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Inpatient Psychiatric Admissions: Forget the Cuckoo’s Nest!

Stigma regarding the emotional and mental disorders is tough enough to deal with. But when it comes to an inpatient psychiatric admission, it’s just downright cruel. Let’s talk about it.

In fact, there’s so much to discuss, I’m going to make this a two-parter.

It’s reality – those of us enduring depression, anxiety, or bipolar disorder may face an inpatient psychiatric admission. Many already have. I think most folks have this vision of the unit on which Jack Nicholson played R.P. McMurphy in the film, One Flew Over the Cuckoo’s Nest. And, of course, there’s a Nurse Ratched or two thrown in for good measure.

But it’s not like that today. And I believe facilities, as well as care, continue to improve. In fact, the image is a pre-construction rendering of a psychiatric facility in Denmark; completed in 2006.

Okay, so whether you walked-in, had an assessment appointment, or were transported from an E.R. – you’re about to be admitted into an inpatient psychiatric facility. What to expect? Well, I’ve worked in numerous facilities, so let’s chat.

First and foremost, the quality of the facility, as well as the care, varies. And, unfortunately, much of this is driven by insurance. If you have private health insurance, Medicare, or Medicaid your experience will likely be more pleasant than the person who has no insurance – unfunded, as they say in the biz.

But that isn’t to say state operated facilities for the unfunded are Cuckoo’s Nests. Not at all. It’s just that they may not be as, shall we say – cushy.

Well, the first order of business is the sign-in protocol. If you’re being admitted on a petition and certificate (P&C), you, unfortunately, have nothing to say about it. And in Illinois, they’re drafted when one is thought to pose a threat to themselves or others, doesn’t have the ability to understand their need for care, and/or is incapable of caring for themselves.

If you’re being admitted in this manner, you must be examined by a psychiatrist within 24 hours. And in Illinois, you must be offered the opportunity to voluntary admit within 12 hours. In either case, you have to be given a copy of the documents keeping you against your will; as well as a copy of the rights which were verbalized to you.

Now, let’s say you’re o.k. with the admission; or you’ve been given the opportunity to sign-in after being admitted involuntarily. In many facilities, the slang for the voluntary admission document is a “five-day.”

Simply, you’re “signing yourself in” for a period of time not to exceed five business days. You have the right to request your discharge at any time; and a psychiatrist can trump you only if he/she believes you meet the criteria for an involuntary admission.

Your rights (different from the P&C rights) are to be read to you before you sign-in. And a copy of the document is to be given to you after you sign.

One other very important note here. Anyone being admitted must be medically appropriate. So that means if you were to come in – say – having difficulty breathing, you’ll be referred to the E.R. for medical clearance.

Well, let’s put the brakes on for today. Much more to come tomorrow as we talk about what happens on the way to the unit, and after arriving.

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image credit   architonic.com