Inpatient Mental Health Approach
Inpatient mental health treatment is an essential, life-saving level of care that more people should know about and use, but that is still widely feared, stigmatized, and misunderstood. We think it’s time to erase the stigma. Going to a hospital for mental health treatment is simply what you do to get the right level of care when you’re in crisis. It’s not that different from going to the hospital for short-term acute treatment of a medical problem or condition.
In either case, it’s only fair to acknowledge that no matter what kind of hospital we’re talking about, no one wants to go to a hospital, and when you have to go to the hospital, it’s usually not the best time in your life. But, of course, it’s also true that psychiatric hospitals, in particular, come with some genuine downsides. But, overall, inpatient mental health treatment is not the Gothic horror it’s often shown to be in movies or television.
Not everyone who needs or wants therapy will ever need inpatient treatment, but some will—and that’s okay. It’s a service that’s there for exactly when you need it and for only as long as you need to be there. The goal of inpatient treatment is to get you stable enough to continue your treatment in the community. It’s nothing more and nothing less than that: a short stop to get the help you need to get through a crisis. But this simple fact means it could be what saves your life.
Who is Inpatient Mental Health Treatment for?
Like medical care, mental health care is a continuum designed to move you through it, not a sorting system that assigns care based on what kind of person you are. Anyone can experience a severe mental health episode, regardless of history or current circumstances. And inpatient care is simply what you need when your mental health symptoms become too painful to manage on your own safely. Common reasons for getting inpatient mental health treatment include:
- Psychosis (delusions and hallucinations)
- Escalating reckless or impulsive behavior
- Altered mental status due to substance use
Sadly, inpatient mental health care can be hard to get, especially if you’re seeking it voluntarily. Since there aren’t enough inpatient beds to meet the need, inpatient facilities often limit care to the people with the most severe symptoms. And because many psychiatric hospitals have these restrictive admissions policies, people who qualify for voluntary admission often also meet the standard to be committed involuntarily.
We’ve written about this before, but in short, being committed is what happens when a police officer, doctor, care professional, or family member requests and is then granted by a judge or magistrate an order to have a person admitted to inpatient care against their will for the sake of their (and others’) safety. To meet commitment criteria, you need to be:
- In danger of harming yourself because of mental illness;
- In risk of damaging other people because of mental illness; or
- At the risk of harm from being unable to care for yourself due to mental illness.
You can meet these criteria if you have a suicide plan, have stopped caring for yourself in a way that puts you in danger, or have physically attacked or threatened to attack someone. (Note that just being belligerent is not enough; your behavior has to be due to a mental health condition.)
It’s important to understand that your symptoms determine if you need hospitalization, not your diagnosis or condition. Transient severe mental health episodes can have causes other than a chronic mental health condition, such as:
- Reactions to prescribed medications
- Complications of medical conditions
- Severe emotional stress or trauma
- Extreme physical stress
- Head trauma
- Substance use
That said, the primary causes for psychiatric hospitalization are mental health conditions, and some conditions are more likely to require inpatient treatment than others. These are:
- Mood disorders (which include major depressive disorder and bipolar disorder)
- Psychotic disorders (which have schizophrenia and schizoaffective disorder)
- Substance-use-related disorders (including substance-induced psychosis or depression)
These conditions are more likely to send you to the hospital because the symptoms of these conditions are the ones that put you at the most significant risk of harm. Psychosis, bipolar mania, and severe depression make it very hard to care for yourself or keep yourself safe.
While it’s possible for transient psychosis (which can include delusions, hallucinations, or disordered thinking) to be triggered by anything that changes your mental status (see the list above), it’s much more common to experience a psychotic episode in the course of a chronic psychotic disorder like schizophrenia. If you have a psychotic disorder, your road to recovery often begins with your first hospital admission and continued follow-up care in the community.
Mood disorders sometimes cause psychotic episodes, but they are more likely to put you in the hospital because of a severe depressive episode. What makes depression insidious is how quietly it can become painful. People often suffer in silence with worsening depression until it reaches a crisis point. What starts as mild depression can expand over time, slowly sucking away your capacity to feel joy or hope. You might withdraw from life further and further until you’re barely making it. And while you might learn how to function this way, you can sometimes get to a point where you just can’t anymore. And that might be the point when you need inpatient care.
How Long Does Mental Health Treatment Last?
Let’s say that your mental health symptoms have gotten to a dangerous level. You’re at the point you feel like you can no longer take care of yourself, manage your everyday activities, or keep yourself safe. You’ve sought admission to an inpatient treatment facility, and you’ve been accepted. What should you expect when you arrive?
First, don’t expect to be there too terribly long. A 2012 study found that the average length of stay was 7-13 days for people with serious mental illness. A 2004 study found that the average length of stay was 15 days and that “absence of serious mental illness was significantly associated with shorter length of stay.” So depending on why you’re admitted and how quickly you respond to treatment, you might be in the hospital for as little as two or three days.
Psychiatric hospital stays are so much shorter than they used to be because inpatient mental health care has a different purpose now. In the past, psychiatric hospitals were places where people went to get long-term care because it wasn’t yet possible to manage their conditions outside of an institution. Now, psychiatric hospitals are for acute care or intensive short-term treatment that improves your condition to the point you can be discharged and continue your treatment on an outpatient basis.
Where Exactly Do You Go for Inpatient Mental Health Care?
State psychiatric hospitals still exist, but they’re not where most people get inpatient treatment anymore, especially not the first time they go. Instead, these extensive facilities are often reserved for forensic patients—people who have been admitted through the criminal justice or corrections systems—or people with severe mental health conditions who did not respond to an initial episode of acute hospital care and who need longer-term treatment (often 30 to 90 days) to stabilize. In addition, most states have separate facilities (or, at minimum, separate units) for forensic and non-forensic patients.
If it’s your first time getting inpatient care, or if you’ve received short-term inpatient treatment before and responded well to it, you’re more likely to be admitted to a general hospital with a psychiatric unit (or, less frequently, a standalone private psychiatric facility that is part of that hospital system). You may have a local hospital with a mental health unit, or you may need to travel to one that does. If you’re involuntarily committed, you may need to be transported by law enforcement, depending on regulations in your state.
It’s possible to call a psychiatric unit or hospital and ask to be admitted voluntarily. Depending on your symptoms and situation, the hospital may ask you to bring yourself or have a loved one bring you to the facility. Otherwise, you’ll be admitted through a local emergency department (ED), where you’ll wait under safe supervision until space becomes available at a mental health unit or facility. Unfortunately, due to demand, you can sometimes wait for a long time in an ED to get into an inpatient facility—sometimes for several days, though usually for one day or less.
What Is Inpatient Mental Health Treatment Like?
What do hospitals do to help you get better? First, they may prescribe psychiatric medication. The clinical staff may recommend that you start taking medication on a long-term basis, or they may want you to take medication on a short-term basis to help you stabilize in the hospital. They may not recommend medicines at all. It depends on your condition, your preferences, and your history. Whether you receive medication or not, you’ll usually also participate in the following during your stay:
- Group therapy sessions
- Individual therapy sessions
- Therapeutic activities like art, exercise, and yoga
Group therapy sessions can be educational, therapeutic, or both. They often focus on topics that will help you understand your symptoms and condition and manage them. They are also designed to help you and others in the group feel seen and understood, which can help you start to accept yourself and your condition and heal.
Individual therapy in an inpatient unit usually focuses on analyzing the conditions that led to your mental health crisis and hospital admission. These sessions can help you gain insight into what happened and how you can recover. They will also help you and your clinical team create an effective discharge plan and identify goals for ongoing therapy in the community.
Therapeutic activities are usually designed to help you feel calm. During a mental health crisis, your nervous system is overwhelmed. Soothing activities can help you heal your nerves, regain your ability to focus on the present, and become better able to participate in and benefit from other therapeutic interventions.
Where to Get Inpatient Mental Health Treatment
While psychiatric hospitals and units have moved past many of the horrors we once associated with them, it’s fair to say they can still sometimes be scary places to be, especially if you’ve never been to one before.
Psychiatric units and facilities treat a wide range of patients. This means a severely depressed person who cringes at how loud a shuffling newspaper sounds can be put on the same unit as a person experiencing a psychotic episode who is screaming at the top of their lungs. The fact that psychiatric units gather people who have some of the worst times of their lives in the same place can make them stressed.
Another issue is that psychiatric facilities sometimes still use restraints—though sparingly. The use of conditions is highly regulated, and hospitals can lose their licenses if they use them inappropriately or too much. So they are only used when someone poses an immediate threat to themselves or others, and they are only used for as long as is needed to calm someone down. Still, it’s scary and demoralizing to be restrained or see someone else be controlled. (Note that this isn’t all that different from medical hospitals, which sometimes use restraints for similar reasons.)
At any hospital, you might be around people crying, yelling, or in distress and might feel a certain sense of sadness or claustrophobia. Remembering why you’re at the hospital can go a long way to ease your discomfort with the unfamiliar setting. You might enjoy your experience in a psychiatric unit, or you might not. But whether you want your experience, remember that your team is working hard to help you get better and get you back home.
At We Level Up Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. In addition, we work as an integrated team providing information about inpatient mental health and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our specialists know what you are going through and answer any of your questions.
Your call is private and confidential, and there is never any obligation.
 Open Counseling – https://www.opencounseling.com/blog/what-to-do-when-you-re-thinking-about-suicide
 NCBI – https://pubmed.ncbi.nlm.nih.gov/22751995/
 Research Gate – https://www.researchgate.net/publication/230601086_What_is_the_usual_length_of_stay_in_a_psychiatric_ward
 Washington Post – https://www.washingtonpost.com/local/psychiatric-patients-wait-in-ers-as-inpatient-beds-are-scaled-back/2013/01/22/28c61b5e-56b7-11e2-a613-ec8d394535c6_story.html