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Life Inside a Psychiatric/Mental Hospital

Updated on August 9, 2013

Life Inside a Psychiatric Hospital

Having been a mental health nurse who has worked in an in-patient psychiatric facility for 6 years and taught mental health nursing for 4 years, I have seen a lot of misconceptions about mental health and illness and the treatments of patients. In an effort to better inform the public, I wrote this article about myths and facts of psychiatric hospitals. Whether you are someone who suffers from mental illness, someone who loves someone with a mental illness, a healthcare professional looking to begin working in a mental healthcare facility, or just generally curious about what it is like on the other side of the locked door, this article describes what it is really like inside a psychiatric hospital.

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Before continuing this article...

...take the short quiz below to see how informed you are about the realities of what it is like inside of a mental hospital. You may be surprised by what you do or don't know!

The Cuckoo's Nest: Fact Vs. Fiction

You may have seen many movies that portray life inside a psychiatric facility. One Flew Over the Cuckoo's Nest, A Beautiful Mind, Girl, Interrupted, or Shutter Island are just a few of the many movies that are based in or around psychiatric facilities. Unfortunately, much of what you see in film is exaggerated for dramatic impact or is simply inaccurate. However, some of what you see is real. It is important to know the difference between fact and fiction, so that you or your loved one is prepared for what to expect.

For example, if you watch Jack Nicholson receiving electroconvulsive therapy (ECT) in One Flew Over the Cuckoo's Nest, what you are seeing is a very dramatic and completely inaccurate portrayal of the actual treatment given today. Current ECT procedure anesthetizes the patient and relaxes the patient's muscles. The patient does not have an actual motor seizure, meaning there is no jerking around on the table, no biting tongues off, no screaming, and no horrific memories of the event. In fact, an ECT procedure nowadays is rather boring to watch, much more like a routine dental surgery than anything you have seen in a movie.

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Common Misconceptions

As a psychiatric nursing instructor, I take nursing students into a locked-door psychiatric facility. The majority of my students have never been in a psychiatric hospital and many of them are utterly shocked at what they see there.

Some common misconceptions I have heard include:

  • Patients will be in straight-jackets.
  • Most patients are violent.
  • Hospital staff, including psychiatrists, nurses, and assistants, are cruel to the patients.
  • Patients are routinely tortured.
  • Almost all patients will be strapped to a bed in restraints.
  • Patients often are rapists, murderers, and the like.
  • Patients are forced to take medications and receive "shock treatments" against their will.
  • Lots of patients commit suicide in the hospital.
  • Patients will all be in hospital gowns.
  • Patients are isolated from everyone else.
  • Patients cannot have visitors or phone calls.
  • Everyone will know if you are admitted to a psychiatric hospital.

Of course, there are many other misconceptions or questions I have encountered, but these are the most common.

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The Reality

The reality is it is a very frightening place, but not for the reasons you might think. This is what usually upsets my students:

  • Mental illness can happen to anyone any time. No one is immune.
  • Friends and family give up on their loved ones when they suffer from chronic mental illnesses. Many patients have nowhere to go when they are discharged.
  • Freedoms are limited in a psychiatric hospital; you do not get shoelaces, extension cords, razor blades, fingernail clippers, make-up mirrors, and so much more. You shower during shower time, you eat during mealtime, you go to group during group time, etc.
  • Not all of the staff is friendly and/or helpful. Of course, it would be a far better place if this were the case, but when you are dealing with people, you are going to encounter some bad attitudes or great people having bad days. That is reality. Odds are that if you are respectful to the staff, they will be respectful to you. However, staff are overwhelmingly helpful to children and patients who are out of touch with reality.
  • There is a huge stigma related to mental illness. It is not as bad as it used to be, but it is still there. Patients are afraid to tell their parents, their children, their bosses, and their friends. We wonder why people "suddenly" go crazy. They didn't; they just didn't tell us something was wrong.
  • Some patients are violent. It does not happen on a regular basis, but sometimes patients do become violent. When that happens, staff are trained to go quickly to the area and help the patient regain control without harming him/herself or others. This will involve verbal de-escalation, and sometimes physical holding the patient, or placing the patient in restraints. Patients also may receive oral or injected medication, like Ativan, Benadryl, Haldol, Thorazine, Geodon, etc.
  • Some patients really are psychotic. Talking to people who are not there, laughing hysterically at nothing we can see, dry humping furniture, cowering behind objects out of fear, looking over their shoulder for the CIA, shouting biblical prophesies, and the list never ends. This part, as much as we may wish it did not exist, does exist.

You may wonder why anyone would ever choose this field of work. Again, there are a lot of reasons, but the most outstanding reason among my colleagues is simply the desire to help those who have been left behind by society. We do not want the glory or the god-like worship of working in surgery or some of the other more fashionable areas of nursing. What we want is pure, elementary, and simple; we want to help when no one else does.

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Moving Beyond the Fear

One of my life's passions is destroying the stigma of mental illness. It is a long, hard road. My more medical-minded colleagues look at me incredulously when I say, "We cannot judge the addicted person. We do not understand all there is to know about addiction. Years from now, we may find that some people's brains are hard-wired toward risk-taking behavior." Some people do not want to hear this. Some people have a hard time letting go of unfounded beliefs. I will continue to fight this fight until I can no longer pass words between my lips, and then, I will hold a sign.

Every person who reads this gets me one step closer to my goal. Thank you so much for stopping by.

Sybil

Sybil provides an excellent portrayal of severe dissociative identity disorder (DID), previously known as multiple personality disorder. While the film is several decades old now, Sally Field's performance is timeless. The story is based on real life events of a woman with DID.

One Flew Over the Cuckoo's Nest

This film is one of Jack Nicholson's best. His performance as a patient with antisocial personality disorder in a mental hospital is an absolute creative masterpiece. Like Sybil, this film also is several decades old, but remains a classic. When watching this particular film, understand that much of what you see is based on historical treatments of mentally ill patients. Very little of what you see in this film happens in current psychiatry. Nonetheless, it is recommended, if for nothing else, just to see Jack Nicholson's performance.

A Beautiful Mind

For an insider's perspective of paranoid schizophrenia, you cannot miss Russell Crowe's portrayal of John Nash, a West Virginia man who, even with a severely debilitating mental illness, won a Nobel Prize in Economics. This is an outstanding film with lots of great examples of various symptoms of paranoid schizophrenia and a brief look at insulin-induced shock therapy.

Shutter Island

Without giving any spoilers, it is difficult to describe how this movie applies to mental illness. However, if you are interested in a newer film rather than, or in addition to watching some older films on mental illness, this one is pretty good. Leonardo DiCaprio is very engaging and enjoyable to watch.

© 2012 Leah Wells-Marshburn

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    • meloncauli profile image

      meloncauli 4 years ago from UK

      What a great hub! Accurate and fair. Voted up and useful.

    • profile image

      Brittany Setser 4 years ago

      I work in a person care facility that is very similar to this, when out residents/patients become hard to handle we send them to a behavior unit for medicine change. They do see things talk to their self, and most were normal before they had a nervous break down. No one is there for them. I love my job. You have to have heart to work around people like that, cause they will scare you, or break your heart. The ones that see things I have a being around them cause I can't hardly be professional about it, due to the fact of laughing. I related to everything you said.

    • Author Cheryl profile image

      Cheryl 4 years ago

      I can't say that I would feel sorry for rapist and murderers to be mistreated but the other yes. I also work in healthcare and have been on these units but I never saw staff mistreating the patients ever. Mental illness is a horrible thing for anyone to endure but they do not deserve to be abused because they can not help it.

    • Camille Harris profile image

      Camille H 4 years ago from SF Bay Area

      Hi Nurse Leah. Thank you for writing such an important Hub. I've never visited a psychiatric facility, but have family members who were placed in them. I frequently question why the stigmatizing of mental illness persists when we know more and more about the origins of these illnesses and how frequently they affect us (about 25% of US citizens have a mental illness!). We need more "soldiers" in the fight against discrimination and ignorance. Thank you for being one. Keep on writing!

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Thank you so much meloncauli, Brittany, Cheryl, and Camille. Cheryl, I have only seen something I would call abusive twice, and in both cases, the staff members were terminated afterwards. However, bad attitudes exist throughout healthcare. I have worked in several facilities and have seen nontherapeutic communication in all of them, from doctors, nurses, nursing assistants, social workers, dietitians, physical therapists and more. It is unfortunate that one person's negative attitude can change another person's life.

      Camille, you sound like a soldier too! Thank you for your feedback. It gives me the motivation to continue when I read comments like yours.

      Brittany, you are right; it does take a lot of heart to do this type of work. I'm proud of you and urge you to continue. Have you thought of going back to school to become an LPN or RN? It sounds like you love the work, and we certainly need more people like you in this field.

    • onlygrace profile image

      onlygrace 4 years ago

      You have a wonderful vision as a nurse on mental hospital. Yes they are the one that has been abandoned by their family, they need someone that truly care, like you and your colleagues. Keep up your spirit

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Thank you, onlygrace, for your comment. Most of the time, my spirit stays up all by itself, but sometimes I need to remind myself of what I am doing and why.

    • profile image

      Debi 4 years ago

      Thankyou Leah, All of this important information is so comforting. I have a daughter who has been diagnosed with bipolar disorder and an ex husband diagnosed with ASPD. I read uup on everythingthaat invilved ASPD and its him to a tee. I had told him once that he owed me 20 dollars he boerowed and he manipulated the. Situation aand told me well I take out the garbage.Everythig is just dead on. Thankyou i

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Debi, thank you for your feedback. It can be a frightening experience for someone you love to have a mental illness. Your ex sounds like he did have some serious issues!

      I hope your daughter is getting all the help she needs. Bipolar disorder can be scary, but it is very treatable. Hopefully, with the right treatment plan, she will be able to live her life fully and without much more difficulty than the average young woman.

    • ladydeonne profile image

      Deonne Anderson 4 years ago from Florence, SC

      Leah,

      I can sense your passion and love for your work with the mentally ill. Kudos on your mission! Change begins with one person and then another...and then another.... I also loved working with individuals in psychiatric hospitals, day treatment, and special housing. My career as a Mental Health Therapist was very fulfilling and rewarding. I would not have traded my work with the chronic mentally ill for one in a plush office with "normal" individuals. Thanks for all that you do!

    • SaritaJBonita profile image

      Sarah Jane Bourdeau 4 years ago from Upstate New York

      This is hands down the best article I've read about inpatient care. I have Bipolar Disorder and have been on the "other side" of that locked door. Your Hub is an accurate, heartfelt, and non sugar-coated insight that so many people need to hear!

      Thank you, voted up, awesome, and shared...

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Wow! Thank you so much for the wonderful compliment on the article! I think this is information the world needs to know and understand. I really appreciate your feedback.

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Ladydeonne, thank you for your feedback. I feel like I am among the minority sometimes in my love of this field, so it is nice to hear from like-minded strangers. Mental health therapists are a huge part of the foundation of successful treatment of people who suffer from mental illnesses. I am grateful to you and so many others who have chosen "fulfilling and rewarding" over "plush."

    • wvugirl2007 profile image

      wvugirl2007 4 years ago from Virginia

      This article is very interesting. I know people who have been placed in a hospital, but that was during the darker days of mental illness. I was glad to see that my views on the subject concerning the hospitals today was correct with my score on the quiz. I continue to hope that the care the patients receive continues to improve with more knowledge.

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      wvugirl2007, yes, I too hope that things continue to get better. With more research and attention, things should change in the future. Psychiatric illness just doesn't get the attention that some of the other illnesses get, so less people put money into donations and time into promotion of education and research. Thank you for stopping by and for the comment. I'm glad to see you took the quiz as well!

    • self-counsel profile image

      self-counsel 4 years ago

      There are many helpless patient inside a psychiatric hospital. They need love, understanding, and support more than anything else. There are a lot of misconceptions about people with poor state of mental health. "Normal" people should look beyond what they could see from the outside.

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Absolutely, self-counsel! I agree completely. People have a tendency to jump to conclusions or base opinions on previous experiences, or worse, what they've seen in movies.

    • CEZern profile image

      CEZern 3 years ago

      Hello!

      I have been writing a persuasive speech for my middle - school debate class on how to stop the copious amounts of gun-related deaths, and I was looking into how people with mental illnesses (the main cause for gun-related deaths) when I ran into your article. It was definitely an eye-opener, but I am still curious to where the mentally-ill people who are rapists and murderers go. Have you ever encountered them?

      Thank you for a great read on a fascinating topic,

      Charli Zern.

    • ThatMommyBlogger profile image

      Missy 18 months ago from The Midwest

      Great hub.

    • grand old lady profile image

      Mona Sabalones Gonzalez 10 months ago from Philippines

      This is a wonderful and enlightening article, which helps people to learn how medication and treatment have changed and improved from the past. I was particularly delighted to learn that electric therapy is now used to calm the patient rather than to hurt them, causing their bodies to distort in pain. I wish more people would read this article because the stigma attached to mental illness is really distorted. I also appreciate your recommending movies to have a more accurate understanding of life in a mental hospital.

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