It’s funny, because although no one would ever question a hospitalisation for physical illness, inpatient treatment for mental illness – and for that matter rehab for drug/alcohol addiction – can often come under scrutiny. There is a school of thought that while hospitalisation may be beneficial in the short term, at the end of the day us crazies or drug addicts have to return to the real world, stop hiding out, and deal with the problem.
And yeah this is true. I get that. I have little doubt that there are people out there who, particularly in the case of mental illness, prefer being in hospital to being at home. I met a few. They were basically homeless and hospital offered them a sanctuary. In hospital you are freed from responsibilities. You don’t have to work. You get your meals cooked for you. You get a bed and someone changes your sheets and cleans the toilet. Just like with jail, where offenders break parole to get back inside, institutionalisation is a real thing, and a real problem for some people.
But, you’ve got to understand, when you are in hospital you lose your basic rights. Privacy for starters. Ever tried going to the toilet with a nurse watching you? Had to point out the diagram (on a seven point scale, with one being “you’re never gonna pass those rocks” and seven being “basically a puddle of brown water”) that best illustrates your latest bowel movement? Had absolutely no choice as to what instruments are poked into your various orafices? Whether you are hospitalised for physical reasons or mental reasons you become property of the medical system. And that ain’t fun.
While you are in hospital you have to put up with a lot of shit. Sharing rooms with people who snore or basically don’t understand what a toilet flush is. Eating reconstituted crap for dinner. Other people’s noisy visitors. People stealing the food you store in the patient fridge. Getting no choice as to what to watch on TV. Only getting to see your loved ones at certain times of the day. Having your clothes and possessions confiscated.
If all that is better than being at home, everyday life has got to be pretty damn hard. The two times I was hospitalised because I ASKED to be hospitalised, life WAS extremely hard. Both times I fought and fought for months, eventually realised that I was going to get extremely unwell or possibly do some damage to myself, and asked for inpatient treatment. It was a last ditch effort. It didn’t occur to me that I could be hiding from life. I just wanted to get better, and hospitalisation was my final option, so I COULD get back to my life.
For each of my hospitalisations, whether for physical or mental reasons, I have been admitted because I was not well enough to cope without 24/7 care, and I was released when I was well enough to care for myself. Whether I was an inpatient for bipolar disorder, the delivery of a newborn, ovarian torsion, surgery, or my autoimmune disease is irrelevant. Whether I stayed for 24 hours of nearly half a year is irrelevant. Each of those times I needed care. I received it. Then I went home. Most of those times I had little choice. All of those times I did not want to be in hospital, and left as soon as I was medically fit.
For each of my hospitalisations, whether for physical or mental reasons, I have also had to go back into the real world, learn to dress my wounds by myself, remember to take my medication, stop lying in bed all day, and continue my recovery on my own. I knew this and I accepted this. And for each of those occasions I was practically begging my doctors to be released.
But this is my personal experience, and I know everyone is different. I do understand where people are coming from when they question the value of hospitalisation, in particular long term hospitalisation. It is not a natural environment. It isn’t an ideal situation.
However, hospitalisation for any illness is less than ideal. For patient comfort, to retain some semblance of a normal life, and, yes, due to the strain on the health system, outpatient treatment for all illnesses is always preferred. But sometimes people need more than outpatient treatment. And the choice (or the un-choice) of being admitted into a psychiatric facility, or going into rehab to kick your drug habit, should be respected in the same manner as physical hospitalisations are.
While I was in the mother and baby unit, I voiced these issues to a nurse. I told her that I was worried that people would think I was just “hiding” from the real world. I didn’t want people to think less of me for receiving inpatient psychiatric care.
She just laughed and told me “Rachael. You’re not in Club Med. You’re in hospital. You’re REALLY REALLY sick, and we are helping you get better. You NEED to be here. Just like you would NEED to be in hospital if you had appendicitis. And they are not going to let you go until we know you will be safe.”
For me, personally, hospitalisation, being torn away from my family, giving up my rights and freedom, and being subject to unpleasant tests and experiences is pretty high on my list of Things I Like To Avoid. But in saying that, despite my complaining, my hospitalisations for mental illness have saved my life. And for that I will be ever thankful.
What is your opinion of psychiatric hospitalisations?