My Experience Working In A Psychiatric Facility

ladsin

I've seen a few questions lately about psychiatric facilities and figured I'd just write my own Take about my experiences in one. I worked in a locked-door psychiatric facility for a year before I moved across the country and I figured that there were some things I should point out that seems to be frequently asked about them.

My Experience Working In A Psychiatric Facility

Holding People Against Their Will

There's typically some conspiratorial type thinking that comes along when people start talking about psychiatric facility. Lay people seem to think that psychiatric facilities are going out of their way to lock up people against their will for some nefarious reasons. I think this is quite silly. Many facilities will have policies about holding people against their wills only in the case of a patient being a danger to themselves or others. For example my hospital mandated a 24 hour hold for persons who had survived a suicide attempt for monitoring and counseling. This was to ensure that the person wouldn't just leave the hospital and walk into the road and kill themselves. This is largely a protective move by the hospital to prevent the family of the person from suing. We additionally would frequently get patients from the police who had harmed themselves or others and needed some psychiatric evaluations or medication in an attempt to prevent this behavior from continuing. These people who are held against their will are done so for good reasons in my experience.

To demonstrate this point I'll give two examples.

-I had one patient who had postpartum psychosis and had attempted to kill herself and her child in response to severe command auditory hallucinations. She wanted to be released, but the hospital was concerned that she would get out and attempt to kill herself and child again and as such mandated that she be held against her will for a 24 hour evaluation. During that hold it was determined that she was a threat and her family asked that she be held for treatment. After a few weeks with counseling and medication she seemed to have gotten far better and last I heard she had gone home and was doing quite well.

- Another patient was suffering from drug-induced psychosis and these delusions were causing him to lash out at both family and others in the general populace. He was arrested and sent to us against his will for the safety of other people around him. While with us he attacked multiple staff members and had he not been with us he likely could have killed them.

My Experience Working In A Psychiatric Facility

Abuse By Staff

People frequently point out instances in which staff members abuse patients and say generalize this to all facilities. This simply seems to be a false generalization to me. It is important to remember that hospital staff are people too. Just like we can have bad police officers, bad nurses, bad teachers etc who abuse those in their care you can have some bad people working in psychiatric facilities too. I personally never saw this happen in my facility, but we had many safeguards to ensure that this wouldn't happen and if it did then the patient was protected. We had several cameras throughout the facility and if anyone was injured we'd go over the film to assess what happened. We additionally had a policy of no staff being alone with a patient, if a patient had to be stripped or confronted we had to always have at least two staff members present to ensure that there was no abuse. The only case I could think to bring up here was one instance in which I think the policy went too far.

- We had one patient who was a young child who suffered from extreme autism and was prone to hurt himself and engage in other aberrant behaviors that required he be always within arms distance from a staff member. He would frequently pace about within any region he could and as such at night we would sit in a chair by the door to his room to effectively block it off as a possible route for him to walk in. This would just leave him to pace within his own room but not go outside at night as he would wake up other patients (and we'd have to force him to wear clothes which was very difficult because he didn't like them). One doctor walked in and saw this and despite no abuse occurring the doctor had the staff member fired because... well just because.

Injuries In The Facility

This partially goes along with the previous section, but I think it's important to separate these two on the basis of intention. During my year we had several patients be injured and although most of them were self-inflicted a few of them came about during conflict with staff members. These are far more rare than self-inflicted injuries, but even then in my experience were explicable. We also had to undergo training for how to take a violent patient down safely, but two injuries stick out from my memory.

- One woman was attacking staff members and was chasing after a security guard. He put his arms up in defense of his face and she ran into his elbow crushing her orbital socket. This was her fault and when I took her to the hospital for surgery she apologized for her behavior, but still the hospital paid for her surgery.

- The other injury was an older man who woke up and thought we were his sons and raping him. He started punching us and screaming. When going to hold him down and give him medication to calm him his arm was fractured. This was likely due to his age and not abuse or excessive force on the part of the staff members.

My Experience Working In A Psychiatric Facility

History

This is one that I don't disagree with. Psychiatric facilities and the field as a whole have come a long way. I don't think this is relevant to facilities today, but it is a blight on their history. Thankfully as the facilities and the science as a whole have progressed these problems have fallen by the wayside, but it's important to remember how recent this was a problem.

- I had one patient who had been in and out of facilities for decades and he was telling me about how it was when he first started with the ice-baths and electro-shock without muscle relaxers.

Conclusion

I'm not sure how well this went and my thoughts were kind of all over the place. My general point is that in my experience psychiatric facilities are far more helpful than they are detrimental, and the problems pointed out by others who think they're bad are all explicable.

My Experience Working In A Psychiatric Facility
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  • skateranon123
    As a person who has been in quite a few of these places from the patient side I can asure you number one is BS

    I've been held in wards against my will for periods of two months without a suicide attempt and with a suicide attempt.

    They would not let me go the doors where automatically locked and it was basically a jail for mental patients. I've had roomies who tried sexually abusing me on many ocassions and the staff never gave a shit about it so I had to defend myself against them.

    They drugged me against my will I never wanted to take medicine so I got injected with it by force multiple times.

    The staff never gave a shit about patients when I got in a second time I
    had a roomie who would shit himself he refused to use the toilet or bathe and never saw a nurse clean him or bathe him as far as I was there.

    Very bad places I feel they made my mental state worse and people still ask me why I refuse to go to psychologist or shirnks hah
    Like 2 People
    Is this still revelant?
    • ladsin

      I can’t speak to your experience, I can only state mine. We didn’t want to hold people against their will for extended periods of time. It didn’t make monetary sense. We had sexual assaults happen between patients and always moved them. Medication is frequently administered to prevent escalation of aggression, but to force it requires several people signing off on it. And it’s a locked door facility, it makes sense for the doors to be locked.

    • I mean I guess but we can't deny mental health hospital are hell for patients. Maybe it seems fine since you're looking at it from an outside view you're not in there and maybe I'll admit my paranoia made it worse but I know martial arts so I laid quite a few guys out even a nurse one time not proud but at the time it seemed like my only option I felt like I was in jail and a bunch of guys where trying to punk me or get the best of me

    • ladsin

      So what you’re saying is that you were a paranoid and violent patient who harmed multiple staff members and you think it unreasonable that they medicated you?

  • Anonymous
    Misdiagnosis, abuse, censorship and forced conformity are things that are still common practices within many (not all) psych wards. They are not exceptions. There are occasions where a person gets misdiagnosed and gets detained against their will. Patients aren’t allow to complain about mistreatment even though that’s their one of their rights. Some wards still force their patients to wear gowns and scrubs rather than their own clothes, this is forced conformity.

    Perhaps the ward you worked at may have been more humane. But that’s only one ward, your experience there cannot speak for what other people have experienced in other wards. Psych wards still have a long way to go even though many have come a long way.
    Like 1 Person
    Is this still revelant?
    • ladsin

      Hence the reason this was titled, "My Experience"
      I don't see any reason to believe abuse and misdiagnosis are as common as you insinuate in these facilities. Patients most certainly are allowed to complain about mistreatment. They have lawyers and case workers specifically to do so.

Most Helpful Girl

  • MlleCake
    I think most people still think facilities are like the ones of the past with people being chucked in for specious reasons and such.

    I have visited many psychiatric facilities in my work and have seen they are generally very professional, clean, organized and humane.
    LikeDisagree 3 People
    Is this still revelant?
    • ladsin

      I agree it seems to an oddly common belief.

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What Girls & Guys Said

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  • OlderAndWiser
    I worked in psychiatric facilities in Florida in 1976-1981. Even then, the care and treatment were much more humane and dignified than people assumed on the basis of the stereotypes.

    Nice myTake.
    Like 1 Person
  • andreasderjuengere
    I guess that you know about ''White Enamel''. Thinking about it, this must be one of the toughest profession fields that one could choose. One of my own impressions is that psychiatry is quite quick in deciding to ''medicate'' patients. What is your own observation there?
    Like 1 Person
    • ladsin

      I hadn’t heard of it, I googled it and it looks like a shut down facility, is that right?

      In my experience it would depend on the nurse and patient in question. Some nurses would intervene sooner and some later especially depending on the patient in question. For example we had one patient who would begin pacing and then attack others. This became apparent enough that we’d call extra staff on unit if he started pacing, but some nurses would still want to wait until he attacked and others would medicate early to prevent an attack. In my experience the former was more common and upsetting to me. They’d have to wait until after someone was injured to forefully give them medication.

      As for the field as a whole? I think some doctors over prescribe (adhd, ssri’s) but that wasn’t the case in forcing medication at my facility.

    • I see. Thanks. // Yes, white enamel photos are from Glenfield State Psychiatric Hospital, USA. There is also much (older) material there that is both fascinating and frustrating. Thanks, mate, for doing this job. I couldn't.

    • ladsin

      It’s a tough job and one that’s under appreciated, but thanks. I don’t understand how some people did that for decades.

  • juliaanita
    i did clinicals in a forensic psychiatricl hospital. It was scary, inspiring an educational, all at once.
    Glad you had the same experience and took away a lot of the same thoughts as I did :)
    alwys fun to read your takes :)
    Like 1 Person
    • ladsin

      Ya the RNs I talk to always have some stories to tell about their psych rounds.

    • juliaanita

      i tell you just one this evening...
      have a good day. :)

  • veronicasegura
    I see your point, and I entirely enjoy your post. For what its worth I will tell all my friends about it, quite inspiring.
    Like 1 Person
  • ninjafemme
    Yes Corry they help you and the nurses will help you back to your correct state. All these people deserve a good pay check because dealing with a mental person is not easy that being said they can't just do what they want they have to keep in mind the person is crazy.
    LikeDisagree 3 People
  • taleswapper
    My experiences with psychiatric facilities are that they substitute procedure for reason, and process for care. I understand why they do this, but it's dehumanizing and often handled aggressively by people who frankly shouldn't be involved in patient care at all.
    For example: In one facility, the fire door to the stairwell was kept locked, in direct contravention of the fire code. "It's too much trouble to monitor the door, so we lock it to prevent patients from wandering out." The door was at the opposite end of the wing from the nurses' station. So, the staff, none of whom were actually trained firefighters much less a fire marshal. violated a safety law and endangered the entire wing for their convenience.
    I have yet to be an in-patient "under observation" without staff insisting on medicating me, based on (presumably) a choice made by a doctor who hasn't even met me. Of course, I refuse such medication categorically. You can't get valid observations if you're already mucking with their brain chemistry. this results in a label of "uncooperative" because I don't follow their "procedure", even when it flies in the face of reason.
    Or my favorite. "Mr. Harrison, we can't let you use your C-PAP machine because you might try to hurt yourself with the cord." So, a psychiatric nurse is going to countermand my doctor's order to use the machine because I might try to do myself an injury, but partial asphyxiation is okay because it's not a psychological issue.
    • ladsin

      Mm locked door facilities have to lock all doors or else it wouldn’t be a locked facility. I don’t know what kind you were in, but in ours all of the staff were trained both in putting out fires and we had several tests of fire readiness. At least one a month if I recall correctly.

      As for medication I can certainly grant you that medicine is frequently pushed for agitation to prevent escalation, but again that’s understandable. If you inform your doctor that you refuse medication they can order forced medication if a judge/ team approves it, but that’s very rare in my experience.

      As for CPAP, did you ask your doctor for it? We allowed them with strict regulation. The patient had to be on 1:1 observation, but they were allowed if necessary. Again though it being difficult to bring objects that a person could use to harm self or others into a facility which is specifically designed to prevent that is only sensible.

    • This is a perfect example of my point; thank you. You're not a fire marshal, but you substitute your judgment for his. You're not a pharmacist or a doctor, but you substitute your convenience for their judgment. You're not a respiratory therapist or doctor, but you're willing to risk hurting or killing a patient because he or she "might" harm self or others.

    • ladsin

      I’m not a fire marshal but the fire marshal signed off on our facility, so yeah... I trust the fire marshal on this one.

      I’ve never forced medication on anyone, so you’re just misunderstanding me. The nurses and doctors (medical professionals) give medication. Doctors determine when medication needs to be used against a persons will and they have to justify it to a team of other doctors, so I typically trust their judgement.

      I’m not a respiratory therapist, and if a respiratory therapist says that it’s necessary we allowed it. We didn’t allow it if the respiratory therapist said it was not necessary.

      So I think you must’ve misread my statement or simply made a lot of assumptions about what I was saying that I didn’t say.

    • Show All
  • MarketData
    Good take. We should expose abuse wherever it occurs but we shouldn't tar good facilities with the same brush.
    Like 1 Person
  • Kaneki05
    With the holding people against there will, i see it as evil and nefarious to stop someone for ending there own life it is there own life they should get to decide by all means you can try and talk them down and give them help and therpy but locking them up that is wrong.
    • ladsin

      As a matter of principle I agree, the difference being that they have to be cognizant of their own actions. This meant some should stay and some shouldn’t have.

    • Kaneki05

      Yeah i say people should be allowed to unless there brain damged or seening halucnations tell them to do it, longs if the person is lucid they shouldn't be held back to take there own life.

  • Bigbob60
    They're evil. They promote blasphemy, when I was a patient they made us do occupational therapy, art, waste of time, but harmless, basket weaving and yoga. Yoga is an evil Buddhist practice. etc won't drive out evil spirits, nor will medication, before I let The Lord Jesus's Christmas into my life I was on every antipsychotic known to man, I spoke to psychiatrist, nothing worked, only prayer and exorcism can free you from demonic possession.
  • MarshmellowPeep
    I have had five stays in hospital psych wards since last fall.
  • DiegoO
    I went to one as well and according to one of my psychology teacher, the facility looked worst. I couldn't imagine it been worst...
  • smahala1991
    Have you ever heard of the horrors of Willowbrook and Pennhurst?
  • admles
    Fascinating read, thank you for this!
    Like 1 Person
  • Secretgardenblood
    Nice take
    Like 1 Person
  • Anon-ymous1
    Good Take.
    Like 1 Person
  • Anonymous
    I have been hospitalized for mental illness in the past. Many psychiatric patients are just innocent people with problems and are more dangerous to themselves than anyone else. Mental illness should be treated as an illness not a crime.
    • ladsin

      Yeah, the majority of our patients were more of a danger to themselves than anyone else.

  • Anonymous
    On the issue of involuntary commitment of suicidal people, the case for doing it is they are not cognizant of their actions. But if that's the case can we have people specify whether or not they should be committed if they enter a compromised state of mind and become suicidal as a result when they're of sound state of mind?
    • ladsin

      I'm sorry, I couldn't really understand your question.

    • Basically if a mentally sound person decides they dont want interference when they become mentally unstable, should they then be allowed to continue walking free or be admitted regardless of consent due to being a danger to themselves.

    • ladsin

      @BaileyisDarcy Oh, if you're asking me I think that a person of sound mind should be allowed to take their own life should they decide to, but I think we should have them take a class or something to ensure that they understand the consequences.

      But that's not something that happened in our facility (or in our nation) people simply are not allowed to do so. I had several patients that I think should've been allowed to end their own lives, but it's not my decision and my job was to save them no matter what.

  • Anonymous
    I think you have a clear bias because this mytake was posted close after another mytake being posted by a guy who had a more reasonable view of such facilities. This is pure damage control in my opinion.
    • ladsin

      My experience is obviously biased because it’s simply my experience. It’s myTake if you will. As you can see on here many people claim to have had a different experience. If it’s the myTake you’re thinking of it was certainly part of the reason I wrote this one as I mentioned in the first sentence.

  • Anonymous
    My father put me in one when he found out I was gay. I lost a year so drugged up i couldnt hold a conversation with others that made sense. I'm also sure some of the staff had sex with me but maybe I imagined it.
    Disagree 1 Person
    • ladsin

      I can't imagine a psychiatric institution accepting someone for being gay... Homosexuality hasn't been considered a mental illness in the US for quite a few decades.

    • Your lack of imagination is offset by the experiences of those who have been (and still are) subjected to "conversion therapy".

    • @taleswapper Actually I've seen this happen specially if the facility is a christian funded one

    • Show All
  • Anonymous
    I paid my way through college in an institution and it's the most inhumane place ever, I felt like a guard of a concentration camp. The things that went on such as women patients being made pregnant, patients being beaten, belongings being stolen, abuse, mysterious deaths, ilegal abortions, babies secretly adopted, over medicated patients, patients prevented from using the bathroom and left in urine and faeces covered clothes. A big one is perfectly sane children getting locked up and medicated because they were an embarrassment to their family or gay, another was maybe an orphan who is underaged getting locked and heavily dosed on drugs for years so they could be declared mentally incapable and thus any money and property their family has can be seized and controlled by their relatives. Like old folks homes or orphanages if you have no one in your life thst cares and comes to see you these places can be he'll on earth as staff know they can do whatever they want to you.
    Like 2 People
    • ladsin

      Lol what institution were you in that accepted and medicated people for being gay?

    • Anonymous

      None of it was done officially of course but that's what went on.

    • ladsin

      Perhaps. I've never seen anything like that though.

    • Show All
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