Life Inside a Psychiatric/Mental Hospital
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.
Before continuing this article...
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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.
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.
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.
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 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.
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