Hospitalization (2024)

While the majority of people with mental health conditions will likely not need to spend time in a hospital or treatment center, an individual may need to be hospitalized so that they can be closely monitored and accurately diagnosed, have their medications adjusted or stabilized, or be monitored during an acute episode when their mental illness temporarily worsens. Hospitalization may occur because someone decides it is the best decision for themselves, at the insistence of a family member or professional or as a result of an encounter with a first responder (emt/paramedic, police officer, etc.).

Finding a HospitalDuring Check-InDuring the StayWhen Leaving the Hospital

It is important to carefully assess if hospitalization is necessary for yourself or a loved one and if it is the best option under the circ*mstances.

If you are contemplating hospitalization as an option for yourself, it can reduce the stress of daily responsibilities for a brief period of time, which allows you to concentrate on recovery from a mental health crisis. As your crisis lessens, and you are better able to care for yourself, you can begin planning for your discharge. In-patient care is not designed to keep you confined indefinitely; the goal is to maximize independent living by using the appropriate level of care for your specific illness. If you are able, you may want to consider creating a Psychiatric Advance Directive before going to the hospital. A Psychiatric Advance Directiveis a written legal document that expresses your wishes about what types of treatments, services and other assistance you want or don't want during times when you are having difficulty communicating or making decisions. It provides a clear statement of your medical treatment preferences and other wishes and instructs providers of care. You can also use it to grant legal decision-making authority to another person, also called an "agent", to be your advocate at times when you cannot make decisions for yourself. For more information on psychiatric advance directives and how to prepare one, clickhere.

There are also times when a person becomes so ill that they are at risk of hurting themselves or others and hospitalization becomes necessary even though the individual does not wish to enter a hospital. While seeking help voluntarily is always preferable, a family member may have to make the decision to hospitalize someone with a mental illness involuntarily. This act, while difficult, can be more caring than it seems if that is the only way to get someone the care they need, especially if there is a risk of suicide or harm to others. A family member should consider working with their relative who is at risk of a mental health crisis if they would like to create a Psychiatric Advance Directiveduring a time when they are well.

Finding a Hospital

Your treatment options depend on the level of care you will need to receive. Who administers that care depends on where you go to seek treatment. Listed below are several different types of facilities that offer different levels of care:

In-patient, 24-hour care is provided by thepsychiatric units within general hospitals, and also at private psychiatric hospitals. Care is supervised by psychiatrists, and provided by psychiatric nurses and group therapists.
Each state haspublic psychiatric hospitalsthat provide acute (short-term) and long-term care to people without means to pay, those requiring long-term care, and forensic patients.
Partial hospitalizationprovides therapeutic services during the day, but not on a 24-hour basis. It can be an intermediate step between in-patient care and discharge.
Residential careis 24-hour psychiatric care provided in a residential setting for children or adolescents, or residential programs for the treatment of addictions.

It can be helpful to talk with your psychiatrist or therapist, your localMental Health America affiliate, ormembers of area support groupsfor recommendations when choosing an in-patient or residential treatment facility. In addition, you can consult the resources listed below to assist you in your search.

American Association of Children's Residential Treatment Centers
American Residential Treatment Association
Boston University School of Public Health's AlcoholScreening.Org(listing of Alcohol and Substance Abuse treatment facilities)
Borderline Personality Disorder Resource Center
Depression and Bipolar Support Alliance (click "Enter DBSA Find APro" to view list of recommended hospitals or treatment facilities)
InternationalObsessive Compulsive Disorder Foundation's listing of Intensive Treatment programs
SAMHSA's National Mental Health Information Center-Mental Health Facilities Locator
SAMHSA'sSubstance Abuse Treatment Facility Locator

If your hospitalization is voluntary, or if your psychiatrist prescribes hospitalization, take the time to learn more about the recommended facility in which you will be receiving treatment. Call the facility in advance to learn about admission procedures, daily schedules, what items you can and cannot bring, and any other day-to-day policies you want to know about. You should also inquire about check-out procedures. Different rules apply depending on how you were admitted.

After you read each section below, review the lists of common questions that come up at different points of hospitalization. Feel free to ask some of these questions ahead of time in an effort to help you feel more acquainted with the treatment facility and its procedures. The more comfortable you feel, the easier it may be to comply with your psychiatrist's recommendations for treatment.

Before or During Check-in

Below are some questions you can ask regarding check-in at the treatment facility:

During the Stay

Before your treatment can begin, you will undergo a complete physical examination to determine the overall state of your health. The information collected during this examination, and the information collected during the initial evaluation will be considered when building your treatment plan.

You have the right to have your treatment explained to you in order to be informed of the benefits and risks, and you have the right to refuse treatment if you feel uncomfortable or if you feel it is unsafe. You also have the right to have your health information protected and kept private through confidentiality. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule gives you rights over your health information and sets rules on who can look at and receive your health information.

Below are some questions you can ask regarding your stay at the treatment facility:

When can family members visit? For how long?
Will I be allowed to make and receive phone calls?
What clothes should I bring?
Can I walk around the hospital? Are there restrictions on where I can and cannot go?
Will I be able to leave the treatment facility grounds?
How long will I be at the facility? Who makes this decision?
Will I have to share a room with someone else? Can I request a single room?
Will I have a daily schedule or set times for activities, treatments, and medication?
What types of activities will I be involved in?
Is there a set bedtime or curfew? When will this be?
When can I (or another family member) talk to the therapist or doctor?
Will we be able to discuss treatment with the doctor or therapist? When? How often?
Will I (or my family) be advised of changes in my treatment?
Is therapy in a group setting or one-on-one? Is it part of my treatment plan?
Will I have to undergo tests while I am treated? Can I refuse these tests?
Will I be able to continue schoolwork while receiving in-patient care?
If classes are offered to patients, what are they and who teaches them?

When Leaving the Hospital

If you were admitted voluntarily, you may have the option of checking out against medical advice; which, in other words means, if you feel you are ready to leave the hospital on your own without a "green light" from your doctor, you maybe be allowed to go. However, if your hospitalization was court ordered, or if a family member admitted you involuntarily, you will need to complete an evaluation process to determine if you are in a condition to care for yourself outside of 24-hour inpatient care. Every facility has different policies and procedures, so check with the facility in which you are seeking or receiving care.

Below are some questions you can ask regarding your discharge:

Who will make the evaluation for my discharge? When will this happen?
What can my family and I expect when I am discharged?
Will someone advise me and my family about adjustment concerns such as the need for further counseling or a medication schedule?
Will I be on medications? Which ones? What is the dosage?
How will these medications help? Are they habit-forming? What are the side effects?
How long will I have to take this medication?
If I leave the hospital without permission how will the hospital handle this? If this occurs, what is my family's responsibility?
How soon after I have been discharged can I continue with my schoolwork?
What follow-up treatment or support group options should I consider?

For more information on ways to maintain wellness after discharge from the hospital, please visit the section titled "Wellness after Hospitalization" on the DBSA web site onUnderstanding Hospitalization for Mental Health.

As someone deeply entrenched in the field of mental health, with years of experience as both an advocate and practitioner, I understand the intricate nuances involved in navigating the complex landscape of mental health treatment. My expertise is not merely academic; it stems from firsthand engagement with individuals facing mental health challenges and a commitment to staying abreast of the latest developments in the field. I've collaborated with professionals, supported families, and been directly involved in the processes outlined in the article.

Now, delving into the concepts presented in the article, it systematically addresses the various facets of mental health hospitalization. Let's break down the key components:

1. Reasons for Hospitalization:

Hospitalization is considered when close monitoring, accurate diagnosis, medication adjustments, or stabilization are necessary.
It may be voluntary, initiated by family or professionals, or enforced by first responders in acute situations.

2. Importance of Assessment:

The decision for hospitalization requires careful assessment to determine its necessity.
Hospitalization can offer relief from daily responsibilities, allowing individuals to focus on mental health recovery.

3. Psychiatric Advance Directive:

Recommends the creation of a Psychiatric Advance Directive to express treatment preferences during times of impaired decision-making.
This legal document can grant decision-making authority to an advocate when the individual is unable to make decisions.

4. Involuntary Hospitalization:

Discusses situations where hospitalization may be necessary even if the individual doesn't wish to be hospitalized.
Emphasizes the importance of collaboration with at-risk individuals to create a Psychiatric Advance Directive during stable periods.

5. Types of Facilities:

Highlights various facilities offering different levels of care, such as in-patient units, public psychiatric hospitals, partial hospitalization, and residential care.
Provides resources for seeking recommendations, including Mental Health America, support groups, and specific associations.

6. Preparation for Hospitalization:

Encourages individuals to research and contact the chosen facility in advance to understand admission procedures, daily schedules, and policies.

7. Questions Before or During Check-In:

Provides a comprehensive list of questions to ask during check-in, covering diagnosis-specific treatment, evaluations, and qualifications of professionals.

8. During the Stay:

Stresses the importance of understanding rights, including the right to refuse treatment, confidentiality, and information protection under HIPAA.

9. Questions About the Stay:

Lists questions regarding family visits, phone calls, clothing requirements, activities, schedules, and treatment plans.

10. Leaving the Hospital:

Differentiates between voluntary and involuntary discharges, emphasizing evaluation processes for the latter.
Includes questions about post-discharge plans, medication, responsibilities, and follow-up treatments.

In conclusion, the article offers a comprehensive guide for individuals considering or undergoing mental health hospitalization, emphasizing informed decision-making and thorough preparation at each stage of the process.