4 MIN READ | Mental Health Stories

Maxwell Guttman, LCSW

Chronic Mental Illness and Hospitalisation

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Maxwell Guttman, LCSW, (2021, July 5). Chronic Mental Illness and Hospitalisation. Psychreg on Mental Health Stories. https://www.psychreg.org/chronic-mental-illness-hospitalisation/
Reading Time: 4 minutes

Have you lost all control in your life, or does it feel that way? We need to explore the feelings and thoughts associated with experiencing an inpatient hospitalisation. While not intended to override the guidance of your treatment team. Please discuss the tools here with your clinicians before implementing them and, as always, safety first.

If you have a chronic mental illness, you are no stranger to the hospital. Sometimes people are hospitalised so often they cannot remember each admission, or they may be so traumatised, and instead would not remember the experience altogether. There are many perspectives, feelings, stigmas, and thoughts people with and without diagnoses have on inpatient psychiatric hospitalisation.

Some of them include:

  • Do I need to go in?
  • When is it the right time?
  • How long do I need to be here?
  • How will people at work and my friends think about knowing I’m here?

None of these are fun topics to think about let alone to discuss with your therapist or supports. Nevertheless, they are some of the most important questions to start an ongoing dialogue about when you live with chronic mental illness. Knowing when hospitalisation is necessary is not the first step in giving up the fight against mental illness, it is the first step you can take towards your recovery.

People with a mental health diagnosis should not fear hospitalisations. This is true for an outsider or a person without a diagnosis. People in mental health and those with a diagnosis understand the hospital’s usefulness as both controversial and questionable in terms of its purpose in community mental health. Hospitalisations and the work put in by patients towards their recovery, upon admission until their final discharge, must be celebrated by everyone in the recovery process, including supports, family, and friends.

Preparing for a future hospitalisation is something you should do once you are first diagnosed with a mental health condition. Waiting and putting off planning for a possible admission is the worst thing you can do if you have a chronic mental illness. You are not only ruling out the safest possible space when you are at imminent risk of harming yourself but also you are limiting your choices for how to proceed with your recovery at the most challenging time in the course of your treatment. There is no reason to put yourself at further risk of harm when you are so far from baseline; even your therapist and closet supports are worried about you and your safety in your living environment.

Getting to know your local hospitals is vital in maintaining your mental health over the long-term. Identify phone numbers to local emergency rooms and the best transportation routes to get there when you aren’t feeling safe. Provide this contact information and your plan to go into friends and family. Getting adjusted and feeling safe in the hospital will make each subsequent hospitalisation that much more comfortable and organic to everyone involved in your recovery.

By reducing the stigma associated with your ‘first admission’, the process becomes normalized as just another step you’ve taken towards your recovery. It is also a giant step to reduce your risk at hospitalization in a state facility because you’re so far from your baseline that you are unmanageable and unsafe at a local hospital and require the resources of state-level long-term care.

Surviving a hospitalisation requires several strengths. The ability to listen, reflect, re-learn habits, adjust and master a new environment, and cultivate safety during episodes where you’ve lost your feelings of control in most aspects of your everyday life.

Mastering self-reflection and rediscovering your inner strength to move beyond your immediate challenges will help regain the power needed to move closer to discharge. Remember that you are escorted onto a unit by security in the hospital. This moment has to correspond to you surrendering your self-control. Instead, it IS the point of departure into your ultimate recovery.

There are three necessary skills needed for inpatient hospitalization experiences:

  • Interacting and with staff and understanding them as a resource not a roadblock in your recovery
  • Self-reflection and care
  • Rediscovering your inner guidance system as a resource to regain self-control

The staff is there to support you in your recovery. Always remember staff members are people too. They are there to help evaluate your mental status at all times. This level of observation may evoke some paranoia, but be aware of mastering your behavior and interactions with staff will only prepare you further for interacting with people in your life.

If you find yourself agitated with the unit’s rules and the staff’s enforcement of them, you should reflect on your readiness for discharge. Reporting your mental status to staff is not a step towards keeping you hospitalised longer; it is a step in reworking roadblocks in your treatment that may prevent you from moving toward recovery.

A tremendous opportunity to reclaim time for self-care is during an inpatient hospitalisation. Practising self-care in a controlled space is enormous practice for when you are discharged. If you are having a hard time staying clean and hygienic on the unit, this may be a sign you are not ready to do these things on your own; this is the time to master your coping skills, not just learn new ones.

The time between rounds should be an opportunity to practice them. Always discuss outcomes with your treatment team and ask for recommendations to revise and rethink your strategies for making these self-soothing activities the most helpful in your recovery.

Before you’re ready to go home, ask yourself, do you feel safe? As always, knowing yourself and trusting your inner guidance system is the most crucial step in regaining control. Use the time in the hospital to test your doubts, reflect on them, and practice troubleshooting instances when these doubts are put to the test upon discharge.

Call people and stay connected to your social world. Don’t forget that you are re-entering your social world upon discharge. If your behaviour before upset admission folks in your social circle, discuss with them on the phone before your release how your mental health has improved after this time of self-reflection in the hospital.


Maxwell Guttman, LCSW, teaches social work at Fordham University. He is also a mental health correspondent for Psychreg.

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