Resource your guide to short-term hospitalization in the USA

[Lawliet]

hi everyone, i saw a similar guide like this for the UK and i wanted to do one for the US. i've been hospitalized short-time over seven times and have gathered a lot of knowledge. this is by no means a definitive guide, but perhaps it could help someone out. i am open to any and all questions but please note that this guide is for the USA, short-term stay (under a month) and public/connected to a hospital and adult unit. my stays have been in three separate places, so this guide is the summation of those stays and is not reflective of every hospital, obviously.

*i apologize in advance for my lack of capitalization, it's just one of my autistic quirks.

THE BASICS: i'm not sure if you plan to go to the emergency room or how you will do it, but if you have a plan to kill yourself you'll most definitely be committed, but that can be a double-edged sword as it could lead to long term institutionalization. they will run an initial risk assessment to determine how critical you are. if you are determined to be at risk which i believe you are, what they'll do is ask you to change into scrubs and they will inventory all of your items. you'll also get a physical health check and possibly a blood draw.

when you're committed, you're basically put on house arrest and given very limited things to do like coloring, arts/crafts/tv/physical activity. you start off wearing your scrubs and if you graduate to a higher level, you can get your street clothes so long as they are considered safe. and strings will be removed.

you'll meet with a series of people and have to explain your situation several times. they'll be different from your regular psychiatrist and counselor, but sometimes you can get your counselor involved if the hospital approves. their main goal is to make sure that you're safe and you're not going to commit suicide. they will try to establish a safety plan with your main psychiatrist, counselor, and any friends/family who can support you.

you will participate in group counseling sessions as well as individual ones. being with other patients can be potentially triggering so never hesitate to tell administration when you're uncomfortable. the techs are there to protect you and keep you secure.

MEDS: if you are on any medications, they will assess how well they're working and if need be, make any changes. this can take a long time, especially because the doctors are usually only there one day of the week, but it can ultimately be worth it. it's more typical to have long-term hospitalizations for major medication fixes.

DAILIES/PRIVILEGES: the food you get is hospital food. it's not the best and it's not the worst. a lot of places will have a little menu where you can choose what you'd like for breakfast, lunch, and dinner. snack time occurs between meals. you'll have a schedule for activities, whether "fun" ones or appointment-related. oftentimes you will meet at the end of the day and discuss the goals you've made with your caretaker and other patients. some places allow you to use a hospital phone to call out. these calls are monitored so be careful what you say. (*NOTE: i've never been to a facility where you're allowed to have electronics, so i would love more info on that from those who have) if you're on really good behavior you'll be able to have monitored visits. (note: during COVID these privileges may not be available, or at the very least masks will be a must.)

every item you want to bring into the facility will be checked out and deemed safe or not. again it varies, but some places let you have comfort items like blankets and stuffed animals (note: COVID could limit these possibilities, or just require these things to be washed.) i was able to bring books in and even my death note manga once (lmao i guess they weren't paying very close attention).

GETTING OUT: you want to be on your best behavior in order to get the best care and get out sooner. taking your meds, meeting with your providers, keeping yourself hygienic (showering and teeth brushing) and engaging with other patients in a positive way. when you're meeting with your providers, i recommend not telling them that you have a plan unless you want to get institutionalized long-term, and do not mention this website!! also, don't act like everything is perfectly fine because that will alert them and lose trust. be careful what you share with other patients as you never know who will snitch. what's really imperative is keeping yourself busy and engaged because it can be really boring and frustrating waiting around for the next doctor. work on earning more privileges to keep busy. creating a safety plan will be very important to your discharge.

**in closing, again if anyone has questions or i've left anything out (which i'm sure i hare) please let me know and i will answer to the best of my ability.

 

[Gyomei]

Thanks for this I live in Canada I hope this is similar. Can you decide to not see your family until you get out? I wouldn't want to.

 

[Lawliet]

Thanks for this I live in Canada I hope this is similar. Can you decide to not see your family until you get out? I wouldn't want to.

you can decide, especially as an adult. if your family isn't conducive to your health, you won't be forced to see them.

 

[chyme]

Some other information I could think of on the top of my head just from my experiences at various psychiatric hospitals in the South:

if the staff deems you as "behaving too aggressively" they have the right to forcefully sedate you. Even if you are rightfully upset about something, be careful about how you speak to the nurses/psychiatrist/counselors/etc.

For meals, they usually have everyone turn in their eating utensils in one place so they can take count at the end.

In addition to taking out any strings in clothes, if you have any bras with underwire, they'll either lock them up or cut the wires out.

Also for some reason every psych ward I've been to was always so cold... the staff's attitudes towards you, but I also mean literally; it's always freezing in there. You only get one light blanket to sleep with, so I'd always try to pack warmer clothes when I was able to.

 

[Lawliet]

Some other information I could think of on the top of my head just from my experiences at various psychiatric hospitals in the South:

if the staff deems you as "behaving too aggressively" they have the right to forcefully sedate you. Even if you are rightfully upset about something, be careful about how you speak to the nurses/psychiatrist/counselors/etc.

For meals, they usually have everyone turn in their eating utensils in one place so they can take count at the end.

In addition to taking out any strings in clothes, if you have any bras with underwire, they'll either lock them up or cut the wires out.

Also for some reason every psych ward I've been to was always so cold... the staff's attitudes towards you, but I also mean literally; it's always freezing in there. You only get one light blanket to sleep with, so I'd always try to pack warmer clothes when I was able to.

Thank you for these additions!!

 

[chloramine]

hi everyone, i saw a similar guide like this for the UK and i wanted to do one for the US. i've been hospitalized short-time over seven times and have gathered a lot of knowledge. this is by no means a definitive guide, but perhaps it could help someone out. i am open to any and all questions but please note that this guide is for the USA, short-term stay (under a month) and public/connected to a hospital and adult unit. my stays have been in three separate places, so this guide is the summation of those stays and is not reflective of every hospital, obviously.

*i apologize in advance for my lack of capitalization, it's just one of my autistic quirks.

THE BASICS: i'm not sure if you plan to go to the emergency room or how you will do it, but if you have a plan to kill yourself you'll most definitely be committed, but that can be a double-edged sword as it could lead to long term institutionalization. they will run an initial risk assessment to determine how critical you are. if you are determined to be at risk which i believe you are, what they'll do is ask you to change into scrubs and they will inventory all of your items. you'll also get a physical health check and possibly a blood draw.

when you're committed, you're basically put on house arrest and given very limited things to do like coloring, arts/crafts/tv/physical activity. you start off wearing your scrubs and if you graduate to a higher level, you can get your street clothes so long as they are considered safe. and strings will be removed.

you'll meet with a series of people and have to explain your situation several times. they'll be different from your regular psychiatrist and counselor, but sometimes you can get your counselor involved if the hospital approves. their main goal is to make sure that you're safe and you're not going to commit suicide. they will try to establish a safety plan with your main psychiatrist, counselor, and any friends/family who can support you.

you will participate in group counseling sessions as well as individual ones. being with other patients can be potentially triggering so never hesitate to tell administration when you're uncomfortable. the techs are there to protect you and keep you secure.

MEDS: if you are on any medications, they will assess how well they're working and if need be, make any changes. this can take a long time, especially because the doctors are usually only there one day of the week, but it can ultimately be worth it. it's more typical to have long-term hospitalizations for major medication fixes.

DAILIES/PRIVILEGES: the food you get is hospital food. it's not the best and it's not the worst. a lot of places will have a little menu where you can choose what you'd like for breakfast, lunch, and dinner. snack time occurs between meals. you'll have a schedule for activities, whether "fun" ones or appointment-related. oftentimes you will meet at the end of the day and discuss the goals you've made with your caretaker and other patients. some places allow you to use a hospital phone to call out. these calls are monitored so be careful what you say. (*NOTE: i've never been to a facility where you're allowed to have electronics, so i would love more info on that from those who have) if you're on really good behavior you'll be able to have monitored visits. (note: during COVID these privileges may not be available, or at the very least masks will be a must.)

every item you want to bring into the facility will be checked out and deemed safe or not. again it varies, but some places let you have comfort items like blankets and stuffed animals (note: COVID could limit these possibilities, or just require these things to be washed.) i was able to bring books in and even my death note manga once (lmao i guess they weren't paying very close attention).

GETTING OUT: you want to be on your best behavior in order to get the best care and get out sooner. taking your meds, meeting with your providers, keeping yourself hygienic (showering and teeth brushing) and engaging with other patients in a positive way. when you're meeting with your providers, i recommend not telling them that you have a plan unless you want to get institutionalized long-term, and do not mention this website!! also, don't act like everything is perfectly fine because that will alert them and lose trust. be careful what you share with other patients as you never know who will snitch. what's really imperative is keeping yourself busy and engaged because it can be really boring and frustrating waiting around for the next doctor. work on earning more privileges to keep busy. creating a safety plan will be very important to your discharge.

**in closing, again if anyone has questions or i've left anything out (which i'm sure i hare) please let me know and i will answer to the best of my ability.

This doesn't feel like you were describing it negatively necessarily and it still sounds absolutely terrifying and awful and just. A culmination of triggers.

 

[Lawliet]

This doesn't feel like you were describing it negatively necessarily and it still sounds absolutely terrifying and awful and just. A culmination of triggers.

it's honestly not a great place to be and i never found it to be helpful. but i also try to present it in the most neutral way possible. in the USA, these places are more like holding pens than places of healing. i have ptsd from them, but mostly from long-term, which i'm too traumatized to deal with at all. each state is different too and i live on one of the states with lowest mental health care.

i think i would rather someone bevhobest with me than go through shock.

 

[chloramine]

it's honestly not a great place to be and i never found it to be helpful. but i also try to present it in the most neutral way possible. in the USA, these places are more like holding pens than places of healing. i have ptsd from them, but mostly from long-term, which i'm too traumatized to deal with at all. each state is different too and i live on one of the states with lowest mental health care.

i think i would rather someone bevhobest with me than go through shock.

Oh honesty and knowing what you're getting into is definitely better. Thank you for sharing your experiences

 

[bananacrackers]

I have been considering a voluntary admission and this information is really helpful. Thank you so much for sharing. How many days do they normally keep you? If you go in voluntarily, are you able to leave when you want or are you kept there no matter what if you've admitted to suicidal thinking?

 

[jupiterwinds]

I have been considering a voluntary admission and this information is really helpful. Thank you so much for sharing. How many days do they normally keep you? If you go in voluntarily, are you able to leave when you want or are you kept there no matter what if you've admitted to suicidal thinking?

I was voluntary as a teen and they only had me inpatient the first time for a week or so before I did day program. The second time I did a couple of 2 week stretches (was discharged, day program, then went back in, discharged again). I actually didn't want to leave and they made me. But not sure if that's changed since this was about 15 years ago. Generally insurance won't want to pay for a long stay.

I would not want to ever go back to one, though. At least with my issues, there's no way they could help me since I'm disabled and have chronic pain. I think it's only helpful if you need urgent, monitored med changes, and be prepared to see and go through some scary shit and ableism and medical/psychiatric trauma.

 

[chyme]

I have been considering a voluntary admission and this information is really helpful. Thank you so much for sharing. How many days do they normally keep you? If you go in voluntarily, are you able to leave when you want or are you kept there no matter what if you've admitted to suicidal thinking?

They usually keep you anywhere between one to two weeks.
Regardless if you are voluntarily or involuntarily admitted, you are only able to leave once the hospital staff deems you stable enough to be discharged.

 

[symphony]

Some other information I could think of on the top of my head just from my experiences at various psychiatric hospitals in the South:

if the staff deems you as "behaving too aggressively" they have the right to forcefully sedate you. Even if you are rightfully upset about something, be careful about how you speak to the nurses/psychiatrist/counselors/etc.

For meals, they usually have everyone turn in their eating utensils in one place so they can take count at the end.

In addition to taking out any strings in clothes, if you have any bras with underwire, they'll either lock them up or cut the wires out.

Also for some reason every psych ward I've been to was always so cold... the staff's attitudes towards you, but I also mean literally; it's always freezing in there. You only get one light blanket to sleep with, so I'd always try to pack warmer clothes when I was able to.

Being sedated is fuuuuuun. And yes, women and people with breasts often have to go without bras unless you have a sports bra.

it's honestly not a great place to be and i never found it to be helpful. but i also try to present it in the most neutral way possible. in the USA, these places are more like holding pens than places of healing. i have ptsd from them, but mostly from long-term, which i'm too traumatized to deal with at all. each state is different too and i live on one of the states with lowest mental health care.

i think i would rather someone bevhobest with me than go through shock.

Yeeeah, I have some trauma from hospitalizations too.

 

[Lawliet]

just boosting this for anyone who might need it.

 

[☆AwaitingEntropy☆]

I've been curious about going in patient, as a last ditch effort, but I'm also nervous. The only mental hospital near me is notorious for being corrupt, over medicating, and uncaring, to the point where it has several cases against it.

 

[readyornot]

As someone who's been looking into hospitalization as a last resort, this was helpful, thank you!

 

[Lawliet]

I've been curious about going in patient, as a last ditch effort, but I'm also nervous. The only mental hospital near me is notorious for being corrupt, over medicating, and uncaring, to the point where it has several cases against it.

definitely do not go there then, i'm sorry that it's such a shifty option.

 

[Lawliet]

if there's any interest in an explanation for long-term psych wards, i could provide info on that. it's pretty triggering to me and pretty negative, but it maybe enlightening.

 

[MelancholyMagic]

i've been hospitalized short-time over seven times

How did you afford this? (broadly speaking, of course - please don't share any personal financial info)

 

[swanlake]

I had multiple hospitalizations and didn't find peace in any of them. The food is awful, there is no privacy. The nurses will open your door to check on you every 15 minutes, even through the night. The bathroom doors don't close, they are swing doors that have about a 2 foot gap on the bottom and 3 foot gap on the top. There are different activities that are about an hour long that you can choose to do. But for the most part, you just sit around watching tv. Depending on the hospital, you can pack ahead to make your stay more comfortable. If you're allowed, I would recommend bringing warm comfy clothes, a blanket, personal hygiene products, and some books. The wards I've been to were co-ed which sucked. I would have been more comfortable if they were gendered. The nurses hate their jobs (understandably) so a lot of them are unkind. It is definitely a last resort option. I don't think anyone should go in with the intention of being healed while you are there. Its goal is to stabilize you and prevent you from killing yourself during your stay there -- that's it. I have trauma from my hospitalizations. They are very expensive, even with healthcare.

 

[Lookingtotalk]

Also, the 72 hour thing is a joke if you are voluntarily committed. All it means is after 72 hours you are leaving but they also have the right if they feel you are not safe to involuntarily committ you. The only real way out is what OP said.

Little trick though, if you wound up there and really don't need to be there, ie drunk and said dumb stuff, if a doc insists on you taking a med you really do not want to be on, a lot of people 'take' their meds tongue it or throat it, and then go spit it in the toilet. Most nurses arent doing tongue checks, they would rather give u ur cup and go back on their phone.

 

[Lawliet]

How did you afford this? (broadly speaking, of course - please don't share any personal financial info)

i was on my parents insurance for a long time

 

[Lawliet]

i just had a friend check themself into a psych hospital, i gave them a guide similar to this. i think at one point i want to discuss my trauma from being in one, but it's too triggering a topic at the moment.

 

[AlighieriTTT]

if there's any interest in an explanation for long-term psych wards, i could provide info on that. it's pretty triggering to me and pretty negative, but it maybe enlightening.

I would love more info on this. If you don't want to share to the whole forum we could dm about it

 

[Lawliet]

boosting this for anyone in case they need it. one of my biggest fears in failing to CTB is to end up in one of these places again, although i don't know how they'd possibly keep me there with how poor my physical health is.

if anyone has had an actually positive experience, i'd be interested in hearing about it. where i live has one of the lowest rankings in mental health care in the usa.

 

[NambaSutra]

I once took an airplane to a "high-end" place (read: expensive). A few things were different. We were allowed shoelaces and phones and our own things generally, we stayed in nice little apartments, and took a van twice a day to a clinic and back. The days were full of various therapies like DBT and yoga and art therapy and stuff like that.

It was slightly less traumatizing that what OP describes, but ultimately still wasn't helpful at all. I've been wanting to CTB even more since I came back, in part because I no longer believe that treatments and therapies can work, even expensive ones.

 

[jorheslen428]

I have been considering a voluntary admission and this information is really helpful. Thank you so much for sharing. How many days do they normally keep you? If you go in voluntarily, are you able to leave when you want or are you kept there no matter what if you've admitted to suicidal thinking?

Most people usually like two weeks max. If you have a more serious problem could be longer. Longest I've been was two months.

 

[Lawliet]

Most people usually like two weeks max. If you have a more serious problem could be longer. Longest I've been was two months.

i cannot imagine two months. i was one month at a long term facility and it was the worst experience of my life

 

[unnormal9]

Guide:
If M1 Hold:
Put on the 'getting better' veil face and get out.

If Voluntary:
Why? Just don't even go there.

 

[jorheslen428]

i cannot imagine two months. i was one month at a long term facility and it was the worst experience of my life

To be fair I live in a state where mental health is pretty destimgatized, and I was also ok with being there that long because I thought they would help me find a medication that helped. Unfortunately they didn't