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  • You wake up at the crack of dawn, a few hours earlier than you really need to.

  • Your bed isn't helping - it's small, if not completely uncomfortable, and there isn't

  • much room to toss and turn.

  • You can hear noises around you - the staff getting ready for the day's work - and the

  • sun is peeking through the curtains.

  • It's looking like a lovely day outside, but you're not likely to be spending much

  • time outside.

  • You're in a mental hospital, and the usual day's routine is about to begin.

  • You should probably get some rest while you can - life here is strictly regimented.

  • Your first taste of this structure comes as it's time to get up.

  • At the same time every day - usually 7 AM - you'll hear a knock at your door.

  • This is one of the staff doing morning checks.

  • They want to make sure that all the residents are okay after the night, and this is usually

  • accompanied by a warning that breakfast will be served in half an hour.

  • Mealtimes are usually carefully structured, and everyone who has the freedom to wander

  • the facility will have to be in the cafeteria at the right time to ensure they don't miss

  • the most important meal of the day.

  • So what's the menu like in a mental facility?

  • In a word, simple.

  • Think of your old school lunchroom or the cafeteria in an office building.

  • You can have something as simple as a bowl of cereal with milk, or many facilities will

  • offer diner-style breakfast options like pancakes or eggs.

  • How good the food will be varies by facility, but there will usually be daily specials - so

  • something to look forward to on your favorite day of the week.

  • But this isn't just any cafeteria - the staff knows the patients well, and any foods

  • or drinks that might interact negatively with medication will be kept away from residents

  • who could be impacted negatively.

  • So some might have to go without that morning cup of coffee.

  • That's not the only area where residents' food habits may be supervised.

  • It's common for residents to have one-on-one supervision after mealtimes.

  • This is for a number of reasons.

  • Some might have eating disorders that would lead them to try to purge their meal after

  • eating it.

  • Others, who are on medication, need to be supervised so they take their pills with food.

  • Others might be supervised to make sure they don't pocket any supplies - like utensils

  • - that could be used for dangerous purposes back in the room.

  • There are many reasons someone could wind up in a mental health facility - and they

  • might warrant different levels of security.

  • Some check in voluntarily for treatment.

  • This is common when someone is struggling with an eating disorder or substance abuse

  • disorder - although private rehab facilities also exist and offer a more luxurious environment

  • to go cold-turkey.

  • But you're not a reality TV star on their third rehab stint.

  • People who are struggling with mental illness like depression and worry that they could

  • be a danger to themselves or others could also turn themselves in for treatment - although

  • once you sign the papers to commit yourself voluntarily, you're usually agreeing that

  • you put it in the doctors' hands to determine when you're released.

  • Of course, most residents are not in this facility voluntarily.

  • Most people who find themselves in a mental health hospital are committed involuntarily.

  • The most common method is when they're placed on a psychiatric hold - which can happen surprisingly

  • easily.

  • If someone contacts the police or social services believing the person is a danger to themselves

  • or to others, it's pretty common to place the person on a 48-72-hour psych hold, which

  • gives the doctors the chance to assess them.

  • If the person passes all psychological tests and convinces the doctor's they're not

  • a risk if released, this could be little more than a strange and scary few days.

  • But often, the doctors recommend a longer stay when real issues are raised - and this

  • can be trickier when someone is committed wrongly but is angry and terrified when questioned.

  • But some residents are there for a more serious reason.

  • Treatment in a mental health facility can be ordered by a court either at the conclusion

  • of or as an alternative to a criminal trial.

  • Famously, the lead of One Flew Over the Cuckoo's Nest convinced a judge that he was too crazy

  • to stand trial - and got more than he bargained for.

  • But it's common for a defendant who is found not competent to stand trial to be referred

  • to a nearby mental health facility.

  • And in more serious cases, defendants can be found not guilty by reason of insanity

  • or arrange plea deals based on mental instability - as happened to the shooter in the attempted

  • assassination of Ronald Reagan, and the teen culprits in the notorious Slenderman stabbing.

  • Both were sentenced to extended stays in high-security mental health facilities.

  • So the residents of a mental health facility can be a varied bunch - and you're about

  • to spend some time with most of them.

  • As a resident, you're likely to spend much of your time in various therapy sessions,

  • starting with community group.

  • This is where all the residents meet with the doctors and do some sharing and discussion

  • with each other.

  • You'll be reminded of the rules of the facility, which govern what you can have in your room,

  • when you can use the phone or other electronics, and how to interact with fellow residents.

  • People air their grievances, and the staff does their best to mediate.

  • New residents will be encouraged to share things about themselves and set goals for

  • themselves.

  • Now, it's time for some one-on-one time.

  • The doctors at the facility will usually meet with the patients independently to check on

  • their case, either in the patient's room or in the doctor's office.

  • This is so they can determine how the patient's medicine regimen is interacting with their

  • mind.

  • The human mind is a tricky thing, and changes in biochemistry can have unpredictable results.

  • The doctors won't hesitate to take patients off one medication, or increase the dose of

  • another, to alleviate symptoms and hopefully speed up recovery or at least equilibrium.

  • Of course, not all cases are stable.

  • Hope you haven't been counting on a relaxed time.

  • Many patients have unpredictable disorders like schizophrenia that make them see things

  • that aren't there or become convinced that they're in danger.

  • It's not uncommon to hear screams or sounds of people punching walls or trying to break

  • things.

  • While the facility tries to respect its patients' autonomy as much as possible, they are ready

  • to sedate and restrain people when needed to protect both themselves and others.

  • But for those who are more stable, this is a time for a little relaxation on a busy day.

  • Residents can usually spend their free time reading or playing games in the common room.

  • It's not uncommon for residents to form friendships among their fellow patients - although

  • there are some rules to follow, including no touching and no being alone in each other's

  • rooms in most situations.

  • But it won't be long before you're reminded of why you're here.

  • One of the most important parts of life in a mental hospital is process group.

  • This is where you meet with your social workers and tackle direct ways to handle your specific

  • mental health issues.

  • This is usually a small group where people who have similar struggles - depression, addiction,

  • etc - can compare notes.

  • The social workers lead residents through exercises to teach them coping mechanisms

  • to minimize the impact of negative thoughts and other challenges.

  • These groups can get emotional, and it's not uncommon to see an outburst, but the social

  • workers know how to bring things back to the focus.

  • Next, it's on to lunchtime - but nothing in this facility is irrelevant to treatment.

  • Lunch is usually simple foods like pizza, sandwiches, or salads.

  • While many patients can just eat with little supervision, any patient there with eating

  • disorders will be monitored far more closely.

  • They might even have a points system assigned, which will track their diet and may set back

  • their release if the doctors feel they're not making progress.

  • And of course, any patient who has to take medication with lunch will be monitored.

  • The rest of the day isn't any less busy than the morning.

  • After lunch, there might be different kinds of therapy including recreational therapy

  • - which can be as simple as watching a movie with a group while your behavior in a semi-normal

  • setting is monitored.

  • There might be education groups where you're taught how to manage your condition once you're

  • hopefully released in short order.

  • And to whet your appetite for that day, there's an added bonus - visitation hour, where you

  • can see the people you love on the outside in a safe and controlled setting.

  • It's not as strict as prison visiting hours, but you'll still likely be monitored closely.

  • Life in a mental health hospital is usually pretty predictable and boring - but it wasn't

  • always that way.

  • Go back a few hundred years, and mental health hospitals were a very different place.

  • Often called the less politically-correctinsane asylumorlunatic asylum”,

  • they were really more a place for containment of the disturbed than anything else.

  • Treatment was basic and often involved heavy restraints, and psychiatric medication was

  • only in its beginning stages.

  • While some early reports of asylums in places like Cairo had surprisingly modern innovations

  • like music therapy, institutions were a far cry from what they are today.

  • And the reasons people wound up in them were different as well.

  • With psychiatric science far from its current developed stage, it was easy to getsent

  • to the nuthousefor behaving erratically in public or other social crimes.

  • It was also not uncommon for family members to have their own kin committed because they

  • were acting in ways they determined to embarrass the family - often women who were acting too

  • independent, or members of the LGBT community who were stepping out of the closet.

  • And while treatment advanced in the 19th and twentieth century, sometimes those new advances

  • were equally barbaric - including electroshock therapy and even lobotomies to surgically

  • alter the patient's personality to make them more compliant.

  • So do any of these barbaric institutions still exist?

  • While some treatments like electroconvulsive therapy do still exist, they are carefully

  • regulated in most countries and will only be undertaken as a short-term solution if

  • evidence shows that the patient could benefit from it and they consent.

  • Even with the most high-risk residents like the criminally insane, the focus will be on

  • managing their conditions with medication and giving them a higher degree of autonomy.

  • There was controversy when attempted assassin John Hinckley Jr, who had nearly killed President

  • Reagan, was allowed to be released from his mental hospital in 2016 to live at his mother's

  • home - with strict conditions.

  • While many people felt an attempted assassin should remain incarcerated, he wasn't in

  • prison - he was in a mental health hospital, and they felt he was no longer a threat to

  • himself or others.

  • But for you, there's still some work to be done - starting with nighttime.

  • Dinner is similar to the other meals of the day, but with heartier options.

  • You'll usually get a stew with meat and starch, and some vegetable sides.

  • Afterward, there will be some time to socialize and unwind, and then it's time for closure

  • group.

  • This is where you'll review the day and discuss any goals you set.

  • This can be stressful for some if they didn't reach their goals, but the social workers

  • will be quick to redirect people to look on the positive side and look ahead to the next

  • day.

  • There's just one more piece of business to take care of.

  • Before bed, everyone has to line up for their nightly medication.

  • While not everyone takes medication throughout the day, it's likely that everyone will

  • be taking at least one thing before bed - often to help with sleep.

  • And speaking of sleep, it's tightly regulated like everything else.

  • The facility has a strict lights-out time to ensure everyone has enough time for a full

  • night's sleep - because tomorrow, the whole routine begins again.

  • And it'll be just like the previous day - right?

  • Not exactly.

  • Every day has wild cards.

  • Routines will vary, some patients will leave, and new patients will come in.

  • Some days are relaxing, other days are chaotic, but a functioning mental health hospital has

  • one goal - to prepare its residents for the day they walk out that door, better able to

  • manage their condition, and be a healthy and productive member of society.

  • For more on life in an asylum, check outJournalist Goes Undercover At Insane Asylum and Becomes

  • Prisoner”, or watchThe World's Craziest ER Storiesfor what goes on at a different

  • kind of hospital.

You wake up at the crack of dawn, a few hours earlier than you really need to.

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Average Day in an Insane Asylum

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    Summer posted on 2021/03/16
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