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About The Not Crazy Podcast Hosts
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Jackie Zimmerman has been in the patient advocacy game for over a decade and has established herself as an authority on chronic illness, patient-centric healthcare, and patient community building. She lives with multiple sclerosis, ulcerative colitis, and depression.
Computer Generated Transcript for‘Inpatient Mental Hospital’ Episode
Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Not Crazy, a Psych Central podcast. And here are your hosts, Jackie Zimmerman and Gabe Howard.
Jackie: Hello and welcome to Not Crazy. I am here in the house of my co-host, Gabe Howard, who is sitting across the table from me staring at me. It’s a little extra weird, but he also lives here in this house with bipolar.
Gabe: I think that is the longest introduction that I have ever received, and I am sitting here with my co-host, Jackie, who is sleeping in my house rent free, eating my food, not contributing in any way and teaching my dog very bad habits. And she lives with major depressive disorder. Welcome, everyone.
Jackie: Hello. Welcome to Gabe’s house. It’s like you’re here with us.
Gabe: It is really cool. And it’s the first time that we’ve been able to record in person. Little behind the scenes. A lot of this stuff is done on an Internet studio. It’s really good. We plan a lot of stuff via video chats and text messages and emails and late night flurries of inspiration. But it’s always good to be in person because the energy just flows and there’s always Diet Coke.
Jackie: Regular Coke, if you’re not Gabe.
Gabe: Diet Coke.
Jackie: Regular Coke.
Gabe: Diet Coke.
Jackie: Right. Regular Coke if. But regular because if you’re going to go to McDonald’s, which we do, and you’re going to get the regular.
Gabe: Side note, McDonald’s and Diet Coke, we are open for sponsorships and we would appreciate hearing from your people.
Jackie: So would appreciate that. Today we are talking about something that I feel like has a lot of mystery and is not very clear, kind of shrouded in silence, which is what it is like to be admitted inpatient in a psychiatric hospital. And Gabe has done that. So I’m going to ask him a bunch of questions about that.
Gabe: And I’m happy to answer these questions because what I didn’t know upon admission would have just been really, really helpful to know. And in addition to my own psychiatric admission, I’ve worked in psychiatric hospitals and I’ve interviewed people who were inpatient and I’ve interviewed staff. And I’ve really just done a lot of work around this subject because it’s the crisis point. Right. A lot of people with serious mental illness have been inpatient and they end up there in a variety of ways. And it’s a terrifying subject. It’s a terrifying subject.
Jackie: I also think that there’s a lot of, I guess, misconceptions or at least assumptions about it based on movies, pop culture, haunted asylums, throwback, to all of the things that we think we know. But I’m going to assume are probably incorrect, but I’m going to find out when I ask you all these questions.
Gabe: Pop culture is a terrible place to get facts.
Jackie: You need to put it on a shirt
Gabe: I don’t know that anybody would wear it. Because, you know, how many people are lawyers because of law and order. How many people are doctors because of Grey’s Anatomy? How many people think they can get away with murder because of the show, how to get away with murder and snapped. I understand why pop culture is spoon feeding you information and it makes you feel like you’re seeing behind the curtain a little bit. And pop culture is really great at playing with our emotions. They don’t just show you what it’s like to be in a psychiatric hospital. They pair it with a dark and stormy night and with sad music and they cut to clips of a family crying. And in some ways, that’s not far off. Being in a psychiatric hospital feels like a dark and stormy night. Anybody who goes to the hospital and has to stay overnight, their family is probably scared. The whole soundtrack thing would be nice, but we don’t really have soundtracks in real life and there’s not quick cuts in real life. Right. There’s a lot of hurry up and wait. There’s a lot of sitting. There’s a lot of wondering.
Jackie: Whoa, whoa, whoa. Let me ask you questions before you continue, because I feel like you’re gonna answer some of the questions that I have in your little intro monologue, which is great, but I would like to make it purposeful because I have good questions at least. I think they’re good questions. I as somebody
Gabe: I will be judge of the good questions.
Gabe: I will tell you how well you’re doing.
Jackie: So I am somebody who has not been inpatient. I have considered it. There were times in my life where I was making the phone calls, trying to find somewhere to go. I don’t even know if that’s really what you should be doing. But there were times that I was I was thinking this is probably what I need to be doing. I didn’t do it for a myriad of reasons. But in those moments, all I’m thinking is the shots of movies that have run through my mind. Is this a good idea? Is this a bad idea? Is this the only idea? So I have a list of questions.
Gabe: Before you get into the questions, I’m going to answer from my personal lived experience, and I think it’s important to say that just like people living with bipolar disorder aren’t the same. All hospitals aren’t the same. I live in a big city. My admission was 17 years ago and different hospitals are different. Some better, some worse. Some the same. So I’m going to speak very general and from personal opinion. Your mileage may vary. Just wanna throw that right out there.
Jackie: Good disclaimer. The first question that I have, which is super relevant. How do you actually get admitted inpatient? Because I feel like this could happen a couple ways. But in my brain, my pop culture brain, where I go is I’m having a crisis. I go to the E.R. because that’s what they always say to do. And the E.R. goes, wow, you’re bananas. You’re losing it. And they go, we’re gonna admit you right here in this hospital. And then I have follow up questions, but I feel like that’s not right. Maybe it’s right.
Gabe: I sincerely don’t believe that the mental health establishment is saying you’re bananas and I understand why people think that. But, you know, just a little side note what their thinking is, is this is a person who needs help. So that is absolutely correct. People can go to an emergency room. They are diagnosed with something or they’re a danger to themselves or others. And then they are admitted to a psychiatric hospital. That is how I ended up in a psychiatric ward.
Jackie: Is it a psychiatric hospital or a ward? Like every hospital has a psych ward.
Gabe: Well, no, not every hospital has a psych ward and some hospitals specialize just in psychiatry. So there are psychiatric hospitals. They do nothing but mental illness. Mental health and psychiatry. And then there’s regular hospitals that just like they would have an oncology ward or a new baby ward. They would also have a psychiatric ward. The hospital that I was in was a psychiatric hospital that was attached to and part of a larger hospital system. So I guess I was in both a ward and a hospital. But it does vary where you are. And it’s also important to point out that some rural areas, they don’t have a ward or a hospital, meaning to get care. They can be driven 25, 50, 100 miles away to get some sort of services.
Jackie: Yikes. That actually was legitimately shocking to me. Not shocking that in rural areas they don’t have access to good care. But just thinking about in a moment of crisis going, well, let’s pack a snack because it’s going to take us 40 minutes to get wherever we’re going. But rewinding for a minute. So you’re having a moment of crisis. You can’t just call up a hospital that specializes in mental illness. Right. Be like, hey, I’m coming on in the way you can with an E.R., right? Like, don’t you have to make an appointment? There’s all this talk about not being enough beds. Right? There’s never enough beds. So how do you when you’re in a crisis, how do you get to where you need to be?
Gabe: This is where it’s really shitty for people with mental illness, especially in crisis. You are often committed to a psychiatric hospital or a psychiatric ward, meaning you did not decide, oh my God, something’s wrong with me. Make an appointment and or go to the emergency room and then check yourself in. A lot of times the police are called, the authorities get involved. It’s scary. Most people end up in the psychiatric ward through some sort of crisis point.
Jackie: And when you get there, you’re just in, right? It’s not like do not pass, go, do not collect $200. We’re just the police show up, you get out and you’re like, I’m here now.
Gabe: That’s probably simplistic. The police show up, they evaluate what is going on, and they decide that you are a danger to yourself or others and they decide not to arrest you. It’s very important to throw that in because it’s certainly possible that the police show up and they arrest you. You are having psychosis. You think that, you know, people are chasing you and that there’s monsters around every corner. But all they’re focusing on is the fact that you’re in a convenience store throwing canned goods and they’re like, well, that’s vandalism, that’s theft, that’s trespassing. And they arrest you and take you to jail and you get no help. So in a way, the police showing up and seeing a crisis, seeing something go wrong, recognize it as mental illness and taking you to the hospital where you are then committed against your will. It is actually things going very, very well. But I want to put a slight pause there and look at it from the perspective of somebody with mental illness. You’re in crisis. You’re scared. You’re not in your right mind. The police show up and now you’re locked behind locked doors in a scary place with crazy people.
Jackie: That sounds pretty terrifying.
Gabe: It’s incredibly terrifying.
Jackie: So how did? Let’s talk about you. How did you get in? Where you were?
Gabe: As far back as I can remember, I always thought about suicide. I wanted to die every day of my life as far back as I can remember. On good days, I thought, well, today is not gonna be the day that I die. And on bad days, I thought, well, maybe this is the day that I’ll do it. I thought this was normal because, hey, no good mental health training purpose of this show. Right. We want to have more conversations surrounding mental illness and mental health. I didn’t know that I had bipolar disorder. My family didn’t know that I had bipolar disorder. Nobody recognized the signs and symptoms of mental illness for reasons that will fill up years and years of not crazy episodes.
Jackie: Gabe, we already know that you’re sick. But how did you get admitted?
Gabe: Someone finally recognized something was wrong and asked me if I was planning on killing myself.
Jackie: Who was that someone?
Gabe: It was practically a stranger. It was a woman that I was casually dating at the time. And I say casually dating because we try to keep this a family show. But she recognized that something was wrong and did something about it.
Jackie: And what did she do?
Gabe: First, she asked me if I was planning on killing myself. And I said yes. And I got excited because I thought this was a normal conversation. I thought that everybody thought about suicide. So the first thing that I thought in my head is, oh, my God, I’ve got a helper, this is gonna be fantastic. You know, after I’m dead, I have like a will and some paperwork and insurance documents I need my family to find and I was gonna leave it on the kitchen table with a note that says, hey, this is what you need to do now that I’m dead. But I can give it to her and she can give it to my mom and dad. This is gonna be fantastic. I was thrilled.
Jackie: I hate the term “heart just sank,” but like I just got that like can’t breathe moment when you said I have a helper. Like that is such a, it’s not good thought processing for obviously shows where you were in the moment of, let’s say, somebody asking you if you’re suicidal and you’re like, yes, someone to help. That’s terrifying.
Gabe: It’s crazy, it’s nuts.
Jackie: It’s terrifying.
Gabe: It shows that something is wrong with your brain
Gabe: Or your thought process, it’s proof that something is going very wrong in your life. To think that somebody is asking you about killing yourself because they want to be involved in some sort of motivating or positive way. Isn’t that messed up? Not surprising. She had the same reaction as you. She freaked out. She freaked out. And honestly, I looked at her like she was crazy. I thought, why? Why is this woman freaking out?
Jackie: So what did she do after that?
Gabe: She said we need to go to the hospital. She said we need to go to the hospital right now. And I said, why do we need to go to the hospital? I’m not sick. And she said, we need to go to the emergency room. I said, the emergency room. The emergency room is where you go. Like when you break your leg, right? When we fall off the roof. When we’re, you know, you’re playing with fireworks on the Fourth of July. You burn your hand. It’s not some place that you go because you’re feeling the way you felt your entire life.
Jackie: Yeah, yeah, I guess if you look at it in hindsight of.
Gabe: I did not see any of my feelings as an issue. This is the way that I always felt. Therefore, I did not see it as sickness. I understood sickness to be aberrant. You feel differently. You know, normally you’re not throwing up. Now you’re throwing up. Sickness. Normally your nose is not running. Now it’s running. Sickness. Not, I felt this way my entire life. I still feel this way. You want me to go to a doctor for it? You, pardon the pun, I thought she was nuts. I really did think, wow. I have come across a crazy person. Just great. Now I have two problems. I need to plan my suicide and I need to take care of this wackadoo that that’s what was going through my mind. I can’t be any more blunt than that.
Jackie: We’ll be right back after these messages.
Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player.
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Jackie: We’re back talking about Gabe’s inpatient hospitalization. So you roll up to the E.R., you get out, as you may know. You do know. And as I know, I’ve been to the E.R. lots of times. You walk up to the desk and they ask you, what are you here for? Which luckily it’s not a gunshot wound in a super emergency. Because then they make you sit in the waiting room. But you walk in and you say.
Gabe: This is fascinating, right? So she did convince me to go, obviously. And here I am. And we walk in and she says, this is my friend Gabe, and he wants to kill himself.
Jackie: And the lady at the counter said, great, we’ll be with you in 20 minutes?
Gabe: No, the lady said, you know, OK, here’s the here’s some paperwork. We’re going to have a social worker come over and talk to you. And I honestly don’t know how long we waited, but they took it very, very seriously. And they put me in a room behind a curtain. And I remember the first person to talk to me was like a nurse and then a social worker. I very clearly remember a social worker. And, you know, some other nurses asked me questions. And finally, the emergency room doctor came in and asked me questions. And that guy said something along the lines of, hey, we need to get you a psych consult. So a psychiatrist is going to come and talk to you. Around this time is when I just started to blackout.
Jackie: Do they ask you questions, though? You know, when you go to your primary care physician or something and they say in the last two weeks, have you felt depressed? Have you had a hard time sleeping or they when you walk in and you say, hi. I want to kill myself. Are they like, OK, well, let’s. What does that mean to you or are they like, OK, cool. So have you been sad lately here? I mean, what did they say?
Gabe: Here is where things are going to diverge greatly. I know what they’re supposed to say.
Jackie: Mm hmm.
Gabe: I want to be very, very clear. I’ve been in the mental health advocacy game for a long time and they have a questionnaire lists and follow up questions and they are gauging you. They ask you if you’re feeling suicidal. They ask you if you have a plan. They ask if you have access to means, you know, they ask you, like you said, how have you felt over the last two weeks? If it interferes with the activity of daily living? That comes up a lot. That day, I don’t remember any of that. I remember a lot of people coming in. And according to the woman who brought me to the hospital, I didn’t seem to notice that they kept asking me the same questions over and over again.
Jackie: This the worst part about the E.R.
Gabe: Yeah, I didn’t notice it.
Jackie: They just ask you the same fucking thing over and over.
Gabe: I did not notice. And again, at some point, I just completely, completely blacked out. And the next thing that I remember was waking up in a psychiatric hospital as an inpatient.
Jackie: Ok, so let’s talk. Let’s talk about that because let’s talk about what I think inpatient looks like. Maybe not what I think, but let’s talk about What Girl, Interrupted taught me about what in-patient looks like. Inpatient care looks like a bunch of people in a nice sunny room doped up out of their minds. So they’re not really walking. They’re not really talking. They’re just like hanging out weirdly and silently. Everybody has a room and a roommate, which they get locked in at night. There’s a line for meds that everybody stands in. And a lot of people don’t want to take their meds. And then there’s a group therapy part of the day and then there’s a one on one therapy part of the day. How close am I?
Gabe: So in some ways, you’re not as far off as you think.
Jackie: That kind of makes me sad.
Gabe: And in other ways, you’re really, really, really far off. That’s the thing about pop culture, right? The reason it’s so devious is that it’s got that little bit of truth in it. Are you locked in a psychiatric ward and or hospital? Yes. Yes, absolutely. Do they try to make the rooms like really big and bright? Yeah, they can’t have a lot of stuff in them. The furniture has to be extremely heavy. So you can’t pick it up and throw it. The furniture has to be not cloth because you have to be able to wipe it down. And listen, if you look at any place in a hospital, all of that furniture is vinyl or leather. It’s not cloth because there’s fluids everywhere. And it is. Is it ugly? Yes. You’re not staying at a bed and breakfast. As far as the people doped up out of their mind, no, but, yes. Do these people look like they’re having a good day? No. We’re in a hospital.
Jackie: Are you interacting with other people, like the way that it’s sort of like a group room? Because when I was in the hospital, if I had a roommate, I didn’t want to talk to them. I don’t want to look at them. And there was no like social area wasn’t mingling. It was like, I’m not here trying not to die. So.
Gabe: There is a social area. Physically, we’re OK in general. Movement is good. They don’t want us to lay in bed all day because, you know, you’re depressed and you’re feeling suicidal and they let you sleep all day, that that’s not going to kind of help move you along. Right. They do get us out of our rooms and hoard us into like sort of that, you know, that sunshiny room that you describe with a bunch of people wandering around as far as interactions concerned. You know, that’s a tough one. We are encouraged to interact with each other. And by the last day, I formed a basketball team that we called the straight jackets.
Jackie: Oh, god.
Gabe: On the first day I sat in the farthest corner and held a book over my face that I was not reading, but I wanted people to think that I was reading. And I also didn’t want to see what was going on. And people largely left me alone in the middle. I played checkers. So it’s tough, right? I don’t think anybody the day they get to the hospital wants to hang out with the other hospital. And I’m not talking psychiatric. I just you know, my dad’s been in the hospital for surgery. He’s had a roommate each and every time. I don’t think he could tell you what they look like.
Jackie: That’s the worst. It’s the absolute worst.
Gabe: Nobody wants to meet friends in the hospital and to use your girl interrupted an allergy that might be the cruelest part of these movies. In my mind, these movies, these books, they always end with these lifelong friendships. They always end with these. You met people who made you better. You met somebody that inspired you. You discovered that you love art. That’s. No. You were in the hospital. You were diagnosed. You were removed from crisis. You were given an emergency care. And then you leave. You don’t. You.
Jackie: You’re not besties with anybody?
Gabe: You really aren’t. And I remember some of the stories of the people who I was inpatient with. And they’re not even necessarily positive stories. They’re not negative ones. They’re just it’s just really hard. It’s you’re scared and you’re sick. And hospitals are ugly and they’re ugly for necessity. And that’s something that I want to touch on. Right. So many people think that psychiatric hospitals and psychiatric wards are ugly because they hate the patients. They’re not. They’re ugly because they have to be. The reason that the doors are locked is because they need to keep a safe. Somebody who’s suicidal or not in their right mind just can’t roam the hospital grounds. What if we get our hands on a knife from the cafeteria? They have to be able to control the area. And when you control the area, you lock the doors.
Jackie: Are the, like your bedroom door? Do those get locked? Did they get locked?
Gabe: They didn’t.
Jackie: Ok, it was like the ward was locked, but.
Gabe: So essentially, the way that it worked. And again, your hospital may vary. Is there were wings. So I was in the male wing. There was another wing for females. And then there was a geriatric wing, which was for older people and.
Jackie: You only wear nightgowns, right? Like that’s what in my head they only wear nightgowns.
Gabe: No. Nope. We all had our street clothes on.
Jackie: And long gray hair, that is not been brushed in a minute.
Jackie: I also learned that in Girl, Interrupted.
Gabe: All, all all of us were in our street clothes. And now the first day that I was in, I came from the emergency room and I wasn’t a gown, but my street clothes were there. When I woke up and figured out what was going on or where I was, they told me that I could take a shower and put on my street clothes. And later that day, the woman who brought me to the psychiatric hospital brought me more clothes. And that’s what I wore the whole time. And so, no, no, there wasn’t long, stringy gray hair. I’m not saying that there wasn’t somebody in a corner rocking back and forth because there was listen, that that is a reality. Some people are sicker than others. It might also be a good idea to point out that Girl, Interrupted was also about like really long term care.
Jackie: It was also in the 60s when it was not as good as it may be today either, right?
Jackie: Yeah, like there’s a lot of things that have changed.
Gabe: There’s a lot of differences. Yeah. Yeah. And again. Since we’re using Girl Interrupted, I don’t think that it’s a bad movie and this is certainly this person’s experience. So it’s really hard to say, no, you’re wrong because I wasn’t there. But the takeaway is that people are getting of sort of this like sad, depressing, miserable place where everybody’s mean to you and you’re locked in this room for some sort of punitive reason. I wanted to smell those myths, but I also want to point out that it is depressing, are locked in a room and some of this is against your will. I don’t know how to put those things in my brain because the reason that you’re locked in the room is to keep you safe. But you’re still an adult who’s locked in a room.
Gabe: The reason that everything’s ugly is because it’s a hospital and hospitals are ugly and there are safety issues at large. But we still can’t get over the fact that it’s ugly and people will be like, well, it’s really depressing to be inpatient. No shit. It’s depressing to be in the hospital. It’s depressing to be at the DMV. There’s just things in life that even though this is the best thing for us, it is depressing. Life is depressing sometimes. And it this is really, really difficult because in a psychiatric hospital, we often believe that these things are punitive. I believed with every single fiber of my being that the reason that that door was locked is because society hated me. And that was not. Why not? Why at all?
Jackie: I want to ask a follow up to that. When you left, did you still feel that way? Like when you walked out, you were thinking to yourself, this door’s locked because society hates me?
Gabe: Because they need to protect society from people like me. And that’s the part that is just so incredibly unfair. Nobody dispelled me of any of these myths. I believed that that door was locked because society was afraid of me and hated me. And I was a bad person. And nobody sat me down and told me that wasn’t why it would be years, years later, after I reached recovery, decided to become an advocate. Like, I didn’t even learn this like early in my advocacy days, like I was holding national awards and published in national publications. And finally, finally, I said this to a psychiatrist. I said, it’s really mean to lock people behind doors because society has given up on them. And the guy said, that’s not why we do it. And I said, why do you do it? And he said, you’re suicidal. You’re not in your right mind. You want to hurt yourself. You’re a danger to yourself or others. We have to be able to control the environment. We can’t let you roam free. We have to have an environment that we know that you’re safe in. And that means that means walls, fences, doors, windows locked. That’s why we do it. That made so much sense. It made so much sense.
Jackie: It took a psychiatrist years, years, years later to explain that to you?
Jackie: So looking back now, how do you feel about that experience?
Gabe: I feel completely differently. Everything is different, I’ve learned so much from those days and I feel really lucky that I could talk to more people on both sides and learn more and realize that even though I felt that was happening, you know, just being locked up because I was a danger and that society hated me. I realize that there was just so much more to it than that. In those moments, I could only see the world through the lens of my own eyes, and becoming an advocate allowed me to see things from so many different perspectives. Society’s perspective, other patients’ perspective, the doctor’s perspectives. I don’t know that I ever would have realized that, and this is why I believe in having conversations surrounding the bad things that happen to us. Right. Because if I hadn’t had those conversations, I would still be walking around thinking that society hated me and locked me in a room because I was a bad person and I never, ever would have seen the broader picture.
Jackie: Well, and that’s why we do the show, right? Because as it turns out, talking about these experiences make them easier for all of us to participate in and appreciate.
Gabe: Yeah. Who knew? It’s almost like working it out versus internalizing it makes the world better. And I had so much to say. We decided to break this up into a two part episode. So this was part one. Come back next week for part two and learn more about Gabe’s inpatient adventures. If you like the show, please share us everywhere on social media. Rate us. Rank us. Use your words and stay tuned after the credits because we always put funny shit there. We will see you next week with part two.
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