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How to Socialise in a Psychiatric Hospital

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After being admitted to an inpatient hospital setting, settling down on the unit as best as possible, and changing into hospital garb, there is little to do other than to sit and wait for your treatment team meetings, medication administration, meals, and pace up and down the hallways. Another option for passing the time is socialising with other peers on the unit.

This has its advantages and disadvantages, and risks too. Peers on the unit carry with them insight (or lack of) and stories that can pass the time on days when you really need to escape, if only mentally, the confines of the unit. After so many hospitalisations, I have experienced the benefits and drawbacks of socialising with others in the hospital.

Without question, peers on the unit each have their own history, their ‘story’ of how they discovered themselves within an in-patient setting and their own versions of the precipitating events to their hospitalisation. As you get to know each consenting new friend on the unit, there is a little bit more to learn each time. I use the word ‘consenting’ because not everyone on the unit will be friendly, or healthy enough, to engage in meaningful communication. Depending on the level-of-care, state hospitalisation versus community-based hospital, there will be a difference between the capacity of most peers on the unit to communicate, and in some cases, there are differences in approachability due to possible aggression or confusion and agitation, which will complicate the ability of a peer to make a connection with another peer.

Stories from peers can and probably will be extremely vivid, sometimes dark, and usually bizarre. While most people are usually talking about their potential and future discharge, you may be lucky enough to catch someone in their reflective stance and talking about their feelings on how they ultimately needed the hospital to improve their mental health or halt the negative life circumstances or symptom they are experiencing from worsening further. I have heard stories of all kinds, painted in both broad and sophisticated strokes depending on the mood, verbal acuity, or level of self-disclosure opted by the patient telling his story.

I had many peer relationships in the hospital. There was one patient I got along with enough to talk with regularly. In her case, it seemed as if she was recovering. So, I invested my energy in speaking and trying to connect with her.

One day, however, I noticed it seemed as if a switch had flipped, and suddenly, she was talking to herself again and responding to internal stimuli. I noticed she was talking with hospital staff and pointing towards me. I was sitting on the couch in the day room at the time. I observed staff approach me and ask me what I was doing at the moment. They told me there was a complaint from my friend that I was threatening her. I told the staff they must be mistaken because we didn’t even speak to one another during the past few hours. A week passed and my friend was transferred to long-term care and extended ongoing treatment unit, which patients are sent to when they begin de-compensating further upon the initial trial of symptom stabilisation on the admissions unit.

I have met people so disordered that they cannot maintain a conversation without spinning out in tangents, and non sequiturs without end. I have also met people so reserved and seemingly together I wondered why they were in the hospital. One memory I had is of a man who took an interest in my books and we would talk about philosophy whenever we had the opportunity to speak with one another. I just couldn’t figure out why this man, seemingly so composed, was in the same unit as me. All the suspicions and questions were answered one day when the buzzer went off and I heard screaming.

Before I knew it, code was called and he was being restrained on a crash cart after attempting to harm himself. Months passed and he never returned to normal clothing. There in his room, mostly isolated for the tenure of my hospitalisation, he remained in hospital clothing, very depressed looking, and not at all appearing or behaving like the same person I had met when I was first admitted to the unit.

In my university yearbook, which my family surprised me with in the hospital, since I just graduated a few weeks prior, I have several comments and signatures from other peers on the unit. In the pages are inscribed well wishes and hopes for a better future. There is no question that the messages, stories, and suggestions from our peers during difficult times give us pause, solace, and inspiration to keep living the best life we can possibly achieve despite the challenges and ghosts from our troubled past.

Together, I hope our collective narrative will live on for another day, somewhere far beyond the confines of the unit and help you take on a life far above the upper limits of yesterday’s problems.

Max E. Guttman, LCSW  is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.


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