urban survival , the psycho ward

Grimspoon said:
Alright, CaptInsano. Myal posted this thread in hopes that his experiences may provide some help for others who might unfortunately find themselves in a similar situation.

How about a point and counter-point from the original post to help clear up some of these issues. I'm still very curious about this topic, and i'm sure others are as well.

Since you're a "professional" in the industry, please grace us with your experience and insight. Maybe with your help you'll even be able to directly help Myal cope a little bit better next time he's at the hospital.
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I hear you, but maybe just 'live and let live'? :)


Thoughts are with you Myal, glad to hear things are better.
 
I'm not sure what you're getting at by live and let live, I thought Myal gave good advice. If it's flawed, and CaptInsano knows better, it's to everyone's benefit to get the best information available.
 
I made a reply and re-read the thread again,all this was from His Observastion....nothing professional,just his opinion of how things were, where his wife was....I like to hear more from Myal....
 
Well, I suppose we could deal with being involuntarily committed, or "sanctioned." It really isn't such an easy thing to have happen. Basically there are three criteria used to justify involuntary commission: danger to self, danger to others, or gross, severe disability. It seems pretty straightforward right off, but severe disability could extend to something like a bipolar patient writing $900,000 worth of bad checks or entering ridiculous contracts while in a manic state. The authorities that use this criteria are medical professionals and the court system. If a patient comes into the ER and states that he wants to kill himself or kill his wife or something, the physician can sign a Physician's Emergency Certificate (PEC). This generally holds a person under involuntary commitment and evaluation for up to 48-72 hours, after which he must be released. During that time, the patient must be evaluated by a coroner. If the coroner's assessment is in agreement with the Physician's, he will sign a Coroner's Emergency Certificate, which can hold a patient under involuntary commitment for up to 2 weeks or 15 days. The courts have the power to issue an Order of Protective Custody that functions much in the same way, and is similarly limited. The courts also have the power to issue orders for long term commitment. Any of these orders can be contested in court. That may or may not be the best description of Australia's procedure, but it is the process with which I am familiar.

Many patients are voluntarily committed. They can refuse medications. They can refuse therapy. They can leave when they like. Some patients enter agreements requiring them to give notice before leaving.

Mental health hospitals are not run like prisons, but they are structured and maintain a lot of rules designed around patient safety. Patients might not be able to wear their own clothing. Their possessions are held for them. They may require 1 on 1 supervision. That may seem restrictive, but patient safety is the number one priority.

Most institutions utilize Milieu therapy. This is a safe, controlled environment that allows the patients to interact socially with the staff and other patients. It provides an opportunity for group discussions, one on one interaction, and patient observation. It doesn't look like a lot of work, but there is a lot going on. The majority of therapy takes place under nursing supervision rather than in an office on the doctor's couch. Shouting at patients is not part of therapy. Being supportive and firm is therapeutic. Family education is an important part of hospital care. If family members are not allowed to observe patient education, then provisions should be made to get them the information they need, including an explanation of treatment, signs and symptoms of illness, and particularly side effects of medications.

If you want to get out, all you need to do is not meet, or stop meeting, the criteria that got you committed in the first place. Participate in therapy. If you are prescribed medication, you need to take it. Keep in mind that the staff will watch to see that you take it, and often check blood levels to make sure that the medication is in your system at appropriate levels. Things like being over-talkative, or pacing, or being socially withdrawn can be symptoms (like forced speech or compulsions) of mental illnesses. Or they could just be personality quirks. Obviously, that is not the case in all instances, but the observations are recorded none the less. This record of observations and patient statements is a tool the staff uses to identify patterns that could indicate illness, and to track progress or deterioration.
 
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Rules are set up for a reason. W/O proper supervision terrible things can happen. One time I was at a hospital, had just dropped off a pt, and was outside restocking the truck when a pt from the psych ward did a header out of a 4th story window and landed about 3 ft from me. No one was watching him, and he managed to get the bars open, and jumped. Not a pretty sight. These patients need supervision, and protical as part of a prescribed treatment program.

That being said, there is a fine line between providing supervision, and structure, and being cruel. I have seen many a burned out nurse that treats her pts like inferior pieces of dirt. There is always some. I agree that assessments are set up to accuratly diagnose and treat the mentally ill, by using proven techniques, and watching for tell tale signs. However, I cant make a judgement on this mans intellect based on his observasions of what he is seeing. I am not in his shoes, and do not know of the faculty at the facility his wife is at. I dont know of any medical protical that states that you treat your pts lke crap when they ask for simple things. If these people dont know who the pts are from the visitors, what level of care is being provided????? Like I said, I am not in aposition to judge, I am not there.

I hope your wife feels better soon bro. I feel for you, and wish the both of you a safe and speedy recovery. Tommarow will be a better day......
 
My thoughts for a positive outcome go out to Myal and his wife.

So, let's take the opportunity to learn about this as a survival scenario. Any of us could find ourselves disoriented after a concussion from accident or mayhem, or with the onset of disease, or any number of perfectly possible situations. We counld, then, find ourselves inside a mental ward under a PEC. Thanks to Capt Insano for persisting past the early responses to his posts His description of the intake process is helpful. I' like to hear more from him. He says " Any of these orders can be contested in court". Can a pattient realistically contest an order without outside assistance? Please, discuss more how we can explain to those in power that we are grateful for the help, but no longer need it and would like to go home.
 
jonesjp@surry.net said:
Thanks to Capt Insano for persisting past the early responses to his posts His description of the intake process is helpful. I' like to hear more from him. He says " Any of these orders can be contested in court". Can a pattient realistically contest an order without outside assistance? Please, discuss more how we can explain to those in power that we are grateful for the help, but no longer need it and would like to go home.
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Absolutely. These orders can be contested in court alone, however I would suggest the assistance of a lawyer. In addition, you are free to file grievances for any treatment or care to which you object. Talking about the specifics of contesting an involuntary commission is difficult without the details of its origin. If someone falsified information that caused you to be committed, you would want to demonstrate that. You'll need to take into account that denial, as well as delusions of persecution are themselves also symptoms of some mental illnesses. If the institution you are in is holding you without reason, your best bet might be to file for a transfer to a different facility. In fact, your best bet is to cooperate with everything that's going on in the institution: all treatment and medication. That would probably get you out the fastest in the absence of any malevolence. Then I would go back and pursue legal recourse for being falsely committed.

You might also want to genuinely consider the possibility that you need some help. As I've said, denial is characteristic of MANY mental illnesses.
 
CaptInsano said:
Well, I suppose we could deal with being involuntarily committed, or "sanctioned." It really isn't such an easy thing to have happen. Basically there are three criteria used to justify involuntary commission: danger to self, danger to others, or gross, severe disability.
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I trimmed the hell out of this , not for arguments sake or to make it look like you are saying something you are not , but cos time is short here now for the moment and I want to address / clear up some points

My wife was not herself for a couple days , I thought it was a flu or something , she was quit and withdrawn , more so after she accompanied me to the doctor and sat in on the discussion of spinal surgery for me .
The day after that , she was looking tired , had a slight fever , I put her in bed , made her a cuppa and left her to have a sleep , and went to do the weekly shopping , while I was gone she had a super sever headache along with mental confusion , she rang for an ambulance it was that bad , the opertor asked the usual questions , she tried to explain that she had a headache that felt like she was being hit , the operator sent the cops instead , only understanding about the woman on the phone being hit

the cops arrived and found a woman in the fetal position on the floor holding her head crying , but couldnt find her "attacker" they couldnt get sense out of her , and called the ambulance , had her sent to the hospital , where she was dosed with valium

She asked for pain killers because she had head pains , the nurses asked her what they felt like , she said it felt like she was being hit with an axe , this was duly noted down , and anti psychotics were given to her , and she was shipped to the psych ward , she being a threat to either herself or someone else , because she was not making sense tot he doctor but was talking about an axe

in all fairness , her head pain was extreme , and she was crying and having trouble talking because of it , the doctors and nurses were busy , and didnt have the time to sit and listen to her and work out what she was saying .

Many patients are voluntarily committed. They can refuse medications. They can refuse therapy. They can leave when they like. Some patients enter agreements requiring them to give notice before leaving.
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here , in the psych ward , I met 4 people who had voluntarily come to their respective hospitals , but were admitted under the mental health act , shipped to the psych ward and they are not allowed out till they are no longer deemed to be a threat to themselves or others . One came in , and wanted out for an hour to go see her kids , but found that since she was in there under mental health act , she wasnt allowed out untill she was assessed and granted an esscorted leave , IF she was assessed as being safe

Mental health hospitals are not run like prisons, but they are structured and maintain a lot of rules designed around patient safety. Patients might not be able to wear their own clothing. Their possessions are held for them. They may require 1 on 1 supervision. That may seem restrictive, but patient safety is the number one priority.
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the double locked doors, the guard allowing entry and exit for anyone not having the security pass card , the high fence around the courtyard , the security staff ... it seemed to be as most other lock ups that I spent a few nights in . Im looking at it from the point of view of being inside looking out , its lock up .
I understand the reasoning and motivation behind it tho , its not a lock up for criminals as such but for folk who are deemed a danger to themselves or others in the community , lock up propper is just for folks who are a danger to the community .

If you want to get out, all you need to do is not meet, or stop meeting, the criteria that got you committed in the first place. Participate in therapy. If you are prescribed medication, you need to take it. Keep in mind that the staff will watch to see that you take it, and often check blood levels to make sure that the medication is in your system at appropriate levels. Things like being over-talkative, or pacing, or being socially withdrawn can be symptoms (like forced speech or compulsions) of mental illnesses. Or they could just be personality quirks. Obviously, that is not the case in all instances, but the observations are recorded none the less. This record of observations and patient statements is a tool the staff uses to identify patterns that could indicate illness, and to track progress or deterioration.
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the staff observing the taking of medications , the staff watching for behaviours , the being confined to the ward , the video surveillance cameras everywhere ,the threat of being sent to "the other side" if you act up make it feel a lot like lock up , where you are watched by the jailers , sent to isolation if you muck up , on video always ...

I know its not meant to be like that

My wife went in with a headache , a very bad one , she was dosed with valium and anti psychotics before she went in .
While she was in there , I spent every minute I could with her

the first night it was extremely scary for her , she has had a very violent abusive childhood , now she is a bit off the planet , maybe from the headache she still has , maybe from the valium and anti psychotics , maybe a combination , I was sitting with her trying to calm her because it was end of visiting hours and I was shortly to be ordered out , when the loonies got up and began pacing the hallway ranting about going to murder someone ...

This freaked my wife out , she went seriously freaky and scared , like I have never seen her before , clinging to me asking over and over "dont let them get me "she refused to be calmed and then forgot ... like forgot who she was who I was , where she was ... but the loony outside kept up her ravings and all my wife knew was terror , sheer utter terror .

I left my wife for a minute with her room mate , a girl who was admitted that day as well and was equally scared , to go get help from the nurses station , to be told to sit and wait till they are ready to deal with me ...

I went back to my wife in kind of hopelessness feeling that this is just like any lock up , the guards come when they are ready , not when they are needed ... and sat with her trying to calm her till eventually a nurse found us , she was trying to find out why my wife hadnt showed up for her medication ...

I KNOW that this kind of thing is heaps worse for me because I am emotionally involved , for the staff it was , Oh , right , she flipped out , OK , here largactyl will fix it , and more valiums as well .... no biggie if one dont fix it the other will"

having the doctor tell me next day that my wife is in a safe and stress free environment was a bit hard to swallow tho ...

the plus side of it is tho , that now after I spent some serious talking time with the doctors , my wife is on meds that deal with the problems she had since before we got married and we tried for more than 10 years and dozens of doctors to get sorted

so some good came of it .

oh yeah , after 4 days of asking for pain killers and complaining of headache when asked how she felt ( they did a CT scan to see if there was a cause for the headache ) she was allowed 2 panadol .... I found it strange , she was given enough valium she lost count of them tho ... but paracetamol is very hard to get hold of .

I forgot to put in the OP , sitting on your bed holding your head in your hand because it hurts and rocking to try and deal with the pain is a psychotic behaviour and will get you further treatment ....
 
In this day and age, mental disorders are becoming vaguer and more encompassing. A friend of mine was hit with the suicidal side effects of antidepressants years before they hit the press, he was diagnosed at a young age for social anxiety. Turns out his symptoms were completely from environmental factors such as a bad school and rough family, the pills did nothing but screw up his chemistry.

Years later, his parents realized he had Asbergers, a highly developed form of autism where they can interact normally, but are still trapped in a different world as the condition works.
...He didn't have that, either. Four specialists had to deal with a parent that was talking about him like he was deaf and slow, and that his comments were just triggered behavior and part of the condition. They asserted that he was in fact autistic, but the reflexes of his mind made it look like he was normal. One of the specialists could tell just from my friend's eye contact that he was indeed alert and lucid, and managed to talk his folks out of pursuing it.

Predictably, this family had some other issues. According to him, his parents meant well and didn't know any better. However, I think it was too convenient that the one the courts would side with, was the one they kept trying to diagnose with something. Since I heard about this, I really started paying attention to parents who mention the issues their kids have.

Best wishes for your wife and yourself, great to hear she's doing better and on leave. From the sound of the event that led to this...It's simply awful that some one has to endure this for coincidental incidents like that.
 
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Alex, thanks
Right now , is recovery time for the rest of the family , we been running on adrenaline pretty much for the last few days , and we are coming down off it .
My wife is doing just fine tho :) .
in a couple weeks , itll all be something we joke about .
 
Thanks for this Myal. You have my hopes and prayers.

Before your wife committed, was she ,at least, given a "stem to stern" physical exam. Just to make sure she wasn't having any physical reaction?
 
Different mental hospitals are very different. (In the United States. I know little about mental health care systems in other countries.) It sounds like the one your wife is in is not a good one. You might want to ask around about other hospitals in the area, in case she or someone else you know is in need in the future.

A couple of things I can tell you: It's true that sometimes it can be difficult to get a patient released when that's appropriate, but in the US in the 21st century it can be much more difficult to keep them from throwing out a patient who is in real need and may not survive a week if they're thrown out.

The most important thing I can tell you: If you are a close relative of a patient, husband, father, boyfriend, brother, whatever, the staff will NOT assume that you are trustworthy or sane or that you have the best interests of the patient in mind. They won't assume you aren't, either -- no assumptions. You have to prove yourself. There is good reason for that.

Once you have proven yourself, once you have had a little conversation with the staff and it becomes clear that you aren't the problem, you are likely to find them much more cooperative. Of course just as when dealing with any hospital staff you have to assert yourself a little, but give them a chance to see that you are a normal rational well-meaning person before you start asserting yourself too much....

P.S. I used to work in a mental hospital.
 
Myal said:
I trimmed the hell out of this , not for arguments sake or to make it look like you are saying something you are not , but cos time is short here now for the moment and I want to address / clear up some points

My wife was not herself for a couple days , I thought it was a flu or something , she was quit and withdrawn , more so after she accompanied me to the doctor and sat in on the discussion of spinal surgery for me .
The day after that , she was looking tired , had a slight fever , I put her in bed , made her a cuppa and left her to have a sleep , and went to do the weekly shopping , while I was gone she had a super sever headache along with mental confusion , she rang for an ambulance it was that bad , the opertor asked the usual questions , she tried to explain that she had a headache that felt like she was being hit , the operator sent the cops instead , only understanding about the woman on the phone being hit

the cops arrived and found a woman in the fetal position on the floor holding her head crying , but couldnt find her "attacker" they couldnt get sense out of her , and called the ambulance , had her sent to the hospital , where she was dosed with valium

She asked for pain killers because she had head pains , the nurses asked her what they felt like , she said it felt like she was being hit with an axe , this was duly noted down , and anti psychotics were given to her , and she was shipped to the psych ward , she being a threat to either herself or someone else , because she was not making sense tot he doctor but was talking about an axe

in all fairness , her head pain was extreme , and she was crying and having trouble talking because of it , the doctors and nurses were busy , and didnt have the time to sit and listen to her and work out what she was saying .
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That sounds terrible. Perhaps they thought your wife's pain was psychosomatic, or that it could have been a Conversion of the stress she was feeling about your back situation. Of course, being curled up in the fetal position, wracked with pain and unable to communicate could certainly be construed as "gravely disabled." However, it seems to me that medical causes were dismissed with such uncommon speed that I would question it as well. Have they attempted to explain how they diagnosed head pain of unknown origin as a mental disorder?



Myal said:
here , in the psych ward , I met 4 people who had voluntarily come to their respective hospitals , but were admitted under the mental health act , shipped to the psych ward and they are not allowed out till they are no longer deemed to be a threat to themselves or others . One came in , and wanted out for an hour to go see her kids , but found that since she was in there under mental health act , she wasnt allowed out untill she was assessed and granted an esscorted leave , IF she was assessed as being safe
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That sounds like some Australian law that I wouldn't be able comment on.



Myal said:
the double locked doors, the guard allowing entry and exit for anyone not having the security pass card , the high fence around the courtyard , the security staff ... it seemed to be as most other lock ups that I spent a few nights in . Im looking at it from the point of view of being inside looking out , its lock up .
I understand the reasoning and motivation behind it tho , its not a lock up for criminals as such but for folk who are deemed a danger to themselves or others in the community , lock up propper is just for folks who are a danger to the community .
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For sure, its a lock up alright. But you are right in distinguishing the differences in motivation. I know it can be frightening and surreal to patients and family members when confronted with locked doors.


Myal said:
the staff observing the taking of medications , the staff watching for behaviours , the being confined to the ward , the video surveillance cameras everywhere ,the threat of being sent to "the other side" if you act up make it feel a lot like lock up , where you are watched by the jailers , sent to isolation if you muck up , on video always ...

I know its not meant to be like that
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Isolation should never be used as a punishment. A patient who acts out in group, or who is unable to control himself around others might be placed in isolation, not as a punishment for his behavior, but as a way of removing the stimulation that caused his behavior.

Myal said:
My wife went in with a headache , a very bad one , she was dosed with valium and anti psychotics before she went in .
While she was in there , I spent every minute I could with her

the first night it was extremely scary for her , she has had a very violent abusive childhood , now she is a bit off the planet , maybe from the headache she still has , maybe from the valium and anti psychotics , maybe a combination , I was sitting with her trying to calm her because it was end of visiting hours and I was shortly to be ordered out , when the loonies got up and began pacing the hallway ranting about going to murder someone ...

This freaked my wife out , she went seriously freaky and scared , like I have never seen her before , clinging to me asking over and over "dont let them get me "she refused to be calmed and then forgot ... like forgot who she was who I was , where she was ... but the loony outside kept up her ravings and all my wife knew was terror , sheer utter terror .
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That sounds like a a real panic attack. Valium can cause some of that disorientation, but it doesn't sound like a normal response. I don't think it is due to Thorazine either. It could just be a combination of the valium and the shock of a strange environment. Its hard to say.


Myal said:
I KNOW that this kind of thing is heaps worse for me because I am emotionally involved , for the staff it was , Oh , right , she flipped out , OK , here largactyl will fix it , and more valiums as well .... no biggie if one dont fix it the other will"
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While that lacks a bit of empathy for your feelings, they really just recognize that your wife's anxiety was not as big an ordeal as it may have seemed. That sounds kind of callous, but you have to understand that it's not as alarming for them as it could be for you.

having the doctor tell me next day that my wife is in a safe and stress free environment was a bit hard to swallow tho ...[/QUOTE]
I understand. I would complain about that, and the poor communication with the staff and among the staff.

Myal said:
the plus side of it is tho , that now after I spent some serious talking time with the doctors , my wife is on meds that deal with the problems she had since before we got married and we tried for more than 10 years and dozens of doctors to get sorted

so some good came of it .
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I hope that leads to some progress and I hope that these issues and current stress prove to be behind her headaches.

oh yeah , after 4 days of asking for pain killers and complaining of headache when asked how she felt ( they did a CT scan to see if there was a cause for the headache ) she was allowed 2 panadol .... I found it strange , she was given enough valium she lost count of them tho ... but paracetamol is very hard to get hold of .[/QUOTE]
That just sounds ridiculous.

Myal said:
I forgot to put in the OP , sitting on your bed holding your head in your hand because it hurts and rocking to try and deal with the pain is a psychotic behaviour and will get you further treatment ....
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It can be. So can many other behaviors. That's part of what makes diagnosing mental illness difficult. It isn't like filling out a survey in a magazine. Diagnosis takes time, interaction, and observation. Things that may or may not be a symptom of illness have to be evaluated.
 
Myal said:
Right now , is recovery time for the rest of the family , we been running on adrenaline pretty much for the last few days , and we are coming down off it .
My wife is doing just fine tho :) .
in a couple weeks , itll all be something we joke about .
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:thumbup: Glad to hear everything is headed in a positive direction for your family...Take care and get some needed rest
 
Grimspoon said:
I'm not sure what you're getting at by live and let live, I thought Myal gave good advice. If it's flawed, and CaptInsano knows better, it's to everyone's benefit to get the best information available.
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I hear you, I was just questioning the choice of time and place, but I guess it's all good :)
 
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She got a going over two days after she was admitted , ct scan , physical exam etc , the scan was unusual , it was for her sake , the physical was more to see if I had been beating her .
After they found no marks apart from her shins where she bruised them bike riding , they explained what they were looking for and asked if there had been any stressful situations recently ....
 
Myal,

Good job protecting your woman and keeping the situation from spiraling any further out of control than it did (e.g. Stanford experiment). Ultimately you got a good result, thankfully, and that is ALL that matters.

I think your initial assessment was dead on target. The American "caregivers" pull the same cr*p in the US as happened to you in Oz, and you handled yourself pretty well IMHO. You politely and intelligently made a complete nuisance of yourself by making the "slugs" do their jobs, and she was promptly released. It's seems pretty simple to me.

Thanks for sharing your real world urban survival experience. I think I'd rather take my chances with the grizzlies than go through what you did :).
 
j williams said:
Rules are set up for a reason. W/O proper supervision terrible things can happen. One time I was at a hospital, had just dropped off a pt, and was outside restocking the truck when a pt from the psych ward did a header out of a 4th story window and landed about 3 ft from me. No one was watching him, and he managed to get the bars open, and jumped. Not a pretty sight. These patients need supervision, and protical as part of a prescribed treatment program.
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after a long day of calls with granny having a fart hung sideways in her single wide with cat crap on the floor, then that? I think you'd have to lock me up..... Outside the hospital "collecting yourself" and all of the sudden "OH WTF MAN?!?!?! WHO"S THROWIN" F*@#ing PEOPLE AT ME?!?!?!". Pretty sure I'd be drooling and talking to myself after that.
 
Dude all I could think was, What if I had been inside and this person had hit my ambulance? I wouldnt have even known till the corpse flew off the top and into traffic! That would have been something.

Really it was one of those f*&^ed from the start kinda days
 
j williams said:
Dude all I could think was, What if I had been inside and this person had hit my ambulance? I wouldnt have even known till the corpse flew off the top and into traffic! That would have been something.

Really it was one of those f*&^ed from the start kinda days
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Ive had some bad days but nothing to compare to that ...
 
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