Fearing Inpatient Hospitalization

By Kristina Randle, Ph.D., LCSW

Im a seventeen year old student in school and im trying to figure out life. I have had issues with self harm for a short time(2yrs).My parents and friends are worried that the depression and self harm arent getting any better and im sufferring.I was diagnosed with major depression recently and i feel so bad all the time.So my therapist recommended inpatient to my family because i cant take care of myself anymore.And im afraid because i know how bad i feel, and i dont want to be locked away forever.Right now im having issues with like basic hygeine,i cant sleep, i havent been eating.I want to be normal and do normal stuff young people do but i dont see the point anymore.However i have told my parents and therapist im afraid of inpatient because i dont understand how it works and whos gonna help me there.And i have never been on medication so my family thinks this is a good time to consider it as a option.

I dont know what to do im tired of struggling to get through the school day. I’ve read horror stories on the internet about inpatient hospitals.And im so scared i dont want anything bad to happen to me.I agree with my therapist that outpatient therapy isnt enough anymore i feel so alone and afraid.I do trust my parents and therapist but im so afraid of inpatient and being locked away forever.I want to be able to take care of myself again and enjoy life.So my question to you is Does inpatient hospitalization have to be so scary?Also what happens when a young person is hospitalized for mental health issues? Thank you for time.

A. I’m sorry you’re struggling. I understand your concern about the hospital. Apparently you’ve heard very negative things about the hospital experience. You mention your fear about “being locked away forever.” That may be part of why you fear the hospital. Your fear may also be related to not knowing what to expect in an inpatient setting. People tend to fear the unknown.

I can’t be certain of what your particular hospital experience would be like but I can give you a general overview of what it might be like. It is important to note that no one can be “locked away forever” in a psychiatric hospital (or any hospital for that matter). In fact, individuals sometimes complain that their stay is too short. Generally speaking, individuals tend to stay for short periods of time in a psychiatric hospital. This is not true in every case but it is for many. Length of stay depends on the nature of one’s symptoms. Generally, psychiatric hospital stays are meant to be temporary, to help a patient stabilize. Once stabilized, the hospital staff is usually attempting to move the patient to the next least restrictive level of care, which may be a partial hospitalization program (where you attend sessions at the hospital during the day but go to your own home at night) or an outpatient setting.

Your family, friends and therapist care about you. They see that you’re unstable and not doing well. They believe that the hospital might be a temporary respite to help decrease your symptoms of depression and to help decrease your desire to self-harm. If you go to the psychiatric hospital, generally there are two ways that one could be admitted: voluntarily and involuntarily. If you choose to enter the hospital voluntarily then you are free to leave at any time. Yes, the inpatient floor doors are locked but you are under no legal obligation to stay. Generally, an individual may enter the hospital voluntarily when they know they need help to stabilize and if they feel that they are a danger to themselves or others. Your family may believe that you are a danger to yourself because of your cutting behavior. They may also be concerned about your depression. Some individuals with depression contemplate suicide.

Once in the hospital, you will likely meet with psychiatrists, social workers and other various mental health professionals. Their goal is to assess your situation, to make a diagnosis and to offer treatment. Their overarching goal is to ensure your safety, keep you stable and ultimately link you to an effective treatment. Perhaps outpatient therapy is not working for you now. The hospital staff may be able to reassess your situation and find a more appropriate program or a more intense treatment to better suit your needs.

During your stay in the hospital, in addition to meeting with psychiatrists and other mental health professionals, you may be asked to participate in individual or group therapy. Some people find group therapy helpful while others do not. You may not be forced to attend group therapy but these groups are generally encouraged. You may also interact with other patients. Some people find this helpful because they meet people who are struggling with similar issues.

Depending on the hospital, there may be certain times when phone use is restricted (i.e. during meal times, group therapy, and so forth). Most facilities will not allow you to have access to your cell phone or other electronic devices (i.e. laptops, computers, etc.) Many facilities allow visitors but like most hospitals, there will be specific visiting hours.

Your case will constantly be evaluated by mental health professionals. If an individual is not a threat to themselves or to others, the hospital staff will make arrangements for the individual to leave and to attend a new program or type of treatment.

If your friends, family and therapist are concerned about your well-being and are suggesting the hospital, you may want to consider their recommendations. You could go to the hospital with your family and be evaluated for inpatient admission. You can go to a hospital to be evaluated by a mental health clinician, psychiatrist or other mental health personnel who will assess your symptoms and determine whether inpatient hospitalization is necessary or recommended. This might be a good place to start. There is no guarantee that if you go to the hospital for an evaluation that you will be admitted. In many states, there are strict voluntary and involuntary commitment criteria. That means that even if you wanted to be admitted to a psychiatric hospital, there’s no guarantee that the hospital staff will admit you.

I would encourage you to speak to your therapist and family about your fears and concerns relating to the hospital. Please try not to be frightened and understand that the hospital staff is not going to “lock you away forever.” They are there to help.

I hope that I have shed light on what the hospital experience may be like. Please consider writing back in the near future and updating me about your situation. Also, don’t hesitate to write back with further questions. I wish you the best of luck.

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Last reviewed: By John M. Grohol, Psy.D. on 28 Apr 2010

APA Reference
Randle, K. (2010). Fearing Inpatient Hospitalization. Psych Central. Retrieved on September 16, 2014, from http://psychcentral.com/ask-the-therapist/2010/04/28/fearing-inpatient-hospitalization/