Attachment to the Hospital
Just before I went on maternity leave I received a question from a member that I haven't had the chance to address. The member wanted me to discuss the phenomenon of "missing the hospital". She wrote to me that when she is away from the care of the psychiatric hospital she misses it and wishes she were there. She has had many hospitalizations and it has become a place where she feels extremely comfortable.
I want to first state that it is not uncommon for someone who has been in and out of psychiatric facilities to become attached to the level of care and attention they receive. There may even be particular individuals that they come in contact with that they feel bonded to over time. The other piece that is compelling about being inpatient for many is the sense of structure and control that they may not have in their life outside the facility. A hospital provides a constant safety net and for many suffering with mental illness being independent is fraught with various perceived and potential dangers. So it makes complete sense why this longing exists.
That being said, living in a hospital is not an ideal situation of course, and it is not a realistic one either. One question the member posed to me, when writing about this, is how she can make the longing go away. There needs to be some reality testing done here. The hospital is not a home and the staff members are not family members or friends. They are paid to care for people and, as kind and helpful as they may be, they have entire lives outside of the facility that don't include patients. This is an important notion to keep in mind. Some patients have a fantasy that their caretakers are in fact friends but the nature of the relationship dictates that this is not the case. If life on the outside is unpleasant then it makes sense that one would crave the serenity of a calm environment but like a vacation it must end. If the job is done well then part of being at the hospital is to prepare someone for being on the outside. Learning skills to cope with everyday "real life" is a valuable part of an inpatient stay.
It is a difficult process for some to readjust to living independently even if they have only spent a short time in the hospital. I have heard it described as, "riding a bicycle without the training wheels". But the wheels must come off and successful navigation of rocky terrain without them is much more rewarding. When being discharged from a hospital there should be clear support systems in place including a therapist to help with the transition. This issue can be discussed and managed in on-going outside therapy.
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WOW... your timing i great...I've been in the hospital 5 times this year for surgery and have made great friends there. But as you said, they have lives outside the hospital setting. Maybe, this phenomena is cropping up more due to the long hours nurses and other health professional have to put in to their work.
If you want a relationship, take it outside the hospital setting.
Well said.
By WJGonza October 19, 2008 1:26pm
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WOW... your timing i great...I've been in the hospital 5 times this year for surgery and have made great friends there. But as you said, they have lives outside the hospital setting. Maybe, this phenomena is cropping up more due to the long hours nurses and other health professional have to put in to their work.
If you want a relationship, take it outside the hospital setting.
Well said.
By WJGonza October 19, 2008 1:26pm
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I totally relate to this but have had a really good wake up call - well several. When I was younger and especially my first admission 9 years ago I felt so safe and looked after I never wanted to leave hospital. I was in hospital twice more in my fourth year of studying - about 5 years ago. All 3 of those were private admissions that were either ED units or had ED patients included in a programme.
This year I became depressed and was admitted to a general government ward. The ward was very threatening and I don't handle aggression well when I am powerless to remove myself from the situation indefinitely (I think that is a fairly healthy reaction) - in a way it was good for me to realise that, even though the staff were nice people they didn't have the time to spend with patients to make them feel safe or comfortable like they had done in the private sector. It was one of my worst experiences but I think it will help me in the long run to manage my own mental health more and not end up in that place ever again.
The other wake up call is that I became a health professional and it is so true - of course I am concerned about and care about what happens to my patients but compared to the safety I felt with health professionals in my teens I have realised that the people who will stay in my life supporting me are my friends and certain family members. I think that I still want to feel cared for and looked after by people treating me but the reality needs to sink in that there will be people to care about me in a healthy reciprocal way outside the healthcare system and that if this is difficult your health professionals might be able to help you bridge the gap in reaching out but they can't fill the gap.
Another thing though is that anyone in an intitution is going to feel weird coming back into society - my friends 2 year old broke his leg and she lived in hospital with him for 2 months and also felt really strange being reintegrated in her normal routine - ok she didn't have the longing but I think it is important to realise adjustment is a 'normal' process and most people find it difficult.
By AnonGirl October 18, 2008 10:44am
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This is a sore subject for me, and I am glad you brought it up. The problem I have with it is not the idea that I think we should all hang out at the hospital all the time. I agree that it is not cool to depend on it. The problem I do have is that the very fact that so many people with Bipolar Disorder are prone to multiple hospital visits and sometimes hospital dependency is because we are not getting appropriate care in the first place. I struggle to survive financially, but if I were able to be a philanthropist, I would do something proactive about it. I would invent a program of help especially for sufferers of BP. The major issues that keep us coming back to the hospital are:
1.There is little opportunity outside of the psych ward to meet, compare, and empathize with other sufferers. Outside of what we do on the computer here, there is little opportunity to compare notes with others that understand what we are going through and can share the benefit of their experience. Most of the people we come in contact with are ignorant and judgmental, and we end up with more loneliness, anger, and self-hatred as a result.
2.There is even less opportunity for our partners, children, and parents to meet with others like themselves who live with the challenges of loving someone with this illness. We need marital support, because 90% of beeper marriages end in divorce. Our kids need to know that they are not the only kids dealing with this.
3. Suicide prevention programs certainly exist, but for beepers it can be difficult to get repeat help with this. Many hotline personnel do not understand Bipolar Disorder, and many get exasperated with repeat callers, thinking that the patients are merely attention seeking. Beepers tend to speak of suicidal ideations because a part of them does not want to die, but without intervention, we can't simply turn off this deadly disease. The suicide rate for us is quite high, yet caregivers tend to feel that the only requirements for treatment are that we go home and take our meds every day, and that will keep it under adequate control. Sorry. The meds treat symptoms, they don't even come close to curing.
4.Psychotic episodes, unreal thinking, believing that its reasonable to stop meds are really common and happen regularly. Friends and family are ill-equipped to help us return to any kind of rational thinking. As a result, family finances, physical health, relationships, and so many other important things go down the tubes, seriously affecting so many people beyond just the patient alone.
We need more than just a quick 40 minute check-in with a therapist one to four times a month. If that were effective the myriad horror stories would not exist. You have only to look at the evidence of what is not working to believe in what I'm saying. Daily strength is awesome and I am so glad I found it, but we need Bipolar Clinics. Places designed to treat our illness without the distraction of treating such a varied group of patients. Most psych wards cannot offer adequate comprehensive care to their patients because all the different dx are lumped in together. We need a place where we can do as much drop-in time as we need on a case by case basis. For example, if you are manic and close to getting into trouble, the clinic can provide a kind of daycare where a patient can drop-in, be reminded to take meds, eat, do self-care, and be distracted from trouble with craft or project workshops of various types. So much of the worst episodes could be avoided this way. Support groups, inpatient care for episodes that cannot safely be managed in outpatient, outpatient care, drop-in groups and activites, information sharing, bipolar reference library, help with secondary comorbidity issues, and probably most important of all, a kind of caseworker that can help guide you towards which of these programs and goals are right for the individual patient, call you at home and check in with you, and do social work for you and your family. To sum up, I believe that those of us with Bipolar Disorder spend most of our time either in crisis or barely out of crisis, trying to cope alone. If we had the kind of care we really need we wouldn't be so attracted to the hospital. Who wants to be locked up and told what to do every second if there is a better solution? That is my two cents. I hope someone somewhere starts to see how important this matter is and does something to help.
By jaybear October 17, 2008 3:53pm
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I used the hospital to do intense work on trauma issues. I went to River Oaks in New Orleans into their trauma program. One of the main reasons I choose the hospital was that I had no support at home from my husband and he was subtly verbally abusive.
I worked hard in the hospital and was exhausted when I got out. I felt like I did four months of therapy in 2 weeks.
I haven't had to go into the hopital in more than 2 years and am pleased about that. One of the reasons I don't like the hospital is the extremely high charges. Even after insurance I still had to pay nearly 5K.
What's really cool is that I don't feel suicidal anymore. That was on option for twenty years and it's amazing to me that I don't feel like that anymore. It's been nearly a year that I have felt like that or done any SI. I never thought I would get reid of the urges, but with an excellent therapist and EMDR my life has changed immensely! I can honestly say there is hope outside of the hospital.
The greatest thing
By walkingthehealingpath October 14, 2008 6:19pm
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wow i feel slightly less crazy for missing hospital and crying wheni left now :)
By musicmad123 October 14, 2008 5:23pm
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WOW I guess I don't understand missing a hospital. I myself was hospitalized once and it was the worst experience I have ever had. I cried the whole time I was there. NOONE would touch you or even try to comfort you. All I needed was just someone to tell me it was going to be ok. It was horrible. I can't imagaine that anyone would miss that. But if they have never been cared for properly and loved maybe they would miss it. That's even sadder. Breaks my heart that we have become a world where the slightest touch from others can get you in a trouble. I don't think I could live with out human touch. I know in the hospital I was dying each and everyday a little more because of lack of it.
By iresh October 14, 2008 9:44am
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I think the hospital offers me a protective reality when life in the real world is slipping... but I agree it is not a healthy place...
By rubyblue October 13, 2008 4:28am
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I once looked at the Hospital as a "safe haven" when things got to be too much, But my last stay in the Hospital was HELL, It was more about punnishing me, than helping me. I was more suicidal when I got out than when I went in.
By Owshen October 12, 2008 2:25pm
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thanks for writing this, i've been in i think seven hospitals, only two i don't miss. i met so many wonderful people, both staff and patients. i wrote to some of the hospitals for more than a year after i was discharged. i'm doing well now, but still have dreams that i'm inpatient and wake up sort of disappointed. *shrugs*
By ThinkHappyThoughts October 12, 2008 1:50pm
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don't they have partial day programs in all hospitals for those people who stay long periods and need time to get used to this. Even a month before over night passes if insurance allows it.
By fusagirl308 October 11, 2008 9:59pm
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I have seen this first hand at a private Psych hospital. Some people have been there 5 months. Eventually they give them a fixed date when they must leave. Felt so sad for them. They get so stressed and depressed. Their actual condition worstens. The Health funds give the hospital notice to get them out, no more money. I believe there was state Govt Psych health support for these people at home.
By Rigil13 October 11, 2008 8:33pm
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inpatient psych - general and ED have been so traumatic for me and i would never ever go back, I fought it even though i have needed it for the last 6 years and still do.It actually caused me to self harm more each time I got out. But I have been in regular hospitals many times due to medical complications and though i feel physically horrible and don't want anyone to do anything for me - i don't want to 'need' thier care even though part of me craves it...that is the part of any hospitalization I relate to longing for. But i think mostly for me, it is that when you are so acutely ill as to be in a medical hospital - FINALLY, nothing can be expected of you. I have been a caregiver in my family since age 8, to each of my parents and each of my 3 siblings, all my friends and as a physical therapist working in an acute care hospital setting since 1990, I always had the role of caregiver. I wanted it,( I convinced myself) it defined me and made me feel almost okay about myself. But giving to others and depriving yourself can only go on for so long. My body wore out in 2001...it seems even now, unless I am deathly ill, in need of a hospital stay... I am expected to be the caregiver. ONLY when i am THAT ill, do i get a reprieve and that is what i long for.
By pixie869 October 10, 2008 6:17pm
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Thank you for writing this. I have never gone back to the hospital JUST because of how much I miss it, and I would never do that! But...It's like this feeling that doesnt go away of needing to be there. I have to picture myself there in order to go to bed at night...or when Im depressed. It was a safe place, people didnt judge me, and they understood everything I was going through. I got attached to a spicific therapist that helped me SO much, and I think thats the reason why I miss it so much.... everything was okay when I was there. Its like the second I get out of the hospital life turns upside down. Thanks for writing it, I just needed to know that it was somewhat 'normal'.. and that I wasnt alone. I would never take up a bed if I didnt need it..in fact, whenever I do really need to go to the hospital, I DONT want to go...because Im scared and so upset I just want to die...its when I am there and when I leave that i miss it. Thanks.
By deathwish October 10, 2008 3:09pm
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Wow, I never had that problem. Hospitals are full of germs and disease and not the place I want to be more than I have to, thanks. Of course, if I'm in a bad way, it is the place I want to be, just not for very long. The nurses I had when I gave birth were very nice, quiet speakers and very efficient without being cloying. I found out later my insurance would have paid for another day but I left the day after her birth because of stitches received.
By Cybercatxq October 10, 2008 11:43am
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ameliemaloo--Sounds like you were in a horrible place. My hospital has a safe, structured environment with therapy groups every hour. The same treatment team is seen by each pstient daily. We have a discharge planner that ensures that every patient has adequate, effective and affordable follow up care.
By KarenPainter October 10, 2008 10:11am
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until there jobs not when there jobs
By Ameliemaloo October 9, 2008 9:51pm
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KarenPainter... if your teams did their jobs properly and prepared people for returning to their communities, this 'phenomenon' would not exist. And also, I talk of the UK, if there was more done with regards to preventative health care rather than leaving people to themselves until in a crisis, perhaps there would not be so many crisis' in the first place. Your concern should not be of tax payers, but of your patients... all of them, however critical their crisis/ health is. When I was admitted to a psychiatric ward, my crisis had been forseen, for months, by myself and my GP and on contacting the mental health team, there was little they could do unless I was in crisis. Then, when I was in crisis and was admitted, there were no therapy groups, saw a different doctor once a week and then they just discharged me without warning or preparation. When released into the community I had no further support from a mental health team and went straight back into crisis. Tax payers money also pays the staffs wages, so when their jobs are carried out effectively you will continue to have patients burden you.
By Ameliemaloo October 9, 2008 9:51pm
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I just want to say that I go in the opposite direction - I've been in psychiatric wards a few times & they were my worst nightmare! I guess I have an extreme fear of being institutionalized in any facility that I cannot just get up & walk away from. I'm very shy & docile, so I'm so scared in there that I couldn't possibly get any appropriate help or even rest. All I could do was put on my best act to get the hell out of there. The meds. they were giving me were causing me to have RLS & spasms, keeping me from being able to sleep at all & when I mentioned this, I Get "That's impossible! These meds.help you to sleep!" They knew nothing of paradoxical effect or they just didn't want to be bothered...I'll do my best to avoid them at all costs...Some people are fortunate with healthcare, others get anything but...
By 9xthemantis October 9, 2008 3:34pm
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Ms. Painter, I may have been mistaken, but I believe this is a support group site, not one for angry psychologists to vent. Furthermore, if you are really and truly upset by the "incredible amount of tax dollars" and truly find your hostile comments to be helpful, I suggest you find a new profession and "leave the hospital beds" to be cared for by someone who actually cares.
By msbrittylouise October 9, 2008 12:21pm