5 Common Myths About Being Admitted to a Psychiatric Hospital

Like many aspects of mental health, admission to a psychiatric hospital is stereotyped and stigmatized. There are so many myths about what the experience is like that make it seem worse than it is.

To help demystify the experience, Jay Augsburger, MD, medical director for the Long Term Civil Commitment Units at the UW Medicine Center for Behavioral Health and Learning, explains what psychiatric care in a hospital is actually like.

Myth 1: All psychiatric hospital patients are involuntarily committed

Involuntary commitment, also called civil commitment, means being taken to and staying at a psychiatric hospital and receiving treatment against your will (at least initially). It’s a difficult situation, but in cases where someone is mentally confused and unable to consent or is a serious threat to themselves or someone else, it may be necessary. Typically family members, emergency medical providers or law enforcement refer someone to treatment.

It is also possible for someone to refer themselves to a psychiatric hospital stay, typically by going into a hospital’s emergency room. They may do this if they feel suicidal or are experiencing a mental health crisis.

Whether someone is involuntarily or voluntarily committed, becoming a psychiatric inpatient only happens when someone is severely affected by mental illness or a substance use disorder and can’t get their treatment needs met by another method, like outpatient therapy. This might mean the person is suicidal, is unable to care for themselves or function in daily life, or, in rarer cases, has tried to harm or has overwhelming intrusive thoughts about harming others. 

“The care that is provided to both types of patients is generally pretty similar,” says Augsburger. “Sometimes it’s difficult to tell just by talking with a patient whether they’re there involuntarily or voluntarily.”  

Myth 2: Patients regularly receive invasive treatments against their will

It’s true that sometimes patients are forced to undergo treatment. They may not be able to consent due to their mental state or they may be court-mandated to participate in treatment.

This only happens in extreme cases when someone is an immediate threat to themselves or others or has been deemed gravely disabled and unable to meet their immediate needs for health and safety.  

There are all kinds of treatments people may undergo, from taking medication to, yes, receiving electroconvulsive therapy (though it actually isn’t as bad as the media has portrayed it as). But the most common, regular treatment is actually psychotherapy, which is frequently done in a group setting.

Patients on psychiatric units have multiple group therapy sessions each day, covering topics like how to manage suicidal thoughts or substance use, how to cope with grief and loss, and how to build occupational, recreational and social skills.

“People expect when they come in that there will be a lot of individual therapy, but there really is not,” Augsburger says. “That’s not to say that we don’t individualize treatment plans, but for a short-term hospitalization, there’s not a lot of opportunity or expected benefit from individual therapy. However, we get more opportunities for individual therapy on our long-term civil commitment units where patients are with us for a while.”

In addition to group therapy, patients will have individual interactions with their care team, including nurses and psychiatrists, and participate in the daily routines of the hospital like mealtimes and taking medications.

Myth 3: Patients are often physically restrained  

Restraints are only used on patients as an absolute last resort when the patient is trying to harm themselves or someone else. There are many strategies to calm patients down — including therapeutic communication, seclusion rooms or medications — that staff will try first.  

“Staff that work on our psychiatric units are incredibly skilled in helping deescalate a patient who is paranoid, threatening or agitated, and they are quite good at helping a patient who has gone from 0 to 60 to get them back down,” Augsburger says. “Even though our units are relatively new, the staff are already quite good at avoiding the use of restraints when they aren’t absolutely required.”

Myth 4: Once you’re admitted, you have to stay at the hospital for a long time

“The worry often is, ‘I’ll be stuck on the psychiatric unit forever,’ but the length of stay is much shorter than what people expect,” Augsburger says. “The reality is we’re always working on a discharge plan for a less-restrictive setting when it’s safely possible to do so. I do try to reassure patients and families that this isn’t an indefinite stay.”

When someone voluntarily goes to the hospital themselves, their stay is often as short as a week or two. Patients who are involuntarily committed often stay longer, but still, they are often discharged before their commitment period expires if there is a safe outpatient plan.

Myth 5: Being discharged means someone has recovered

“There’s often this idea that once a patient leaves, they will be 100% better, but that is generally not the case,” Augsburger says. “Hospitalization is a stepping stone, the first step, in getting better. After that, the important piece is connecting with community resources in order to make more progress.”

Hospitalization just serves as a way to stabilize someone who is in crisis — the way emergency room care does for people who have life-threatening physical injuries. It is not meant to be long-term care. The goal is to get someone stable enough that they aren’t going to hurt themselves or someone else, then have them return home and receive long-term mental health care in their own community.

This may look like more group therapy sessions, intensive outpatient programs held at a hospital, one-on-one therapy sessions with a mental health professional, consulting with a psychiatrist, working with a primary care provider and more.

Experiencing a mental health crisis is scary, and seeking help can be, too. But the only way someone will improve and start feeling better is by getting the support they need.  

If you or someone you know is experiencing thoughts of suicide, contact the Nationwide 988 Lifeline and check out the resources at Forefront Suicide Prevention.