Content Note: mental health, psychiatric hospital
I’ve written extensively about my mental health. It has been a lifelong battle that I wasn’t even armed for until I was age 22. And now at age 50, I am uncovering new layers of my story and history that sometimes feel amazing and sometimes, so very sad.
In 2010, my bipolar disorder symptoms flared and went unchecked by me. It started as hypomania, then full fledged mania mixed with depression. It was terrible time in my life and A LOT of people fled or walked away or turned away. My partner, Laura, and my therapist, Debbie Frankel, did not and with their help and support I eventually acknowledged I just couldn’t function like other people, took disability leave that became permanent, and entered a partial hospitalization program for six weeks to get my bearings.
I am so grateful for the supports that pulled me through, that I am here and able to write this post, that I am alive.
One piece along that journey was a little under 72 hours I spent on the behavioral health unit at Forbes Hospital in Monroeville. The Thursday before, my mind was wrestling with itself and I desperately wanted that to stop. I was still cognizant enough to realize that was not good. So I agreed to go the behavioral health unit. Part of me was secretly sure that they would say “Oh, she’s fine” and everyone would stop hounding me.
Thank God, they did not. I was swooped into a room and examined.
Let me jump to the end, I was released in less than 72 hours because my actual psychiatrist was on in-patient rotation that weekend and we had an appointment that same week. I went back to work two days later and continued on my downward spiral. But that’s another story for another post.
Allegheny Health Network merged their psych units into one at Forbes Regional. They did some renovations to accommodate the extra “beds” they absorbed from AGH, but they did not renovate the common areas. So a space intended for say 16 people to eat meals had to serve 25 people. The conference room for “therapy” (OMG) was so crowded that we spilled into the hall on chairs dragged from various rooms and the therapist stood in the doorway sort of yelling to all of us. Also the nurses aides had to constantly tell us to eat in the common area while standing in the doorway seeing there were no available seats. That was maddening!
Another thing AHN did was cut funding for therapy. I was admitted at 3 PM on Friday and did not have a speck of therapeutic interaction until Monday AM. No group therapy, no individual therapy, no occupational therapy, no art therapy. Just medication management, hourly checks, and a lot of long boring hours to fill. I was safe, but I believe this is a terrible environment for people with my diagnosis – to be stuck with quiet surrounding our active minds. I’m glad I went because I think it helped me to eventually turn the curve, but hoo boy – they could do better.
When I signed the paperwork in the ER, I was told IN FRONT OF LAURA that of course I would get my own room and yes I could keep some of my things. After a final hug, I followed the aide out of the ER and up the elevator to the unit. He didn’t speak to me. I was terrified. He unlocked the door, escorted me to the area near the nursing station and told me to wait. I stood there clutching my overnight bag, trembling with regret. Nothing happened.
Being dutiful, I walked over to the nurses station and reported for confinement. The nurses stared at me. They were in a staff meeting. Apparently, the aide had clocked out and rushed for his bus without telling anyone I was there. Yep, that happened. Of course, I complained but the head nurse told it probably wouldn’t go anywhere – as if she knew perfectly well that I was right, but the system was stacked against me.
Of course, I wasn’t in my own room. Only people who were an active threat to themselves or others had solo rooms. I was crammed into a room for two, but housing three.
I was compliant because this wasn’t my first rodeo. I responded to the medication calls, I took a shower each day and kept my area tidy. I did eat in my room which was a no-no, but I pointed out that there weren’t enough chairs. I showed up for “snack” (like we were in fucking Britain) and gratefully took my handful of whatever. I did the morning exercise VHS tape with the nurses.
Of course, I was seething with rage inside. I refused to talk with Laura on the phone. I called a few friends, but they couldn’t understand my torment so that didn’t go well. I was all alone and it was of my own doing, at least that part of it. I wanted OUT but I also desperately wanted someone to help me. I know intuitively that my meds were only part of the issue, that I needed therapy.
On Monday morning rounds, my then-psychiatrist saw me and told me I could go. I called Laura and asker her to pick me up, packed up my belongings and walked unescorted off the unit, down the elevator, and outside. I had no shoes. No slippers. Just socks on my feet. They had sent my shoes home with Laura. I also had no coat and it was November. I sat on the little wall outside the entrance a shoeless, coatless mental ward dischargee. Don’t judge us harshly.
Of course, Laura brought me shoes and a coat and took care of me. But she was appalled that literally nothing had changed. I felt both triumphant and despondent. I called my therapist to report what happened. She was not thrilled, but started seeing my twice a week and calling my psychiatrist to discuss medications.
I took another day off and decided for some reason to walk to the Giant Eagle on the Northside to get milk. It is like two miles away, but this was November and I had barely put shoes back on my feet. I had promised not to drive and wanted milk so off I went. Laura figured it out and came to fetch me. I remember walking along Allegheny Center listening to a GLEE CD on my headphones and carrying the milk.
I was not better.
But I was a step toward better. And I was absolutely sure I was going to work to not end back up in the behavioral health unit. So I started trying to accept that my brain was broken and needed to heal. And that’s the shift in attitude I needed to start that process.
Behavioral health units are horrible, but essential pieces of our broken system. I will never forget that experience. The long line to get our morning juice snack. The endless line of all of us filling out water pitchers because our meds made us thirsty. The people walking the halls endlessly. The woman afraid her kids would commit her permanently. The guy who ate an entire pizza and downed a 2 liter bottle of Sprite his family brought during visiting hours without saying a word. Finishing the novel I had started in the summer and starting to read Anne of Green Gables because it was the only book in the “library” that appealed to me. The young woman who had been there for 28 days because she was homeless and they would not discharge her until social workers got her set up – she cried, a lot. She also showed most of us the ropes.
It was dehumanizing and demoralizing. And all because of money. If AHN had invested properly, there was be lots of treatment available, not just VHS tapes and a bored nurse. There would be enough room for everyone to eat in the common areas. I could say that I didn’t really like blue Gatorade and request a different flavor without fear of being labeled non-compliant. Our meals wouldn’t be all carbs. We wouldn’t be allocated a child’s portion of juice for our daily snack. There would be no yelling therapy and not the good kind, either. I could say that I was confident I was no longer taking drug ABC and they would believe me or be able to pull up my file because I was part of their out patient clinic and verify. Nope, instead I just swallowed the wrong meds.
But that’s what we got. That’s how we are treated. There are no carrots (literally) just the looming potential of a stick smacking you back into another commitment.
As terrible as that is, I would go back if I thought my mental health warranted it. If Laura and my current therapist told me I needed to go, I would because I know that no matter how much it sucks – it beats the alternative of untreated symptoms.
I needed to be there so I could be here right now doing this.
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