1. Rumwriter
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    Rumwriter Active Member

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    Psychiatric Ward

    Discussion in 'Research' started by Rumwriter, Jan 20, 2016.

    Frankly, I think I need to go visit one as my story is basically set there, so if anyone has thoughts as to how I might approach a psychiatrist in hopes of getting an hour of their time to take a visit and ask questions, that would be helpful. Barring that, what is a psych ward like? How are people separated by level of mental instability? I also need to know what sort of mental illness would cause hallucinations, and what the appropriate treatment would be.

    Gracias.
     
  2. Jack Asher
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    Jack Asher Wildly experimental Contributor

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    Unless you're a med student on a tour it's very unlikely that a psychiatrist is going to take time out of his day to escort you around the building. Never mind that just to get passed the visitor section you'd need a background check at the very least. The other option to see the inside is getting committed. Med school or acting crazy, those are your only options.

    But wait, it gets worse!
    Most facilities are out-patient as soon as they can be. The "ward" that your probably envisioning doesn't really exist anymore. In most cases the patients are completely free to leave once they've had a 72 hour 51-50. That means that some agent of the law or a medical professional has determined that they are a danger to themselves or others. But after that 72 hours is up, without a court order they can just walk out of the facility. The people treating them will try to discourage it, if they think the person is still in need of care, but they can't force them.

    People aren't separated by "level of mental instability." They're separated by behaviors. An autistic patient that reacts violently to people touching him isn't more or less unstable than a patient that suffers from persistent attempts at self harm, but they might be in the same section because the staff there is better able to deal with them. Similarly a patient that suffers from paranoid delusions, and a patient that occasionally screams at the staff might be together. They aren't more or less unstable, they just have a staff that's trained differently.

    On that note, the ward with more behaviors is looking for a very specific kind of staff member. One chosen for his weight class, rather than his medical knowledge.

    Now for your last question.
    Pretty much any disorder you can name can come with hallucinations. It would be diagnosed as "with psychotic features," and it could go with anything. You can be ADHD with psychotic features, you can be PTSD with psychotic features, you can be depressed with psychotic features. Most frequently psychosis is associated with schizophrenia, or one of the many sub-types. Typical treatment would be an a-typical anti-psychotic, like serroquel or abilify. As an aside, these medications offer very little in the way of abusibility. In a non-pyschotic they probably wouldn't do much other than make you feel really weird. But nothing like a high that anyone in his right mind would crave, unless they were on them because they weren't in their right mind.
     
  3. Shadowfax
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    Shadowfax Contributing Member Contributor

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    Are you talking general mental illness, or a secure facility?

    In the UK, there is a lot of care in the community. Clients (mustn't call them patients!) who are a risk to themselves (convicted murderers and rapists, etc.) or others, on the other hand, are likely to be sectioned and cared for in a secure facility...I'd be surprised if you could just swing a sight-seeing research visit!

    http://www.nhs.uk/NHSEngland/AboutNHSservices/mental-health-services-explained/Pages/accessing%20services.aspx

    I'm guessing from what I've seen of you that you're US based, but the above may get you started.
     
  4. SethLoki
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    SethLoki Unemployed Autodidact Contributor

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    I think you may find this helpful...


    It's a visit that takes you inside a secure facility that holds those sent there by reason of insanity; there are some good shots of the layout, an overview of the structure and interviews with individuals that have been committed and also their psychiatrists.
     
  5. kateamedeo
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    kateamedeo Active Member

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    The thing about hallucinations is that there are different 'levels' or 'types' to consider. As @Jack Asher has already mentioned, usually they are associated with schizophrenia. There can be hearing hallucinations or the visual ones, it all depends on the particular patient. As far as I know, they are often accompanied by the paranoia (again, what kind of paranoia depends on the particular person).
     
  6. matwoolf
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    matwoolf Contributing Member Contributor

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    Why not write out your draft as you perceive things for the sakes of your story? Later, you might research - to beef up context. No point stewing in scribe paralysis.

    I was interested in this scene when I was younger, and taken by a neighbour to a halfway house. I found it a very frightening house, and also was teased by the medics - who were blase (sp) about the delivery of medication and such. The chief nurse was a Dutchman, like your typical 'head.'

    'We give them the drugs and they are good boys, eh?' he said.

    'Quite,' I replied. 'And what kind of people actually live upstairs?'

    'We have murderer, rapist, rapist-murderer, molester, all combination are available. I will introduce you to Tiny, he killed seven fellow, I believe. But with drug he is like mouse. Hang on, one moment
    TINY...
    Tiny, there is visitor for yoooou. Tiny, come meet Matty...'
    ...

    To this day I visualise Tiny stood at the top of the stairs.

    ...Psychiatric nursing is fascinating. This must have been 1995, and remains the basis of many nightmares, creative writing projects of mine.
     
  7. TheoremAlpha
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    TheoremAlpha Member

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    So I have a few family members with some very sevear mental health issues that causes them to frequent locations like this.

    The first you'll notice:
    Everything is very quiet. Everything is very sterile. There is no clutter, there is no mess, the walls are all soft colors like greys and whites. The tables are usually those cheap plastic and metal fold out ones. There is nothing that can really be used as a weapon, and anything sharper than a plastic eating utilsil is no where in sight.

    The rooms usually all have hospital style beds with reclining capability. The rooms are rather bare with just a chair or two, a nightstand/dresser too. Very few places to be able to hide anything.

    At the nicer facilities each room will have it's own shower. Usually there are no locks on the doors.

    The more run down ones will typically have a locker room type shower place.

    The place is usually full enclosed with one or two main entrances that are always monitored. There is typically a nurse going about checking up on people, and social workers can usually be seen either talking with patients or walking through. There's always at least a couple of staff members on shift: A night time nurse and a security officer or two.

    Everyone is sent off to bed and medicated by 10, and is awaken fairly early in the morning.

    There can either be a specific meal time in a cafeteria like setting, or just order it in yourself when ever you happen to be hungry.

    It varies, but often you can see a few people walking about mumbling to themselves, and there's usually always a couple of very quiet people stuck in their head staring off into space.
    There's usually a central snack room, and a phone on the wall to request food. Things like juice and cereal are kept in the fridge to be accessed by anyone. There will also be some basic bored games and a TV with a limited set of channels. Not really much to do, particularly if you're used to being constantly bathed in technology like most of us are.

    Then in that same room, typically a time table about various classes the patients have to attend for rehabilitation and scheduled things.

    There's usually one time restricted computer the more stable patients can use.

    It's almost like being in a combination of an Elementary school, a Hospital, and a Prison.

    Hope that helps.
     
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  8. GoldenFeather
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    GoldenFeather Active Member

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    Most of the info you're asking for can be easily researched. As for the mental ward experience, I would try some different approaches.

    The first would be the truthful one: I'm a writer creating a story that takes place in a ward like this, and am looking to do some minimal research by walking around and getting a feel.

    If that doesn't work, you could say you're a journalist writing a piece of psychiatry and part of your research requires that you explore a psychiatry ward.

    If you're absolutely desperate and that committed to your story, you could enact all the symptoms of a particular mental illness, allow yourself to be diagnosed and then get admitted to the ward itself :D

    Where there is a will, there is a way :p
     
  9. Jack Asher
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    Jack Asher Wildly experimental Contributor

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    That's not just extremely dangerous, it would be nearly impossible to work. Setting aside his chances of fooling a psychiatrist, the first thing they would do is jump start him on some meds. Taking an aniti-psychotic is dangerous in any case, but for a normal person, it might trigger as serious psychotic episode. At the very least he'll be far to out of it to get any research done.

    As mentioned above, the people running these facilities have far more important concerns than showing your ass around their psych ward.
     
  10. Malisky
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    Malisky Fuzz Overdriver Contributor

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  11. Lewdog
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    Lewdog Come ova here and give me kisses! Supporter Contributor

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    One extremely important thing to know about these types of places, they are so plain and boring because they are tried to made to be suicide proof. So that means the showers are made a certain way so that you can't hang yourself on them, the sheets are of a certain type so they can't be made into nooses, etc.

    Some of the other things I was going to say have already been covered. It is important to understand that they don't separate individuals with certain mental illnesses. I for one was in the hospital because I am bi-polar, have MDD (Major depressive Disorder), and what they call treatment resistant depression. Well my room mate was obviously schizophrenic as he would stay up all night talking into his hand like it was a telephone. Yes, he would make his hand look like a telephone and walk around night and day talking to someone on it. I complained to the doctor about it because I couldn't get any sleep at night, and she basically told me life sucks and to deal with it, that I was at a hospital not a hotel.

    Jack is right about the 72 hour hold and that you can't leave during that time, but if the doctors don't feel you should be able to leave after that, they can talk to a judge and get him to rule that you are either a danger to yourself or society still, or too incompetent to make the decision to leave, and then you are stuck there until the doctor actually releases you to leave.
     
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