Of the people we spoke to, about one in four had some experience of hospitalisation for depression, perinatal depression, psychosis and depression, or eating disorders. A few people had been hospitalised for more than one of these conditions. Some participants were hospitalised in relation to suicide attempts or if they were not responding to other forms of treatment. Most people had been hospitalised voluntarily. Some admitted themselves, and others agreed to their doctor’s suggestion, although the definition of ‘voluntary’ could be debatable. As Suzi said, ‘there were times when I was a voluntary admission with the thing of – oh if you discharge we’ll certify you.’
Many people saw hospitalisation as a big step and an indication that their condition was serious. Emma whose GP suggested she be admitted to a mother/and baby unit for her perinatal depression said while she trusted her GP’s judgement it was difficult to accept: ‘And I remember thinking, “I’m not that bad. Yes I am. No, I’m not”. Because again it’s almost like being slapped with another label that you’re an actual in-patient mental health case now. So it’s the next level.’ Jane described her first night in a secure psychiatric facility due to severe perinatal depression as ‘scary’, while jack, an older man, admitted himself to a psychiatric hospital in full knowledge that the price would be his career, so stigmatised was mental illness at that time.
Daily life in hospital was described as highly structured and often authoritarian, and people reacted differently to this. Some found it disempowering and resisted by being ‘difficult patients’, while others accepted it as just part of the hospital experience.
Aspects of hospital life people commented on included experiences of being on high levels of medication, having a daily routine imposed on them, lack of choice about therapies provided, staff-patient interactions, and relationships with fellow patients. Jules said she sometimes had to leave during conversations with other patients: ‘Watching them not want to go home, because they don’t want to go back the isolation and the loneliness, and it’s a pretty sad situation where people would prefer to be in a psychiatric clinic.’ Shaz and Suzi, each hospitalised initially for anorexia, talked about friendships among patients as being problematic – Suzi found she had to cut ties after discharge to avoid peer pressure to lose weight again (see
‘Getting better’).
Some people objected to the controlling environment of hospital. Jack described his efforts at first resisting, then subverting group therapy until his doctors agreed to his discharge. Jules took a very active role in decisions about her medication and treatment, and tried to advocate for other patients, while Suzi contrasted her experience in hospital for anorexia being treated as a ‘good’ patient to later being hospitalised for depression, when she described her behaviour as much more assertive.
Gabrielle and Ron had experienced Electroconvulsive Therapy (ECT), and had mixed feelings about it. Gabrielle linked it to significant memory loss but thought it had probably saved her life, while Ron felt that had his depression been managed differently he might have been able to avoid ECT, but in the event it had shortened his episodes.
Most people who were hospitalised felt that despite the drawbacks, their hospital admissions had been beneficial – as Suzi put it, ‘Hospitalisations more recently – while being difficult times in my life have been more positive. I’ve appreciated them trying to keep me alive. I’ve appreciated it a little bit more than back earlier.’ Gabrielle who had been hospitalised many times said about the staff in the psychiatric hospitals she had been in: ‘no difference between private or public; they’re all angels. It’s a very scary experience, but I now look upon it as it saved my life.’