Dealing With Shrinks/Dealing With Hospitals

So we're about to give you a whole bunch of suggestions that will help you get better informed about the places you might need to turn for help if things get really out of hand. If you feel like you're headed that way, write down your own plan when you're in a clear head space and give it to a friend you really trust. If your mind is moving like molasses and there's a repeating tape loop in your head saying that you don't deserve to live, it's very hard to advocate for yourself or have the patience to be put on hold for long periods of time or sit in waiting rooms for hours. Chances are that if you get so far lost you need a hospital or serious psychiatric intervention; you might not be able to handle the whole bureaucratic process yourself.

So where do you turn if you feel like you're ready for some medical intervention? If you just want to talk, you can look for a therapist. If you think you might need medication, you'll need to see a psychiatrist. Psychiatrists these days are very expensive and usually see patients for a half hour to consult on meds. Therapists usually give you an hour to talk over your problems and can't prescribe meds. One of the best ways to get hooked up with these people is to find a mental health clinic in your area. If you can find yourself a good case worker or advocate much of this process will be a lot easier. If you find yourself getting put on long waiting lists and being tangled in frustrating webs of bureaucracy when trying to get an appointment at a clinic, a good trick is to ask to speak to the clinical director. Remember that the folks behind the desk deserve your respect, but that it's their responsibility to help you get what you need.

Trying to get appointments with shrinks or therapists in private practice usually entails a long wait, depending where you live"”often as much as 6 weeks"”but might be the only route to go if you're trying to get covered by health insurance. If you feel like you really need help now but your brain is too much of a mess to handle the frustrating process of trying to get an appointment somewhere, swallow your fears and be really honest with a friend, family member, co-worker, whoever you can turn to, and ask them to make the phone calls for you.

"When I first knew I was breaking down I started calling up psychiatrists but the process was so impossible I had no idea what I was doing. No one had any time to see me unless I was on the edge of suicide. I would cry for an hour after every unsuccessful phone call and finally gave up completely. I started the phone calls again after a couple weeks, but by the time I actually got in to see someone my mind had deteriorated so much that I ended up in the hospital 2 days later. I wish I'd asked someone to help me but I was way too ashamed and just felt like I was weak."

If you have an inkling that something funny's going on in your brain, which you most likely do since you've got this book in your hands, do as much of your own research as you can before you go see a psychiatrist or a therapist so you'll be familiar with the words they use, the diagnoses they might suggest, and the treatments they'll recommend. It's so important when walking into a doctor's office for the first time to feel empowered as much as possible. You have to remember that they're here to help you, even if everything seems clinical and intimidating. You will most likely see tons of free samples from drug companies and outlandish things like Prozac pens, as well as lots of diplomas and enormous books. It may seem terrifying or ridiculous to tell this person about your life history. But if you go into it believing they can help you, they just might.

Questions for Potential Psychiatrists and Therapists

• How long have you been practicing?
• Do you have experience treating the issues I'm dealing with?
• Do you yourself have personal experience of mental illness?
• With your self, friends, or family?
• Have you ever worked on a psych unit? Do you have experience working with people in crisis?
• Are you familiar with alternative therapies and are you comfortable combining them with my pharmaceutical treatment? (if this is an issue) How do you feel about my ambivalence towards taking psych drugs?
• Why did you become a mental health worker?
• What is it about your work you like?
• Where has your work been ineffective?

Hospitals

No one wants to end up in a mental hospital, but sometimes it is"”if not the best"”then the only option currently available for someone in a state of extreme crisis. In an ideal world there would be beautiful safe houses everywhere full of nurturing friends and creative activities and organic food, but unfortunately this is something we need to work to create instead of something that is a widespread reality. For now we're stuck with psych wards.

What does "extreme crisis" mean? The answer really varies depending who you ask. For the mental health establishment you must be "a danger to yourself or to others." Perhaps the simplest definition is that you cannot take care of yourself at all"”you're intensely suicidal, delusionally manic, or in some other combination of hell that renders you past the point of all functioning. You need a safe place where you're not going to hurt yourself and you're not going to have to be responsible for anything, and your friends and family may not be able to provide this. At some point they may be overwhelmed, or there may be no one to take care of you, and you might need some medical intervention to derail total catastrophe"”in the world we live in, the hospital may become the only alternative.

One thing to keep in mind is that even if you're terrified of having to go to the hospital, if it's seeming like you might end up there at some point anyway, it's wise to pick a hospital that you can live with - not the one that the police bring you to in restraints. You might want to designate a friend or family member to help deal with the bureaucracy and advocate for your rights should the time come. Hospitals are miserable places to end up, but it's usually a very temporary situation and there are ways you can make the best of it and learn lessons to keep you from having to end up back there.

If you're doing the research for yourself or for a friend to find the best hospital around, here are a few things to ask: Can your friends have easy access to visit you? If you already have a doctor you trust, can your doctor consult on your care? Can any other outpatient providers (counselors and therapists) be involved in decision-making? Do patients have access to the outdoors, decent food, alternative therapies, or books?

Know your rights!

If you end up in the emergency room, no hospital is allowed to refuse you treatment due to lack of funds if you're in a state of extreme crisis"”they should push through Emergency Medicaid. But this also means they can commit you against your will if you decide to back out in the waiting room and they've decided you need treatment.

Not everyone who ends up in the psych ward checks themselves in voluntarily. We're encouraging you to get real about the problems in your head before you end up getting dragged in by an authority figure of one form or another. If it's decided that your judgment is impaired and you are too dangerous to yourself or others to walk the streets, you can be incarcerated against your will; this is called a "5150 hold." During this time you have no right to refuse drugs or treatment. The psych team has 24 hours to decide whether to release you or try to make you stay in the hospital; usually they'll try to convince you to sign yourself in voluntarily. If you're checked in voluntarily, you have the right to refuse drugs and the right to check yourself out. If you won't agree, and they still think you're a hazard, they can recommit you involuntarily for 72 hours"”this involuntary commitment can be extended indefinitely as long as the treatment team can substantiate their reasons for doing so. The only way to overturn them is to win a hearing with a judge.

Honestly, time spent in a hospital can be excruciatingly miserable, in no small part because you had to be in a pretty bad state to end up there in the first place; it can be boring and barely remembered through a haze of psych drugs; it can feel incredibly claustrophobic and horribly depressing; it can be a welcome respite from the pressure of trying to keep together a daily appearance of normality around functioning people; it can feel like you're being held hostage by a bunch of patronizing doctors who have no idea what you're talking about; it can feel like a cinderblock prison full of zombies; it can feel like a collection of people whose versions of reality are too bizarre and interesting to be walking the streets; it can feel like hell or it can feel like the most necessary calm in the eye of a storm.

But no matter how you experience it, hospitalization is temporary; you will make it through and tell the tale. If you're determined, getting hospitalized can be the first step in making a serious commitment to healing yourself and listening hard to what your soul needs to live out all its crazy dreams.

Your spirit is not dead.

If you make it through this you will be strong as hell"”and you will be able to help so many people. Don't give up.

"I had this vision in the hospital"¦ I was still pretty manic but I was so dulled down from all the drugs that it was hard to think clearly about much of anything or remember who I was. I was beginning to despair, wondering if I'll ever have my life together again or feel passion about anything.

So here's the memory: I've just come from the med line and I lie back in bed. I've slickly pocketed the Depakote and as I'm lying there with its blood level decreasing in my system, I can feel this power inside of me that I'd forgotten was there, literally feel it welling up and pouring out of me without its suppression from the drug. Then I have one of those half-dream images. There are a bunch of other people in the room, patients and hospital workers and doctors and I know they can't see it, but I close my eyes and I feel weeds growing all around my bed, vining and trellising plants, bunch grass, and dandelion flowers. I can feel the wild still in me even amidst the sterile hospital walls. It's my little secret and I grin to myself. And even though I know the road is going to be hard, I know for that moment that in the end everything is going to be alright."-Sascha