Your Control Over Inpatient Psychiatric CareHow much say you get in your meds and treatment depends on your personality (some people are more passive in their treatment, others more active), how ill you are, and your psychiatrist (pdoc). During my first two hospitalizations I was a little too new to my mental illness to really be able to advocate too much for myself. I would tell them if I was getting side effects, and we negotiated dose increases based on how I was feeling. My third stay saw me have virtually no say, as the pdocs were quite control-happy. At the beginning of my last and longest stay, I didn't really care what they did to me, so the pdoc made changes and ordered tests as he saw fit. Once I started to feel a bit better, I started asking more questions and taking a greater responsibility for my care.
You will have more control over your care if you go in voluntarily. If you are committed to hospital against your will, you may have no control over what medications or treatments they use. In some jurisdictions, you can be given electroconvulsive therapy (ECT) against your will if you are a committed patient and if the pdocs think that it is the only thing that will help you.
If you go in of your own will, then you have the right to refuse treatments or medications. If you are committed and later show that you will stay in hospital and will help the doctors treat you, then they can lift the committal documents, and you can refuse some treatments. Being committed to the hospital isn't easy - in my state, you have to be a clear and present danger to yourself or others, and you have to be refusing care. If you go in and ask for help, they can't hold you against your will.
Mechanical restraints are used very rarely - only as a last resort, and for the least amount of time possible. The staff members usually try to use either talking or medications to calm an irate person down. In the 9 weeks I spent inpatient last fall, I saw one person in restraints for one night. That's it. If someone was really out of control, they would even prefer to call in a security guard who would just sit near the person and make sure they were safe, instead of using restraints.
Privacy and Activities During Inpatient Psychiatric CareYou may have your own room, or you may share with up to three other people, depending on the facility. I've always been put with a roommate; the hospital I stayed in usually saves the private rooms for the people who are very sick or who need a security guard with them 24/7.
The routine varies from hospital to hospital; some have activities and groups that run all day, others have set groups, depending on the patient, that may go for an hour here or there. Once I was ready, I went to a therapy group and to occupational therapy. Occupational therapy is mainly crafts and stuff - it supposedly teaches patience, increases memory, etc. There were also voluteers who came by three or four times a week and helped with activities right in the unit. We made pizza, had a football party, did some karaoke.
I also spent a lot of time in the chapel and was visited by the hospital chaplain several times a week, as well as by my own pastors. If faith is important to you, they are usually good to let spiritual advisers in, as long as you aren't delusional when it comes to your faith (for example, if you think you're Christ, and your pastor is going to crucify you, they will probably not let him come for a little while, until you're feeling better). Otherwise, they usually don't block visitors.
My Personal ExperiencesTwo of my admissions for psychiatric inpatient care were very beneficial, one was so-so, and the other one wasn't very positive at all. The not-so-good admission was that way partly because the nursing and medical staff missed a dysphoric mixed episode with delusions, and instead thought I was just trying to get attention and manipulate them.
The time in hospital isn't always comfortable or happy - this past admission, I cried a lot, had a lot of fears, and felt quite sick for a good six weeks. However, I was in a place where it was okay to be sick, okay to cry, and someone was there to help me and protect me when I couldn't do that for myself. I was mainly depressed, but had some agitation and short hypomanic/mixed episodes, and I also spent close to a week with low-grade psychosis. If I had to be psychotic, there was no safer place to be.
My parents took me out one day a week (with time and trust, you can get grounds passes or day passes) for dinner and a chance to check my e-mails. Friends sent cards (this was the first time I was really open about the hospital stay; I got close to 30 cards, fruit baskets, baking) and took me on day passes, and as I said before, my pastors came by and made sure I was doing all right on a weekly basis.