lights out is also scheduled to make sure residents get adequate sleep.
Day-to-day, programming and scheduling change slightly, but the structure will be roughly the same. This approach may seem restrictive, but it is designed to provide a stable foundation for those going through therapy.
Encouragement of Healthy Habits
When in the midst of struggles with mental health, it’s not uncommon for healthy habits to fall by the wayside. Diet gets worse, exercise habits cease, sleeping becomes disrupted and self-care stops being important. Getting back on the right track is often a central part of a treatment program.
Most programs, both voluntary and involuntary, put a large emphasis on restoring healthy habits. A clean, healthy diet high in nutrients is encouraged while sleep is scheduled so that each resident gets at least eight hours.
Some programs also emphasize exercise or physical therapy so that residents benefit from the endorphins that come with exercise. While exercise is not necessarily a cure for mental illness, studies indicate that regular physical activity can support treatment in disorders like anxiety and depression.
Tackling these basics can go a long way in overall wellness, helping residents get into a better headspace while approaching treatment.
Customized Treatment Plans
Therapy isn’t one-size-fits-all, and that includes inpatient rehabilitation. While some programs may use roughly the same concepts with all patients, others are deeply committed to creating a customized plan of action.
Many treatment programs hold an initial individual session upon admission. In this assessment, trained psychologists or psychiatrists work to gain a deeper understanding of the condition or conditions at hand, past life experiences that may influence a diagnosis, prior attempts at treatments, medical history, medications in use and anything else that may affect a course of care. This information is then used to develop a treatment plan.
Group therapy is generally not customized — some facilities may run groups specific to disorders or symptoms; others may involve all patients — but individual counseling is. In these sessions, psychologists work to teach coping mechanisms, utilize proven therapeutic techniques like cognitive behavioral therapy and eye movement desensitization and reprocessing (EMDR), and otherwise do what is necessary to help patients see an improvement in symptoms.
The Bottom Line
Above all else, it’s very important to understand that all facilities are different and no two forms of care are identical. Different programs have different philosophies, different ways of addressing treatment, different approaches to medicine and different specialties. Even the length of mental health stay may vary greatly from one facility to the next.
If you are considering entering a voluntary inpatient mental health program, keep these elements in mind when comparing programs. To improve your chances of lasting success, you need to find the right approach for you.
From strict and traditional to holistic and alternative or a blend of the two, there’s a solution for everyone. Feel free to reach out to programs, tour facilities, speak to alumni and do your own research to explore which options are the most appropriate for your mental health needs.