Borderline Personality Disorder, PTSD, psychotic features, delusional. Words that you don’t hear often. Unless, of course, you’re a patient in a psychiatric hospital…or a professional in one. Me? I’ve been both.
When I go to work in the morning, I walk through the units and see people at the lowest point they may ever be at in their lives. I’ve met people who honestly believe that I’m Satan (or on a good day, Jesus himself), who think that the doctors have kidnapped them, or who think that we’re there to steal their thoughts and sell them to the government (and surprise, that’s not what an EKG machine does).
I’ve had men look me in the eye and say to me, “I want to break your legs, so you can’t run away, and rape you”, “I’m going to murder your family”, and a common one from a current patient, “hey there whitey, you’ve got your fuck me boots on today, I’m going to fuck you whitey”.
Every day when I go to work, there’s a very real chance someone is going to assault me. It’s almost a guarantee that someone’s going to call me an offensive name. And at least five times in a shift, I’ll have a patient tell me that I suck at my job and that I’m not helping them.
I’ve also had young girls cry on my shoulder because they don’t want to live anymore and don’t know why, had grown men break down in front of me and ask for help, and day after day I see people come in with the desire to die, to leave everything they have behind, walk out the front doors of the hospital with a smile on their face and a new-found hope for life.
This is my reality as a professional in a psychiatric hospital.
When I was new to my profession, I had a young girl look me in the eyes and say, “you don’t know how to help me, because you don’t know what it’s like to not be able to leave here.”
That girl had no idea that I had said those exact words to a staff member just like me before, when I was a patient in the same hospital.
When I came to my hospital as a patient, I was strapped to a gurney and wheeled down the halls. When I reached the unit (not knowing that it was a unit specific for acute, psychotic patients), I was put on display in front of all the other patients while they unhooked me and took my vitals. No one knew me, the other patients just saw me as a distraction from their meticulously scheduled day, and the only thing I could think about was the click I heard when the doors locked behind me.
Whether I liked it or not, as of that moment I was involuntarily committed for 72 hours.
I was put in a room with multiple other patients, and since I was lucky, they weren’t violent. If you’re not lucky, your roommate will stay up all night staring at you, whispering things about wanting to hurt you, and frankly, scare you more than anyone you’d ever met.
During the day, I’d attend groups that were run by the staff, and the entire time I was sitting there wrapped in a blanket, I was putting on a front and wishing that I could just go back to bed. I didn’t really want to be there, I just wanted to die. That’s why I was sent there in the first place – people were starting to see just how large that desire was.
Watching the people who loved me cry, beg me to go to the hospital, get mad when I kept promising to go and then refusing last minute – their concern started to make sense. The hushed conversations when they thought I was asleep, the “just checking in” calls from people throughout the day, it all led to a DMHP sitting by my side in the Emergency Room, subtly making sure I didn’t make a break for it.
When I met with my psych doctor for the first time, it felt like she didn’t care about me. She had a whole hospital of patients to meet with, so I only got a few minutes to talk to her. It didn’t matter anyways though, because she already knew everything she need to know from my file – that I was restrained on the way over because I was scared and got angry, that I had a list of diagnoses longer than my arm, that I wanted to hurt myself, and even worse, that I wanted to hurt someone else.
You’re only allowed to go outside if you’re on good behavior, and even then, it’s only for a few minutes a day, if there’s enough staff to take you – surprise, there rarely is.
I went outside twice my entire stay.
I spent most of my time in the hospital hanging out at the nurse’s station, because when I was in the dayroom there was an old lady who had decided that I was pregnant with Satan’s baby, and she kept trying to perform an exorcism on me – spitting at me, mumbling spells under her breath, the works.
The nurses were nice, the program specialists were nicer, and the doctors were bearable. If you made friends with the staff, they’d give you extra snacks and not get mad when you swore.
There was one staff member that always sat with me more than the rest and taught me card games, and he had even told me a little bit about his struggles, too. Eventually I started to see that the staff were human, and that they did care, even if it didn’t always seem like it.
After a few days, I started to realize that it wasn’t so bad after all. I wanted a cigarette more than life itself, and I would’ve killed for some Taco Bell (but you can’t say that, because they write down everything you say and use it against you in court). I kept reminding myself that the 72-hour hold was almost up, and if I was lucky, I’d get out of there soon.
Court came and went, and I got handed a 14-day hold on a silver platter. I freaked out, cried, and didn’t go to groups. Eventually, my doctor came to find me and told me that I was getting out. Even if I didn’t feel completely ready, it didn’t matter because it was time to go. The hospital was a short-term facility, and I was taking up a bed.
At that point, someone else wanted to die more than I did, so they got my room.
After waiting 10 extra hours for the cab to show up, they packed up my hospital grade scrubs, shower shoes, and the sweatshirt that they cut the drawstring out of (“you could hang yourself with it”, they told me when I protested) and sent me out the front door. When I walked outside and heard that click of the lock behind me, it hit me that for a whole week, I didn’t try to kill myself.
I didn’t try to hurt anyone else.
I learned how to get a little bit better.
Better yet, I could walk out of any room I wanted.
When I think back on being a patient in the hospital, there’s still some resentments – there probably always will be. There’s so much that the staff could have done better, and so much I could have done differently. I’ll never get that week of my life back. But I also know, without a doubt, that I wouldn’t have had any more weeks in my life without that one.
That week of dragging a blanket through the hallways and telling a stranger with a fake smile all about my goals for the day, it was the end of my sickness and the beginning of my recovery.
Fast forward a few months, I found my copy of the paperwork the hospital gave me when I discharged. Reading the words “patient is an immediate danger to herself and others, suffering from delusions and showing signs of psychosis” I started to realize how sick I had been. I wasn’t “bad,” I wasn’t crazy; but I was so, so sick.
But I wasn’t anymore – I had gotten a job, I paid my bills on time, and I took my meds. I had accepted the fact that I had Borderline Personality Disorder and PTSD, and I learned healthy coping mechanisms on how to deal with it. I was okay.
Finally, I was okay.
This was my reality as a patient in a psychiatric hospital
So, I went online, looked up the hospital so I could write them a review, and noticed that they were hiring.
I applied, got hired, and on my first day of work the staff members that remembered me beamed with joy. I get told “I was just thinking about you the other day, and here you are” and “I’ve never seen anything like this, you did it – you got through it.”
The one staff member, the program specialist who taught me how to play cards, looked like he had seen a ghost when I walked in the door. When he realized I wasn’t going to have a mental breakdown, he got the biggest smile on his face.
Not wanting to blow my cover, he simply said, “I know you from somewhere – do you play cards?”
I developed a relationship with the staff in the hospital that I never, ever would have thought possible when I was glaring at them from across the nurse’s station the last time we saw each other.
After a few weeks, the reason I went into this profession in the first place happened. I had a patient say to me, “fuck you, you don’t know what it’s like being here” for the first time, and I smiled to myself.
Because I did.
I still do.
I remember saying those same words, because once upon a time it was me who would be stopped before I could even think about sneaking out the door behind a doctor.
I remember hating everyone who had the audacity to work in such a place, hating them more than I thought possible.
I also remember the moment that I snapped, I switched, and started to hate them a little less, until eventually, I realized why they did what they did.
So that they could help people like me go from being a patient, to a professional.
Today, when patients scream at me “go to hell, you get to go home, and I don’t”, I shrug and walk away, and say a prayer that someday they’ll experience what I did.
That someday, I’ll walk by orientation and see a familiar face smile at me knowingly or see someone walk through the doors with keys and a badge, that I get to be proud of.
The reality of a psychiatric hospital is a harsh one, and sometimes the reality is as a patient, a professional, or both.