Patient or Prisoner? My Hospital Experience

We need to come up with a plan that destigmatizes mental health issues for all races, including respectful and non-punitive treatment in in-patient settings.

I was diagnosed with bipolar disorder in the summer of 2004 at the age of 19. All my life I had been the robust, bubbly, and friendly young Black lady, always hyper and active. I never thought I would be plagued with a mental illness until years later, when I found myself in a mental hospital bed, sedated with a cocktail of antipsychotics, mood stabilizers, antidepressants, and benzodiazepines. It was hell for me. For most of the time I was sick, I was manic, in a state of extreme euphoria and sleep-deprived. To make things worse, some incidents occurred in the hospital that I will explain in this essay, but I felt I could not fight back because I had no energy to fight.

During the start of my bipolar experience, a doctor once told me that I was not like other people who can stay up late at night or eat whatever they want. He tried to explain in a simple way for me to understand, offering the analogy of Ferrari versus a Jeep. He said something to the effect of, “You don’t have the powerful parts of a Jeep to go off-road, but you are unique like a Ferrari.”

At that time, I ignored the advice I was given and tried to live a normal life like everyone else, but the decisions I made came with a price. I was in and out of hospitals, which was not a good experience. After being in the hospital more than six times and some self-reflection and prayer, I started listening to all the advice I had received from doctors, friends, and family and decided it was time to pay attention and focus on conscientiously caring for the “Ferrari” that I was. It was important for me to focus on myself. I felt it was time I start paying attention to my triggers, like the doctors said, in order to prevent a manic episode that could potentially land me in the hospital again.

I started to research what the triggers for bipolar were. I read on many topics such as food, weather, hormones, and light. Things like these were affecting my mania symptoms. I realized it after I started to record everything that happened to me. This included how I felt after each meal and what my meal was. I discovered that anytime I ate anything with sugar, I would get hyper and “on top” for few hours, then later crash into a depressed state. I now try not to include sugar into my diet, but I’m still working on this piece. With hormones, I noticed that about one or two weeks prior to my menstrual cycle, I would exhibit mood shifts: I would get depressed, and there would be a dramatic dip in my mood. I came to realize that light would also affect my mood, in that getting too much light would give me insomnia, and not enough light would make me feel depressed. Other triggers are hard to track, but less sugar and daily exercise have helped me control them. I still have relapses, that’s the difficult part, but I have an honest relationship with a good doctor I found, and these practices keep me out of the hospital.

The reason for changing my life was my negative experiences at one such mental facility. The last time I decided to go for help was in 2006 during one of my relapses, which was like having a manic episode on steroids. Imagine driving drunk in a sports car on a cliff highway at full speed with no headlights. Sure, the adrenaline feels good, but eventually you will crash, and I did. I had racing thoughts, grandiose thoughts like I could do anything, and bad insomnia because of the mania. I eventually decided to go to a hospital after I experienced suicidal ideation and then attempted suicide. I thought this would be a place of refuge, and in essence it was, but I also ran into some hidden circumstances.

After being there from 9 a.m. until 2 a.m. the next morning, I was told that there were no beds available, but they had found me a bed in a mental facility nearby. I was loaded into an ambulance and shipped to the other location. I later concluded that the reason they had run out of beds was because patients were being kept longer than necessary so the facilities could collect larger insurance payments. According to this article in The Washington Post and others, some hospitals have cheated their patients and haven’t always had their best interests at heart.

Upon my arrival at the facility, I was led to a small office where I was supposed to give information about my insurance. I couldn’t help but notice that the place was set up like a prison. There was a long row of rooms, and the doors opened to a balcony. I also noticed that all doors locked from the outside. I quickly came to the realization that I would be locked into one of these rooms and have no control over when I would come out. I knew I was in trouble, especially when I heard a man screaming and cursing from one of the rooms. It was even scarier when I was led to the small room next to where the screaming was coming from. The difference between this place and other hospitals was that the rooms were spaced out and you could decide to leave the door open. Also, after 24 hours there, you could come out and sit in a common room to watch television. I entered my room feeling cold inside, holding tight to the little red Bible my mom had given me. As I looked outside through the translucent window, I wondered when I would be freed.

In the morning, I was still manic and had not slept due to the screaming of the other patients. A female nurse unlocked my door from outside. I asked if I could use the bathroom and she led me to a medium-sized room with orange walls. As soon as I sat down on the toilet, to my horror, the door opened and a large man with a beard stood there watching me without saying a word. I could not run because I was too terrified to move, and there was no space for me to pass anyway. Then I heard someone coming and the huge man walked away and left me there with the door wide open.

The nurse had returned and led me back to my room. I asked her why I was there because it did not seem like I should be. She explained that the place was where people who are mentally ill and addicted to recreational drugs come for treatment. She said I was brought there because the other hospital was full, and I needed to be protected from harming myself.

This wasn’t the first time I’d felt like a prisoner instead of a patient. I would like to address my treatment concerning the hospital admission and release process. I recall the first time I told my parents to take me to the hospital because I thought I could receive the help I needed after feeling suicidal. My first evaluation was by the ER doctor, who told us that we would have to wait for a social worker to assess me, and after that, I would be given a bed in the psychiatric department.

The wait was excruciating, lasting from morning to 3 a.m. the next day, when someone finally came, evaluated me, and admitted me on involuntary status, which meant that a judge and a lawyer would later decide when I would be discharged from the hospital. The doctor would give his assessment of my condition, and these people would then decide my fate. After this was explained to us, my mother asked how that was possible, when her daughter had come to the hospital on her own accord. We were informed that it was because they believed I would harm myself if I were to be released just yet.

We were also told that after three days, I would appear before the judge who would ask me questions regarding my status. The judge would then ask my social worker and the lawyer what they had observed about my condition. I kept thinking, “I am not a criminal, I came to the hospital willingly to seek help, and now I am being treated like a criminal. What kind of law is that?”

I wondered when and how my status had changed from voluntary to involuntary hold. I also wondered, since I would be medicated, how I could face a judge while I was under such heavy sedation? How much could I possibly comprehend about my situation? I don’t remember much about the hearing, except my social worker asking me something about telling the judge whether I wanted to go home or stay in the hospital. Naturally, as I predicted, I was unable to answer their questions and the judge ruled that I should stay, which resulted in my case officially being confirmed as an involuntary commitment. (According to a newspaper investigation, hospitals in Washington state can change your status without notifying you.)

Now, if I wanted to be discharged, I had to go through a trial to defend my innocence. “This is crazy,” I thought. Not only was I disgruntled, but I had not showered in days, because showering was one of the phobias that had developed while in my manic state. I felt worse while in the hospital because I was fearful of male patients. The fear made the mania worse. I thought, “Am I really safe? What if one of the other male patients opens the door while I’m in the shower? That will completely break me.”

As the team of defense attorneys lined up at my hospital room door, I was thinking, “This must be huge, why do I need four or five attorneys just to get out? What have I done?” In the end, it was my parents who fought with the hospital administration to get me out and I did not have to go to court. I also did not see any evidence that the defense lawyers had done anything for me.

I came out of this place after five days and later decided to change my life and pay attention to my triggers so I’d never have to return to these facilities. My goal was to focus on preventing relapses. I feel that what happened to me was wrong and should not happen to anyone. Mental illness is not a crime, and everyone should be treated with empathy because it is not anyone’s fault.

In my experience, one way these mental health facilities are different from prisons is that there is no separation of the sexes, whereas in prisons there is. I believe that cohabitation of men and women in mental facilities is not safe for women patients or the female nurses, social workers, and doctors who work there. For example, there was a frightening incident when I was in the hospital, in which a female social worker was attacked by a male patient. I saw her eye was bruised and bleeding. Not only that, but a male patient there was hitting on me and making me feel really uncomfortable. Men with criminal backgrounds and/or drug-users might become violent towards other patients, and if you are a female, this is especially concerning. Sometimes there isn’t enough staff on hand to watch everyone. Plus, as I mentioned, the rooms and restrooms are unlocked for safety reasons. In my opinion, this has to change because it is not safe.  I believe if we can afford to separate men and women in prisons, we can try to separate them in mental hospital facilities as well.

Anyone could be traumatized by both types of negative experiences I had. On top of that, as a person of color, I had the additional burden of feeling the stigma that exists among minority communities, who have a history of being marginalized. For example, it is hard for us (people of color) to ask for help when there is a fear of being labeled “crazy” or “insane.” Data show that minorities are more prone to mental illness, given our history of adversity and socioeconomic background. I think we can come up with a good plan that destigmatizes mental illness for all races, including respectful and non-punitive treatment in in-patient settings.

Based on my experience, we can improve the mental health system’s practices by:

1. Destigmatizing mental illness in communities of color by providing more conversation on the issue, especially in disadvantaged communities, where mental health problems are most prevalent.
2. Asking our state representatives to support changes in some laws such as making it mandatory to incorporate mental health conversations in the classroom as part of the school curriculum. I think maintaining good mental health starts at a young age, and at the core of that is learning to take care of ourselves.
3. Helping to review and change state laws that encourage facilities to treat mental illness patients cruelly, such as failure to separate the sexes in psychiatric hospitals. As I stated earlier, I believe if we can afford to have separate jail blocks for the sake of inmate safety, we can do the same for patients in psychiatric wards.
4. Ensuring the facilities review the amount of time the patient remains in the hospital. For example, if a patient is admitted voluntarily, they should be notified as to why their status is changed to involuntary and should have some say regarding their rights.

By telling my story, I hope my experience can galvanize others to take action. My reason for being so candid is to let others know the layers involved when getting admitted to psychiatric hospitals. It is not to say the hospitals are always a bad place to be when in crisis, but to shed light on what has happened or could happen and, more importantly, what needs to change.