It’s not easy getting a bed in a psych ward. Most psych evaluations that I’ve been through happen at regular hospitals or at Emergency Rooms of hospitals. Even a patient with psychiatric history, or a diagnosed mental illness, still has to go through the lengthy process of being admitted and transferred to your typical psych ward; This process is apt to change and is sure to throw you (the patient) a few curveballs.
First, you go about checking into the hospital for a psych evaluation. They take this request seriously and sequester you away from the typical or standard patient that is waiting for more normal hospital care or relief. There is only one time that I can remember not being immediately transferred to some type of special waiting room (and I have been through at least nine of these). The whole deal with psych evaluations is that they are trying to monitor your behavior so they start tracking pretty much everything you do right away.
Now you’ve made it to the first waiting or surveillance station, but you have a long way to go before being designated a hospital bed at a nearby psych ward. What do they have you do in order to evaluate you further? Well, at some point they take your vitals. They might ask you a few preliminary questions to see where your head is at and what your story is upon early arrival. Once the hospital staff makes their initial evaluation and/or judgement, they’re waiting for your next move. In my last psych evaluation (at this stage in the process) I was put into a small room with about nine chairs. No floor space to sleep. There were three other guys who had taken off most of their clothes and were attempting to fall asleep or, in fact, were already asleep on these different chairs. When in Rome, I figured. I played the part, which is what I assume they wanted me to do. So I stripped down a little bit, pulled up a chair, and fell asleep alongside these other guys. It felt and looked like a bunch of arranged hobos trying to get some shuteye. Sleep is the truth serum for finding answers from psychiatric patients -- they always want you to fall asleep before they get into any serious line of questioning. Hours went by and I finally fell asleep. As soon as you nod off that’s when they wake your ass up and start the questions. They will wait an eternity for you to finally doze off.
After the hospital receives your sleep induced opening statements, they make the call to continue or discontinue with their observation. I would imagine, at this point, especially if you have had a history of mental health issues, the hospital has made up their mind on whether or not they are going to admit you. If they are unsure, get ready for a room change and a whole new round of surveillance.
One time I was taken into my own separate room with a bed and a wooden chair. There were mirrors on two adjacent walls and I figured I was at my new home at the psych ward or I was still being questioned and monitored. I used the chair to start doing sit-ups. Within thirty seconds, a nurse entered the room and took the chair away. I approached the mirrors on the wall and confirmed one of the mirrors was a two way mirror with my finger. A psychiatric doctor immediately rushed into the room, and I was off to be evaluated somewhere else. Sometimes they’ll throw you for a loop, and you need to be ready for anything.
A lot of the times I’ve gone through psych evaluations where there is often a ton of dubious questioning as to the actual problems I am or am not going through. I am not your typical patient; Sometimes I admit that I am not having a psychotic break, but need to use the psych ward as refuge… Other times I am trying to get a clean bill of health and be on my way, and the psych ward doctor(s) believe I am, in fact, going through a manic episode. One thing is for sure, in order for a bed to open up for you in inpatient care, they don’t ever stop monitoring you for peculiar behavior and, of course, the honest truth from the patient themselves; They’ll wait over ten hours for you to fall asleep just so they can wake you up and start the questioning. It’s much harder to explain your story and yourself to the doctors when you have been in deep sleep; the doctors are counting on this, and they don’t want you to weave a web of lies. In the end, psych evaluations can get exhausting. They disrupt any type of schedule you might possibly be on. I guess it’s a necessary evil, as the hospital staff and doctors are just trying to make the best decisions possible before admitting a patient to inpatient care at a psych facility; a place that is far from comforting.
Some psych evaluations don’t take that long. These are the ones where they aren’t going to admit you. They check your vitals. They ask if you are a harm to yourself and others. They monitor your behavior real quickly. They get a clear understanding that you are not willingly going to admit yourself, and you’re on your way. A lot of the times people with bipolar disorder just need to catch up on sleep, reset, and be on their merry way. However, if you’re feeling psychotic and in need of admittance to a psychiatric ward be prepared to back-it-up.