Growing up influenced by cultural representations of psychiatric hospitals as soul-crushing, prison-like institutions, my impression of such treatment centers was quite negative. Then I was a patient in one.
When I tell friends I was hospitalized for 19 days, they’re horrified. Generally it’s less because of what they think might have landed me there, and more the brutal conditions they assume I must have encountered inside. In their imaginations, I likely barely escaped without having my frontal lobe scooped out with a spatula.
Needless to say, this wasn’t my experience at all. Instead I found a supportive, non-judgmental community made up of staff who quickly diagnosed my problem and fellow patients who I count as friends today. Granted, the hospital at which I stayed in April 2012, Four Winds Saratoga in upstate New York, is private. Perhaps public hospitals are so underfunded they amount to detention centers for the mentally ill. But there is no reason that places like Four Winds couldn’t be socialized and the quality of mental-health treatment provided there be made available to everyone.
One day, the film “One Flew Over the Cuckoo’s Nest” was playing on television and, enjoying the irony, we patients actually watched it in our housing unit’s common room. Hoping to share the laugh, I told the doctor about it when he next did his rounds. While mildly amused, he said nothing had done more to prevent those who needed help from seeking psychological treatment in general, and electroconvulsive therapy in particular, than that movie. ECT, as the procedure was known, saved lives, he insisted. Indeed, I’d guess that as many as one quarter of the people on my unit received ECT – voluntarily, it should go without saying. And all spoke positively of its effects.
As far as I was aware, all of the patients in my unit had signed themselves into the facility by choice. This included my roommate who escaped the locked building, before being returned by police! Patients only stayed, on average, between five and seven days. While there were obviously exceptions, most wanted significantly more time to recover from what led them to be initially hospitalized. In decades past they would have received it, but increasingly-aggressive insurance companies cut short their treatment.
I was likely allowed to stay nearly three weeks because my intrusive thoughts were horrific enough to freak out even a penny-pinching claims adjustor. But other patients, who had a more common diagnosis but undoubtedly represented a greater danger to themselves or those around them, were released earlier. There was perhaps no better anecdotal evidence that many patients needed additional time than one young woman I befriended who was discharged at the beginning of my stay and readmitted before I left.
An incredibly strong intimacy was built between patients by sharing a living space, hours of group therapy per day, and a particularly vulnerable period in all of our lives. I remain in contact with many of the friends I made there. I knew none of them for more than a few weeks. Yet I feel closer to many of those I’m no longer in touch with than some non-patients I’ve known for decades. Together in the hospital we created something like the Island of Misfit Toys, that sanctuary for defective playthings in the television special “Rudolph the Red-Nosed Reindeer.” Together, we were safe, valued and understood.
There’s perhaps no better recommendation of the staff’s professionalism than the fact that they diagnosed me almost immediately after multiple outpatient therapists failed to do so. Simply put, if I hadn’t entered the hospital my symptoms might still be a mystery to me. After all, the outpatient therapists I had visited later admitted they had never heard of the specific form of obsessive-compulsive disorder with which I was diagnosed. Nothing did more for my recovery, not anti-psychotic or anti-depressant drugs, than knowing other people had experienced what I was going through and that despite my unwanted, disturbing thoughts I wasn’t a monster. This realization wouldn’t have been possible without a diagnosis.
As odd as it might sound, I’m often nostalgic for my time in the hospital, specifically for the comradery and acceptance I felt there. I will always remember my first karaoke night on the unit, for instance. Psychiatric patients, as anxious as they often are, seem unlikely participants in the activity. But the staff’s relentless enthusiasm overcame most of our reserves. One staff member could belt out “Before He Cheats” with more beauty and vengeful heartbreak than Carrie Underwood. Her impressive skill was intimidating for those of us who could barely hold a tune. However her staff partner’s flawed – but entirely committed – crooning of soul classics made musical mortals like me feel welcome. Us patients took turns singing off-key duets late into the night. We looked and sounded crazy. And that was OK.
None of the descriptions of psychiatric hospitals I encountered in literature and film prepared me for what I found firsthand – a therapeutic environment and healing community that I would recommend to anyone experiencing severe emotional turmoil. If today there are real institutions reminiscent of “One Flew Over the Cuckoo’s Nest,” there is nothing inherent to mental health care that means they must be so, and socialization can make treatment available to all who need it.