forced psych ward/hospital stay - how does it work?

[dinosavr]

I know it depends on a professional who you talk to and on the law in your area, but basically there is a rule that says that a patient can be admitted to psychiatric hospital even without consent when their life or health is in immediate danger. But I'm not sure how to interpret this.

So basically I'm planning to finally confront it and tell my psychotherapist that I feel awful and that I have constant urges to self harm and that I have a full plan ready for my suicide but also that I'm not going to do it anytime soon.
Do you think she will trust me and just explain the safety plan again or should I try not to be too honest with her? So that she can still provide proper care without forcing the immediate healing process on me.

I really don't know what to do. On one hand, I'm terrified, the psych wards in my city (or even the whole country lol) have really low opinions. On the other hand though, maybe I feel a little desperate to make it all a tiny bit easier to go through.

I still want to die, there's 99% of chance that I'll kill myself before I turn 30, but I swear I'm not ready yet. But I'm also aware she doesn't really have any reason to believe me, given that I was lying about my suicidal ideation for over 6 months.

 

[lacrimosa]

Well, not knowing what country you're from, I will try to enlighten you as to my experience in my own country.

This was during my last hospital stay.

Basically, I was spun out in a total state of psychosis, convinced I was going to kill myself... So, I went to the hospital to the emergency room, and said I am feeling suicidal... I did not falter or change my story in any way, shape, or form with the intake nurses. I just said I am feeling suicidal and I am going to CTB. They wanted to turn me away (lack of beds and whatnot) but I did not falter, and said I would not leave, I stated that I would even sleep in the overflow section for the emergency ward (which I did for 3 days while waiting for a bed) but I did not falter... You really have to stick to your guns if you want help in my country.

Now comes the next fun part, the psyche ward.

If you have depression, it isn't so bad because you're not suffering form paranoid delusions and the like... But, if you are suffering form psychosis, then it's no cakewalk and if you can, get a quiet or isolated room if you are having any delusions, even if they have to put you in a more secure area. Hell, do this if your gut instinct to harm yourself is high just incase... You will feel like a fish in a fishbowl and will be away from other patients but at least you can get some peace and they will pay more attention to you (doctors and nurses) and you will be discharged earlier if you comedown back to your baseline level of thinking. IE - your suicidal tendencies are low enough to consider you safe to yourself and others. This could also have the opposite effect if you decide to go into the more isolated/secure ward and your condition doesn't improve. Just don't try to escape or run away. I saw guards bodyslam a 100lb 16 year old girl who pulled the fire alarm because she was having a bad episode during my very first psyche ward stay in 2002.

If you state, in no uncertain terms, that you are planning to CTB, then you will be admitted by law and if there are a lack of beds, you will most likely be in and out... just get your meds after being treated as quickly as possible and get a referral for a long-term psychiatrist. Then you will go through the medication gauntlet trying to find something that works and sometimes it's worth it and sometimes the side effects are worse than the symptoms themselves... So, it's a crap shoot IMHO. Luckily, the medications to treat depression have way less side effects than medications used to treat psychosis (I've been on both anti-depressants and anti-psychotics), so you're luckier than me, especially if you only have to take anti-depressants.

In general, antidepressants tend to have fewer and less severe side effects compared to antipsychotics. Here's a breakdown:

Antidepressants:

1. Common side effects: These can include nausea, headache, insomnia or drowsiness, sexual dysfunction, and weight gain.
2. Serious side effects: Although rare, some antidepressants can cause more serious side effects such as increased suicidal thoughts in young adults, serotonin syndrome (especially when combined with other medications), and manic episodes in individuals with bipolar disorder.

Antipsychotics:

1. Common side effects: These often include weight gain, sedation, dizziness, dry mouth, constipation, and blurred vision.
2. Serious side effects: Antipsychotics can lead to more significant side effects such as movement disorders (like tardive dyskinesia), metabolic problems (such as diabetes and high cholesterol), increased risk of stroke in elderly patients with dementia, and in rare cases, neuroleptic malignant syndrome.

Key Differences:

• Frequency of serious side effects: Antipsychotics are more likely to cause serious side effects compared to antidepressants.
• Variability in side effects: The specific side effects vary greatly depending on the individual, the type of medication, and its dosage.

By the way, you are brave for seeking treatment and psyche wards are no picnic, and that's the brutal reality. But, you getting help at this point seems important to you so please do yourself a solid and get help if that's what you feel you need.

 

[Praestat_Mori]

I don't know about your local law and voluntary/involuntary (forced) admission to a psych ward. I understand that you may not want to kys and try to seek help somehow. But I would say if you really hope that they can help you then a voluntary admission is always preferable to an involuntary (forced) stay in a psych ward.

I would say if your therapist/psychiatrists suggests an admission to a psych ward after you tell them everything you would still have the option to go there voluntarily.

This is my opinion: Think about it very carefully if you really want to open up to them, I would only consider this step if I really had hopes they could help me - this is my personal opinion. I wish you all the best and I hope you make the right decisions for you.

 

[kyhoti]

Around my area, involuntary commitment is kind of a joke, especially if it's through insurance, because insurance will only pay for 7 days. If you're a stark raving lunatic, it's still only 10 days, WITH INSURANCE. Hospitals can issue a 72-hour psychiatric hold and if you don't have insurance, will turn you out after the time has passed. Rinse and repeat.

In that time, you get shot-gun blasted with a mix of meds, just to get you "manageable", then cut loose on the streets. Longer "treatment" has to be pre-approved, but is slightly better.

That said, if you WANT help, get your shrink to back you up, even if it means getting committed. Nothing is worse than wanting help and not getting it. Keep clawing away at it. Best of luck in your recovery journey.

 

[dinosavr]

Well, not knowing what country you're from, I will try to enlighten you as to my experience in my own country.

This was during my last hospital stay.

Basically, I was spun out in a total state of psychosis, convinced I was going to kill myself... So, I went to the hospital to the emergency room, and said I am feeling suicidal... I did not falter or change my story in any way, shape, or form with the intake nurses. I just said I am feeling suicidal and I am going to CTB. They wanted to turn me away (lack of beds and whatnot) but I did not falter, and said I would not leave, I stated that I would even sleep in the overflow section for the emergency ward (which I did for 3 days while waiting for a bed) but I did not falter... You really have to stick to your guns if you want help in my country.

Now comes the next fun part, the psyche ward.

If you have depression, it isn't so bad because you're not suffering form paranoid delusions and the like... But, if you are suffering form psychosis, then it's no cakewalk and if you can, get a quiet or isolated room if you are having any delusions, even if they have to put you in a more secure area. Hell, do this if your gut instinct to harm yourself is high just incase... You will feel like a fish in a fishbowl and will be away from other patients but at least you can get some peace and they will pay more attention to you (doctors and nurses) and you will be discharged earlier if you comedown back to your baseline level of thinking. IE - your suicidal tendencies are low enough to consider you safe to yourself and others. This could also have the opposite effect if you decide to go into the more isolated/secure ward and your condition doesn't improve. Just don't try to escape or run away. I saw guards bodyslam a 100lb 16 year old girl who pulled the fire alarm because she was having a bad episode during my very first psyche ward stay in 2002.

If you state, in no uncertain terms, that you are planning to CTB, then you will be admitted by law and if there are a lack of beds, you will most likely be in and out... just get your meds after being treated as quickly as possible and get a referral for a long-term psychiatrist. Then you will go through the medication gauntlet trying to find something that works and sometimes it's worth it and sometimes the side effects are worse than the symptoms themselves... So, it's a crap shoot IMHO. Luckily, the medications to treat depression have way less side effects than medications used to treat psychosis (I've been on both anti-depressants and anti-psychotics), so you're luckier than me, especially if you only have to take anti-depressants.

In general, antidepressants tend to have fewer and less severe side effects compared to antipsychotics. Here's a breakdown:

Antidepressants:

1. Common side effects: These can include nausea, headache, insomnia or drowsiness, sexual dysfunction, and weight gain.
2. Serious side effects: Although rare, some antidepressants can cause more serious side effects such as increased suicidal thoughts in young adults, serotonin syndrome (especially when combined with other medications), and manic episodes in individuals with bipolar disorder.

Antipsychotics:

1. Common side effects: These often include weight gain, sedation, dizziness, dry mouth, constipation, and blurred vision.
2. Serious side effects: Antipsychotics can lead to more significant side effects such as movement disorders (like tardive dyskinesia), metabolic problems (such as diabetes and high cholesterol), increased risk of stroke in elderly patients with dementia, and in rare cases, neuroleptic malignant syndrome.

Key Differences:

• Frequency of serious side effects: Antipsychotics are more likely to cause serious side effects compared to antidepressants.
• Variability in side effects: The specific side effects vary greatly depending on the individual, the type of medication, and its dosage.

By the way, you are brave for seeking treatment and psyche wards are no picnic, and that's the brutal reality. But, you getting help at this point seems important to you so please do yourself a solid and get help if that's what you feel you need.

Thank you for your exhaustive response, it really gives me at least some perspective on how it looks in reality and what I may expect.

I don't know about your local law and voluntary/involuntary (forced) admission to a psych ward. I understand that you may not want to kys and try to seek help somehow. But I would say if you really hope that they can help you then a voluntary admission is always preferable to an involuntary (forced) stay in a psych ward.

I would say if your therapist/psychiatrists suggests an admission to a psych ward after you tell them everything you would still have the option to go there voluntarily.

This is my opinion: Think about it very carefully if you really want to open up to them, I would only consider this step if I really had hopes they could help me - this is my personal opinion. I wish you all the best and I hope you make the right decisions for you.

Could you please precise what you mean by a voluntary admission being better to an involuntary? Do they treat you differently?
And thank you for sharing your opinion. Anyway I have social anxiety and I totally don't believe in healing in such hospitals (unless maybe they give you the meds that you need but it would be a miracle) so unless it's absolutely necessary I'll try not to get assessed. But I'll think about it, if I really have anything to lose.

Around my area, involuntary commitment is kind of a joke, especially if it's through insurance, because insurance will only pay for 7 days. If you're a stark raving lunatic, it's still only 10 days, WITH INSURANCE. Hospitals can issue a 72-hour psychiatric hold and if you don't have insurance, will turn you out after the time has passed. Rinse and repeat.

In that time, you get shot-gun blasted with a mix of meds, just to get you "manageable", then cut loose on the streets. Longer "treatment" has to be pre-approved, but is slightly better.

That said, if you WANT help, get your shrink to back you up, even if it means getting committed. Nothing is worse than wanting help and not getting it. Keep clawing away at it. Best of luck in your recovery journey.

God, in my area at least it's for free so I guess it's a positive side. On the other hand, it's actually difficult to be admitted. I've heard stories of people who were basically right after their suicide attempt and they claimed to try it again in the closest future, but they still didn't get a bed in there. And it's not that the nurses are so cruel, but the whole system doesn't work so there's no place for new patients. So it will for sure make me feel like I shouldn't be there cause there are people who need help way more than me or these who at least are sure they would like to recover.

 

[Praestat_Mori]

Could you please precise what you mean by a voluntary admission being better to an involuntary? Do they treat you differently?

I have no experience with psych wards but I think I read somewhere here that if you admit yourself voluntarily you have more freedom you may even be able to leave whenever you want. As I understand it - involunary = they can force any meds and treatments on you to "save you". I assume it depends on laws where you live how it actually is handled.

Perhaps there's someone here who went there voluntarily / involuntarily and they can report first hand about their experience.

 

[dinosavr]

I have no experience with psych wards but I think I read somewhere here that if you admit yourself voluntarily you have more freedom you may even be able to leave whenever you want. As I understand it - involunary = they can force any meds and treatments on you to "save you". I assume it depends on laws where you live how it actually is handled.

Perhaps there's someone here who went there voluntarily / involuntarily and they can report first hand about their experience.

Oh right, it makes a lot of sense. Thank you!
So I think the plan is I'll refuse but if she insists I won't fight and I guess just see how it goes.

 

[Praestat_Mori]

Oh right, it makes a lot of sense. Thank you!
So I think the plan is I'll refuse but if she insists I won't fight and I guess just see how it goes.

Good luck and hopefully recovery whatever you decide to do!

 

[headswillroll]

I have no experience with psych wards but I think I read somewhere here that if you admit yourself voluntarily you have more freedom you may even be able to leave whenever you want. As I understand it - involunary = they can force any meds and treatments on you to "save you". I assume it depends on laws where you live how it actually is handled.

Perhaps there's someone here who went there voluntarily / involuntarily and they can report first hand about their experience.

One of my greatest fears - involuntary medical treatment.

 

[dinosavr]

Update: Okay so basically she didn't even think to tell me to go to the hospital, she just suggested that I should go there when it gets worse because my coward ass didn't have the guts to tell her that I do have a plan. Very specific fucking plan.
And unfortunately it didn't make me feel better, maybe just a little less overwhelmed because she made me realize even more that life is a nightmare and healing requires a lot of things that I cant even imagine to provide. I'm stuck forever. Good fucking job Alex :)

Update: Okay so basically she didn't even think to tell me to go to the hospital, she just suggested that I should go there when it gets worse because my coward ass didn't have the guts to tell her that I do have a plan. Very specific fucking plan.
And unfortunately it didn't make me feel better, maybe just a little less overwhelmed because she made me realize even more that life is a nightmare and healing requires a lot of things that I cant even imagine to provide. I'm stuck forever. Good fucking job Alex :)

She also said that I'm right, after some time no one will really care that I'm not there anymore and that suicide is my decision and I can always do it. Good thing she didn't lie at least.

 

[ScC]

In my state, if you admit to being suicidal they will first take you to the ER for supervision. A pyschiatrist will come and evaluate you up to 24 hours later, then they make the decision whether to release you or admit you to another facility. If they want to admit you, they will ask you if you will voluntarily go. If you do voluntarily admit yourself, you will be out sooner than involuntary (usually 3-5 days)

Once you are admitted to the ER if you change your mind about suicide. You will easily be able to convince the psychiatrist to release you.