This post originally went live on mydnyht.wordpress.com on 4 April 2013.
I’m here to talk about the following game (which you can view on Youtube): The Cat Lady.
Despite the fact that I suspect this game to have been created by pretentious self-suffering art students, it was pretty good. The synopsis of the game is that a woman who suffers from depression kills herself and, instead of going to hell, is given a second chance – on the condition that she kill five serial killers, or “parasites”, that are not doing anyone any good. While I don’t necessarily agree with the concept of any human being a parasite or worthless, regardless of the mistakes they have made or the horrible things they have done, the game gets pretty into what it’s like to feel depressed and seek treatment for it. And overall, I thought the game’s portrayal of these topics was pretty accurate. One of the things that I thought was really accurate was the shitty way the game’s main character, Susan, was treated when she was hospitalized in a psychiatric ward. The game appears to take place in England, so I can’t really speak for what it’s like to be hospitalized in a different country, but in case you were wondering: yes, psych wards suck. The main reason for this is that you’re stuck with care providers that you can’t change as easily as you can change a therapist, and many of them are super jaded or really should never have applied for that job in the first place. In my experience, the care you receive is sub-par and not all that intense – you meet with someone (who doesn’t know anything about your background except what you tell them) who adjusts your meds, if you’re on any, and who prescribes you meds if you’re not on any. There are various group therapy sessions you can attend, and if it’s your first time in a ward, they might be helpful to you. That being said, a lot of the therapy sessions get pretty redundant after a while, and you probably aren’t going to benefit from any of them over a longer period of time except the opening and closing groups of the day, where you can discuss your feelings in an open setting.
I have some pretty big problems with the way psychiatric hospitals are run, due to some bad experiences I’ve had during both voluntary and involuntary hospitalizations. The first time I was hospitalized, I was thirteen and so the decision to bring me in was left up to my parents, and considered “voluntary” because they were the ones who submitted me in for care. My therapist tried to convince my parents that I needed a long-term stay – six months to a year – and after about two weeks, my parents decided that was a load of bullshit and had me released. When I entered the psychiatric ward, I was still getting over a pretty bad case of scarlet fever. I explained this to the nurses, but instead of letting me rest until I was better, they told me I had to participate in all the groups or else I would have privileges taken away. A few days later, while hanging around in the common area, I blacked out and collapsed. I was still conscious, but I couldn’t see anything and I was very weak from being sick, so down on the floor I went. When I reported this to one of the nurses, he gave me a glass of water and told me that he thought I was just making up my symptoms for attention, and nothing was done. When my mother arrived that night during visiting hours, I explained the situation to her and she furiously approached the staff. She pointed out that my face was swollen and I was covered in a rash, and she asked if they had even bothered to take my temperature. At her insistence, they did, and sure enough I was running a low-grade fever. I was finally given medication and was allowed to rest from my scarlet fever relapse. One of the other inappropriate happenings that I recall from this hospitalization was that a young boy – maybe eleven or twelve – forgot to hand his plastic utensils back in to the nurse after eating. Because the plastic utensils were considered sharps, if you had the privilege to eat in the common area or cafeteria, you were given the utensils and had to make sure you gave them back to nurse when you were done eating. Throwing them in the trash was against the rules. When it was realized that the young boy had thrown away the utensils, the nurse in charge gave him a pair of plastic gloves, told him to empty the trash out onto the floor, and made him dig for the plastic utensils while the rest of us were ordered to stand around and watch. It was a pretty demeaning experience for the kid and completely unnecessary.
The second time I was hospitalized, I was fourteen and it was involuntary, due to the fact that I’d taken an accidental overdose and this was labeled as a suicide attempt (it wasn’t, but most accidental overdoses are processed this way in our mental health care system). The first thing I remember from this hospitalization was a warning from a fellow patient. I walked in and a girl pulled me aside. “Do you see that woman over there?” she said (for the record, I can still remember what she looked like). “Be careful of her. Don’t let her see you naked. She’ll try to touch you.” Great. One of the nurses at the hospital was a child molester. This particular hospital was very lax in their security – so much so that, a few years after I was there, a patient died while in care. They had been admitted for a drug overdose, were left in their room alone, and the nurses never bothered to check on this person. By the time the hospital staff had realized this person was dead, rigor mortis had already set in. It takes about four hours for that to happen, and at around hour twelve it when it hits its peak. If I recall correctly, this person had been dead for a full eight hours before someone checked in – and these checks are supposed to happen ever half hour or every hour, depending on hospital policy.
The third time I was in a psychiatric hospital, I was nineteen and it was a voluntary hospitalization. I was deeply depressed and suicidal, and I knew I needed intensive help. I was deeply disappointed. There was all of one group therapy session that was helpful, and most of them (with the exception of the day’s closing group) were over by noon, which left a lot of downtime and a lot less time spent in therapy than I would have liked. I could have gotten the same care outside of the hospital, and been able to sleep in my own bed, and use my computer and cell phone. While upset one night, I left my room visibly in tears, hoping to talk to one of the nurses. I was carrying my teddy bear that my sister had given me for my fifth birthday for comfort. When I reached the front desk, the nurse in charge of the night shift looked up and coldly said, “You can’t have your personal items outside of your room.” A few days later, one of the nurses started prying into my religious beliefs. I tried to explain that I was a Neo-Pagan and what that meant. The next day she showed up with one of those obnoxious “Jesus will save you” pamphlets that the door-to-door Jehovah’s Witnesses pass out. But my “favorite” experience from this hospitalization was the discharge process. During the week, I requested to be discharged on a Saturday, and was told that this would be fine, despite the fact that apparently most discharges were supposed to happen during the week. When Saturday came, the on-call doctor (who was different from the doctor I’d seen during the week) was called in to interview me to see if I was well enough for discharge. After a five minute conversation, he decided it would not be a good idea to discharge me because I was a danger to myself and others. I had no idea where he had gotten this impression – he clearly did not look over my notes, and the doctor I’d seen during the week obviously did not communicate to the weekend staff that yes, I was OK to leave. I brought my concerns to the nurse on duty, and she informed me that because this was a voluntary hospitalization, I was free to leave whenever I wanted to. That being said, she also told me that it would be recorded in my records that I had refused treatment, meaning that my insurance company may charge me extra money or refuse to cover my care at this hospital, and that future doctors could refuse to treat me because I had refused treatment in the past. Furious and sick of being in a hospital with all the restrictions, I opted to leave anyway.
I think it’s important to share bad experiences people have had in the mental health community, not to frighten people from receiving treatment, but to improve the process for others who need to go through it. While I’ve had nothing but bad experiences in psychiatric hospitals, there are plenty of other treatment options for when you are in crisis. Your therapist or the Emergency Room at your local hospital should be able to refer you to the area’s crisis center, and you can opt to stay in a respite center instead of a psychiatric hospital, or receive intensive outpatient treatment. I’ve enjoyed my stays in respite centers, and you have significantly more freedom than you do in a hospital setting. You still get the same (minimal) care that you would receive in a hospital, but you have access to your phone, a computer if you want to bring it (although there probably won’t be internet access), and you can shop for/cook your own food. The visitation hours and leave of absence rules are also much more fluid and allow you much more freedom. Also, if you are feeling suicidal and/or have made a suicide attempt, you can still contract for safety and still ask to be placed in a respite center over a hospital – in my personal experience, because you are interested in your own care and want a say in things, they will consider this seeking voluntary treatment and allow you a bit of leeway.
It’s always good to be interested in and take a proactive role in your treatment options. This way, you can advocate for yourself and receive the care that is most helpful to you. One of the things I regret not doing was reporting my bad experiences to hospital staff at the time these things were happening – these hospitals will never know that their behavior was inappropriate and the problem won’t be fixed for people who are looking into future stays there. You do have rights as a patient, and you should absolutely exercise them. One of the most powerful things about the game that I mentioned above was not that it was so accurate about the bad things – the feeling bad and the bad hospital stays – but that it highlights the point that, yes, it does get better. It’ll take some work on your part, but you can be happy and move through your darkest points. Just make sure to advocate for yourself and take an active role in your treatment, and the process of healing will be much smoother for you.