Decision To Be Admitted To Hospital Or Not

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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.

 

11 comments

  1. If only there could be options for respite care facilities not framed in the traditional institutional contexts of hospitals and clinics. Somewhere that family members / trusted carers can also be facilitated, and actively involved to whatever level is appropriate.

    It should be easier on support staff and on people under care.

    The efficacy of treatment may be superior as well.

  2. i’ve certainly seen hospital in terms of a ‘circuit breaker’ before – i think it’s a great analogy. whatever direction you choose i wish you healing (Elle)

    • Thank you Elle. I think as a circuit breaker it works. It will also give my husband some respite care from supervision which he desperately needs. All the best Erin. Thank you for your kind comment.

  3. Your last incident with self-harming was very severe. I have a great deal of co-consciousness with my alters now and can talk with many through a journal I keep. Many now talk to my therapist now. This is very helpful in that the alters can express themselves through words rather than acting out. But, I don’t know how coconsciousness is achieved. My therapist had suggested I journal early on in my therapy and soon other alters were speaking to me as I wrote their words down. They can speak to me now without journaling but the writing slows down the dialogue so I can really hear what they have to say rather than it rushing through my head and not hearing all they have to say. Anyway, I think you should go to the hospital. I have been in a few times when one of my alters took overdoses of pills and then another would call 911. Perhaps, the alter that harms you does not like the hospital. If they know that you will go if they harm you, this may keep them from harming you in the future. I have had alters that were very abusive to me verbally or would cut me change to protectors or stop the abuse once they were heard or found out that they no longer needed to be like one of my abusers. That it was now safe to tell about the abuse since our abusers couldn’t punish or hurt us anymore. Just recently, I started hearing from one who was very sadistic in his verbal abuse and I was able to tell him that we were safe now and he no longer needed to play the role of our abuser. He was relieved to give up that role of my father (who had sexually abused me and threatened me into silence). He was not sure what his role would be now, and I suggested that he could be a protector, and look out for anyone unsafe or who was mentally abusing me in my present life. It took some months for him to completely stop the verbal abuse and learn a more healthy way to live. But he did it. A few weeks ago, another alter was trying to cut me. He talked to my therapist who learned that he did this to keep me from doing something worse to myself when I become very depressed. After speaking to my therapist, he decided to stop doing this since he realized that it only made me feel crazier. Anyway, I share all this with you to give you (and your alters) some ideas to live in a healthier way. I am very sorry that you have been being harmed so violently. Please know that I am rooting for you.

    • Thank you so much for such a lenghty comment. I truly appreciate it. I take it on board. I don’t want a hospitalisation so will talk to my therapist today and decide. The alter is very active so dangerous. The alters are unable to combat here. She is planning all the time and waiting for an opportunity for my husband to not be watching me. It’s very tough on him. I will bear you advice in mind. Thank you once again. All the best Erin

  4. Thank you for sharing. This does a good job at explaining the hospitalization process to those who may not know it’s an option. 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. Take care

    • Thank you for commenting. I will add that extra bit of information to the post. I wasn’t aware that was an option for people. Thank you for pointing it out. All the best. Erin

I would love to hear from you so please leave a comment. All feedback is much appreciated. Thank you. Erin