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"I was scared to death," said Jake, a 39-year-old systems analyst in Seattle. "But it was my last hope. I knew I had to do something. I'd had a big career change, family pressures. I was depressed and anxious," he said. "I wondered, 'Can I face another day?' I was home alone and I had firearms in the house. I came very close to suicide.

I realized I needed help. I called my company EAP [employee assistance program], and I was referred to a therapist. She immediately suggested I go into the hospital."

Hospitalization is the best place to get help if your illness has become severe. It can give you an opportunity to stabilize, rest and recover while you receive medical care. It is a safe place to be if you are feeling out of control, having thoughts of harming yourself or someone else, having trouble taking care of yourself or your family, not eating or sleeping for days, or if you are experiencing other serious symptoms. It is also a good place to be if you don't have family members or other support to care for you while you are in crisis.

"I didn't want to go," said Jake. " I always thought I was strong as a rock; Mr. Macho. I didn't want to be considered a nut job. I felt derailed. I worried about how my family was going to react. And what about my job? But I knew I had to save my life."

In the hospital, you will receive medical treatment, psychotherapy, learn coping skills and learn about your illness, medications and community resources.

""You will find a great deal of support from lots of people in the hospital."," said Elizabeth Walden, Director of Intake at Centennial Peaks Hospital near Boulder, Colorado.

"You'll get help to create a plan for recovery and prepare for outpatient treatment," said Walden. "You'll learn how to watch for red flags in the future. The goal is to stay out of the hospital."

What happens when I am admitted?
A psychiatrist will evaluate your symptoms to determine the best treatment plan and the most appropriate treatment setting for you. You may want to have a family member or friend help you with the admission process.

Hospital staff will work with your insurance company to get approval for admission for a limited hospital stay. The insurance company will then periodically review your progress to determine whether the stay should be extended. If care is denied, the psychiatrist and patient may appeal. When you prepare to check-in, find out what items you can bring into the hospital, visiting hours and how and when people can reach you by phone.

What can I expect in the hospital?
In the hospital, you will work with a variety of mental health professionals: a psychiatrist, a clinical psychologist, nurses, social workers, activity and rehabilitation therapists and, if needed, an addiction counselor. You will probably participate in individual therapy with a primary therapist, group therapy with other patients and family therapy with your spouse, children, parents or other significant people. You will probably be treated with one or more psychiatric medicines.

"In the morning, there was a therapy group, where everyone checked-in. 'How did you sleep, how is your appetite, what is your goal for today?' I had never been to any kind of therapy, " said Jake.

"I realized that these people had come to the same point in their lives as I had," he said. "Getting to know them, I didn't feel so alone. The staff was very caring. They helped me talk my problems out, learn relaxation techniques and about medications. I could take a time out and leave my problems outside; I could work on me; let someone else take care of me. During down time, I talked with other patients and really bonded with them. They're not judging you."

Sources
Depression Bipolar Support Alliance (DBSA)
American Psychiatric Association
Group therapy photo courtesy Mary Jane Hooper, MS

Here's what will happen in the hospital

• You will be asked to have certain of your belongings locked away for safekeeping.
• You will not be able to use your cell phone or computer.
• You will probably share a room with another patient.
• You will have less privacy than you're accustomed to.
• Your activities will be on a schedule for meal times, group activities and sessions with your doctor or therapists, free time and bedtimes.
• You will probably join other people on your ward for meals in a cafeteria.
• You may refuse to participate in activities, but you will gain the most benefit from your stay if you take part.
• The hospital staff will monitor your medications.
• You may get passes to leave the hospital for outings with friends or family members.
• Your family may be involved in your treatment.
• In necessary circumstances, staff may take steps to protect you from injury that could include the use of restraints or isolation from other patients for very brief periods.
• Adults may stay in a psychiatric facility for periods of a few days to two weeks.

Who will be informed about my hospitalization?
"My employer didn't know anything except that I had been on medical leave," said Jake. "The EAP had arranged everything. I did choose to tell my boss about it, to keep him in the loop. He was very understanding."

No one will be notified about your hospitalization without your permission, except your insurance company. If you don't want to tell friends and co-workers you were in a psychiatric hospital, you can tell them you went in "for a tune-up" and thank them for their concern. In an ideal world, everyone would be informed and understanding about mental illness. Unfortunately, that's not the case. You may want to be prudent about who you confide in.

What happens when I am discharged?
Once your condition is more stable, your psychiatrist may recommend a day treatment program. This can be an effective choice even for people who haven't been in in-patient care. This type of partial hospitalization provides individual and group psychotherapy, help with vocational and educational needs, and other services to help patients learn to cope better at home, at work and in social interactions. You will return home at night and on weekends.

After you are at home, take time to get better. Ask for help when you need it. Practice relaxation techniques and learn what triggers bring on your symptoms. Keep appointments with your doctor and try to take your medication as prescribed. Find out about support groups and find a therapist you are comfortable working with. Care for yourself as anyone recovering from a serious medical condition - get enough sleep, eat a healthy diet and try to exercise. Read books that will help you and your family members learn more about your illness.

Friends and family members may be uncomfortable and uncertain about what to say or do around you. Try to be open and honest with them. There may be hurts that need to be healed because of things that were said and done when you were very ill.

"If it weren't for the hospital" said Jake," I wouldn't be here today."

For help in finding a mental health facility: National Mental Health Information Center

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