Today I had a therapy session with my psychotherapist. It was following yet another self-harm incident. The eight in as many weeks. I have been dissociating and switching alters several times a day and as a result self-harming badly requiring stitching constantly. My GP and therapist have spoken and both agreed that they think an admission to either a clinic or hospital is necessary for containment and safety reasons. One of the alters is even talking suicide under EMDR therapy.
I don’t want an admission. I hate the clinic/hospital environment and I hate leaving my husband at home on his own. We live on an isolated property and I dread to think of him there on his own. All our kids are grown up and living away from home now. It would be so lonely for him. I’m not sure what the alternatives are though. Therapy is not not containing the dissociation and switching so I need a circuit breaker and maybe an admission would do that. I’m in such a quandary about it. I feel like I have let everyone down by going back to the hospital and not being able to deal with it at home.
I suppose I shouldn’t see it as failure. Everyone needs help at some time or another and I’m no different. Suffering from Complex PTSD and Dissociative Identity Disorder is a very mixed bag to deal with. It will probably be a welcome break for my husband. He can relax for a few weeks and perhaps some of the kids can organise to come home and be with him.
So if you need an admission to a clinic or hospital what can you expect?
Mental Health Units specialise in treating people experiencing a range of different mental illnesses, including depression and psychotic disorders such as schizophrenia. Voluntary admission to a mental health unit occurs in much the same way as admission to a general hospital. You may be admitted to a hospital at your own request or on the advice of a doctor or guardian – this may be at a time when you need some extra support. Any person over the age of 14 can request voluntary admission or a parent or guardian of the person who is under the age of 18 can request voluntary admission on their behalf. Many people find spending time in a mental health unit a very helpful way to: • Find out what is happening to them and why • Stabilise medication • Get intensive treatment by medical and allied health staff with specialised training The length of your stay will depend on a range of factors. These may include what you are being treated for; the type of treatment needed and what the treating team decides will benefit you the most. When you first arrive you will have a consultation with a doctor. The doctor will conduct an assessment with you. This is a good time for you to ask any questions you might have about your treatment or what to expect. Depending on the ward and your needs, you may have your own room or you may share with others. You may also be allowed to bring some of your personal belongings.
During your stay, the activities you take part in will vary depending on whether the task is to find out what has been happening for you, to help you manage any prescribed medication or to assist you to better manage your mental health symptoms. It might include: • Group work – attending a group discussion with other patients that is facilitated by a social worker, nurse, psychologist or occupational therapist (OT). • Individual therapy – attend one on one counselling with a mental health professional. • Personal Time – you may find you have lots of time to yourself. How you fill this time is up to you, but it might include interacting with other patients, doing work or study, exercising or just relaxing. • Visitors – many hospitals have set visiting times, so you can see family and friends Informed Consent The Mental Health Act requires that “Informed Consent” be obtained for voluntary admission and treatment. Giving informed consent means that you: • Have agreed to admission without any pressure from anyone else and • Have been given information about your assessment, the proposed treatment and any questions you have been asking. • Understand the treatment you are consenting to • Have been informed that you can withdraw your consent at any time.
Your rights You have the right to stop treatment at any time and to refuse treatment offered to you. However, it is always a good idea to talk to someone first in the treating team prior to stopping. A medical officer may discharge a voluntary patient at any time if the doctor is of the opinion that the patient is not likely to benefit from further care or treatment as a voluntary patient. Official Visitors All public mental health facilities have regular visits from Official Visitors who can look into any concerns that people raise during their inpatient stay. Each unit in a public mental health facility has a locked container that people can put their written queries into. Official Visitors visit mental health facilities monthly. Involuntary Patient If you become unwell during your stay as a voluntary patient you may be detained as an involuntary patient. If staff believe that you are becoming unwell, you may need to be detained for assessment by a doctor to determine possible involuntary admission. You can be detained for a maximum of 3 days if you are scheduled as being mentally disordered or 5 days if you are scheduled as being a mentally ill person.
If the doctor has applied to the Mental Health Review Tribunal for a decision regarding your capacity to give informed consent, they can administer treatment whist they are waiting for a decision where it is necessary to: • Prevent you hurting yourself or someone else • Prevent you doing something that is likely to harm you or someone else • Prevent you from becoming more unwell.
Some areas/hospitals offer “partial hospitalization”, which is usually 8 hours in duration daily (for up to 3 weeks) and offers the same types of interventions as voluntary hospitalization without the residential component.